Efficacy and cost-effectiveness of internet-based cognitive behavioral therapy for obsessive-compulsive disorder / 上海交通大学学报（医学版）

ABSTRACT

Objective • To compare the therapeutic effect, cost, cost-effectiveness and utility between internet-based cognitive behavioral therapy (ICBT) and cognitive behavioral group therapy (CBGT) in the patients with obsessive-compulsive disorder (OCD). Methods • Twenty-eight patients who met the OCD diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) were assigned to ICBT group (n=16) and CBGT group (n=12) according to the patients' willingness. Both groups were treated for 6 weeks. The study compared differences in the severity of OCD and symptoms of anxiety and depressive at baseline, during treatment and after treatment, as well as differences in cost, cost-effectiveness and utility between two groups. Results • There was no significant difference in the scores of Yale-Brown Obsessive Compulsive Scale (YBOCS), Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), and Visual Analog Scale (VAS) [a component of EuroQol Five Dimensions Questionnaire, (EQ-5D)] between the two groups at baseline (P=0.291, P=0.114, P=0.478, P=0.799). After treatment, the YBOCS scores decreased compared to pre-treatment in two groups. There was no statistical difference in subtraction rate of YBOCS between the two groups (P=0.291). The SDS scores of ICBT group also decreased after treatment compared to pre-treatment (P=0.003). The average cost per patient in ICBT group was 2 710.50 yuan less than that in CBGT group. When one YBOCS score per patient reduced, ICBT group spent 281.33 yuan less than CBGT group. The VAS scores were significantly improved after 6-week treatment and ICBT group has a more significant improvement. Conclusion • ICBT and CBGT have comparable and significant efficacy. And ICBT is a lower cost and more cost-effectiveness and utility treatment than CBGT.