Abstract
BackgroundThe incidence of depression is increasing worldwide. Depression can lead to poor physical health and even suicide. However, in high-income countries, only about 50% of the people with depression receive appropriate therapy, and the detection rate of depression in low- and middle-income countries is relatively lower. Web-based self-management enables remote treatment and solves the problem of insufficient psychological treatment resources. Many past studies have evaluated the effectiveness of web-based self-management of depression, but there has been no synthesis of evidence. Therefore, this study conducted a meta-analysis of the effectiveness of web-based self-management for depressive symptoms.MethodSix electronic databases (Cochrane Central Register of Controlled Trials, PubMed, Web of Science, Embase, CINAHL, and PsycINFO) were searched in September 2020. All literature referring to the effects of web-based self-management on depression were shortlisted by performing the medical subject headings (MeSH) search combined with a text word search.ResultsA total of 18 eligible randomized controlled trials were identified, and the results from 3055 participants were consolidated. The web-based self-management group exhibited a greater reduction in depressive symptoms than the control group (g = − 0.46; 95% CI: 0.62,0.30), and there was no evidence of publication bias. Subgroup analysis revealed that patients with moderate-to-severe depression benefited from web-based self-management interventions. In terms of interventions, those based on cognitive behavioral therapy (CBT) were highly effective. We noted that the longer the intervention time, the better was the improvement in the status of depression. Furthermore, it was established that participants who communicated with therapists and showed greater adherence to the intervention experienced significant improvement in their symptoms. The results of the intervention group were better than those of the waiting-list, treatment-as-usual, and online psychoeducation groups.ConclusionsWeb-based self-management is a promising therapy for depression. Future research should aim to refine these aspects of the intervention to achieve a beneficial impact.
Highlights
According to the World Health Organization’s World Mental Health Survey (WMH), the lifetime prevalence of severe depression varies widely across country, with 19.2% people in the United States, 21% in France, 17.9% in the Netherlands, 6.6% in Japan, and 18.4% in Brazil being afflicted by this condition [1]
The web-based self-management group exhibited a greater reduction in depressive symptoms than the control group (g = − 0.46; 95% confidence intervals (CI): 0.62,0.30), and there was no evidence of publication bias
Subgroup analysis revealed that patients with moderate-to-severe depression benefited from web-based self-management interventions
Summary
According to the World Health Organization’s World Mental Health Survey (WMH), the lifetime prevalence of severe depression varies widely across country, with 19.2% people in the United States, 21% in France, 17.9% in the Netherlands, 6.6% in Japan, and 18.4% in Brazil being afflicted by this condition [1]. The lifetime prevalence of depression was noted to be higher in high-income countries (14.6%) than in low- and middle-income countries (11.1%) [2]. The results of a Hong Kong-based cohort study suggest that depressive symptoms are likely to be independent causes of suicide [6, 7]. Depression can lead to poor physical health and even suicide. In high-income countries, only about 50% of the people with depression receive appropriate therapy, and the detection rate of depression in low- and middle-income countries is relatively lower. Many past studies have evaluated the effectiveness of web-based self-management of depression, but there has been no synthesis of evidence. This study conducted a meta-analysis of the effectiveness of web-based self-management for depressive symptoms
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