Abstract/Summary

Background: Depression and anxiety have become increasingly prevalent across the globe. The rising need for treatment and the lack of clinicians has resulted in prolonged waiting times for patients to receive their first session. Responding to this gap, digital mental health interventions (DMHIs) have been found effective in treating depression and anxiety and are potential promising pre-treatments for patients who are awaiting face-to-face psychotherapy. Nevertheless, whether digital interventions effectively alleviate symptoms for patients on waiting lists for face-to-face psychotherapy remains unclear. Objective: This review aimed to synthesize the effectiveness of DMHIs for relieving depression and anxiety symptoms of patients on waiting lists for face-to-face therapy. This review also investigated the features, perceived credibility, and usability of DMHIs during waiting times. Methods: In this systematic review, we searched PubMed, PsycINFO, Cochrane, and Web of Science for research articles investigating the effectiveness of digital mental health interventions to reduce either depression or anxiety symptoms among individuals waiting for face-to-face psychotherapy. The search was conducted in June 2024, and we have included the articles that met the inclusion criteria and were published before June 6, 2024. Results: Of the 9267 unique records identified, eight studies met the eligibility criteria and were included in the systematic review. Five studies were randomized controlled trials (RCTs), and three studies were not. Among the RCTs, we found that digital interventions reduced depression and anxiety symptoms, but the majority of interventions were not more effective compared to the control groups where participants simply waited or received a self-help book. For the non-RCTs, the interventions also reduced symptoms, but without control groups the interpretation of the findings is limited. Finally, participants in the included studies perceived the digital interventions to be credible and useful, but high dropout rates raised concern about treatment adherence. Conclusions: Due to the lack of effective interventions among the reviewed studies, especially among the RCTs, our results suggest that waiting list digital mental health interventions are not more effective compared to simply waiting or using a self-help book. However, more high-quality RCTs with larger samples sizes are warranted in order to draw a more robust conclusion. Additionally, as this review revealed concerns regarding high dropout rate in digital interventions, future studies could perhaps adopt more personalized and human-interactive functions in interventions to increase user engagement, as a potential to increase treatment adherence and effectiveness.