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Could the use of web-based applications assist in neuropsychiatric treatment? An umbrella review

BMC Psychology volume 13, Article number: 302 (2025) Cite this article

Abstract

Background

The aim of this study was to evaluate the use of applications accessed through internet browsers as tools for neuropsychiatric treatment, as well as to verify the benefits and efficacy of virtual support as a therapeutic approach.

Methods

A broad review of the MEDLINE (PubMed), SciELE and Cochrane databases for review articles was conducted. Articles involving the use of browser-based applications as a support for neurological and psychiatric treatment, with available texts on the selected platforms with no language or year restrictions, were included.

Results

A total of 83 reviews were included in this study. Due to the homogeneity of the information between some articles, the research was grouped according to the following revised themes: mindfulness, tinnitus, electronic health (eHealth), youth and students’ mental health, mobile health applications (mHealth), depression, anxiety and stress, psychoactive substances, sleep quality, chronic diseases and mental disorders.

Conclusion

The findings suggest that the use of virtual support through applications helps neuropsychiatric treatment, improving the well-being and quality of life of these patients.

Peer Review reports

Background

The treatment of mental health disorders will likely change substantially over the next 10–20 years as a result of the vast availability of applications for mobile devices and their ability to offer specific psychological treatment directly to the user [1, 2]. This therapeutic approach favors a new treatment paradigm. However, it is associated with many risks, such as the propagation of ineffective interventions or even harmful interventions. In that sense, physicians and patients need access to reliable and updated information on the empirical status and clinical utility of online interventions, referred to as virtual therapy [1, 2].

The science of implementation aims to spread virtual practices in several contexts. This means introducing new habits through technology, such as websites, browser-based applications, and mobile device applications. Countless mental health applications (MHapps) were indeed developed and made available to users through smartphones. These applications intend to enhance the well-being and quality of life of patients, offering guidance for mental health recovery and encouraging beneficial habits for the integral health of the subject. In this regard, a great need for MHapps is noted, as shown by recent public research, which found that 76% of 525 interviewed subjects would be interested in using their mobile devices for self-management and mental health self-monitoring if access was complimentary [3].

Smartphones are not limited by geography and are generally used in a private manner by an individual; this means that applications are extremely flexible and attractive for users, who are supported by the confidentiality of their engagement. Help through MHapps seems appropriate for young adults and users who search for more autonomous treatment [4]. There are also those who prefer self-help material if it is delivered by a familiar mean [5], such as a personal smartphone. Applications are almost always widely available and easy to access. As a result, they can be used in various contexts and in almost any environment [6]. Furthermore, the user is motivated throughout the day to reach the goal that made them opt for the virtual therapeutic approach and feels rewarded upon reaching it [7].

This broad review outlines the main findings in the neuropsychiatric context regarding the use of technology and web applications as a therapeutic approach. The articles were selected from a literature review that revealed the need to understand the applicability and efficacy of virtual therapy for the care and health of different patients [1,2,3,4,5,6]. On this basis, randomized and controlled clinical trials are needed to validate future applications and the principles from which they are projected to corroborate the results achieved in this work. The aim of this study was to evaluate the use of applications accessed through internet browsers, which are used as tools for neuropsychiatric treatment, and to verify the benefits and efficacy of virtual support as a therapeutic approach.The aim of this study was to evaluate the use of applications accessed through internet browsers as tools for neuropsychiatric treatment and to verify the benefits and efficacy of virtual support as a therapeutic approach in the prevention and treatment of mental disorders. Thus, obtaining a better understanding of this topic has great relevance for clinical practice.

Methods

This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search for review articles was performed on October 30th, 2023, on the MEDLINE (PubMed), SciELE and Cochrane databases. Articles regarding web-based applications as treatment resources or management strategies with available text in the selected platforms, without language or year restrictions, were included (PROSPERO recording CRD42024593512). The Population, Intervention, Comparison, and Outcome (PICO) framework for this study is as follows: P-evaluate research on the use of applications accessed through internet browsers as tools for neuropsychiatric treatment; I—browser-based applications as support for neurological and psychiatric treatment; C- a total of 83 review articles were included in this study, and owing to the homogeneity of the information between some articles, the research was grouped according to the following revised themes: mindfulness, tinnitus, eHealth, youth and students’ mental health, mHealth, depression, anxiety and stress, psychoactive substances, sleep quality, chronic diseases and mental disorders; O—the use of virtual support through applications helps neuropsychiatric treatment, improving the well-being and quality of life of these patients.

For the research plan, we used Prospero for registration and initial searches on the platforms (MEDLINE (PubMed), SciELE and Cochrane databases), the study inclusion and exclusion criteria were delimited, organized as data sources and the terms of search within the existing literature, the search procedures were organized and reviewed by three authors, after all the articles found, they were separated as duplicates, incomplete articles or articles that were not within the objective proposed in this review, where we analyzed the consolidated metrics of the 83 reviews completed.

Study selection

The search terms used were “applications” OR “application” AND “cognitive-behavioral therapy”; “self-guided cognitive behavioral therapy”; “internet cognitive behavioral therapy” OR “unguided internet cognitive behavioral therapy” OR “self-guided internet cognitive behavioral therapy” AND “internet cognitive behavioral therapy with interventions”. Eligible studies included: (1) review articles only; (2) the use of applications as a resource for any circumstantial neuropsychiatric treatment; (3) any symptomatic disease whose diagnostic criteria were established by specific cutoff points in self-reported scales or diagnostic interviews; (4) neuropsychiatric disorders that developed an internet intervention as a resource for treatment; and (5) applications that were interventional in the treatment of neuropsychiatric disorders.

The excluded articles were those whose intervention (1) did not include applications or technological devices with the ability to treat or manage a neuropsychiatric disorder and (2) included applications or technological resources that were not used as therapeutic tools. (3) applications that did not contribute to neuropsychiatric support or treatment (4) articles that were not systematic reviews (5) articles that did not have instructions as the objective of the article (6) diseases or symptoms that were not with neuropsychiatric associations.

Language restrictions were not applied to cover the possibilities of using the application and achieving its use in different languages. However, despite different discoveries, all articles included were published in English.

Two authors selected the studies to be included (L.P.R. and L.A.Q.). Discrepancies were resolved by the third author (A.E.N.).

The use of the PRISMA guidelines and the systematic search of the electronic databases resulted in a total of 2360 articles for initial screening. No additional studies were found by manual reference search. After 53 duplicates were identified, 2307 articles remained, of which 2138 were rejected on the basis of the title and abstract, and 169 articles were selected for entire text reading. Eighty-six additional studies were excluded because they did not meet the eligibility criteria. Therefore, 83 articles were included in this broad review.

Data extraction, quality score and bias evaluation

The following variables were extracted from all studies: authors, publication year, study design and main outcome. The AMSTAR2 tool was used to assess the quality of the studies. L.P.R. and L.A.Q. extracted the data, and L.P.R., L.A.Q. and A.E.N. agreed upon the final inclusion of the studies in the systematic review, data abstraction and quality assessment.

The quality of the systematic reviews was high in 4.1%, moderate in 8.6%, low in 19.8% and critically low in 67.5% of the total studies included (AMSTAR2) (Fig 1).

Fig. 1
figure 1

Prisma 2020 flow diagram for new systematic reviews which included searches of databases and registers only

Full size image

Results

Considering the 83 retrieved articles, a category chart was created by grouping the articles with the same themes for a better understanding of the associations. The categories that were selected for the division of the findings were mindfulness (8); tinnitus (3); eHealth (9); youth and students’ mental health (5); mHealth (12); depression, anxiety and stress (19); psychoactive substances (6); sleep quality (2); chronic diseases (9); and mental health and mental disorders (10) (Table 1).

Table 1 Summary of studies included in the Umbrella Review grouped by categories
Full size table

Mindfulness

The reviews concerning mindfulness were composed of studies focused on different mental conditions to understand the impact of the use of meditation applications on mental health. Mindfulness devices are broadly cited as therapeutic resources for treating different diseases, as they favor the general well-being of patients. A vast variation in sample size, friction rate and intervention period was observed, which, along with the variation in the well-being measures and mobile applications, limited the comparability of the studies. Despite these initial results, the use of technology as mindfulness therapy seems promising [7,8,9,10,11,12,13,14,15].

Tinnitus

Tinnitus, a complex and heterogeneous psychophysiological condition responsible for causing a ghost sound even in the absence of an external sound source, has a direct influence on the quality of life of patients. A positive aspect of tinnitus therapies is that they can be administered in person and delivered online. Each study used a variety of standardized and validated quizzes to measure treatment results [16,17,18]. It can be assumed that the development of applications and web-based platforms for the treatment of tinnitus has had a significant effect on the well-being of individuals who suffer from tinnitus.

Electronic health (eHealth)

eHealth offers solutions for the autonomy of patients and health care on the basis of value [19,20,21,22,23,24,25,26,27]. eHealth services represent efficient, escalating, and cost-effective options for the treatment of patients with limited or no in-person access to mental health care. Research suggests that health interventions through e-Health can contribute to mental health management and reduce stress symptoms in pregnant women, children, and elderly individuals [20,21,22,23,24,25,26,27].

Mental health

With respect to youth and students’ mental health, studies have demonstrated the great potential of technology for improving depressive symptoms and other psychiatric disorders among university students through mobile application interventions. Considering the exponential growth of these mental health resources, virtual support is seen as a concrete tool for treating students. In that sense, universities, particularly university counseling services, can benefit from mHealth interventions not only to approach university students’ mental health but also to reduce difficulties related to a lack of human resources [28,29,30,31,32].

Mobile health applications (mHealth)

mHealth have been recommended as electronic interventions in several studies. The synergy of these technologies allows patients to self-manage and self-monitor to access relevant information about their health, which allows them to cope with certain clinical conditions and ultimately to self-treat [33,34,35,36,37,38,39,40,41,42,43,44].

The rapid development of technology related to mental health is a reality, with many mobile applications being created. However, there is a lack of theoretical knowledge and structured research that support their efficacy in clinical practice [33,34,35,36,37,38,39,40,41,42,43,44].

Depression, anxiety and stress

The studies that relate the use of digital resources to depression, anxiety, and stress suggest that applications favor the reduction of symptoms related to these disorders. This field is an emerging area in mental health, and to reach conclusive evidence, new research has to be performed [45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64]. Nevertheless, even though eHealth results are incipient, they suggest a promising and tangible field for the treatment of depression, anxiety, and stress.

Psychoactive substances

Psychoactive substances are mentioned in studies that have described a great variety of digital applications, including paid and complimentary versions. There is evidence of their applicability, acceptance, and preliminary efficacy in open pilot studies of mHealth aimed at alcohol and tobacco addiction. However, there is a continuous need for studies in this area, especially in the elaboration of efficient digital protocols. Furthermore, no studies regarding the use of mHealth for the treatment of other substance addictions have been conducted [65,66,67,68,69,70].

Sleep disturbances

Only two studies on the use of applications for sleep disturbances were found, and despite the development of mobile health technologies as interventions for sleep quality improvement, evidence of their efficacy remains limited [71, 72].

Chronic diseases

Articles that mentioned the impact of chronic diseases, such as knee arthritis, kidney disease, multiple sclerosis and obesity; applications for pain; and the evaluation and measurement of fatigue, neurological diseases and cancer, on mental health were also included. Studies suggest the importance of virtual intervention for patients’ education. In general, technological approaches integrate communication with clinical cases, as well as biofeedback or patient monitoring. Applications help improve the quality of life, symptoms or physical and emotional handling of patients with different diseases as a support or resource for different treatments [73,74,75,76,77,78,79,80,81].

Neuropsychiatric disorders

Neuropsychiatric disorders and mental health were described in a total of 10 articles, which were subdivided into eating disorders, neurodevelopment disorders, and autistic spectrum disorders. Therapies based on smartphone applications offer clear promise in the mental health care of symptomatic patients or those at risk of developing these conditions [1, 3, 82,83,84,85,86,87,88,89]. To this end, as smartphone ownership has become generalized, app-based therapies have become increasingly common. However, research on app-based therapies has failed to keep pace. Mental disorders cause a substantial burden on health care worldwide. Mobile health interventions are increasingly used to promote mental health and well-being, as they can improve access to treatment and reduce the associated costs. The aim is to highlight the main areas of consideration to leverage the technology to support the implementation of evidence-based treatments and emphasize the challenges and opportunities arising from the use of technology to escalate evidence-based mental health treatments [1, 3, 82,83,84,85,86,87,88,89].

More explicit connections between specific results podem ser compreendidos peland the broader theoretical implications or hypotheses about digital interventions in mental health, among the categories mentioned above, we have several patients who experience more than one of the issues mentioned and we know that, in addition, today mental health involves a range of care and methods for different treatments [1, 3, 7].

A total of 83 studies were used, divided into the themes mentioned above, to better understand the data. This study provides an overview of the effects of diverse interventions that are interconnected in the conduct and means of treatments, highlighting that the use of web-based applications helps in neuropsychiatric treatment. Our aim is clarifying how these findings interact with existing theories or models could deepen the impact and relevance of the discussion this study.

Discussion

As the use of smartphones has spread, application-based therapies have become more common. However, scientific research on the efficacy of virtual approaches through applications is scarce and limited. Mental disorders have a substantial impact on public health worldwide. The proof that mobile interventions are efficient can speed up and improve access to treatment and reduce associated costs. Therefore, it becomes necessary to highlight the gaps and benefits of technology in the implementation of web-based applications [1, 3, 82,83,84,85,86,87,88,89].

The studies included in this systematic review demonstrate a strong interconnection point, which is the use of applications as a technological resource favorable to the development of scientific research or health management in all ten categories that were listed for disorders or diseases.

Mindfulness

As previously described, studies based on mindfulness, for example, have shown concrete benefits for mental health. They are useful both in the remission and reduction of psychiatric symptoms and related disorders, as well as in improving sleep quality. Mindfulness studies revealed that various mental conditions can be improved through the effects of meditation applications on mental health. Given the broad variation of these studies and the positive results, the findings may be related in future studies, contributing to their improvement and new eHealth connections, quality of life, sleep quality, depression, anxiety, stress, and psychiatric disorders in general [7,8,9,10,11,12,13,14,15].

Mental health

The mental health of young people and students has also improved in aspects such as anxiety, stress, and the reduction of psychoactive substance use or abuse. We know how important it is to have studies aimed at caring for the health of the youth so that society can develop, enabling young people to be even more included. Such studies contribute more each day to technological advancements in health care, with young people having better mental health and remission of psychiatric disorders [28,29,30,31,32].

Electronic health (eHealth)

Studies in eHealth have demonstrated advances in patients’ global treatment, especially with respect to stress and mental health, and even in health management. This finding suggests that it can facilitate all aspects of the treatment and administrative structuring of patients because the use of mobile applications allows self-management and data recognition. eHealth applied to inform health professionals or manage patients’ information helps organize data and possible clinical care. Moreover, professionals who are better supported by improved administration, management, and patient information are more proficient in clinical conduct. They have more space and more quality time to better attend to patients and consequently offer more organized treatment directed at the needs of each patient [19,20,21,22,23,24,25,26,27].

Sleep disturbances

In terms of sleep quality, studies have shown that good sleep quality promotes health in general, as in the aspects mentioned here, such as stress, anxiety, depression, illnesses, and health disorders. Without quality sleep, stress levels increase, as do physical illnesses, and even mental health can be compromised. This and many other studies need to demonstrate how technological resources can help raise awareness of the necessity for and management of sleep, as well as its time and quality, for positive effects on the lives of individuals, such as increased quality of life and overall well-being [71, 72].

Depression, anxiety and stress

This study also analyzed studies on anxiety, depression, stress, and psychiatric disorders that use technology as a treatment resource. Many patients have monthly consultations and technology and applications can facilitate communication with health care professionals so that patients feel more supported and have even more humanized management of treatment time and engagement. The World Health Organization predicts that depression will become the leading cause of the global disease burden by 2030. Thus, there is an enormous need for improved preventative mental health care, and MHapps aimed at emotional well-being are ready to provide exciting new opportunities in this field. The evidence-based recommendations discussed here are important for all MHapp developers to recognize whether better interventions should be developed to meet this growing demand in the future [45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90].

Technology can assist in information management for both patients and health care professionals in terms of aspects such as teleconsultations and test results, among many other aspects, as mentioned in the different studies in this review [3, 6, 7, 9,10,11,12, 14, 15, 17,18,19].

In general, combined technology that incorporates doctor and patient communication, along with biofeedback and patient monitoring, has shown favorable results with the use of virtual resources. Therefore, these applications help improve the quality of life, symptoms, and physical and emotional handling of patients with different disorders as a support or an instrument for different treatments. Such applications may provide support for patients who can access applications that remind them of when to take medication or provide a psychological technique for relaxation, meditation, or many clinical examples that support treatment, to which the patient can gain access through a smartphone at any time of day in any location [19,20,21,22,23,24,25,26,27,28,29,30,31,32].

Mobile health interventions are increasingly used to promote mental health and well-being since they can improve access to treatment and reduce the associated costs. It is known that online consultations are an example in which technology is already established and is increasingly gaining space and openings to assist in access, minimize the need for transportation, organize the routines of patients and health care professionals, and increase general access and resources.

In this study, there is a wide variety of associations in the results. Our main aim was to research the use of applications and technological innovations in mental health to understand the current scenario and increase the need for further studies and possible treatment paths. Our findings indicate that in terms of mental health, stress, anxiety, depression, sleep quality, tinnitus, psychoactive substances, diseases, and disorders, technological means such as applications and systems that help these patients and their treatments become even more efficient and organized for even more robust results and improved well-being.

There is a need for in-depth discussions on the use of technology and applications to manage psychological support and information in mental health and psychiatric disorders. Owing mainly to technological advancements in general society, such as in neuropsychiatric treatments, understanding the use of the internet, applications, different disorders and issues linked to neuropsychiatry, as reported, is important for clinical health treatments and management.

Conclusion

In addition to the 83 studies reported here, there are others in the literature, but most of them are initial, requiring monitoring and evidence on the development and applicability of the findings in different patients and neuropsychiatric treatments. The evidence presented in this work highlights the necessity of developing new preventive and therapeutic instruments that could benefit patients’ physical and mental health.

In this study, we demonstrate different discoveries about the use of applications accessed through internet browsers for neuropsychiatric treatment, even though they initially already benefitted from different treatments, such as mental health in general, anxiety, depression, stress, sleep disorders, mindfulness disciplines, chronic illnesses, and tinnitus, among others associated with neuropsychiatric disorders and treatments.

The findings suggest that the use of virtual support through applications that favor neuropsychiatric treatment improves the well-being and quality of life of these patients.

From this perspective, browser-based applications have emerged as great allies for patients and health professionals, above all, for neuropsychiatric treatment. Therefore, the findings of this review suggest that the proper use of technology for mental health benefits the well-being and quality of life of patients and represents advances in clinical practice.

Limitations of the review

We recognize the limitations of this review, such as possible prejudices that still exist among health professionals or specific areas of health where the evidence is still inicial; as we observed in this study, few articles in some categories mentioned. We believe that this study contributes to the literature, but more efforts are needed to validate these findings.

Data availability

No datasets were generated or analysed during the current study.

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Methodology

We confirmed that all methods were carried out in accordance with relevant guidelines and regulations.

Funding

Antonio Egidio Nardi is a researcher funded by the Conselho Nacional de Desenvolvimento Científico e Tecnológico (National Council for Scientific and Technological Development) (CNPq) and Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (Carlos Chagas Filho Foundation for Research Support of the State of Rio de Janeiro) – FAPERJ

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  1. Institute of Psychiatry, Depression Ambulatory Care, Federal University of Rio de Janeiro, Resistant, Rua Norberto Froes de Andrade, n.27/apt 102, RJ, Santa Rosa, Barra Mansa, Brazil

    Luísa Pelucio, Laiana A. Quagliato & Antonio Egidio Nardi

  2. Institute of Psychiatry, Laboratory of Panic and Respiration, Federal University of Rio de Janeiro, Rio de Janeiro RJ, Rio de Janeiro, Brazil

    Amanda Cardoso & Natia Horato

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  1. Luísa Pelucio
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LP: Conceptualization, Data curation, Formal Analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing – original draft, Writing – review editing. LAQ: Conceptualization, Data curation, Formal Analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing – original draft, Writing – review editing. AC: Conceptualization, Data curation, Formal Analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing – original draft, Writing – review editing. NH: Conceptualization, Data curation, Formal Analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing – original draft, Writing – review editing. AEN: Conceptualization, Data curation, Formal Analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing – original draft, Writing – review editing.

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Pelucio, L., Quagliato, L.A., Cardoso, A. et al. Could the use of web-based applications assist in neuropsychiatric treatment? An umbrella review. BMC Psychol 13, 302 (2025). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s40359-024-02263-x

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