title: Internet-delivered transdiagnostic and tailored cognitive behavioral therapy for anxiety and depression: a systematic review and meta-analysis of randomized controlled trials.
abstract: Anxiety and depressive disorders are often comorbid. Transdiagnostic and tailored treatments seem to be promising approaches in dealing with comorbidity. Although several primary studies have examined the effects of Internet-delivered cognitive behavior therapy (iCBT) for anxiety and depression, no meta-analysis including different types of iCBT that address comorbidity has been conducted so far. We conducted systematic searches in databases up to 1 July 2016. Only randomized trials comparing transdiagnostic/tailored iCBT for adult anxiety and/or depression with control groups were included. Nineteen randomized trials with a total of 2952 participants that met inclusion criteria were analyzed. The quality of the studies was high, however the blinding criteria were not fulfilled. The uncontrolled effect size (Hedges' g) of transdiagnostic/tailored iCBT on anxiety and depression outcomes was large and medium for quality of life. The controlled effect size for iCBT on anxiety and depression outcomes was medium to large (anxiety: g = .82, 95% CI: .58-1.05, depression: g = .79, 95% CI: .59-1.00) and medium on quality of life (g = .56, 95% CI: .37-.73). Heterogeneity was small (quality of life) to moderate (anxiety, depression). There was a large effect on generic outcome measures and a moderate effect on comorbidities. When compared to disorder-specific treatments there were no differences on anxiety and quality of life outcomes, however there were differences in depression outcomes. Transdiagnostic and tailored iCBT are effective interventions for anxiety disorders and depression. Future studies should investigate mechanisms of change and develop outcome measures for these interventions.
authors.affiliation: a Doctoral School Evidence-Based Assessment and Psychological Interventions , Babeș-Bolyai University , Cluj-Napoca , Romania.
authors.forename: Costina Ruxandra
authors.initials: CR
authors.lastname: Păsărelu
authors.affiliation: b Department of Behavioural Sciences and Learning , Linköping University , Linkoping , Sweden.|c Psychiatry Section, Department of Clinical Neuroscience , Karolinska Institutet , Stockholm , Sweden.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Andersson
authors.affiliation: b Department of Behavioural Sciences and Learning , Linköping University , Linkoping , Sweden.
authors.forename: Lise
authors.initials: L
authors.lastname: Bergman Nordgren
authors.affiliation: d Department of Clinical Psychology and Psychotherapy , Babeș-Bolyai University , Cluj-Napoca , Romania.
authors.forename: Anca
authors.initials: A
authors.lastname: Dobrean
mesh_terms: D001008:Anxiety Disorders / Q000453:epidemiology* / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology* / Q000628:therapy*; D006801:Humans; D020407:Internet; D016032:Randomized Controlled Trials as Topic; D013813:Therapy, Computer-Assisted
keywords: Internet; cognitive behavioral therapy; meta-analysis; tailored; transdiagnostic