Cognitive behavioral therapy in pharmacoresistant obsessive-compulsive disorder

BackgroundThe aim of the study was to determine whether patients with OCD resistant to drugs may improve using intensive, systematic CBT lasting six weeks and whether it is possible to predict the therapeutic effect using demographic, clinical and psychological characteristics at baseline.MethodThere were 66 patients included in the study. Fifty-seven patients completed the program. The diagnosis was confirmed by a structured interview MINI. Patient were rated before the treatment using Y-BOCS (objective and subjective form), CGI (objective and subjective form), BAI, BDI, DES (Dissociative Experiences Scale), SDQ 20 (Somatoform Dissociation Questionnaire), and SDS (Sheehan Disability Scale), and at the end of the treatment using subjective Y-BOCS, objective and subjective CGI, BAI, and BDI. Patients were treated with antidepressants and daily intensive group cognitive behavioral therapy for the period of six weeks.ResultsDuring the 6-week intensive cognitive behavioral therapy program in combination with pharmacotherapy, there was a significant improvement in patients suffering from OCD formerly resistant to pharmacotherapy. There were statistically significant decreases in the scales assessing the severity of OCD symptoms, anxiety, and depressive feelings. The lower treatment effect was achieved specifically in patients who:– showed fewer OCD themes in symptomatology;– showed a higher level of somatoform dissociation;– with poor insight;– with a higher level of overall severity of the disorder in the beginning.The remission of the disorder was achieved more probably in patients with:– good insight;– the lower level of initial anxiety;– without comorbidity with the depressive disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Application of Cognitive-behavioral Therapy in a Case of Obsessive-compulsive Disorder

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1067 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S644-S644

Author(s):

L. Rodríguez Andrés ◽

A. Rodriguez Campos ◽

I. Sevillano Benito ◽

H. De la Red Gallego ◽

C. Noval Canga ◽

...

Keyword(s):

Depressive Symptoms ◽

Cognitive Behavioral Therapy ◽

Obsessive Compulsive Disorder ◽

Behavioral Therapy ◽

Psychiatric Inpatient ◽

Normal Function ◽

Cognitive Behavioral ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Competing Interest

We present the case report of a 46-year-old woman who experienced obsessive-compulsive symptoms for over twenty years, with multiple relapses, severe depressive symptoms and many hospitalizations in the psychiatric Inpatient Unit. Treatment with different SSRIs, tricyclic antidepressants, atypical antipsychotics and even electroconvulsive therapy were administered with poor results.After her last hospitalization a Cognitive-Behavioral Therapy, including exposure and response prevention and cognitive therapy, is initiated combined with medication, improving depressive symptoms, the ritual behaviors and levels of anxiety.Modern treatments for Obsessive-Compulsive Disorder (OCD) have radically changed how the disorder is viewed. While in the past OCD was regarded as chronic and untreatable, a diagnosis of OCD may now be regarded with hope. Cognitive and behavior therapy and antidepressant medications are currently used to treat the disorder. They can be used to control the symptoms and enable people with OCD to restore normal function in their lives.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Cognitive Behavioral Therapy Added to Pharmacotherapy in Patients Suffering from Pharmacoresistant Obsessive-compulsive Disorder

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1066 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S643-S644

Author(s):

J. Vyskocilova ◽

J. Prasko ◽

J. Sipek ◽

M. Slepecky

Keyword(s):

Obsessive Compulsive Disorder ◽

Initial Level ◽

Behavioral Therapy ◽

Behavioural Therapy ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Somatoform Dissociation ◽

Cognitive Behavioural ◽

Competing Interest ◽

Intensive Group

BackgroundThe objective of investigation was to determine whether patients with obsessive-compulsive disorder (OCD) resistant to drug therapy may improve their condition using intensive, systematic cognitive behavioural therapy (CBT) lasting six weeks and whether it is possible to predict treatment outcome using clinical and selected psychological characteristics.MethodFrom 66 OCD patients fifty-seven completed program. The diagnosis was confirmed using the structured mini international neuropsychiatric Interview. Patients were rated using the objective and subjective forms of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), objective and subjective forms of the Clinical Global Impression (CGI), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), dissociative experiences scale, 20-item Somatoform dissociation questionnaire and sheehan disability scale before treatment, and with subjective Y-BOCS, objective and subjective CGI, BAI and BDI at the end of treatment. Patients were treated with antidepressants and daily intensive group CBT for six weeks.ResultsDuring 6-week intensive CBT program in combination with pharmacotherapy, there was significant improvement in patients suffering from OCD resistant to drug treatment. There were statistically significantly decreased scores of scales assessing severity of OCD symptoms, anxiety, and depressive feelings. A lower treatment effect was achieved specifically in patients who (a) showed fewer OCD themes in symptomatology, (b) showed higher level of somatoform dissociation, (c) had poor insight and (d) had a higher initial level of overall severity of the disorder. Remission of the disorder was more likely in patients who (a) had good insight, (b) had a lower initial level of anxiety and (c) had no comorbid depressive disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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