| 1. |
- Andersson, Erik, et al.
(författare)
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Cost-effectiveness of an internet-based booster program for patients with obsessive-compulsive disorder : Results from a randomized controlled trial
- 2015
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Ingår i: Journal of Obsessive-Compulsive and Related Disorders. - : Elsevier. - 2211-3649 .- 2211-3657. ; 4, s. 14-19
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Tidskriftsartikel (refereegranskat)abstract
- Cognitive behavior therapy (CBT) is an effective treatment for OCD when delivered face-to-face, in group-format and also via the internet. However, despite overall large effect sizes, a considerable amount of the patients relapse. One intervention that has the potential to reduce these relapse rates is booster programs, but if booster program is a cost-effective method of preventing relapse is still unknown. We used health economical data from a recent randomized controlled trial, where patients who had undergone an internet-based CBT were randomly allocated to receive an additional booster program. Assessment points were 4-, 7-, 12- and 24-month. Health economical data were primarily analyzed using a societal perspective. Results showed that the booster program was effective in preventing relapse, and the cost of one avoided relapse was estimated to $1066-1489. Cost-effectiveness acceptability curves showed that the booster program had a 90% probability of being cost-effective given a willingness to pay of $1000-1050 the first year, but this figure grew considerably after two years ($2500-5500). We conclude that internet-based booster programs are probably a cost-effective alternative within one-year time frame and that more treatment may be needed to maintain adequate cost-effectiveness up to two years. (C) 2014 Elsevier Inc. All rights reserved.
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| 2. |
- Andersson, Erik, et al.
(författare)
-
Cost-effectiveness of internet-based cognitive behavior therapy for obsessive-compulsive disorder : results from a randomized controlled trial
- 2015
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Ingår i: Journal of Obsessive-Compulsive and Related Disorders. - : Elsevier. - 2211-3649 .- 2211-3657. ; 4, s. 47-53
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Tidskriftsartikel (refereegranskat)abstract
- Obsessive-compulsive disorder (OCD) is a common and disabling disorder. Although evidence-based psychological treatments exists, such as cognitive behavior therapy (CBT), the cost-effectiveness of CBT has not been properly investigated. In this trial, we used health economic data from a recently conducted randomized controlled trial, where 101 OCD patients were allocated to either internet-based CBT (ICBT) or control condition (online support therapy). We analyzed treatment effectiveness in relation to costs, using both a societal- (including all direct and indirect costs) and a health care unit perspective (including only the direct treatment costs). Bootstrapped net benefit regression analyses were also conducted, comparing the difference in costs and effects between ICBT and control condition, with different willingness-to-pay scenarios. Results showed that ICBT produced one additional remission for an average societal cost of $931 and this figure was even lower ($672) when narrowing the perspective to treatment costs only. The cost-utility analysis also showed that ICBT generated one additional QALY to an average price of $7186 from a societal perspective and $4800 when just analyzing the treatment costs. We conclude that ICBT is a cost-effective treatment and the next step in this line of research is to compare the cost-effectiveness of ICBT with face-to-face CBT. (C) 2014 Elsevier Inc. All rights reserved.
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| 3. |
- Andersson, Erik, et al.
(författare)
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Predictors and moderators of Internet-based cognitive behavior therapy for obsessive-compulsive disorder : Results from a randomized trial
- 2015
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Ingår i: Journal of Obsessive-Compulsive and Related Disorders. - : Elsevier. - 2211-3649 .- 2211-3657. ; 4, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- Internet-based cognitive behavior therapy (ICBT) for obsessive-compulsive disorder (OCD) has shown efficacy in randomized trials but many patients do not respond to the treatment, we therefore need to find predictors and moderators of treatment response. In this study, we analyzed predictors of ICBT response using both post-treatment as well as 24-month outcome data. As half of the participants were randomized to receive an Internet-based booster program as an adjunct to ICBT, we also investigated moderators of ICBT with or without booster. Results showed that more severe baseline OCD symptoms predicted worse end state outcome but also higher degree of change. Furthermore, high degree of working alliance predicted better outcome but patients with primary disgust emotions had worse treatment effects. The moderator analysis also indicated that scoring high on the obsessing subscale on the Obsessive-Compulsive Inventory-Revised predicted worse treatment outcome in the booster group. In conclusion, there are some possible predictors and moderators of ICBT for OCD but more research is needed with larger and clinically representative samples. (C) 2014 Elsevier Inc. All rights reserved.
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| 4. |
- Colak, Burcin, et al.
(författare)
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Misophonic symptoms in non-psychotic psychiatric outpatients and its association with trait psychological variables
- 2021
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Ingår i: Journal of Obsessive-Compulsive and Related Disorders. - : Elsevier. - 2211-3649 .- 2211-3657. ; 29
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Tidskriftsartikel (refereegranskat)abstract
- Background: Misophonia is commonly described as abnormal or disproportionately aversive and emotional reactions to specific sounds that interfere with patients' psychosocial functioning. In this study, we aimed to investigate the possible associations of specific psychological traits with misophonic symptoms in psychiatric outpatients.Subjects: Misophonic Symptoms Checklist (MSC), Eysenck Personality Questionnaire-Revised Short Form (EPQRS), Maudsley Obsessive-Compulsive Inventory (MOCI), State-Trait Anxiety Inventory (STAI), Buss-Perry Aggression Questionnaire (BPAQ) and Somatosensory Amplification Scale (SASS) were used to assess various psychological traits in a sample of consecutive outpatients at University Hospital Psychiatry Department in September 2019.Results: After multiple regression analysis, we found that the MOCI, STAI, EPQRSneuroticism, SASS, and BPAQ predicted misophonic symptoms where only SASS and MOCI were significant predictors.Conclusions: Our findings indicate that proneness to somatization and obsessivecompulsive symptoms are significantly associated with misophonic symptoms. These findings contribute to the phenomenological understanding of misophonia.
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| 5. |
- Havnen, Audun, et al.
(författare)
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Concentrated ERP delivered in a group setting : An effectiveness study
- 2014
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Ingår i: Journal of Obsessive-Compulsive and Related Disorders. - : Elsevier BV. - 2211-3649 .- 2211-3657. ; 3:4, s. 319-324
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Tidskriftsartikel (refereegranskat)abstract
- The aims of the present study were to evaluate the acceptability and long term gains of a highly concentrated exposure and response prevention (ERP) for obsessive compulsive disorder (OCD). Treatment was individually tailored and delivered in a group format over four consecutive days in an outpatient OCD treatment unit, part of the ordinary specialist health care. A total of 35 patients accepted the offer of treatment; 23 of the patients were classified with severe to extreme OCD, and 74% of the sample had previously received treatment for their OCD (20% of these with ERP). The results showed that more than 90% of the patients expressed a high degree of satisfaction with the concentrated ERP. At six months follow-up 27 (77%) were classified as recovered and a significant improvement was seen in depressive symptoms as well. The majority of the sample also showed improvement with regard to employment status 12 months after treatment. The results indicate that this highly concentrated treatment may be a feasible format of delivering ERP.
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| 6. |
- Holmgren Melin, Karin, et al.
(författare)
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Treatment and 12-month outcome of children and adolescents with obsessive-compulsive disorder: A naturalistic study
- 2015
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Ingår i: Journal of Obsessive-Compulsive and Related Disorders. - Amsterdam : Elsevier BV. - 2211-3649 .- 2211-3657. ; 6, s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- Pediatric obsessive-compulsive disorder (OCD) is a disorder associated with distress and impairment in many domains. Moreover, there is a high risk of relapse and developing a chronic illness. Randomized-controlled trails (RCT), the gold-standard for evaluating treatments, show treatments to be efficacious, yet little is known about their generalizability and long-term durability in "usual-care" settings. The aim of the present study is to evaluate the feasibility and effectiveness of evidence-based pediatric OCD-treatments in regular practice. Participants were 109 children (aged 7-17 years) with a primary diagnosis of OCD, recruited from a specialized OCD-clinic in Sweden. Few exclusion criteria were applied. The youths were assessed at baseline, 6 and 12 months following the first assessment, using Children's Yale-Brown Obsessive Compulsive Scale and Children's OCD Impact Scale. They were treated with Cognitive Behavior Therapy, augmented with SSRI when indicated. The majority responded well to treatment i.e. were free from OCD or in remission at 12 month evaluation. Moreover, the participants psychosocial functioning significantly improved from baseline to evaluation at 6 and 12 months. (C) 2015 Elsevier Inc. All rights reserved.
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| 7. |
- Jensen, Sanne, et al.
(författare)
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The Children's Yale-Brown Obsessive-Compulsive Scale's auxiliary items: Long-term outcome
- 2020
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Ingår i: Journal of Obsessive-Compulsive and Related Disorders. - : Elsevier BV. - 2211-3649 .- 2211-3657. ; 27
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Tidskriftsartikel (refereegranskat)abstract
- © 2020 Elsevier Inc. Objective: Standard assessment of pediatric obsessive-compulsive disorder (OCD) patients includes ratings of insight, avoidance, indecisiveness, sense of responsibility, pervasive slowness, pathological doubting, and obsession-free intervals. The present study aims to identify pre-treatment associations of these clinical features to symptom severity and symptom dimensions as well as to describe and analyze the long-term levels and distribution in different treatment responder groups. Method: Severity ratings as well as clinical feature ratings were evaluated in 268 pediatric OCD patients using the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) at seven time points before, during, and up to three years after first-line cognitive-behavioral therapy. The CY-BOCS auxiliary items were evaluated on the basis of three symptom severity trajectory classes: acute, slow, and limited responders. Results: Insight, avoidance, pervasive slowness, and obsession-free intervals were positively associated with pre-treatment symptom severity. Symptom dimensions were associated with different auxiliary items. At three-year follow-up, the limited responder class had higher scores than the acute and slow responder classes on all items except for responsibility. Conclusion: The CY-BOCS auxiliary items are closely related to symptom dimensions and partly to symptom severity. The features appear to be dynamic concepts prone to change, yet, less so in patients showing limited long-term treatment response.
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| 8. |
- Riise, Eili N., et al.
(författare)
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Concentrated exposure and response prevention for adolescents with obsessive-compulsive disorder : An effectiveness study
- 2016
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Ingår i: Journal of Obsessive-Compulsive and Related Disorders. - : Elsevier BV. - 2211-3649 .- 2211-3657. ; 11, s. 13-21
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Tidskriftsartikel (refereegranskat)abstract
- This study evaluated the effectiveness of a concentrated exposure and response prevention (ERP) treatment for adolescents with obsessive-compulsive disorder (OCD). Twenty-two adolescents with OCD (range 11–17 years) received therapist-assisted ERP during four consecutive days, followed by a three week period of self-administered ERP. Treatment was delivered to 2–3 patients and their parents simultaneously at an outpatient clinic for child and adolescent psychiatry as part of standard health care. OCD-symptoms were assessed at pre-treatment, post-treatment, 3- and 6-month follow-up. The results demonstrated that patients had significant reduction in OCD-symptoms from pre- to post-treatment and the gains were maintained at follow-up. 91% (n=20) were classified as responders at post-treatment, and 77% (n=17) at six-month follow-up. Remission rates were 73% (n=16) at post-treatment and 68% (n=15) at six-month follow-up. OCD-related impairment and symptoms of anxiety and depression were significantly reduced at post-treatment and follow-up. The results suggest that concentrated ERP is a promising treatment for adolescents with OCD.
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| 9. |
- Riise, Eili N., et al.
(författare)
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Concentrated exposure and response prevention for adolescents with obsessive-compulsive disorder : A replication study
- 2018
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Ingår i: Journal of Obsessive-Compulsive and Related Disorders. - : Elsevier BV. - 2211-3649 .- 2211-3657. ; 19, s. 15-22
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Tidskriftsartikel (refereegranskat)abstract
- A previous effectiveness study (Riise et al., 2016) demonstrated promising findings from a 4-day concentrated exposure and response prevention (ERP) treatment, the Bergen 4-day treatment (B4DT), for adolescents with obsessive-compulsive disorder (OCD). The present study investigated whether the results reported in the original study were replicated in a new sample of adolescents. Forty-one referred patients aged 11–18 underwent treatment at an outpatient clinic, as part of public health care. Treatment was delivered to 2–4 patients and their parents simultaneously, during four consecutive days, followed by a three-week period of self-administered ERP. Obsessive-compulsive symptoms were assessed at pre-treatment, post-treatment, 3- and 6-month follow-up. The results demonstrated significant reductions in OCD-symptoms. Remission was achieved by 33 patients (80%) at post-treatment, and 30 (73%) at follow-up. At post-treatment or follow-up there were no significant differences between the present sample and the sample in Riise et al. (2016) on OCD-severity or on rates of response or remission. The results demonstrate that the treatment was successfully replicated in a new sample and adds further support to the efficacy of the B4DT. Findings suggest that a concentrated treatment format with prolonged sessions might be a viable option to improve treatment outcomes of ERP.
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| 10. |
- Weidle, Bernhard, et al.
(författare)
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Sexual obsessions in children and adolescents: Prevalence, clinical correlates, response to cognitive-behavior therapy and long-term follow up
- 2022
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Ingår i: Journal of Obsessive-Compulsive and Related Disorders. - : Elsevier BV. - 2211-3649 .- 2211-3657. ; 32
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Tidskriftsartikel (refereegranskat)abstract
- Sexual obsessions occur in pediatric and adult OCD including thoughts about sexual acts with family members, sexually inappropriate behavior, or homosexual orientation. They may remain undiagnosed because of embarrassment to report thoughts that are perceived as unacceptable. Prevalence studies of sexual obsessions in pediatric populations are rare. The present study investigated prevalence of sexual obsessions and treatment outcome compared to youth with OCD without sexual obsessions in a large sample. Sexual obsessions and OCD severity were assessed with the Children's Yale-Brown Obsessive- Compulsive Scale in all 269 participants of the Nordic Longterm OCD Treatment study (mean age 12.8 years, 48.7% boys) at baseline, after treatment and three years follow-up. Treatment consisted in individual manualized CBT with exposure and response prevention. Patients with and without sexual obsessions were compared on clinical characteristics and treatment outcomes. Sexual obsessions were reported by 18%, those with sexual obsessions were slightly older (13.5 versus 12.7 years). Both groups had no difference in treatment outcome, suggesting that if addressed, the response to CBT is similar in sexual, as in other obsessions. Clinicians need to be aware that children may need help to disclose and to identify these thoughts as obsessions to address them in treatment.
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