Comparative Efficacy and Attrition Rates of Psychosocial Interventions for Individuals Affected by the COVID-19 Pandemic: A Network Meta-Analysis.

The comparative examination of psychosocial interventions' efficacy and attrition rates in addressing COVID-19's psychological consequences is still limited. This study examined the efficacy and attrition rates of psychosocial interventions among individuals impacted by the COVID-19 pandemic. Systematic searches were conducted to identify randomised controlled trials targeting COVID-19-affected groups. Data on symptoms of anxiety, depression, and stress, as well as attrition rates, were analysed using frequentist random-effects network meta-analyses. One hundred and forty-two studies with 20,470 participants were included. Emotional freedom technique, art-based therapy, stress management, mindfulness- and acceptance-based intervention, positive psychotherapy, yoga therapy, and cognitive behavioural therapy showed significant effects in reducing anxiety symptoms compared with no treatment and treatment as usual. For depressive symptoms, positive psychotherapy, mindfulness- and acceptance-based intervention, cognitive behavioural therapy, and yoga therapy demonstrated significant superiority over no treatment or treatment as usual, with positive psychotherapy also outperforming expressive writing. Regarding stress symptoms, multi-component therapy and yoga therapy produced greater improvements than no treatment, and positive psychotherapy surpassed expressive writing. In terms of attrition rates, resilience training, art-based therapy and yoga therapy had higher dropout rates than no treatment and several other interventions. Sensitivity analyses yielded largely consistent results, confirming the robustness of the main findings. The confidence ranged from moderate to very low. Publication bias was not observed. This study illuminates and compares the efficacy and attrition rate of several psychosocial interventions in attenuating mental health symptoms among COVID-19-affected individuals. The impact of COVID-19 on people remains ongoing, and the findings of this study can also serve as a reference for selecting the best therapeutic options for mental health symptoms in future public health crises.