A prediction analysis testing if internet-delivered cognitive-behaviour therapy is most suitable for the milder cases of pediatric obsessive-compulsive disorder

Common clinical sense would suggest that individuals with milder obsessive-compulsive disorder (OCD) symptoms should be the most suitable for guided internet-delivered cognitive behaviour therapy (CBT), with more intensive forms of treatment reserved for more severe or complex cases.

In this secondary data analysis of a non-inferiority clinical trial comparing internet-delivered CBT with in-person CBT for young people with OCD (N = 152), we found that higher baseline symptom severity predicted worse treatment outcomes in the in-person group but not the internet-delivered CBT group. Additional analyses showed that among individuals with milder symptoms, internet-delivered CBT was associated with worse outcomes than in-person CBT.

If replicated, these results would question the axiom that internet-delivered CBT is most suitable for milder cases.

The original trial was registered at ClinicalTrials.gov ID NCT03263546. Date of registration 2017–08–28.