A Systematic Review and Meta-Analysis of e-Mental Health Interventions to Treat Symptoms of Posttraumatic Stress

Sara Simblett; Jennifer Birch; Faith Matcham; Lidia Yaguez; Robin Morris

doi:10.2196/mental.5558

A Systematic Review and Meta-Analysis of e-Mental Health Interventions to Treat Symptoms of Posttraumatic Stress

JMIR Ment Health. 2017 May 17;4(2):e14. doi: 10.2196/mental.5558.

Authors

Sara Simblett¹, Jennifer Birch², Faith Matcham³, Lidia Yaguez⁴, Robin Morris⁴

Affiliations

¹ Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, King's College London, London, United Kingdom.
² Springfield University Hospital, South West London and St Georges Mental Health NHS Trust, London, United Kingdom.
³ Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, King's College London, London, United Kingdom.
⁴ King's College Hospital, Clinical Neuropsychology Department, King's College Hospital NHS Foundation Trust, London, United Kingdom.

Abstract

Background: Posttraumatic stress disorder (PTSD) is a stress disorder characterized by unwanted intrusive re-experiencing of an acutely distressing, often life-threatening, event, combined with symptoms of hyperarousal, avoidance, as well as negative thoughts and feelings. Evidence-based psychological interventions have been developed to treat these symptoms and reduce distress, the majority of which were designed to be delivered face-to-face with trained therapists. However, new developments in the use of technology to supplement and extend health care have led to the creation of e-Mental Health interventions.

Objective: Our aim was to assess the scope and efficacy of e-Mental Health interventions to treat symptoms of PTSD.

Methods: The following databases were systematically searched to identify randomized controlled trials of e-Mental Health interventions to treat symptoms of PTSD as measured by standardized and validated scales: the Cochrane Library, MEDLINE, EMBASE, and PsycINFO (in March 2015 and repeated in November 2016).

Results: A total of 39 studies were found during the systematic review, and 33 (N=3832) were eligible for meta-analysis. The results of the primary meta-analysis revealed a significant improvement in PTSD symptoms, in favor of the active intervention group (standardized mean difference=-0.35, 95% confidence interval -0.45 to -0.25, P<.001, I2=81%). Several sensitivity and subgroup analyses were performed suggesting that improvements in PTSD symptoms remained in favor of the active intervention group independent of the comparison condition, the type of cognitive behavioral therapy-based intervention, and the level of guidance provided.

Conclusions: This review demonstrates an emerging evidence base supporting e-Mental Health to treat symptoms of PTSD.

Keywords: PTSD; e-Mental Health; meta-analysis; psychological treatment; systematic review.

©Sara Simblett, Jennifer Birch, Faith Matcham, Lidia Yaguez, Robin Morris. Originally published in JMIR Mental Health (http://mental.jmir.org), 17.05.2017.