Cognitive behavioral therapy in pharmacoresistant obsessive-compulsive disorder

Abstract

Background

The aim of the study was to determine whether patients with OCD resistant to drugs may improve using intensive, systematic CBT lasting six weeks and whether it is possible to predict the therapeutic effect using demographic, clinical and psychological characteristics at baseline.

Method

There were 66 patients included in the study. Fifty-seven patients completed the program. The diagnosis was confirmed by a structured interview MINI. Patient were rated before the treatment using Y-BOCS (objective and subjective form), CGI (objective and subjective form), BAI, BDI, DES (Dissociative Experiences Scale), SDQ 20 (Somatoform Dissociation Questionnaire), and SDS (Sheehan Disability Scale), and at the end of the treatment using subjective Y-BOCS, objective and subjective CGI, BAI, and BDI. Patients were treated with antidepressants and daily intensive group cognitive behavioral therapy for the period of six weeks.

Results

During the 6-week intensive cognitive behavioral therapy program in combination with pharmacotherapy, there was a significant improvement in patients suffering from OCD formerly resistant to pharmacotherapy. There were statistically significant decreases in the scales assessing the severity of OCD symptoms, anxiety, and depressive feelings. The lower treatment effect was achieved specifically in patients who:

– showed fewer OCD themes in symptomatology;

– showed a higher level of somatoform dissociation;

– with poor insight;

– with a higher level of overall severity of the disorder in the beginning.

The remission of the disorder was achieved more probably in patients with:

– good insight;

– the lower level of initial anxiety;

– without comorbidity with the depressive disorder.

Disclosure of interest

The authors have not supplied their declaration of competing interest.