Efficacy of cognitive-behavioral therapy for obsessive-compulsive disorder

Dean McKay; Debbie Sookman; Fugen Neziroglu; Sabine Wilhelm; Dan J Stein; Michael Kyrios; Keith Matthews; David Veale; Accreditation Task Force of The Canadian Institute for Obsessive Compulsive Disorders

doi:10.1016/j.psychres.2015.02.004

Efficacy of cognitive-behavioral therapy for obsessive-compulsive disorder

Psychiatry Res. 2015 May 30;227(1):104-13. doi: 10.1016/j.psychres.2015.02.004.

Authors

Dean McKay¹, Debbie Sookman², Fugen Neziroglu³, Sabine Wilhelm⁴, Dan J Stein⁵, Michael Kyrios⁶, Keith Matthews⁷, David Veale⁸; Accreditation Task Force of The Canadian Institute for Obsessive Compulsive Disorders

Affiliations

¹ Fordham University, Bronx, NY, USA. Electronic address: mckay@fordham.edu.
² Obsessive Compulsive Disorder Clinic, Department of Psychology, McGill University Health Centre, and Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
³ Biobehavioral Institute, Great Neck, NY, USA.
⁴ Harvard University & Massachusetts General Hospital, Boston, MA, USA.
⁵ University of Cape Town, Cape Town, South Africa.
⁶ University of Melbourne, Melbourne, Australia.
⁷ University of Dundee, Dundee, UK.
⁸ NIHR Specialist Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust, UK; The Institute of Psychiatry, King׳s College London, UK.

PMID: 25937054
DOI: 10.1016/j.psychres.2015.02.004

Abstract

Cognitive-behavioral therapy (CBT), which encompasses exposure with response prevention (ERP) and cognitive therapy (CT), has demonstrated efficacy in the treatment of obsessive-compulsive disorder (OCD). However, the samples studied (reflecting the heterogeneity of OCD), the interventions examined (reflecting the heterogeneity of CBT), and the definitions of treatment response vary considerably across studies. This review examined the meta-analyses conducted on ERP and cognitive therapy (CT) for OCD. Also examined was the available research on long-term outcome associated with ERP and CT. The available research indicates that ERP is the first line evidence based psychotherapeutic treatment for OCD and that concurrent administration of cognitive therapy that targets specific symptom-related difficulties characteristic of OCD may improve tolerance of distress, symptom-related dysfunctional beliefs, adherence to treatment, and reduce drop out. Recommendations are provided for treatment delivery for OCD in general practice and other service delivery settings. The literature suggests that ERP and CT may be delivered in a wide range of clinical settings. Although the data are not extensive, the available research suggests that treatment gains following ERP are durable. Suggestions for future research to refine therapeutic outcome are also considered.

Keywords: Cognitive therapy; Exposure with response prevention; Meta-analysis; Obsessive–compulsive disorder; Treatment adherence.

Publication types

Review

MeSH terms

Cognitive Behavioral Therapy / methods*
Humans
Obsessive-Compulsive Disorder / psychology
Obsessive-Compulsive Disorder / therapy*
Treatment Outcome