Efficacy And Cost-effectiveness Of Computerized Cognitive Behavioral Therapy For Obsessive-Compulsive Disorder

This study conducts randomized controlled trials to compare the efficacy,costs,cost-effectiveness of Internet-based cognitive behavioral therapy(ICBT),cognitive behavioral group therapy(CBGT),and treat as usual(TAU)in patients with Obsessive and Compulsive disorder(OCD).The study selected 99 patients with OCD who met the diagnostic criteria of DSM-5,and randomly assigned to the ICBT combined with medical treatment group(ICBT group),CBGT combined medical treatment group(CBGT group)and treat as usual(TAU group).All the 3 groups were treated for 6 weeks.The severity of symptoms such as OCD,anxiety and depression in the three groups were compared at baseline,during treatment,and after treatment.The cost-effectiveness of three groups were analyzed.The results showed that at baseline,there were no significant differences in the YBOCS score,the HAMA score,the HAMD score,the SDS score,and SAS scores in the three groups(p = 0.557,p = 0.774,p = 0.894,p = 0.966,p = 0.529).After treatment,the YBOCS scores of the three groups were significantly decreased(p < 0.001),and the YBOCS scores of the CBGT group(p = 0.006)and the ICBT group(p = 0.024)were significantly increased compared to those of the TAU group.In the CBGT group(p=0.006),ICBT group(p<0.001)and TAU group(p=0.002),the HAMD scores significantly decreased before and after treatment.HAMD scale scores were significantly different before and after treatment(p=0.010)in the ICBT group,but there was no significant difference between the CBGT group(p = 0.113)and the TAU group(p = 0.582).The ICBT group(p < 0.001)and the TAU group(p< 0.001)showed a significant decrease in SDS scores,while the CBGT group There was no significant difference in SDS scores before and after treatment(p = 0.062).In CBGT group(p = 0.271),ICBT group(p = 0).098)and TAU group(p=0.286),no significant difference is found in SAS scores before and after treatment.In terms of health economics,ICBT group,CBGT group and TAU group spent an average of 7043.52,3151.85 and2139.71 yuan per patient.The total cost of the CBGT group was significantly higher than that of the ICBT group(p<0.001)and the TAU group(p<0.001).Compared with the CBGT group and the TAU group,the ICBT group reduced 1 YBOCS score by 372.28 and 25.74 yuan.ICBT,CBGT and TAU all have significant efficacy on patients with OCD.And medical treatment combines with ICBT or CBGT have a more significant improvement in OCD symptoms than medical-only treatment,and ICBT is a lower cost and more cost-effective treatment.