Objective:

To map the methodologies, populations, interventions, and outcomes of completed, ongoing, and terminated/withdrawn RCTs of digital psychotherapies for depression.

Approach:

• Study Selection: Systematic scoping review of RCTs registered in major clinical trial registries from 2018 to 2025, focusing on digital psychotherapies for adults with depressive disorders.
• Data Extraction: Data on methodological features, population characteristics, settings, intervention descriptions, control types, funders, registration timing, and reporting practices were extracted.

Key Findings:

• Amongthe681RCTs,51.8%werecompleted,34.1%publishedtheirresults,78.1%wereprospectivelyregistered,and8.5%wereindustryfunded.MulticentreRCTsaccountedfor23.1%,with42.9%beingplannedintheUSA,Germany,orCanadaand25.1%recruitinginlow-ormiddle-incomecountries.Inclusionreliedonself-reportedsymptomsonlyfor61.5%,andsuicidalideationwasanexclusioncriterionin61.8%.Themostfrequenttypeofdigitalpsychotherapywascognitive-behaviouraltherapyfor64.6%.Humansupportwasacomponentoftheinterventionin44.2%.Chatbotswereassessedby4.6%.Waitlistcontrolwasusedin21%,with49.3%ofRCTsbeingopen-label.ThemostfrequentprimaryoutcomewasthePatientHealthQuestionnaire-9for35.7%.

Interpretation:

The review highlights persistent issues in trial registration, funding transparency, and the predominance of cognitive-behavioral therapy, suggesting a need for diversification and improved methodological rigor.

Limitations:

• Thereviewmaynotcaptureunpublishedorongoingtrialsthatarenotregistered.Potentialbiasesintrialdesignandreportingpracticeswerenoted.

Conclusion:

To strengthen the evidence base for digital psychotherapies, timely dissemination of results, use of active controls, and diversification of interventions are essential.