1 |
Does the addition of cognitive therapy to exposure and response prevention for obsessive compulsive disorder enhance clinical efficacy? A randomized controlled trial in a community setting British Journal of Clinical Psychology
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Rector et al.2828. Rector NA, Richter MA, Katz D, Leybman M. Does the addition of cognitive therapy to exposure and response prevention for obsessive compulsive disorder enhance clinical efficacy? A randomized controlled trial in a community setting. Br J Clin Psychol. 2019;58:1-18. |
N=127 with OCD were randomly assigned to receive individual outpatient ERP or ERP + CT. |
ERP + CT led to significantly greater symptom and belief reduction compared to ERP across all main symptom presentations of OCD. |
2 |
A randomized waitlist-controlled trial comparing detached mindfulness and cognitive restructuring in obsessive-compulsive disorder PloS ONE
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Rupp et al.2929. Rupp C, Jürgens C, Doebler P, Andor F, Buhlmann U. A randomized waitlist-controlled trial comparing detached mindfulness and cognitive restructuring in obsessive-compulsive disorder. PloS One. 2019;14:e0213895. |
N=43 participants were randomly assigned to either DM or CR.N=21 participants had been previously assigned to a 2-week waitlist condition. |
The results suggest the potential efficacy of DM as a stand-alone intervention for OC. Both CR and DM should be considered as possible alternative treatments for OCD, whereas the working mechanisms of DM have yet to be elucidated. |
3 |
Effectiveness of Exposure/Response prevention plus eye movement desensitization and reprocessing in reducing anxiety and obsessive-compulsive symptoms associated with stressful life experiences: A randomized controlled trial Iranian Journal of Psychiatry and Behavioral Sciences
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Sarichloo et al.3030. Sarichloo ME, Taremian F, Dolatshahee B, Javadi SAHS. Effectiveness of exposure/response prevention plus eye movement desensitization and reprocessing in reducing anxiety and obsessive-compulsive symptoms associated with stressful life experiences: a randomized controlled trial. Iran J Psychiatry Behav Sci. 2020;14:e101535. |
N=60 participants were randomly assigned to the ERP plus EMDR group (n = 30) or the ERP (n=30) group. |
Compared to the ERP protocol, the ERP plus EMDR protocol had a higher rate of OCD treatment completion and efficacy. |
4 |
Unguided Internet-based cognitive-behavioral therapy for obsessive-compulsive disorder: A randomized controlled trial Depression and Anxiety
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Schröder et al.3131. Schröder J, Werkle N, Cludius B, Jelinek L, Moritz S, Westermann S. Unguided Internet-based cognitive-behavioral therapy for obsessive-compulsive disorder: a randomized controlled trial. Depress Anxiety. 2020;37:1208-20. |
N=128 individuals with self-reported OCD symptoms were randomly allocated to either an intervention group (unguided iCBT) or to a care-as-usual control group. |
Unguided iCBT for OCD may be a viable option for individuals who experience treatment barriers. |
5 |
Cognitive-behavioral therapy vs risperidone for augmenting serotonin reuptake inhibitors in obsessive-compulsive disorder: a randomized clinical trial JAMA Psychiatry
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Simpson et al.3232. Simpson HB, Foa EB, Liebowitz MR, Huppert JD, Cahill S, Maher MJ, et al. Cognitive-behavioral therapy vs risperidone for augmenting serotonin reuptake inhibitors in obsessive-compulsive disorder: a randomized clinical trial. JAMA Psychiatry. 2013;70:1190-9. |
N=100 were randomized (risperidone, n=40; EX/RP, n=40; and placebo, n=20). |
Adding EX/RP to SRIs was superior to both risperidone and pill placebo. Patients with OCD receiving SRIs who continue to have clinically significant symptoms should be offered EX/RP before antipsychotics, given its superior efficacy and less negative adverse effect profile. |
6 |
A randomized clinical trial of cognitive-behavioral group therapy and sertraline in the treatment of obsessive-compulsive disorder Journal of Clinical Psychiatry
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Sousa et al.3333. Sousa MB, Isolan LR, Oliveira RR, Manfro GG, Cordioli AV. A randomized clinical trial of cognitive-behavioral group therapy and sertraline in the treatment of obsessive-compulsive disorder. J Clin Psychiatry. 2006;67(7):1133-9. |
N=56 participated in the randomized clinical trial: 28 took 100 mg/day of sertraline and 28 underwent CBGT for 12 weeks. |
CBGT and sertraline effectively reduced OCD symptoms. The rate of symptom reduction, compulsion intensity reduction, and percentage of patients who obtained full remission were significantly higher among patients treated with CBGT. |
7 |
Behavior therapy augments response of patients with obsessive-compulsive disorder responding to drug treatment Journal of Clinical Psychiatry
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Tenneij et al.3434. Tenneij NH, van Megen HJGM, Denys DAJP, Westenberg HGM. Behavior therapy augments response of patients with obsessive-compulsive disorder responding to drug treatment. J Clin Psychiatry. 2005;66:1169-75. |
N=96 patients who had responded to 3 months of drug treatment were randomly assigned to receive either added BT or drug treatment alone for 6 months. |
Adding BT is beneficial for patients who have responded to drug treatment. The data also suggest that the effect is greater when BT is added immediately after attaining a drug response. |
8 |
A randomized controlled trial of self-directed versus therapist-directed cognitive-behavioral therapy for obsessive-compulsive disorder patients with prior medication trials Behavior Therapy
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Tolin et al.3535. Tolin DF, Hannan S, Maltby N, Diefenbach GJ, Worhunsky P, Brady RE. A randomized controlled trial of self-directed versus therapist-directed cognitive-behavioral therapy for obsessive-compulsive disorder patients with prior medication trials. Behav Ther. 2007;38:179-91. |
N=41 adult outpatients who reported at least one current or previous adequate medication trial were randomly assigned to self-administered or therapist-administered ERP. |
Patients in both treatment conditions showed statistically and clinically significant symptom reduction. However, patients receiving therapist-administered ERP showed a superior response in terms of OCD symptoms and self-reported functional impairment. |
9 |
Adding acceptance and commitment therapy to exposure and response prevention for obsessive-compulsive disorder: A randomized controlled trial Behaviour Research and Therapy
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Twohig et al.3636. Twohig MP, Abramowitz JS, Smith BM, Fabricant LE, Jacoby RJ, Morrison KL, et al. Adding acceptance and commitment therapy to exposure and response prevention for obsessive-compulsive disorder: a randomized controlled trial. Behav Res Ther. 2018;108:1-9. |
N=58 adults engaged in a multisite randomized controlled trial of 16 individual twice-weekly sessions of ERP or ACT + ERP. |
CT + ERP and ERP were both highly effective treatments for OCD, and no differences were found in outcomes, processes of change, acceptability, or exposure engagement. |
10 |
The treatment of obsessive‐compulsive checking: A randomized trial comparing danger ideation reduction therapy with exposure and response prevention Clinical Psychologist
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Vaccaro et al.3737. Vaccaro LD, Jones MK, Menzies RG, Wootton BM. The treatment of obsessive‐compulsive checking: a randomised trial comparing danger ideation reduction therapy with exposure and response prevention. Clin Psychol. 2014;18:74-95. |
N=50 OCD patients were randomly allocated to either the DIRT for obsessive‐compulsive checkers DIRT‐C (n=28) or ERP treatment (n=22). |
This study provides further evidence of the usefulness of the DIRT‐C package for people with the OCD checking subtype. |
11 |
Cognitive and behavioral therapies alone versus in combination with fluvoxamine in the treatment of obsessive compulsive disorder Journal of Nervous and Mental Disease
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Van Balkom et al.3838. Van Balkom AJ, de Haan E, van Oppen P, Spinhoven P, Hoogduin KA, van Dyck R. Cognitive and behavioral therapies alone versus in combination with fluvoxamine in the treatment of obsessive compulsive disorder. J Nerv Ment Dis. 1998;186:492-9. |
N=117 patients were randomized to one of the following five conditions: 1) CT for weeks 1 to 16; 2) exposure in vivo with response prevention for weeks 1 to 16; 3) fluvoxamine for weeks 1 to 16 plus CT in weeks 9 to 16; 4) fluvoxamine for weeks 1 to 16 plus exposure in vivo with response prevention in weeks 9 to 16; or 5) WL control condition for weeks 1 to 8 only. |
In OCD, a sequential combination of fluvoxamine with CT or exposure in vivo with response prevention was not superior to either cognitive therapy or exposure in vivo alone. |
12 |
Cognitive therapy versus fluvoxamine as a second-step treatment in obsessive-compulsive disorder nonresponsive to first-step behavior therapy Psychotherapy and Psychosomatics
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Van Balkom et al.3939. Van Balkom AJLM, Emmelkamp PMG, Eikelenboom M, Hoogendoorn AW, Smit JH, van Oppen P. Cognitive therapy versus fluvoxamine as a second-step treatment in obsessive-compulsive disorder nonresponsive to first-step behavior therapy. Psychother Psychosom. 2012;81:366-74. |
N=118 subjects with OCD treated with 12 weeks of ERP, 48 appeared to be nonresponders (Y-BOCS improvement score of less than one third). These nonresponders were randomized to CT (n=22) or fluvoxamine (n=26). |
OCD patients who are nonresponsive to ERP may benefit more from a switch to treatment with an antidepressant instead of switching to CT. |
13 |
Inference-based approach versus cognitive behavioral therapy in the treatment of obsessive-compulsive disorder with poor insight: A 24-session randomized controlled trial Psychotherapy and Psychosomatics
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Visser et al.4040. Visser HA, van Megen H, van Oppen P, Eikelenboom M, Hoogendorn AW, Kaarsemaker M, et al. Inference-based approach versus cognitive behavioral therapy in the treatment of obsessive-compulsive disorder with poor insight: a 24-session randomized controlled trial. Psychother Psychosom. 2015;84:284-93. |
N=90 patients with OCD and poor insight received either 24 CBT sessions or 24 IBA sessions. |
Patients with OCD and poor insight improved significantly after psychological treatment. The results of this study suggest that both CBT and IBA are effective treatments for OCD with poor insight. |
14 |
Remote treatment of obsessive-compulsive disorder: a randomized controlled trial Journal of Obsessive-Compulsive and Related Disorders
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Wootton et al.4141. Wootton BM, Dear BF, Johnston L, Terides MD, Titov N. Remote treatment of obsessive-compulsive disorder: A randomized controlled trial. J Obsessive-Compuls Relat Disord. 2013;2:375-384. |
N=56 OCD patients were randomly allocated to the guided bCBT Group (n=20), the guided iCBT (n=17) group, or the control group (n=19). |
Results from the control group, after receiving iCBT treatment, indicated that large effect sizes can be obtained with weekly contact. These results provide preliminary support for the use of either bCBT or iCBT in the remote treatment of OCD. |
15 |
Self-guided Internet-delivered cognitive behavior therapy (ICBT) for obsessive-compulsive symptoms: A randomized controlled trial Journal of Anxiety disorders
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Wootton et al.4242. Wootton BM, Karin E, Titov N, Dear BF. Self-guided internet-delivered cognitive behavior therapy (ICBT) for obsessive-compulsive symptoms: a randomized controlled trial. J Anxiety Disord. 2019;66:102111. |
N=190 participants were randomized to either a self-guided iCBT group or a waitlist control group. |
The results indicate that self-guided iCBT may be a viable treatment option for some individuals with OCD symptoms. |
16 |
Long-term efficacy of Internet-based cognitive behavior therapy for obsessive-compulsive disorder with or without booster: a randomized controlled trial Psychological Medicine
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Andersson et al.4343. Andersson E, Steneby S, Karlsson K, Ljótsson B, Hedman E, Enander J, et al. Long-term efficacy of Internet-based cognitive behavior therapy for obsessive-compulsive disorder with or without booster: a randomized controlled trial. Psychol Med. 2014;44:2877-87. |
N=101 participants were included in the long-term follow-up analysis of iCBT. Of these, 93 were randomized to a booster program or no booster program. |
The results suggest that iCBT has sustained long-term effects and that adding an Internet-based booster program can further improve long-term outcomes and prevent relapse for some OCD patients. |
17 |
The effect of treatment on quality of life and functioning in OCD Comprehensive Psychiatry
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Asnaani et al.4444. Asnaani A, Kaczkurkin AN, Alpert E, McLean CP, Simpson HB, Foa EB. The effect of treatment on quality of life and functioning in OCD. Compr Psychiatry. 2017;73:7-14. |
N=100 adults with OCD on SRIs were enrolled in a randomized clinical trial comparing SRI augmentation with EX/RP therapy, risperidone, or pill placebo. |
Improvements in quality of life/functioning were associated with reduced OCD symptom severity. |
18 |
Group cognitive-behavioral therapy versus SSRIs for obsessive-compulsive disorder: a practical clinical trial Journal of Anxiety Disorders
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Belotto-Silva et al.1111. Belotto-Silva C, Diniz JB, Malavazzi DM, Valério C, Fossaluza V, Borcato S, et al. Group cognitive-behavioral therapy versus selective serotonin reuptake for obsessive-compulsive disorder: A practical clinical trial. J Anxiety Disord. 2012;26:25-31. |
N=158 adults with OCD were sequentially allocated for treatment with GCBT (n=70) or fluoxetine (n=88). |
Response rates to both treatments were similar and lower than those reported in the literature, probably due to the broad inclusion criteria and the resulting sample similar to the real world population. |
19 |
Need for speed: evaluating slopes of OCD recovery in behavior therapy enhanced with d-cycloserine Behavior Research and Therapy
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Chasson et al.4545. Chasson GS, Buhlmann U, Tolin DF, Rao SR, Reese HE, Rowley T, et al. Need for speed: evaluating slopes of OCD recovery in behavior therapy enhanced with d-cycloserine. Behav Res Ther. 2010;48:675-9. |
N=22 adults with OCD were randomized in controlled trial of ERP + DCS vs. ERP + placebo. |
DCS did not amplify the effects of ERP but instead initiated treatment effects sooner in treatment. |
20 |
A randomized controlled trial of cognitive therapy versus intensive behavior therapy in obsessive compulsive disorder Psychotherapy and Psychosomatics
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Cottraux et al.4646. Cottraux J, Note I, Yao SN, Lafont S, Note B, Mollard E, et al. A randomized controlled trial of cognitive therapy versus intensive behavior therapy in obsessive compulsive disorder. Psychother Psychosom. 2001;70:288-97. |
N=65 outpatients with OCD were randomized into two groups for 16 weeks of individual treatment in three centers. Group 1 received 20 sessions of CT. Group 2 received a BT program of 20 hours in two phases: 4 weeks of intensive treatment (16 hours) and 12 weeks of maintenance sessions (4 hours). |
CT and BT were equally effective in OCD but, at post-test, CT had specific effects on depression that were stronger than those of BT. Pathways to improvement may be different in CT and BT. |
21 |
Cognitive-behavioral therapy versus transcranial direct current stimulation for augmenting SSRIs in obsessive-compulsive disorder patients Basic and Clinical Neuroscience
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Dadashi et al.4747. Dadashi M, Asl VY, Morsali Y. Cognitive-behavioral therapy versus transcranial direct current stimulation for augmenting selective serotonin reuptake inhibitors in obsessive-compulsive disorder patients. Basic Clin Neurosci. 2020;11:111-20. |
N=26 OCD patients were randomly assigned to two treatment groups: ERP (n=13) or tDCS (n=13). |
Although the present findings revealed no significant difference between the ERP and tDCS groups (except for quality of life), the pharmacotherapy-ERP combination proved more effective than pharmacotherapy-tDCS in treating OCD patients. |
22 |
D-cycloserine addition to exposure sessions in the treatment of patients with obsessive-compulsive disorder European Psychiatry
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De Leeuw et al.4848. De Leeuw AS, van Megen HJGM, Kahn RS, Westenberg HGM. D-cycloserine addition to exposure sessions in the treatment of patients with obsessive-compulsive disorder. Eur Psychiatry J Assoc Eur Psychiatr. 2017;40:38-44. |
N=39 patients with OCD were randomized. Patients received six guided exposure sessions once a week. One hour before each session, 125 mg DCS or placebo was administered. |
The results of this study did not support the application of DCS to exposure therapy in OCD. Some specific aspects need further investigation: the efficacy of DCS in a larger ‘cleaning/contamination’ (sub-)group, DCS addition only after successful sessions, and interaction with antidepressants. |
23 |
Optimal treatment for obsessive compulsive disorder: a randomized controlled feasibility study of the clinical-effectiveness and cost-effectiveness of cognitive-behavioral therapy, SSRIs and their combination in the management of obsessive compulsive disorder Clinical Psychopharmacology
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Fineberg et al.4949. Fineberg NA, Baldwin DS, Drummond LM, Wyatt S, Hanson J, Gopi S, et al. Optimal treatment for obsessive compulsive disorder: a randomized controlled feasibility study of the clinical-effectiveness and cost-effectiveness of cognitive-behavioural therapy, selective serotonin reuptake inhibitors and their combination in the management of obsessive compulsive disorder. Int Clin Psychopharmacol. 2018;33:334-48. |
N=49 adults with OCD were randomly assigned to CBT, SSRI, or SSRI + CBT. |
Combined treatment appeared the most clinically effective option, especially over CBT, but the advantages over SSRI monotherapy were not sustained beyond 16 weeks. SSRI monotherapy was the most cost-effective treatment. |
24 |
Six-month outcomes from a randomized trial augmenting serotonin reuptake inhibitors with exposure and response prevention or risperidone in adults with obsessive-compulsive disorder The Journal of Clinical Psychiatry
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Foa et al.5050. Foa EB, Simpson HB, Rosenfield D, Liebowitz MR, Cahill SP, Huppert JD, et al. Six-month outcomes from a randomized trial augmenting serotonin reuptake inhibitors with exposure and response prevention or risperidone in adults with obsessive-compulsive disorder. J Clin Psychiatry. 2015;76:440-6. |
N=100 patients on therapeutic SRI dose with at least moderate OCD severity were randomized to 8 weeks of EX/RP, risperidone, or pill placebo. |
The finding that 50% of patients randomized to EX/RP had minimal symptoms at 6-month maintenance, a rate double that of prior studies, suggests that EX/RP maintenance helps maximize long-term outcome. |
25 |
Combination of behavior therapy with fluvoxamine in comparison with behavior. Results of a multicentre study British Journal of Psychiatry
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Hohagen et al.5151. Hohagen F, Winkelmann G, Rasche-Rüchle H, Hand I, König A, Münchau N, et al. Combination of behaviour therapy with fluvoxamine in comparison with behaviour therapy and placebo. Results of a multicentre study. Br J Psychiatry Suppl. 1998:71-8. |
N=30 patients were treated for 9 weeks with BT plus placebo and 30 patients with BT plus fluvoxamine. |
The results suggest that BT should be combined with fluvoxamine when obsessions dominate the clinical picture and when secondary depression is present. |
26 |
Highly efficacious cognitive-coping therapy for overt or covert compulsions Psychiatry Research
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Hu et al.5252. Hu XZ, Ma JD, Huang P, Shan XW, Zhang ZH, Zhang JH, et al. Highly efficacious cognitive-coping therapy for overt or covert compulsions. Psychiatry Res. 2015;229:732-8. |
N=215 OCD patients were randomized into pharmacotherapy plus psychological support (n=107) or PCCT (n=108). |
The results suggest that PCCT could efficaciously treat OCD with overt or covert compulsions, suggesting that PCCT might be a potential option for adult OCD. |
27 |
A promising randomized trial of a new therapy for obsessive-compulsive disorder Brain and Behavior
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Hu et al.5353. Hu XZ, Wen YS, Ma JD, Han DM, Li YX, Wang SF. A promising randomized trial of a new therapy for obsessive-compulsive disorder. Brain Behav. 2012;2:443-54. |
N=108 patients with OCD were randomly allocated into three groups: pharmacotherapy (n=38), pharmacotherapy plus CBT (PCBT, n =34), or pharmacotherapy plus CCT (PCCT, n=36). |
The preliminary data suggest that PCCT is a more efficacious psychotherapy for OCD patients than pharmacotherapy or PCBT. |
28 |
Association splitting versus cognitive remediation in obsessive-compulsive disorder: a randomized controlled trial Journal of Anxiety Disorders
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Jelinek et al.5454. Jelinek L, Hauschildt M, Hottenrott B, Kellner M, Moritz S. “Association splitting” versus cognitive remediation in obsessive-compulsive disorder: a randomized controlled trial. J Anxiety Disord. 2018;56:17-25. |
N=109 patients with OCD undergoing CBT were randomly assigned to either AS or cognitive remediation. |
Although patient acceptance of AS was good, AS was not better than cognitive remediation for overall symptom severity. |
29 |
Mindfulness-based cognitive therapy (MBCT) in patients with obsessive-compulsive disorder (OCD) and residual symptoms after cognitive behavioral therapy (CBT): a randomized controlled trial European Archives of Psychiatry and Clinical Neuroscience
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Külz et al.5555. Külz AK, Landmann S, Cludius B, Rose N, Heidenreich T, Jelinek L, et al. Mindfulness-based cognitive therapy (MBCT) in patients with obsessive-compulsive disorder (OCD) and residual symptoms after cognitive behavioral therapy (CBT): a randomized controlled trial. Eur Arch Psychiatry Clin Neurosci. 2019;269:223-33. |
N=125 patients with OCD and residual symptoms after CBT were randomized to either an MBCT group (n=61) or a psychoeducational group (OCD-EP; n=64) as an active control condition. |
The results suggest that, compared to a psychoeducational program, MBCT leads to accelerated improvement of self-reported OC symptoms and secondary outcomes, but not of clinician-rated OC symptoms. |
30 |
Therapist-Assisted Internet-Based Cognitive Behavioral Therapy Versus Progressive Relaxation in Obsessive-Compulsive Disorder: Randomized Controlled Trial Journal of Medical Internet Research
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Kyrios et al.5656. Kyrios M, Ahern C, Fassnacht DB, Nedeljkovic M, Moulding R, Meyer D. Therapist-assisted Internet-based cognitive behavioral therapy versus progressive relaxation in obsessive-compulsive disorder: randomized controlled trial. J Med Internet Res. 2018;20:e242. |
N=179 OCD patients were randomized to iCBT or iPRT. |
The results indicate that iCBT has a large effect magnitude for OCD. Interestingly, iPRT was also moderately efficacious, albeit significantly less so than the iCBT intervention. |
31 |
A randomized controlled trial of concentrated ERP, self-help and waiting list for obsessive-compulsive disorder: The Bergen 4-day treatment Frontiers in Psychology
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Launes et al.5757. Launes G, Hagen K, Sunde T, Öst LG, Klovning I, Laukvik IL, et al. A randomized controlled trial of concentrated ERP, self-help and waiting list for obsessive-compulsive disorder: the Bergen 4-day treatment. Front Psychol. 2019;10:2500. |
N=48 patients with OCD were randomized to B4DT (n=16), SH (n=16), or WL (n=16). |
The results indicate that B4DT is an effective treatment for patients suffering from OCD. |
32 |
Cognitive-coping therapy for obsessive-compulsive disorder: A randomized controlled trial Journal of Psychiatric Research
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Ma et al.5858. Ma JD, Wang CH, Li HF, Zhang XL, Zhang YL, Hou YH, et al. Cognitive-coping therapy for obsessive-compulsive disorder: a randomized controlled trial. J Psychiatr Res. 2013;47:1785-90. |
N=145 OCD patients were randomly assigned to pharmacotherapy (n=72) or PCCT (n=73). |
The response rates and remission rates were higher in PCCT than the pharmacotherapy group. Therefore, CCT is a potential treatment for OCD. |
33 |
Improving treatment outcome in obsessive-compulsive disorder: Does motivational interviewing boost efficacy? Journal of Obsessive-Compulsive and Related Disorders
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McCabe et al.5959. McCabe RE, Rowa K, Farrell NR, Young L, Swinson RP, Antony MM. Improving treatment outcome in obsessive-compulsive disorder: does motivational interviewing boost efficacy? J Obsessive-Compuls Relat Disord. 2019;22:100446. |
N=40 OCD patients were randomized to a three-session motivational interviewing intervention or a three-session relaxation intervention prior to 15 sessions of ERP. The groups were compared regarding treatment dropout, homework compliance, and treatment outcome post-ERP and at follow up. |
The results show that ERP may confer a small but meaningful benefit for treatment outcome. |
34 |
Efficacy of cognitive behavioural therapy with medication for patients with obsessive-compulsive disorder: A multicentre randomised controlled trial in China Journal of Affective Disorders
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Meng et al.6060. Meng FQ, Han HY, Luo J, Liu J, Liu ZR, Tang Y, et al. Efficacy of cognitive behavioural therapy with medication for patients with obsessive-compulsive disorder: a multicentre randomised controlled trial in China. J Affect Disord. 2019;253:184-92. |
N=167 OCD patients were randomly allocated to receive either CBT combined with medication (n=92) or medication alone (n=75) for a 24-week treatment period. |
CBT plus medication may alleviate the symptoms and social impairment associated with OCD and is more effective than medication alone in China, particularly for treating compulsive behaviors. |
35 |
Internet-based cognitive behaviour therapy for obsessive-compulsive disorder: a randomized controlled trial Psychological Medicine
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Andersson et al.6161. Andersson E, Enander J, Andrén P, Hedman E, Ljótsson B, Hursti T, et al. Internet-based cognitive behaviour therapy for obsessive-compulsive disorder: a randomized controlled trial. Psychol Med. 2012;42:2193-203. |
N=101 patients diagnosed with OCD were randomized to either 10 weeks of iCBT or to an attention control condition, consisting of online supportive therapy. |
iCBT is an efficacious treatment for OCD that could substantially increase access to CBT for OCD patients. Replication studies are warranted. |
36 |
Efficacy of exposure versus cognitive therapy in anxiety disorders: Systematic review and meta-analysis BioMed Central Psychiatry
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Ougrin et al.6262. Ougrin D. Efficacy of exposure versus cognitive therapy in anxiety disorders: systematic review and meta-analysis. BMC Psychiatry. 2011;11:200. |
PsycINFO, Medline, and Embase were searched from the first available year to May 2010. All randomized controlled studies comparing the efficacy of exposure with CT were included. Odds ratios or standardized mean differences (Hedges’ g) for the most clinically relevant primary outcomes were calculated. The study outcomes were grouped according to specific disorders and combined in meta-analyses exploring short-term and long-term outcomes. |
Based on the literature, there appears to be no evidence of differential efficacy between CT and exposure in PD, PTSD and OCD, and strong evidence of superior efficacy of CT in social phobia. |
37 |
Computer-delivered cognitive-behavioral treatments for obsessive compulsive disorder: preliminary meta-analysis of randomized and non-randomized effectiveness trials The Cognitive Behaviour Therapist
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Pozza et al.6363. Pozza A, Andersson G, Antonelli P, Dèttore D. Computer-delivered cognitive-behavioural treatments for obsessive compulsive disorder: preliminary meta-analysis of randomized and non-randomized effectiveness trials. Cogn Behav Ther. 2014;7:e16. |
A meta-analysis was conducted according to PRISMA guidelines. Treatments were classified as CCBTs if they included evidence-based cognitive-behavioral components for OCD (psychoeducation, ERP, cognitive restructuring), delivered through devices like computers, palmtops, telephone-interactive voice-response systems, CD-ROMS, or cell phones. |
Findings from this meta-analysis suggest that CCBTs are a valid and promising alternative way of delivering CBT to target OCD. Given the evidence in the literature about the cost-effectiveness of such treatment modalities, CCBTs could be effectively used in the context of public mental health services as a low-intensity treatment and as a main intervention for patients diagnosed with OCD. |
38 |
Efficacy of group psychotherapy for obsessive-compulsive disorder: A meta-analysis of randomized controlled trials Journal of Obsessive Compulsive Related Disorders
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Schwartze et al.6464. Schwartze D, Barkowski S, Burlingame GM, Strauss B, Rosendahl J. Efficacy of group psychotherapy for obsessive-compulsive disorder: A meta-analysis of randomized controlled trials. J Obsessive-Compuls Relat Disord. 2016;10:49-61. |
Twelve studies including 16 comparisons and 832 patients. The majority of studies examined the CBT group. |
The findings highlight the value of group therapy as an efficacious treatment for patients suffering from OCD. |
39 |
Pharmacological and psychotherapeutic interventions for management of obsessive-compulsive disorder in adults: a systematic review and network meta-analysis The Lancet Psychiatry
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Skapinakis et al.1010. Skapinakis P, Caldwell DM, Hollingworth W, Bryden P, Fineberg NA, Salkovskis P, et al. Pharmacological and psychotherapeutic interventions for management of obsessive-compulsive disorder in adults: a systematic review and network meta-analysis. Lancet Psychiatry. 2016;3:730-9. |
A total of 1,480 articles were identified, of which 53 were included (54 trials; 6,652 participants) in the network meta-analysis. |
A range of interventions is effective for OCD, but there is considerable uncertainty regarding their relative efficacy. Taking all the evidence into account, a combination of psychotherapeutic and psychopharmacological interventions is likely to be more effective than psychotherapeutic interventions alone, at least for severe OCD. |
40 |
Family and couple integrated cognitive-behavioral therapy for adults with OCD: A meta-analysis Journal of Affective Disorders
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Stewart et al.6565. Stewart KE, Sumantry D, Malivoire BL. Family and couple integrated cognitive-behavioural therapy for adults with OCD: a meta-analysis. J Affect Disord. 2020;277:159-68. |
Fifteen studies were reviewed (16 independent samples). |
Family-integrated treatment appears to be effective for adult OCD, related symptoms, and relationship factors. There is preliminary support that family-integrated treatment leads to better outcomes than individual treatment. |
41 |
A meta-analysis on the treatment of obsessive compulsive disorder: A comparison of antidepressants, behavior, and cognitive therapy Clinical Psychology Review
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Van Balkom et al.6666. Van Balkom AJLM, van Oppen P, Vermeulen AWA, van Dyck R, Nauta MCE, Vorst HCM. A meta-analysis on the treatment of obsessive compulsive disorder: A comparison of antidepressants, behavior, and cognitive therapy. Clin Psychol Rev. 1994;14:359-81. |
86 studies dealing with the efficacy of treatment for OCD with antidepressants, pill-placebo, BT, CT, attention placebo, or a combination of these treatments were analyzed. |
From this meta-analysis on the efficacy of treatment of OCD, it can be concluded that serotonergic antidepressants, BT, CT, and a combination of these treatments are generally associated with large effect sizes for obsessive compulsive symptoms, depression, anxiety, and social adjustment. |
42 |
Efficacy of technology-delivered cognitive behavioral therapy for OCD versus control conditions, and in comparison with therapist-administered CBT: Meta-analysis of randomized controlled trials Cognitive Behavioral Therapy
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Dèttore et al.6767. Dèttore D, Pozza A, Andersson G. Efficacy of technology-delivered cognitive behavioural therapy for OCD versus control conditions, and in comparison with therapist-administered CBT: meta-analysis of randomized controlled trials. Cogn Behav Ther. 2015;44:190-211. |
Eight RCTs were included (n=420). |
The efficacy difference for OCD symptoms between T-CBT and therapist-administered CBT was not significant. |
43 |
A multidimensional meta-analysis of psychotherapy and pharmacotherapy for obsessive-compulsive disorder Clinical Psychology Review
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Eddy et al.6868. Eddy KT, Dutra L, Bradley R, Westen D. A multidimensional meta-analysis of psychotherapy and pharmacotherapy for obsessive-compulsive disorder. Clin Psychol Rev. 2004;24:1011-30. |
We included 32 clinical trials (six of which had a cross-over design) involving 68 treatment conditions. |
Both psychotherapy and pharmacotherapy produce substantial decreases in OCD symptoms, reflected in; i) pre-treatment vs. post-treatment effect sizes; ii) a substantial percentage of patients who improve with treatment; and iii) considerable declines in symptoms from pre- to post-treatment. |
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Cognitive behavioral treatments of obsessive-compulsive disorder. A systematic review and meta-analysis of studies published 1993-2014 Clinical Psychology Review
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Öst et al.6969. Öst LG, Havnen A, Hansen B, Kvale G. Cognitive behavioral treatments of obsessive-compulsive disorder. A systematic review and meta-analysis of studies published 1993-2014. Clin Psychol Rev. 2015;40:156-69. |
This meta-analysis included 37 RCTs with CBT for OCD using the Y-BOCS. |
CBT was significantly better than antidepressant medication, but CBT plus medication was not significantly better than CBT plus placebo. |