Effectiveness of telepsychiatry interventions for youth with depressive and/or anxiety disorders: A systematic review with meta-analysis

Abstract

Objective

Since the onset of the COVID-19 pandemic, rates of anxiety and depression in youth have risen. Telepsychiatry is a potential mode of intervention for such digital natives. This systematic review aims to examine the effectiveness of telepsychiatry for youth with depression and/or anxiety.

Methods

Four electronic databases, PubMed, MEDLINE, Embase, PsycINFO, were searched from their inception to May 12, 2024. Included studies were assessed for study quality and risk of bias.

Results

A search returning 29,944 records yielded 26 included studies, comprising 1,558 youths. Of 13 studies comparing depressive symptoms pre- and post-telepsychiatry intervention, symptom severity was significantly lower post-intervention compared to baseline (Hedges’ g: 0.83; 95% CI: 0.59, 1.08). Similarly, of six studies comparing pre- and post-telepsychiatry intervention anxiety symptoms, anxiety scores were significantly lower post-intervention (Hedges’ g: 1.15; 95% CI: 0.79, 1.50). Patients undergoing telepsychiatry also had superior outcomes when compared to waitlist control groups for depression (Hedges’ g: 0.54; 95% CI: 0.23, 0.85) but not anxiety (Hedges’ g: 0.50; 95% CI: −0.09, 1.10). Certainty of these estimates ranged from moderate to very low. Qualitative feedback noted subjective improvement in symptoms and high levels of satisfaction.

Conclusion

Telepsychiatry has potential as a therapeutic intervention for youth anxiety and depression. Further research with more controlled methodology is needed for development of recommendations that can guide growing use of this technology.

Plain language summary

Effectiveness of Telemedicine in Treating Youth with Depression and/or Anxiety: Since the COVID-19 pandemic, many psychiatry providers have adopted the use of telemedicine. This study evaluates the effectiveness of telemedicine in treating youth, a population known as “digital natives,” with depression and/or anxiety. This study combined the findings from 26 studies involving 1,558 youths. Overall, in youths that were treated with telepsychiatry, depression and anxiety symptoms improved after treatment. For youths with depression, those who were treated with telepsychiatry had better outcomes compared to those who were put on a waitlist, but for youths with anxiety, it is uncertain whether there is a difference in outcomes between the two. This study suggests that telepsychiatry has potential as a treatment modality for youth, with additional benefits compared to conventional therapy such as convenience. However, we have moderate to low certainty in our conclusions, and more research is needed to support these findings and guide how this technology should be implemented.