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Computer-delivered cognitive-behavioural treatments for obsessive compulsive disorder: preliminary meta-analysis of randomized and non-randomized effectiveness trials

Published online by Cambridge University Press:  20 November 2014

Andrea Pozza ,
Gerhard Andersson ,
Paolo Antonelli  and
Davide Dèttore
Andrea Pozza*
Affiliation:
Miller Institute of Behavioural and Cognitive Psychotherapy, Genoa/Florence, Corso Torino Genoa, Italy
Gerhard Andersson
Affiliation:
Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stokholm, Sweden
Paolo Antonelli
Affiliation:
Miller Institute of Behavioural and Cognitive Psychotherapy, Genoa/Florence, Corso Torino Genoa, Italy
Davide Dèttore
Affiliation:
Miller Institute of Behavioural and Cognitive Psychotherapy, Genoa/Florence, Corso Torino Genoa, Italy Department of Health Sciences, University of Florence, Florence, Italy
*
*Author for correspondence A. Pozza, Miller Institute of Behavioural and Cognitive Psychotherapy, Genoa/Florence, Corso Torino 19/2, 16129 Genoa, Italy (email: [email protected]).
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Abstract

Cognitive behavioural treatments (CBTs) are well-established for obsessive compulsive disorder (OCD). However, few patients receive CBT, due to factors like geographical limitations, perceived stigmatization, and lack of CBT services. Some evidence suggests that computer-delivered cognitive-behavioural treatments (CCBTs) could be an effective strategy to improve patients’ access to CBT. To date a meta-analysis on effectiveness of CCBTs for OCD has not been conducted. The present study used meta-analytical techniques to summarize evidence on CCBTs for OCD on OCD and depression symptom outcomes at post-treatment and follow-up. A meta-analysis was conducted according to PRISMA guidelines. Treatments were classified as CCBTs if including evidence-based cognitive-behavioural components for OCD (psychoeducation, exposure and response prevention, cognitive restructuring), delivered through devices like computers, palmtops, telephone-interactive voice-response systems, CD-ROMS, and cell phones. Studies were included if they used validated outcomes for OCD. Eight studies met inclusion criteria (n = 392). A large effect favouring CCBTs over control conditions was found for OCD symptoms at post-treatment (d = 0.82, p = 0.001), but not for depression symptom outcomes (d = 0.15, p = 0.20). Theoretical implications and directions for research are discussed. A larger number of randomized controlled trials is required.

Keywords

Cognitive behaviour therapycomputer-delivered cognitive-behavioural treatmentsmeta-analysisobsessive compulsive disordertreatment outcome
Type
Review
Information
the Cognitive Behaviour Therapist , Volume 7 , December 2014 , e16
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2014 

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