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DIGITAL COGNITIVE BEHAVIORAL THERAPY FOR CHILDREN AND ADOLESCENTS WITH OBSESSIVE-COMPULSIVE DISORDER: A SYSTEMATIC REVIEW AND META-ANALYSIS

درمان شناختی-رفتاری دیجیتال برای کودکان و نوجوانان مبتلا به اختلال وسواس فکری-عملی: مرور نظام‌مند و فراتحلیل

Essam A. Al Ameer, Fatimah Aeydh Saeed Alqahtani, Rawan R Alruwaili, Joharah Almubrad, Faisal Saeed Alahmari, Mohammed Saeed ALmasodi Asiri, Hussain Mohammed Altaweel Ali Saeed A. Aladalah

Research 2026 Vol. 12(5)
https://doi.org/10.5281/zenodo.23167276

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چکیده

Digital cognitive behavioral therapy (CBT) has emerged as a promising strategy to improve access to evidence-based treatment for pediatric obsessive-compulsive disorder (OCD). However, its comparative efficacy relative to conventional interventions remains uncertain. This systematic review and meta-analysis evaluated the effectiveness of digital CBT in children and adolescents with OCD. PubMed, Scopus, and Web of Science were systematically searched from inception to July 2026 for randomized controlled trials (RCTs) comparing digital CBT with face-to-face CBT, waitlist, or treatment as usual. The primary outcome was Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) scores post-treatment and at 3- and 6-month follow-up. Secondary outcomes included Clinical Global Impression-Severity (CGI-S), Clinical Global Impression-Improvement (CGI-I), Children's Global Assessment Scale (CGAS), Child Obsessive-Compulsive Inventory (ChOCI-C/P), and Family Accommodation Scale (FAS). Random-effects meta-analyses were performed using mean differences (MDs) with 95% confidence intervals (CIs). Six RCTs involving 404 participants were included. Digital CBT showed no significant difference from comparator interventions in reducing CY-BOCS scores post-treatment (MD = −2.09, 95% CI −4.92 to 0.74), at 3 months (MD = 1.15, 95% CI −0.74 to 3.04), or at 6 months (MD = 0.01, 95% CI −1.58 to 1.60). Similarly, no significant differences were observed for CGI-S, CGI-I, CGAS, ChOCI-C, ChOCI-P, or FAS. Moderate-to-high heterogeneity was present for several outcomes; however, sensitivity analyses resolved heterogeneity in most secondary outcomes. Digital CBT demonstrated comparable clinical effectiveness to conventional interventions for pediatric OCD, supporting its role as an accessible alternative when face-to-face CBT is unavailable. Larger, high-quality trials are needed to determine the optimal digital delivery modalities and long-term effectiveness.

چکیده به فارسی

درمان شناختی-رفتاری (CBT) دیجیتال به عنوان راهبردی نویدبخش برای بهبود دسترسی به درمان مبتنی بر شواهد برای اختلال وسواس فکری-عملی کودکان و نوجوانان مطرح شده است. با این حال، اثربخشی مقایسه‌ای آن نسبت به مداخلات متعارف همچنان نامشخص است. این مرور نظام‌مند و فراتحلیل، اثربخشی درمان شناختی-رفتاری دیجیتال را در کودکان و نوجوانان مبتلا به اختلال وسواس فکری-عملی ارزیابی کرد. پایگاه‌های PubMed، Scopus و Web of Science از ابتدا تا ژوئیه ۲۰۲۶ به طور نظام‌مند برای کارآزمایی‌های تصادفی کنترل‌شده (RCT) که درمان شناختی-رفتاری دیجیتال را با درمان شناختی-رفتاری حضوری، فهرست انتظار یا درمان معمول مقایسه کرده بودند، جست‌وجو شدند. پیامد اصلی، نمرات مقیاس وسواس فکری-عملی ییل-براون کودکان (CY-BOCS) پس از درمان و در پیگیری‌های ۳ و ۶ ماهه بود. پیامدهای ثانویه شامل مقیاس برداشت کلی بالینی-شدت (CGI-S)، مقیاس برداشت کلی بالینی-بهبود (CGI-I)، مقیاس ارزیابی کلی کودکان (CGAS)، پرسشنامه وسواس فکری-عملی کودکان (ChOCI-C/P) و مقیاس سازگاری خانواده (FAS) بود. فراتحلیل‌های مدل اثرات تصادفی با استفاده از تفاوت میانگین‌ها (MD) با فاصله اطمینان ۹۵٪ (CI) انجام شد. شش کارآزمایی تصادفی کنترل‌شده با مشارکت ۴۰۴ نفر وارد مطالعه شدند. درمان شناختی-رفتاری دیجیتال تفاوت معناداری با مداخلات مقایسه‌ای در کاهش نمرات CY-BOCS پس از درمان (MD = ‎−۲.۰۹، ۹۵٪ CI ‎−۴.۹۲ تا ۰.۷۴)، در ۳ ماه (MD = ۱.۱۵، ۹۵٪ CI ‎−۰.۷۴ تا ۳.۰۴) یا در ۶ ماه (MD = ۰.۰۱، ۹۵٪ CI ‎−۱.۵۸ تا ۱.۶۰) نشان نداد. به طور مشابه، تفاوت معناداری در CGI-S، CGI-I، CGAS، ChOCI-C، ChOCI-P یا FAS مشاهده نشد. ناهمگنی متوسط تا زیاد برای چندین پیامد وجود داشت؛ با این حال، تحلیل‌های حساسیت ناهمگنی را در بیشتر پیامدهای ثانویه برطرف کرد. درمان شناختی-رفتاری دیجیتال اثربخشی بالینی مشابهی با مداخلات متعارف برای اختلال وسواس فکری-عملی کودکان و نوجوانان نشان داد و نقش آن را به عنوان جایگزینی در دسترس در مواقع عدم دسترسی به درمان شناختی-رفتاری حضوری تأیید می‌کند. انجام کارآزمایی‌های بزرگ‌تر و با کیفیت بالاتر برای تعیین شیوه‌های بهینه ارائه دیجیتال و اثربخشی بلندمدت ضروری است.

ترجمه‌ی خودکار برای آشنایی سریع؛ برای نقل و ارجاع، متن اصلی ملاک است.

موضوع‌ها و کلیدواژه‌ها

درمانسلامت روانشناختChildren's Yale-Brown Obsessive Compulsive Scalechildren and adolescentsdigital cognitive behavioral therapydigital mental health interventionsfamily accommodationpediatric obsessive-compulsive disordersymptom severitytreatment efficacy

ارجاع

Ali Saeed A. Aladalah, E. A. A. A. F. A. S. A. R. R. A. J. A. F. S. A. M. S. (2026). DIGITAL COGNITIVE BEHAVIORAL THERAPY FOR CHILDREN AND ADOLESCENTS WITH OBSESSIVE-COMPULSIVE DISORDER: A SYSTEMATIC REVIEW AND META-ANALYSIS. Research, 12(5). https://doi.org/10.5281/zenodo.23167276

(Ali Saeed A. Aladalah, 2026)

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  1. با احترام و بدون توهین، تحقیر، برچسب‌زنی یا حمله‌ی شخصی با دیگران گفتگو کنید.
  2. از نوشتن هرگونه اطلاعات هویتی یا قابل‌شناسایی مراجعان، بیماران یا اشخاص ثالث، از جمله نام، شماره‌ی تماس، تصویر، نشانی، محل کار یا جزئیات منحصربه‌فرد پرونده خودداری کنید.
  3. اگر درباره‌ی یک تجربه‌ی بالینی سؤال می‌کنید، اطلاعات را تا حد ممکن بی‌نام و کلی بیان کنید تا امکان شناسایی فرد وجود نداشته باشد.
  4. این بخش برای یادگیری و گفت‌وگوی علمی است و جایگزین ارزیابی، تشخیص، مشاوره یا روان‌درمانی شخصی نیست.
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  6. انتشار تبلیغات، معرفی خدمات شخصی، شماره‌ی تلفن، شناسه‌ی شبکه‌های اجتماعی، پیوند تبلیغاتی یا درخواست جذب مراجع در این بخش مجاز نیست.
  7. در بیان ادعاهای علمی، به‌ویژه درباره‌ی اثربخشی درمان‌ها، تشخیص یا یافته‌های پژوهشی، تا حد امکان نام منبع معتبر، مقاله یا راهنمای علمی را ذکر کنید.
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  9. پاسخ‌هایی که کارشناسان فکر بنیان می‌دهند با برچسب «پاسخ فکر بنیان» یا «کارشناس فکر بنیان» نمایش داده می‌شوند و سایر نوشته‌ها بیانگر نظر کاربران هستند.
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