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REVIEW article

Front. Psychiatry
Sec. Anxiety and Stress Disorders
Volume 15 - 2024 | doi: 10.3389/fpsyt.2024.1433558

Effects of internet-based cognitive behavioral therapy on anxiety and depressive symptoms among patients with cardiovascular and cerebrovascular diseases: A systematic review and meta-analysis

Provisionally accepted
Shuangyu Wang Shuangyu Wang 1*Lishuo Gao Lishuo Gao 1Congyu Wang Congyu Wang 2Jinbing (Bing) Bai Jinbing (Bing) Bai 3Mengshuang Shen: Mengshuang Shen: 1Xuejie Zhao Xuejie Zhao 1Mei Lin Mei Lin 1*
  • 1 Tianjin Medical University General Hospital, Tianjin, China
  • 2 Tianjin Medical University, Tianjin, People’ s Republic of China, tianjin, China
  • 3 Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, United States

The final, formatted version of the article will be published soon.

    Background: This study aimed to evaluate the effectiveness of Internet-based Cognitive Behavioral Therapy (ICBT) in reducing anxiety and depressive symptoms among patients with cardiovascular diseases (CVDs) and to explore how intervention characteristics, such as module number and program duration, influence treatment outcomes. Methods: A systematic review and meta-analysis were conducted by searching eight databases, including PubMed, Embase, and Cochrane Library, for randomized controlled trials (RCTs) published up to December 2023. Studies involving adult CVD patients with anxiety or depressive symptoms who underwent ICBT interventions were included. Statistical analyses used randomeffects models, with subgroup analyses performed to assess the impact of intervention format, module number, and program duration. Sensitivity and publication bias assessments ensured the robustness of the findings.Results: Eight RCTs with 1177 participants were included. ICBT significantly reduced depressive symptoms (SMD = -0.32, 95% CI [-0.56, -0.08], p < 0.015) and anxiety symptoms (SMD = -0.37, 95% CI [-0.68, -0.06], p < 0.001). Subgroup analysis indicated that self-guided ICBT was more effective than therapist-guided ICBT. Programs with fewer than eight modules were more effective for anxiety, while those with eight or more modules were more effective for depression. Shorter programs (< 9 weeks) were better for anxiety, whereas longer programs (≥ 9 weeks) were more effective for depression.: ICBT is an effective intervention for managing anxiety and depression in CVD patients. Tailoring ICBT interventions based on symptom type, module number, and program duration can optimize outcomes. Future research should explore personalized, long-term strategies to enhance effectiveness and safety.

    Keywords: cognitive behavioral therapy, Cardiovascular Diseases, Anxiety Disorders, Depressive Disorder, Meta-analysis

    Received: 16 May 2024; Accepted: 23 Dec 2024.

    Copyright: © 2024 Wang, Gao, Wang, Bai, Shen:, Zhao and Lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Shuangyu Wang, Tianjin Medical University General Hospital, Tianjin, China
    Mei Lin, Tianjin Medical University General Hospital, Tianjin, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.