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Accepted for/Published in: Journal of Medical Internet Research

Date Submitted: Feb 26, 2023
Date Accepted: Apr 23, 2023

The final, peer-reviewed published version of this preprint can be found here:

The Effects of Internet-Based Cognitive Behavioral Therapy for Suicidal Ideation or Behaviors on Depression, Anxiety, and Hopelessness in Individuals With Suicidal Ideation: Systematic Review and Meta-Analysis of Individual Participant Data

Sander LB, Beisemann M, Doebler P, Micklitz H, Kerkhof A, Cuijpers P, Batterham P, Calear A, Christensen H, De Jaegere E, Domhardt M, Erlangsen A, Eylem van Bergeijk O, Hill R, Mühlmann C, Österle M, Pettit J, Portzky G, Steubl L, Spijker B, Tighe J, Werner-Seidler A, Büscher R

The Effects of Internet-Based Cognitive Behavioral Therapy for Suicidal Ideation or Behaviors on Depression, Anxiety, and Hopelessness in Individuals With Suicidal Ideation: Systematic Review and Meta-Analysis of Individual Participant Data

J Med Internet Res 2023;25:e46771

DOI: 10.2196/46771

PMID: 37358893

PMCID: 10337381

The Effects of Internet-based Cognitive Behavior Therapy for Suicidal Ideation or Behaviors on Depression, Anxiety, and Hopelessness in Individuals with Suicidal Ideation: Systematic Review and Meta-analysis of Individual Participant Data

  • Lasse Bosse Sander; 
  • Marie Beisemann; 
  • Philipp Doebler; 
  • Hannah Micklitz; 
  • Ad Kerkhof; 
  • Pim Cuijpers; 
  • Philip Batterham; 
  • Alison Calear; 
  • Helen Christensen; 
  • Eva De Jaegere; 
  • Matthias Domhardt; 
  • Annette Erlangsen; 
  • Ozlem Eylem van Bergeijk; 
  • Ryan Hill; 
  • Charlotte Mühlmann; 
  • Marie Österle; 
  • Jeremy Pettit; 
  • Gwendolyn Portzky; 
  • Lena Steubl; 
  • Bregje Spijker; 
  • Joe Tighe; 
  • Aliza Werner-Seidler; 
  • Rebekka Büscher

ABSTRACT

Background:

Internet-based cognitive behavioral therapy (iCBT) targeting suicidal ideation has demonstrated effectiveness in reducing suicidal ideation. Yet, the effects of iCBT on related symptoms, such as depression, anxiety, and hopelessness, remain unclear.

Objective:

We aimed to analyze whether digital interventions targeting suicidal ideation had an effect on related mental health symptoms.

Methods:

We systematically searched CENTRAL, PsycINFO, Embase and PubMed for randomized controlled trials that investigated iCBT for suicidal ideation or behaviors. Participants reporting baseline suicidal ideation were eligible. We conducted a one-stage individual participant data (IPD) meta-analysis on the effects on depression, anxiety and hopelessness, analyzed as two indices: symptom severity and treatment response.

Results:

We included IPD from eight out of nine eligible trials comprising 1980 participants with suicidal ideation. iCBT was associated with significant reductions in depression severity (b=-0.169; 95%-CI -0.248 to -0.089, p<0.001) and higher treatment response (i.e., 50% reduction of depressive symptoms) (b=0.359; 95%-CI 0.116 to 0.603, p=0.008). We did not find significant effects on anxiety and hopelessness.

Conclusions:

iCBT for people with suicidal ideation revealed significant effects on depression outcomes, but only minor or no effects on anxiety and hopelessness. Studies that monitor symptoms with higher temporal resolution and consider a broader spectrum of factors influencing suicidal ideation are needed to understand the complex interaction of suicidality and related mental health symptoms. Clinical Trial: https://osf.io/mvnjk


 Citation

Please cite as:

Sander LB, Beisemann M, Doebler P, Micklitz H, Kerkhof A, Cuijpers P, Batterham P, Calear A, Christensen H, De Jaegere E, Domhardt M, Erlangsen A, Eylem van Bergeijk O, Hill R, Mühlmann C, Österle M, Pettit J, Portzky G, Steubl L, Spijker B, Tighe J, Werner-Seidler A, Büscher R

The Effects of Internet-Based Cognitive Behavioral Therapy for Suicidal Ideation or Behaviors on Depression, Anxiety, and Hopelessness in Individuals With Suicidal Ideation: Systematic Review and Meta-Analysis of Individual Participant Data

J Med Internet Res 2023;25:e46771

DOI: 10.2196/46771

PMID: 37358893

PMCID: 10337381

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