Evidence on Technology-Based Psychological Interventions in Diagnosed Depression: Systematic Review
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Abstract
Background: Evidence on technology-based psychological interventions (TBIs) for the treatment of depression is rapidly growing and covers a broad scope of research. Despite extensive research in this field, guideline recommendations are still limited to the general effectiveness of TBIs. Objective: This study aims to structure evidence on TBIs by considering different application areas (eg, TBIs for acute treatment and their implementation in health care, such as stand-alone interventions) and treatment characteristics (eg, therapeutic rationale of TBIs) to provide a comprehensive evidence base and to identify research gaps in TBIs for diagnosed depression. Moreover, the reporting of negative events in the included studies is investigated in this review to enable subsequent safety assessment of the TBIs. Methods: Randomized controlled trials on adults diagnosed with unipolar depression receiving any kind of psychotherapeutic treatment, which was at least partly delivered by a technical medium, were eligible for inclusion in our preregistered systematic review. We searched for trials in CENTRAL (Cochrane Central Register of Controlled Trials; until August 2020), MEDLINE, PsycINFO, PSYNDEX, CINAHL; until the end of January 2018), clinical trial registers, and sources of gray literature (until the end of January 2019). Study selection and data extraction were conducted by 2 review authors independently. Results: Database searches resulted in 15,546 records, of which 241 publications were included, representing 83 completed studies and 60 studies awaiting classification (ie, preregistered studies, study protocols). Almost all completed studies (78/83, 94%) addressed the acute treatment phase, being largely either implemented as stand-alone interventions (66/83, 80%) or blended treatment approaches (12/83, 14%). Studies on TBIs for aftercare (4/83, 5%) and for bridging waiting periods (1/83, 1%) were scarce. Most TBI study arms (n=107) were guided (59/107, 55.1%), delivered via the internet (80/107, 74.8%), and based on cognitive behavioral treatment approaches (88/107, 79.4%). Almost all studies (77/83, 93%) reported information on negative events, considering dropouts from treatment as a negative event. However, reports on negative events were heterogeneous and largely unsystematic. Conclusions: Research has given little attention to studies evaluating TBIs for aftercare and for bridging waiting periods in people with depression, even though TBIs are seen as highly promising in these application areas; thus, high quality studies are urgently needed. In addition, the variety of therapeutic rationales on TBIs has barely been represented by identified studies hindering the consideration of patient preferences when planning treatment. Finally, future studies should use specific guidelines to systematically assess and report negative events. Trial Registration: International Prospective Register of Systematic Reviews (PROSPERO) CRD42016050413; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42016050413. International Registered Report Identifier (IRRID): RR2-10.1136/bmjopen-2018-028042
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Many reviews of the evidence for web-based interventions for specific disorders and for specific populations have been undertaken in recent years.
“many reviews of the evidence for web-based interventions for specific disorders (eg, depression [29-31]) and for specific populations (eg, adolescents and young adults [32,33]) have been undertaken in recent years.”
From Web-Based Interventions to Help Australian Adults Address Depression, Anxiety, Suicidal Ideation, and General Mental Well-being: Scoping Review (2022) · cites this paper as [29]
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Do Parkinson’s disease patients disclose their adverse events spontaneously?
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Internet- und Mobilebasierte Interventionen in der Psychotherapie
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“…being (at least partly) delivered by technical mediums and tailored to the treatment of depression (eg, guided or unguided web-based self-help programs, telephone therapy, or the combination of onsite therapy and web-based self-help; see study protocol by Köhnen et al [12] for details).”
InfluentialSelf-citationKann die Online-Therapie die Psychotherapie sinnvoll ergänzen? Pro
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Flagged first, then by citations
1 of the 132 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
- [1]DGPPN BÄK KBV AWMF for the guideline group unipolar depression S3 Guideline/National Disease Management Guideline Unipolar Depression – Long Version, 2nd edition. Version 5 2015 www.depression.versorgungsleitlinien.de
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Ghosh, A., Cherian, R. J., Wagle, S., Sharma, P., Kannan, K. R., Bajpai, A., & Gupta, N. (2023) · Journal of Medical Internet Research · doi:10.2196/41005 · Cited by 23 · see citing works
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Effectiveness of telemedicine on common mental disorders: An umbrella review and meta-meta-analysis
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Digital Mental Health Amid COVID-19
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“We note that many reviews of the evidence for web-based interventions for specific disorders (eg, depression [29-31]) and for specific populations (eg, adolescents and young adults [32,33]) have been undertaken in recent years.”
BackgroundMultiagent System and Rainfall-Runoff Model in Hydrological Problems: A Systematic Literature Review
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Self-citationWirksamkeitsfokussierte Bewertung von internetbasierten Interventionen: ein Studienprotokoll
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Effectiveness of a mental health mobile application for the academic community: A Longitudinal StudyPreprint
Rilveria, J. R. C., Grepo, L. C., Lim, P. M. Q., Malapit, J. A. N., Tan, B. E. D., Custodio, B. P., Landicho, S. C. D., & Isip-Tan, I. T. (2025) · Research Square · doi:10.21203/rs.3.rs-6321910/v1
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Exploring Digital Therapeutic Alliance (DTA) with Artificial Intelligence (AI): A Systematic Review
Tanisha, Chakma, A., & Grover, N. (2026) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-026-00733-0
- Authors
- Köhnen, M., Dreier, M., Seeralan, T., Kriston, L., Härter, M., Baumeister, H., & Liebherz, S.
- Affiliations
- University Medical Center Hamburg-Eppendorf (DE)
- Universität Ulm (DE)
- Corresponding author
- Köhnen, Moritz
- ORCID
- Venue
- JMIR Mental Health
- Publisher
- JMIR Publications Inc.
- Published
- 2021-02-10
- Volume
- 8
- Issue
- 2
- Pages
- e21700
- ISSN
- 2368-7959 (ISSN-L)
- PMC
- PMC7904404
- OpenAlex
- W3103035999
- Cited by
- 23
- References
- 132
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 3 · 2023: 5 · 2022: 3 · 2021: 5 · 2020: 1
- FWCI
- 0.55
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR Mental Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- depression, major depressive disorder, online intervention, cognitive behavioral therapy, acute treatment, follow-up care, blended treatment, treatment safety, research gaps, digital mental health, treatment discontinuation, waiting lists, guideline recommendations, adults with depression, reporting quality
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