| Sumario: | • 85.7% of participants completed the ICBT treatment for obsessive-compulsive disorder. • At the 6-month follow-up, 60% were treatment responders and 30% were in remission. • Participants also showed significant improvement in depressive symptoms. • After treatment, 54.5% were responders and 27.3% were in remission. • The study shows that ICBT for OCD is effective and feasible in a Brazilian population. This study describes the implementation of an Internet-based cognitive-behavior therapy program (ICBT) developed in Sweden for individuals seeking OCD treatment in Sao Paulo, Brazil. After translating and adapting the treatment manual (OCD-NET), we conducted an open-label trial including 35 adults with OCD. The ICBT treatment was conducted in 10 modules and was based on Exposure and Response Prevention (EPR). The RE-AIM implementation science framework was used to evaluate Reach, Effectiveness, Adoption, Implementation, and Maintenance. Our primary outcome was the reduction of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) total score. The study enrolled 35 participants, with 30 completing all of the ICBT protocol (85.7%). OCD severity decreased significantly over time, with 60% of participants showing a treatment response, and 30% were in remission at the 6-month follow-up. At posttreatment, 54.5% of the participants (95% CI, 37.8–70.4) were classified as treatment responders, and 27.3% (95% CI, 14.8–44.7) were in remission. At the 6-month follow-up, 60% (95% CI, 41.9–75.7) were responders, and 30% (95% CI, 16.4–48.3) were in remission. Depressive symptoms measured by PHQ-9 (SE = 1.68, [95% CI 15.2 to 21.9], p <.001) also improved. Our results provide preliminary evidence that ICBT is effective and feasible to be implemented in an upper-middle-income country. Further research investigating the acceptability and feasibility of ICBT in marginalized populations living in underserved areas is necessary.
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