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Online psychological interventions to reduce symptoms of depression, anxiety, and general distress in those with chronic health conditions: a systematic review and meta-analysis of randomized controlled trials

Published online by Cambridge University Press:  17 July 2020

V. White Open the ORCID record for V. White [Opens in a new window] ,
J. Linardon Open the ORCID record for J. Linardon [Opens in a new window] ,
J. E. Stone Open the ORCID record for J. E. Stone [Opens in a new window] ,
E. Holmes-Truscott Open the ORCID record for E. Holmes-Truscott [Opens in a new window] ,
L. Olive ,
A. Mikocka-Walus Open the ORCID record for A. Mikocka-Walus [Opens in a new window] ,
C. Hendrieckx Open the ORCID record for C. Hendrieckx [Opens in a new window] ,
S. Evans  and
J. Speight Open the ORCID record for J. Speight [Opens in a new window]
V. White*
Affiliation:
School of Psychology, Faculty of Health, Deakin University Geelong, Victoria3220, Australia
J. Linardon
Affiliation:
School of Psychology, Faculty of Health, Deakin University Geelong, Victoria3220, Australia
J. E. Stone
Affiliation:
Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria3168, Australia
E. Holmes-Truscott
Affiliation:
School of Psychology, Faculty of Health, Deakin University Geelong, Victoria3220, Australia The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria3000, Australia
L. Olive
Affiliation:
School of Psychology, Faculty of Health, Deakin University Geelong, Victoria3220, Australia
A. Mikocka-Walus
Affiliation:
School of Psychology, Faculty of Health, Deakin University Geelong, Victoria3220, Australia
C. Hendrieckx
Affiliation:
School of Psychology, Faculty of Health, Deakin University Geelong, Victoria3220, Australia The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria3000, Australia
S. Evans
Affiliation:
School of Psychology, Faculty of Health, Deakin University Geelong, Victoria3220, Australia
J. Speight
Affiliation:
School of Psychology, Faculty of Health, Deakin University Geelong, Victoria3220, Australia The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria3000, Australia
*
Author for correspondence: V. White, E-mail: vicki.white@deakin.edu.au
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Abstract

Background

Over the past 15 years, there has been substantial growth in web-based psychological interventions. We summarize evidence regarding the efficacy of web-based self-directed psychological interventions on depressive, anxiety and distress symptoms in people living with a chronic health condition.

Method

We searched Medline, PsycINFO, CINAHL, EMBASE databases and Cochrane Database from 1990 to 1 May 2019. English language papers of randomized controlled trials (usual care or waitlist control) of web-based psychological interventions with a primary or secondary aim to reduce anxiety, depression or distress in adults with a chronic health condition were eligible. Results were assessed using narrative synthases and random-effects meta-analyses.

Results

In total 70 eligible studies across 17 health conditions [most commonly: cancer (k = 20), chronic pain (k = 9), arthritis (k = 6) and multiple sclerosis (k = 5), diabetes (k = 4), fibromyalgia (k = 4)] were identified. Interventions were based on CBT principles in 46 (66%) studies and 42 (60%) included a facilitator. When combining all chronic health conditions, web-based interventions were more efficacious than control conditions in reducing symptoms of depression g = 0.30 (95% CI 0.22–0.39), anxiety g = 0.19 (95% CI 0.12–0.27), and distress g = 0.36 (95% CI 0.23–0.49).

Conclusion

Evidence regarding effectiveness for specific chronic health conditions was inconsistent. While self-guided online psychological interventions may help to reduce symptoms of anxiety, depression and distress in people with chronic health conditions in general, it is unclear if these interventions are effective for specific health conditions. More high-quality evidence is needed before definite conclusions can be made.

Keywords

Anxietychronic health conditionsdepressiondistresse-interventionsmeta-analysisRCTssystematic review
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 3 , February 2022 , pp. 548 - 573
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Copyright
Copyright © The Author(s) 2020. Published by Cambridge University Press

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