title: Internet-based cognitive behavior therapy for obsessive compulsive disorder: a pilot study.
abstract: BACKGROUND
  Cognitive behavior therapy (CBT) is widely regarded as an effective treatment for obsessive compulsive disorder (OCD), but access to CBT therapists is limited. Internet-based CBT (ICBT) with therapist support is a way to increase access to CBT but has not been developed or tested for OCD. The aim of this study was to evaluate ICBT for OCD.
  
  
  METHODS
  An open trial where patients (N = 23) received a 15-week ICBT program with therapist support consisting of psychoeducation, cognitive restructuring and exposure with response prevention. The primary outcome was the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), which was assessed by a psychiatrist before and immediately after treatment. Secondary outcomes were self-rated measures of OCD symptoms, depressive symptoms, general functioning, anxiety and quality of life. All assessments were made at baseline and post-treatment.
  
  
  RESULTS
  All participants completed the primary outcome measure at all assessment points. There were reductions in OCD symptoms with a large within-group effect size (Cohen's d = 1.56). At post-treatment, 61% of participants had a clinically significant improvement and 43% no longer fulfilled the diagnostic criteria of OCD. The treatment also resulted in statistically significant improvements in self-rated OCD symptoms, general functioning and depression.
  
  
  CONCLUSIONS
  ICBT with therapist support reduces OCD symptoms, depressive symptoms and improves general functioning. Randomized trials are needed to confirm the effectiveness of this new treatment format.
authors.affiliation: Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden. erik.m.andersson@ki.se
authors.forename: Erik
authors.initials: E
authors.lastname: Andersson
authors.forename: Brjánn
authors.initials: B
authors.lastname: Ljótsson
authors.forename: Erik
authors.initials: E
authors.lastname: Hedman
authors.forename: Viktor
authors.initials: V
authors.lastname: Kaldo
authors.forename: Björn
authors.initials: B
authors.lastname: Paxling
authors.forename: Gerhard
authors.initials: G
authors.lastname: Andersson
authors.forename: Nils
authors.initials: N
authors.lastname: Lindefors
authors.forename: Christian
authors.initials: C
authors.lastname: Rück
mesh_terms: D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy / Q000379:methods* / Q000706:statistics & numerical data; D003863:Depression / Q000150:complications / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D020407:Internet; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000150:complications / Q000523:psychology / Q000628:therapy*; D010349:Patient Compliance / Q000706:statistics & numerical data; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology; D057566:Self Report; D013813:Therapy, Computer-Assisted / Q000379:methods* / Q000706:statistics & numerical data