Cited by 104Digital Mental Health InterventionsObsessive-Compulsive Spectrum DisordersAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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Internet-Delivered Cognitive Behavior Therapy for Adolescents with Obsessive-Compulsive Disorder: An Open Trial

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Abstract

BACKGROUND: International guidelines recommend Cognitive Behavior Therapy (CBT) as the first line treatment for pediatric obsessive-compulsive disorder (OCD). However, a substantial proportion of patients do not have access to such treatment. We developed and tested the feasibility, efficacy and acceptability of a novel therapist-guided, Internet-delivered CBT (ICBT) platform for adolescents with OCD. METHODS: An interactive, age-appropriate ICBT platform ("BiP OCD") was developed. Twenty-one adolescents (12-17 years) with a DSM-IV diagnosis of OCD and their parents were enrolled in the study. All participants received 12 weeks of ICBT with therapist support. The primary outcome measure was the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). Acceptability was assessed at post-treatment. RESULTS: Participants completed on average 8.29 (SD = 3.0) of the 12 treatment chapters. Treatment yielded significant improvements on all clinician-, parent- and most self-administered outcome measures, with a large effect size of d = 2.29 (95% CI 1.5-3.07) on the CY-BOCS. Patients continued to improve at follow-up. At 6-month follow-up, 71% were classified as responders (≥35% decrease on the CY-BOCS) and 76% as being in remission (CY-BOCS score ≤12). Average clinician support time was less than 20 minutes per patient per week. The majority of participants felt that BiP OCD was age-appropriate and rated the treatment as good or very good. CONCLUSIONS: ICBT could be efficacious, acceptable, and cost-effective for adolescents with OCD. More rigorously controlled studies are needed to further evaluate the treatment. TRIAL REGISTRATION: ClinicalTrials.gov; NCT01809990.

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Crossref · 10.1371/journal.pone.0100773

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Figure 1 Study flow chart.
Figure 1 Study flow chart.CC BY · PubMed Central
Figure 2 Screenshot of an animated psychoeducation film from BiP OCD (Chapter 1).
Figure 2 Screenshot of an animated psychoeducation film from BiP OCD (Chapter 1).CC BY · PubMed Central
Figure 3 Mean CY-BOCS and adolescent- respective parent-rated ChOCI-R impairment subscale scores at pre-treatment, post-treatment and follow-up.
Figure 3 Mean CY-BOCS and adolescent- respective parent-rated ChOCI-R impairment subscale scores at pre-treatment, post-treatment and follow-up.CC BY · PubMed Central

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Metadata

Authors
Lenhard, F., Vigerland, S., Andersson, E., Rück, C., Mataix-Cols, D., Thulin, U., Ljótsson, B., & Serlachius, E.
Affiliations
Karolinska Institutet (SE)
Corresponding author
Lenhard, Fabian
Venue
PLoS ONE
Published
2014-06-20
Volume
9
Issue
6
Pages
e100773
ISSN
1932-6203 (ISSN-L)
OpenAlex
W2116170399
Cited by
104
References
66
Citations by year
2025: 1 · 2024: 9 · 2023: 3 · 2022: 8 · 2021: 21 · 2020: 5 · 2019: 10 · 2018: 7 · 2017: 16 · 2016: 12 · 2015: 10 · 2014: 2
FWCI
20.73
Type
journal article
Language
en
Open access
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
Funders
  • Karolinska Institutet
  • Stockholms Läns Landsting (20120167)
Topics
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
internet-based cognitive behavioral therapy, obsessive-compulsive disorder, adolescents, pediatric OCD, treatment acceptability, treatment efficacy, treatment feasibility, Children's Yale-Brown Obsessive Compulsive Scale, parental involvement
MeSH terms
Adolescent, Child, Female, Humans, Male, Obsessive-Compulsive Disorder, Parents, Severity of Illness Index, Cognitive Behavioral Therapy, Treatment Outcome, Telemedicine, Internet

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