Step Down from Maximal Support: Efficacy of Stepped-care Internet-based Cognitive Behavior Therapy for Obsessive-compulsive Disorder
This study is conducted to explore the efficacy and cost-effectiveness of stepped-care internet-based cognitive behavior therapy (sc-ICBT) with reduced support compared to cognitive-behavioral group therapy(CBGT), to identify the optimal transition points for shorter effective stepped treatments, to find clinical indicators that can predict the effectiveness of CBT interventions, and to investigate predictive outcomes. The main questions the investigators aim to answer are: 1. Is the reduction in YBOCS scores following stepped-care Internet-based cognitive-behavioral therapy (SC-ICBT) with reduced support non-inferior to that observed in traditional cognitive-behavioral group therapy (CBGT)? 2. Does SC-ICBT for obsessive-compulsive disorder offer better health economic benefits compared to CBGT? 3. What is the optimal time point for transitioning to shorter effective stepped care, and what clinical indicators can predict the efficacy of CBT interventions post-treatment?
• Individuals aged between 18 and 50 years, inclusive of both genders;
• Presenting primarily with compulsive symptoms that meet the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for Obsessive-Compulsive Disorder (OCD);
• Yale-Brown Obsessive Compulsive Scale (YBOCS) scores ranging from 16 to 31, inclusive;
• Have been on a stable regimen of standard anti-compulsive pharmacotherapy for a period of 8 weeks;
• Possess a minimum educational level of junior high school;
• Demonstrate adequate auditory and visual acuity to perform the assessments required by the study;
• The participant and their legal guardian have comprehended the nature of the study and have provided informed consent;
• Right-handedness (this criterion applies exclusively to participants undergoing magnetic resonance imaging).