Matsumoto Kazuki, Hamatani Sayo, Shimizu Eiji
Division of Clinical Psychology, Kagoshima University Medical and Dental Hospital, Research and Education Assembly Medical and Dental Sciences Area, Kagoshima University, Kagoshima-City, Kagoshima, Japan.
Research Center for Child Mental Development, Chiba University, Chiba-City, Chiba, Japan.
Internet Interv. 2024 Feb 8;35:100725. doi: 10.1016/j.invent.2024.100725. eCollection 2024 Mar.
This study investigated the long-term effectiveness and cost-effectiveness of guided internet-based cognitive behavioral therapy (ICBT) for obsessive-compulsive disorder (OCD). Twenty-five patients with OCD who had undergone guided ICBT in a randomized controlled trial or a single-arm trial were followed up for 6, 12, and 24 months. Missing data were imputed using the mice package in R, and a one-way analysis of variance with repeated measures was performed. The total Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score significantly decreased from baseline to all endpoints < 0.001). OCD remission (the total Y-BOCS score < 14) rates significantly increased from post-treatment (48 %) at the 12 months (80 %) and 24 months (76 %) follow-up (χ2 (1) = 7.11-11.08, < 0.01) post guided ICBT. Regression analysis predicted the maintenance of remission at 12 and 24 months following post-treatment remission (z = 2.20, = 0.03). An incremental cost-effectiveness ratio was calculated to assess the cost-effectiveness of guided ICBT. The incremental cost-effectiveness ratio was JPY 999,495, below the JPY 5 million threshold for willingness to pay in Japan. Our findings demonstrate the long-term effectiveness and cost-effectiveness of guided ICBT for OCD. Guided ICBT can mitigate the severity of OCD even after treatment.
本研究调查了基于互联网的指导性认知行为疗法（ICBT）治疗强迫症（OCD）的长期有效性和成本效益。对25例在随机对照试验或单臂试验中接受过指导性ICBT治疗的强迫症患者进行了6个月、12个月和24个月的随访。使用R语言中的mice包对缺失数据进行插补，并进行重复测量的单因素方差分析。耶鲁-布朗强迫症量表（Y-BOCS）总分从基线到所有终点均显著降低（<0.001）。强迫症缓解率（Y-BOCS总分<14）从治疗后（48%）在12个月（80%）和24个月（76%）随访时显著增加（χ2(1)=7.11-11.08，<0.01），在指导性ICBT治疗后。回归分析预测了治疗后缓解在12个月和24个月时缓解的维持情况（z=2.20，=0.03）。计算了增量成本效益比以评估指导性ICBT的成本效益。增量成本效益比为999,495日元，低于日本500万日元的支付意愿阈值。我们的研究结果证明了指导性ICBT治疗强迫症的长期有效性和成本效益。指导性ICBT即使在治疗后也能减轻强迫症的严重程度。
