Digital mental health interventions for anxiety: An umbrella review and multiverse meta- analysis
Abstract
Several meta-analyses and meta-reviews have yielded inconclusive results on the efficacy of digital mental health interventions for anxiety disorders. To address this discrepancy, we conducted an umbrella review and multiverse meta-analysis of randomized controlled trials with no restrictions on intervention type, target group, format, control condition, or diagnosis. Studies focusing on comorbid anxiety were excluded. We screened 10.942 records and retrieved 1.263 full texts, identifying 10 meta-analyses and 81 randomized controlled trials meeting inclusion criteria. Unfortunately, the majority of included meta-analyses and primary investigations were of suboptimal quality, with possible conflicts of interest. Only two meta-analyses provided suggestive evidence, and the majority yielded weak evidence. Digital interventions demonstrated stronger evidence for the treatment of generalized anxiety disorder than other anxiety disorders. The multiverse meta-analysis calculated 2.220 additional meta-analyses, with an average effect size of Hedges’ g = 0.65 with 79% of the meta-analyses reaching at least a small effect size. Results suggest the overall robustness of digital interventions, with larger effect sizes observed for guided interventions, internet-based interventions, and comparisons with waitlist control groups. Nonetheless, we caution against overinterpreting findings given the overall low quality of evidence.
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BibTeX
@misc{plessen2026digital,
title = {{Digital mental health interventions for anxiety: An umbrella review and multiverse meta- analysis}},
author = {Constantin Yves Plessen and Olga-Maria Panagiotopoulou and Clara Miguel and Marketa Ciharova and Davide Papola and Darin Pauley and Eirini Karyotaki and Pim Cuijpers},
howpublished = {PsyArXiv},
year = {2026},
month = aug,
doi = {10.31234/osf.io/24qyp_v1},
url = {https://osf.io/preprints/psyarxiv/24qyp_v1/},
note = {CC BY 4.0},
}
RIS
TY - UNPB
TI - Digital mental health interventions for anxiety: An umbrella review and multiverse meta- analysis
AU - Constantin Yves Plessen
AU - Olga-Maria Panagiotopoulou
AU - Clara Miguel
AU - Marketa Ciharova
AU - Davide Papola
AU - Darin Pauley
AU - Eirini Karyotaki
AU - Pim Cuijpers
PY - 2026
DA - 2026/08/31
PB - PsyArXiv
DO - 10.31234/osf.io/24qyp_v1
UR - https://osf.io/preprints/psyarxiv/24qyp_v1/
AB - Several meta-analyses and meta-reviews have yielded inconclusive results on the efficacy of digital mental health interventions for anxiety disorders. To address this discrepancy, we conducted an umbrella review and multiverse meta-analysis of randomized controlled trials with no restrictions on intervention type, target group, format, control condition, or diagnosis. Studies focusing on comorbid anxiety were excluded. We screened 10.942 records and retrieved 1.263 full texts, identifying 10 meta-analyses and 81 randomized controlled trials meeting inclusion criteria. Unfortunately, the majority of included meta-analyses and primary investigations were of suboptimal quality, with possible conflicts of interest. Only two meta-analyses provided suggestive evidence, and the majority yielded weak evidence. Digital interventions demonstrated stronger evidence for the treatment of generalized anxiety disorder than other anxiety disorders. The multiverse meta-analysis calculated 2.220 additional meta-analyses, with an average effect size of Hedges’ g = 0.65 with 79% of the meta-analyses reaching at least a small effect size. Results suggest the overall robustness of digital interventions, with larger effect sizes observed for guided interventions, internet-based interventions, and comparisons with waitlist control groups. Nonetheless, we caution against overinterpreting findings given the overall low quality of evidence.
ER -