Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis

Psychol Med. 2007 Mar;37(3):319-28. doi: 10.1017/S0033291706008944. Epub 2006 Nov 20.

Abstract

Background: We studied to what extent internet-based cognitive behaviour therapy (CBT) programs for symptoms of depression and anxiety are effective.

Method: A meta-analysis of 12 randomized controlled trials.

Results: The effects of internet-based CBT were compared to control conditions in 13 contrast groups with a total number of 2334 participants. A meta-analysis on treatment contrasts resulted in a moderate to large mean effect size [fixed effects analysis (FEA) d=0.40, mixed effects analysis (MEA) d=0.60] and significant heterogeneity. Therefore, two sets of post hoc subgroup analyses were carried out. Analyses on the type of symptoms revealed that interventions for symptoms of depression had a small mean effect size (FEA d=0.27, MEA d=0.32) and significant heterogeneity. Further analyses showed that one study could be regarded as an outlier. Analyses without this study showed a small mean effect size and moderate, non-significant heterogeneity. Interventions for anxiety had a large mean effect size (FEA and MEA d=0.96) and very low heterogeneity. When examining the second set of subgroups, based on therapist assistance, no significant heterogeneity was found. Interventions with therapist support (n=5) had a large mean effect size, while interventions without therapist support (n=6) had a small mean effect size (FEA d=0.24, MEA d=0.26).

Conclusions: In general, effect sizes of internet-based interventions for symptoms of anxiety were larger than effect sizes for depressive symptoms; however, this might be explained by differences in the amount of therapist support.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / psychology
  • Anxiety Disorders / therapy*
  • Cognitive Behavioral Therapy*
  • Depressive Disorder / diagnosis
  • Depressive Disorder / psychology
  • Depressive Disorder / therapy*
  • Humans
  • Internet*
  • Outcome and Process Assessment, Health Care
  • Professional-Patient Relations
  • Randomized Controlled Trials as Topic
  • Social Support
  • Therapy, Computer-Assisted*