Web-Based Interventions Supporting Adolescents and Young People With Depressive Symptoms: Systematic Review and Meta-Analysis.
Web-Based Interventions Supporting Adolescents and Young People With Depressive Symptoms: Systematic Review and Meta-Analysis.
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DOI：
10.2196/mhealth.8624
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发表时间：
2017-12-08
影响因子：
5
通讯作者：
Lahti M
中科院分区：
文献类型：
--
作者：
Välimäki M;Anttila K;Anttila M;Lahti M
尽管以前关于基于信息和通信技术(ICT)的干预措施对有抑郁症状的青少年的心理健康的研究已经被合并到一些系统审查中，但关于所使用的干预措施、参与者参与这些干预措施以及这些干预措施如何发挥作用，仍然缺乏连贯的信息。我们对试验进行了系统的回顾和荟萃分析，以描述基于网络的干预措施对患有抑郁或抑郁症状、焦虑和压力的青少年的支持效果。我们还探讨了干预措施的内容，因为以前对这些目的的网上干预措施的详细内容缺乏连贯一致的理解。我们纳入了平行的随机对照试验，目标是有抑郁和焦虑症状或诊断的青少年或年龄在10岁和24岁之间的年轻人。这些干预措施来自旨在支持青少年心理健康的原始研究，并通过基于网络的信息和通信技术提供。在确定的2087项记录中，27篇论文(22项研究)符合纳入标准。在对22项研究进行叙述性分析的基础上，发现了各种基于网络的干预措施；最常用的干预措施是基于认知行为疗法。进一步对15项研究(4979名参与者)进行了荟萃分析。干预结束时，干预组(10项研究)的抑郁症状有显著改善(P=0.02，中位数1.68，95%可信区间3.11~0.25)，6个月后(3项研究，P=0.01，中位数1.78，95%可信区间3.20~0.37)。网络干预组的焦虑症状(8项研究；P<；.001，中位数1.47，95%可信区间2.36-0.59)和情绪和感觉(2项研究；P=0.04，中位数5.55，95%可信区间10.88-0.22)也有所改善，但压力得分没有差异。然而，在短期研究(11项研究；P=.007，中位数1.31，95%可信区间1.08-1.58)和中期研究(3项研究；P=0.02，中位数1.65，95%可信区间1.09-2.49)中，干预组的青少年更早地离开了研究。我们没有发现任何评估基于网络的干预成本的研究。尽管广泛报道说，信息技术的使用对患有抑郁症的青少年有益，但我们的综述结果显示，对青少年的心理健康只有短期影响，而长期影响仍然值得怀疑，因为审查的研究数量有限。关于基于网络的干预措施的经济效益的信息仍然缺乏。研究的质量，特别是与自然减员率和选择性报告有关的偏见，仍然需要认真关注。
Although previous studies on information and communication technology (ICT)–based intervention on mental health among adolescents with depressive symptoms have already been combined in a number of systematic reviews, coherent information is still missing about interventions used, participants’ engagement of these interventions, and how these interventions work. We conducted a systematic review and meta-analysis of trials to describe the effectiveness of Web-based interventions to support adolescents with depression or depressive symptoms, anxiety, and stress. We also explored the content of the interventions, as there has previously been a lack of coherent understanding of the detailed content of the Web-based interventions for these purposes. We included parallel randomized controlled trials targeted at adolescents, or young people in the age range of 10 and 24 years, with symptoms or diagnoses of depression and anxiety. The interventions were from original studies aimed to support mental health among adolescents, and they were delivered via Web-based information and communication technology. Out of 2087 records identified, 27 papers (22 studies) met the inclusion criteria. On the basis of a narrative analysis of 22 studies, a variety of Web-based interventions were found; the most commonly used intervention was based on cognitive behavioral therapy. Meta-analysis was further conducted with 15 studies (4979 participants). At the end of the intervention, a statistically significant improvement was found in the intervention group (10 studies) regarding depressive symptoms (P=.02, median 1.68, 95% CI 3.11-0.25) and after 6 months (3 studies; P=.01, median 1.78, 95% CI 3.20-0.37). Anxiety symptoms (8 studies; P<.001, median 1.47, 95% CI 2.36-0.59) and moods and feelings (2 studies; P=.04, median 5.55, 95% CI 10.88-0.22) improved as well in the Web-based intervention group, but there was no difference in stress scores. However, adolescents in the intervention group left the study early more often, both in short-term studies (11 studies; P=.007, median 1.31, 95% CI 1.08-1.58) and mid-term studies (3 studies; P=.02, median 1.65, 95% CI 1.09-2.49). We did not find any studies that had assessed the costs of the Web-based interventions. Despite widely reported promises that information technology use is beneficial to adolescents with depression, the results of our review show only short-term effects on adolescents’ mental well-being, whereas long-term effects remain questionable because of the limited number of studies reviewed. Information about the economic benefits of Web-based interventions is still lacking. The quality of the studies, especially biases related to attrition rates and selective reporting, still needs serious attention.
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