Cognitive-behavioral group therapy in obsessive-compulsive disorder: a clinical trial

Abstract

Objective: To develop a cognitive-behavioral group therapy protocol and to verify its efficacy to reduce obsessivecompulsive symptoms.Methods: An open clinical trial with 32 obsessive-compulsive patients was performed, in which a cognitivebehavioral group therapy protocol of 12 weekly sessions of two hours, in 5 consecutive groups, was applied. The severity of symptoms was rated with the Yale-Brown Obsessive-Compulsive (Y-BOCS), Hamilton Anxiety (HAM A) and Hamilton Depression (HAM D) scales. The patients were followed up for 3 months after the end of the treatment. Results: There was a significant reduction in the scores of Y-BOCS, HAM A and HAM D scales with the treatment regardless the use of anti-obsessive medications. The rate of improved patients (decrease of ≥35% in Y-BOCS) was 78.1%. Two patients (6.25%) dropped out from the study. The effect size calculated for the Y-BOCS scale was 1.75. Conclusions: This study suggests that cognitive-behavioral group therapy reduces obsessive-compulsive symptoms. In addition, patients presented good compliance.Obsessive-compulsive disorder. Behavior therapy. Cognitive therapy. Group therapy.Objetivos: Desenvolver um protocolo de terapia cognitivo-comportamental em grupo e verificar sua eficácia em reduzir os sintomas obsessivo-compulsivos. Métodos: Foi realizado um ensaio clínico não controlado com 32 pacientes portadores de transtorno obsessivocompulsivo, com aplicação de um protocolo de terapia cognitivo-comportamental em grupo, de 12 sessões semanais de duas horas, em cinco grupos sucessivos. Os pacientes foram avaliados pela escalas Yale-Brown

A terapia cognitivo-comportamental no transtorno obsessivo-compulsivo

“…63 It is interesting that, for example, the observation that CBT seems to be efficient even in patients who do not respond or partially respond to pharmacological treatment. [64][65][66] A recent study performed with children and adolescents has verified that the combination of CBT and medications presented better results than the use of medications alone. 67 A similar result was found in adult patients.…”

“…Several studies have proved that the efficacy of group CBT in the treatment of OC symptoms 38,65,69 is similar to that of individual ERP 70,71 or to sertraline. 59 Its effects, apparently, remain within the period of at least one year after discharge.…”

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

“…In a case series, switching from an SSRI to the SNRI duloxetine was successful in a number of treatment-resistant patients (Dell'osso et al 2008). Two studies showed the superiority of CBT to a wait list condition (Cordioli et al 2003;Freeston et al 1997). Also, in children and adolescents, ERP was superior to a wait list (Bolton and Perrin 2008).…”

Psychometric properties of the Brazilian Portuguese version of the Obsessive-Compulsive Inventory: Revised (OCI-R)

“…[19][20][21] CBGT consisted of 12 weekly two-hour sessions. The treatment approach emphasizes psycho-education, ERP techniques, cognitive techniques to change dysfunctional thoughts and beliefs, strategies to prevent relapses, and group techniques.…”

“…Details on the manual can be found elsewhere. 20,22 Data were collected between March 2006 and July 2007. The Ethics Committee of the HCPA approved the research protocol (Process: 05/505).…”