Effectiveness of telemedicine on common mental disorders: An umbrella review and meta-meta-analysis

Background: and aims: Common Mental Disorders (CMD) emerged as a substantial global burden, emphasizing the necessity of investigating effective treatment modalities, particularly in telemedicine. This umbrella review and meta-meta-analysis systematically evaluated telemedicine's effectiveness for CMD.

Methods: Key databases (PsycINFO, PubMed, EMBASE, Cochrane Library) were searched for telemedicine interventions targeting CMD, including depression and anxiety. The interventions included video conferencing, mobile applications, remote monitoring, and other communication technologies. Multiple subgroup analyses were conducted based on diverse outcomes, populations, and severity levels to gauge real-world effectiveness. The study, registered on PROSPERO (CRD42023452382), began in October 2022, with analysis from June to August 2023 and an update in April 2024. Results: The umbrella review included 191 systematic reviews, and the meta-meta-analysis incorporated 72 metaanalyses, assessed for quality using the AMSTAR-2 tool.

Results showed significant differences in depression outcomes between telemedicine and positive controls (SMD = -0.29) and blank controls (SMD = -0.53), both P < 0.001. For anxiety, effects were also notable (SMD = -0.26 for positive controls, SMD = -0.68 for blank controls, both P < 0.001). Telemedicine had no significant impact on adolescents but significantly improved depression (SMD = -0.49, P < 0.001) and anxiety (SMD = -0.37, P < 0.001) in adults. Across mild and severe CMD cases, telemedicine consistently demonstrated positive effects with no subgroup variations (both SMD = -0.47, P < 0.001).

Conclusions: In summary, telemedicine interventions showcase effectiveness comparable to traditional face-toface methods in treating CMD. Furthermore, compared to blank controls, telemedicine exhibits significant therapeutic effectiveness.