Faculty of Arts and Sciences, New York University Shanghai, Shanghai, China.
Center for Global Health Equity, New York University Shanghai, Shanghai, China.
JMIR Ment Health. 2024 Sep 10;11:e56650. doi: 10.2196/56650.
Depression and anxiety have become increasingly prevalent across the globe. The rising need for treatment and the lack of clinicians has resulted in prolonged waiting times for patients to receive their first session. Responding to this gap, digital mental health interventions (DMHIs) have been found effective in treating depression and anxiety and are potentially promising pretreatments for patients who are awaiting face-to-face psychotherapy. Nevertheless, whether digital interventions effectively alleviate symptoms for patients on waiting lists for face-to-face psychotherapy remains unclear.
This review aimed to synthesize the effectiveness of DMHIs for relieving depression and anxiety symptoms of patients on waiting lists for face-to-face therapy. This review also investigated the features, perceived credibility, and usability of DMHIs during waiting times.
In this systematic review, we searched PubMed, PsycINFO, Cochrane, and Web of Science for research studies investigating the effectiveness of DMHIs in reducing either depression or anxiety symptoms among individuals waiting for face-to-face psychotherapy. The search was conducted in June 2024, and we have included the studies that met the inclusion criteria and were published before June 6, 2024.
Of the 9267 unique records identified, 8 studies met the eligibility criteria and were included in the systematic review. Five studies were randomized controlled trials (RCTs), and 3 studies were not. Among the RCTs, we found that digital interventions reduced depression and anxiety symptoms, but the majority of interventions were not more effective compared to the control groups where participants simply waited or received a self-help book. For the non-RCTs, the interventions also reduced symptoms, but without control groups, the interpretation of the findings is limited. Finally, participants in the included studies perceived the digital interventions to be credible and useful, but high dropout rates raised concerns about treatment adherence.
Due to the lack of effective interventions among the reviewed studies, especially among the RCTs, our results suggest that waiting list DMHIs are not more effective compared to simply waiting or using a self-help book. However, more high-quality RCTs with larger sample sizes are warranted in order to draw a more robust conclusion. Additionally, as this review revealed concerns regarding the high dropout rate in digital interventions, future studies could perhaps adopt more personalized and human-centered functions in interventions to increase user engagement, with the potential to increase treatment adherence and effectiveness.
抑郁和焦虑在全球范围内变得越来越普遍。治疗需求的增加和临床医生的缺乏导致患者等待首次治疗的时间延长。为了应对这一差距，数字心理健康干预（DMHI）已被证明对治疗抑郁和焦虑有效，并且对于等待面对面心理治疗的患者来说，可能是一种很有前途的预处理方法。然而，数字干预是否能有效缓解等待面对面心理治疗的患者的症状仍不清楚。
本综述旨在综合 DMHI 缓解等待面对面治疗的患者的抑郁和焦虑症状的效果。本综述还研究了 DMHI 在等待期间的特点、感知可信度和可用性。
在这项系统综述中，我们在 PubMed、PsycINFO、Cochrane 和 Web of Science 中搜索了研究 DMHI 在减少等待面对面心理治疗的个体的抑郁或焦虑症状方面的有效性的研究。搜索于 2024 年 6 月进行，我们纳入了符合纳入标准且在 2024 年 6 月 6 日之前发表的研究。
在 9267 条独特的记录中，有 8 项研究符合纳入标准并被纳入系统综述。其中 5 项为随机对照试验（RCT），3 项不是。在 RCT 中，我们发现数字干预降低了抑郁和焦虑症状，但大多数干预措施与对照组相比并不更有效，对照组的参与者只是等待或接受自助书籍。对于非 RCT，干预措施也降低了症状，但由于没有对照组，结果的解释受到限制。最后，纳入研究的参与者认为数字干预措施具有可信度和有用性，但高辍学率引起了对治疗依从性的关注。
由于综述研究中缺乏有效的干预措施，尤其是 RCT，我们的结果表明，与简单地等待或使用自助书籍相比，等待名单上的 DMHI 并没有更有效。然而，为了得出更有力的结论，需要进行更多具有更大样本量的高质量 RCT。此外，正如本综述所揭示的，数字干预措施的高辍学率令人担忧，未来的研究可能会在干预措施中采用更个性化和以人为中心的功能，以提高用户参与度，从而有可能提高治疗依从性和效果。
