Effectiveness of Digital Health Interventions on Stress, Anxiety, and Depression in University Students: A Systematic Review and Meta-Analysis

Stress, anxiety, and depression are among the most common mental health problems experienced by university students. The aim of this study was to systematically review and analyze the effectiveness of digital health interventions in reducing stress, anxiety, and depression in university students. Several databases (the Cochrane Library, Ovid Embase, Ovid MEDLINE, PubMed, Scopus, and Web of Science Core Collection databases) were searched for randomized controlled trials (RCTs) of digital health interventions published by June 30, 2024. The trials were reviewed, and outcome data were analyzed using random effects meta-analyses for each outcome. A total of 22 RCTs involving 3,655 participants (3,041 analyzed) were included. The meta-analysis revealed that digital health interventions significantly reduced stress, anxiety, and depression in university students (stress: WMD = -1.79; 95% CI: -2.51, -1.07; P<0.001; anxiety: WMD = -1.73; 95% CI: -2.20, -1.25; P<0.001; depression: WMD = -2.05; 95% CI: -2.91, -1.19; P<0.001). Intervention duration and technique were significant moderators of effect size across all outcomes (all P<0.001). Interventions lasting 4 to 8 weeks demonstrated the greatest reductions in symptoms (stress: WMD = -3.7, 95% CI: -5.02, -2.39; anxiety: WMD = -2.77, 95% CI: -3.46, -2.08; depression: WMD = -4.1, 95% CI: -5.31, -2.89). The effect sizes were significantly greater when the interventions were compared to the passive control groups (stress: WMD = -2.46, 95% CI: -3.56, -1.36; anxiety: WMD = -2.32, 95% CI: -2.89, -1.75; depression: WMD = -2.61, 95% CI: -3.92, -1.29). In contrast, comparisons with active control groups yielded smaller, although still significant, effects for stress and depression and a nonsignificant effect for anxiety. The findings indicate that digital health interventions are effective at reducing stress, anxiety, and depression in university students. These findings underscore the necessity of digital health interventions for promoting university students' mental health in higher education settings.