Universität zu Köln

Rzayeva, Uma ORCID: 0000-0002-8294-7171 (2022). A systematic review of digital and face-to-face cognitive behavioral therapy for depression. PhD thesis, Universität zu Köln.

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Abstract

Cognitive behavioral therapy (CBT) represents one of the major treatment options for depressive disorders besides pharmacological interventions. While newly developed digital CBT approaches hold important advantages due to higher accessibility, their relative effectiveness compared to traditional CBT remains unclear. We conducted a systematic literature search to identify all studies that conducted a CBT-based intervention (face-to-face or digital) in patients with major depression. Random-effects meta-analytic models of the standardized mean change using raw score standardization (SMCR) were computed. In 106 studies including n = 11854 patients face-to-face CBT shows superior clinical effectiveness compared to digital CBT when investigating depressive symptoms (p < 0.001, face-to-face CBT: SMCR = 1.97, 95%-CI: 1.74-2.13, digital CBT: SMCR = 1.20, 95%-CI: 1.08-1.32) and adherence (p = 0.014, face-to-face CBT: 82.4%, digital CBT: 72.9%). However, after accounting for differences between face-to-face and digital CBT studies, both approaches indicate similar effectiveness. Important variables with significant moderation effects include duration of the intervention, baseline severity, adherence and the level of human guidance in digital CBT interventions. After accounting for potential confounders our analysis indicates comparable effectiveness of face-to-face and digital CBT approaches. These findings underline the importance of moderators of clinical effects and provide a basis for the future personalization of CBT treatment in depression.

Item Type:	Thesis (PhD thesis)
Translated title:	Title Language Ein systematischer Review der digitalen und Face-to-Face kognitiven Verhaltenstherapie bei Depressionen German
Creators:	Creators Email ORCID ORCID Put Code Rzayeva, Uma UNSPECIFIED orcid.org/0000-0002-8294-7171 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-726448
DOI:	10.1038/s41746-022-00677-8.
Date:	2022
Place of Publication:	NPJ Digital Medicine
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Psychiatrie und Psychotherapie
Subjects:	Psychology Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language Depression English Cognitive behavioral therapy (CBT) English Digital CBT English
Date of oral exam:	19 February 2024
Referee:	Name Academic Title Kambeitz, Joseph Universitätsprofessor Dr. Dipl.-Psych. Walter, Daniel Professor Dr. rer. medic. Dipl.-Psych.
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/72644