Digital health–based exposure therapies for patients with posttraumatic stress disorder: A systematic review of randomized controlled trials

Although exposure therapies have established effects in treating posttraumatic stress disorder (PTSD), these therapies might be hindered by issues of cost, distance, time, and human resources, which are potentially alleviated by digital health. Despite the potential of digital health, there is currently no systematic review specifically evaluating digital health–based exposure therapies. We aimed to conduct a systematic literature review of randomized controlled trials (RCTs) examining the impact of digital health–based exposure therapies in treating patients with PTSD. A literature search was conducted from December 31, 2023, to February 22, 2024, using the PubMed, Web of Science, and PsycINFO databases. A total of 12 RCTs with 1,361 participants were included in the systematic review. These RCTs were conducted mainly in the United States and primarily enrolled military samples. Overall, the utility of digital health–based exposure therapies appeared plausible and comparable to that of in-person therapies. The dropout rate was counterintuitively high, potentially due to technological issues and the absence of personal connections. The findings suggest that digital health–based exposure therapies may potentially resolve the issues of cost, distance, time, and human resources in the treatment of patients with PTSD. Future RCTs should employ larger sample sizes. Addressing technological challenges and the absence of personal connection may be important in resolving the high dropout rate.