title: Transdiagnostic computerised cognitive behavioural therapy for depression and anxiety: A systematic review and meta-analysis.
abstract: An increasing number of computerised transdiagnostic cognitive behavioural therapy programs (TD-cCBT) have been developed in the past decade, but there are no meta-analyses to explore the efficacy of these programs, nor moderators of the effects. The current meta-analysis focused on studies evaluating TD-cCBT interventions to examine their effects on anxiety, depression and quality of life (QOL). Results from 17 RCTs showed computerised TD-cCBT outperformed control conditions on all outcome measures at post-treatment, with large effect sizes for depression (g's=.84), and medium effect sizes for anxiety (g=.78) and QOL (g=.48). RCT quality was generally good, although heterogeneity was moderate to high. Further analyses revealed that studies comparing TD-cCBT to waitlist controls had the largest differences (g=.93) compared to active (g=.59) and usual care control groups (g=.37) on anxiety outcomes, but there was no influence of control group subtype on depression outcomes. Treatment length, symptom target (mixed versus anxiety only), treatment design (standardised versus tailored), and therapist experience (students versus qualified therapists) did not influence the results. Preliminary evidence from 4 comparisons with disorder-specific treatments suggests transdiagnostic treatments are as effective for reducing anxiety, and there may be small but superior outcomes for TD-cCBT programs for reducing depression (g=.21) and improving QOL (g=.21) compared to disorder-specific cCBT. These findings show that TD-cCBT programs are efficacious, and have comparable effects to disorder-specific cCBT programs.
authors.affiliation: Clinical Research Unit for Anxiety and Depression (CRUfAD), School of Psychiatry, Faculty of Medicine, UNSW Australia at St Vincent's Hospital, Sydney, Australia. Electronic address: j.newby@unsw.edu.au.
authors.forename: Jill M
authors.initials: JM
authors.lastname: Newby
authors.affiliation: Faculty of Social and Human Sciences, University of Southampton, Southampton, UK.
authors.forename: Conal
authors.initials: C
authors.lastname: Twomey
authors.affiliation: Clinical Research Unit for Anxiety and Depression (CRUfAD), School of Psychiatry, Faculty of Medicine, UNSW Australia at St Vincent's Hospital, Sydney, Australia.
authors.forename: Susan Shi
authors.initials: SS
authors.lastname: Yuan Li
authors.affiliation: Clinical Research Unit for Anxiety and Depression (CRUfAD), School of Psychiatry, Faculty of Medicine, UNSW Australia at St Vincent's Hospital, Sydney, Australia.
authors.forename: Gavin
authors.initials: G
authors.lastname: Andrews
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology / Q000628:therapy*; D001521:Behavior Therapy / Q000379:methods*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000523:psychology / Q000628:therapy*; D006801:Humans; D011788:Quality of Life; D013813:Therapy, Computer-Assisted / Q000379:methods*; D014850:Waiting Lists
keywords: Anxiety; Depression; Meta-analysis; Systematic review; Transdiagnostic; Transdiagnostic, Cognitive Behaviour Therapy (CBT), depression, anxiety, computer, internettreatment outcome