CClinicalTrials.gg
Not yet recruitingNCT06658756Updated Nov 13, 2024

Implementation of Internet-Based Psychotherapy for OCD in Primary Health Care in Two Cities in the State of São Paulo

An interventional study of internet-CBT in Obsessive-Compulsive Disorder, sponsored by University of Sao Paulo General Hospital. Not yet recruiting at 4 sites in Brazil. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2024-11-13.

Sponsored by University of Sao Paulo General Hospital · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
140
Allocation
Randomized
Ages
18 Years to 65 Years
Sex
All
01

Study summary

The aim of this study is to assess the implementation of Internet-based Cognitive Behavioral Therapy (I-CBT) treatment in a Brazilian sample.

Researchers will compare 140 participants (70 with I-CBT and 70 in usual care to see if the treatment is feasible.

Participants will undergo online treatment for OCD, lasting 10 to 14 weeks.

Read the detailed description

Obsessive-compulsive disorder (OCD) affects 2 to 3% of the adult population worldwide. The efficacy of pharmacological therapy with IRS and cognitive-behavioral therapy (CBT) is well recognized, but the clinical spectrum of OCD symptoms makes it difficult for patients to engage in sessions outside the home, decreasing treatment adherence. CBT is a psychological intervention increasingly delivered over the internet, with studies showing its efficacy in patients with OCD. The present study aims to verify the efficacy of implementing internet-based psychotherapy (I-CBT) in the context of a developing country, identifying the barriers and facilitators of this implementation. It will be a pragmatic, randomized-controlled, parallel, open-label, two-arm clinical trial. The implementation will be carried out in the cities of Indaiatuba and Jaguariúna, state of São Paulo, in all their Basic Health Units, in which 140 participants will be randomized between the I-CBT and usual treatment (UT) groups. Results will be assessed post-treatment and at 3- and 12-month follow-up. The hypothesis is that I-CBT is an effective and feasible treatment modality for OCD in a large Brazilian sample.

02

Conditions studied

  • Obsessive-Compulsive Disorder
03

In context

Compulsive Personality Disorder

367 studies on the registry are indexed under Compulsive Personality Disorder; 67 are open to participants now.

This study's planned enrollment of 140 is above the median of 37 across 306 interventional studies indexed under Compulsive Personality Disorder.

Browse Compulsive Personality Disorder studies →

Lead sponsor

University of Sao Paulo General Hospital is the lead sponsor of 595 studies on the registry; 98 are open to participants now.

Of its 8 completed or terminated interventional studies of FDA-regulated products, 0 (0%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • primary diagnosis of OCD according to the DSM-5 (American Psychiatric Association, 2013);
  • internet access.

Exclusion criteria

Exclusion Criteria:

  • acute suicide risk, assessed by a positive response (1, 2 or 3) to item 9 of the PHQ-9 and considered serious (suicidal imminence) in the suicide risk assessment protocol (S-RAP);
  • psychotic symptoms;
  • dependence on alcohol or other known psychoactive substances;
  • recent bereavement;
  • significant cognitive impairment;
  • terminal illness for clinical reasons (based on their knowledge of the patient);
  • illiterate patients or those unable to read (for example, due to severe dyslexia or visual impairment);
  • patients without access to the internet or an electronic device to access the treatment platform.
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
140 participants (estimated)

Study arms

  • Experimental
    I-CBT

    Internet cognitive-behavioral therapy

    Behavioral: internet-CBT

  • No intervention
    TU

    Treatment as Usual

Interventions

  • Behavioralinternet-CBT

    10 modules on line of I-CBT for OCD

06

What researchers measure

Primary outcomes

  1. Y-BOCS

    Yale Brown Obsessive-Compulsive Scale. (range from 0 to 40). The lower the score on the scale, the lower the severity or the greater the reduction of symptoms.

    Time frame: From enrollment to the end of treatment at 10 weeks. 3 and 12 months after end of treatment

Secondary outcomes

  1. PHQ-9

    Patient Health Questionnaire-9 (range 0 to 27). The lower the score on the scale, the lower the severity or the greater the reduction of symptoms

    Time frame: From enrollment to the end of treatment at 10 weeks. 3 and 12 months after end of treatment

  2. GAD-7

    Generalized Anxiety Disorder 7-item (range 0 to 21). The lower the score on the scale, the lower the severity or the greater the reduction of symptoms.

    Time frame: From enrollment to the end of treatment at 10 weeks. 3 and 12 months after end of treatment

07

Study locations

4 sites
  • University of Sao Paulo General Hospital
    São Paulo, SP 05403903, Brazil
  • Basic Health System
    Indaiatuba, São Paulo, Brazil
  • University of Sao Paulo General Hospital
    Sao Paulo, 05403903, Brazil
  • University of Sao Paulo General Hospital.
    São Paulo, 05403903, Brazil
08

References and documents

Publications

  • Andersson E, Enander J, Andren P, Hedman E, Ljotsson B, Hursti T, Bergstrom J, Kaldo V, Lindefors N, Andersson G, Ruck C. Internet-based cognitive behaviour therapy for obsessive-compulsive disorder: a randomized controlled trial. Psychol Med. 2012 Oct;42(10):2193-203. doi: 10.1017/S0033291712000244. Epub 2012 Feb 21. PubMed 22348650 ↗
  • Andersson G, Cuijpers P, Carlbring P, Riper H, Hedman E. Guided Internet-based vs. face-to-face cognitive behavior therapy for psychiatric and somatic disorders: a systematic review and meta-analysis. World Psychiatry. 2014 Oct;13(3):288-95. doi: 10.1002/wps.20151. PubMed 25273302 ↗
  • Andersson G, Carlbring P. Internet-Assisted Cognitive Behavioral Therapy. Psychiatr Clin North Am. 2017 Dec;40(4):689-700. doi: 10.1016/j.psc.2017.08.004. Epub 2017 Sep 19. PubMed 29080594 ↗
  • Cuijpers P, Riper H. & Andersson G. Internet- based treatment of depression. Current Opinion in Psychology 4, 131-135 (2015).
  • Fairburn CG, Patel V. The impact of digital technology on psychological treatments and their dissemination. Behav Res Ther. 2017 Jan;88:19-25. doi: 10.1016/j.brat.2016.08.012. PubMed 28110672 ↗
  • Fineberg NA, Reghunandanan S, Simpson HB, Phillips KA, Richter MA, Matthews K, Stein DJ, Sareen J, Brown A, Sookman D; Accreditation Task Force of The Canadian Institute for Obsessive Compulsive Disorders. Obsessive-compulsive disorder (OCD): Practical strategies for pharmacological and somatic treatment in adults. Psychiatry Res. 2015 May 30;227(1):114-25. doi: 10.1016/j.psychres.2014.12.003. Epub 2015 Feb 11. PubMed 25681005 ↗
  • Gentil AF, Lopes AC, Dougherty DD, Ruck C, Mataix-Cols D, Lukacs TL, Canteras MM, Eskandar EN, Larsson KJ, Hoexter MQ, Batistuzzo MC, Greenberg BD, Miguel EC. Hoarding symptoms and prediction of poor response to limbic system surgery for treatment-refractory obsessive-compulsive disorder. J Neurosurg. 2014 Jul;121(1):123-30. doi: 10.3171/2014.2.JNS131423. Epub 2014 Apr 4. PubMed 24702323 ↗
  • Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, Heninger GR, Charney DS. The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability. Arch Gen Psychiatry. 1989 Nov;46(11):1006-11. doi: 10.1001/archpsyc.1989.01810110048007. PubMed 2684084 ↗
  • Karyotaki E, Efthimiou O, Miguel C, Bermpohl FMG, Furukawa TA, Cuijpers P; Individual Patient Data Meta-Analyses for Depression (IPDMA-DE) Collaboration; Riper H, Patel V, Mira A, Gemmil AW, Yeung AS, Lange A, Williams AD, Mackinnon A, Geraedts A, van Straten A, Meyer B, Bjorkelund C, Knaevelsrud C, Beevers CG, Botella C, Strunk DR, Mohr DC, Ebert DD, Kessler D, Richards D, Littlewood E, Forsell E, Feng F, Wang F, Andersson G, Hadjistavropoulos H, Christensen H, Ezawa ID, Choi I, Rosso IM, Klein JP, Shumake J, Garcia-Campayo J, Milgrom J, Smith J, Montero-Marin J, Newby JM, Breton-Lopez J, Schneider J, Vernmark K, Bucker L, Sheeber LB, Warmerdam L, Farrer L, Heinrich M, Huibers MJH, Kivi M, Kraepelien M, Forand NR, Pugh N, Lindefors N, Lintvedt O, Zagorscak P, Carlbring P, Phillips R, Johansson R, Kessler RC, Brabyn S, Perini S, Rauch SL, Gilbody S, Moritz S, Berger T, Pop V, Kaldo V, Spek V, Forsell Y. Internet-Based Cognitive Behavioral Therapy for Depression: A Systematic Review and Individual Patient Data Network Meta-analysis. JAMA Psychiatry. 2021 Apr 1;78(4):361-371. doi: 10.1001/jamapsychiatry.2020.4364. PubMed 33471111 ↗
  • Lenhard F, Andersson E, Mataix-Cols D, Ruck C, Vigerland S, Hogstrom J, Hillborg M, Brander G, Ljungstrom M, Ljotsson B, Serlachius E. Therapist-Guided, Internet-Delivered Cognitive-Behavioral Therapy for Adolescents With Obsessive-Compulsive Disorder: A Randomized Controlled Trial. J Am Acad Child Adolesc Psychiatry. 2017 Jan;56(1):10-19.e2. doi: 10.1016/j.jaac.2016.09.515. Epub 2016 Oct 25. PubMed 27993223 ↗
  • Marques L, LeBlanc NJ, Weingarden HM, Timpano KR, Jenike M, Wilhelm S. Barriers to treatment and service utilization in an internet sample of individuals with obsessive-compulsive symptoms. Depress Anxiety. 2010 May;27(5):470-5. doi: 10.1002/da.20694. PubMed 20455248 ↗
  • McKay D, Sookman D, Neziroglu F, Wilhelm S, Stein DJ, Kyrios M, Matthews K, Veale D. Efficacy of cognitive-behavioral therapy for obsessive-compulsive disorder. Psychiatry Res. 2015 Feb 28;225(3):236-46. doi: 10.1016/j.psychres.2014.11.058. Epub 2014 Dec 8. PubMed 25613661 ↗
  • Menezes P, Quayle J, Garcia Claro H, da Silva S, Brandt LR, Diez-Canseco F, Miranda JJ, Price LN, Mohr DC, Araya R. Use of a Mobile Phone App to Treat Depression Comorbid With Hypertension or Diabetes: A Pilot Study in Brazil and Peru. JMIR Ment Health. 2019 Apr 26;6(4):e11698. doi: 10.2196/11698. PubMed 31025949 ↗
  • Mewton L, Smith J, Rossouw P, Andrews G. Current perspectives on Internet-delivered cognitive behavioral therapy for adults with anxiety and related disorders. Psychol Res Behav Manag. 2014 Jan 30;7:37-46. doi: 10.2147/PRBM.S40879. eCollection 2014. PubMed 24511246 ↗
  • Patel SR, Wheaton MG, Andersson E, Ruck C, Schmidt AB, La Lima CN, Galfavy H, Pascucci O, Myers RW, Dixon LB, Simpson HB. Acceptability, Feasibility, and Effectiveness of Internet-Based Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder in New York. Behav Ther. 2018 Jul;49(4):631-641. doi: 10.1016/j.beth.2017.09.003. Epub 2017 Sep 15. PubMed 29937263 ↗
  • Richards D, Richardson T. Computer-based psychological treatments for depression: a systematic review and meta-analysis. Clin Psychol Rev. 2012 Jun;32(4):329-42. doi: 10.1016/j.cpr.2012.02.004. Epub 2012 Feb 28. PubMed 22466510 ↗
  • Ruck C, Lundstrom L, Flygare O, Enander J, Bottai M, Mataix-Cols D, Andersson E. Study protocol for a single-blind, randomised controlled, non-inferiority trial of internet-based versus face-to-face cognitive behaviour therapy for obsessive-compulsive disorder. BMJ Open. 2018 Sep 5;8(9):e022254. doi: 10.1136/bmjopen-2018-022254. PubMed 30185575 ↗
  • Ruscio AM, Stein DJ, Chiu WT, Kessler RC. The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Mol Psychiatry. 2010 Jan;15(1):53-63. doi: 10.1038/mp.2008.94. Epub 2008 Aug 26. PubMed 18725912 ↗
  • Skapinakis P, Caldwell DM, Hollingworth W, Bryden P, Fineberg NA, Salkovskis P, Welton NJ, Baxter H, Kessler D, Churchill R, Lewis G. Pharmacological and psychotherapeutic interventions for management of obsessive-compulsive disorder in adults: a systematic review and network meta-analysis. Lancet Psychiatry. 2016 Aug;3(8):730-739. doi: 10.1016/S2215-0366(16)30069-4. Epub 2016 Jun 16. PubMed 27318812 ↗
  • Stein MB. Public health perspectives on generalized anxiety disorder. J Clin Psychiatry. 2004;65 Suppl 13:3-7. PubMed 15384930 ↗
  • Torres AR, Lima MC. [Epidemiology of obsessive-compulsive disorder: a review]. Braz J Psychiatry. 2005 Sep;27(3):237-42. doi: 10.1590/s1516-44462005000300015. Epub 2005 Oct 4. Portuguese. PubMed 16224614 ↗

Individual participant data

Plan to share: Yes — All IPD that underlie results in a publication will be shared.

Supporting information: Study protocol, Sap, Icf, Csr, Analytic code

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Nov 13, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06658756
Lead sponsor
University of Sao Paulo General Hospital
Collaborators
Fundação de Amparo à Pesquisa do Estado de São Paulo
Responsible party
Sponsor
First posted
Oct 26, 2024
Start date
Jan 2025 (estimated)
Primary completion
Jan 2027 (estimated)
Completion
Jan 2028 (estimated)
Last update
Nov 13, 2024

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Aug 2024. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion