1. Two decades of digital interventions for anxiety disorders
- Author
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Darin Pauley, Pim Cuijpers, Clara Miguel, Eirini Karyotaki, Davide Papola, Clinical Psychology, APH - Global Health, APH - Mental Health, World Health Organization (WHO) Collaborating Center, and APH - Methodology
- Subjects
Generalized anxiety disorder ,business.industry ,Panic disorder ,effect size ,Social anxiety ,Psychological intervention ,effectiveness ,digital interventions ,medicine.disease ,meta-analysis ,Psychiatry and Mental health ,SDG 3 - Good Health and Well-being ,Meta-analysis ,medicine ,Anxiety ,medicine.symptom ,business ,Applied Psychology ,Anxiety disorder ,Agoraphobia ,Clinical psychology ,Anxiety disorders - Abstract
Background Digital interventions for anxiety disorders are a promising solution to address barriers to evidence-based treatment access. Precise and powerful estimates of digital intervention effectiveness for anxiety disorders are necessary for further adoption in practice. The present systematic review and meta-analysis examined the effectiveness of digital interventions across all anxiety disorders and specific to each disorder v. wait-list and care-as-usual controls. Methods A systematic search of bibliographic databases identified 15 030 abstracts from inception to 1 January 2020. Forty-seven randomized controlled trials (53 comparisons; 4958 participants) contributed to the meta-analysis. Subgroup analyses were conducted by an anxiety disorder, risk of bias, treatment support, recruitment, location and treatment adherence. Results A large, pooled effect size of g = 0.80 [95% Confidence Interval: 0.68–0.93] was found in favor of digital interventions. Moderate to large pooled effect sizes favoring digital interventions were found for generalized anxiety disorder (g = 0.62), mixed anxiety samples (g = 0.68), panic disorder with or without agoraphobia (g = 1.08) and social anxiety disorder (g = 0.76) subgroups. No subgroups were significantly different or related to the pooled effect size. Notably, the effects of guided interventions (g = 0.84) and unguided interventions (g = 0.64) were not significantly different. Supplemental analysis comparing digital and face-to-face interventions (9 comparisons; 683 participants) found no significant difference in effect [g = 0.14 favoring digital interventions; Confidence Interval: −0.01 to 0.30]. Conclusion The precise and powerful estimates found further justify the application of digital interventions for anxiety disorders in place of wait-list or usual care.
- Published
- 2023
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