Limitations
This study has a few limitations. First, the dose and duration of patients’ SSRI treatment before enrollment were not clearly recorded, which were variables that could be included in the analysis. In addition, 8 weeks should be used as a standard for stable medication to screen subjects to reduce the impact of medication duration on the trial. Furthermore, the mean imputation may underestimate the variability of the data, although the sensitivity analysis of complete cases (n=80) showed consistent results with the primary analyses. In terms of health economics, it would be more comprehensive to include the cost of treatment space and therapists’ time in the cost analyses in the future. For example, CBGT requires renting treatment rooms and takes more time of therapists, which may lead to more costs for CBGT.Based on the results of the equivalent efficacy of ICBT and CBGT, researchers and physicians can provide ICBT as a treatment option for patients in clinical practice, try to enhance the interactivity of ICBT courses or develop a combination of online and offline treatment methods, and gradually carry out some in-depth research in the future. For example, researchers should develop and validate the feasibility and efficacy of combined online and offline treatments. In addition, researchers can try to explore ICBT based on individualized assessment and make better use of the advantages of the online form through a step care model. Multicenter studies need to be carried out in the future. In addition, some studies have focused on the long-term efficacy of ICBT [Second, this study only focused on therapist-guided ICBT and did not explore self-guided ICBT. The latest research has verified the feasibility of self-guided ICBT (unguided ICBT) [