TY - JOUR
T1 - Effects of digital cognitive behavioral therapy for depression on suicidal thoughts and behavior
T2 - Protocol for a systematic review and meta-analysis of individual participant data
AU - Sander, Lasse Bosse
AU - Beisemann, Marie
AU - Karyotaki, Eirini
AU - van Ballegooijen, Wouter
AU - Cuijpers, Pim
AU - Teismann, Tobias
AU - Doebler, Philipp
AU - Domhardt, Matthias
AU - Baumeister, Harald
AU - Büscher, Rebekka
N1 - Funding Information: LBS received funding for the study described in this protocol from the German Research Foundation (project “Effects of internet interventions for depression on suicide ideation - a meta-analysis of individual participant data (IPDMA), grant No. SA 3767/2-1). URL: http:// www.dfg.de The article processing charge was funded by the German Research Foundation (DFG) and the University of Freiburg in the funding program Open Access Publishing. The funders had no role in the study design, the decision to publish, or in the preparation of the manuscript. The views expressed are those of the author(s) and not necessarily those of the funder. Publisher Copyright: © 2023 Sander et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2023/6/1
Y1 - 2023/6/1
N2 - Introduction Digital cognitive behavioral therapy (i-CBT) interventions for the treatment of depression have been extensively studied and shown to be effective in the reduction of depressive symptoms. However, little is known about their effects on suicidal thoughts and behaviors (STB). Information on the impact of digital interventions on STB are essential for patients’ safety because most digital interventions are self-help interventions without direct support options in case of a suicidal crisis. Therefore, we aim to conduct a meta-analysis of individual participant data (IPDMA) to investigate the effects of i-CBT interventions for depression on STB and to explore potential effect moderators. Methods Data will be retrieved from an established and annually updated IPD database of randomized controlled trials investigating the effectiveness of i-CBT interventions for depression in adults and adolescents. We will conduct a one-stage and a two-stage IPDMA on the effects of these interventions on STB. All types of control conditions are eligible. STB can be measured using specific scales (e.g., Beck scale suicide, BSS) or single items from depression scales (e.g., item 9 of the PHQ-9) or standardized clinical interviews. Multilevel linear regression will be used for specific scales, and multilevel logistic regression will be used for treatment response or deterioration, operationalized as a change in score by at least one quartile from baseline. Exploratory moderator analyses will be conducted at participant, study, and intervention level. Two independent reviewers will assess the risk of bias using the Cochrane Risk of Bias Tool 2. Conclusion This IPDMA will harness the available data to assess the effects (response and deterioration) of i-CBT interventions for depression interventions on STB. Information about changes in STB is essential to estimate patients’ safety when engaging in digital treatment formats. Trial registration We will pre-register this study with the open science framework after article acceptance to ensure consistency between online registration and the published trial protocol.
AB - Introduction Digital cognitive behavioral therapy (i-CBT) interventions for the treatment of depression have been extensively studied and shown to be effective in the reduction of depressive symptoms. However, little is known about their effects on suicidal thoughts and behaviors (STB). Information on the impact of digital interventions on STB are essential for patients’ safety because most digital interventions are self-help interventions without direct support options in case of a suicidal crisis. Therefore, we aim to conduct a meta-analysis of individual participant data (IPDMA) to investigate the effects of i-CBT interventions for depression on STB and to explore potential effect moderators. Methods Data will be retrieved from an established and annually updated IPD database of randomized controlled trials investigating the effectiveness of i-CBT interventions for depression in adults and adolescents. We will conduct a one-stage and a two-stage IPDMA on the effects of these interventions on STB. All types of control conditions are eligible. STB can be measured using specific scales (e.g., Beck scale suicide, BSS) or single items from depression scales (e.g., item 9 of the PHQ-9) or standardized clinical interviews. Multilevel linear regression will be used for specific scales, and multilevel logistic regression will be used for treatment response or deterioration, operationalized as a change in score by at least one quartile from baseline. Exploratory moderator analyses will be conducted at participant, study, and intervention level. Two independent reviewers will assess the risk of bias using the Cochrane Risk of Bias Tool 2. Conclusion This IPDMA will harness the available data to assess the effects (response and deterioration) of i-CBT interventions for depression interventions on STB. Information about changes in STB is essential to estimate patients’ safety when engaging in digital treatment formats. Trial registration We will pre-register this study with the open science framework after article acceptance to ensure consistency between online registration and the published trial protocol.
UR - http://www.scopus.com/inward/record.url?scp=85161868783&partnerID=8YFLogxK
U2 - https://doi.org/10.1371/journal.pone.0285622
DO - https://doi.org/10.1371/journal.pone.0285622
M3 - Article
C2 - 37289758
SN - 1932-6203
VL - 18
JO - PLOS ONE
JF - PLOS ONE
IS - 6 June
M1 - e0285622
ER -