Systemic Review of Clinical- and Cost-effectiveness of Computerized Cognitive Behavioral Therapy (CCBT) for Adult Depression

There has recently been increasing attention paid to cognitive behavioral therapy (CBT) as a treatment for depression, despite its limitations such as a shortage of therapists. Therefore, computerized-CBT (CCBT) was developed to overcome this issue. Within our meta-analysis of adult depression (So et al., 2013), a sub-analysis was conducted on 1) guidance, 2) generation, 3) the severity of depression, and 4) multimedia functions, followed by a systematic review of cost-benefit analyses. 1) The effectiveness of guided CCBT was nearly double (p<.05) that of non-guided. 2) Significantly higher effectiveness was observed in patients in their 30s and 40s relative to that in other age groups (p<.05). 3) It was also found that high severity was correlated with higher dropout rates (p<.05), despite no significant difference in the effect according to severity. 4) CCBT with multimedia functions led to a reduction in dropout rates irrespective of a lack of significant difference in effectiveness observed. Furthermore, all three randomized controlled trials (RCTs) available on economic evaluation supported the advantages of CCBT both in terms of cost effectiveness and cost utility.