An individual participant data meta-analysis of predictors of adherence to internet-based interventions for depression – Nature Mental Health

Data availabilityThe IPD analyzed in this study cannot be shared publicly because restrictions related to participant consent, ethics approvals and institutional agreements apply. For data access, please submit a request…

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Data availability

The IPD analyzed in this study cannot be shared publicly because restrictions related to participant consent, ethics approvals and institutional agreements apply. For data access, please submit a request to the corresponding author (L.T.) and the last senior author (E.K.). Access requests will be considered in consultation with all co-authors who contributed the IPD, and an initial response will be provided within 2 weeks. Access can be granted upon approval from all relevant data contributors, provided that an appropriate data-sharing agreement is in place, the original studies permit onward data sharing under their participant consent and ethics approvals, and the proposed analysis plan has been approved by the data contributors. Any shared data may be used only for the approved research purposes.

Code availability

The R code used for data analysis is publicly available at https://osf.io/azq5k/files/osfstorage.

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Acknowledgements

We extend our sincere gratitude to our co-authors for their willingness to participate in the SYNTHESIS IPD project, recruit participants, share the primary data, contribute to the feedback and collaborate on this study. We also thank C. A. Crawford from the Department of Psychology, Indiana University Indianapolis, Indianapolis, USA, for his key scientific and technical contributions to the SYNTHESIS IPD project, specifically by leading the data preparation and sharing data for his relevant trial included in the project.

Funding

A.R. was funded by the company (Meru Health Inc) by the Research Council of Finland (grant 259764). F.W.B. was funded by the Dutch Cancer Society, Alpe d’HuZes (VU 2010–4808). J.M.-M. was supported by a ‘Miguel Servet’ research contract from the Institute of Health Carlos III (ISCIII: CP21/00080) and received support from the Department of Psychiatry at the University of Oxford, UK, and the Spanish CIBER of Epidemiology and Public Health (CIBERESP CB22/02/00052; ISCIII). J.M. was funded by grants from the National Health and Medical Research Council (NHMRC) 1046875, Beyond Blue and Windemere. J.N. was funded by an Australian National Health and Medical Research Council grant (2008839) and Australian Medical Research Future Fund grant (1145382). R.M.F.K. was funded by a Norwegian Research Council (309264). E.K. was funded by a Veni grant from Dutch Research Council (Veni.195.215 6806). The other authors declare no relevant funding.

Author information

Authors and Affiliations

  1. Department of Clinical, Neuro & Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands

    Lingyao Tong, Olga-Maria Panagiotopoulou, Clara Miguel, Mathias Harrer, Arpana Amarnath, Marketa Ciharova, Annemieke van Straten, Heleen Riper, Pim Cuijpers & Eirini Karyotaki

  2. Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands

    Olga-Maria Panagiotopoulou, Arnoud Arntz & Eirini Karyotaki

  3. Center for Research in Epidemiology and Statistics, Paris, France

    Clara Miguel

  4. Department of Psychiatry and Psychotherapy, School of Medicine and Health, Technical University of Munich, Munich, Germany

    Mathias Harrer

  5. Parent-Infant Research Institute and Austin Health, Heidelberg, Victoria, Australia

    Alan W. Gemmill & Jeannette Milgrom

  6. Agency for Science, Technology and Research, Institute for Human Development and Potential, Singapore, Singapore

    Alicia Salamanca-Sanabria

  7. College of Health and Care Professionals of British Columbia, Vancouver, British Columbia, Canada

    Alishia Williams

  8. Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal

    Ana Fonseca

  9. Department of Clinical Psychology, Division of eHealth in Clinical Psychology, Philipps University of Marburg, Marburg, Germany

    Anna Carlotta Zarski

  10. Department of Clinical Psychology and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany

    Anna Carlotta Zarski & Matthias Berking

  11. Arbo Unie, Utrecht, the Netherlands

    Anna Geraedts

  12. Department of Psychiatry, Division of Adolescent Psychiatry, Helsinki University Hospital, Helsinki, Finland

    Anu Raevuori

  13. Clinicum, Department of Psychiatry, University of Helsinki, Helsinki, Finland

    Anu Raevuori

  14. Division of Clinical Informatics and Digital Transformation, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA

    Arka Ghosh

  15. Research Department, GAIA AG, Hamburg, Germany

    Björn Meyer

  16. Foundation for Depression and Suicide Prevention, Depression Research Center, Leipzig, Germany

    Caroline Allenhof

  17. mentalis GmbH, Nuremberg, Germany

    Christian Aljoscha Lukas

  18. Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany

    Christine Knaevelsrud, Manuel Heinrich & Pavle Zagorscak

  19. German Center for Mental Health (DZPG), partner site Berlin-Potsdam, Berlin-Potsdam, Germany

    Christine Knaevelsrud

  20. School of Health and Wellbeing, University of Glasgow, Glasgow, UK

    Christopher Williams

  21. Department of Medical Statistics and Epidemiology, Sun Yat-sen University, Guangzhou, China

    Ciyong Lu

  22. Amsterdam UMC, Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands

    Claudi Bockting

  23. Amsterdam Public Health Research Institute, Mental Health, Amsterdam, the Netherlands

    Claudi Bockting

  24. Amsterdam Neuroscience Research Institute, Amsterdam, the Netherlands

    Claudi Bockting

  25. Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands

    Claudi Bockting

  26. Psychology and Digital Mental Health Care, Technical University Munich, Munich, Germany

    David Daniel Ebert

  27. RED Digital Health Consulting, Dublin, Ireland

    Derek Richards

  28. Oregon Research Institute, Springfield, OR, USA

    Edward G. Feil

  29. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Elizabeth L. Addington

  30. Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden

    Erik Forsell

  31. Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden

    Erik Forsell

  32. Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China

    Fenglin Cao

  33. Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain

    Fernando L. Vázquez

  34. School of Medicine, Leeds Institute of Medical Research, University of Leeds, Leeds, UK

    Florien Willemijn Boele

  35. Stichting Epilepsie Instellingen Nederland, Heemstede, the Netherlands

    Florien Willemijn Boele

  36. School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia

    Frances Kay-Lambkin

  37. University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden

    Fredrik Holländare

  38. Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden

    Gerhard Andersson

  39. Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden

    Gerhard Andersson

  40. Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Ulm, Germany

    Harald Baumeister

  41. Department of Psychology, University of Regina, Regina, Saskatchewan, Canada

    Heather D. Hadjistavropoulos

  42. Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia

    Isabella Choi

  43. Department of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany

    Jan Philipp Klein

  44. Center for Brain, Behavior and Metabolism, University of Lübeck, Lübeck, Germany

    Jan Philipp Klein

  45. Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia

    Jeannette Milgrom

  46. Department for Health, University of Bath, Bath, UK

    Jeffrey Lambert

  47. Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA

    Jennifer Dahne

  48. Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA

    Jennifer Dahne

  49. Department of Psychology, Indiana University Indianapolis, Indianapolis, IN, USA

    Jesse C. Stewart

  50. Imperial Clinical Trials Unit, Imperial College London, London, UK

    Jessica Smith

  51. Teaching, Research and Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain

    Jesus Montero-Marin

  52. Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK

    Jesus Montero-Marin

  53. Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health-CIBERESP), Madrid, Spain

    Jesus Montero-Marin

  54. Black Dog Institute, Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia

    Jill Newby & Mark Deady

  55. Department of Clinical, Neuro and Developmental Psychology, World Health Organization Collaborating Center for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands

    Jinane Abi Ramia

  56. National Mental Health Programme, Ministry of Public Health of Lebanon, Beirut, Lebanon

    Jinane Abi Ramia & Rabih El Chammay

  57. Institute for Interactive Systems, Technical University of Lübeck, Lübeck, Germany

    Jo Annika Reins

  58. Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden

    Johan Lundgren & Peter Johansson

  59. Department of Medical Social Sciences, Osher Center for Integrative Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Judith Tedlie Moskowitz

  60. Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA

    Kathryn L. Jackson

  61. Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway

    Kjersti Lillevoll

  62. Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden

    Kristofer Vernmark

  63. Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany

    Lasse B. Sander

  64. Clinic for Psychosomatic Medicine and Psychotherapy, University Hospital Ulm, University of Ulm, Ulm, Germany

    Lina Braun

  65. National Health Care Institute Netherlands, Diemen, the Netherlands

    Lisanne Warmerdam

  66. Department of Health Sciences, University of York, York, UK

    Liz Littlewood & Simon Gilbody

  67. Health Research Institute of the Balearic Islands, Hospital Universitari Son Espases, Palma, Spain

    Margalida Gili

  68. Research Institute of Health Sciences, University of the Balearic Islands, Palma, Spain

    Margalida Gili

  69. Department of Psychology, University of the Balearic Islands, Palma, Spain

    Margalida Gili

  70. Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden

    Martin Kraepelien, Nils Lindefors & Viktor Kaldo

  71. Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland

    Michael P. Schaub

  72. Division of Clinical Psychology, Department of Psychology, Uppsala University, Uppsala, Sweden

    Monica Buhrman

  73. Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Uniondale, NY, USA

    Nicholas R. Forand

  74. School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia

    Nickolai Titov

  75. Private practice, Vancouver, British Columbia, Canada

    Nicole Pugh

  76. Department of Biological Sciences and Bioengineering, Indian Institute of Technology Kanpur, Kanpur, India

    Nitin Gupta

  77. Department of Psychology, Stockholm University, Stockholm, Sweden

    Per Carlbring & Robert Johansson

  78. School of Psychology, Korea University, Seoul, Republic of Korea

    Per Carlbring

  79. Psychiatry Department, Saint Joseph University, Beirut, Lebanon

    Rabih El Chammay

  80. Faculty of Psychology, Atma Jaya Catholic University of Indonesia, South Jakarta, Indonesia

    Retha Arjadi

  81. Student Wellbeing Programmes, Erasmus University Rotterdam, Rotterdam, the Netherlands

    Rianne van der Zanden

  82. Health Service and Population Research Department, Centre for Global Mental Health, King’s College London, London, UK

    Ricardo Araya

  83. Department of Psychiatry and Neuroscience, Charité – Universitätsmedizin Berlin, Berlin, Germany

    Rico Krämer

  84. Research Center for Digital Mental Health Services, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway

    Robin Maria Francisca Kenter

  85. Department of Psychiatry, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands

    Rosa Boeschoten

  86. Mental Health Program, Amsterdam Public Health, Amsterdam, the Netherlands

    Rosa Boeschoten

  87. Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, IN, USA

    Samir K. Gupta

  88. Clinic of Psychotherapy, Cologne, Germany

    Sandra Schlicker

  89. Wise Institute, Sydney, New South Wales, Australia

    Sarah Perini

  90. Department of Psychiatry and Neurosciences, Charité – Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany

    Stephan Köhler

  91. Klinikum Osnabrück, Osnabrück, Germany

    Stephanie Nobis

  92. Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland

    Thomas Berger

  93. Depression Research Centre of the German Foundation for Depression and Suicide Prevention, Department for Psychiatry, Psychosomatics and Psychotherapy, Goethe University, Frankfurt, Germany

    Ulrich Hegerl

  94. Department of Evolutionary and Educational Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain

    Vanessa Blanco

  95. Department of Psychology, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden

    Viktor Kaldo

  96. Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands

    Viktor Pop

  97. Fontys University of Applied Sciences, Eindhoven, the Netherlands

    Viola Spek

  98. Arjuna Labs, Kentfield, CA, USA

    Wendy Pots

  99. Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China

    Yaoyao Sun

  100. Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden

    Yvonne Forsell

  101. WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands

    Pim Cuijpers & Eirini Karyotaki

  102. Babeș-Bolyai University, International Institute for Psychotherapy, Cluj-Napoca, Romania

    Pim Cuijpers

Authors

  1. Lingyao Tong
  2. Olga-Maria Panagiotopoulou
  3. Clara Miguel
  4. Mathias Harrer
  5. Arpana Amarnath
  6. Marketa Ciharova
  7. Alan W. Gemmill
  8. Alicia Salamanca-Sanabria
  9. Alishia Williams
  10. Ana Fonseca
  11. Anna Carlotta Zarski
  12. Anna Geraedts
  13. Annemieke van Straten
  14. Anu Raevuori
  15. Arnoud Arntz
  16. Arka Ghosh
  17. Björn Meyer
  18. Caroline Allenhof
  19. Christian Aljoscha Lukas
  20. Christine Knaevelsrud
  21. Christopher Williams
  22. Ciyong Lu
  23. Claudi Bockting
  24. David Daniel Ebert
  25. Derek Richards
  26. Edward G. Feil
  27. Elizabeth L. Addington
  28. Erik Forsell
  29. Fenglin Cao
  30. Fernando L. Vázquez
  31. Florien Willemijn Boele
  32. Frances Kay-Lambkin
  33. Fredrik Holländare
  34. Gerhard Andersson
  35. Harald Baumeister
  36. Heather D. Hadjistavropoulos
  37. Heleen Riper
  38. Isabella Choi
  39. Jan Philipp Klein
  40. Jeannette Milgrom
  41. Jeffrey Lambert
  42. Jennifer Dahne
  43. Jesse C. Stewart
  44. Jessica Smith
  45. Jesus Montero-Marin
  46. Jill Newby
  47. Jinane Abi Ramia
  48. Jo Annika Reins
  49. Johan Lundgren
  50. Judith Tedlie Moskowitz
  51. Kathryn L. Jackson
  52. Kjersti Lillevoll
  53. Kristofer Vernmark
  54. Lasse B. Sander
  55. Lina Braun
  56. Lisanne Warmerdam
  57. Liz Littlewood
  58. Manuel Heinrich
  59. Margalida Gili
  60. Mark Deady
  61. Martin Kraepelien
  62. Matthias Berking
  63. Michael P. Schaub
  64. Monica Buhrman
  65. Nicholas R. Forand
  66. Nickolai Titov
  67. Nicole Pugh
  68. Nils Lindefors
  69. Nitin Gupta
  70. Pavle Zagorscak
  71. Per Carlbring
  72. Peter Johansson
  73. Rabih El Chammay
  74. Retha Arjadi
  75. Rianne van der Zanden
  76. Ricardo Araya
  77. Rico Krämer
  78. Robert Johansson
  79. Robin Maria Francisca Kenter
  80. Rosa Boeschoten
  81. Samir K. Gupta
  82. Sandra Schlicker
  83. Sarah Perini
  84. Simon Gilbody
  85. Stephan Köhler
  86. Stephanie Nobis
  87. Thomas Berger
  88. Ulrich Hegerl
  89. Vanessa Blanco
  90. Viktor Kaldo
  91. Viktor Pop
  92. Viola Spek
  93. Wendy Pots
  94. Yaoyao Sun
  95. Yvonne Forsell
  96. Pim Cuijpers
  97. Eirini Karyotaki

Contributions

L.T., P.Cu. and E.K. conceived and designed this study. L.T. acquired and curated the data, conducted the statistical analyses with input from M.Ha., and drafted the paper. L.T., O.-M.P., C.M., A.Am. and E.K. collected and harmonized the IPD. E.K. and P.Cu. supervised the study. All authors (L.T., O.-M.P., C.M., M.Ha., A.Am., M.C., A.W.G., A.S.-S., A.W., A.F., A.C.Z., A.Ge., A.v.S., A.R., A.Ar., A.Gh., B.M., C.A., C.A.L., C.K., C.W., C.L., C.B., D.D.E., D.R., E.G.F., E.L.A., E.F., F.C., F.L.V., F.W.B., F.K.-L., F.H., G.A., H.B., H.D.H., H.R., I.C., J.P.K., J.M., J.La., J.D., J.C.S., J.S., J.M.-M., J.N., J.A.Ra., J.A.Re., J.Lu., J.T.M., K.L.J., K.L., K.V., L.B.S., L.B., L.W., L.L., M.He., M.G., M.D., M.K., M.Be., M.P.S., M.Bu., N.R.F., N.T., N.P., N.L., N.G., P.Z., P.Ca., P.J., R.E.C., R.Arj., R.v.d.Z., R.Ara., R.K., R.J., R.M.F.K., R.B., S.K.G., S.S., S.P., S.G., S.K., S.N., T.B., U.H., V.B., V.K., V.P., V.S., W.P., Y.S., Y.F., P.Cu. and E.K.) contributed to study conduct and critically reviewed the paper. L.T., O.-M.P., C.M., M.Ha., A.Am., M.C., P.Cu. and E.K. had full access to the anonymized data used in the study. All authors were responsible for the decision to submit the manuscript for publication.

Corresponding author

Correspondence to Lingyao Tong.

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Competing interests

A.R. has equity ownership in Meru Health Inc. F.W.B. received Speaker fees from Servier, MedScape and MedTalks. N.R.F. has equity in Two Chairs, a tech-enabled behavioral health company headquartered in San Fransisco, CA. The other authors declare no competing interests.

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Nature Mental Health thanks Inés Nieto, Xin Wang and the other, anonymous, reviewer(s) for their contribution to the peer review of this work. Peer reviewer reports are available.

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Tong, L., Panagiotopoulou, OM., Miguel, C. et al. An individual participant data meta-analysis of predictors of adherence to internet-based interventions for depression. Nat. Mental Health (2026). https://doi.org/10.1038/s44220-026-00707-4

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