Are Internet- and mobile-based interventions effective in adults with diagnosed panic disorder and/or agoraphobia? A systematic review and meta-analysis
Abstract
Background There is no meta-analysis that specifically evaluates the effectiveness of Internet- and mobile-based interventions (IMIs) in adults with diagnosed panic disorder and/or agoraphobia (PD/A) so far. The current meta-analysis aims to fill this gap (PROSPERO CRD 42016034016).Methods Systematic literature searches in six databases for randomised and controlled clinical trials investigating IMIs in adults, who met diagnostic criteria for PD/A. Study selection and data extraction were conducted independently by two reviewers. Random-effects meta-analyses, pre-planned subgroup and sensitivity analyses were conducted when appropriate. Primary outcomes were PD and A symptom severity. In addition, adherence, response, remission, quality of life, anxiety and depression symptom severity were examined.Results A total of 16 trials (1015 patients), with 21 comparisons (9 IMI vs. waitlist; 7 IMI vs. IMI; 5 IMI vs. active treatment condition), were included. IMIs revealed beneficial effects on panic (Hedges' g range -2.61 to -0.25) and agoraphobia symptom severity when compared to waitlist (pooled g = -1.15, [95%-CI = -1.56; -0.74]). Studies comparing IMIs to active controls (i.e., face-to-face CBT and applied relaxation) did not find significant differences for reductions in panic (g = -0.02, [95%-CI = -0.25; 0.21]) and agoraphobia symptom severity (g = -0.10, [95%-CI = -0.39; 0.19]). Furthermore, IMIs were superior to waitlist controls regarding anxiety and depression symptom severity and quality of life.Limitations Tests for publication bias were not feasible due to the limited number of trials per comparison, and the risk of bias assessment indicated some methodological shortcomings.Conclusions Findings from this meta-analytic review provide support for the effectiveness of IMIs in patients with verified PD/A. However, before IMIs can be included in treatment guidelines for PD/A, future high quality research is needed that substantiates and extends the evidence base, especially in regard to intervention safety.
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Numerous clinical trials summarized in several meta-analyses have shown the effectiveness of IMIs in the treatment of mental disorders, particularly well-studied in depressive disorders and anxiety disorders.
“Numerous clinical trials summarized in several meta-analyses have now shown the effectiveness of IMIs in the treatment of mental disorders (8), particularly well-studied in depressive disorders and anxiety disorders (10, 11).”
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“PD and agoraphobia require accessible evidence-based care, making it essential to explore diverse treatments, with internet-based interventions highlighted as a potentially central approach for managing these conditions (Domhardt et al. 2020).”
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Wirkfaktoren und Veränderungsmechanismen
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- Authors
- Domhardt, M., Letsch, J., Kybelka, J., Koenigbauer, J., Doebler, P., & Baumeister, H.
- Affiliations
- Universität Ulm (DE)
- TU Dortmund University (DE)
- Corresponding author
- Domhardt, Matthias
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2020-11
- Volume
- 276
- Pages
- 169-182
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W3042986702
- Cited by
- 75
- References
- 71
- Citations by year
- 2026: 4 · 2025: 12 · 2024: 35 · 2023: 7 · 2022: 6 · 2021: 10 · 2020: 1
- FWCI
- 0.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- online intervention, mobile-based interventions, panic disorder, agoraphobia, symptom severity, medication adherence, remission, quality of life, anxiety, depression, waitlist control, cognitive behavioral therapy, applied relaxation, digital mental health
- MeSH terms
- Adult, Agoraphobia, Anxiety Disorders, Humans, Quality of Life, Panic Disorder, Internet
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