Adapted cognitive behavior therapy for obsessive–compulsive disorder with co-occurring autism spectrum disorder: A clinical effectiveness study

Autism ◽  
2019 ◽  
Vol 24 (1) ◽  
pp. 190-199
Author(s):  
Oskar Flygare ◽  
Erik Andersson ◽  
Helene Ringberg ◽  
Anna-Clara Hellstadius ◽  
Johan Edbacken ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Obsessive Compulsive Disorder ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Cognitive Behavior ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

Obsessive–compulsive disorder and autism spectrum disorder commonly co-occur. Adapted cognitive behavior therapy for obsessive–compulsive disorder in adults with autism spectrum disorder has not previously been evaluated outside the United Kingdom. In this study, 19 adults with obsessive–compulsive disorder and autism spectrum disorder were treated using an adapted cognitive behavior therapy protocol that consisted of 20 sessions focused on exposure with response prevention. The primary outcome was the clinician-rated Yale–Brown Obsessive–Compulsive Scale. Participants were assessed up to 3 months after treatment. There were significant reductions on the Yale–Brown Obsessive–Compulsive Scale at post-treatment (d = 1.5), and improvements were sustained at follow-up (d = 1.2). Self-rated obsessive–compulsive disorder and depressive symptoms showed statistically significant reductions. Improvements in general functioning and quality of life were statistically non-significant. Three participants (16%) were responders at post-treatment and four (21%) were in remission from obsessive–compulsive disorder. At follow-up, three participants (16%) were responders and one (5%) was in full remission. Adapted cognitive behavior therapy for obsessive–compulsive disorder in adults with co-occurring autism spectrum disorder is associated with reductions in obsessive–compulsive symptoms and depressive symptoms. However, outcomes are modest; few patients were completely symptom free, and treatment engagement was low with few completed exposures and low adherence to homework assignments. We identify and discuss the need for further treatment refinement for this vulnerable group.

Exposure and Ritual Prevention, Clomipramine, or Their Combination for Obsessive-Compulsive Disorder

2018 ◽  
Author(s):  
Brandon M. Kitay ◽  
Michael H. Bloch
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Clinical Management ◽  
Clinical Case ◽  
Cognitive Behavior ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Landmark Study

This chapter provides a summary of a landmark study on the management of obsessive-compulsive disorder (OCD) in adults. Is the combination of exposure and ritual prevention (a cognitive behavior therapy based intervention) along with clomipramine more efficacious than monotherapy with either treatment for OCD? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study interventions, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications for clinical management, and concludes with an exemplary clinical case applying the evidence.

Long-term efficacy of Internet-based cognitive behavior therapy for obsessive–compulsive disorder with or without booster: a randomized controlled trial

2014 ◽  
Vol 44 (13) ◽  
pp. 2877-2887 ◽  
Author(s):  
E. Andersson ◽  
S. Steneby ◽  
K. Karlsson ◽  
B. Ljótsson ◽  
E. Hedman ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Cognitive Behavior ◽  
Long Term Effects ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Term Efficacy

BackgroundAs relapse after completed cognitive behavior therapy (CBT) for obsessive–compulsive disorder (OCD) is common, many treatment protocols include booster programs to improve the long-term effects. However, the effects of booster programs are not well studied. In this study, we investigated the long-term efficacy of Internet-based CBT (ICBT) with therapist support for OCD with or without an Internet-based booster program.MethodA total of 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. Outcome assessments were collected at 4, 7, 12 and 24 months after receiving ICBT.ResultsThe entire sample had sustained long-term effects from pre-treatment to all follow-up assessments, with large within-group effect sizes (Cohen's d = 1.58–2.09). The booster group had a significant mean reduction in OCD symptoms compared to the control condition from booster baseline (4 months) to 7 months, but not at 12 or 24 months. Participants in the booster group improved significantly in terms of general functioning at 7, 12 and 24 months, and had fewer relapses. Kaplan–Meier analysis also indicated a significantly slower relapse rate in the booster group.ConclusionsThe results suggest that ICBT has sustained long-term effects and that adding an Internet-based booster program can further improve long-term outcome and prevent relapse for some OCD patients.

scholarly journals Long-term outcomes of therapist-guided Internet-delivered cognitive behavior therapy for pediatric obsessive-compulsive disorder

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Fabian Lenhard ◽  
Erik Andersson ◽  
David Mataix-Cols ◽  
Christian Rück ◽  
Kristina Aspvall ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Cost Effective ◽  
Cognitive Behavior ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Long Run

Abstract Cognitive behavior therapy (CBT) is the recommended first-line intervention for children and adolescents with obsessive-compulsive disorder (OCD), but is not broadly accessible. Internet-delivered CBT (ICBT) with minimal therapist support is efficacious and cost-effective, at least in the short term. Whether the therapeutic gains of ICBT for OCD are sustained in the long run is unknown. In this study, 61 adolescents with OCD who participated in a randomized trial of ICBT were followed-up 3 and 12 months after treatment. The proportion of treatment responders and remitters remained stable from post-treatment to 3-month follow-up and increased significantly from 3-month to 12-month follow-up. This study suggests that the gains of ICBT for youth with OCD are not only maintained long-term, but that further improvements continue to occur during follow-up.

Adapted cognitive behavior therapy for obsessive compulsive disorder with co-occurring autism spectrum disorder: A clinical effectiveness study

2018 ◽  
Author(s):  
Oskar Flygare ◽  
Erik Andersson ◽  
Helene Ringberg ◽  
Anna-Clara Hellstadius ◽  
Johan Edbacken ◽  
...  
Keyword(s):  
Autism Spectrum Disorder ◽  
Depressive Symptoms ◽  
Obsessive Compulsive Disorder ◽  
Clinical Effectiveness ◽  
Autism Spectrum ◽  
Post Treatment ◽  
Spectrum Disorder ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

Obsessive-compulsive disorder (OCD) and autism spectrum disorder (ASD) commonly co-occur. Adapted CBT for OCD in adults with ASD has not previously been evaluated outside the United Kingdom. In this study, 19 adults with OCD and ASD were treated using an adapted CBT protocol that consisted of 20 sessions focused on exposure with response prevention. The primary outcome was the clinician-rated Yale-Brown Obsessive-Compulsive Scale (YBOCS). Participants were assessed up to 3 months after treatment. There were significant reductions on the YBOCS at post-treatment (d=1.5), and improvements were sustained at follow-up (d=1.2). Self-rated OCD symptoms and depressive symptoms showed statistically significant reductions. Improvements in general functioning and quality of life were statistically non-significant. Three participants (16%) were responders at post-treatment and four (21%) were in remission from OCD. At follow-up, three participants (16%) were responders and one (5%) was in full remission. Adapted CBT for OCD in adults with co-occurring ASD is associated with reductions in obsessive-compulsive symptoms and depressive symptoms. However, outcomes are modest; few patients were completely symptom free, and treatment engagement was low with few completed exposures and low adherence to homework assignments. We identify and discuss the need for further treatment refinement for this vulnerable group.

scholarly journals Treatment of Monozygotic Twins with Obsessive Compulsive Disorder Using Cognitive Therapy and Exposure with Ritual Prevention

2009 ◽  
Vol 37 (4) ◽  
pp. 475-480
Author(s):  
Michael P. Twohig ◽  
Maureen L. Whittal ◽  
Katherine A. Peterson
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Monozygotic Twins ◽  
Cognitive Behavior ◽  
Obsessive Beliefs ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Mz Twins

Background: Assessment and treatment of cohabiting monozygotic (MZ) twins with obsessive compulsive disorder (OCD) is a possible challenge for clinical psychologists. Aims: This study aims to present a detailed history of two sets of cohabiting MZ twins with OCD, and describe the adaption of cognitive behavior therapy in their treatments. Method: Two sets of cohabiting MZ twins completed a structured intake and the Yale Brown Obsessive Compulsive Scale as well as measures of depression, anxiety, a measure of obsessive beliefs, and thought action fusion. One set received cognitive behavior therapy and exposure with ritual prevention (ERP) simultaneously and the other received ERP separately. Pre-, post-treatment and follow-up assessments occurred for both sets of twins. Results: All four individuals showed notable decreases in OCD, and results were maintained for three of the four participants at follow-up points. Conclusions: This study highlights the developmental course of OCD that can occur in cohabiting twins, and the clinical adaption that may be necessary.

scholarly journals Long-term outcomes of therapist-guided Internet-delivered cognitive behavior therapy for pediatric obsessive-compulsive disorder: A naturalistic one-year follow-up

2020 ◽  
Author(s):  
Fabian Lenhard ◽  
Erik Andersson ◽  
David Mataix-Cols ◽  
Christian Rück ◽  
Kristina Aspvall ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Cost Effective ◽  
Cognitive Behavior ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Long Run

Cognitive behavior therapy (CBT) is the recommended first-line intervention for children and adolescents with obsessive-compulsive disorder (OCD), but is not broadly accessible. Internet-delivered CBT (ICBT) with minimal therapist support is efficacious and cost-effective, at least in the short term. Whether the therapeutic gains of ICBT for OCD are sustained in the long run is unknown. In the current study, 61 adolescents with OCD who participated in a randomized trial of ICBT were followed-up 3 and 12 months after treatment. The proportion of treatment responders and remitters remained stable from post-treatment to 3-month follow-up but significantly increased from 3-month to 12-month follow-ups. This study suggests that the gains of ICBT for youth with OCD are not only maintained long-term, but that further improvements continue to occur during follow-up.

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