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Internet-Based Cognitive Behavioral Therapy to Reduce Suicidal Ideation: A Systematic Review and Meta-analysis
Rebekka Büscher1, Michelle Torok2, Yannik Terhorst3,4
1Department of Rehabilitation Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany.
JAMA Network Open
|April 29, 2020
Summary
Internet-based cognitive behavioral therapy (iCBT) significantly reduces suicidal ideation. These digital interventions show potential for reducing suicide mortality due to their scalability and effectiveness in clinical trials.
Area of Science:
- Mental Health
- Digital Health
- Psychiatry
Background:
- Suicidal ideation is a significant public health concern, with many at-risk individuals not seeking traditional treatment.
- Internet-based self-help interventions offer a low-threshold approach to address this gap in care.
Purpose of the Study:
- To determine if internet-based self-help interventions targeting suicidal ideation or behavior reduce suicidal ideation.
- To synthesize evidence from randomized clinical trials on the efficacy of these digital interventions.
Main Methods:
- A systematic literature search was conducted across major databases (PsycINFO, MEDLINE, CENTRAL, CRESP) for relevant randomized clinical trials.
- Two independent reviewers screened studies, including those based on psychotherapeutic elements and reporting quantitative suicide-specific outcomes.
- Data were extracted and synthesized using a random-effects model following PRISMA guidelines.
Main Results:
- Six trials involving 1567 participants were included, all utilizing internet-based cognitive behavioral therapy (iCBT).
- Participants receiving iCBT showed a significant reduction in suicidal ideation compared to control groups (SMD = -0.29, P < .001).
- These reductions were maintained at follow-up in a subset of studies, with low heterogeneity observed.
Conclusions:
- Internet-based cognitive behavioral therapy (iCBT) is an effective intervention for reducing suicidal ideation.
- The scalability of iCBT suggests its potential to decrease suicide mortality rates.
- Further research is recommended to explore the impact of digital health interventions on suicidal behavior and identify mechanisms of action.
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