Effectiveness of digital mental health interventions for children and adolescents with anxiety and depressive symptoms: A systematic review and meta-analysis using ChatGPT4o

Context Depression and anxiety are the most common mental disorders in children and adolescents. While numerous well-studied Digital Mental Health Interventions (DMHI) are already available for these indications in adulthood, few DMHI exist for children and adolescents. In particular, there is a lack of an up-to-date systematic overview of their effectiveness that also takes into account the influence of subgroups (e.g., guided vs. unguided DMHI, type of control group). Objective The aim of this registered (PROSPERO: CRD42023452852) meta-analysis is to systematically summarize the efficacy of DMHI in the treatment of depressive and anxiety disorders and symptoms in children and adolescents. Efficacy will be differentiated by subgroup analyses. Methods We included randomized controlled trials on the efficacy of DMHI for children and adolescents up to 21 years of age with diagnosed anxiety, depressive disorder, or clinically prominent symptoms. The literature search encompassed the following databases: PubMed, EBSCO-Host, APA PsycINFO, APA PsycArticles, The Nation Archive (DFG), The New Republic Archive (DFG), MEDLINE Complete, CINAHL Complete, and Psychology and Behavioral Sciences Collection. Risk of bias was determined using the Revised Cochrane Risk-of-Bias Tool for randomized trials (RoB 2), and the initial RoB analysis was performed using ChatGPT 4o and subsequently assessed by two independent reviewers. Results A total of 30 studies (17 anxiety disorders, 11 depression, and 2 transdiagnostic) were included. Cognitive behavioral therapy served as the therapeutic foundation for 22 DMHIs. The study revealed a combined effect size of g = 0.65 (95% CI) for DMHI in treating anxiety and depression when compared to the control group. Further analysis indicated a larger, though not statistically significant, effect for guided DMHI (g = 0.75, 95% CI) in contrast to unguided DMHI (g = 0.42, 95% CI). Moreover, no substantial differences were observed among the various control groups, which included waitlist, attention placebo, and treatment control conditions. Conclusions DMHIs are an effective treatment option for anxiety and depressive disorders in children and adolescents, with an effect size comparable to that of face-to-face psychotherapy. However, there is a lack of randomized controlled trials investigating the effectiveness of the DMHI for anxiety and depressive disorders in children and adolescents compared to face-to-face psychotherapy or as a blended care option.