Effectiveness of Internet- and Mobile-Based Cognitive Behavioral Therapy to Reduce Suicidal Ideation and Behaviors: Protocol for a Systematic Review and Meta-Analysis of Individual Participant Data

Int J Environ Res Public Health. 2020 Jul 17;17(14):5179. doi: 10.3390/ijerph17145179.

Abstract

Internet- and mobile-based cognitive behavioral therapy (iCBT) might reduce suicidal ideation. However, recent meta-analyses found small effect sizes, and it remains unclear whether specific subgroups of participants experience beneficial or harmful effects. This is the study protocol for an individual participant meta-analysis (IPD-MA) aiming to determine the effectiveness of iCBT on suicidal ideation and identify moderators. We will systematically search CENTRAL, PsycINFO, Embase, and Pubmed for randomized controlled trials examining guided or self-guided iCBT for suicidality. All types of control conditions are eligible. Participants experiencing suicidal ideation will be included irrespective of age, diagnoses, or co-interventions. We will conduct a one-stage IPD-MA with suicidal ideation as the primary outcome, using a continuous measure, reliable improvement and deterioration, and response rate. Moderator analyses will be performed on participant-, study-, and intervention-level. Two independent reviewers will assess risk of bias and the quality of evidence using Cochrane's Risk of Bias Tool 2 and GRADE. This review was registered with OSF and is currently in progress. The IPD-MA will provide effect estimates while considering covariates and will offer novel insights into differential effects on a participant level. This will help to develop more effective, safe, and tailored digital treatment options for suicidal individuals.

Keywords: cognitive behavioral therapy; iCBT; individual participant data meta-analysis; internet-based; mobile-based; online; review; suicidal ideation; suicide.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cognitive Behavioral Therapy*
  • Humans
  • Internet
  • Meta-Analysis as Topic
  • Suicidal Ideation*
  • Systematic Reviews as Topic