Disorders - Obsessive Compulsive Disorder
Pirog-Balcerzak, A., Bazynska, A., Bragoszewska, J., Niwinski, P., Popek, L., Remberk, B., Rybakowski, F.
Introduction: In anorexia nervosa, in addition to many somatic problems, reversible decrease in brain gray matter volume and the changes in all key neurotransmitter systems occurs [1]. It may cause coexistence of various disorders and mental illnesses. The most common are episodes of depression (up to 80%), obsessive compulsive disorder, panic attacks (20-60%), social phobia or generalized anxiety disorder. Polyunsaturated fatty acids omega-3 (PUFAs) are major component of cellular and intercellular membranes of neurons and they play many regulatory processes in central nervous system. Some studies show the efficacy of PUFAs supplementation in the depression [2] or anxiety [3] treatment. Purpose of the study: To determine if polyunsaturated fatty acids omega-3 are effective in reducing depression and obsessivecompulssive disorder symptoms in adolescent girls with anorexia nervosa. Methods: 61 teenage girls (12-19 years old) diagnosed with anorexia nervosa according to International Classification Diseases Tenth Revision (ICD-10) were recruited in the period from September 2012 till October 2014. Subjects were hospitalized in Child and Adolescent Psychiatry Department in Institute of Psychiatry and Neurology, Warsaw. Mean age at the index admission was 16.2+/-1.6. Demographic data, history of illness, laboratory tests, weight, height, Body Mass Index and psychometric tests (Beck Depression Inventory - BDI, Hamilton Depression Rating Scale - HDRS, Yale-Brown Obsessive Compulsive Scale - Y-BOCS) were obtained at the baseline visit. During the stay patients underwent therapeutic and behavioral program and were fed with rich - calories diet. In the randomized, double-blind manner subjects received active substance or placebo for 10 weeks. The active capsules contained 558 mg of eicosapentaenoic acid, 174 mg of docosahexaenoic acid and 60 mg of gamma linolenic acid, and placebo capsules contained olive oil without omega-3 fatty acids. At the end of the study subjects were reexamined with the same evaluation measures. Normally and non-normally distributed variables were analyzed respectively with t-test and Mann-Whitney U-test and categorical variables were analyzed with chi-square test. The groups were unblinded after analyzing statistics data. Results: 53 patients completed the 10 weeks trial. There was an improvement of depression and obsessive and compulsive symptoms in the whole group of inpatients. There was an insignificant decrease in placebo group as compared with PUFAs group in depression scores measured by HDRS (7.64+/-6.95 vs 6.54+/-6.02) and BDI (10.04+/-11.53 vs 9.39+/-11.76). The same was observed in obsessive and compulsive symptoms as measured by Y-BOCS (9.92+/-8.73 vs 7.39+/-8.02). Conclusion: In teenage girls with anorexia nervosa, supplementaion with PUFAs during inpatient treatment did not improve depressive and obsessive and compulsive symptoms. As in add-on studies on depression PUFAs are effective the current results suggest that depressive symptoms in anorexia are a part of anorexia clinical presentation not a comorbid disorder.
European Neuropsychopharmacology, 26 : S729-S730
- Year: 2016
- Problem: Obsessive Compulsive Disorder, Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Fish oil (Omega-3 fatty acids)
, Omega 3 fatty acids (e.g. fish oil, flax oil)
Shavitt, R. G.
Objectives: This study aimed to implement a sequential treatment trial for pediatric OCD. Methods: The attendance rates, postbaseline assessments, treatment adherence, and completion were measured along a sequential randomized trial comprising four adaptive treatment strategies (ATSs). First, subjects were allocated to group CBT (GCBT) or fluoxetine (FLX) for 14 weeks. Responders to the initial treatment continued to receive treatment for additional 14 weeks. Nonresponders, defined by less than 50 percent reduction in baseline Yale-Brown Obsessive Compulsive Scale (YBOCS) scores, were re-randomized to either switch to or add the other treatment. Assessments were performed at baseline and at the middle and end of treatments. Results: Eighty-three children [40 males, mean age (SD) = 11.8 (3.1) years] were randomized. Sixty-eight (81.9 percent) subjects completed the first treatment, and 63 (75.9 percent) completed the study. The overall rate of appointments/sessions attendance was 78.6 percent. Seventy-four (89.1 percent) subjects completed at least one postbaseline assessment. Compliance with pharmacological treatment was high. The presence of a comorbid depressive disorder was associated with dropout. The four groups improved after treatment [percent reduction of YBOCS scores (SD) from baseline to the end of the second treatment is indicated as follows: 1) switch FLX to GCBT = 70.6 percent (35.4); 2) add GCBT to FLX = 72.8 percent (27.6); 3) switch GCBT to FLX = 64.5 percent (30.1); and 4) add FLX to GCBT = 66.7 percent (22.7); t-tests for comparisons: 1 x 3, p = 0.543; 1 x 4, p = 0.674; 2 x 3, p = 0.308; 2 x 4, p = 0.397]. Additional comparisons between the four ATSs performed by means of multiple imputations and generalized estimating equations did not show significant differences between the four ATSs with regard to outcome. Conclusions: Different ATSs that use switching or adding first-choice treatments for pediatric OCD seem to lead to the same treatment outcome. This observation is relevant to mental health policy and service planning. The intensification of educational approaches throughout the trial seems necessary to enhance the feasibility of sequential trials for pediatric OCD. Patients with comorbid depression may require specific retention strategies.
Journal of the American Academy of Child and Adolescent Psychiatry, 55 (10 Supplement 1) : S263
- Year: 2016
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
, Treatment resistant/treatment refractory
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Antidepressants (any)
, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Skapinakis, P., Caldwell, D., Hollingworth, W., Bryden, P., Fineberg, N., Salkovskis, P., Welton, N., Baxter, H., Kessler, D., Churchill, R., Lewis, G.
Background: Obsessive-compulsive disorder (OCD) is a relatively common and disabling condition. Objectives: To determine the clinical effectiveness, acceptability and cost-effectiveness of pharmacological and psychological interventions for the treatment of OCD in children, adolescents and adults. Data sources: We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Trials Registers, which includes trials from routine searches of all the major databases. Searches were conducted from inception to 31 December 2014. Review methods: We undertook a systematic review and network meta-analysis (NMA) of the clinical effectiveness and acceptability of available treatments. Outcomes for effectiveness included mean differences in the total scores of the Yale-Brown Obsessive-Compulsive Scale or its children's version and total dropouts for acceptability. For the cost-effectiveness analysis, we developed a probabilistic model informed by the results of the NMA. All analyses were performed using OpenBUGS version 3.2.3 (members of OpenBUGS Project Management Group; see www.openbugs.net). Results: We included 86 randomised controlled trials (RCTs) in our systematic review. In the NMA we included 71 RCTs (54 in adults and 17 in children and adolescents) for effectiveness and 71 for acceptability (53 in adults and 18 in children and adolescents), comprising 7643 and 7942 randomised patients available for analysis, respectively. In general, the studies were of medium quality. The results of the NMA showed that in adults all selective serotonin reuptake inhibitors (SSRIs) and clomipramine had greater effects than drug placebo. There were no differences between SSRIs, and a trend for clomipramine to be more effective did not reach statistical significance. All active psychological therapies had greater effects than drug placebo. Behavioural therapy (BT) and cognitive therapy (CT) had greater effects than psychological placebo, but cognitive-behavioural therapy (CBT) did not. BT and CT, but not CBT, had greater effects than medications, but there are considerable uncertainty and methodological limitations that should be taken into account. In children and adolescents, CBT and BT had greater effects than drug placebo, but differences compared with psychological placebo did not reach statistical significance. SSRIs as a class showed a trend for superiority over drug placebo, but the difference did not reach statistical significance. However, the superiority of some individual drugs (fluoxetine, sertraline) was marginally statistically significant. Regarding acceptability, all interventions except clomipramine had good tolerability. In adults, CT and BT had the highest probability of being most cost-effective at conventional National Institute for Health and Care Excellence thresholds. In children and adolescents, CBT or CBT combined with a SSRI were more likely to be cost-effective. The results are uncertain and sensitive to assumptions about treatment effect and the exclusion of trials at high risk of bias. Limitations: The majority of psychological trials included patients who were taking medications. There were few studies in children and adolescents. Conclusions: In adults, psychological interventions, clomipramine, SSRIs or combinations of these are all effective, whereas in children and adolescents, psychological interventions, either as monotherapy or combined with specific SSRIs, were more likely to be effective. Future RCTs should improve their design, in particular for psychotherapy or combined interventions. Copyright © Queen's Printer and Controller of HMSO 2016.
Health Technology Assessment, 20(43) :
- Year: 2016
- Problem: Obsessive Compulsive Disorder
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Psychological Interventions (any)
Lenhard, F., Ssegonja, R., Andersson, E., Feldman, I., Ruck, C., Mataix-Cols, D., Serlachius, E.
Objectives: OCD affects about 2 percent of children and adolescents. The first line treatment recommendation for OCD is CBT, however, a majority of patients do not get access to treatment due to geographical distances and limited health care resources. Internet-delivered CBT (ICBT) has been proposed as a way to overcome those treatment barriers. One advantage of ICBT that commonly is emphasized is its potential to reduce health related costs for patients and resource use costs for the health care system. Yet, studies on the cost-effectiveness of ICBT for children and adolescents are scarce, and no data exists on the cost-effectiveness for ICBT in pediatric OCD patients. Methods: N=67 adolescents (12-17yrs) with OCD participated in a single-blinded randomized controlled trial comparing ICBT to a waitlist control, each 12 weeks. Clinical effectiveness outcomes were defined as treatment responder rates and change in Quality Adjusted Life Years (QALYs) from pre- to post-treatment. Cost data was collected on health care use, informal resource use, prescription drugs, prescriptionfree drugs, school absence and productivity loss as well as the cost of ICBT. Results: There was a significant difference of treatment responders in ICBT (27 percent) compared to the waitlist (0 percent). No effect on QALYs was observed. Compared to waitlist control, ICBT generated substantial cost savings averaging -150.63USD (95% CI [-166.02, -135.23]) per patient. The cost reductions were mainly driven by reduced health care use in the ICBT group. Conclusions: The results suggest that ICBT is associated with significant societal cost-savings compared to leaving patients untreated. A next step would be to compare cost-effectiveness of ICBT and regular face-to-face CBT.
Journal of the American Academy of Child and Adolescent Psychiatry, 55 (10 Supplement 1) : S204
- Year: 2016
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Technology, interventions delivered using technology (e.g. online, SMS)
Lee, M. S., Kwon, S. M.
Introduction Obsessive thoughts can be categorized in to two sub types, autogenous obsessions and reactive obsessions. Although it has been investigated that each subtype associates with different maladaptive coping strategies, no studies have yet empirically compared the effectiveness of adaptive coping strategies on autogenous and reactive obsessions. Objectives It is hypothesized that acceptance, which is a core therapeutic principle of acceptance-based cognitive therapy (ACT), is more effective on autogenous obsessions, whereas response suppression as a principle of exposure and response prevention (ERP) has a stronger effect on reactive obsessions. Aims To compare the effectiveness of two coping strategies (acceptance and response suppression) on autogenous and reactive obsessions. Methods A total of 164 undergraduate students completed questionnaires for obsessional thoughts and coping strategies. According to the most distressing thought, sixty subjects (n=30 with autogenous obsession, n = 30 with reactive obsession) were randomly assigned to two groups differing in treatment conditions. Individual psychoeducation and practice were performed for four different groups (2 obsessional subtypes x2 coping strategies). Results Repeated measure ANOVA demonstrated that the autogenous obsessional group showed greater distress reduction after acceptance treatment than response suppression treatment, although its effect was not statistically significant. However, the reactive obsessional group did not show the interaction effect between distress reduction and the two coping strategies. Conclusions The results suggest that coping strategies have differential effects on distress reduction of obsessional subtypes. Different therapeutic approaches may need to be offered to individuals with autogenous and reactive obsessions.
European Psychiatry, 33 : S201
- Year: 2016
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions (any)
, Exposure therapy, Exposure and response prevention, Other Psychological Interventions
Moritz, S., Stepulovs, O., Schroder, J., Hottenrott, B., Meyer, B., Hauschildt, M.
Self-help resources are frequently sought out by individuals with obsessive-compulsive disorder (OCD); however their efficacy has rarely been evaluated in randomized controlled trials, despite frequently bold claims for their efficacy. In the present study, we examined if a metacognitive self-help manual called myMCT (for "my Metacognitive Training"), which encompasses exercises from cognitive-behavioral therapy (CBT) and its "third wave", is superior to a wait-list control group in reducing OCD symptoms. Further, we examined whether an individually adapted version of the manual suited to personal problems would yield larger effects than the full manual. Methods: A total of 89 individuals with OCD symptoms participated in the online study. Participants were randomly assigned to three conditions; patients either received the full myMCT manual (sent via email attachment), an individually adapted myMCT version, or were allocated to a wait-list control group. Before randomization (pre-assessment) and six weeks later (post-assessment), individuals were asked to fill out several questionnaires tapping obsessive-compulsive and depressive symptoms. Results: Individuals in the two myMCT conditions improved significantly more on the Yale-Brown Obsessive Compulsive Scale and Obsessive-Compulsive Inventory-Revised total scores than the wait-list control group (between-group comparison), with a medium to large effect size. Subsidiary analyses showed that improvements were particularly pronounced for obsessions, while effects on compulsions were mainly small and insignificant. Contrary to our expectation, the adapted version did not lead to better outcomes than the full version. Discussion: The present study supports the feasibility of a bibliotherapeutic metacognitive approach for the treatment of obsessive thoughts. While results confirm prior reports that metacognitive training is effective in OCD, results are limited by a rather high non-completion rate. Further studies should investigate the long-term effectiveness of the approach and its utility in the framework of guided self-help or face-to-face treatment. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Journal of Obsessive-Compulsive and Related Disorders, 9 : 107-115
- Year: 2016
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Self-help
Elbeh, K. A., Elserogy, Y. M., Khalifa, H. E., Ahmed, M. A., Hafez, M. H., Khedr, E. M.
Repetitive transcranial magnetic stimulation (rTMS) has become widely used as a therapeutic tool in psychiatric research. The aim of this study was to evaluate the impact of different frequencies of rTMS over right dorsolateral prefrontal cortex (DLPFC) in OCD. Forty five patients with OCD participated in the study. Patients were evaluated using: Yale-Brown obsessive compulsive scale (Y-BOCS), Hamilton Anxiety Rating Scale (HAM-A), and Clinical Global Impression-Severity scale (CGI-S). They were randomly classified into three groups: 1st group received 1 Hz rTMS; 2nd group received 10Hz rTMS; and 3rd group received sham stimulation all at 100% of the resting motor threshold for 10 sessions. They were followed up after the last treatment session and 3 months later. There was a significant "time" x "group" interaction for 1Hz versus Sham but not for 10Hz versus Sham. 1Hz versus 10Hz groups showed a significant interaction for Y-BOCS and HAM-A (P = 0.001 and 0.0001 respectively). 1Hz rTMS has a greater clinical benefit than 10Hz or Sham. There was also a significantly larger percentage change in GCI-S in the 1Hz group versus either 10Hz or sham. We conclude that 1Hz-rTMS, targeting right DLPFC is a promising tool for treatment of OCD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Psychiatry Research, 238 : 264-269
- Year: 2016
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Transcranial magnetic stimulation (TMS)
Black, M. J., Grisham, J. R.
Pathological doubting and checking is a common symptom presentation in obsessive-compulsive disorder (OCD). Previous research has established that compulsive checkers do not display an actual memory deficit, but lack confidence in their memories and experience intolerance of uncertainty regarding the completion of tasks. We investigated whether interpretive cognitive bias modification (CBM-I) reduced memory distrust and intolerance of uncertainty in a nonclinical sample. We also examined the possible enhancement of CBM-I for OCD through imagery training. The results provide evidence that participants who received positive imagery CBM-I training may have interpreted novel ambiguous checking scenarios more adaptively and endorsed negative checking beliefs less relative to participants in the control imagery CBM-I condition. Findings on behavioural checking tasks did not indicate any specific response to CBM-I training. Future research may translate these suggestive findings into a useful adjunct to traditional strategies targeting maladaptive OCD beliefs. Copyright © 2016 Elsevier Ltd.
Behaviour Research and Therapy, 83 : 45-52
- Year: 2016
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Attention/cognitive bias modification
Bloch, M. H., Storch, E. A.
Objective: To review the assessment and treatment of treatment-refractory pediatric obsessive-compulsive disorder (OCD). Method: A PubMed search was conducted to identify controlled trials in pediatric OCD. In addition, practice guidelines for the treatment of adults and children were further reviewed for references in treatment-refractory OCD across the lifespan. Results: Pharmacotherapy with selective serotonin reuptake inhibitors (SSRIs) and cognitive-behavioral therapy (CBT) were found to be effective treatments for pediatric OCD. Evidence suggests that CBT is also effective even in pediatric patients with refractory OCD symptoms. Antipsychotic augmentation, raising SSRI dosage, and several glutamate-modulating agents have some evidence of efficacy in adults with treatment-refractory OCD but have not been studied in pediatric populations. Conclusion: Several pharmacological treatment options exist for children with refractory OCD symptoms. However, little evidence-based data exist to guide treatment for our most challenging pediatric OCD patients. Further research is needed to evaluate the efficacy/side effect profile of commonly used interventions in treatment-refractory pediatric OCD. (PsycINFO Database Record (c) 2015 APA, all rights reserved) (journal abstract).
Journal of the American Academy of Child & Adolescent Psychiatry, 54(4) : 251-262
- Year: 2015
- Problem: Obsessive Compulsive Disorder
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
, Treatment resistant/treatment refractory
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Franklin, M. E., Kratz, H. E., Freeman, J. B., Ivarsson, T., Heyman, I., Sookman, D., McKay, D., Storch, E. A., March, J.
The efficacy of cognitive-behavioral therapy (CBT) for pediatric obsessive-compulsive disorder (OCD) has been the subject of much study over the past fifteen years. Building on a foundation of case studies and open clinical trials, the literature now contains many methodologically sound studies that have compared full CBT protocols to waitlist controls, pill placebo, psychosocial comparison conditions, active medication, combined treatments, and brief CBT. This review is part of a series commissioned by The Canadian Institute for Obsessive Compulsive Disorders (CIOCD) in an effort to publish in one place what is known about the efficacy of treatments for OCD. A total of fourteen studies were identified; collectively their findings support the efficacy of CBT for youth with OCD. CBT protocols that emphasized either strictly behavioral or cognitive conceptualizations have each been found efficacious relative to waitlist controls. Efforts to enhance CBT׳s efficacy and reach have been undertaken. These trials provide guidance regarding next steps to be taken to maximize efficacy and treatment availability. Findings from studies in community clinics suggest that significant treatment benefits can be realized and are not reported only from within academic contexts. These findings bode well for broader dissemination efforts. Recommendations for future research directions are provided.; Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Psychiatry Research, 227(1) : 78-92
- Year: 2015
- Problem: Obsessive Compulsive Disorder
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Murphy, T. K., Parker-Athill, E. C., Lewin, A. B., Storch, E. A., Mutch, P. J.
Objective: Previous studies suggest that the unexplained sudden and severe onset of obsessive-compulsive disorder (OCD) and/or tics may be infection or immune precipitated. Beta lactam antibiotics may be neuroprotective beyond their antimicrobial efficacy. We examine the preliminary safety and efficacy of cefdinir in reducing obsessive-compulsive and/or tic severity in children with new-onset symptoms.; Method: Twenty subjects were randomized to receive placebo or cefdinir for 30 days for the treatment of recent-onset OCD and/or tics. The placebo group received a comparable inactive treatment matched for taste, color, and consistency. The Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) and Yale Global Tic Severity Scale (YGTSS) were the primary outcome measures utilized.; Results: Subjects receiving cefdinir saw notable improvements in tic symptoms, with 44.4% showing at least a 25% reduction in YGTSS (mean decrease=9.5) scores compared with 9.1% of the placebo group (mean decrease=0.13). Despite improvements, significant group differences were not observed for YGTSS (F [1, 13]=4.03, p=0.066) although there were moderate differences between group treatment effects (d=0.72). For OCD symptoms, subjects receiving cefdinir saw improvements in OCD symptoms, with 33.3% showing at least a 25% reduction in CY-BOCS scores (mean decrease=7.8) compared with 27.3% of the placebo group (mean decrease=4.7), but there were also no significant differences for CY-BOCS (F [1, 13]=0.385, p=0.546; d=0.24).; Conclusions: Subjects assigned to cefdinir exhibited notable, albeit nonstatistically significant, improvements in tic symptoms, compared with the placebo group. There were also some improvements in OCD symptoms, although these were not significant. Overall, cefdinir was well tolerated. Given these preliminary results, a fully powered study is warranted to explore the efficacy of cefdinir as a therapeutic tool for new-onset pediatric neuropsychiatric symptoms, particularly those that appear to be precipitated by infection.;
Journal of Child & Adolescent Psychopharmacology, 25(1) : 57-64
- Year: 2015
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Other biological interventions
McGuire, J. F., Piacentini, J., Lewin, A. B., Brennan, E. A., Murphy, T. K., Storch, E.A.
Background: Individual randomized controlled trials (RCTs) have demonstrated the efficacy of cognitive behavioral therapy (CBT) and serotonin reuptake inhibitors (SRIs) for the treatment of youth with obsessive-compulsive disorder (OCD). Although meta-analyses have confirmed these results, there has been minimal examination of treatment moderators or an examination of treatment response and symptom/diagnostic remission for these two treatment types. The present report examined the treatment efficacy, treatment response, and symptom/diagnostic remission for youth with OCD receiving either CBT or SRIs relative to comparison conditions, and examined treatment moderators.; Method: A comprehensive literature search identified 20 RCTs that met inclusion criteria, and produced a sample size of 507 CBT participants and 789 SRI participants.; Results: Random effects meta-analyses of CBT trials found large treatment effects for treatment efficacy (g = 1.21), treatment response (relative risk [RR] = 3.93), and symptom/diagnostic remission (RR = 5.40). Greater co-occurring anxiety disorders, therapeutic contact, and lower treatment attrition were associated with greater CBT effects. The number needed to treat (NNT) was three for treatment response and symptom/diagnostic remission. Random effects meta-analyses of SRI trials found a moderate treatment effect for treatment efficacy (g = 0.50), treatment response (RR = 1.80), and symptom/diagnostic remission (RR = 2.06). Greater methodological quality was associated with a lower treatment response for SRI trials. The NNT was five for treatment response and symptom/diagnostic remission.; Conclusions: Findings demonstrate the treatment effects for CBT and SRIs across three important outcome metrics, and provide evidence for moderators of CBT across trials.; © 2015 Wiley Periodicals, Inc.
Depression & Anxiety, 32(8) : 580-593
- Year: 2015
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs), Tricyclic antidepressants, Antidepressants (any)
, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)