Behavior therapy and tricyclic medication in the treatment of obsessive-compulsive disorder: A quantitative review.

Abstract

A meta-analysis was used to integrate the research literature on the treatment of obsessive-compulsive disorder. Antidepressants, such as clomipramine, and behavior therapy have produced appreciable changes in obsessive-compulsive and depressive symptoms. Patients with obsessions who did not suffer from compulsions have responded less to treatment. No follow-up data have been available for clomipramine, but the benefits of behavior therapy have been shown to be stable at follow-up. Ratings of improvement by assessors have been higher than ratings made by patients. The effects of tricyclic medication and exposure therapies have not significantly differed, but both have proven significantly superior to nonspecific treatment programs. There is a need for a large, randomized comparison of clomipramine and exposure that includes adequate follow-up of subjects after treatment has concluded.

Obsessive-Compulsive Symptom Dimensions as Predictors of Compliance with and Response to Behaviour Therapy: Results from a Controlled Trial

“…Instead, in our study higher scores on the ‘sexual/religious’ dimension, corresponding to the classic ‘pure obsessions’ [1], predicted poorer outcome with ERP. This accords with previous anecdotal reports and studies suggesting that pure obsessions might respond less well to ERP [17, 18]. The presence of sexual obsessions has also been related to poorer outcome with clomipramine [18, 35].…”

“…However, there is little empirical evidence to support these assumptions. In a meta-analysis, patients with primary obsessive thoughts without rituals tended to improve less with BT than those who had overt, motor rituals [17]. Similarly, a recent longitudinal study examining the long-term outcome of 66 patients treated with SRIs and BT found that having obsessions of sexual or religious content predicted poorer long-term outcome [18], although because most patients had both treatments, it was not clear from this study whether these symptoms predicted poorer outcome with SRIs, BT or both.…”

No Talking, Just Writing! Efficacy of an Internet-Based Cognitive Behavioral Therapy with Exposure and Response Prevention in Obsessive Compulsive Disorder

“…This corresponds with the findings of other authors [60,61]. A self-help program by Moritz et al [62] aimed specifically at reducing the obsessive thoughts and yielded good results.…”

Religious Psychotherapy in Depressive Patients

“…Their peers and families fully support this form of therapy as it coincides with their value system and most of them helped the patient by further encouraging praying and other religious rites that were psychologically beneficial for the patient. Cognitive behavior therapy is now reported to be superior to oth er forms of psychotherapy in a lot of neurotic conditions [8][9][10][11] and we believe the focus of this therapy to be a variant of cognitive thera py, hence more effective.…”