Long-term outcomes of therapist-guided Internet-delivered cognitive behavior therapy for pediatric obsessive-compulsive disorder

Abstract

Cognitive behavior therapy (CBT) is the recommended first-line intervention for children and adolescents with obsessive-compulsive disorder (OCD), but is not broadly accessible. Internet-delivered CBT (ICBT) with minimal therapist support is efficacious and cost-effective, at least in the short term. Whether the therapeutic gains of ICBT for OCD are sustained in the long run is unknown. In this study, 61 adolescents with OCD who participated in a randomized trial of ICBT were followed-up 3 and 12 months after treatment. The proportion of treatment responders and remitters remained stable from post-treatment to 3-month follow-up and increased significantly from 3-month to 12-month follow-up. This study suggests that the gains of ICBT for youth with OCD are not only maintained long-term, but that further improvements continue to occur during follow-up.

Internet-based cognitive behavioral therapy in children and adolescents with obsessive-compulsive disorder: A randomized controlled trial

“…It is possible that the 3 months to follow-up measurement frequently chosen in studies is too short and that further reductions in OCD symptoms do not become significant until after this time. Our own results, in addition to those of other studies ( 26 , 61 ), support this interpretation. Therefore, the question of the follow-up periods required for internet-based treatments to fully capture the long-term treatment effects should be further explored.…”

Feasibility of internet-delivered cognitive-behavior therapy for obsessive-compulsive disorder in youth with autism spectrum disorder: A clinical benchmark study

“…In essence, ICBT mimics traditional in-person CBT in terms of content, the only difference being the mode of delivery ( Hedman et al, 2012 ). The safety, efficacy, durability and cost-effectiveness of ICBT for children and adolescents for OCD have been well established ( Aspvall et al, 2018 ; Lenhard and Andersson, 2017 ; Lenhard et al, 2014 ; Aspvall et al, 2021 ; Lenhard et al, 2020 ; Lenhard et al, 2017 ). A recent study demonstrated non-inferiority of ICBT compared to in-person CBT for OCD when delivered in a stepped-care fashion ( Aspvall and Andersson, 2021 ).…”

Cost-effectiveness of Internet-Delivered vs In-Person Cognitive Behavioral Therapy for Children and Adolescents With Obsessive-Compulsive Disorder

“…This low-intensity intervention has demonstrated efficacy and cost-effectiveness in 3 open studies 15 , 16 , 17 and 1 randomized waitlist clinical superiority trial. 18 , 19 , 20 In a subsequent randomized noninferiority clinical trial, 19 , 20 152 children and adolescents with OCD were randomly assigned to receive either internet-delivered CBT or in-person CBT during a 16-week period. At the 3-month follow-up, nonresponders in both groups were offered additional in-person CBT sessions.…”

“…This study formally tested this hypothesis via a health economic evaluation of our noninferiority trial, as prespecified in the study protocol. 19 , 20 …”

“…Baseline CY-BOCS score, mean (SD) [range] b 22.96 (3.64)[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] 22.95 (3.70)[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] Baseline total societal costs, mean (SD), $…”