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.