Digital Interventions for People With Co-Occurring Depression and Problematic Alcohol Use: A Systematic Review and Meta-Analysis.

Abstract

AIMS\nThis systematic review and meta-analysis assessed the effectiveness of digital interventions addressing depressive symptoms and alcohol use simultaneously among people with co-occurring depression and problematic alcohol use.\n\n\nMETHODS\nSeven databases were searched for trials evaluating digital interventions aimed at depression and alcohol use. Random-effects meta-analyses were conducted to pool effects on depressive symptoms and alcohol use up to 3-month and 6-month follow-up. Overall quality for every outcome was assessed with GRADE (Grading of Recommendations Assessment, Development and Evaluation).\n\n\nRESULTS\nThe pooled effect of digital interventions compared to their comparators was in favour of digital interventions. Small but significant effects on depressive symptoms at 3-month follow-up were found (g\xa0=\xa00.34, 95% confidence interval (CI): 0.06-0.62, P\xa0=\xa00.02, k\xa0=\xa06) and non-significant effects at 6-month follow-up (g\xa0=\xa00.29, 95% CI: -0.16 to 0.73, P\xa0=\xa00.15, k\xa0=\xa05). For alcohol use, the pooled effect of digital interventions was small and non-significant at 3-month follow-up (g\xa0=\xa00.14, 95% CI: -0.02 to 0.30, P\xa0=\xa00.07, k\xa0=\xa06) and significant at 6-month follow-up (g\xa0=\xa00.14, 95% CI: 0.07-0.20, P\xa0=\xa00.005, k\xa0=\xa05). Sensitivity analysis indicated the latter finding to be sensitive to statistical estimator choice. Quality of evidence was moderate, except for depressive symptoms at 6-month follow-up for which it was low.\n\n\nCONCLUSION\nBased on the literature, digital interventions are effective in reducing depressive symptoms at 3-month follow-up and alcohol use at 6-month follow-up among people with comorbid depression and problematic alcohol use. More high-quality trials are needed to confirm the current findings.