Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Apr 10, 2023)
Date Submitted: Jul 18, 2022
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
The Effects of Psychotherapeutic e-Mental Health Interventions on Male Depression and Anxiety: Systematic Review and Meta-Analysis
ABSTRACT
Background:
Only a minority of adult males who experience depression or anxiety receive any formal help from a healthcare professional for these issues. While psychotherapeutic e-mental health interventions may circumvent or reduce many of the barriers males face when accessing mental health care, the effects of these interventions in male populations have not been evaluated.
Objective:
(1) Synthesise the characteristics of psychotherapeutic e-mental health interventions for depression or anxiety that have been trialled and evaluated in male populations; (2) synthesise and meta-analyse the effects of these interventions on depression and anxiety outcomes in males, including examining the influence of participant, intervention, and study characteristics.
Methods:
Systematic searches (January 2000-October 2020) of six online research databases, manual reference list searching, and citation searches of included articles. Data were narratively synthesised and, where possible, meta-analysed.
Results:
Seven high-quality papers (N=552 male participants) were included. A total of 177 studies were excluded because although they met all other inclusion criteria, they did not present analysable data on male participants. The seven reviewed interventions varied in content, length, and format; only one was gender sensitive. All studies used non-gendered, self-report symptom measures. All three randomised controlled trials detected no post-trial difference in depression symptoms between male intervention and male control participants. All four treatment studies presenting pre-post data reported post-intervention improvements in depression or social anxiety symptoms; this was supported by our meta-analysis of two studies, which found a medium-sized, positive effect of treatment interventions on depression symptoms in pre-post data (g=0.64, p<0.005). Further meta-analyses could not be conducted due to data limitations.
Conclusions:
Limited data indicate that psychotherapeutic e-mental health treatment interventions resulted in pre- to post-intervention improvements in male depression symptoms; superior outcomes were not seen when compared to control conditions. There is urgent need for consideration of gender and sex throughout the development, evaluation, and dissemination of these interventions for males, and for additional information on their effects.
Citation
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