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Self-Help and Internet-Guided Interventions in Depression and Anxiety Disorders: A Systematic Review of Meta-Analyses

Published online by Cambridge University Press:  07 November 2014

Edith van‘t Hof ,
Pim Cuijpers  and
Dan J. Stein
Edith van‘t Hof
Affiliation:
Ms. van‘t Hof is a researcher in the Department of Psychiatry and Mental Health at the, University of Cape Town
Pim Cuijpers*
Affiliation:
Dr. Cuijpers is head of the Department of Clinical Psychology at VU, University in Amsterdam
Dan J. Stein
Affiliation:
Dr. Stein is professor in and chair of the Department of Psychiatry and Mental Health at the, University of Cape Town, and is on faculty at the Mount Sinai School of Medicine in New York City.
*
Pim Cuijpers, PhD, Department of Clinical Psychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands; E-mail: [email protected]
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Abstract

There is a growing database of research on self-help and Internet-guided interventions in the treatment of common mental disorders, and a number of meta-analyses have now been published. This article provides a systematic review of meta-analyses on the efficacy of self-help interventions, including Internet-guided therapy, for depression and anxiety disorders. Searches were conducted in PubMed, PsychINFO, EMBASE, and the Cochrane database for statistical meta-analyses of randomized, controlled trials of self-help or Internet-guided interventions for depression or anxiety disorders published in English. Reference lists were also used to find additional studies. Effect sizes were tabulated; 13 meta-analyses reported medium to large effect sizes for self-help interventions. Studies included in the meta-analyses differed in samples, type of self-help (eg, computer-aided, Internet-guided), control conditions, and study design. The meta-analyses indicate that self-help methods are effective in a range of different disorders, including depression and anxiety disorders. Most meta-analyses found relatively large effect sizes for self-help treatments, independent of the type of self-help, and comparable to effect sizes for face-to-face treatments. However, further research is needed to optimize the use of self-help methods.

Type
Research Article
Information
CNS Spectrums , Volume 14 , Issue S3 , 2009 , pp. 34 - 40
Copyright
Copyright © Cambridge University Press 2009

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References

1.Kessler, RC, Angermeyer, M, Anthony, JC, et al.Lifetime prevalence and age-of-onset distributions of mental disorders in the World Health Organization’s World Mental Health Survey Initiative. >World Psychiatry. 2007;6(3):168–176.Google Scholar
2.World Health Organization. Integrating Mental Health Into Primary Care: A Global Perspective. Geneva, Switzerland: World Health Organization; 2008.Google Scholar
3.Mendlowicz, MV, Stein, MB. Quality of life in individuals with anxiety disorders. >Am J Psychiatry. 2000;157(5):669–682.Google Scholar
4.Saarni, SI, Suvisaari, J, Sintonen, H, et al.Impact of psychiatric disorders on health-related quality of life: general population survey. >Br J Psychiatry. 2007;190:326–332.Google Scholar
5.Ustün, TB, Ayuso-Mateos, JL, Chatterji, S, Mathers, C, Murray, CJ. Global burden of depressive disorders in the year 2000. Br J Psychiatry. 2004;184:386–392.Google Scholar
6.World Health Organization. Mental Health Atlas 2005. Geneva, Switzerland: World Health Organization; 2005.Google Scholar
7.Lopez, AD, Mathers, CD. Measuring the global burden of disease and epidemiological transitions: 2002-2030. Ann Trop Med Parasitol. 2006;100(5-6):481–499.Google Scholar
8.Mathers, CD, Loncar, D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006;3(11):e442.Google Scholar
9.Murray, CJ, Lopez, AD. Evidence-based health policy: lessons from the Global Burden of Disease Study. Science. 1996;274(5288):740–743.CrossRefGoogle ScholarPubMed
10.Cuijpers, P, Smit, F. Excess mortality in depression: a meta-analysis of community studies. J Affect Disord. 2002;72(3):227–236.Google Scholar
11.Berto, P, D’Ilario, D, Ruffo, P, Di Virgilio, R, Rizzo, F. Depression: cost-of-illness studies in the international literature, a review. J Ment Health Policy Econ. 2000;3(1):3–10.Google Scholar
12.Smit, F, Cuijpers, P, Oostenbrink, J, Batelaan, N, de Graaf, R, Beekman, A. Costs of nine common mental disorders: implications for curative and preventive psychiatry. J Ment Health Policy Econ. 2006;9(4):193–200.Google Scholar
13.Demyttenaere, K, Bruffaerts, R, Posada-Villa, J, et al. and the WHO World Mental Health Survey Consortium. Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA. 2004;291(21):2581–2590.Google Scholar
14.Wang, PS, Angermeyer, M, Borges, G, et al.Delay and failure in treatment seeking after first onset of mental disorders in the World Health Organization’s World Mental Health Survey Initiative. World Psychiatry. 2007;6(3):177–185.Google Scholar
15.Andrews, G, Issakidis, C, Sanderson, K, Corry, J, Lapsley, H. Utilising survey data to inform public policy: comparison of the cost-effectiveness of treatment of ten mental disorders. Br J Psychiatry. 2004;184:526–533.Google Scholar
16.Hirai, M, Clum, GA. A meta-analytic study of self-help interventions for anxiety problems. Behav Ther. 2006;37(2):99–111.Google Scholar
17.Cuijpers, P, Schuurmans, J. Self-help interventions for anxiety disorders: an overview. Curr Psychiatry Rep. 2007;9(4):284–290.Google Scholar
18.den Boer, PC, Wiersma, D, Van den Bosch, RJ. Why is self-help neglected in the treatment of emotional disorders? A meta-analysis. Psychol Med. 2004;34(6):959–971.Google Scholar
19.Anderson, L, Lewis, G, Araya, R, et al.Self-help books for depression: how can practitioners and patients make the right choice? Br J Gen Pract. 2005;55(514):387–392.Google Scholar
20.Cuijpers, P. Bibliotherapy in unipolar depression: a meta-analysis. J Behav Ther Exp Psychiatry. 1997;28(2):139–147.Google Scholar
21.Spek, V, Cuijpers, P, Nyklicek, I, Riper, H, Keyzer, J, Pop, V. Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis. Psychol Med. 2007;37(3):319–328.Google Scholar
22.Apodaca, TR, Miller, WR. A meta-analysis of the effectiveness of bibliotherapy for alcohol problems. J Clin Psychol. 2003;59(3):289–304.Google Scholar
23.Marrs, RW. A meta-analysis of bibliotherapy studies. Am J Community Psychol. 1995;23(6):843–870.Google Scholar
24.Scogin, F, Bynum, J, Stephens, G, Calhoon, S. Efficacy of self-administered treatment programs: meta-analytic review. Profess Psychol Res Pract. 1990;21:42–47.Google Scholar
25.Butler, AC, Chapman, JE, Forman, EM, Beck, AT. The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clin Psychol Rev. 2006;26(1):17–31.Google Scholar
26.Mains, JA, Scogin, FR. The effectiveness of self-administered treatments: a practice-friendly review of the research. J Clin Psychol. 2003;59(2):237–246.Google Scholar
27.Osgood-Hynes, DJ, Greist, JH, Marks, IM, et al.Self-administered psychotherapy for depression using a telephone-accessed computer system plus booklets: an open U.S.-U.K. study. J Clin Psychiatry. 1998;59(7):358–365.Google Scholar
28.Scogin, F, Floyd, M, Jamison, C, Ackerson, J, Landreville, P, Bissonnette, L. Negative outcomes: what is the evidence on self-administered treatments? J Consult Clin Psychol. 1996;64(5):1086–1089.CrossRefGoogle ScholarPubMed
29.Ghaderi, A. Attrition and outcome in self-help treatment for bulimia nervosa and binge eating disorder: a constructive replication. Eat Behav. 2006;7(4):300–308.Google Scholar
30.Khan, N, Bower, P, Rogers, A. Guided self-help in primary care mental health: meta-synthesis of qualitative studies of patient experience. Br J Psychiatry. 2007;191:206–211.Google Scholar
31.Cuijpers, P, van Straten, A, Andersson, G. Internet-administered cognitive behavior therapy for health problems: a systematic review. J Behav Med. 2008;31(2):169–177.CrossRefGoogle ScholarPubMed
32.Marks, I, Cavanagh, K, Gaga, L. Hands-on Help: Computer-aided Psychotherapy. New York, NY: Psychology Press; 2007.Google Scholar
33.Willemse, GR, Smit, F, Cuijpers, P, Tiemens, BG. Minimal-contact psychotherapy for sub-threshold depression in primary care. Randomised trial. Br J Psychiatry. 2004;185:416–421.Google Scholar
34.Cuijpers, P, Riber, H. Internet-guided self help for common mental disorders: state of the art and challenges of the future. In: Sorbi, MJ, Ruddel, H, Buhring, MEF, eds. Frontiers in Stepped Ecare. Utrecht, The Netherlands: University of Utrecht; 2007.Google Scholar
35.Wright, JH, Wright, AS, Albano, AM, et al.Computer-assisted cognitive therapy for depression: maintaining efficacy while reducing therapist time. Am J Psychiatry. 2005;162(6):1158–1164.Google Scholar
36.Rosen, GM, Glasgow, RE, Barrera, M Jr.A controlled study to assess the clinical efficacy of totally self-administered systematic desensitization. J Consult Clin Psychol. 1976;44(2):208–217.Google Scholar
37.Christensen, H, Griffiths, KM, Jorm, AF. Delivering interventions for depression by using the internet: randomised controlled trial. BMJ. 2004;328(7434):265.Google Scholar
38.Ahmead, M, Bower, P. The effectiveness of self help technologies for emotional problems in adolescents: a systematic review. Child Adolesc Psychiatry Ment Health. 2008;2(1):20.Google Scholar
39.Bower, P, Richards, D, Lovell, K. The clinical and cost-effectiveness of self-help treatments for anxiety and depressive disorders in primary care: a systematic review. Br J Gen Pract. 2001;51(471):838–845.Google Scholar
40.Gellatly, J, Bower, P, Hennessy, S, Richards, D, Gilbody, S, Lovell, K. What makes self-help interventions effective in the management of depressive symptoms? Meta-analysis and meta-regression. Psychol Med. 2007;37(9):1217–1228.Google Scholar
41.Gould, RA, Clum, GA. A meta-analysis of self-help treatment approaches. Clin Psychol Rev. 1993;13(2):169–186.Google Scholar
42.Gregory, RJ, Canning, SS, Lee, TW, Wise, JC. Cognitive bibliotherapy for depression: a meta-analysis. Profess Psychol Res Pract. 2004;35:275–280.Google Scholar
43.Menchola, M, Arkowitz, H, Burke, BL. Efficacy of self-administered treatments for depression and anxiety. Profess Psychol Res Pract. 2007;38(4):421–429.Google Scholar
44.van Straten, A, Cuijpers, P, Smits, N. Effectiveness of a web-based self-help intervention for symptoms of depression, anxiety, and stress: randomized controlled trial. J Med Internet Res. 2008;10(1):e7.Google Scholar
45.Slack, WV. A path to computer-empowered patients. Forum: Risk Management Foundation of the Harvard Medical Institutions. 1998;19(3):10–11. Available at: http://www.rmf.harvard.edu/files/documents/Forum_V19N3.pdf. Accessed February 4, 2009.Google Scholar
46.National Institute for Health and Clinical Excellence. NICE clinical guideline 22 - Anxiety (amended). London, England: National Institute for Health and Clinical Excellence; 2007.Google Scholar