Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: a meta-analysis

• Published in: PloS one 2010-10, Vol.5 (10), p.e13196-e13196
• Main Authors: Andrews, Gavin, Cuijpers, Pim, Craske, Michelle G, McEvoy, Peter, Titov, Nickolai
• Format: Article
• Language: English
• Subjects: Acceptability; Active control; Analysis; Anxiety; Anxiety - therapy; Behavior therapy; Behavioral medicine; Bias; Care and treatment; Clinical trials; Cognitive ability; Cognitive behavioral therapy; Comorbidity; Depressive Disorder - therapy; Diagnostic systems; Disorders; Fear & phobias; Health care; Human behavior; Humans; Literature reviews; Medical research; Mental depression; Mental Health; Mental Health/Anxiety Disorders; Mental Health/Mood Disorders; Meta-analysis; Panic attacks; Patient compliance; Randomization; Studies; Therapy; Therapy, Computer-Assisted; Treatment Outcome
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0013196

Depression and anxiety disorders are common and treatable with cognitive behavior therapy (CBT), but access to this therapy is limited. Review evidence that computerized CBT for the anxiety and depressive disorders is acceptable to patients and effective in the short and longer term. Systematic reviews and data bases were searched for randomized controlled trials of computerized cognitive behavior therapy versus a treatment or control condition in people who met diagnostic criteria for major depression, panic disorder, social phobia or generalized anxiety disorder. Number randomized, superiority of treatment versus control (Hedges g) on primary outcome measure, risk of bias, length of follow up, patient adherence and satisfaction were extracted. 22 studies of comparisons with a control group were identified. The mean effect size superiority was 0.88 (NNT 2.13), and the benefit was evident across all four disorders. Improvement from computerized CBT was maintained for a median of 26 weeks follow-up. Acceptability, as indicated by adherence and satisfaction, was good. Research probity was good and bias risk low. Effect sizes were non-significantly higher in comparisons with waitlist than with active treatment control conditions. Five studies comparing computerized CBT with traditional face-to-face CBT were identified, and both modes of treatment appeared equally beneficial. Computerized CBT for anxiety and depressive disorders, especially via the internet, has the capacity to provide effective acceptable and practical health care for those who might otherwise remain untreated. Australian New Zealand Clinical Trials Registry ACTRN12610000030077.