Institute of Medical Information/Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100020, China.
Institute of Medical Information/Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100020, China.
J Affect Disord. 2023 Oct 1;338:569-580. doi: 10.1016/j.jad.2023.06.057. Epub 2023 Jun 29.
To evaluate the effectiveness of digital psychotherapies for depression and anxiety. We conducted a systematic review and network meta-analyses (NMA) to make comparisons of digital psychotherapies.
A bayesian NMA was conducted in this study. The databases including PubMed, Embase, Web of Science, the Cochrane Central Register of Controlled Trials and CINAL were searched for all eligible randomized controlled trials (RCTs) published from Jan 1, 2012 to Oct 1, 2022. We used the Cochrane Collaboration's Risk of bias tool for quality assessment. The primary outcomes were set as a standardized mean difference model in efficacy to describe continuous outcomes. We used STATA and WinBUGS to conduct a bayesian network meta-analysis of all interventions based on a random-effects model. This study was registered with PROSPERO, number CRD42022374558.
From the retrieved 16,750 publications, we included 72 RCTs (13,096 participants) with the overall medium quality and above. In terms of depression scale, cognitive behavioral therapy (CBT) was more effective than TAU (SMDs 0.53) and NT (SMDs 0.98). In terms of anxiety scale, CBT (SMDs 0.68; SMDs 0.72) and exercise therapy (ERT) (SMDs 1.01; SMDs 1.05) were more effective than TAU and NT.
Uneven quality of literature, simple network, and subjective judgment.
Based on NMA results, we suggest that CBT, which is the most commonly used digital technology, should be preferred among digital psychotherapy for relieving depression and anxiety symptoms. Digital exercise therapy is an effective strategy to relieve some anxiety problems in the context of COVID-19.
评估数字心理疗法治疗抑郁和焦虑的有效性。我们进行了系统评价和网络荟萃分析（NMA），以对数字心理疗法进行比较。
本研究采用贝叶斯 NMA。从 2012 年 1 月 1 日至 2022 年 10 月 1 日，我们在 PubMed、Embase、Web of Science、Cochrane 对照试验中心注册库和 CINAL 数据库中检索了所有符合条件的随机对照试验（RCT）。我们使用 Cochrane 协作风险偏倚工具进行质量评估。主要结局采用标准化均数差值模型进行疗效评估，以描述连续性结局。我们使用 STATA 和 WinBUGS 基于随机效应模型对所有干预措施进行贝叶斯网络荟萃分析。本研究已在 PROSPERO 注册，编号为 CRD42022374558。
从检索到的 16750 篇文献中，我们纳入了 72 项 RCT（13096 名参与者），总体质量中等偏上。在抑郁量表方面，认知行为疗法（CBT）比 TAU（SMD 0.53）和 NT（SMD 0.98）更有效。在焦虑量表方面，CBT（SMD 0.68；SMD 0.72）和运动疗法（ERT）（SMD 1.01；SMD 1.05）比 TAU 和 NT 更有效。
文献质量不均一、网络简单、主观判断。
基于 NMA 结果，我们建议在缓解抑郁和焦虑症状方面，CBT 作为最常用的数字技术，应该优先于数字心理疗法。在 COVID-19 背景下，数字运动疗法是缓解某些焦虑问题的有效策略。
