Internet cognitive behavioural treatment for obsessive compulsive disorder: A randomised controlled trial

Alison E J Mahoney; Anna Mackenzie; Alishia D Williams; Jessica Smith; Gavin Andrews

doi:10.1016/j.brat.2014.09.012

Internet cognitive behavioural treatment for obsessive compulsive disorder: A randomised controlled trial

Behav Res Ther. 2014 Dec:63:99-106. doi: 10.1016/j.brat.2014.09.012. Epub 2014 Oct 7.

Authors

Alison E J Mahoney¹, Anna Mackenzie², Alishia D Williams³, Jessica Smith⁴, Gavin Andrews⁵

Affiliations

¹ Clinical Research Unit for Anxiety and Depression (CRUfAD), St. Vincent's Hospital, Level 4 O'Brien Centre, 394-404 Victoria Street, Darlinghurst, Sydney, New South Wales, 2010, Australia. Electronic address: amahoney@stvincents.com.au.
² Clinical Research Unit for Anxiety and Depression (CRUfAD), St. Vincent's Hospital, Level 4 O'Brien Centre, 394-404 Victoria Street, Darlinghurst, Sydney, New South Wales, 2010, Australia; School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney, NSW, 2052, Australia.
³ Clinical Research Unit for Anxiety and Depression (CRUfAD), St. Vincent's Hospital, Level 4 O'Brien Centre, 394-404 Victoria Street, Darlinghurst, Sydney, New South Wales, 2010, Australia; School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney, NSW, 2052, Australia. Electronic address: alishia.williams@unsw.edu.au.
⁴ Clinical Research Unit for Anxiety and Depression (CRUfAD), St. Vincent's Hospital, Level 4 O'Brien Centre, 394-404 Victoria Street, Darlinghurst, Sydney, New South Wales, 2010, Australia. Electronic address: Smith@svha.org.au.
⁵ Clinical Research Unit for Anxiety and Depression (CRUfAD), St. Vincent's Hospital, Level 4 O'Brien Centre, 394-404 Victoria Street, Darlinghurst, Sydney, New South Wales, 2010, Australia; School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney, NSW, 2052, Australia. Electronic address: gavina@unsw.edu.au.

PMID: 25461784
DOI: 10.1016/j.brat.2014.09.012

Abstract

Internet-based cognitive behaviour therapy (iCBT) is becoming increasing accepted as an efficacious and effective treatment for the anxiety and depressive disorders. However few studies have examined the efficacy of iCBT for obsessive compulsive disorder (OCD). This randomised controlled trial compared technician-administered iCBT (n = 32) to a treatment as usual (TAU) control group (n = 35) in patients with OCD. The primary outcome measures were the Dimensional Obsessive-Compulsive Scale (DOCS) and the Obsessional Beliefs Questionnaire (OBQ-20) administered at pre- and post-treatment (or matched time points). The iCBT group was followed-up at 3-months post-treatment when diagnostic status was assessed at clinical interview. The iCBT program was more efficacious than TAU in reducing maladaptive OC beliefs as well as symptoms of OCD, distress, and depression, with large within- and between-groups effect sizes found (>.78). Adherence was high (75%) and gains were maintained at 3 month-follow-up with 54% of treatment completers no longer meeting diagnostic criteria for OCD at follow-up. These results are comparable to outcomes obtained by clinician-administered face-to-face and internet-based programs and suggest that iCBT for OCD is efficacious when administered by a clinically-supervised technician. Future research is now needed to evaluate how effective iCBT for OCD is in routine clinical settings.

Keywords: Cognitive behaviour therapy; Internet-based cognitive behaviour therapy; Obsessive compulsive disorder.

Publication types

Comparative Study
Randomized Controlled Trial

MeSH terms

Adult
Analysis of Variance
Cognitive Behavioral Therapy / methods*
Female
Follow-Up Studies
Humans
Internet*
Male
Obsessive-Compulsive Disorder / therapy*
Patient Satisfaction
Surveys and Questionnaires
Therapy, Computer-Assisted / methods
Treatment Outcome