Meta-analysis of the efficacy of internet-based cognitive behavior therapy for anxiety disorders in children and adolescents
Objective To systematically evaluate the efficacy and satisfaction of internet-based cognitive behavior therapy(iCBT)for children and adolescents with anxiety disorders.Methods China National Knowledge Infrastructure(CNKI),WanFang,VIP database,PubMed,Cochrane Library,Web of Science and Embase were searched for randomized controlled trials(RCTs)on iCBT for children and adolescents with anxiety disorders published up to December 2022.Two reviewers independently screened the retrieved RCTs,extracted the data and assessed the risk of bias of included RCTs.Meta-analysis was performed using RevMan 5.4.1 software.Results A total of 7 RCTs involving 519 patients were included.Compared with the control group,the children and adolescents with anxiety disorders in the treatment group showed a greater reduction in anxiety symptom scores,with the post-treatment effect size of Spence Children's Anxiety Scale Chid version(SCAS-C),SCAS Parent version(SCAS-P),and Clinical Severity Rating-Anxiety Disorder Interview Schedule(CSR-ADIS)being-5.22(95％CI:-8.16--2.27,P＜0.01),-7.28(95％CI:-9.72--4.85,P＜0.01),and-1.36(95％CI:-1.61--1.11,P＜0.01),respectively.The anxiety symptom of children and adolescents with anxiety disorders in the treatment group continued to decrease over time during the follow-up period(3-12 months),with the effect size of SCAS-C,SCAS-P,and CSR-ADIS after long-term follow-up being-4.71(95％CI:-7.34--2.08,P＜0.01),-5.07(95％CI:-7.26--2.88,P＜0.01),and-1.57(95％CI:-1.91--1.22,P＜0.01),respectively.The mean satisfaction with iCBT among the participants and their parents was(3.25±0.88)and(3.45±0.80)out of 5.Moreover,85.19％and 83.33％of them considered iCBT as helpful and 79.63％and 85.90％of them said they would recommend iCBT to others.Conclusions ICBT should be promoted in clinical practice as it can improve the anxiety symptoms of children and adolescents with anxiety disorders.High-quality,large-scale,multi-center RCTs are needed in China.
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