Comparative effectiveness and acceptability of internet-based psychological interventions on depression in young people: a systematic review and network meta-analysis.

Abstract

Background: Depression represents a major global public health challenge, particularly among young individuals aged between 10 and 25. This age bracket is notably critical, as the onset of depression during these years tends to be more severe and consequential. In response to the growing demand for mental health services, internet-based psychological interventions have gained traction as a flexible and convenient alternative to traditional face-to-face treatment. This systematic review and network meta-analysis aims to rigorously assess the comparative efficacy and acceptability of internet-based psychological interventions in addressing depression within the young population over the past three decades.

Methods: We conducted a comprehensive search of seven electronic databases for eligible randomized controlled trials published from January 1995 to July 2024. The literature screening process adhered to the principles of population, intervention, comparator, outcome, and study design. The quality of the included studies was assessed using the Cochrane Risk of Bias Assessment Tool. To evaluate the ranking probability of each intervention, we calculated the surface under the cumulative ranking curve values. Network meta-analysis (NMA) was conducted using RStudio and Stata software.

Results: The NMA incorporated a total of 27 studies involving 3,451 participants. Among these studies, 18 assessed internet-based cognitive behavioral therapy (iCBT) interventions, whereas 12 employed a waitlist as a control group. At the end of the interventions, internet-based acceptance and commitment therapy (iACT), iCBT, internet-based dialectical behavior therapy (iDBT), and internet-based psychodynamic therapy (iPDT) all demonstrated statistically significant reductions in depression scores. Notably, no intervention measure was found to be statistically more acceptable than the others.

Conclusions: Our NMA indicated that iDBT appeared to be more effective, whereas internet-based mindfulness-based therapy (iMBT) may be more acceptable. These findings offered preliminary evidence regarding the comparative effectiveness and acceptability of internet-based psychological interventions in treating depression among young people. However, the limited number of eligible studies underscored the importance and necessity of further research to evaluate novel intervention measures.

Trial registration: The study was registered with the International Prospective Register of Systematic Reviews (PROSPERO), with the registration number CRD42024580958.