The Effects of Psychotherapeutic e-Mental Health Interventions on Male Depression and Anxiety: Systematic Review and Meta-Analysis (Preprint)
Authors: Opozda Melissa J , Oxlad Melissa , Turnbull Deborah , Gupta Himanshu , Vincent Andrew D , Ziesing Samuel , Nankivell Murray , Wittert Gary 
Published: July 2022

BACKGROUND

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 experience when accessing mental health care, the effects of these interventions in male populations have not been evaluated.

OBJECTIVE

Objectives: (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

Methods: Systematic searches (January 2000-October 2020) of six online research databases, manual reference list searching, and citation searches of included articles. Study quality was assessed using the Qualsyst tool, with a minimum total score of 0.55 prespecified for inclusion. Data were narratively synthesised and, where possible, meta-analysed.

RESULTS

Results: Seven papers comprising 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. With a lowest total score of 0.85, study quality was high and no exclusions were made due to poor quality. Four studies used a single-arm pre-post design and three were randomised controlled trials (all with inactive/care as usual control conditions); five studies were focused on treating existing symptoms, while two focused on prevention. The seven studied interventions varied in content, length, and format. Only one intervention was classified as gender sensitive, having been designed specifically for male needs. All of the studies used non-gendered, self-report symptom measures to measure the effects of their intervention. 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 the two pre-post design depression treatment 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

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 inactive/care as usual 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.

CLINICALTRIAL