Acceptability, feasibility, and efficacy of Internet cognitive behavioral therapy (iCBT) for pediatric obsessive-compulsive disorder: a systematic review

Abstract

Background:Obsessive-compulsive disorder (OCD) is a chronic mental health disorder characterized by recurringobsessions and compulsions affecting 1–3% of children and adolescents. Current treatment options are limited byaccessibility, availability, and quality of care. New technologies provide opportunities to address at least some ofthese challenges. This paper aims to investigate the acceptability, feasibility, and efficacy of traditional cognitivebehavioral therapy with Internet cognitive behavioral therapy (iCBT) for pediatric OCD according to PreferredReporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Method:We searched EMBASE, Medline, PsycINFO, CENTRAL, LILACS, CINAHL, and Scopus. Results include articlesfrom 1987 to March 2018. Main inclusion criteria were patients aged 4–18, primary diagnosis of OCD, and iCBT.Results:Of the 2323 unique articles identified during the initial search, six studies with a total of 96 participants metour inclusion criteria: three randomized controlled trials, one single-case multiple-baseline design, one open-label trial,and one case series. Four studies reported a significant decrease in OCD severity on the Children’sYale-BrownObsessive-Compulsive Scale (CY-BOCS) following iCBT, one study reported significant decrease in CY-BOCS scores foriCBT relative to waitlist, and the case series reported (some) symptom reduction in all participants. Six studies reportedhigh rates of feasibility, and five studies reported good acceptability of iCBT.Conclusion:At present, evidence regarding acceptability, feasibility, and efficacy of iCBT for pediatric OCD is limited.Results are promising but need to be confirmed and refined in further research.