Cognitive-behavioral therapy for obsessive–compulsive disorder: A non-randomized comparison of intensive and weekly approaches

Department of Psychiatry, University of Florida, Gainesville, FL 32610, USA.
Journal of Anxiety Disorders (Impact Factor: 2.96). 10/2008; 22(7):1146-58. DOI: 10.1016/j.janxdis.2007.12.001
Source: PubMed


This study examined the relative efficacy of intensive versus weekly cognitive-behavioral therapy (CBT) for adults with obsessive-compulsive disorder (OCD). Sixty-two adults with OCD received either 14 sessions of weekly (n=30) or intensive CBT (n=32; daily psychotherapy sessions) in a non-randomized format. Assessments were conducted at Pre-treatment, Post-treatment, and 3-month Follow-up by raters who were blind to treatment group at the Pre-treatment assessment. Intensive and weekly CBT were similar in efficacy at Post-treatment and Follow-up and associated with large treatment effect sizes. Since many people with OCD do not have access to trained CBT providers, intensive treatment may be a viable option in such cases.

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    • "In this study of 40 patients, intensive and weekly treatments were associated with equivalent decreases in the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS; m ¼15.7 and 15.6, respectively). Similarly, in the largest study of intensive OCD treatment to date, Storch et al. (2008) found that a similar percentage of adults no longer met the criteria for OCD following a 3-week intensive treatment, 40.7%, and weekly treatment, 52.3%. Despite the success of these intensive programs, a three-to fourweek treatment protocol places a considerable burden on families staying away from home. "
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    ABSTRACT: This study extends support for a 5-day intensive exposure and response prevention (ERP) treatment protocol for pediatric obsessive compulsive disorder (OCD). Twenty-two children with OCD received ERP treatment twice daily for 5 days. The treatment also emphasized teaching children and parents how to conduct ERP independently after they returned home. Symptoms were assessed at four time-points: Baseline, 4 weeks later at pre-treatment, one week after the intensive treatment 5-day treatment, and at 3 month follow-up. Changes on the primary outcome measure, clinician severity ratings on the Anxiety Disorders Interview Schedule for Children, and secondary measures, indicated that OCD symptoms remained stable from the evaluation to baseline and improved significantly from baseline to follow-up. Moreover, parental accommodation of OCD decreased significantly from baseline to post-treatment and from post-treatment to follow-up. These data suggest that the 5-day intervention demonstrates efficacy in reducing OCD symptoms and may initiate change in parent accommodation that continues to improve after the family returns home.
    Psychiatry Research 07/2014; 220(1-2). DOI:10.1016/j.psychres.2014.07.006 · 2.47 Impact Factor
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    • "These intensive interventions tend to provide many of the same cognitive behavioral skills included in traditional weekly therapies, although they are provided across a highly condensed time. Preliminary evidence generated through the conduct of single case designs and small opentrial evaluations suggests that interventions such as these are promising and are associated with significant reductions in the severity of the anxiety disorder diagnoses targeted in treatment (Deacon & Abramowitz, 2006; Storch, et al., 2007) as well as patient-rated comorbid anxious and depressive symptomatology (e.g., Storch, et al., 2008). More recently, Ollendick and colleagues (2010) investigated the impact of comorbidity on a one session Specific Phobia treatment as well as the impact of the treatment on comorbid disorders. "
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    ABSTRACT: Previous research findings have shown positive effects of cognitive-behavioral therapy for primary anxiety disorders as well as for nonprimary, co-occurring anxiety disorders. In this study, we analyzed data from an existing randomized controlled trial of intensive treatment for panic disorder with or without agoraphobia (PDA) to examine the effects of the treatment on comorbid psychiatric diagnoses. The overall frequency and severity of aggregated comorbid diagnoses decreased in a group of adolescents who received an 8-day treatment for PDA. Results suggest that an 8-day treatment for PDA can alleviate the symptoms of some specific comorbid clinical diagnoses; in particular specific phobias, generalized anxiety disorder, and social phobia. These findings suggest that an intensive treatment for PDA is associated with reductions in comorbid symptoms even though disorders other than PDA are not specific treatment targets.
    Behavior therapy 03/2012; 43(1):153-9. DOI:10.1016/j.beth.2011.05.002 · 2.85 Impact Factor
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    • "An independent evaluator, who was blinded to the treatment conditions of the patients, administered the pre and post treatment Y-BOCS and CGI ratings. Raters were trained to a high degree of reliability (procedures are described elsewhere, e.g., Storch et al., 2008). "
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    ABSTRACT: This research aimed to provide clinicians and investigators with optimal treatment outcome criteria for accurately predicting response and remission in both research studies and clinical practice. Data from 153 adult OCD outpatients (ages 18-79) who had participated in a treatment outcome study were examined. Signal detection analysis was conducted to compare levels of Yale-Brown Obsessive Compulsive Scale (Y-BOCS) symptom percent reductions and post treatment absolute scores with Clinical Global Impression (CGI) ratings of symptom improvement and severity. Optimal cutoff criteria were based on sensitivity, specificity and efficiency and were assessed via the Quality Receiver Operating Characteristic curve. A Y-BOCS reduction of 45% was observed to be the most efficient for predicting response in research trials, whereas a reduction of 35% may be optimal for clinical use. A 55% Y-BOCS reduction was determined to be the optimal cutoff for predicting remission in both clinical and research settings. A Y-BOCS absolute raw score of 12 or less was optimal for predicting remission in a clinical setting and a raw score of 14 or below was most favorable in research trials. This research provides the first empirical contrast of optimal outcome criteria in OCD based on differing ideals of both research and practice.
    Psychiatry Research 02/2011; 185(3):394-401. DOI:10.1016/j.psychres.2010.08.021 · 2.47 Impact Factor
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