Infectious Disease
CBT provided over the internet is effective and inexpensive for adolescents with social anxiety disorder
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Nordh does not report any relevant financial information. In the study you will find all relevant financial information from all other authors.
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Cognitive behavioral therapy, provided over the Internet, was effective and inexpensive for children and adolescents with social anxiety disorder, according to the results of a randomized clinical trial published in JAMA Psychiatry.
“To the best of our knowledge, no study is evaluated [internet-delivered CBT (ICBT)] to the [social anxiety disorder] has previously used an active comparator which is essential in determining the true effect of behavioral intervention beyond the effects of the doctor’s attention and frequent monitoring and reporting of symptoms. ” Martina Nordh, PhD, the Department of Clinical Neuroscience at Karolinska Institute and Stockholm Health Care Services in Sweden, and colleagues wrote. “In addition, there are no formal health economic assessments of ICBT for [social anxiety disorder] in adolescents were previously carried out. Cost-benefit analyzes are important when evaluating new interventions in order to support policy makers in the best possible allocation of resources. “
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The researchers wanted to compare ICBT with Internet Support Therapy (ISUPPORT), the active comparator, in terms of effectiveness and cost-effectiveness for adolescents with social anxiety disorder. They participated in a clinical research unit integrated with the child and adolescent mental health services in Stockholm, Sweden, between September 1, 2017 and October 31, 2018. The final participant had reached three-month follow-up in May 2019. The researchers included 103 children and adolescents aged 10 to 17 years (mean age 14.1 years; 77% women) who had a primary diagnosis of social anxiety disorder , as well as their parents. They randomly assigned 51 to therapist-led ICBT and 52 to therapist-led ISUPPORT for social anxiety disorder for 10 weeks. Both interventions consisted of 10 online modules, five separate parent modules, and three video call sessions with a therapist. The main result was the Clinician Severity Rating (CSR), which was derived from the interview schedule for anxiety disorders and the rate of masked reviewers 3 months after the end of treatment. Nordh and colleagues defined caseness as CSR values of four or higher. Secondary results were the diagnostic status of a social anxiety disorder and global functioning, the social anxiety and depressive symptoms reported by children and parents, and health-related costs.
The results showed a significantly higher effectiveness in reducing the severity of social anxiety symptoms in ICBT compared to ISUPPORT with mean CSR values for ICBT at baseline and 3-month follow-up of 5.06 and 3.96 compared to 4.94 and 4, 48 at ISUPPORT. At the 3-month follow-up, Nordh et al. Observed a significant effect size between Cohen’s groups d = 0.67 (95% CI, 0.21-1.12). In addition, all secondary outcome measures showed significant differences for small to large effect sizes, apart from the quality of life assessed by children. According to the results of cost-benefit analyzes, ICBT was associated with cost savings compared to ISUPPORT. Lower drug costs and higher school productivity made up the bulk of the cost savings in the ICBT group. The researchers reported one suicide attempt in the ISUPPORT group, which was the only serious adverse event that occurred in both groups.
“Internet-provided cognitive behavioral therapy has the potential to overcome common treatment barriers and increase the availability of evidence-based psychological treatments for this patient population,” wrote Nordh and colleagues.
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