Accepted for/Published in: JMIR Mental Health
Date Submitted: Apr 25, 2022
Open Peer Review Period: Apr 22, 2022 - May 2, 2022
Date Accepted: Aug 18, 2022
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Efficacy of Virtual Care for Depressive Disorders: A Systematic Review and Meta-Analysis
ABSTRACT
Background:
The COVID-19 pandemic has created an epidemic of depression while simultaneously necessitating a shift to virtual mental health care, yet the evidence to support the use of virtual interventions is unclear.
Objective:
The purpose of this study is to evaluate the efficacy of virtual interventions for depressive disorders by addressing three key questions: Does virtual intervention provide better outcomes than no-treatment or attention control conditions (i.e., waitlist, treatment as usual [TAU], or virtual sham)? Does in-person intervention provide better outcomes than virtual intervention? Does one type of virtual intervention provide better outcomes than another?
Methods:
We searched PubMed, EMBASE, and PsycINFO for trials published from 01/01/2010-10/30/2021. We included randomized controlled trials of adults with depressive disorders that tested a virtual intervention and used a validated depression measure. Primary outcomes were remission, response, and depression severity at post-treatment. Two researchers independently selected studies and extracted data using PRISMA guidelines. Risk of bias was evaluated based on AHRQ guidelines. We calculated odds ratios for binary outcomes and standardized mean differences for continuous outcomes.
Results:
We identified 3797 references, 24 of which were eligible. Compared with waitlist, virtual intervention had higher odds of remission (OR=10.30, CI=5.70-18.60, N=619 patients) and lower post-treatment symptom severity (SMD=0.81, CI=0.52-1.10, N=1071). Compared with TAU and virtual sham conditions, virtual intervention had higher odds of remission and lower post-treatment symptom severity. In-person interventions did not provide better outcomes than virtual interventions (e.g., remission OR=0.84, CI=0.51-1.37, N=789). No eligible studies directly compared one active virtual intervention to another.
Conclusions:
Virtual interventions were efficacious and no different from in-person interventions for depressive disorders. Clinical Trial: Open Science Framework doi.org/10.17605/OSF.IO/8A976
Citation
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Copyright
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