{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T03:33:47Z","timestamp":1790307227125,"version":"4.1.0"},"reference-count":39,"publisher":"American Medical Association (AMA)","issue":"18","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2021,5,11]]},"DOI":"10.1001\/jama.2021.3839","type":"journal-article","created":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T16:26:34Z","timestamp":1620750394000},"page":"1863","source":"Crossref","is-referenced-by-count":67,"title":["Effect of an Internet-Delivered Stepped-Care Program vs In-Person Cognitive Behavioral Therapy on Obsessive-Compulsive Disorder Symptoms in Children and Adolescents"],"prefix":"10.1001","volume":"325","author":[{"given":"Kristina","family":"Aspvall","sequence":"first","affiliation":[{"name":"Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden"},{"name":"Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Andersson","sequence":"additional","affiliation":[{"name":"Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Melin","sequence":"additional","affiliation":[{"name":"Institute Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"},{"name":"Region V\u00e4stra G\u00f6taland, Department of Child and Adolescent Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Norlin","sequence":"additional","affiliation":[{"name":"Region V\u00e4stra G\u00f6taland, Department of Child and Adolescent Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktor","family":"Eriksson","sequence":"additional","affiliation":[{"name":"Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Vigerland","sequence":"additional","affiliation":[{"name":"Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden"},{"name":"Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maral","family":"Jolstedt","sequence":"additional","affiliation":[{"name":"Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden"},{"name":"Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Silverberg-M\u00f6rse","sequence":"additional","affiliation":[{"name":"Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Wallin","sequence":"additional","affiliation":[{"name":"Region V\u00e4stra G\u00f6taland, Department of Child and Adolescent Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden"},{"name":"Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filipa","family":"Sampaio","sequence":"additional","affiliation":[{"name":"Department of Public Health and Caring Sciences, Uppsala Universitet, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inna","family":"Feldman","sequence":"additional","affiliation":[{"name":"Department of Public Health and Caring Sciences, Uppsala Universitet, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Bottai","sequence":"additional","affiliation":[{"name":"Divison of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Lenhard","sequence":"additional","affiliation":[{"name":"Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Mataix-Cols","sequence":"additional","affiliation":[{"name":"Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden"},{"name":"Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Serlachius","sequence":"additional","affiliation":[{"name":"Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden"},{"name":"Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"4","key":"joi210028r1","doi-asserted-by":"crossref","DOI":"10.4088\/JCP.19r13085","article-title":"Women are at greater risk of OCD than men: a meta-analytic review of OCD prevalence worldwide.","volume":"81","author":"Fawcett","year":"2020","journal-title":"J Clin Psychiatry"},{"issue":"1","key":"joi210028r2","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1001\/jamapsychiatry.2017.3523","article-title":"Association of obsessive-compulsive disorder with objective indicators of educational attainment: a nationwide register-based sibling control study.","volume":"75","author":"P\u00e9rez-Vigil","year":"2018","journal-title":"JAMA Psychiatry"},{"issue":"6","key":"joi210028r3","doi-asserted-by":"publisher","first-page":"1015","DOI":"10.1017\/S0033291718001691","article-title":"Labour market marginalisation in obsessive-compulsive disorder: a nationwide register-based sibling control study.","volume":"49","author":"P\u00e9rez-Vigil","year":"2019","journal-title":"Psychol Med"},{"issue":"11","key":"joi210028r4","doi-asserted-by":"publisher","first-page":"1626","DOI":"10.1038\/mp.2016.115","article-title":"Suicide in obsessive-compulsive disorder: a population-based study of 36?788 Swedish patients.","volume":"22","author":"Fern\u00e1ndez de la Cruz","year":"2017","journal-title":"Mol Psychiatry"},{"issue":"5","key":"joi210028r5","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1016\/j.biopsych.2017.12.003","article-title":"Metabolic and cardiovascular complications in obsessive-compulsive disorder: a total population, sibling comparison study with long-term follow-up.","volume":"84","author":"Isomura","year":"2018","journal-title":"Biol Psychiatry"},{"issue":"7","key":"joi210028r6","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.1016\/j.cpr.2011.06.007","article-title":"Early versus late onset obsessive-compulsive disorder: evidence for distinct subtypes.","volume":"31","author":"Taylor","year":"2011","journal-title":"Clin Psychol Rev"},{"issue":"5","key":"joi210028r7","doi-asserted-by":"publisher","first-page":"703","DOI":"10.4088\/JCP.v67n0503","article-title":"The Brown Longitudinal Obsessive Compulsive Study: clinical features and symptoms of the sample at intake.","volume":"67","author":"Pinto","year":"2006","journal-title":"J Clin Psychiatry"},{"issue":"4","key":"joi210028r8","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1016\/j.euroneuro.2019.02.002","article-title":"Early intervention for obsessive compulsive disorder: an expert consensus statement.","volume":"29","author":"Fineberg","year":"2019","journal-title":"Eur Neuropsychopharmacol"},{"issue":"1","key":"joi210028r9","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1016\/j.jaac.2011.09.019","article-title":"Practice parameter for the assessment and treatment of children and adolescents with obsessive-compulsive disorder.","volume":"51","author":"Geller","year":"2012","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"2","key":"joi210028r10","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1034\/j.1600-0447.2002.01221.x","article-title":"Helpseeking and access to mental health treatment for obsessive-compulsive disorder.","volume":"106","author":"Goodwin","year":"2002","journal-title":"Acta Psychiatr Scand"},{"issue":"1","key":"joi210028r11","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1186\/s13643-019-1166-6","article-title":"Acceptability, feasibility, and efficacy of internet cognitive behavioral therapy (iCBT) for pediatric obsessive-compulsive disorder: a systematic review.","volume":"8","author":"Babiano-Espinosa","year":"2019","journal-title":"Syst Rev"},{"issue":"3","key":"joi210028r12","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1192\/bjo.2018.10","article-title":"Internet-delivered cognitive behavioural therapy for young children with obsessive-compulsive disorder: development and initial evaluation of the BIP OCD Junior programme.","volume":"4","author":"Aspvall","year":"2018","journal-title":"BJPsych Open"},{"key":"joi210028r13","doi-asserted-by":"crossref","DOI":"10.1016\/j.invent.2020.100308","article-title":"Implementation of internet-delivered cognitive behaviour therapy for pediatric obsessive-compulsive disorder: lessons from clinics in Sweden, United Kingdom and Australia.","volume":"20","author":"Aspvall","year":"2020","journal-title":"Internet Interv"},{"issue":"5","key":"joi210028r14","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2016-015246","article-title":"Cost-effectiveness of therapist-guided internet-delivered cognitive behaviour therapy for paediatric obsessive-compulsive disorder: results from a randomised controlled trial.","volume":"7","author":"Lenhard","year":"2017","journal-title":"BMJ Open"},{"issue":"1","key":"joi210028r15","doi-asserted-by":"publisher","first-page":"e10","DOI":"10.1016\/j.jaac.2016.09.515","article-title":"Therapist-guided, internet-delivered cognitive-behavioral therapy for adolescents with obsessive-compulsive disorder: a randomized controlled trial.","volume":"56","author":"Lenhard","year":"2017","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"10","key":"joi210028r16","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2019.13810","article-title":"Stepped care internet-delivered vs face-to-face cognitive-behavior therapy for pediatric obsessive-compulsive disorder: a trial protocol for a randomized noninferiority trial.","volume":"2","author":"Aspvall","year":"2019","journal-title":"JAMA Netw Open"},{"issue":"6","key":"joi210028r17","doi-asserted-by":"publisher","first-page":"844","DOI":"10.1097\/00004583-199706000-00023","article-title":"Children\u2019s Yale-Brown obsessive compulsive scale: reliability and validity.","volume":"36","author":"Scahill","year":"1997","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"3","key":"joi210028r18","doi-asserted-by":"publisher","first-page":"313","DOI":"10.4088\/JCP.09m05305whi","article-title":"Reliability and validity of the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID).","volume":"71","author":"Sheehan","year":"2010","journal-title":"J Clin Psychiatry"},{"issue":"6","key":"joi210028r20","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0100773","article-title":"Internet-delivered cognitive behavior therapy for adolescents with obsessive-compulsive disorder: an open trial.","volume":"9","author":"Lenhard","year":"2014","journal-title":"PLoS One"},{"issue":"12","key":"joi210028r21","doi-asserted-by":"publisher","first-page":"1298","DOI":"10.1016\/j.jaac.2014.09.012","article-title":"Telephone cognitive-behavioral therapy for adolescents with obsessive-compulsive disorder: a randomized controlled non-inferiority trial.","volume":"53","author":"Turner","year":"2014","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"11","key":"joi210028r22","doi-asserted-by":"publisher","first-page":"792","DOI":"10.1016\/S2352-4642(18)30275-X","article-title":"Efficacy and cost-effectiveness of therapist-guided internet cognitive behavioural therapy for paediatric anxiety disorders: a single-centre, single-blind, randomised controlled trial.","volume":"2","author":"Jolstedt","year":"2018","journal-title":"Lancet Child Adolesc Health"},{"issue":"11","key":"joi210028r24","doi-asserted-by":"publisher","first-page":"1228","DOI":"10.1001\/archpsyc.1983.01790100074010","article-title":"A children\u2019s global assessment scale (CGAS).","volume":"40","author":"Shaffer","year":"1983","journal-title":"Arch Gen Psychiatry"},{"issue":"1","key":"joi210028r25","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1186\/s12888-020-2450-7","article-title":"Validity and clinical utility of the obsessive compulsive inventory-child version: further evaluation in clinical samples.","volume":"20","author":"Aspvall","year":"2020","journal-title":"BMC Psychiatry"},{"issue":"6","key":"joi210028r26","doi-asserted-by":"publisher","first-page":"979","DOI":"10.1016\/j.janxdis.2007.10.001","article-title":"Self-, parent-report and interview measures of obsessive-compulsive disorder in children and adolescents.","volume":"22","author":"Uher","year":"2008","journal-title":"J Anxiety Disord"},{"issue":"4","key":"joi210028r27","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1016\/j.jocrd.2012.06.001","article-title":"Development and preliminary psychometric evaluation of a self-rated version of the Family Accommodation Scale for Obsessive-Compulsive Disorder.","volume":"2","author":"Pinto","year":"2013","journal-title":"J Obsessive Compuls Relat Disord"},{"issue":"3","key":"joi210028r28","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1007\/s10578-020-00956-z","article-title":"The Work and Social Adjustment Scale, youth and parent versions: psychometric evaluation of a brief measure of functional impairment in young people.","volume":"51","author":"Jassi","year":"2020","journal-title":"Child Psychiatry Hum Dev"},{"issue":"4","key":"joi210028r29","first-page":"237","article-title":"Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents.","volume":"5","author":"Angold","year":"1995","journal-title":"Int J Methods Psychiatric Res"},{"issue":"4","key":"joi210028r30","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1016\/S1389-9457(00)00065-4","article-title":"Validation of the Insomnia Severity Index as an outcome measure for insomnia research.","volume":"2","author":"Bastien","year":"2001","journal-title":"Sleep Med"},{"issue":"3","key":"joi210028r31","doi-asserted-by":"publisher","first-page":"157","DOI":"10.2165\/11587350-000000000-00000","article-title":"Assessing the performance of a new generic measure of health-related quality of life for children and refining it for use in health state valuation.","volume":"9","author":"Stevens","year":"2011","journal-title":"Appl Health Econ Health Policy"},{"key":"joi210028r33","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1016\/j.janxdis.2016.08.003","article-title":"Cognitive behavioral and pharmacological treatments of OCD in children: a systematic review and meta-analysis.","volume":"43","author":"\u00d6st","year":"2016","journal-title":"J Anxiety Disord"},{"issue":"7574","key":"joi210028r34","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1136\/bmj.38940.355602.80","article-title":"Telephone administered cognitive behaviour therapy for treatment of obsessive compulsive disorder: randomised controlled non-inferiority trial.","volume":"333","author":"Lovell","year":"2006","journal-title":"BMJ"},{"issue":"1","key":"joi210028r35","doi-asserted-by":"crossref","first-page":"i-19","DOI":"10.1002\/j.2333-8504.1975.tb01053.x","article-title":"Inference and missing data.","volume":"1975","author":"Rubin","year":"1975","journal-title":"ETS Research Bulletin Series."},{"issue":"1","key":"joi210028r37","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1002\/wps.v15.1","article-title":"Towards an international expert consensus for defining treatment response, remission, recovery and relapse in obsessive-compulsive disorder.","volume":"15","author":"Mataix-Cols","year":"2016","journal-title":"World Psychiatry"},{"issue":"7","key":"joi210028r38","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1089\/cap.2015.0041","article-title":"Sertraline Treatment of Nonresponders to Extended Cognitive-Behavior Therapy in Pediatric Obsessive-Compulsive Disorder.","volume":"25","author":"Skarphedinsson","year":"2015","journal-title":"J Child Adolesc Psychopharmacol"},{"issue":"4","key":"joi210028r39","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1016\/j.comppsych.2005.11.007","article-title":"Effect of referral source on outcome with cognitive-behavior therapy self-help.","volume":"47","author":"Mataix-Cols","year":"2006","journal-title":"Compr Psychiatry"},{"key":"joi210028r19","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425596","volume-title":"Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition","author":"American Psychiatric Association","year":"2013"},{"key":"joi210028r23","volume-title":"The ECDEU Assessment Manual for Psychopharmacology-Revised Volume","author":"Guy","year":"1976"},{"key":"joi210028r36","doi-asserted-by":"crossref","DOI":"10.1002\/9780470316696","volume-title":"Multiple Imputation for Nonresponse in Surveys","author":"Rubin","year":"1987"},{"key":"joi210028r32","unstructured":"Guideline on the Choice of the Non-inferiority Margin. European Medicines Agency Committee For Medicinal Products For Human Use; 2005. Accessed April 15, 2021. https:\/\/www.ema.europa.eu\/docs\/en_GB\/document_library\/Scientific_guideline\/2009\/09\/WC500003636.pdf"}],"container-title":["JAMA"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jama\/articlepdf\/2779829\/jama_aspvall_2021_oi_210028_1620430674.02026.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T16:26:50Z","timestamp":1620750410000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2779829"}},"subtitle":["A Randomized Clinical Trial"],"short-title":[],"issued":{"date-parts":[[2021,5,11]]},"references-count":39,"journal-issue":{"issue":"18","published-print":{"date-parts":[[2021,5,11]]}},"URL":"https:\/\/doi.org\/10.1001\/jama.2021.3839","relation":{},"ISSN":["0098-7484"],"issn-type":[{"value":"0098-7484","type":"print"}],"subject":[],"published":{"date-parts":[[2021,5,11]]}}}