Effectiveness of mobile-based cognitive behavioural therapy for adolescent depression: A systematic review and meta-analysis.

Abstract

Objective: Adolescent depression is a significant public health concern, with prevalence rates increasing globally over recent years. Mobile-based cognitive behavioural therapy applications are increasingly used to address adolescent depression, but their effectiveness remains unclear. This study evaluated the impact of mobile-based cognitive behavioural therapy apps on depressive symptoms in this population, with secondary analyses examining anxiety, quality of life, usability and adverse events.

Method: A systematic review identified 10 randomized controlled trials containing 1896 participants. These studies were published since 2014 and assessed the effects of mobile-based cognitive behavioural therapy for depression in adolescents (aged 13-25 years). Databases searched included MEDLINE, PsycINFO, Embase, PubMed and the Cochrane Library. Subsequent meta-analysis was conducted on nine studies (n = 1127). Studies reporting depressive symptom outcomes were included in meta-analyses using a random-effects model.

Results: Meta-analysis showed a significant reduction in depressive symptoms compared with the control groups (Cohen's d = -0.24; 95% confidence interval = [-0.36, -0.13], p < 0.001), with negligible heterogeneity (I² = 0%). Meta-regression showed no significant association between follow-up duration and effect size. No significant effects were found for anxiety (d = -0.16), but improvements were observed in quality of life (d = 0.37) and usability (d = 0.37). Adverse event rates were lower in the intervention groups (risk ratio = 0.68).

Conclusion: Mobile-based cognitive behavioural therapy is a moderately effective short-term intervention for adolescent and young adult depression. These findings support its integration into mental health service delivery, although strategies to sustain long-term benefits are needed.