Publication

Effectiveness of digital psychological interventions for mental health problems in low-income and middle-income countries: a systematic review and meta-analysis

Fu, Z., Burger, H., Arjadi, R. & Bockting, C. L. H., Oct-2020, In : The Lancet. Psychiatry. 7, 10, p. 851-864 14 p.

Research output: Contribution to journalReview articleAcademicpeer-review

APA

Fu, Z., Burger, H., Arjadi, R., & Bockting, C. L. H. (2020). Effectiveness of digital psychological interventions for mental health problems in low-income and middle-income countries: a systematic review and meta-analysis. The Lancet. Psychiatry, 7(10), 851-864. https://doi.org/10.1016/S2215-0366(20)30256-X

Author

Fu, Zhongfang ; Burger, Huibert ; Arjadi, Retha ; Bockting, Claudi L H. / Effectiveness of digital psychological interventions for mental health problems in low-income and middle-income countries : a systematic review and meta-analysis. In: The Lancet. Psychiatry. 2020 ; Vol. 7, No. 10. pp. 851-864.

Harvard

Fu, Z, Burger, H, Arjadi, R & Bockting, CLH 2020, 'Effectiveness of digital psychological interventions for mental health problems in low-income and middle-income countries: a systematic review and meta-analysis', The Lancet. Psychiatry, vol. 7, no. 10, pp. 851-864. https://doi.org/10.1016/S2215-0366(20)30256-X

Standard

Effectiveness of digital psychological interventions for mental health problems in low-income and middle-income countries : a systematic review and meta-analysis. / Fu, Zhongfang; Burger, Huibert; Arjadi, Retha; Bockting, Claudi L H.

In: The Lancet. Psychiatry, Vol. 7, No. 10, 10.2020, p. 851-864.

Research output: Contribution to journalReview articleAcademicpeer-review

Vancouver

Fu Z, Burger H, Arjadi R, Bockting CLH. Effectiveness of digital psychological interventions for mental health problems in low-income and middle-income countries: a systematic review and meta-analysis. The Lancet. Psychiatry. 2020 Oct;7(10):851-864. https://doi.org/10.1016/S2215-0366(20)30256-X


BibTeX

@article{8231cc8a92374e519f74096101ea96cd,
title = "Effectiveness of digital psychological interventions for mental health problems in low-income and middle-income countries: a systematic review and meta-analysis",
abstract = "Background The effectiveness of digital psychological interventions in low-income and middle-income countries (LMICs) remains unclear. We aimed to systematically investigate the available evidence for digital psychological interventions in reducing mental health problems in LMICs.Methods In this systematic review and meta-analysis, we searched PubMed, PsycINFO, Embase, and Cochrane databases for articles published in English from database inception to March 9, 2020. We included randomised controlled trials investigating digital psychological interventions in individuals with mental health problems in LMICs. We extracted data on demographics, inclusion and exclusion criteria, details of the intervention, including the setting, digital delivery method, control group conditions, number of sessions, therapeutic orientation (eg, cognitive therapy or behaviour therapy), presence or absence of guidance, and length of follow-up, and statistical information to calculate effect sizes. If a study reported insufficient data to calculate effect sizes, the corresponding authors were contacted to provide data that could be aggregated. We did random-effects meta-analyses, and calculated the standardised mean difference in scores of digital psychological interventions versus control conditions (Hedges' g). Quality of evidence was assessed by use of the Grading of Recommendations Assessment, Development, and Evaluation approach. The primary outcome was post-intervention mental health problems, as measured by self-reporting instruments or clinical interviews. This study is registered with PROSPERO, CRD42019137755.Findings We identified 22 eligible studies that were included in the meta-analysis. The included studies involved a total of 4104 participants (2351 who received a digital psychological intervention and 1753 who were in the control group), and mainly focused on young adults (mean age of the study population was 20-35 years) with depression or substance misuse. The results showed that digital psychological interventions are moderately effective when compared with control interventions (Hedges' g 0.60 [95% CI 045-0.75]; Hedges' g with treatment as usual subgroup for comparison 0.54 [0.35-0.73]). Heterogeneity between studies was substantial (P =74% [95% CI 60-83]). There was no evidence of publication bias, and the quality of evidence according to the GRADE criteria was generally high.Interpretation Digital psychological interventions, which have been mostly studied in individuals with depression and substance misuse, are superior to control conditions, including usual care, and are moderately effective in LMICs. However, the considerable heterogeneity observed in our analysis highlights the need for more studies to be done, with standardised implementation of digital psychological intervention programmes to improve their reproducibility and efficiency. Digital psychological interventions should be considered for regions where usual care for mental health problems is minimal or absent. Copyright (C) 2020 Elsevier Ltd. All rights reserved.",
keywords = "RANDOMIZED CONTROLLED-TRIAL, COGNITIVE-BEHAVIORAL THERAPY, DEPRESSION, PREVENTION, EFFICACY, ANXIETY",
author = "Zhongfang Fu and Huibert Burger and Retha Arjadi and Bockting, {Claudi L H}",
note = "Copyright {\textcopyright} 2020 Elsevier Ltd. All rights reserved.",
year = "2020",
month = oct,
doi = "10.1016/S2215-0366(20)30256-X",
language = "English",
volume = "7",
pages = "851--864",
journal = "The Lancet. Psychiatry",
issn = "2215-0366",
publisher = "ELSEVIER SCI LTD",
number = "10",

}

RIS

TY - JOUR

T1 - Effectiveness of digital psychological interventions for mental health problems in low-income and middle-income countries

T2 - a systematic review and meta-analysis

AU - Fu, Zhongfang

AU - Burger, Huibert

AU - Arjadi, Retha

AU - Bockting, Claudi L H

N1 - Copyright © 2020 Elsevier Ltd. All rights reserved.

PY - 2020/10

Y1 - 2020/10

N2 - Background The effectiveness of digital psychological interventions in low-income and middle-income countries (LMICs) remains unclear. We aimed to systematically investigate the available evidence for digital psychological interventions in reducing mental health problems in LMICs.Methods In this systematic review and meta-analysis, we searched PubMed, PsycINFO, Embase, and Cochrane databases for articles published in English from database inception to March 9, 2020. We included randomised controlled trials investigating digital psychological interventions in individuals with mental health problems in LMICs. We extracted data on demographics, inclusion and exclusion criteria, details of the intervention, including the setting, digital delivery method, control group conditions, number of sessions, therapeutic orientation (eg, cognitive therapy or behaviour therapy), presence or absence of guidance, and length of follow-up, and statistical information to calculate effect sizes. If a study reported insufficient data to calculate effect sizes, the corresponding authors were contacted to provide data that could be aggregated. We did random-effects meta-analyses, and calculated the standardised mean difference in scores of digital psychological interventions versus control conditions (Hedges' g). Quality of evidence was assessed by use of the Grading of Recommendations Assessment, Development, and Evaluation approach. The primary outcome was post-intervention mental health problems, as measured by self-reporting instruments or clinical interviews. This study is registered with PROSPERO, CRD42019137755.Findings We identified 22 eligible studies that were included in the meta-analysis. The included studies involved a total of 4104 participants (2351 who received a digital psychological intervention and 1753 who were in the control group), and mainly focused on young adults (mean age of the study population was 20-35 years) with depression or substance misuse. The results showed that digital psychological interventions are moderately effective when compared with control interventions (Hedges' g 0.60 [95% CI 045-0.75]; Hedges' g with treatment as usual subgroup for comparison 0.54 [0.35-0.73]). Heterogeneity between studies was substantial (P =74% [95% CI 60-83]). There was no evidence of publication bias, and the quality of evidence according to the GRADE criteria was generally high.Interpretation Digital psychological interventions, which have been mostly studied in individuals with depression and substance misuse, are superior to control conditions, including usual care, and are moderately effective in LMICs. However, the considerable heterogeneity observed in our analysis highlights the need for more studies to be done, with standardised implementation of digital psychological intervention programmes to improve their reproducibility and efficiency. Digital psychological interventions should be considered for regions where usual care for mental health problems is minimal or absent. Copyright (C) 2020 Elsevier Ltd. All rights reserved.

AB - Background The effectiveness of digital psychological interventions in low-income and middle-income countries (LMICs) remains unclear. We aimed to systematically investigate the available evidence for digital psychological interventions in reducing mental health problems in LMICs.Methods In this systematic review and meta-analysis, we searched PubMed, PsycINFO, Embase, and Cochrane databases for articles published in English from database inception to March 9, 2020. We included randomised controlled trials investigating digital psychological interventions in individuals with mental health problems in LMICs. We extracted data on demographics, inclusion and exclusion criteria, details of the intervention, including the setting, digital delivery method, control group conditions, number of sessions, therapeutic orientation (eg, cognitive therapy or behaviour therapy), presence or absence of guidance, and length of follow-up, and statistical information to calculate effect sizes. If a study reported insufficient data to calculate effect sizes, the corresponding authors were contacted to provide data that could be aggregated. We did random-effects meta-analyses, and calculated the standardised mean difference in scores of digital psychological interventions versus control conditions (Hedges' g). Quality of evidence was assessed by use of the Grading of Recommendations Assessment, Development, and Evaluation approach. The primary outcome was post-intervention mental health problems, as measured by self-reporting instruments or clinical interviews. This study is registered with PROSPERO, CRD42019137755.Findings We identified 22 eligible studies that were included in the meta-analysis. The included studies involved a total of 4104 participants (2351 who received a digital psychological intervention and 1753 who were in the control group), and mainly focused on young adults (mean age of the study population was 20-35 years) with depression or substance misuse. The results showed that digital psychological interventions are moderately effective when compared with control interventions (Hedges' g 0.60 [95% CI 045-0.75]; Hedges' g with treatment as usual subgroup for comparison 0.54 [0.35-0.73]). Heterogeneity between studies was substantial (P =74% [95% CI 60-83]). There was no evidence of publication bias, and the quality of evidence according to the GRADE criteria was generally high.Interpretation Digital psychological interventions, which have been mostly studied in individuals with depression and substance misuse, are superior to control conditions, including usual care, and are moderately effective in LMICs. However, the considerable heterogeneity observed in our analysis highlights the need for more studies to be done, with standardised implementation of digital psychological intervention programmes to improve their reproducibility and efficiency. Digital psychological interventions should be considered for regions where usual care for mental health problems is minimal or absent. Copyright (C) 2020 Elsevier Ltd. All rights reserved.

KW - RANDOMIZED CONTROLLED-TRIAL

KW - COGNITIVE-BEHAVIORAL THERAPY

KW - DEPRESSION

KW - PREVENTION

KW - EFFICACY

KW - ANXIETY

U2 - 10.1016/S2215-0366(20)30256-X

DO - 10.1016/S2215-0366(20)30256-X

M3 - Review article

C2 - 32866459

VL - 7

SP - 851

EP - 864

JO - The Lancet. Psychiatry

JF - The Lancet. Psychiatry

SN - 2215-0366

IS - 10

ER -

ID: 133023393