Disorders - Obsessive Compulsive Disorder
Schuck, Kathrin, Keijsers, Ger P. J., Rinck, Mike
Thirty-four college students suffering from pathological skin picking were randomly assigned to a four-session cognitive-behavioural treatment (n = 17) or a waiting-list condition (n= 17). Severity of skin picking, psycho-social impact of skin picking, strength of skin-picking-related dysfunctional cognitions, and severity of skin injury were measured at pre-, post-, and two-months follow-up assessment. Participants in the treatment condition showed a significantly larger reduction on all measured variables in comparison to the waiting-list condition. The obtained effect sizes for the outcome measures were large, ranging from .90 to 1.89. Treatment effects were maintained at follow-up. In conclusion, cognitive behavioural therapy, even in brief form, constitutes an adequate treatment option for pathological skin-picking behaviour. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Behaviour Research & Therapy, 49(1) : 11-17
- Year: 2011
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
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Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Storch, Eric A., Caporino, Nicole E., Morgan, Jessica R., Lewin, Adam B., Rojas, Ariz, Brauer, Lindsay, Larson, Michael J., Murphy, Tanya K.
This study reports a waitlist controlled randomized trial of family-based cognitive-behavioral therapy delivered via web-camera (W-CBT) in children and adolescents with obsessive-compulsive disorder (OCD). Thirty-one primarily Caucasian youth with OCD (range=7–16years; 19 male) were randomly assigned to W-CBT or a Waitlist control. Assessments were conducted immediately before and after treatment, and at 3-month follow-up (for W-CBT arm only). Primary outcomes included the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), clinical global improvement rates, and remission status. When controlling for baseline group differences, W-CBT was superior to the Waitlist control on all primary outcome measures with large effect sizes (Cohen's d ≥1.36). Thirteen of 16 youth (81%) in the W-CBT arm were treatment responders, versus only 2/15 (13%) youth in the Waitlist arm. Similarly, 9/16 (56%) individuals in the W-CBT group met remission criteria, versus 2/15 (13%) individuals in the Waitlist control. Gains were generally maintained in a naturalistic 3-month follow-up for those randomized to W-CBT. This preliminary study suggests that W-CBT may be helpful in reducing obsessive-compulsive symptoms in youth with OCD. Given considerable access issues, such findings hold considerable promise for treatment dissemination. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Psychiatry Research, 189(3) : 407-412
- Year: 2011
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
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Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Piacentini, John, Bergman, R. Lindsey, Chang, Susanna, Langley, Audra, Peris, Tara, Wood, Jeffrey J., McCracken, James
Objective: To examine the efficacy of exposure-based cognitive-behavioral therapy (CBT) plus a structured family intervention (FCBT) versus psychoeducation plus relaxation training (PRT) for reducing symptom severity, functional impairment, and family accommodation in youths with obsessive-compulsive disorder (OCD). Method: A total of 71 youngsters 8 to 17 years of age (mean 12.2 years; range, 8–17 years, 37% male, 78% Caucasian) with primary OCD were randomized (70:30) to 12 sessions over 14 weeks of FCBT or PRT. Blind raters assessed outcomes with responders followed for 6 months to assess treatment durability. Results: FCBT led to significantly higher response rates than PRT in ITT (57.1% vs 27.3%) and completer analyses (68.3% vs. 35.3%). Using HLM, FCBT was associated with significantly greater change in OCD severity and child-reported functional impairment than PRT and marginally greater change in parent-reported accommodation of symptoms. These findings were confirmed in some, but not all, secondary analyses. Clinical remission rates were 42.5% for FCBT versus 17.6% for PRT. Reduction in family accommodation temporally preceded improvement in OCD for both groups and child functional status for FCBT only. Treatment gains were maintained at 6 months. Conclusions: FCBT is effective for reducing OCD severity and impairment. Importantly, treatment also reduced parent-reported involvement in symptoms with reduced accommodation preceding reduced symptom severity and functional impairment. (PsycINFO Database Record (c) 2012 APA, all rights reserved) (journal abstract)
Journal of the American Academy of Child & Adolescent Psychiatry, 50(11) : 1149-1161
- Year: 2011
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
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Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Family therapy, Psychoeducation, Relaxation
Storch, E. A., Murphy, T. K., Goodman, W. K., Geffken, G. R., Lewin, A. B., Henin, A., Micco, J. A., Sprich, S., Wilhelm, S., Bengtson, M., Geller, D. A.
Background Research on the neural circuitry underlying fear extinction has led to the examination of D-cycloserine (DCS), a partial agonist at the N-methyl-D-aspartate receptor in the amygdala, as a method to enhance exposure therapy outcome. Preliminary results have supported the use of DCS to augment exposure therapy in adult anxiety disorders; however, no data have been reported in any childhood anxiety disorder. Thus, we sought to preliminarily examine whether weight-adjusted DCS doses (25 or 50 mg) enhanced the overall efficacy of cognitive-behavioral therapy (CBT) for pediatric obsessive-compulsive disorder (OCD). Method Participants were 30 youth (aged 817) with a primary diagnosis of OCD. The study design was a randomized, double-blinded, placebo-controlled augmentation trial examining CBT + DCS versus CBT + Placebo (15 youth per group). All patients received seven exposure and response prevention sessions paired with DCS or placebo taken 1 hour before sessions. Results Although not significantly different, compared with the CBT + Placebo group, youth in the CBT + DCS arm showed small-to-moderate treatment effects (d = .31.47 on primary outcomes). No adverse events were recorded. Conclusions These results complement findings in adult OCD and non-OCD anxiety disorders and provide initial support for a more extensive study of DCS augmentation of CBT among youth with OCD. (copyright) 2010 Society of Biological Psychiatry.
Biological Psychiatry, 68(11) : 1073-1076
- Year: 2010
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
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Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Biological Interventions (any)
, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, D-cycloserine (DCS)
Williams, T. I., Salkovskis, P. M., Forrester, L., Turner, S., White, H., Allsopp, M. A.
Cognitive behaviour therapy (CBT) for young people with obsessive compulsive disorder (OCD) has become the treatment of first choice. However, the literature is largely based on studies emphasising exposure and response prevention. In this study, we report on a randomised controlled trial of CBT for young people carried out in typical outpatient clinic conditions which focused on cognitions. A randomised controlled trial compares 10 sessions of manualised cognitive behavioural treatment with a 12-week waiting list for adolescents and children with OCD. Assessors were blind to treatment allocation. 21 consecutive patients with OCD aged between 9 and 18 years were recruited. The group who received treatment improved more than a comparison group who waited for 3 months. The second group was treated subsequently using the same protocol and made similar gains. In conclusion, CBT can be delivered effectively to young people with OCD in typical outpatient settings. (copyright) 2009 Springer-Verlag.
European Child & Adolescent Psychiatry, 19(5) : 449-456
- Year: 2010
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Merlo, L. J., Storch, E. A., Lehmkuhl, H. D., Jacob, M. L., Murphy, T. K., Goodman, W. K., Geffken, G. R.
Lack of motivation may negatively impact cognitive behavioral therapy (CBT) response for pediatric patients with obsessive-compulsive disorder (OCD). Motivational interviewing is a method for interacting with patients in order to decrease their ambivalence and support their self-efficacy in their efforts at behavior change. The authors present a preliminary randomized trial (N = 16) to evaluate the effectiveness of adding motivational interviewing (MI) as an adjunct to CBT. Patients aged 6 to 17 years who were participating in intensive family-based CBT for OCD were randomized to receive either CBT plus MI or CBT plus extra psychoeducation (PE) sessions. After four sessions, the mean Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) score for the CBT plus MI group was significantly lower than for the CBT plus psychoeducation group, t(14) = 2.51, p < .03, Cohen's d = 1.34. In addition, the degree of reduction in CY-BOCS scores was significantly greater, t(14) = 2.14, p = .05, Cohen's d = 1.02, for the CBT plus MI group (mean (Delta) = 16.75, SD = 9.66) than for the CBT plus psychoeducation group (mean (Delta) = 8.13, SD = 6.01). This effect decreased over time, and scores at posttreatment were not significantly different. However, participants in the MI group completed treatment on average three sessions earlier than those in the psychoeducation group, providing support for the utility of MI in facilitating rapid improvement and minimizing the burden of treatment for families. (copyright) 2010 Taylor & Francis.
Cognitive Behaviour Therapy, 39(1) : 24-27
- Year: 2010
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
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Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Motivational interviewing, includes Motivational Enhancing Therapy
Marazziti, D., Consoli, G., Baroni, S., Dell'Osso, M. Catena
In the last decades, the treatment of obsessive-compulsive disorder (OCD) has been revolutioned by the introduction into the clinical practice of the selective serotonin (5-HT) reuptake inhibitors (SSRIs), following the observation of the unique response of OCD patients to clomipramine. However, if with no doubt the 5-HT system is central to the pharmacological treatment of OCD, it is unlikely that it represents the whole story. In fact, different studies suggest abnormalities of other neurotransmitters, neuropeptides or second messengers, so that it can be hypothesized that the possible heterogeneity of pathophysiological mechanisms might underlie the different clinical pictures and responses to treatment. Moreover, latest developments in the pharmacology of SSRIs have shown that they share the common property of 5-HT reuptake blockade, but, with the exception of citalopram and escitalopram, they do interact with other receptors and systems. In this paper, the latest findings on pharmacological treatments of OCD will be reviewed, together with a focus on putative targets for future drugs, such as the glutamate system or second messengers, and the problems related to treating OCD in different ages.
Current Medicinal Chemistry, 17(29) : 3410-3421
- Year: 2010
- Problem: Obsessive Compulsive Disorder
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Biological Interventions (any)
Najmi, S., Amir, N.
In the current study, we evaluated the effectiveness of attention training in individuals with subclinical obsessive-compulsive symptoms. We hypothesized that after completing attention training, participants would be more likely to complete steps in a hierarchy approaching their feared contaminant compared with participants in the control condition. Participants completed a probe detection task by identifying letters replacing one member of a pair of words (neutral or contamination related). We trained attention by building a contingency between the location of the contamination-related word in the active condition and not in the control condition. Participants in the active group showed a significant reduction in attention bias for threat and completed significantly more steps when approaching their feared objects compared with participants in the control group. Our results suggest that attention disengagement training may facilitate approaching feared objects in individuals with obsessive-compulsive symptoms. (copyright) 2010 American Psychological Association.
Journal of Abnormal Psychology, 119(1) : 136-142
- Year: 2010
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
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Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Psychological Interventions (any)
, Attention/cognitive bias modification
Khodarahimi, S.
The purpose of present study was to test the comparative effectiveness of Satiation Therapy and Exposure Response Prevention techniques in the treatment of obsessive-compulsive disordered patients. Sixty self-referred male outpatient cases were investigated within a randomized controlled trial. Patients were allocated to Satiation Therapy, Exposure Response Prevention or wait-list control groups. Obsessive-compulsive symptoms were measured by the Yale-Brown Obsessive Compulsive Scale at baseline, post-treatment, and 3 and 6 month follow-ups. The therapeutic groups had more significant improvement than the control group. In addition, there was not a significant difference between therapeutic groups on post-treatment and follow-up assessments which showed that Satiation Therapy and Exposure Response Prevention were similarly effective in reducing obsessive-compulsive symptoms. Analyses revealed that therapeutic groups had improved significantly while the control group had continued unchanged. Finally, the present investigation supported both Satiation Therapy and Exposure Response Prevention in the treatment of obsessive-compulsive disorder. (copyright) 2009 Springer Science+Business Media, LLC.
Journal of Contemporary Psychotherapy, 39(3) : 203-207
- Year: 2009
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Exposure therapy, Exposure and response prevention, Other Psychological Interventions
O'Leary, E. M. M., Barrett, P., Fjermestad, K. W.
This study evaluated the long-term durability of individual and group cognitive-behavioral family-based therapy (CBFT) for childhood obsessive-compulsive disorder (OCD). Thirty-eight participants (age 13-24 years) from a randomized controlled trial of individual or group CBFT for childhood OCD were assessed 7 years post-treatment. Diagnostic, symptom severity interviews and self-report measures of OCD, anxiety, and depression were administered. Seven years after treatment, 79% of participants from individual therapy and 95% from group therapy had no diagnosis of OCD. These results are near identical to results found at 12 and 18 months follow-ups of the same sample. No significant differences were found between treatment conditions, self-reports of symptom severity, except that depressive symptoms were significantly more pronounced for individual treatment condition, and those in the older age group (19-24 years of age). Results suggest that CBFT for obsessive-compulsive disorder is effective 7 years post-treatment. (copyright) 2009 Elsevier Ltd. All rights reserved.
Journal of Anxiety Disorders, 23(7) : 973-978
- Year: 2009
- Problem: Obsessive Compulsive Disorder
- Type: Controlled clinical trials
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Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
Kaiser, B., Bouvard, M.
The empirical literature on treatment of obsessive-compulsive disorder (OCD) in children and adolescents supports the efficacy of OCD-specific cognitive-behavioural therapy (CBT) or pharmacotherapy with selective serotonin reuptake inhibitors (SSRI). However, little is known about their combined efficacy in this type of population. The objective of this article was to review the whole of work referring to the implementation of therapeutic protocols associating CBT and medication. It revealed that treatments with the combination of CBT plus a SSRI seem to be at least as effective as the CBT alone with children and adolescents suffering from OCD, and that these two methods of treatment would be at the origin of a reduction in the severity of OCD, in spite of the presence of comorbidities considered as factors of bad treatment prognosis. In addition, the combination between CBT and atypical antipsychotics could constitute a promising approach for the treatment of OCD. Future research will have to confirm these preliminary results coming from too few studies, often not controlled, or simple case studies. (copyright) 2009 Giovanni Fioriti Editore s.r.l.
Clinical Neuropsychiatry, 6(2) : 94-100
- Year: 2009
- Problem: Obsessive Compulsive Disorder
- Type: Systematic reviews
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Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Biological Interventions (any)
, Psychological Interventions (any)
Alaghband-Rad, J., Hakimshooshtary, M.
Objective: Several controlled trials have demonstrated the efficacy and safety of Fluoxetine in children and adolescents with Obsessive-Compulsive Disorder (OCD), but there is no controlled study on the effectiveness of Citalopram in this group. This report describes the use of Citalopram in comparison with Fluoxetine in childhood-onset OCD. Method: This study is a randomized, double blind, fixed-does (20mg) trial of Fluoxetine versus Citalopram in 29 children and adolescents (17 boys and 12 girls) with OCD, aged 7-18 years (mean 13.8 and SD 3.05). The length of study was 6 weeks. Obsessive-Compulsive symptom severity was measured by Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) and Clinician's Global Impression Scale (CGI). DICA (Diagnostic Interview of Children and Adolescents) was used to diagnose the psychiatric disorders. Results: Each group showed significant improvement over the baseline as measured by the CY-BOCS (p < 0.01) but not by CGI (p = NS). The Comparison between two groups showed no significant differences in efficacy and safety of the drugs. Most common adverse effects were headache for Citalopram and tremor for Fluoxetine. Conclusion: The results suggest that Citalopram is as safe and effective as Fluoxetine for children and adolescents with OCD. Further studies are needed to replicate our findings. (copyright) 2009 Steinkopff Verlag Darmstadt.
European Child & Adolescent Psychiatry, 18(3) : 131-135
- Year: 2009
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions (any)
, Selective serotonin reuptake inhibitors (SSRIs)