Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Dec 27, 2022
Date Accepted: Jun 30, 2023
Overall Anxiety Severity and Impairment Scale (OASIS) as an outcome measure in Internet-delivered Cognitive Behavioral Therapy (iCBT) for anxiety disorders
ABSTRACT
Background:
Internet-delivered Cognitive Behavioral Therapy (iCBT) is effective in treatment of anxiety disorders. ICBT clinical trials utilize relatively long and time-consuming disorder-specific rather than transdiagnostic anxiety measurements. Overall Anxiety Severity and Impairment Scale (OASIS) is a brief self-report scale that could offer a universal We aimed to investigate relationships between OASIS and disorder-specific instruments in iCBT.and easy-to-use anxiety measurement option in disorder-specific and transdiagnostic iCBT programs.
Objective:
We aimed to investigate relationships between OASIS and disorder-specific instruments in iCBT.
Methods:
We investigated patients in original nationwide iCBT programs for general anxiety disorders (GAD), obsessive-compulsive disorder (OCD), panic disorder (PD), and social anxiety disorder (SAD) administered by Helsinki University Hospital, Finland. In each program, anxiety symptoms were measured both by disorder-specific scales (Generalized Anxiety Disorder 7-item scale (GAD-7), Penn State Worry Questionnaire (PSWQ), Obsessive-Compulsive Inventory (OCI-R), Panic Disorder Severity Scale (PDSS), Social Phobia Inventory (SPIN)) and by OASIS. General linear model for repeated measures (mixed models) and interaction analysis were used for investigating the changes and relationships in mean scores of OASIS and disorder-specific scales from first to last session.
Results:
Overall, 6752 subjects were accepted to iCBT for GAD, 1510 for OCD, 2351 for PD, and 2047 for SAD. The corresponding numbers of patients who completed the entire course of treatment were 2901 (43.1%), 866 (57.3%), 874 (37.1%), and 773 (37.8%), respectively. The main effect of linear mixed models indicated a clear association between OASIS and disorder-specific scale scores. Interaction analysis demonstrated a stable association between OASIS and OCI (F=.09, CI .090 – .277, P=.317) and PDSS (F=-.02, CI -.108 – -.065, P=.627) from first session to last, while GAD-7 (F=-.06, CI -.109 – -.017, P=.007), PSWQ (F=-.52, CI -.620 – -.437, P<.001), and SPIN (F=-.39, CI -.596 – -.187, P<.001) interrelated with OASIS more strongly at the last session than at the first one.
Conclusions:
OASIS demonstrates clear and relatively stable associations with disorder-specific symptom measures. Thus, OASIS might have a role as an outcome measurement instrument for disorder-specific and, plausibly, transdiagnostic iCBT programs for anxiety disorders n regular clinical practice.
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