Scholarlink

Purpose <p>Blended cognitive behavioral therapy (bCBT) combines traditional face-to-face CBT (ftfCBT) with internet-based CBT (iCBT), potentially merging the accessibility of online interventions with the adherence benefits of conventional therapy. However, the evidence about its therapeutic effectiveness remains scattered. This meta-analysis aims to measure the treatment effects of bCBT in patients with depression, examine the factors influencing outcomes, and identify the best treatment protocols.</p> Methods <p>Following the PRISMA guidelines, we searched the PubMed, Web of Science, PsycINFO, and Cochrane Library databases (up to April 17, 2025) to identify randomised controlled trials comparing bCBT with ftfCBT, iCBT, treatment as usual (TAU), or no-treatment controls in patients diagnosed with depression. A random-effects model was used to compute standardised mean differences (SMD) as effect sizes. Subgroup analyses were performed based on geographic location, duration of intervention, intervention parameters, depression severity, and measurement scales. Additionally, meta-regression was conducted to identify significant moderators, and a nonlinear dose–response model was used to estimate the optimal intervention protocol.</p> Results <p>After removing one outlier, ten randomised controlled trials with 1163 participants were analysed. BCBT significantly improved depressive symptoms, although the effect size is small (SMD = – 0.19, 95% CI – 0.36 to – 0.02, <i>P</i> = 0.0328). Subgroup analyses showed that the largest improvement happened when the intervention lasted less than 10&#xa0;weeks (SMD = – 0.79, <i>P</i> = 0.011). Additionally, patients with mild to moderate depression saw the greatest benefits (SMD = – 0.37, <i>P</i> = 0.013). Furthermore, combined treatments showed positive effects (SMD = – 0.25), with the strongest effect observed compared to iCBT (SMD = – 0.54). Meta-regression results showed that region (β = – 1.18), depression severity (β = 0.32), and intervention duration (β = 0.07) were significant moderators. The nonlinear regression results showed that the recommended intervention protocol involved about one to two sessions per week, with each session lasting slightly longer, approximately 60 to 100&#xa0;min, over five weeks, although several significant limitations were identified with the included studies.</p> Conclusion <p>The therapeutic effect of bCBT on depressive symptoms in patients with depression, although small, was statistically significant. BCBT combines the accessibility of ftfCBT with the convenience of iCBT, thereby increasing patient engagement in treatment. This offers a scalable and easily accessible treatment option. Future research with larger sample sizes and longer follow-up periods is needed to confirm its long-term effectiveness and cost-effectiveness.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

The Intervention Effects of Blended Cognitive Behavioral Therapy on Patients with Depression: A Meta-analysis

  • 期刊论文

  • 发表日期：

    2025年10月31日

查看全文
  • Jiajun Lan,
  • Zhikai Qin,
  • Huan Niu,
  • Junsheng Wang

摘要

Purpose

Blended cognitive behavioral therapy (bCBT) combines traditional face-to-face CBT (ftfCBT) with internet-based CBT (iCBT), potentially merging the accessibility of online interventions with the adherence benefits of conventional therapy. However, the evidence about its therapeutic effectiveness remains scattered. This meta-analysis aims to measure the treatment effects of bCBT in patients with depression, examine the factors influencing outcomes, and identify the best treatment protocols.

Methods

Following the PRISMA guidelines, we searched the PubMed, Web of Science, PsycINFO, and Cochrane Library databases (up to April 17, 2025) to identify randomised controlled trials comparing bCBT with ftfCBT, iCBT, treatment as usual (TAU), or no-treatment controls in patients diagnosed with depression. A random-effects model was used to compute standardised mean differences (SMD) as effect sizes. Subgroup analyses were performed based on geographic location, duration of intervention, intervention parameters, depression severity, and measurement scales. Additionally, meta-regression was conducted to identify significant moderators, and a nonlinear dose–response model was used to estimate the optimal intervention protocol.

Results

After removing one outlier, ten randomised controlled trials with 1163 participants were analysed. BCBT significantly improved depressive symptoms, although the effect size is small (SMD = – 0.19, 95% CI – 0.36 to – 0.02, P = 0.0328). Subgroup analyses showed that the largest improvement happened when the intervention lasted less than 10 weeks (SMD = – 0.79, P = 0.011). Additionally, patients with mild to moderate depression saw the greatest benefits (SMD = – 0.37, P = 0.013). Furthermore, combined treatments showed positive effects (SMD = – 0.25), with the strongest effect observed compared to iCBT (SMD = – 0.54). Meta-regression results showed that region (β = – 1.18), depression severity (β = 0.32), and intervention duration (β = 0.07) were significant moderators. The nonlinear regression results showed that the recommended intervention protocol involved about one to two sessions per week, with each session lasting slightly longer, approximately 60 to 100 min, over five weeks, although several significant limitations were identified with the included studies.

Conclusion

The therapeutic effect of bCBT on depressive symptoms in patients with depression, although small, was statistically significant. BCBT combines the accessibility of ftfCBT with the convenience of iCBT, thereby increasing patient engagement in treatment. This offers a scalable and easily accessible treatment option. Future research with larger sample sizes and longer follow-up periods is needed to confirm its long-term effectiveness and cost-effectiveness.