Mind-body internet and mobile-based interventions for depression and anxiety in adults with chronic physical conditions: A systematic review of RCTs

Author: Emily Johnson1, Shaina Corrick1, Serena Isley1, Ben Vandermeer2, Naomi Dolgoy3, Jack Bates4, Elana Godfrey5, Cassidy Soltys4, Conall Muir4, Sunita Vohra6, Puneeta Tandon1
1 Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Alberta.
2 Department of Medicine, University of Alberta, Edmonton, Alberta.
3 Faculty of Rehabilitation Science, Edmonton, Alberta.
4 Faculty of Science, University of Alberta, Edmonton, Alberta.
5 Faculty of Science, University of Toronto, Toronto, Ontario.
6 Department of Pediatrics, University of Alberta, Edmonton, Alberta.
Conference/Journal: PLOS Digit Health
Date published: 2024 Jan 23
Other: Volume ID: 3 , Issue ID: 1 , Pages: e0000435 , Special Notes: doi: 10.1371/journal.pdig.0000435. , Word Count: 264

This review summarizes the effectiveness of scalable mind-body internet and mobile-based interventions (IMIs) on depression and anxiety symptoms in adults living with chronic physical conditions. Six databases (MEDLINE, PsycINFO, SCOPUS, EMBASE, CINAHL, and CENTRAL) were searched for randomized controlled trials published from database inception to March 2023. Mind-body IMIs included cognitive behavioral therapy, breathwork, meditation, mindfulness, yoga or Tai-chi. To focus on interventions with a greater potential for scale, the intervention delivery needed to be online with no or limited facilitation by study personnel. The primary outcome was mean change scores for anxiety and depression (Hedges' g). In subgroup analyses, random-effects models were used to calculate pooled effect size estimates based on personnel support level, intervention techniques, chronic physical condition, and survey type. Meta-regression was conducted on age and intervention length. Fifty-six studies met inclusion criteria (sample size 7691, mean age of participants 43 years, 58% female): 30% (n = 17) neurological conditions, 12% (n = 7) cardiovascular conditions, 11% cancer (n = 6), 43% other chronic physical conditions (n = 24), and 4% (n = 2) multiple chronic conditions. Mind-body IMIs demonstrated statistically significant pooled reductions in depression (SMD = -0.33 [-0.40, -0.26], p<0.001) and anxiety (SMD = -0.26 [-0.36, -0.17], p<0.001). Heterogeneity was moderate. Scalable mind-body IMIs hold promise as interventions for managing anxiety and depression symptoms in adults with chronic physical conditions without differences seen with age or intervention length. While modest, the effect sizes are comparable to those seen with pharmacological therapy. The field would benefit from detailed reporting of participant demographics including those related to technological proficiency, as well as further evaluation of non-CBT interventions. Registration: The study is registered with PROSPERO ID #CRD42022375606.

PMID: 38261600 DOI: 10.1371/journal.pdig.0000435