Mind-body internet and mobile-based interventions for depression and anxiety in adults with chronic physical conditions: A systematic review of RCTs
Open accessAbstract
This review summarizes the effectiveness of scalable mind-body internet and mobile-based interventions (IMIs) on depression and anxiety symptoms in adults living with chronic physical conditions. Six databases (MEDLINE, PsycINFO, SCOPUS, EMBASE, CINAHL, and CENTRAL) were searched for randomized controlled trials published from database inception to March 2023. Mind-body IMIs included cognitive behavioral therapy, breathwork, meditation, mindfulness, yoga or Tai-chi. To focus on interventions with a greater potential for scale, the intervention delivery needed to be online with no or limited facilitation by study personnel. The primary outcome was mean change scores for anxiety and depression (Hedges’ g ). In subgroup analyses, random-effects models were used to calculate pooled effect size estimates based on personnel support level, intervention techniques, chronic physical condition, and survey type. Meta-regression was conducted on age and intervention length. Fifty-six studies met inclusion criteria (sample size 7691, mean age of participants 43 years, 58% female): 30% (n = 17) neurological conditions, 12% (n = 7) cardiovascular conditions, 11% cancer (n = 6), 43% other chronic physical conditions (n = 24), and 4% (n = 2) multiple chronic conditions. Mind-body IMIs demonstrated statistically significant pooled reductions in depression ( SMD = -0.33 [-0.40, -0.26], p<0.001) and anxiety ( SMD = -0.26 [-0.36, -0.17], p<0.001). Heterogeneity was moderate. Scalable mind-body IMIs hold promise as interventions for managing anxiety and depression symptoms in adults with chronic physical conditions without differences seen with age or intervention length. While modest, the effect sizes are comparable to those seen with pharmacological therapy. The field would benefit from detailed reporting of participant demographics including those related to technological proficiency, as well as further evaluation of non-CBT interventions. Registration: The study is registered with PROSPERO ID # CRD42022375606 .
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Without distinguishing between self-guided and minimally facilitated interventions, moderate-in-magnitude effects on depression and anxiety have been found for internet and mobile-based interventions delivered to adults with chronic physical conditions.
“Without distinguishing between interventions that are self-guided and those that are minimally facilitated by expert personnel, moderate-in-magnitude effects on depression and anxiety have been found for internet and mobile-based interventions delivered to adults with chronic physical conditions [16].”
From Evolution of Primary Research Studies in Digital Interventions for Mental Well-Being Promotion from 2004 to 2023: A Bibliometric Analysis of Studies on the Web of Science (2024) · cites this paper as [16]
The Discussion (page unavailable) reports pooled benefits for depression and anxiety across self-guided and minimally supported interventions, with no discernible difference between those groups. It calls the effects small, however, not moderate in magnitude; the reported moderate heterogeneity does not describe effect size. (LLM, conf=0.88)
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- Authors
- Johnson, E., Corrick, S., Isley, S., Vandermeer, B., Dolgoy, N., Bates, J., Godfrey, E., Soltys, C., Muir, C., Vohra, S., & Tandon, P.
- Affiliations
- University of Alberta (CA)
- University of Toronto (CA)
- Corresponding author
- Tandon, Puneeta
- ORCID
- Venue
- PLOS Digital Health
- Publisher
- Public Library of Science (PLoS)
- Published
- 2024-01-23
- Volume
- 3
- Issue
- 1
- Pages
- e0000435
- ISSN
- 2767-3170 (ISSN-L)
- PMC
- PMC10805319
- OpenAlex
- W4391131595
- Cited by
- 24
- References
- 136
- Citations by year
- 2026: 10 · 2025: 7 · 2024: 7
- FWCI
- 1.26
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLOS Digital Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Canadian Institutes of Health Research (RES0057213)
- Alberta Strategy for Patient-Oriented Research unit Pragmatic Clinical trials Platform (RES0048995)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- mind-body interventions, online intervention, mobile health intervention, depression, anxiety, chronic physical illness, cognitive behavioral therapy, mindfulness, meditation, yoga, Tai Chi, breathwork, scalability
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.
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