Table 2. Outcomes in a Study of the Effect of Internet-Delivered vs In-Person Cognitive Behavioral Therapy (CBT) on Obsessive-Compulsive Disorder Symptoms in Children and Adolescents (N = 152)a.
| Outcome | Mean (SD) | Estimated absolute difference (CI)b | P value | |
|---|---|---|---|---|
| Stepped care (n = 74) | In-person CBT (n = 78) | |||
| Primary outcome | ||||
| CY-BOCS score | ||||
| Pretreatment | 23.9 (3.6) | 23.0 (3.7) | ||
| Posttreatment | 13.6 (5.9) | 12.8 (7.1) | ||
| 3-mo follow-up | 13.6 (6.7) | 11.8 (7.1) | ||
| 6-mo follow-up | 11.6 (6.4) | 10.6 (7.6) | 0.9 (−∞ to 3.3) | .02c |
| Secondary outcomes | ||||
| Clinician-rated | ||||
| Children’s Global Assessment Scale score | ||||
| Pretreatment | 55.1 (8.6) | 56.29 (7.2) | ||
| Posttreatment | 64.0 (10.5) | 66.61 (11.5) | ||
| 3-mo follow-up | 64.1 (11.5) | 66.96 (10.8) | ||
| 6-mo follow-up | 66.3 (11.5) | 67.99 (12.3) | −1.7 (−5.2 to 1.8) | .33 |
| Child-rated | ||||
| Obsessive-Compulsive Inventory-Child version | ||||
| Pretreatment | 18.7 (7.5) | 20.4 (6.4) | ||
| Posttreatment | 9.6 (6.4) | 11.2 (8.4) | ||
| 3-mo follow-up | 9.6 (7.6) | 11.1 (8.6) | ||
| 6-mo follow-up | 8.1 (5.67) | 8.8 (7.8) | −0.9 (−3.6 to 1.9) | .53 |
| Mood and Feelings Questionnaire-Child version | ||||
| Pretreatment | 8.9 (5.6) | 9.9 (6.3) | ||
| Posttreatment | 5.4 (5.1) | 6.3 (6.2) | ||
| 3-mo follow-up | 5.5 (5.4) | 5.5 (6.2) | ||
| 6-mo follow-up | 4.8 (4.9) | 5.0 (5.7) | 0.03 (−2.2 to 2.2) | .98 |
| Work and Social Adjustment Scale-Youth version | ||||
| Pretreatment | 15.1 (8.0) | 17.2 (8.7) | ||
| Posttreatment | 8.7 (6.7) | 9.9 (8.6) | ||
| 3-mo follow-up | 7.3 (7.0) | 8.0 (6.9) | ||
| 6-mo follow-up | 6.1 (5.5) | 7.5 (7.7) | −0.9 (−3.8 to 2.1) | .57 |
| Child Health Utility 9D | ||||
| Pretreatment | 19.9 (5.7) | 20.0 (5.5) | ||
| Posttreatment | 16.9 (5.7) | 16.7 (6.2) | ||
| 3-mo follow-up | 17.3 (6.2) | 15.8 (5.8) | ||
| 6-mo follow-up | 16.1 (5.2) | 14.8 (4.9) | 1.7 (−0.4 to 3.7) | .12 |
| Insomnia Severity Index | ||||
| Pretreatment | 7.0 (5.7) | 5.8 (4.9) | ||
| Posttreatment | 4.8 (4.5) | 4.4 (4.2) | ||
| 3-mo follow-up | 5.1 (5.3) | 4.8 (5.8) | ||
| 6-mo follow-up | 4.8 (4.5) | 4.0 (5.0) | 1.3 (−0.5 to 3.1) | .15 |
| Parent-rated | ||||
| Children’s Obsessional Compulsive Inventory-Revised-Parent version | ||||
| Pretreatment | 27.7 (6.6) | 28.5 (7.8) | ||
| Posttreatment | 16.1 (9.1) | 15.5 (9.9) | ||
| 3-mo follow-up | 15.3 (9.6) | 14.1 (10.0) | ||
| 6-mo follow-up | 13.3 (7.9) | 13.5 (9.7) | −0.5 (−3.8 to 2.9) | .78 |
| Family Accommodation Scale-Self Rated | ||||
| Pretreatment | 19.5 (14.4) | 21.4 (16.0) | ||
| Posttreatment | 7.0 (9.1) | 8.9 (11.8) | ||
| 3-mo follow-up | 8.8 (13.2) | 7.7 (11.1) | ||
| 6-mo follow-up | 5.2 (7.4) | 8.2 (10.7) | −2.4 (−6.4 to 1.5) | .23 |
| Mood and Feelings Questionnaire-Parent version | ||||
| Pretreatment | 9.2 (5.6) | 10.3 (5.9) | ||
| Posttreatment | 5.7 (4.6) | 6.4 (5.9) | ||
| 3-mo follow-up | 5.4 (5.2) | 5.8 (6.2) | ||
| 6-mo follow-up | 4.7 (4.7) | 5.6 (6.0) | −1.1 (−3.1 to 0.9) | .28 |
| Work and Social Adjustment Scale-Parent version | ||||
| Pretreatment | 16.6 (8.5) | 17.6 (8.3) | ||
| Posttreatment | 8.9 (7.1) | 10.0 (8.8) | ||
| 3-mo follow-up | 8.7 (8.3) | 7.9 (8.2) | ||
| 6-mo follow-up | 7.5 (7.4) | 7.8 (8.5) | −0.3 (−3.3 to 2.7) | .83 |
a
Data were analyzed according to the randomization groups and all participants were included in the analyses. The Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS) scores range from 0 to 40, with higher scores indicating more severe symptoms. See eMethod 3 in Supplement 2 for detailed information about the secondary outcome measures.
b
Group × time interaction from mixed-effect regression analyses. 1-sided 97.5% CI is reported for the primary outcome measure (CY-BOCS score) and 2-sided 95% CIs are reported for the secondary outcome measures.
c
P value reported for the CY-BOCS score is for the test of noninferiority. A significant P value indicates noninferiority.