Klein Carolin S, Alt Annika K, Pascher Anja, Kühnhausen Jan, Seizer Lennart, Ilg Winfried, Thierfelder Annika, Primbs Jonas, Menth Michael, Barth Gottfried M, Gawrilow Caterina, Conzelmann Annette, Renner Tobias J, Hollmann Karsten
Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, Osianderstr. 14-16, 72076, Tübingen, Germany.
DZPG (German Center for Mental Health), Partner site Tübingen, Tübingen, Germany.
Child Adolesc Psychiatry Ment Health. 2024 Dec 4;18(1):154. doi: 10.1186/s13034-024-00844-7.
Between 1 and 4% of children and adolescents suffer from obsessive-compulsive disorder (OCD) worldwide, but the majority of these young people do not have access to cognitive behavioral therapy (CBT) as a first-line treatment. CBT delivered via online videoconferencing (vCBT) offers a new way to provide young people with therapy, especially in the home environment where symptoms usually occur.
In this study, we investigated the feasibility of a newly revised vCBT manual, symptom change during treatment, and effects on family life and social functioning. 20 patients with OCD, aged 12-18 years, were treated during 14 weekly sessions while using a multimodal sensor system that assessed their physiological and behavioral responses during therapy. Treatment was delivered in real time via an online videoconferencing platform. Measurements of feasibility, acceptance, and implementation were evaluated descriptively, and clinical measures were assessed with t tests.
The primary results showed that patients and parents perceived the manual-based vCBT as feasible and easy to understand. According to the therapists' ratings, all treatment modules and the content could be carried out in accordance with the manual. As a secondary outcome, OCD symptoms improved significantly during treatment (p <.001, d = 1.87), revealed by an average decrease of more than half in the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) score. As the psychotherapy could be implemented directly in the patients' home environment, low barriers to participation were reported, and the majority of participants reported improvements in family life after treatment.
In summary, the results of this feasibility study indicated a successful application of manual-based psychotherapy delivered via videoconferencing for pediatric OCD supported by a sensor system. This method should be further investigated in future randomized controlled trials with larger patient samples.
[ www.
gov ], identifier [NCT05291611], first submission: 2021-12-10.
在全球范围内,1%至4%的儿童和青少年患有强迫症(OCD),但这些年轻人中的大多数无法获得认知行为疗法(CBT)作为一线治疗方法。通过在线视频会议提供的CBT(vCBT)为为年轻人提供治疗提供了一种新途径,尤其是在通常出现症状的家庭环境中。
在本研究中,我们调查了新修订的vCBT手册的可行性、治疗期间的症状变化以及对家庭生活和社会功能的影响。20名年龄在12至18岁的强迫症患者在为期14周的疗程中接受治疗,同时使用多模式传感器系统评估他们在治疗期间的生理和行为反应。治疗通过在线视频会议平台实时进行。对可行性、接受度和实施情况的测量进行了描述性评估,临床测量采用t检验进行评估。
主要结果表明,患者和家长认为基于手册的vCBT可行且易于理解。根据治疗师的评分,所有治疗模块和内容都可以按照手册进行。作为次要结果,治疗期间强迫症症状显著改善(p <.001,d = 1.87),儿童耶鲁-布朗强迫症量表(CY-BOCS)得分平均下降超过一半表明了这一点。由于心理治疗可以直接在患者的家庭环境中实施,据报告参与障碍较低,大多数参与者报告治疗后家庭生活有所改善。
总之,这项可行性研究的结果表明,在传感器系统的支持下,通过视频会议提供的基于手册的心理治疗成功应用于儿童强迫症。这种方法应在未来更大患者样本的随机对照试验中进一步研究。