A systematic review and meta-analysis of Internet-based self-help interventions for mental health among adolescents and college students

IF 3.6 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health Pub Date : 2023-11-03 DOI:10.1016/j.invent.2023.100690

Qing Wang , Weixin Zhang , Senbo An

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引用次数: 0

Abstract

Purpose

This meta-analysis aims to evaluate the impact of Internet-based self-help interventions on the mental health of adolescents and college students.

Methods

We conducted a systematic review of randomized controlled trials (RCTs) that investigated Internet-based self-help interventions aiming to mitigate mental health symptoms such as anxiety and depression, as well as managing high levels of stress, among adolescents and college students. Our search spanned databases including Web of Science, PubMed, Cochrane Library, and Embase, up until November 1st, 2022. It is essential to emphasize that our focus was the evaluation of symptoms (continuous outcomes), rather than the diagnosis of specific mental disorders. The meta-analysis was performed using the R version 4.3.1. The effect size measure was the standardized mean difference (SMD), and random-effects models were used to pool data from eligible RCTs. Subgroup analyses were carried out to examine variations in intervention effects based on factors such as sample type, intervention modality, guidance type, and intervention duration.

Results

The meta-analysis was based on 25 comparisons involving a total of 4480 participants. In comparison to the control group (n = 2125), participants receiving interventions (n = 2355) reported significant reductions in symptoms of anxiety, depression, and stress, along with a significant improvement in quality of life. Specifically, for depression, we observed moderate intervention effects (SMD = −0.42, 95 % CI: −0.56, −0.27), and a similar pattern was seen for quality of life (SMD = 0.36, 95%CI: 0.22, 0.49). Small intervention effects were found for anxiety (SMD = −0.35, 95 % CI [−0.48, −0.22]) and stress (SMD = −0.35, 95 % CI [−0.51, −0.20]). Given significant heterogeneity, subgroup analyses were conducted for anxiety and depression, considering factors such as sample type, intervention method, and intervention duration. Notably, college students experienced more significant benefits in both anxiety and depression alleviation compared to adolescents. Longer interventions (>8 weeks) were particularly effective in reducing anxiety and depression. Additionally, third-wave cognitive-behavioral therapy (CBT) showed pronounced intervention effects in both outcome measures, while the presence of guidance did not notably influence results.

Conclusion

This meta-analysis underscores the positive impact of Internet-based self-help programs in alleviating the symptoms of psychological disorders among adolescents and college students. However, it is crucial to acknowledge that the available evidence exhibits inconsistencies and limitations. Therefore, further research utilizing rigorous methodologies is necessary to verify and broaden the findings of this meta-analysis.

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网络自助干预对青少年和大学生心理健康的系统回顾和meta分析

目的本荟萃分析旨在评估网络自助干预对青少年和大学生心理健康的影响。方法我们对随机对照试验(rct)进行了系统回顾，这些试验调查了基于互联网的自助干预措施，旨在减轻青少年和大学生的心理健康症状，如焦虑和抑郁，以及管理高水平的压力。我们的搜索涵盖了Web of Science、PubMed、Cochrane Library和Embase等数据库，截止日期为2022年11月1日。必须强调的是，我们的重点是对症状(持续结果)的评估，而不是对特定精神障碍的诊断。meta分析采用R版本4.3.1进行。效应量测量为标准化平均差(SMD)，随机效应模型用于汇集符合条件的随机对照试验的数据。进行亚组分析，以检查基于样本类型、干预方式、指导类型和干预持续时间等因素的干预效果变化。结果荟萃分析基于25项比较，共涉及4480名参与者。与对照组(n = 2125)相比，接受干预的参与者(n = 2355)报告焦虑、抑郁和压力症状显著减轻，生活质量显著改善。具体来说，对于抑郁症，我们观察到适度的干预效果(SMD = - 0.42, 95%CI: - 0.56， - 0.27)，在生活质量方面也观察到类似的模式(SMD = 0.36, 95%CI: 0.22, 0.49)。对焦虑(SMD = - 0.35, 95% CI[- 0.48， - 0.22])和压力(SMD = - 0.35, 95% CI[- 0.51， - 0.20])的干预效果较小。鉴于异质性显著，考虑样本类型、干预方式、干预时间等因素，对焦虑和抑郁进行亚组分析。值得注意的是，与青少年相比，大学生在缓解焦虑和抑郁方面都有更显著的好处。较长的干预(8周)在减少焦虑和抑郁方面特别有效。此外，第三波认知行为疗法(CBT)在两种结果测量中都显示出明显的干预效果，而指导的存在对结果没有显著影响。结论本荟萃分析强调了网络自助项目在缓解青少年和大学生心理障碍症状方面的积极作用。然而，重要的是要承认，现有的证据显示出不一致和局限性。因此，有必要利用严格的方法进行进一步的研究，以验证和扩大本荟萃分析的发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health Medicine-Health Informatics

CiteScore

6.50

自引率

9.30%

发文量

审稿时长

6 weeks

期刊介绍： Official Journal of the European Society for Research on Internet Interventions (ESRII) and the International Society for Research on Internet Interventions (ISRII). The aim of Internet Interventions is to publish scientific, peer-reviewed, high-impact research on Internet interventions and related areas. Internet Interventions welcomes papers on the following subjects: • Intervention studies targeting the promotion of mental health and featuring the Internet and/or technologies using the Internet as an underlying technology, e.g. computers, smartphone devices, tablets, sensors • Implementation and dissemination of Internet interventions • Integration of Internet interventions into existing systems of care • Descriptions of development and deployment infrastructures • Internet intervention methodology and theory papers • Internet-based epidemiology • Descriptions of new Internet-based technologies and experiments with clinical applications • Economics of internet interventions (cost-effectiveness) • Health care policy and Internet interventions • The role of culture in Internet intervention • Internet psychometrics • Ethical issues pertaining to Internet interventions and measurements • Human-computer interaction and usability research with clinical implications • Systematic reviews and meta-analysis on Internet interventions