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Cited by 42Digital Mental Health InterventionsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Treatment and Access

The efficacy of self-guided internet and mobile-based interventions for preventing anxiety and depression–A systematic review and meta-analysis

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Edge, Daniel, Watkins, Edward R., Limond, Jenny, Mugadza, Jane·2023·Behaviour Research and Therapy
DOI 10.1016/j.brat.2023.104292
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Abstract

BACKGROUND: Anxiety and depression are highly prevalent mental disorders which are associated with a considerable personal and economic burden. As treatment alone has a minimal impact on prevalence, there is now a growing focus on interventions which may help prevent anxiety and depression. Internet and mobile based interventions have been identified as a useful avenue for the delivery of preventative programmes due to their scalability and accessibility. The efficacy of interventions that do not require additional support from a trained professional (self-guided) in this capacity is yet to be explored. METHOD: A systematic search was conducted on the Cochrane Library, PubMed, PsycARTICLES, PsycINFO, OVID, MEDline, PsycEXTRA and SCOPUS databases. Studies were selected according to defined inclusion and exclusion criteria. The primary outcome was evaluating the effect of self-guided internet and mobile based interventions on incidence of anxiety and depression. The secondary outcome was effect on symptom severity. RESULTS: After identifying and removing duplicates, 3211 studies were screened, 32 of which were eligible for inclusion in the final analysis. Nine studies also reported incidence data (depression = 7, anxiety = 2). The overall Risk Ratios for incidence of anxiety and depression were 0.86 (95% CI [0.28, 2.66], p = .79) and 0.67 (95% CI [0.48, 0.93], p = .02) respectively. Analysis for 27 studies reporting severity of depressive symptoms revealed a significant posttreatment standardised mean difference of -0.27 (95% CI [ -0.37, -0.17], p < .001) for self-guided intervention groups relative to controls. A similar result was observed for 29 studies reporting severity of anxiety symptoms with a standardised mean difference of -0.21 (95% CI [-0.31, -0.10], p < .001). CONCLUSIONS: Self-guided internet and mobile based interventions appear to be effective at preventing incidence of depression, though further examination of the data suggests that generalisability of this finding may be limited. While self-guided interventions also appear effective in reducing symptoms of anxiety and depression, their ability to prevent incidence of anxiety is less clear. A heavy reliance on symptom measures in the data analysed suggests future research could benefit from prioritising the use of standardised diagnostic measuring tools to assess incidence. Future systematic reviews should aim to include more data from grey literature and reduce the impact of study heterogeneity.

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Authors
Edge, D., Watkins, E. R., Limond, J., & Mugadza, J.
Affiliations
University of Exeter (GB)
Corresponding author
Edge, Daniel
ORCID
Venue
Behaviour Research and Therapy
Publisher
Elsevier BV
Published
2023-05
Volume
164
Pages
104292
ISSN
0005-7967 (ISSN-L)
DOI
10.1016/j.brat.2023.104292
OpenAlex
W4353051679
Cited by
42
References
83
Citations by year
2026: 12 · 2025: 16 · 2024: 12 · 2023: 2
FWCI
1.41
Type
journal article
Language
en
Open access
Licence
Locations
  • Behaviour Research and Therapy (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Figshare (submittedVersion, cc-by)
  • Open Research Exeter (University of Exeter) (submittedVersion, cc-by)
Topics
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
depression prevention, anxiety prevention, self-guided intervention, online intervention, mobile-based interventions, digital mental health, depression incidence, depression severity, anxiety symptom severity, implementation barriers and facilitators
MeSH terms
Anxiety, Anxiety Disorders, Depression, Humans, Internet

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