J. Med. Internet Res. - Online and social networking interventions for the treatment of depression in young people: a systematic review.


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CKGROUND: Major depression accounts for the greatest burden of all diseases globally. The peak onset of depression occurs between adolescence and young adulthood, and for many individuals, depression displays a relapse-remitting and increasingly severe course. Given this, the development of cost-effective, acceptable, and population-focused interventions for depression is critical. A number of online interventions (both prevention and acute phase) have been tested in young people with promising results. As these interventions differ in content, clinician input, and modality, it is important to identify key features (or unhelpful functions) associated with treatment outcomes.OBJECTIVE: A systematic review of the research literature was undertaken. The review was designed to focus on two aspects of online intervention: (1) standard approaches evaluating online intervention content in randomized controlled designs (Section 1), and (2) second-generation online interventions and services using social networking (eg, social networking sites and online support groups) in any type of research design (Section 2).METHODS: Two specific literature searches were undertaken. There was no date range specified. The Section 1 search, which focused on randomized controlled trials, included only young people (12-25 years) and yielded 101 study abstracts, of which 15 met the review inclusion criteria. The Section 2 search, which included all study design types and was not restricted in terms of age, yielded 358 abstracts, of which 22 studies met the inclusion criteria. Information about the studies and their findings were extracted and tabulated for review.RESULTS: The 15 studies identified in Section 1 described 10 trials testing eight different online interventions, all of which were based on a cognitive behavioral framework. All but one of the eight identified studies reported positive results; however, only five of the 15 studies used blinded interviewer administered outcomes with most trials using self-report data. Studies varied significantly in presentation of intervention content, treatment dose, and dropout. Only two studies included moderator or clinician input. Results for Section 2 were less consistent. None of the Section 2 studies reported controlled or randomized designs. With the exception of four studies, all included participants were younger than 25 years of age. Eight of the 16 social networking studies reported positive results for depression-related outcomes. The remaining studies were either mixed or negative. Findings for online support groups tended to be more positive; however, noteworthy risks were identified.CONCLUSIONS: Online interventions with a broad cognitive behavioral focus appear to be promising in reducing depression symptomology in young people. Further research is required into the effectiveness of online interventions delivering cognitive behavioral subcomponents, such as problem-solving therapy. Evidence for the use of social networking is less compelling, although limited by a lack of well-designed studies and social networking interventions. A range of future social networking therapeutic opportunities are highlighted.

Resumo Limpo

ckground major depress account greatest burden diseas global peak onset depress occur adolesc young adulthood mani individu depress display relapseremit increas sever cours given develop costeffect accept populationfocus intervent depress critic number onlin intervent prevent acut phase test young peopl promis result intervent differ content clinician input modal import identifi key featur unhelp function associ treatment outcomesobject systemat review research literatur undertaken review design focus two aspect onlin intervent standard approach evalu onlin intervent content random control design section secondgener onlin intervent servic use social network eg social network site onlin support group type research design section method two specif literatur search undertaken date rang specifi section search focus random control trial includ young peopl year yield studi abstract met review inclus criteria section search includ studi design type restrict term age yield abstract studi met inclus criteria inform studi find extract tabul reviewresult studi identifi section describ trial test eight differ onlin intervent base cognit behavior framework one eight identifi studi report posit result howev five studi use blind interview administ outcom trial use selfreport data studi vari signific present intervent content treatment dose dropout two studi includ moder clinician input result section less consist none section studi report control random design except four studi includ particip younger year age eight social network studi report posit result depressionrel outcom remain studi either mix negat find onlin support group tend posit howev noteworthi risk identifiedconclus onlin intervent broad cognit behavior focus appear promis reduc depress symptomolog young peopl research requir effect onlin intervent deliv cognit behavior subcompon problemsolv therapi evid use social network less compel although limit lack welldesign studi social network intervent rang futur social network therapeut opportun highlight

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