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Effects of digital cognitive behavioral therapy for depression on suicidal thoughts and behavior: Protocol for a systematic review and meta-analysis of individual participant data

Author

Listed:
  • Lasse Bosse Sander
  • Marie Beisemann
  • Eirini Karyotaki
  • Wouter van Ballegooijen
  • Pim Cuijpers
  • Tobias Teismann
  • Philipp Doebler
  • Matthias Domhardt
  • Harald Baumeister
  • Rebekka Büscher

Abstract

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.

Suggested Citation

  • Lasse Bosse Sander & Marie Beisemann & Eirini Karyotaki & Wouter van Ballegooijen & Pim Cuijpers & Tobias Teismann & Philipp Doebler & Matthias Domhardt & Harald Baumeister & Rebekka Büscher, 2023. "Effects of digital cognitive behavioral therapy for depression on suicidal thoughts and behavior: Protocol for a systematic review and meta-analysis of individual participant data," PLOS ONE, Public Library of Science, vol. 18(6), pages 1-13, June.
    • Handle: RePEc:plo:pone00:0285622
    DOI: 10.1371/journal.pone.0285622
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    References listed on IDEAS

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    1. Viechtbauer, Wolfgang, 2010. "Conducting Meta-Analyses in R with the metafor Package," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 36(i03).
    2. Jayne F Tierney & Claire Vale & Richard Riley & Catrin Tudur Smith & Lesley Stewart & Mike Clarke & Maroeska Rovers, 2015. "Individual Participant Data (IPD) Meta-analyses of Randomised Controlled Trials: Guidance on Their Use," PLOS Medicine, Public Library of Science, vol. 12(7), pages 1-16, July.
    3. Jürgen Barth & Thomas Munder & Heike Gerger & Eveline Nüesch & Sven Trelle & Hansjörg Znoj & Peter Jüni & Pim Cuijpers, 2013. "Comparative Efficacy of Seven Psychotherapeutic Interventions for Patients with Depression: A Network Meta-Analysis," PLOS Medicine, Public Library of Science, vol. 10(5), pages 1-17, May.
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