Efficacy of digital interventions in social anxiety disorder: a systematic review and Bayesian network meta-analysis

Social anxiety disorder (SAD) is characterized by a significant and persistent fear of social or performance situations. The prevalence of SAD has gradually increased recently, and the unique advantages of digital interventions (DIs) have gained traction in psychiatric disorders. However, there is currently no comprehensive review comparing the effectiveness of diverse DIs for SAD.

Randomized controlled trials (RCTs) evaluating DIs for patients with SAD were identified by searching the PubMed, Cochrane Library, and Embase databases from January 1, 1995, to March 31, 2025. The study protocol for this network meta-analysis was registered in PROSPERO. Data were analyzed via Bayesian framework network meta-analysis.

Forty-two RCTs were included. The results showed that DIs exerted better efficacy than non-digital interventions and wait-list controls (WLC). Different forms of internet-based cognitive behavioral therapy (ICBT) demonstrated robust effects across all four outcomes. Internet-based cognitive therapy (ICT) yielded favorable effects in reducing social anxiety and depressive symptoms. VR showed relatively large effect sizes for improving quality of life.

DIs can be recommended as adjunctive or combined treatments for SAD. Different forms of ICBT show consistent efficacy and can serve as the first-line option among digital interventions. We recommend promoting the application of DIs to expand treatment coverage for SAD and overcome the limitations of traditional psychotherapy.

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251077835.