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COVID-19 related differences in the uptake and effects of internet-based cognitive behavioural therapy for symptoms of obsessive-compulsive disorder

Published online by Cambridge University Press:  10 November 2021

Ian Li Open the ORCID record for Ian Li [Opens in a new window] ,
Michael Millard ,
Hila Haskelberg ,
Megan Hobbs ,
John Luu  and
Alison Mahoney Open the ORCID record for Alison Mahoney [Opens in a new window]
Ian Li
Affiliation:
Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales, 2010, Australia
Michael Millard
Affiliation:
Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales, 2010, Australia School of Psychiatry, University of New South Wales, Sydney, New South Wales, 2052, Australia
Hila Haskelberg
Affiliation:
Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales, 2010, Australia
Megan Hobbs
Affiliation:
Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales, 2010, Australia School of Psychiatry, University of New South Wales, Sydney, New South Wales, 2052, Australia New England Institute of Healthcare Research, University of New England, ArmidaleNSW 2351, Australia
John Luu
Affiliation:
Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales, 2010, Australia
Alison Mahoney*
Affiliation:
Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital, 390 Victoria Street, Darlinghurst, Sydney, New South Wales, 2010, Australia School of Psychiatry, University of New South Wales, Sydney, New South Wales, 2052, Australia
*
*Corresponding author. Email: alison.mahoney@svha.org.au
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Abstract

Background:

The impacts of COVID-19 for people with obsessive-compulsive disorder (OCD) may be considerable. Online cognitive behavioural therapy (iCBT) programmes provide scalable access to psychological interventions, although the effectiveness of iCBT for OCD during COVID-19 has not been evaluated.

Aim:

This study investigated the uptake and effectiveness of iCBT for OCD (both self- and clinician-guided courses) during the first 8 months of the pandemic in Australia (March to October 2020) and compared outcomes with the previous year.

Method:

1,343 adults (824/1343 (61.4%) female, mean age 33.54 years, SD = 12.00) commenced iCBT for OCD (1061 during the pandemic and 282 in the year before) and completed measures of OCD (Dimensional Obsessive-Compulsive Scale) and depression (Patient Health Questionaire-9) symptom severity, psychological distress (Kessler-10), and disability (WHO Disability Assessment Schedule) pre- and post-treatment.

Results:

During COVID-19, there was a 522% increase in monthly course registrations compared with the previous year, with peak uptake observed between April and June 2020 (a 1191% increase compared with April to June 2019). OCD and depression symptom severity were similar for the COVID and pre-COVID groups, although COVID-19 participants were more likely to enrol in self-guided courses (versus clinician-guided). In both pre- and during-COVID groups, the OCD iCBT course was associated with medium effect size reductions in OCD (g = 0.65–0.68) and depression symptom severity (g = 0.56–0.65), medium to large reductions in psychological distress (g = 0.77–0.83) and small reductions in disability (g = 0.35–.50).

Conclusion:

Results demonstrate the considerable uptake of online psychological services for those experiencing symptoms of OCD during COVID-19 and highlight the scalability of effective digital mental health services.

Keywords

effectivenessiCBTinternet interventionOCDpandemic
Type
Main
Information
Behavioural and Cognitive Psychotherapy , Volume 50 , Issue 2 , March 2022 , pp. 219 - 236
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the British Association for Behavioural and Cognitive Psychotherapies

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