Use of the internet to assist in the treatment of depression and anxiety: a systematic review.

Objective: This systematic review aims to describe the Internet's potential role in assisting patients with depression and anxiety.

Data Sources: A MEDLINE search was conducted of articles published between 1998 and 2008 using the terms depression and anxiety and Internet, computers and depression and anxiety, Internet and compliance and depression, and Internet and adherence and depression.

Study Selection: Publications cited include articles concerned with the Internet in screening, supporting, educating, and treating patients with depression and anxiety.

Data Extraction: The efficacy of Internet-based interventions for depression and anxiety was reviewed, alongside the quality of available online information regarding these disorders.

Data Synthesis: Little progress has been made in developing a universally accepted system for quality assurance of medical information Web sites. Furthermore, there is a lack of research describing the effect of self-diagnosis sites on meaningful outcomes, such as the proportion of patients who go on to receive successful treatment for their depression. Early studies of Internet-based cognitive-behavioral therapy for depression were promising; however, results of clinical trials for "e-therapy" have been variable due to methodological issues. A novel compliance support Web site for patients with depression and anxiety is being evaluated to establish whether providing such assistance can improve patient outcomes.

Conclusions: The use of the Internet to assist patients with depression and anxiety is currently in its infancy. However, it appears that the Internet has great potential to support patients with depression and may consequently also be of benefit to physicians.