Unguided Internet-based cognitive-behavioral therapy for obsessive-compulsive disorder: A randomized controlled
Johanna Schröder1, Nathalie Werkle2, Barbara Cludius3
1Department of Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
Depression and Anxiety
|November 10, 2020
Summary
Unguided internet-based cognitive-behavioral therapy (iCBT) effectively reduced obsessive-compulsive disorder (OCD) symptoms. However, higher internet usage correlated with diminished treatment benefits, highlighting a need for further research.
Area of Science:
- Mental Health
- Psychiatry
- Digital Therapeutics
Background:
- Many individuals with obsessive-compulsive disorder (OCD) face barriers to professional treatment.
- Internet-based cognitive-behavioral therapy (iCBT) offers a potential solution to bridge treatment gaps.
- The efficacy of unguided iCBT, particularly with third-wave approaches, requires further investigation.
Purpose of the Study:
- To evaluate the effectiveness of an unguided iCBT intervention for OCD symptoms.
- To assess the impact of unguided iCBT on secondary outcomes such as self-esteem and quality of life.
- To explore potential moderators of treatment efficacy, such as internet usage frequency.
Main Methods:
- 128 individuals with self-reported OCD symptoms were randomized into an unguided iCBT group or a care-as-usual (CAU) control group.
- Symptom changes were assessed over eight weeks using the Yale-Brown Obsessive-Compulsive Scale via online surveys.
- The per-protocol analysis included participants utilizing the intervention for at least 60 minutes.
Main Results:
- The unguided iCBT group demonstrated a significantly greater reduction in OCD symptoms compared to the CAU group (medium effect size).
- Treatment benefits were moderated by internet usage frequency, with higher usage associated with less improvement.
- Secondary outcomes showed a medium effect size on self-esteem, but no significant changes in quality of life, depression, impulsivity, or social insecurity were observed.
Conclusions:
- Unguided iCBT presents a feasible treatment option for individuals with OCD facing access barriers.
- The study highlights the need for further research into non-compliance challenges within digital mental health interventions.
- Acceptability of the unguided iCBT intervention was reported as good.
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