Table 1. Selected characteristics of randomised controlled studies examining the effects of cCBT and iCBT for anxiety and depression in children and adolescents.
| Study | Cond | Age Range | Inclusion | Diagn | Recr | Setting | Mean Age (SD), % Boys | Conditions | N | Nmod | Par Inv | Guid-ance | Outcomes and Method | FU | Bias a | Country |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Fleming, | Dep | 13–16 | CDRS-R >29, excl: severe depr | N | School | School | 14.9 (0.79) 56 | cCBT (SPARX) | 20 | 7 | N | Y | D: CDRS-R (Y, O), RADS-2 (Y, SR); A: SCAS-C (Y, SR) | N | ++++ | NZ |
| 2012 [47] | WL | 12 | ||||||||||||||
| Keller, | Anx | 6–12 | GAD > 8, SepA > 4 / SP > 7 on SCARED-P, excl:depr T-score > 65 on CDI-S | N | Com | Home | 8.41 (1.59), 51.35 | iCBT | 22 | 12 | Y | Y | A: SCARED-P (P, SR), DISC IV-P (P, O), RCMAS (Y, SR); D: CDI-S (Y, SR) | N | ++++ | USA |
| 2009 [48] | ||||||||||||||||
| WL | 15 | |||||||||||||||
| Khanna, 2010 [49] | Anx | 7–13 | SepA, SoP, GAD, SP / PD on ADIS-P CSR > 3 | Y | Com | Uni | 10.1 (1.6), 67.35 | cCBT (Camp Cope-A-Lot) | 17 | 12, Par:2 | Y | Y | A: ADIS-P CSR (P, O), MASC (Y, SR) | N | +?++ | USA |
| Placebo | 16 | D: CDI (Y, SR) | ||||||||||||||
| Makarushka, 2012 [46] | Dep | 11–15 | CES-D > 15, excl: no MD, D / M on K-SADS-E | Y | Com | Home | 12.7 (1.24) 44 | iCBT (Blues Blaster) | 76 | 6 | N | N | D: CES-D (Y, SR) | 6M | +?++ | USA |
| Placebo | 85 | |||||||||||||||
| March, | Anx | 7–12 | Anx Dis (other than OCD, PD / PTSD) on ADIS-C/-P CSR > 3 | Y | Com | Home | 9.45 (1.37), 51.95 | iCBT, (BRAVE for Children—ONLINE) | 40 | 10 + 2 Boost Par:6 | Y | Y | A: ADIS-C (Y, O), /-P CSR (P, O),SCAS-C (Y, SR), /-P (P, SR), D: CES-D (Y, SR) | N | ++++ | AU |
| 2009 [50] | ||||||||||||||||
| WL | 33 | |||||||||||||||
| Sethi, | Trans | 15–25 | low/ moderate depr/anx on DASS-21, excl: severe Depr/Anx | N | School | Uni | 19.47 (1.57) 34.21 | iCBT | 9 | 5 | N | Y | D+A: DASS-21 (Y, SR), K, K10 (Y, SR) | N | ??+? | AUS |
| 2010 [51] | ||||||||||||||||
| No treatment | 10 | |||||||||||||||
| Spence, | Anx | 12–18 | GAD, SoP, SepA, SP on ADIS-C/-P CSR > 3, excl: prim diag of PD, OCD/ PTSD, moderate—severe mood disturbance on ADIS-C > 5 | Y | Com | Home | 13.98 (1.63), 40.87 | iCBT, BRAVE for Children—ONLINE | 44 | 10 + 2 Boost Par: 5 + 2 Boost | Y | Y | A: ADIS-C (Y, O) /-P CSR (P, O), SCAS-C (Y, SR), /-P (P, SR) | N | ++++ | AU |
| 2011 [52] | ||||||||||||||||
| WL | 27 | |||||||||||||||
| Stallard, | Trans | 11–16 | GAD, SP, SoP / PD, excl: PTSD; mild/moderate depr, excl: severe depr | N | Clin | Home | Median 12, 66.7 | cCBT (Think, Feel, Do) | 10 | 6 | N | Y | A: SCAS (Y, SR), D: AWS (Y, SR) | N | +++- | UK |
| 2011 [53] | ||||||||||||||||
| WL | 10 | |||||||||||||||
| Stasiak, | Dep | 13–18 | CDRS-R > 29, RADS-2 > 75 | N | School | School | 15.2 (1.6) 59 | cCBT (The Journey) | 17 | 7 | N | N | D: CDRS-R (Y, O), RADS-2 (Y, SR) | 1M | ++++ | NZ |
| 2012 [45] | Placebo | 17 | ||||||||||||||
| Storch, 2011 [54] | Anx | 7–16 | OCD on ADIS-IV-C/-P CSR > 3, CY-BOCS > 15 | Y | Clin Com | Home | 11.10 (2.59), 61 | cCBT WL | 16 15 | 14 | Y | Y | A: ADIS-IV-C (Y, O) /-P CSR (P, O), CY-BOCS (Y, O), COIS-C (Y, SR) /-P (P, SR), MASC (Y, SR), | N | +?-+ | USA |
| D: CDI (Y, SR) | ||||||||||||||||
| Tillfors, | Anx | 15–21 | SoP on SPSQ-C, public speaking fears, Depr < 30 on MADRS-S | Y | Com | Home | 16.5 (1.6), 10.53 | iCBT | 10 | 9 | N | Y | A: LSAS-SR (Y, SR); SPS (Y, SR), SIAS (Y, SR), SPSQ (Y, SR), BAI (Y, SR); D: MADRS-S (Y, SR) | N | ??+- | SWE |
| 2011 [55] | ||||||||||||||||
| WL | 9 | |||||||||||||||
| Wuthrich, 2012 [56] | Anx | 14–17 | Any Anx Dis on ADIS-IV-C/-P CSR | Y | Com | Home | 15.17 (1.11) 37.21 | cCBT, Cool TeensWL | 24 19 | 8 | Y | Y | A: ADIS-C (Y, O) /-P CSR (P, O), SCAS-C (Y, O) /-P (P, O) | N | ++++ | AU |
| Van der Zanden, | Dep | 16–25 | CES-D >10 < 45 | N | Com | Home | 20.9 (2.2), 15.6 | iCBT, Master your Mood | 121 | 6 | N | Y | D: CES-D (Y, SR), A: HADS-A (Y, SR) | N | ++++ | NL |
| 2012 [57] | WL | 123 |
a) Bias: Risk of Bias: In this column a positive or negative sign is given for four risk of bias criteria, respectively: allocation sequence; concealment of allocation to conditions; blinding of assessors; and intention-to-treat analyses. A? is given if there were not enough information to judge.
Abbreviations:
ADIS-C: Anxiety Disorders Interview Schedule for Children; ADIS-IV-C: for DSM-IV: Child Version; ADIS-IV-P: Parent Version; ADIS-P: Parent Version; Anx: Anxiety; Attention: Attention Control; AU: Australia; AWS: Adolescent Well Being Scale; BAI: Beck Anxiety Inventory; Boost: Booster Sessions; CBT: Cognitive Behaviour Therapy; cCBT: Computerized CBT; CDI-S: Children´s Depression Inventory, Short Form; CDI: Children's Depression Inventory; CDRS-R: Children’s Depression Rating Scale, Revised; CES-D: Center for Epidemiologic Studies Depression Scale; Clin: Clinical Sample; COIS-C: Child Obsessive Compulsive Impact Scale, Child Version; COIS-P: Parent Version; Com: Community Sample; Cond: Condition; CSR: Clinical Severity Rating; CY-BOCS: Children's Yale-Brown Obsessive-Compulsive Scale; D: Dysthymia; DASS-21: Depression Anxiety Stress Scale Dep: Depression; Diagn: Diagnostic Confirmation, Diagnostic Interview + all participant fulfil disorder (no subclinical); Dis: Disorders; DISC IV-P: Diagnostic Interview Schedule for Children; Excl: Excluded; FU: Follow-Up; GAD: Generalized Anxiety Disorder; Guidance: Therapeutic or Administrative Support by a Professional; HADS-A: Hospital Anxiety and Depression Scale (Anxiety subscale); iCBT: Internetbased CBT; K-SADS-E: Schedule for Affective Disorders and Schizophrenia for School-Age Children, Epidemiological Version; K10: Kessler Psychological Distress Scale; LSAS-SR: Liebowitz Social Anxiety Scale, Self-Report; M: Month: Trans: Transdiagnostic; M. Mania; MADRS-S: Montgomery-Åsberg Depression Rating Scale-Self-Rated; MASC: Multidimensional Anxiety Scale for Children; MD: Major Depression; N: NoN: Number of participants in each condition;NL: Netherlands;Nmod: Number of modules in the intervention;NZ: New Zealand; O: Observerrating (Clinician) OCD = Obsessive Compulsive Disorder; P: Parent Report; Par Inv: Parental Involvement;Par: Parent Sessions; PD: Panic Disorder; Prim Diag: Primary Diagnosis; PTSD: Posttraumatic Stress Disorder; RADS-2: Reynolds ´Adolescent Depression Scale, 2nd Edition; RCMAS: Revised Children ´s Manifest Anxiety Scale; Recr: Recruitment; SCARED-P: Screen for Child Anxiety Related Emotional Disorders, Parent Version; SCAS-C: Spence Children´s Anxiety Scale, Child Version; SCAS-P: Parent Version; SD: Standard Deviation, SepA: Separation Anxiety Disorder; SIAS: Social Interaction Anxiety Scale; SoP: Social Phobia; SP: Specific Phobia; SPS: Social Phobia Scale; SPSQ-C: Social Phobia Screening Questionnaire for Children; SR: Self Report; SWE: Sweden; UK: United Kingdom; Uni: University Lab; USA: United States of America; WL: Waiting List Control; Y: Yes; Y: Youth Report.