以技术为基础的CBT减轻儿童强迫症症状:一项系统综述

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

背景:强迫症(OCD)是一种焦虑症,影响了美国高达3%的儿童和青少年。认知行为疗法(CBT)是儿童轻中度强迫症的一线治疗方法。尽管CBT在治疗强迫症方面有好处,但由于缺乏途径,与精神药物相比,只有三分之一的临床医生经常使用CBT。COVID-19大流行导致强迫症严重程度的复发增加,由于健康和安全预防措施,进一步限制了传统面对面CBT治疗的获得。目的:本系统综述旨在通过评价临床试验结果及其与传统CBT方法的可比性来证明基于技术的CBT的有效性。方法:使用“强迫症”、“互联网”、“认知行为疗法”、“儿童”等词进行循证检索。共鉴定出716件物品。结果:在筛选标题、摘要和全文的相关性后,本系统综述纳入了7项研究,共254名受试者和4个不同的项目,涉及基于技术的CBT。本综述收集的信息支持使用基于技术的CBT作为降低强迫症症状严重程度的有效治疗方法,儿童耶鲁-布朗强迫症量表得分有统计学意义的显著降低。此外,本综述的结果支持先前的临床研究,表明基于技术的CBT的效果并不亚于传统的CBT方法。结论:本系统综述的结果支持在儿童和青少年中使用基于技术的CBT治疗强迫症,特别是在由于地理或全球问题而无法获得面对面治疗师会议的时候。需要进一步的研究来了解新的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的强迫症病例的有效性。
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Technology-based CBT in Reducing Symptoms of OCD in Children: A Systematic Review
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.
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