{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T02:19:48Z","timestamp":1789438788443,"version":"build-2803163510"},"reference-count":119,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T00:00:00Z","timestamp":1594944000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0033291720002251_sec_a1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Over the past 15 years, there has been substantial growth in web-based psychological interventions. We summarize evidence regarding the efficacy of web-based self-directed psychological interventions on depressive, anxiety and distress symptoms in people living with a chronic health condition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291720002251_sec_a2\" sec-type=\"methods\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We searched Medline, PsycINFO, CINAHL, EMBASE databases and Cochrane Database from 1990 to 1 May 2019. English language papers of randomized controlled trials (usual care or waitlist control) of web-based psychological interventions with a primary or secondary aim to reduce anxiety, depression or distress in adults with a chronic health condition were eligible. Results were assessed using narrative synthases and random-effects meta-analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291720002251_sec_a3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total 70 eligible studies across 17 health conditions [most commonly: cancer (\n                      <jats:italic>k<\/jats:italic>\n                      = 20), chronic pain (\n                      <jats:italic>k<\/jats:italic>\n                      = 9), arthritis (\n                      <jats:italic>k<\/jats:italic>\n                      = 6) and multiple sclerosis (\n                      <jats:italic>k<\/jats:italic>\n                      = 5), diabetes (\n                      <jats:italic>k<\/jats:italic>\n                      = 4), fibromyalgia (\n                      <jats:italic>k<\/jats:italic>\n                      = 4)] were identified. Interventions were based on CBT principles in 46 (66%) studies and 42 (60%) included a facilitator. When combining all chronic health conditions, web-based interventions were more efficacious than control conditions in reducing symptoms of depression\n                      <jats:italic>g<\/jats:italic>\n                      = 0.30 (95% CI 0.22\u20130.39), anxiety\n                      <jats:italic>g<\/jats:italic>\n                      = 0.19 (95% CI 0.12\u20130.27), and distress\n                      <jats:italic>g<\/jats:italic>\n                      = 0.36 (95% CI 0.23\u20130.49).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0033291720002251_sec_a4\" sec-type=\"conclusions\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Evidence regarding effectiveness for specific chronic health conditions was inconsistent. While self-guided online psychological interventions may help to reduce symptoms of anxiety, depression and distress in people with chronic health conditions in general, it is unclear if these interventions are effective for specific health conditions. More high-quality evidence is needed before definite conclusions can be made.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s0033291720002251","type":"journal-article","created":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T04:54:48Z","timestamp":1594961688000},"page":"548-573","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":81,"title":["Online psychological interventions to reduce symptoms of depression, anxiety, and general distress in those with chronic health conditions: a systematic review and meta-analysis of randomized controlled trials"],"prefix":"10.1017","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6619-8484","authenticated-orcid":false,"given":"V.","family":"White","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4475-7139","authenticated-orcid":false,"given":"J.","family":"Linardon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7706-7471","authenticated-orcid":false,"given":"J. E.","family":"Stone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9139-4663","authenticated-orcid":false,"given":"E.","family":"Holmes-Truscott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Olive","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4864-3956","authenticated-orcid":false,"given":"A.","family":"Mikocka-Walus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0075-828X","authenticated-orcid":false,"given":"C.","family":"Hendrieckx","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Evans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1204-6896","authenticated-orcid":false,"given":"J.","family":"Speight","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2020,7,17]]},"reference":[{"key":"S0033291720002251_ref89","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000494"},{"key":"S0033291720002251_ref63","doi-asserted-by":"publisher","DOI":"10.1037\/ccp0000245"},{"key":"S0033291720002251_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2015.01.003"},{"key":"S0033291720002251_ref45","first-page":"217","article-title":"An online programme to reduce depression in patients with multiple sclerosis: A randomised controlled trial","volume":"2","author":"Fischer","year":"2015","journal-title":"The Lancet: Psychiatry"},{"key":"S0033291720002251_ref110","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-1248"},{"key":"S0033291720002251_ref12","doi-asserted-by":"publisher","DOI":"10.1177\/1352458516671820"},{"key":"S0033291720002251_ref77","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-016009"},{"key":"S0033291720002251_ref23","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2010.00879.x"},{"key":"S0033291720002251_ref20","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.12350"},{"key":"S0033291720002251_ref74","doi-asserted-by":"publisher","DOI":"10.1080\/16506073.2017.1365929"},{"key":"S0033291720002251_ref78","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2016.06.001"},{"key":"S0033291720002251_ref56","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2011-300474"},{"key":"S0033291720002251_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2017.07.009"},{"key":"S0033291720002251_ref100","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1002\/acr.22042","article-title":"RAHelp: An online intervention for individuals with rheumatoid arthritis","volume":"65","author":"Shigaki","year":"2013","journal-title":"Arthritis Care Research"},{"key":"S0033291720002251_ref43","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20472"},{"key":"S0033291720002251_ref106","doi-asserted-by":"publisher","DOI":"10.1007\/s10865-014-9579-0"},{"key":"S0033291720002251_ref41","doi-asserted-by":"publisher","DOI":"10.1186\/1471-230X-13-68"},{"key":"S0033291720002251_ref101","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2018.02.004"},{"key":"S0033291720002251_ref26","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.112.1.155"},{"key":"S0033291720002251_ref31","doi-asserted-by":"publisher","DOI":"10.1177\/070674371305800702"},{"key":"S0033291720002251_ref90","doi-asserted-by":"publisher","DOI":"10.1080\/07347332.2018.1457125"},{"key":"S0033291720002251_ref46","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2016.03.032"},{"key":"S0033291720002251_ref88","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2016.08.015"},{"key":"S0033291720002251_ref107","doi-asserted-by":"publisher","DOI":"10.1007\/s10865-015-9622-9"},{"key":"S0033291720002251_ref118","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.37.2979"},{"key":"S0033291720002251_ref49","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2019.05.001"},{"key":"S0033291720002251_ref38","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2004.01.008"},{"key":"S0033291720002251_ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2016.09.003"},{"key":"S0033291720002251_ref102","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-018-4431-7"},{"key":"S0033291720002251_ref116","doi-asserted-by":"publisher","DOI":"10.1002\/pon.4687"},{"key":"S0033291720002251_ref87","doi-asserted-by":"publisher","DOI":"10.1080\/16506073.2016.1231219"},{"key":"S0033291720002251_ref71","doi-asserted-by":"publisher","DOI":"10.1038\/sc.2015.221"},{"key":"S0033291720002251_ref96","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2011.10.025"},{"key":"S0033291720002251_ref34","doi-asserted-by":"publisher","DOI":"10.1002\/pon.3104"},{"key":"S0033291720002251_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2013.03.004"},{"key":"S0033291720002251_ref36","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2013.03.005"},{"key":"S0033291720002251_ref25","first-page":"Cd010078","article-title":"Pharmacological interventions for promoting smoking cessation during pregnancy","volume":"3","author":"Claire","year":"2020","journal-title":"Cochrane Database Systematic Reviews"},{"key":"S0033291720002251_ref3","doi-asserted-by":"publisher","DOI":"10.1037\/ccp0000317"},{"key":"S0033291720002251_ref105","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-15-0578"},{"key":"S0033291720002251_ref114","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2010.08.034"},{"key":"S0033291720002251_ref93","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000121"},{"key":"S0033291720002251_ref22","doi-asserted-by":"publisher","DOI":"10.1002\/pon.3714"},{"key":"S0033291720002251_ref44","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2017.04.046"},{"key":"S0033291720002251_ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-015-2867-6"},{"key":"S0033291720002251_ref92","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.2011.05860.x"},{"key":"S0033291720002251_ref14","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.3348"},{"key":"S0033291720002251_ref83","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23257"},{"key":"S0033291720002251_ref104","doi-asserted-by":"publisher","DOI":"10.1007\/s11764-018-0693-9"},{"key":"S0033291720002251_ref47","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000802"},{"key":"S0033291720002251_ref16","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-017-3735-1"},{"key":"S0033291720002251_ref111","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.2777"},{"key":"S0033291720002251_ref97","doi-asserted-by":"publisher","DOI":"10.1097\/NCC.0b013e31824d90d4"},{"key":"S0033291720002251_ref65","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-2153"},{"key":"S0033291720002251_ref52","volume-title":"Statistical methods for meta-analysis","author":"Hedges","year":"1985"},{"key":"S0033291720002251_ref32","doi-asserted-by":"publisher","DOI":"10.1007\/s10865-007-9144-1"},{"key":"S0033291720002251_ref75","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2009.166"},{"key":"S0033291720002251_ref67","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6815-14-3"},{"key":"S0033291720002251_ref54","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2017.0044"},{"key":"S0033291720002251_ref33","doi-asserted-by":"publisher","DOI":"10.1037\/a0013075"},{"key":"S0033291720002251_ref84","doi-asserted-by":"publisher","DOI":"10.1007\/s12160-017-9890-4"},{"key":"S0033291720002251_ref40","doi-asserted-by":"publisher","DOI":"10.1111\/j.0006-341X.2000.00455.x"},{"key":"S0033291720002251_ref66","doi-asserted-by":"publisher","DOI":"10.1002\/art.23817"},{"key":"S0033291720002251_ref62","doi-asserted-by":"publisher","DOI":"10.1037\/ccp0000459"},{"key":"S0033291720002251_ref58","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.11.002"},{"key":"S0033291720002251_ref64","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2012.03.025"},{"key":"S0033291720002251_ref86","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2013.01.006"},{"key":"S0033291720002251_ref72","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2015.12.045"},{"key":"S0033291720002251_ref37","doi-asserted-by":"publisher","DOI":"10.1097\/00006842-200107000-00015"},{"key":"S0033291720002251_ref4","first-page":"810","article-title":"Randomized controlled trial of internet-based cognitive behavior therapy for distress associated with tinnitus","volume":"64","author":"Andersson","year":"2002","journal-title":"Psychosomatic Medicine"},{"key":"S0033291720002251_ref35","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000251"},{"key":"S0033291720002251_ref27","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/hpv047"},{"key":"S0033291720002251_ref94","doi-asserted-by":"publisher","DOI":"10.1002\/pon.1969"},{"key":"S0033291720002251_ref42","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000845"},{"key":"S0033291720002251_ref85","doi-asserted-by":"publisher","DOI":"10.1586\/14737167.7.3.291"},{"key":"S0033291720002251_ref69","doi-asserted-by":"publisher","DOI":"10.1007\/s10865-018-9984-x"},{"key":"S0033291720002251_ref50","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31678-6"},{"key":"S0033291720002251_ref51","doi-asserted-by":"publisher","DOI":"10.1097\/PSY.0000000000000096"},{"key":"S0033291720002251_ref28","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.76.5669"},{"key":"S0033291720002251_ref81","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2010.09.008"},{"key":"S0033291720002251_ref79","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2015.06.002"},{"key":"S0033291720002251_ref48","doi-asserted-by":"publisher","DOI":"10.1177\/0269215509360648"},{"key":"S0033291720002251_ref91","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5158"},{"key":"S0033291720002251_ref60","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2017.02.006"},{"key":"S0033291720002251_ref17","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2011.02031.x"},{"key":"S0033291720002251_ref68","doi-asserted-by":"publisher","DOI":"10.1097\/MIB.0000000000000567"},{"key":"S0033291720002251_ref113","doi-asserted-by":"publisher","DOI":"10.1002\/pon.4113"},{"key":"S0033291720002251_ref1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30815"},{"key":"S0033291720002251_ref119","first-page":"e104","article-title":"Mobile breast cancer e-support program for Chinese women with breast cancer undergoing chemotherapy (part 2): Multicenter randomized controlled trial","volume":"6","author":"Zhu","year":"2018","journal-title":"JMIR: Mhealth And Uhealth"},{"key":"S0033291720002251_ref99","article-title":"Feasibility randomized-controlled trial of online acceptance and commitment therapy for patients with complex chronic pain in the United Kingdom","volume":"April 28","author":"Scott","year":"2018","journal-title":"European Journal of Pain"},{"key":"S0033291720002251_ref59","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16050708"},{"key":"S0033291720002251_ref10","article-title":"Audiologist-Guided internet-based cognitive behavior therapy for adults with tinnitus in the United Kingdom: A randomized controlled trial","author":"Beukes","year":"2017","journal-title":"Ear and Hearing"},{"key":"S0033291720002251_ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-017-3598-7"},{"key":"S0033291720002251_ref112","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.54.9386"},{"key":"S0033291720002251_ref80","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.7274"},{"key":"S0033291720002251_ref6","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.3020"},{"key":"S0033291720002251_ref82","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.9710"},{"key":"S0033291720002251_ref95","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-0327(12)70004-6"},{"key":"S0033291720002251_ref5","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.18.00655"},{"key":"S0033291720002251_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2004.07.021"},{"key":"S0033291720002251_ref57","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2009.08.014"},{"key":"S0033291720002251_ref29","doi-asserted-by":"publisher","DOI":"10.1186\/1745-6215-12-259"},{"key":"S0033291720002251_ref61","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20673"},{"key":"S0033291720002251_ref70","doi-asserted-by":"publisher","DOI":"10.1111\/epi.14673"},{"key":"S0033291720002251_ref11","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-017-2712-5"},{"key":"S0033291720002251_ref117","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0143843"},{"key":"S0033291720002251_ref73","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2010.02.007"},{"key":"S0033291720002251_ref39","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2013.869541"},{"key":"S0033291720002251_ref19","doi-asserted-by":"crossref","first-page":"500","DOI":"10.2340\/16501977-0805","article-title":"Guided internet-based cognitive behavioural treatment for chronic back pain reduces pain catastrophizing: A randomized controlled trial","volume":"43","author":"Buhrman","year":"2011","journal-title":"Journal of Rehabilitation Medicine"},{"key":"S0033291720002251_ref98","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12833"},{"key":"S0033291720002251_ref115","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmn.2014.09.009"},{"key":"S0033291720002251_ref13","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.12"},{"key":"S0033291720002251_ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-018-4526-1"},{"key":"S0033291720002251_ref76","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2012.03.001"},{"key":"S0033291720002251_ref109","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2015.06.006"},{"key":"S0033291720002251_ref103","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.68.4.722"},{"key":"S0033291720002251_ref55","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2016.06.004"},{"key":"S0033291720002251_ref53","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.2017.22"},{"key":"S0033291720002251_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2018.02.023"},{"key":"S0033291720002251_ref108","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.74.8491"}],"container-title":["Psychological Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0033291720002251","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,10]],"date-time":"2024-08-10T02:24:04Z","timestamp":1723256644000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0033291720002251\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,17]]},"references-count":119,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,2]]}},"alternative-id":["S0033291720002251"],"URL":"https:\/\/doi.org\/10.1017\/s0033291720002251","relation":{},"ISSN":["0033-2917","1469-8978"],"issn-type":[{"value":"0033-2917","type":"print"},{"value":"1469-8978","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,17]]},"assertion":[{"value":"Copyright \u00a9 The Author(s) 2020. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}