An update on the efficacy of psychological treatments for obsessive–compulsive disorder in adults

Abstract

We conducted a review to provide an update on the efficacy of psychological treatments for OCD in general and with regard to specific symptom presentations. The PubMed and PsycINFO databases were searched for randomized controlled trials (RCTs) published up to mid February 2012. Forty-five such studies were identified. Exposure and response prevention (ERP) and cognitive-behavioral therapy (CBT) were found to be efficacious and specific for OCD. More purely cognitive interventions that did not include ERP or behavioral experiments were found to be possibly efficacious, as were Acceptance and Commitment Therapy, Motivational Interviewing as an adjunct to the established treatments, Eye Movement Desensitization and Reprocessing, and Satiation Therapy. There was little support for Stress Management or Psychodynamic Therapy. Although the majority of the studies recruited mixed or unspecified samples of patients and did not test for moderation, CBT was efficacious for obsessional patients who lacked overt rituals. One more purely cognitive intervention named Danger Ideation Reduction Therapy was found to be possibly efficacious for patients with contamination obsessions and washing compulsions. Although ERP and CBT are the best established psychological treatments for OCD, further research is needed to help elucidate which treatments are most effective for different OCD presentations.

Cognitive-behavioural therapy for obsessive-compulsive disorder co-occurring with psychosis: Systematic review of evidence

“…According to our experience, pharmachotherapy should be used in patients who either refused or did not respond to CBT and, vice versa , CBT should be tried in patients who did not respond to medication or are at higher risk of psychotic exacerbation. In high resistant patients further potential options could be some somatic treatments ( e.g ., electroconvulsive therapy, repetitive transcranial magnetic stimulation, deep brain stimulation)[50-52] and psychological treatments alternative to CBT ( e.g ., psychodynamic therapy)[53]. Further clinical trials are warranted to accrue evidence on the efficacy of CBT as well as pharmacological treatment and their combination and to provide useful information to define specific guidelines for the treatment of OCS/OCD in schizophrenia.…”

Cognitive-behavioral therapy for body dysmorphic disorder: A systematic review and meta-analysis of randomized controlled trials

“…At present, there is insufficient data to suggest that any particular modality of CBT is superior to another. Like in OCD (Öst et al, 2015;Ponniah et al, 2013), both exposure-based and cognitive interventions may be comparably efficacious for BDD, arguably because these interventions may address the same maintaining factors (e.g., avoidance). Dismantling studies may be helpful to determine, for example, if adding cognitive techniques (such as metacognitive tools; Rabiei et al, 2012) enhances the efficacy of more purely behavioral interventions.…”

Mindfulness-based exposure and response prevention for obsessive compulsive disorder: Findings from a pilot randomised controlled trial

“…Exposure-based therapies are theorised to work through habituation to the obsession (Ponniah, Magiati, & Hollon, 2013) and/or through inhibitory learning, i.e. strengthening competing non-fear memories about the feared object/event (Craske, Treanor, Conway, Zbozinek, & Vervliet, 2014).…”