Drop-out and efficacy of group versus individual cognitive behavioural therapy: What works best for Obsessive-Compulsive Disorder? A systematic review and meta-analysis of direct comparisons

Psychotherapy, including cognitive behavioural therapy (CBT), reminiscence and general psychotherapy (GPT), is viewed as effective treatment for depression, but its efficacy in older people is not well defined. This systematic review included 14 randomized controlled trials that assessed the efficacy of psychotherapy for treating depression in elderly people (≥ 55 years). The results of this meta-analysis showed that, compared with placebo, psychotherapy was more effective in reducing depression scores (standardized mean difference −0.92; 95% confidence interval −1.21, −0.36). Subgroup analysis showed that CBT, reminiscence and GPT were all more effective than placebo; psychotherapy as an adjunct to antidepressant medication did not increase effectiveness. There was no significant difference between CBT and reminiscence in improving depression. A higher drop-out rate was observed in studies that did not include psychotherapy versus those that did, although this difference was not statistically significant. Thus, various general formats of psychotherapy are effective for treating depression in older people, although psychotherapy does not significantly increase the effectiveness of antidepressant medication.

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A Pilot Investigation of Cognitive Behavioural Therapy for Clinical Perfectionism in Obsessive Compulsive Disorder

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465816000618 ◽

2017 ◽

Vol 45 (3) ◽

pp. 312-320 ◽

Cited By ~ 3

Author(s):

Shalane K. Sadri ◽

Rebecca A. Anderson ◽

Peter M. McEvoy ◽

Robert T. Kane ◽

Sarah J. Egan

Keyword(s):

Obsessive Compulsive Disorder ◽

Cognitive Behavioural Therapy ◽

Behavioural Therapy ◽

Drop Out ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Cognitive Behavioural ◽

Pilot Investigation ◽

Clinically Significant ◽

Group Cbt

Background: Perfectionism is strongly associated with obsessive compulsive disorder (OCD). Cognitive behavioural therapy for perfectionism (CBT-P) has been found to result in reductions in a range of symptoms in individuals with anxiety disorders, depression and eating disorders. Aim: To pilot-test the efficacy of group CBT for perfectionism in participants with OCD and elevated perfectionism. Method: Participants were randomized to receive immediate 8-week group CBT-P (n = 4) or an 8-week waitlist followed by CBT-P (n = 7). Results: Reliable reductions and a large effect size indicated that CBT-P was associated with improvements in perfectionism and OCD severity at post-test. However, these changes were not clinically significant and drop-out was high, resulting in a small final sample. Conclusions: CBT-P may be effective in reducing perfectionism and disorder-specific OCD symptoms. However, the high drop-out rate and lack of clinically significant findings suggest that further research needs to be conducted to determine the efficacy of CBT for perfectionism in OCD.

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Is Intensive Cognitive Behavioural Therapy an Efficacious and Acceptable Treatment Format for Adults with Obsessive Compulsive Disorder? A Systematic Review of Randomised Controlled Trials

10.31234/osf.io/rndcu ◽

2020 ◽

Author(s):

Josie Frances Adeline Millar ◽

Andreas Bauer ◽

Sarah Halligan ◽

Sophie-Anne Purnell ◽

Gemma Taylor ◽

...

Keyword(s):

Systematic Review ◽

Obsessive Compulsive Disorder ◽

Cognitive Behavioural Therapy ◽

Randomised Controlled Trials ◽

Behavioural Therapy ◽

Controlled Trials ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Cognitive Behavioural ◽

Randomised Controlled

Background: Clinical guidelines recommend the use of an intensive version of cognitive behavioural therapy (iCBT) in obsessive compulsive disorder (OCD) when evidence-based treatment has previously failed. This systematic review aimed to 1) assess the efficacy of iCBT for adults with OCD; 2) assess the acceptability of iCBT for adults with OCD.Methods: PROSPERO ID: CRD42018106840. We searched the Cochrane Controlled Register of Trials (CENTRAL), Cochrane Library, PubMed, Embase and PsycINFO for articles published between 1966 and November 2018, and reference lists and other sources for registered or ongoing studies. We included Randomised Controlled Trials (RCTs) of adults with OCD comparing iCBT to active or non-active controls. iCBT was defined as: at least five hours of CBT delivered per week in no more than four weeks for at least 10 CBT hours. The primary outcome was change in OCD symptoms from baseline to follow-up; secondary outcome was attrition; risk of bias was assessed using the Cochrane Tool. Results: Searches retrieved 5125 records, with only four RCTs with a total of 313 participants meeting inclusion criteria. Large effect sizes in favour of iCBT relative to controls were found, range (1.35 to 3.18). Drop-out rate across studies was low. However, none of the included studies focused on participants with a specific history of treatment failure. Studies were highly heterogeneous, which precluded meta-analysis. Conclusions: There was evidence that iCBT may be efficacious and acceptable. Further high quality RCTs are required to assess the efficacy and acceptability of iCBT specifically for OCD non-responders.

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