Acceptance and Commitment Therapy, Selective Serotonin Reuptake Inhibitors and Their Combination in the Improvement of Obsessive-Compulsive Symptoms and Experiential Avoidance in Patients With Obsessive-Compulsive Disorder

Abstract

Background:Selective serotonin reuptake inhibitors (SSRIs) and exposure with response prevention for treatment of obsessive-compulsive disorder (OCD) have demonstrated empirical support; however, a substantial number of patients remain with clinically significant OCD symptoms after such treatments. Objectives:The aim of this study was to compare the effectiveness of acceptance and commitment therapy (ACT), selective serotonin reuptake inhibitors (SSRIs) and combination of ACT and SSRIs in the treatment of adults with obsessive-compulsive disorder (OCD).Patients and Methods:Thirty-two outpatients meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria for OCD were randomly assigned to one of the three treatment conditions: ACT, SSRIs and combined treatment. The Yale-Brown Obsessive-Compulsive Scale and Acceptance and Action Questionnaire were administered at pre-treatment and post-treatment. Twenty-seven patients completed the study. Data was analyzed using one-way analysis of variance (ANOVA) and one-way analysis of covariance (ANCOVA), clinically significant change (CSC) and complete remission status.Results:ANCOVA revealed that patients treated with ACT and combined treatment experienced a significantly greater improvement in obsessive-compulsive (OC) symptoms and experiential avoidance (EA) at post-treatment compared to those treated with SSRIs alone. However, there were no significant differences between ACT and combined treatment on OC symptoms and EA. CSC and complete remission status results showed that unlike SSRI, ACT and combined treatment led to more improvement in OC symptoms.Conclusions:ACT and combined treatment are more effective than SSRIs alone in treating OC symptoms and EA. However, it appears that adding SSRIs to ACT does not increase the effectiveness of ACT in the treatment of adults with OCD in the short-term.

Suicidality in a 27-year-old Male with Obsessive Compulsive Disorder

“…ACT works to minimize experiential avoidance which is aversion to situations which may trigger obsessions and changing patients coping strategies thus allowing patients to be more open to experiences. It showed statistically significant improvements in patients in the ACT treatment group with 47.3% reduction in Y-BOCS scores [18].…”

Terapia de Aceptación y Compromiso como Tratamiento de Elección para el TOC: un Estudio de Caso

“…En este sentido, cabe destacar que el tratamiento basado en ACT produjo una reducción significativa de la sintomatología del TOC. Estos resultados se encuentran en consonancia con otros estudios (Dehlin, Morrison, y Twohig, 2013;Gutiérrez-Martínez, Luciano, y Visdómine, 2012;Twohig et al, 2010;Vakili et al, 2015). Asimismo, hay que reseñar la reducción de otros componentes psicopatológicos significativos y comórbidos en BJE, tal y como son el estado de ánimo y sintomatología depresivos, y los niveles de estado y rasgo ansiogénicos, y preocupación patológica.…”

“…Pocos estudios han explorado el efecto de un tratamiento de psicoterapia basado en ACT con farmacoterapia para pacientes con TOC (véase Vakili, Gharaee, y Habibi, 2015). Por ello, este estudio tiene por objetivo analizar los efectos de este tratamiento en la sintomatología psicológica derivada del trastorno, la retirada de la medicación y la orientación a las direcciones valiosas.…”

Mindfulness-based and acceptance-based programmes in the treatment of obsessive–compulsive disorder: a study protocol for a systematic review and meta-analysis

“…In recent years, a growing number of RCTs [33][34][35][36][37][38][39][40] and non-randomised trials (NRTs) 16 25 41-45 on the effectiveness of MABPs for patients diagnosed with OCD have been published. Further RCTs are also expected to be available soon.…”