Group cognitive behavioural therapy for obsessive-compulsive disorder: a systematic review and meta-analysis

IntroductionGroup Cognitive Behavioural Therapy (GCBT) is a cost-effective modality of treatment alternative to individual Cognitive Behavioural Therapy (CBT). Despite several well-controlled trials demonstrated the efficacy of GCBT for Obsessive Compulsive Disorder (OCD), few studies evaluated the effectiveness of GCBT on outpatients attending routinary psychiatric services, and in Italy this topic appears understudied.ObjectivesThe current study evaluated the effectiveness of a GCBT protocol on OCD symptoms and comorbid depression and anxiety in a group of outpatients attending a psychiatric service in Italy.MethodTwenty outpatients with a diagnosis of OCD were included in the study and received 20 sessions of GCBT, consisting of psychoeducation on anxiety and OCD, relaxation training, in vivo/imaginal exposure and response prevention, cognitive restructuring for obsessive beliefs, cognitive defusion, and assertiveness training. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI) were administered at pre- and post-treatment.ResultsTwo outpatients had a comorbid bipolar disorder, eight had a concurrent personality disorder. Ten outpatients were on concurrent antidepressants, five on antipsychotics. Three outpatients prematurely dropped out from treatment. Among completers, GCBT produced significant changes on OCD symptoms, anxiety and depression from pre- to post-treatment. The GCBT protocol was feasible and the outpatients reported high satisfaction judgements.ConclusionsFuture studies should investigate clinical predictors of best response after GCBT and assess maintenance of symptom changes at long-term follow-up.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Download Full-text

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.

Download Full-text