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Randomized Controlled Trial
. 2012 Oct;42(10):2193-203.
doi: 10.1017/S0033291712000244. Epub 2012 Feb 21.

Internet-based cognitive behaviour therapy for obsessive-compulsive disorder: a randomized controlled trial

E Andersson  1 , J Enander, P Andrén, E Hedman, B Ljótsson, T Hursti, J Bergström, V Kaldo, N Lindefors, G Andersson, C Rück
Affiliations
Free PMC article
Randomized Controlled Trial

Internet-based cognitive behaviour therapy for obsessive-compulsive disorder: a randomized controlled trial

E Andersson et al. Psychol Med. 2012 Oct.
Free PMC article

Abstract

Background: Cognitive behaviour therapy (CBT) is an effective treatment for obsessive-compulsive disorder (OCD) but access to CBT is limited. Internet-based CBT (ICBT) with therapist support is potentially a more accessible treatment. There are no randomized controlled trials testing ICBT for OCD. The aim of this study was to investigate the efficacy of ICBT for OCD in a randomized controlled trial.

Method: Participants (n=101) diagnosed with OCD were randomized to either 10 weeks of ICBT or to an attention control condition, consisting of online supportive therapy. The primary outcome measure was the Yale-Brown Obsessive Compulsive Scale (YBOCS) administered by blinded assessors.

Results: Both treatments lead to significant improvements in OCD symptoms, but ICBT resulted in larger improvements than the control condition on the YBOCS, with a significant between-group effect size (Cohen's d) of 1.12 (95% CI 0.69-1.53) at post-treatment. The proportion of participants showing clinically significant improvement was 60% (95% CI 46-72) in the ICBT group compared to 6% (95% CI 1-17) in the control condition. The results were sustained at follow-up.

Conclusions: ICBT is an efficacious treatment for OCD that could substantially increase access to CBT for OCD patients. Replication studies are warranted.

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Figures

Fig. 1
Fig. 1
Participant flow and reasons for dropout throughout the trial. CBT, Cognitive behavioural therapy; OCD, obsessive–compulsive disorder; SSRI, selective serotonin reuptake inhibitor; YBOCS, Yale–Brown Obsessive Compulsive Scale.
Fig. 2
Fig. 2
Weekly Obsessive Compulsive Inventory – Revised (OCI-R) total score ratings with 95% confidence intervals. ICBT, Internet-based cognitive behaviour therapy; W, week.
See this image and copyright information in PMC

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