Psychiatry · 4 h ago
Concentrated exposure therapy outperforms internet CBT for OCD in single-center trial
In a randomized trial of 119 adults with obsessive-compulsive disorder, Bergen 4-day treatment (B4DT) reduced symptoms more than an 8-week unguided internet-based CBT program. Differences persisted at the 3-month follow-up, although the study was conducted at a single center and follow-up was limited.
- B4DT reduced OCD symptoms more than unguided iCBT.
- Symptom differences persisted at 3-month follow-up.
- Single-center trial enrolled 119 adults.
- Longer-term effectiveness remains unknown.
This single-center randomized clinical trial compared Bergen 4-day treatment (B4DT), a concentrated exposure-based intervention with preparatory sessions, with an 8-week unguided internet-based cognitive behavioral therapy (iCBT) program. It enrolled 119 adults with obsessive-compulsive disorder (OCD), randomized 60 to B4DT and 59 to iCBT. Masked evaluators assessed outcomes through 3 months; the primary endpoint was change in Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score.
B4DT produced greater symptom reductions than iCBT at posttreatment (between-group mean difference, −7.9 points; 95% CI, −9.7 to −6.0; Hedges g, −1.6) and at 3 months (−5.6; 95% CI, −7.8 to −3.4; g, −1.0). At follow-up, response was reported in 61.4% of B4DT participants versus 25.0% of iCBT participants; remission rates were 42.1% and 13.6%, respectively.
The findings suggest concentrated exposure therapy may be a more effective option than unguided iCBT for adults similar to those enrolled. However, the trial was single-center, included 119 participants, and followed patients for only 3 months. The results do not establish longer-term effectiveness or generalizability to other settings and patient groups.
In practice
For adults with OCD resembling the trial population, B4DT produced larger symptom reductions and higher response and remission rates at 3 months than an 8-week unguided iCBT program. This supports B4DT as a promising treatment approach, but does not establish that it should replace other care: the randomized evidence comes from one center, involved 119 participants, and has only 3 months of follow-up. Longer-term outcomes and performance in other settings remain uncertain.
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JAMA Network Open: Concentrated Exposure Therapy vs Internet-Based Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.