Effectiveness of Digital Psychological Interventions for Adolescents With Chronic Pain and Comorbid Anxiety and/or Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
In brief
Digital therapies modestly lower pain and anxiety in teens with chronic pain
A meta-analysis of 12 randomized trials involving 1,403 adolescents found that internet-based cognitive-behavioral or acceptance-based programs reduced pain intensity and anxiety symptoms by small but statistically significant margins, while having no clear effect on depressive symptoms. The findings suggest digital tools can complement standard care, though larger studies are needed to define optimal integrated approaches.
- Journal
- Journal of adolescence (Q1)
- Published
- 22 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Ziqian Li, Wanyue Chen, Tongshuang Yuan, Chengbin Zheng, Kai Liu, Zhongqiong Huang, et al.
- PMID
- 42484278
- DOI
- 10.1002/jad.70236
Why clinicians should know about it
- Picked for Anesthesiology and Pain Medicine (top studies of the week, 26 July 2026).
- Picked for Psychiatry and Mental Health (top studies of the week, 26 July 2026).
Abstract
BACKGROUND: Adolescence is a high-risk period for co-occurring conditions like chronic pain, anxiety, and depression. Although digital psychological interventions offer a scalable and accessible alternative to traditional care, their comprehensive efficacy in addressing these interconnected symptoms remains underexplored. This meta-analysis evaluates the effects of digital interventions on pain in adolescents with comorbid emotional problems, with secondary outcomes including anxiety and depressive symptoms. METHODS: We systematically searched five databases for randomized controlled trials through October 5, 2025, ultimately including 12 studies. Statistical analyses were performed in Review Manager 5.4 and Stata 17.0 using a random-effects model and specifically focused on adolescents with comorbid conditions. The review protocol was registered with PROSPERO. Subgroup analyses were conducted based on intervention type (Internet-based Cognitive Behavioral Therapy [iCBT], self-management, and Internet-based Acceptance and Commitment Therapy [iACT]). RESULTS: A total of 12 studies involving 1403 adolescents were included. Meta-analysis indicated that digital interventions significantly improved pain (SMD = -0.21, 95% CI: [-0.35, -0.06]) and anxiety (SMD = -0.15, 95% CI: [-0.21, -0.10]). The effects of digital psychosocial interventions on depression were not statistically significant. CONCLUSION: Digital interventions show potential in managing pain and anxiety among adolescents with comorbidities. Future efforts should prioritize integrated intervention programs that combine pain management with emotion regulation, establishing them as foundational components within the broader care system to complement routine clinical practice. TRIAL REGISTRATION: This systematic review was prospectively registered with PROSPERO (CRD420251270961) on 12 December 2025. REGISTRATION DETAILS: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251270961.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.