Effectiveness of online psychological and psychoeducational interventions to prevent depression: Systematic review and meta-analysis of randomized controlled trials

Alina Rigabert; Emma Motrico; Patricia Moreno-Peral; Davinia María Resurrección; Sonia Conejo-Cerón; Pim Cuijpers; Carmen Martín-Gómez; Yolanda López-Del-Hoyo; Juan Ángel Bellón

doi:10.1016/j.cpr.2020.101931

Effectiveness of online psychological and psychoeducational interventions to prevent depression: Systematic review and meta-analysis of randomized controlled trials

Clin Psychol Rev. 2020 Dec:82:101931. doi: 10.1016/j.cpr.2020.101931. Epub 2020 Oct 24.

Authors

Alina Rigabert¹, Emma Motrico², Patricia Moreno-Peral³, Davinia María Resurrección⁴, Sonia Conejo-Cerón³, Pim Cuijpers⁵, Carmen Martín-Gómez⁴, Yolanda López-Del-Hoyo⁶, Juan Ángel Bellón⁷

Affiliations

¹ Department of Psychology, Universidad Loyola Andalucía, Seville, Spain; Fundación Andaluza Beturia para la Investigación en Salud, Huelva, Spain.
² Department of Psychology, Universidad Loyola Andalucía, Seville, Spain; Prevention and Health Promotion Research Network (redIAPP), ISCIII, Spain. Electronic address: emotrico@uloyola.es.
³ Prevention and Health Promotion Research Network (redIAPP), ISCIII, Spain; Institute of Biomedical Research in Málaga (IBIMA), Málaga, Spain; Research Unit, Primary Care District of Málaga-Guadalhorce, Málaga, Spain.
⁴ Department of Psychology, Universidad Loyola Andalucía, Seville, Spain.
⁵ Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands.
⁶ Prevention and Health Promotion Research Network (redIAPP), ISCIII, Spain; Instituto de Investigación Sanitaria de Aragón, Universidad de Zaragoza, Spain.
⁷ Prevention and Health Promotion Research Network (redIAPP), ISCIII, Spain; Institute of Biomedical Research in Málaga (IBIMA), Málaga, Spain; Research Unit, Primary Care District of Málaga-Guadalhorce, Málaga, Spain; El Palo Health Center, Andalusian Health Service (SAS), Málaga, Spain; Department of Public Health and Psychiatry, University of Málaga (UMA), Spain.

PMID: 33137611
DOI: 10.1016/j.cpr.2020.101931

Abstract

Although evidence exists for the efficacy of interventions to prevent depression, little is known about its prevention through online interventions. We aim to assess the effectiveness of online psychological and psychoeducational interventions to prevent depression in heterogeneous populations. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted based on literature searches in eight electronic data bases and other sources from inception to 22 July 2019. Of the 4181 abstracts reviewed, 501 were selected for full-text review, and 21 RCTs met the inclusion criteria, representing 10,134 participants from 11 countries and four continents. The pooled SMD was -0·26 (95%CI: -0·36 to -0·16; p < 0.001) and sensitivity analyses confirmed the robustness of this result. We did not find publication bias but there was substantial heterogeneity (I² = 72%; 95%CI, 57% to 82%). A meta-regression including three variables explained 81% of the heterogeneity. Indicated prevention and interactive website delivery were statistically associated with higher effectiveness, and no association was observed with risk of bias. Online psychological and psychoeducational interventions have a small effect in reducing depressive symptoms in non-depressed and varied populations, and the quality of evidence is moderate. Given that these types of interventions are very accessible and can be applied on a wide scale, they should be further developed and implemented. Registration details: Registration number (PROSPERO): CRD42014014804.

Keywords: Depression; Meta-analysis; Online interventions; Prevention; Systematic review.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Depression* / prevention & control
Humans
Randomized Controlled Trials as Topic