The DOI matches its Crossref record; 50 of the 50 references it cites were found in a registry or an index.
Effectiveness of digital psychological interventions for mental health problems in low-income and middle-income countries: a systematic review and meta-analysis
Open accessAbstract
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 0·45–0·75]; Hedges' g with treatment as usual subgroup for comparison 0·54 [0·35–0·73]). Heterogeneity between studies was substantial ( I 2 =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. Funding None. Translations For the Persian, Chinese, Hindi, Portuguese, Bahasa, Turkish, Romanian, Spanish and Thai translations of the abstract see Supplementary Materials section.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source says what the claim attributes to it.
In the citing paper
“The results add to the growing evidence base for low-threshold digital mental health offers aimed at underserved populations in low- and middle-income countries [20,57].”
From Effects of a self-guided digital mental health self-help intervention for Syrian refugees in Egypt: A pragmatic randomized controlled trial (2024) · cites this paper as [57]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
The Cochrane Collaboration's tool for assessing risk of bias in randomised trials
Higgins, J. P. T., Altman, D. G., Gotzsche, P. C., Juni, P., Moher, D., Oxman, A. D., Savovic, J., Schulz, K. F., Weeks, L., Sterne, J. A. C., et al. (2011) · BMJ · doi:10.1136/bmj.d5928 · Cited by 33,817
The Psychological Impact of Quarantine and How to Reduce It: Rapid Review of the Evidence
Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020) · doi:10.2139/ssrn.3532534 · Cited by 16,394
The psychological impact of quarantine and how to reduce it: Rapid review of the evidence
Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30460-8 · Cited by 16,378
GRADE guidelines: 3. Rating the quality of evidence
Balshem, H., Helfand, M., Schünemann, H. J., Oxman, A. D., Kunz, R., Brozek, J., Vist, G. E., Falck-Ytter, Y., Meerpohl, J., & Norris, S. (2011) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2010.07.015 · Cited by 8,285
Holmes, E. A., O'Connor, R. C., Perry, V. H., Tracey, I., Wessely, S., Arseneault, L., Ballard, C., Christensen, H., Cohen Silver, R., Everall, I., et al. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(20)30168-1 · Cited by 5,715
Stanaway, J. D., Afshin, A., Gakidou, E., Lim, S. S., Abate, D., Abate, K. H., Abbafati, C., Abbasi, N., Abbastabar, H., Abd-Allah, F., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(18)32225-6 · Cited by 4,943
No health without mental health
Prince, M. J., Patel, V., Saxena, S., Maj, M., Maselko, J., Phillips, M. R., & Rahman, A. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61238-0 · Cited by 4,028
Resources for mental health: scarcity, inequity, and inefficiency
Saxena, S., Thornicroft, G., Knapp, M., & Whiteford, H. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61239-2 · Cited by 1,789
Scaling-up treatment of depression and anxiety: a global return on investment analysis
Chisholm, D., Sweeny, K., Sheehan, P., Rasmussen, B., Smit, F., Cuijpers, P., & Saxena, S. (2016) · The Lancet Psychiatry · doi:10.1016/s2215-0366(16)30024-4 · Cited by 1,451
Barak, A., Hen, L., Boniel-Nissim, M., & Shapira, N. (2008) · Journal of Technology in Human Services · doi:10.1080/15228830802094429 · Cited by 1,283
Cited by
Sorted by citations
Philippe, T. J., Sikder, N., Jackson, A., Koblanski, M. E., Liow, E., Pilarinos, A., & Vasarhelyi, K. (2022) · JMIR Mental Health · doi:10.2196/35159 · Cited by 436
Consequences of visiting restrictions during the COVID‐19 pandemic: An integrative review
Hugelius, K., Harada, N., & Marutani, M. (2021) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2021.104000 · Cited by 378
“The effectiveness of telemedicine has been demonstrated by multiple meta-analyses in various settings (Fu et al., 2020).”
BackgroundTorous, J., Linardon, J., Goldberg, S. B., Sun, S., Bell, I., Nicholas, J., Hassan, L., Hua, Y., Milton, A., & Firth, J. (2025) · World Psychiatry · doi:10.1002/wps.21299 · Cited by 323
“%) and focusing on adults with elevat ed depression, anxiety, PTSD or substance use symptoms 257 .”
Werner‐Seidler, A., Spanos, S., Calear, A. L., Perry, Y., Torok, M. H., O’Dea, B., Christensen, H. M., & Newby, J. M. (2021) · Clinical Psychology Review · doi:10.1016/j.cpr.2021.102079 · Cited by 364
Public mental health: required actions to address implementation failure in the context of COVID-19
Campion, J., Javed, A., Lund, C., Sartorius, N., Saxena, S., Marmot, M., Allan, J., & Udomratn, P. (2022) · The Lancet Psychiatry · doi:10.1016/s2215-0366(21)00199-1 · Cited by 177
Metadata
- Authors
- Fu, Z., Burger, H., Arjadi, R., & Bockting, C. L. H.
- Affiliations
- Beijing Normal University (CN)
- University Medical Center Groningen (NL)
- Atma Jaya Catholic University of Indonesia (ID)
- Amsterdam UMC Location University of Amsterdam (NL)
- Corresponding author
- Bockting, Claudi L H
- Venue
- The Lancet Psychiatry
- Publisher
- Elsevier BV
- Published
- 2020-10
- Volume
- 7
- Issue
- 10
- Pages
- 851-864
- ISSN
- 2215-0366 (ISSN-L)
- PMC
- PMC7455253
- OpenAlex
- W3082767440
- Cited by
- 336
- References
- 49
- Citations by year
- 2026: 39 · 2025: 73 · 2024: 73 · 2023: 57 · 2022: 52 · 2021: 38 · 2020: 4
- FWCI
- 5.94
- Type
- journal article
- Language
- en
- Update notices
- erratum (2021-11-01)
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The Lancet Psychiatry (publishedVersion, other-oa)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- digital psychological interventions, mental illness, low- and middle-income countries, depression, substance abuse, young adults, usual care, cognitive therapy, behavior therapy, intervention effectiveness, usual care comparison, publication bias, quality of evidence, study heterogeneity, GRADE quality assessment, effect size, clinical interview, follow-up duration
- MeSH terms
- Depressive Disorder, Developing Countries, Humans, Psychotherapy, Randomized Controlled Trials as Topic, Outcome Assessment, Health Care, Telemedicine, Substance-Related Disorders
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
