Franklin Martin E, Engelmann Jeffrey M, Bulkes Nyssa Z, Horvath Gregor, Piacsek Kelly, Osterlund Erik, Freeman Jennifer, Schwartz Rachel A, Himle Michael B, Riemann Bradley C
Rogers Behavioral Health, Oconomowoc, Wisconsin.
University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
JAACAP Open. 2023 Oct 5;2(1):26-35. doi: 10.1016/j.jaacop.2023.09.007. eCollection 2024 Mar.
This naturalistic, nonblinded, nonrandomized study examined the efficacy of multimodal treatment including intensive cognitive-behavioral therapy (CBT) for pediatric obsessive-compulsive disorder (OCD) delivered via telehealth (TH) compared with a matched sample of youth treated in person (IP).
Patients included 1,286 youth ages 7 to 17 inclusive (643 TH, 643 IP) who received TH or IP in either partial hospitalization (n = 818) or intensive outpatient (n = 468) programs. Changes in patient-rated OCD symptoms and quality of life from pretreatment to posttreatment were examined.
TH patients were discharged with a statistically higher Children's Yale-Brown Obsessive-Compulsive Scale Self-Report score than IP patients, although this group difference (1.4) was not clinically significant. Quality-of-life scores at discharge did not significantly differ between TH patients and IP patients. Treatment response was robust attesting to the broad applicability of the treatment model.
Youth receiving CBT via TH responded both well and comparably to youth treated IP, offering a viable access path forward. These findings extend the reach of CBT for pediatric OCD. Concerted efforts must now be made to improve CBT availability for families for whom financial, insurance, geographical, and other barriers preclude access at present.
DIVERSITY & INCLUSION STATEMENT: We worked to ensure that the study questionnaires were prepared in an inclusive way. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We actively worked to promote sex and gender balance in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list.
本项自然主义、非盲法、非随机研究，考察了通过远程医疗（TH）提供的多模式治疗（包括强化认知行为疗法（CBT））对儿童强迫症（OCD）的疗效，并与匹配的亲自接受治疗（IP）的青少年样本进行比较。
患者包括1286名7至17岁（含）的青少年（643名接受远程医疗，643名接受亲自治疗），他们在部分住院（n = 818）或强化门诊（n = 468）项目中接受远程医疗或亲自治疗。研究了患者自评的强迫症症状和生活质量从治疗前到治疗后的变化。
远程医疗患者出院时儿童耶鲁-布朗强迫症量表自评得分在统计学上高于亲自治疗患者，尽管这一组间差异（1.4）在临床上并不显著。远程医疗患者和亲自治疗患者出院时的生活质量得分没有显著差异。治疗反应良好，证明了该治疗模式的广泛适用性。
通过远程医疗接受认知行为疗法的青少年与亲自接受治疗的青少年反应良好且相当，提供了一条可行的途径。这些发现扩展了认知行为疗法对儿童强迫症的应用范围。现在必须共同努力，改善认知行为疗法对那些因经济、保险、地理和其他障碍目前无法获得治疗的家庭的可及性。
我们努力确保研究问卷以包容的方式编制。我们努力确保在招募人类参与者时实现性别平衡。我们努力确保在招募人类参与者时实现种族、民族和/或其他类型的多样性。我们积极努力促进作者团队中的性别平衡。在引用与这项工作科学相关的参考文献时，我们还积极努力促进参考文献列表中的性别平衡。在引用与这项工作科学相关的参考文献时，我们还积极努力促进在参考文献列表中纳入历史上在科学领域代表性不足的种族和/或民族群体。
