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基于技术的认知行为疗法对减轻儿童强迫症症状的作用:一项系统评价

Technology-based CBT in Reducing Symptoms of OCD in Children: A Systematic Review.

作者信息

Samson Francine, Tafuto Barbara, Jose Nadina, Kim Lisa Palladino

机构信息

Rutgers University, School of Health Professions, 65 Bergen St. Newark NJ, 07107.United States.

出版信息

J Public Health Issues Pract. 2021;5(1). doi: 10.33790/jphip1100177. Epub 2021 May 12.

Abstract

BACKGROUND

Obsessive Compulsive Disorder (OCD) is an anxiety disorder affecting up to 3% of children and adolescent in the United States. Cognitive behavioral therapy (CBT) is the first-line treatment for mild to moderate OCD in children. Despite the benefits of CBT in treatment of OCD, only one-third of clinicians regularly use CBT compared to psychotropic medication due to lack of access. The COVID-19 pandemic has resulted in increased relapses in OCD severity and further limited access to traditional face-to-face CBT treatment due to health and safety precautions.

PURPOSE

This systematic review aims to demonstrate the efficacy of technology-based CBT by evaluating results of clinical trials and its comparability to traditional CBT methods.

METHODS

An evidence-based search was conducted using terms such as "Obsessive-Compulsive disorder" AND " internet" AND "cognitive behavior therapy" and "children". A total of 716 articles were identified.

RESULTS

After screening titles, abstracts, and full articles for relevance, 7 studies with a total of 254 subjects and four different programs involving technology-based CBT were included in this systematic review. Information gathered in this review support the use of technology-based CBT as an effective treatment in reducing the severity of OCD symptoms as shown by statistically significant reductions in Children Yale-Brown Obsessive-Compulsive Scale scores. Additionally, the results from this review support previous clinical studies demonstrating that effects of technology-based CBT were non-inferior to traditional CBT methods.

CONCLUSION

The results of this systematic review support the use of technology-based CBT for the treatment of OCD in children and adolescents, especially in times where access to in-person therapist sessions are not possible due to geographical or global concerns. Additional research is needed to understand the impact and acceptability of new CBT methods on daily-life as well as the effectiveness of technology-based methods on more severe cases of OCD.

摘要

背景

强迫症(OCD)是一种焦虑症,在美国影响着多达3%的儿童和青少年。认知行为疗法(CBT)是治疗儿童轻度至中度强迫症的一线疗法。尽管CBT对治疗强迫症有益,但由于难以获得该疗法,只有三分之一的临床医生会定期使用CBT,相比之下精神药物的使用更为普遍。由于健康和安全预防措施,新冠疫情导致强迫症严重程度的复发增加,进一步限制了获得传统面对面CBT治疗的机会。

目的

本系统评价旨在通过评估临床试验结果及其与传统CBT方法的可比性,证明基于技术的CBT的疗效。

方法

使用“强迫症”、“互联网”、“认知行为疗法”和“儿童”等术语进行循证检索。共识别出716篇文章。

结果

在筛选标题、摘要和全文的相关性后,本系统评价纳入了7项研究,共254名受试者,涉及4个不同的基于技术的CBT项目。本评价收集的信息支持使用基于技术的CBT作为一种有效治疗方法来减轻强迫症症状的严重程度,儿童耶鲁-布朗强迫症量表评分的统计学显著降低表明了这一点。此外,本评价的结果支持了先前的临床研究,表明基于技术的CBT的效果不劣于传统CBT方法。

结论

本系统评价的结果支持使用基于技术的CBT治疗儿童和青少年的强迫症,特别是在由于地理或全球问题无法获得面对面治疗师治疗的情况下。需要更多的研究来了解新的CBT方法对日常生活的影响和可接受性,以及基于技术的方法对更严重强迫症病例的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d42e/11951855/9994b13e2f66/nihms-2015832-f0001.jpg

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