Internet-based and mobile-based cognitive behavioral therapy for chronic diseases: A systematic review and meta-analysis

Tiffany Junchen TAO, Teck Kuan LIM, Ernest Tsun Fung YEUNG, Huinan LIU, Phoenix Bibha SHRIS, Ka Yin Lawrence MA, Tatia Mei Chun LEE, Wai Kai HOU

Research output: Contribution to journalArticlespeer-review

4 Citations (Scopus)

Abstract

Positive adjustment to chronic diseases reduces psychiatric comorbidity and enhances quality of life. Very little is known about the benefit of internet-based and mobile-based Cognitive Behavioral Therapy (IM-CBT) on physical outcomes and its reciprocal interactions with psychiatric outcomes, the active therapeutic elements, and effect moderators among people with major chronic medical conditions. In this systematic review and meta-analysis (PROSPERO: CRD42022265738), CINAHL of Systematic Reviews, MEDLINE, PsycINFO, PubMed, Web of Science are systematically searched up to 1 June 2022, for randomized controlled trials (RCTs) comparing IM-CBT against non-CBT control condition(s) among people with chronic disease(s). Primary outcomes include improvements in psychiatric symptoms (depressive, anxiety, PTSD symptoms, general psychological distress) from baseline to post-intervention and follow-ups. Secondary outcomes include improvements in physical distress (physical symptoms, functional impairment, self-rated ill health, objective physiological dysfunction). Among 44 RCTs (5077 patients with seven different chronic diseases), IM-CBT improves depressive symptoms, anxiety symptoms, and general psychological distress at post-intervention and across follow-ups, and improves physical distress and functional impairment at post-intervention. Preliminary evidence suggests that behavioral modification and problem-solving could be necessary components to reduce psychiatric symptoms in IM-CBT, whereas cognitive restructuring, psychoeducation, and mindfulness elements relate to reduced physical distress. IM-CBT shows stronger benefits in chronic pain, cancer, arthritis, and cardiovascular disease, relative to other conditions. Changes in psychiatric symptoms and physical distress prospectively predict each other over time. IM-CBT is an effective intervention for comprehensive symptom management among people with chronic diseases. Copyright © 2023 The Author(s).

Original languageEnglish
Article number80
Journalnpj Digital Medicine
Volume6
DOIs
Publication statusPublished - Apr 2023

Citation

Tao, T. J., Lim, T. K., Yeung, E. T. F., Liu, H., Shris, P. B., Ma, L. K. Y., . . . Hou, W. K. (2023). Internet-based and mobile-based cognitive behavioral therapy for chronic diseases: A systematic review and meta-analysis. npj Digital Medicine, 6. Retrieved from https://doi.org/10.1038/s41746-023-00809-8

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