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Improving adherence to unguided Internet-based therapy for obsessive-compulsive disorder: A randomized controlled trial

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Improving adherence to unguided Internet-based therapy for obsessive-compulsive disorder: A randomized controlled trial. / Jelinek, Lena; Schröder, Johanna; Bücker, Lara; Miegel, Franziska; Baumeister, Anna; Moritz, Steffen; Sibilis, Arne; Schultz, Josephine.

In: J AFFECT DISORDERS, Vol. 338, 01.10.2023, p. 472-481.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Jelinek, L, Schröder, J, Bücker, L, Miegel, F, Baumeister, A, Moritz, S, Sibilis, A & Schultz, J 2023, 'Improving adherence to unguided Internet-based therapy for obsessive-compulsive disorder: A randomized controlled trial', J AFFECT DISORDERS, vol. 338, pp. 472-481. https://doi.org/10.1016/j.jad.2023.06.038

APA

Jelinek, L., Schröder, J., Bücker, L., Miegel, F., Baumeister, A., Moritz, S., Sibilis, A., & Schultz, J. (2023). Improving adherence to unguided Internet-based therapy for obsessive-compulsive disorder: A randomized controlled trial. J AFFECT DISORDERS, 338, 472-481. https://doi.org/10.1016/j.jad.2023.06.038

Vancouver

Jelinek L, Schröder J, Bücker L, Miegel F, Baumeister A, Moritz S et al. Improving adherence to unguided Internet-based therapy for obsessive-compulsive disorder: A randomized controlled trial. J AFFECT DISORDERS. 2023 Oct 1;338:472-481. https://doi.org/10.1016/j.jad.2023.06.038

Bibtex

@article{a52a27bd8e7c4b56b8634a585cf5b272,
title = "Improving adherence to unguided Internet-based therapy for obsessive-compulsive disorder: A randomized controlled trial",
abstract = "BACKGROUND: Adherence to internet-based cognitive-behavioral therapy (iCBT) is often low, possibly reducing its potential. The current study set out to test whether adherence and effects of unguided iCBT for obsessive-compulsive disorder (OCD) could be improved by varying the degree of autonomy in which modules are completed (free choice vs. fixed order).METHODS: We randomized 151 individuals with OCD to either an unguided iCBT with a fixed (iCBTfixed) or a free-choice (iCBTfree+) order of the modules. We assessed participants at baseline (t0), eight weeks (t1), and 16 weeks (t2). Primary outcomes were adherence (utilization time, modules completed) and change in OCD severity (Y-BOCS). Secondary outcomes included depression, self-esteem, and treatment satisfaction. We calculated intent-to-treat (ITT) and complete case (CC) analyses.RESULTS: Analyses showed that both iCBT programs significantly reduced OCD severity. While groups did not differ on the ITT analyses, for the CC analyses, a greater improvement was found in the iCBTfixed in comparison to the iCBTfree+ group regarding OCD severity and quality of life, with medium effect sizes from t0 to t1 (ηp2 = 0.067-0.077). Time of utilization and number of modules completed did not differ between groups.LIMITATIONS: No placebo control group, short follow-up period, self-report assessment.CONCLUSIONS: iCBT is effective in improving OCD. Despite similar adherence in the fixed versus the free-choice module order, the study offers tentative evidence that a fixed order of content is associated with better effects. More research on the effects of adherence on outcome is necessary.",
keywords = "Humans, Quality of Life, Obsessive-Compulsive Disorder/therapy, Therapy, Computer-Assisted, Self Report, Internet, Treatment Outcome",
author = "Lena Jelinek and Johanna Schr{\"o}der and Lara B{\"u}cker and Franziska Miegel and Anna Baumeister and Steffen Moritz and Arne Sibilis and Josephine Schultz",
note = "Copyright {\textcopyright} 2023 Elsevier B.V. All rights reserved.",
year = "2023",
month = oct,
day = "1",
doi = "10.1016/j.jad.2023.06.038",
language = "English",
volume = "338",
pages = "472--481",
journal = "J AFFECT DISORDERS",
issn = "0165-0327",
publisher = "Elsevier",

}

RIS

TY - JOUR

T1 - Improving adherence to unguided Internet-based therapy for obsessive-compulsive disorder: A randomized controlled trial

AU - Jelinek, Lena

AU - Schröder, Johanna

AU - Bücker, Lara

AU - Miegel, Franziska

AU - Baumeister, Anna

AU - Moritz, Steffen

AU - Sibilis, Arne

AU - Schultz, Josephine

N1 - Copyright © 2023 Elsevier B.V. All rights reserved.

PY - 2023/10/1

Y1 - 2023/10/1

N2 - BACKGROUND: Adherence to internet-based cognitive-behavioral therapy (iCBT) is often low, possibly reducing its potential. The current study set out to test whether adherence and effects of unguided iCBT for obsessive-compulsive disorder (OCD) could be improved by varying the degree of autonomy in which modules are completed (free choice vs. fixed order).METHODS: We randomized 151 individuals with OCD to either an unguided iCBT with a fixed (iCBTfixed) or a free-choice (iCBTfree+) order of the modules. We assessed participants at baseline (t0), eight weeks (t1), and 16 weeks (t2). Primary outcomes were adherence (utilization time, modules completed) and change in OCD severity (Y-BOCS). Secondary outcomes included depression, self-esteem, and treatment satisfaction. We calculated intent-to-treat (ITT) and complete case (CC) analyses.RESULTS: Analyses showed that both iCBT programs significantly reduced OCD severity. While groups did not differ on the ITT analyses, for the CC analyses, a greater improvement was found in the iCBTfixed in comparison to the iCBTfree+ group regarding OCD severity and quality of life, with medium effect sizes from t0 to t1 (ηp2 = 0.067-0.077). Time of utilization and number of modules completed did not differ between groups.LIMITATIONS: No placebo control group, short follow-up period, self-report assessment.CONCLUSIONS: iCBT is effective in improving OCD. Despite similar adherence in the fixed versus the free-choice module order, the study offers tentative evidence that a fixed order of content is associated with better effects. More research on the effects of adherence on outcome is necessary.

AB - BACKGROUND: Adherence to internet-based cognitive-behavioral therapy (iCBT) is often low, possibly reducing its potential. The current study set out to test whether adherence and effects of unguided iCBT for obsessive-compulsive disorder (OCD) could be improved by varying the degree of autonomy in which modules are completed (free choice vs. fixed order).METHODS: We randomized 151 individuals with OCD to either an unguided iCBT with a fixed (iCBTfixed) or a free-choice (iCBTfree+) order of the modules. We assessed participants at baseline (t0), eight weeks (t1), and 16 weeks (t2). Primary outcomes were adherence (utilization time, modules completed) and change in OCD severity (Y-BOCS). Secondary outcomes included depression, self-esteem, and treatment satisfaction. We calculated intent-to-treat (ITT) and complete case (CC) analyses.RESULTS: Analyses showed that both iCBT programs significantly reduced OCD severity. While groups did not differ on the ITT analyses, for the CC analyses, a greater improvement was found in the iCBTfixed in comparison to the iCBTfree+ group regarding OCD severity and quality of life, with medium effect sizes from t0 to t1 (ηp2 = 0.067-0.077). Time of utilization and number of modules completed did not differ between groups.LIMITATIONS: No placebo control group, short follow-up period, self-report assessment.CONCLUSIONS: iCBT is effective in improving OCD. Despite similar adherence in the fixed versus the free-choice module order, the study offers tentative evidence that a fixed order of content is associated with better effects. More research on the effects of adherence on outcome is necessary.

KW - Humans

KW - Quality of Life

KW - Obsessive-Compulsive Disorder/therapy

KW - Therapy, Computer-Assisted

KW - Self Report

KW - Internet

KW - Treatment Outcome

U2 - 10.1016/j.jad.2023.06.038

DO - 10.1016/j.jad.2023.06.038

M3 - SCORING: Journal article

C2 - 37348657

VL - 338

SP - 472

EP - 481

JO - J AFFECT DISORDERS

JF - J AFFECT DISORDERS

SN - 0165-0327

ER -