No Talking, Just Writing! Efficacy of an Internet-Based Cognitive Behavioral Therapy with Exposure and Response Prevention in Obsessive Compulsive Disorder
No Talking, Just Writing! Efficacy of an Internet-Based Cognitive Behavioral Therapy with Exposure and Response Prevention in Obsessive Compulsive Disorder
复制标题
DOI：
10.1159/000357570
复制
发表时间：
2014-01-01
影响因子：
22.8
通讯作者：
Kuelz, Anne Katrin
中科院分区：
文献类型：
--
作者：
Herbst, Nirmal;Voderholzer, Ulrich;Kuelz, Anne Katrin
背景资料：由于治疗障碍，许多强迫症（OCD）患者没有根据现行指南（认知行为疗法与暴露和反应预防，CBT与ERP）接受一线治疗。基于互联网的治疗旨在克服这些障碍。本研究旨在评估基于认知行为疗法（CBT）和事件相关电位（ERP）概念的互联网写作治疗对强迫症患者的疗效。研究方法：34名符合DSM-IV标准的强迫症志愿者被纳入试验，并根据等待列表控制设计进行随机分组，并在8周和6个月进行随访。干预包括14个阶段，随机化后直接开始或延迟8周开始。主要结果测量是强迫症症状严重程度的变化（Yale-Brown强迫症量表自我评定，Y-BOCS SR和强迫症量表修订版，OCI-R）。结果如下：使用意向治疗分析，与等待列表对照组相比，治疗组的强迫症状得到显著改善，Cohen的d = 0.82（Y-BOCS SR）和d = 0.87（OCI-R）的效应量较大。该效应在6个月随访时保持稳定。只有4名参与者（12%）提前退出研究。在30名完成者中，90%的人认为他们的病情有所改善，并会向他们的朋友推荐该计划。结论：基于网络的写作治疗导致强迫症状的显着改善。尽管需要更大样本量的重复，但结果支持基于互联网的方法有可能改善强迫症患者的治疗情况。(C)2014 S. Karger AG，巴塞尔
Background: Many patients with obsessive-compulsive disorder (OCD) do not receive first-line treatment according to the current guidelines (cognitive behavioral therapy with exposure and response prevention, CBT with ERP) due to barriers to treatment. Internet-based therapy is designed to overcome these barriers. The present study evaluates the efficacy of an Internet-based writing therapy with therapeutic interaction based on the concept of CBT with ERP for patients with OCD. Methods: Thirty-four volunteers with OCD according to DSM-IV-criteria were included in the trial and randomized according to a waiting-list control design with follow-up measures at 8 weeks and 6 months. The intervention consisted of 14 sessions, either starting directly after randomization or with an 8-week delay. Main outcome measure was the change in the severity of OCD symptoms (Yale-Brown Obsessive Compulsive Scale Self-Rating, Y-BOCS SR, and Obsessive-Compulsive Inventory-Revised, OCI-R). Results: Obsessive-compulsive symptoms were significantly improved in the treatment group compared to the waiting-list control group with large effect sizes of Cohen's d = 0.82 (Y-BOCS SR) and d = 0.87 (OCI-R), using an intention-to-treat analysis. This effect remained stable at 6-month follow-up. Only 4 participants (12%) dropped out prematurely from the study. Of the 30 completers, 90% rated their condition as improved and would recommend the program to their friends. Conclusions: Internet-based writing therapy led to a significant improvement of obsessive-compulsive symptoms. Even though replications with larger sample sizes are needed, the results support the notion that Internet-based approaches have the potential for improving the treatment situation for patients with OCD. (C) 2014 S. Karger AG, Basel