Effekt av internettbaserte tiltak for barn, unge og unge voksne med angst og/eller depresjon: Systematisk oversikt og metaanalyse

Effectiveness of internet-based interventions for children, youth, and young adults with anxiety and/or depression: a systematic review and meta-analysis

Forfattere
Ye, X. Bapuji, S. B. Winters, S. E. Struthers, A. Raynard, M. Metge, C. Kreindler, S. A. Charette, C. J. Lemaire, J. A. Synyshyn, M. Sutherland, K.
Årstall
2014
Tidsskrift
BMC Health Services Research
Volum
14
Sider
313
BACKGROUND: The majority of internet-based anxiety and depression intervention studies have targeted adults. An increasing number of studies of children, youth, and young adults have been conducted, but the evidence on effectiveness has not been synthesized. The objective of this research is to systematically review the most recent findings in this area and calculate overall (pooled) effect estimates of internet-based anxiety and/or depression interventions. METHODS: We searched five literature databases (PubMed, EMBASE, CINAHL, PsychInfo, and Google Scholar) for studies published between January 1990 and December 2012. We included studies evaluating the effectiveness of internet-based interventions for children, youth, and young adults (age <25 years) with anxiety and/or depression and their parents. Two reviewers independently assessed the risk of bias regarding selection bias, allocation bias, confounding bias, blinding, data collection, and withdrawals/dropouts. We included studies rated as high or moderate quality according to the risk of bias assessment. We conducted meta-analyses using the random effects model. We calculated standardized mean difference and its 95% confidence interval (95% CI) for anxiety and depression symptom severity scores by comparing internet-based intervention vs. waitlist control and internet-based intervention vs. face-to-face intervention. We also calculated pooled remission rate ratio and 95% CI. RESULTS: We included seven studies involving 569 participants aged between 7 and 25 years. Meta-analysis suggested that, compared to waitlist control, internet-based interventions were able to reduce anxiety symptom severity (standardized mean difference and 95% CI = -0.52 [-0.90, -0.14]) and increase remission rate (pooled remission rate ratio and 95% CI =3.63 [1.59, 8.27]). The effect in reducing depression symptom severity was not statistically significant (standardized mean difference and 95% CI = -0.16 [-0.44, 0.12]). We found no statistical difference in anxiety or depression symptoms between internet-based intervention and face-to-face intervention (or usual care). CONCLUSIONS: The present analysis indicated that internet-based interventions were effective in reducing anxiety symptoms and increasing remission rate, but not effective in reducing depression symptom severity. Due to the small number of higher quality studies, more attention to this area of research is encouraged. TRIAL REGISTRATION: PROSPERO registration: CRD42012002100.

Oversett med Google Translate
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Tiltaksnivå

Behandling og hjelpetiltak

Tema

Psykiske vansker og lidelser

Følelsesmessige problemer

Depresjon og nedstemthet (inkl. både vansker og lidelse)

Angstproblematikk

Angst og engstelighet (inkl. både vansker og lidelse)

Tiltak

Organisering av tiltak

E-helsetiltak (spill, internett, telefon)

Aldersgruppe

Barn i skolealder (6-12 år)

Ungdom (13-18 år)

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