Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Systematic Reviews
Published in: Systematic Reviews 1/2019

Open Access 01-12-2019 | Obsessive-Compulsive Disorder | Research

Acceptability, feasibility, and efficacy of Internet cognitive behavioral therapy (iCBT) for pediatric obsessive-compulsive disorder: a systematic review

Authors: Lucía Babiano-Espinosa, Lidewij H. Wolters, Bernhard Weidle, Vivian op de Beek, Sindre A. Pedersen, Scott Compton, Norbert Skokauskas

Published in: Systematic Reviews | Issue 1/2019

Login to get access

Abstract

Background

Obsessive-compulsive disorder (OCD) is a chronic mental health disorder characterized by recurring obsessions and compulsions affecting 1–3% of children and adolescents. Current treatment options are limited by accessibility, availability, and quality of care. New technologies provide opportunities to address at least some of these challenges. This paper aims to investigate the acceptability, feasibility, and efficacy of traditional cognitive behavioral therapy with Internet cognitive behavioral therapy (iCBT) for pediatric OCD according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Method

We searched EMBASE, Medline, PsycINFO, CENTRAL, LILACS, CINAHL, and Scopus. Results include articles from 1987 to March 2018. Main inclusion criteria were patients aged 4–18, primary diagnosis of OCD, and iCBT.

Results

Of the 2323 unique articles identified during the initial search, six studies with a total of 96 participants met our inclusion criteria: three randomized controlled trials, one single-case multiple-baseline design, one open-label trial, and one case series. Four studies reported a significant decrease in OCD severity on the Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) following iCBT, one study reported significant decrease in CY-BOCS scores for iCBT relative to waitlist, and the case series reported (some) symptom reduction in all participants. Six studies reported high rates of feasibility, and five studies reported good acceptability of iCBT.

Conclusion

At present, evidence regarding acceptability, feasibility, and efficacy of iCBT for pediatric OCD is limited. Results are promising but need to be confirmed and refined in further research.

Systematic review registration

PROSPERO CRD4201808587
Appendix
Available only for authorised users
Footnotes
1
Percentages based on group differences between mean pre- and mean post-treatment score.
 
Literature
1.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. Arlington: Am Psychiatric Assoc; 2013.CrossRef
2.
Piacentini J, Bergman RL, Keller M, McCracken J. Functional impairment in children and adolescents with obsessive-compulsive disorder. J Child Adolesc Psychopharmacol. 2003;13(Suppl 1):S61–9.PubMedCrossRef
3.
Weidle B, Ivarsson T, Thomsen PH, Lydersen S, Jozefiak T. Quality of life in children with OCD before and after treatment. Eur Child Adolesc Psychiatry. 2015;24(9):1061–74.PubMedCrossRef
4.
Skoog G, Skoog I. A 40-year follow-up of patients with obsessive-compulsive disorder. Arch Gen Psychiatry. 1999;56(2):121–7.PubMedCrossRef
5.
Stewart SE, McKenney KS, Simpson A, Belschner L, Lin S. Group and family cognitive behavioral therapy for pediatric obsessive-compulsive disorder: Examining traditional and novel outcomes. J Am Acad Child Adolesc Psychiatry. 2016;55(10 Supplement 1):S341.CrossRef
6.
Olatunji BO, Davis ML, Powers MB, Smits JA. Cognitive-behavioral therapy for obsessive-compulsive disorder: a meta-analysis of treatment outcome and moderators. J Psychiatr Res. 2013;47(1):33–41.PubMedCrossRef
7.
Wu Y, Lang Z, Zhang H. Efficacy of cognitive-behavioral therapy in pediatric obsessive-compulsive disorder: a meta-analysis. Med Sci Monit. 2016;22:1646–53.PubMedPubMedCentralCrossRef
8.
Ivarsson T, Skarphedinsson G, Kornør H, Axelsdottir B, Biedilae S, Heyman I, et al. The place of and evidence for serotonin reuptake inhibitors (SRIs) for obsessive compulsive disorder (OCD) in children and adolescents: views based on a systematic review and meta-analysis. Psychiatry Res. 2015;227(1):93–103.PubMedCrossRef
9.
McGuire JF, Piacentini J, Lewin AB, Brennan EA, Murphy TK, Storch EA. A meta-analysis of cognitive behavior therapy and medication for child obsessive-compulsive disorder: moderators of treatment efficacy, response, and remission. Depress Anxiety. 2015;32(8):580–93.PubMedPubMedCentralCrossRef
10.
Højgaard DRMA, Hybel KA, Ivarsson T, Skarphedinsson G, Becker Nissen J, Weidle B, et al. One-year outcome for responders of cognitive-behavioral therapy for pediatric obsessive-compulsive disorder. J Am Acad Child Adolesc Psychiatry. 2017;56(11):940–7.e1.PubMedCrossRef
11.
Torp NC, Dahl K, Skarphedinsson G, Thomsen PH, Valderhaug R, Weidle B, et al. Effectiveness of cognitive behavior treatment for pediatric obsessive-compulsive disorder: acute outcomes from the Nordic Long-term OCD Treatment Study (NordLOTS). Behav Res Ther. 2015;64:15–23.PubMedCrossRef
12.
Watson HJ, Rees CS. Meta-analysis of randomized, controlled treatment trials for pediatric obsessive-compulsive disorder. J Child Psychol Psychiatry. 2008;49(5):489–98.PubMedCrossRef
13.
Wolters LH, op de Beek V, Weidle B, Skokauskas N. How can technology enhance cognitive behavioral therapy: the case of pediatric obsessive compulsive disorder. BMC Psychiatry. 2017;17(1):226.PubMedPubMedCentralCrossRef
14.
Schwartz C, Schlegl S, Kuelz AK, Voderholzer U. Treatment-seeking in OCD community cases and psychological treatment actually provided to treatment-seeking patients: a systematic review. J Obsessive Compulsive Relat Disord. 2013;2(4):448–56.CrossRef
15.
Rooksby M, Elouafkaoui P, Humphris G, Clarkson J, Freeman R. Internet-assisted delivery of cognitive behavioural therapy (CBT) for childhood anxiety: systematic review and meta-analysis. J Anxiety Disord. 2015;29:83–92.PubMedCrossRef
16.
Pennant ME, Loucas CE, Whittington C, Creswell C, Fonagy P, Fuggle P, et al. Computerised therapies for anxiety and depression in children and young people: a systematic review and meta-analysis. Behav Res Ther. 2015;67:1–18.PubMedCrossRef
17.
Newman MG, Szkodny LE, Llera SJ, Przeworski A. A review of technology-assisted self-help and minimal contact therapies for anxiety and depression: is human contact necessary for therapeutic efficacy? Clin Psychol Rev. 2011;31(1):89–103.PubMedCrossRef
18.
19.
20.
21.
Ye X, Bapuji SB, Winters SE, Struthers A, Raynard M, Metge C, et al. Effectiveness of internet-based interventions for children, youth, and young adults with anxiety and/or depression: a systematic review and meta-analysis. BMC Health Serv Res. 2014;14(1):313.PubMedPubMedCentralCrossRef
22.
Dettore D, Pozza A, Andersson G. Efficacy of technology-delivered cognitive behavioural therapy for OCD versus control conditions, and in comparison with therapist-administered CBT: meta-analysis of randomized controlled trials. Cogn Behav Ther. 2015;44(3):190–211.PubMedCrossRef
23.
Wootton BM. Remote cognitive–behavior therapy for obsessive–compulsive symptoms: a meta-analysis. Clin Psychol Rev. 2016;43:103–13.PubMedCrossRef
24.
Baer L, Minichiello WE, Jenike MA. Use of a portable-computer program in behavioral treatment of obsessive-compulsive disorder. Am J Psychiatry. 1987;19:237–40.
25.
Beller EM, Glasziou PP, Altman DG, Hopewell S, Bastian H, Chalmers I, et al. PRISMA for abstracts: reporting systematic reviews in journal and conference abstracts. PLoS Med. 2013;10(4):e1001419.PubMedPubMedCentralCrossRef
26.
Myers KM, Valentine JM, Melzer SM. Feasibility, acceptability, and sustainability of telepsychiatry for children and adolescents. Psychiatr Serv. 2007;58(11):1493–6.PubMedCrossRef
27.
Morrison A, Polisena J, Husereau D, Moulton K, Clark M, Fiander M, et al. The effect of English-language restriction on systematic review-based meta-analyses: a systematic review of empirical studies. Int J Technol Assess Health Care. 2012;28(2):138–44.PubMedCrossRef
28.
Comer JS, Furr JM, Cooper-Vince CE, Kerns CE, Chan PT, Edson AL, et al. Internet-delivered, family-based treatment for early-onset OCD: a preliminary case series. J Clin Child Adolesc Psychol. 2014;43(1):74–87.PubMedCrossRef
29.
Lenhard F, Anderson E, Mataix-Cols D, Rück C, Vigerland S, Högström J, Hillborg M, et al. Therapist-guided, Internet-delivered cognitive-behavioral therapy for adolescents with obsessive-compulsive disorder: a randomized controlled trial. J Am Acad Child Adolesc Psychiatry. 2017;56(1):10–19.e2.PubMedCrossRef
30.
Comer JS, Furr JM, Kerns CE, Miguel E, Coxe S, Meredith Elkins R, et al. Internet-delivered, family-based treatment for early-onset OCD: a pilot randomized trial. J Consult Clin Psychol. 2017;85(2):178–86.PubMedCrossRef
31.
Farrell LJ, Oar EL, Waters AM, McConnell H, Tiralongo E, Garbharran V, et al. Brief intensive CBT for pediatric OCD with E-therapy maintenance. J Anxiety Disord. 2016;42:85–94.PubMedCrossRef
32.
Lenhard F, Vigerland S, Andersson E, Ruck C, Mataix-Cols D, Thulin U, et al. Internet-delivered cognitive behavior therapy for adolescents with obsessive-compulsive disorder: an open trial. PLoS One. 2014;9(6):e100773.PubMedPubMedCentralCrossRef
33.
Lenhard F, Ssegonja R, Andersson E, Feldman I, Ruck C, Mataix-Cols D, et al. Cost-effectiveness of therapist-guided internet-delivered cognitive behaviour therapy for paediatric obsessive-compulsive disorder: results from a randomised controlled trial. BMJ Open. 2017;7(5):e015246.PubMedPubMedCentralCrossRef
34.
Storch EA, Caporino NE, Morgan JR, Lewin AB, Rojas A, Brauer L, et al. Preliminary investigation of web-camera delivered cognitive-behavioral therapy for youth with obsessive-compulsive disorder. Psychiatry Res. 2011;189(3):407–12.PubMedCrossRef
35.
Pediatric O. Cognitive-behavior therapy, sertraline, and their combination for children and adolescents with obsessive-compulsive disorder: the Pediatric OCD Treatment Study (POTS) randomized controlled trial. JAMA. 2004;292(16):1969.CrossRef
36.
Goodman WK, Price LH. Assessment of severity and change in obsessive compulsive disorder. Psychiatr Clin North Am. 1992;15(4):861–9.PubMedCrossRef
37.
Jozefiak T, Hanssen-Bauer K, Bjelland I. Psychometric properties of the Norwegian version of Children's Global Assessment Scale (CGAS). PsykTestBarn. 2018;1:3.
38.
Busner J, Targum SD. The clinical global impressions scale: applying a research tool in clinical practice. Psychiatry (Edgmont). 2007;4(7):28.
39.
Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928.PubMedPubMedCentralCrossRef
40.
Firth J, Torous J, Yung AR. Ecological momentary assessment and beyond: the rising interest in e-mental health research. J Psychiatr Res. 2016;80:3–4.PubMedCrossRef
41.
42.
43.
Firth J, Torous J, Nicholas J, Carney R, Pratap A, Rosenbaum S, et al. The efficacy of smartphone-based mental health interventions for depressive symptoms: a meta-analysis of randomized controlled trials. World Psychiatry. 2017;16(3):287–98.PubMedPubMedCentralCrossRef
44.
Reyes-Portillo JA, Mufson L, Greenhill LL, Gould MS, Fisher PW, Tarlow N, et al. Web-based interventions for youth internalizing problems: a systematic review. J Am Acad Child Adolesc Psychiatry. 2014;53(12):254–1270.e5.CrossRef
45.
46.
Huckvale K, Prieto JT, Tilney M, Benghozi P-J, Car J. Unaddressed privacy risks in accredited health and wellness apps: a cross-sectional systematic assessment. BMC Med. 2015;13(1):214.PubMedPubMedCentralCrossRef
47.
Rothwell PM. External validity of randomised controlled trials:“to whom do the results of this trial apply?”. Lancet. 2005;365(9453):82–93.PubMedCrossRef
Metadata
Title
Acceptability, feasibility, and efficacy of Internet cognitive behavioral therapy (iCBT) for pediatric obsessive-compulsive disorder: a systematic review
Authors
Lucía Babiano-Espinosa
Lidewij H. Wolters
Bernhard Weidle
Vivian op de Beek
Sindre A. Pedersen
Scott Compton
Norbert Skokauskas
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2019
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-019-1166-6

Other articles of this Issue 1/2019

Systematic Reviews 1/2019 Go to the issue

Correction

Correction to: Systematic review and meta-analysis of diagnostic accuracy of detection of any level of diabetic retinopathy using digital retinal imaging

Protocol

Physically aggressive behaviors in older people living with cognitive disorders: a systematic scoping review protocol

Protocol

Sonographic reference values of median nerve cross-sectional area: a protocol for a systematic review and meta-analysis

Research

Understanding patient engagement in health system decision-making: a co-designed scoping review

Protocol

Effectiveness and safety of inpatient versus extended venous thromboembolism (VTE) prophylaxis with heparin following major pelvic surgery for malignancy: protocol for a systematic review

Protocol

What should be the preferred exercise modality for overweight and obese individuals? Protocol for a systematic review and network meta-analysis