Disorders - Obsessive Compulsive Disorder
Shelemy, L., Harvey, K., Waite, P.
A large proportion
of emotional problems begin in adolescence and negatively impact quality of life into adulthood. There have been multiple teacher-delivered,
classroom-based programs created to reduce internalizing problems amongst young people. This meta-analysis and systematic review aims to examine the
effectiveness of teacher-delivered interventions for depression, anxiety, post-traumatic stress disorder (PTSD) and obsessive-compulsive disorder
(OCD) symptoms in adolescents, and a range of factors that may impact outcomes. Database searches were conducted from PsycInfo, Medline (PubMed),
Scopus, Cochrane Library and the British Educational Index (database inception to January 2020). Quality assessment of studies used the EPHPP Quality
Assessment Tool. Fifty-two studies were identified that quantitatively assessed, via controlled design, intervention effects on internalizing
disorder symptoms. Three meta-analyses found teacher-delivered interventions were significantly better than control conditions at improving
depression (g = -0.12), anxiety (g = -0.13) and PTSD symptoms (g = -0.66) in students. Improvements were only maintained at follow-up for anxiety
symptoms and no effect sizes reached a 'small' threshold. However, the effect sizes were 'moderate' within the context of universal prevention
programs for young people. No interventions measured OCD outcomes. Improved outcomes were associated with interventions that lasted up to 16 weeks,
had 45-90 minute long sessions and included two or more days of teacher training. Future studies should report number of sessions taught, quality of
teacher training and fidelity of intervention. Analysis of outcomes for participants with high versus low baseline mental health scores would enable
a better understanding of for whom interventions are most effective. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
Mental Health and Prevention Vol 19 2020, ArtID 200182, 19 :
- Year: 2020
- Problem: Anxiety Disorders (any), Obsessive Compulsive Disorder, Post Traumatic Stress Disorder, Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Skills training, Mindfulness based
therapy
Nasiry, S., Ameli, Z., Pezeshki, P.
Objective: Numerous children with Obsessive-Compulsive Disorder (OCD) either have no access to its main treatment,
i.e. Cognitive Behavioral Therapy (CBT), or fail to respond to it. Cognitive Bias Modification of Interpretation (CBMI) is a novel and promising
intervention that targets the incorrect interpretation of intrusive thoughts and impulses, i.e. the characteristics of OCD. The present study aimed
to determine the effects of CBMI in children with OCD for the first time. Besides, we evaluated the possibility of online implementation of this
intervention. Methods: A sample of 35 children with OCD (aged 7-12 years) were randomly assigned to two study groups. The experimental group (n = 18)
received CBMI and the controls (n = 17) received placebo treatment. Interpretation bias and OCD severity were assessed at pre-test, post-test, and 2
-month follow-up stages, using the Obsessive Compulsive Inventory-Child Version (OCICV), Obsessive Beliefs Questionnaire-Child Version (OBQCV), and
Ambiguous Scenarios Task (AST). The present study results were analyzed using two-way repeated-measures Analysis of Variance (ANOVA) and Paired
Samples t-test. Results: The collected findings demonstrated that after receiving CBMI, children's propensity to positively interpret ambiguous
situations was increased, their tendency towards negative interpretation and OCD severity was also decreased. There was no such significant change in
the control group. Furthermore, the effects of CBMI was sustained at the 2-month follow-up step. Conclusion: This study provided preliminary evidence
that suggests CBMI is capable of modifying interpretation bias in children with OCD, can reduce the severity of their disorder, and works as an
online intervention. This brief and inexpensive intervention could be considered as an auxiliary or standalone treatment for OCD in children.
(PsycInfo Database Record (c) 2021 APA, all rights reserved)
Journal of Practice in Clinical Psychology, 8(4) : 325-
334
- Year: 2020
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Attention/cognitive bias
modification, Technology, interventions delivered using technology (e.g. online, SMS)
Lenhard, F., Andersson, E., Mataix-Cols, D., Ruck, C., Aspvall, K., Serlachius,
E.
Cognitive behavior therapy (CBT) is the recommended first-line
intervention for children and adolescents with obsessive-compulsive disorder (OCD), but is not broadly accessible. Internet-delivered CBT (ICBT) with
minimal therapist support is efficacious and cost-effective, at least in the short term. Whether the therapeutic gains of ICBT for OCD are sustained
in the long run is unknown. In this study, 61 adolescents with OCD who participated in a randomized trial of ICBT were followed-up 3 and 12 months
after treatment. The proportion of treatment responders and remitters remained stable from post-treatment to 3-month follow-up and increased
significantly from 3-month to 12-month follow-up. This study suggests that the gains of ICBT for youth with OCD are not only maintained long-term,
but that further improvements continue to occur during follow-up. Copyright © 2020, The Author(s).
npj Digital
Medicine, 3(1) :
- Year: 2020
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Technology, interventions delivered using technology (e.g. online, SMS)
Kemp, J., Barker, D., Benito, K., Herren, J., Freeman, J.
This brief report examines the evidence for moderators of psychosocial
treatment for youth with obsessive-compulsive disorder (OCD). Understanding treatment moderators can help clinicians select the most appropriate
intervention for a particular patient and consequently increase the likelihood of initial response. A systematic search of the literature was
conducted to identify randomized trials and meta-analyses reporting on moderators of psychosocial treatment for pediatric OCD. All studies included a
comparison of cognitive-behavioral therapy (CBT) to active or control conditions. Few studies have evaluated moderators of psychosocial treatment for
youth with OCD, and among those studies, few variables have demonstrated a differential effect on treatment response. Moderator analyses require
large samples to garner the statistical power necessary to adequately evaluate differential responding in subgroups, and unfortunately, most reports
of moderators in this review are post-hoc investigations of datasets from trials with relatively small sample sizes. Given the overwhelming number of
CBT treatment variants and potential moderators, it would be impossible to conduct all the necessary head-to-head trials with sufficient sample sizes
to develop helpful clinical guidelines. The best option for advancing the moderator literature is to utilize advanced statistical approaches for
pooling existing data sets. Recommendations for leveraging emerging techniques in individual participant data meta-analysis (IPD-MA) are briefly
discussed.
Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent
Psychology, American Psychological Association, Division 53, : 1-8
- Year: 2020
- Problem: Obsessive Compulsive Disorder
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Inozu, M., Celikcan, U., Akin, B., Cicek, N. M.
Background and objectives: Virtual reality (VR) has become a new
tool in psychological research and application. Although several studies have investigated its triggering and reducing role in anxiety via VR-based
exposure and response prevention (VR-ERP) across different psychopathologies, its efficiency in contamination fear and reduction of disgust are yet
to be examined. The study contributes to the field by investigating the effectiveness of the VR-ERP on the reduction of anxiety, disgust and urge to
wash levels using an experimental design. Methods: A total of 21 non-clinical participants with high contamination fear were randomly assigned to
experimental (n = 9) and control (n = 12) groups. The experimental group was exposed to repeated VR-ERP sessions. Results: After a minimum of three
VR-ERP sessions, the experimental group scored significantly lower than the control group on the anxiety, disgust, and urge to wash hands scores.
Limitations: A small sample size, an analogue sample, and a generic virtual scenario content were potential limitations of the study. Conclusions:
The results indicated that the VR-ERP can be an efficient and alternative exposure tool in the reduction of anxiety, disgust, and urge to wash hands.
The theoretical and clinical applications of the VR-ERP in the treatment of contamination-based OCD symptoms were discussed in light of our
findings.
Journal of Obsessive-Compulsive and Related Disorders, 25 : ArtID
100518
- Year: 2020
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Exposure therapy, Exposure
and response prevention, Technology, interventions delivered using technology (e.g. online, SMS)
Cerea, S., Ghisi, M., Bottesi, G., Carraro, E., Broggio, D., Doron, G.
Background: Relationship Obsessive Compulsive Disorder (ROCD) is a
presentation of OCD centering on interpersonal relationships. The aim of this Randomized Control Trial (RCT) was to assess the efficacy of short,
game like, daily cognitive interventions delivered via mobile application in reducing subclinical ROCD symptoms and associated phenomena. Method(s):
Fifty university students identified as having subclinical levels of ROCD symptoms (using the Structured Clinical Interview for DSM-5 Clinical
Version) were randomized into: immediate-use group (iApp group; n = 25) and delayed-use group (dApp group; n = 25). The iApp group started using the
evaluated cognitive-behavioral training application at baseline for 15 days (T0 to T1). The dApp group commenced using the application at T1 for 15
days (T1 to T2). All participants completed questionnaires at baseline (T0), 15 days from baseline (T1), and 30 days from baseline (T2). Result(s):
Repeated measure MANOVAs showed significant Group (iApp vs. dApp) x Time (T0 vs. T1) interactions. These interactions indicated greater decrease in
ROCD symptoms, OCD beliefs and social anxiety symptoms, as well as a greater increase in self-esteem in the iApp group compared to dApp group at T1.
Moreover, the Reliable Change Index (RCI) indicated reliable change on ROCD symptoms for a significant portion of participants (42-52%). Limitation
(s): Sample size and the use of self-report measures limits the generalizability of the results. Conclusion(s): Short, daily cognitive training
interventions delivered via mobile applications may be useful in reducing subclinical ROCD symptoms and associated features. Further testing is
needed for clinical populations. Copyright © 2020 Elsevier B.V.
, 276 : 775-787
- Year: 2020
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive remediation
therapy, Technology, interventions delivered using technology (e.g. online, SMS)
Melin, K., Skarphedinsson, G., Thomsen, P. H., Weidle, B., Torp, N. C., Valderhaug, R., etal.
Objective: This study evaluated the long-term outcomes of a stepped care treatment for
pediatric obsessive-compulsive disorder (OCD) and investigated whether response to first-step cognitive-behavioral therapy (CBT) is an important
indicator of 3-year outcomes. Method(s): This study is a part of the Nordic Long-term OCD Treatment Study (NordLOTS), in which 269 children and
adolescents were treated with CBT. Nonresponders to CBT were randomized to extended treatment with continued CBT or pharmacotherapy with sertraline.
Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) scores no higher than 15 and no higher than 10 were defined as treatment response and
remission, respectively. Participants were assessed 2 and 3 years after first-step CBT. Linear mixed-effects models were used to analyze the
outcomes. Result(s): Intent-to-treat analyses showed a significant decrease in CY-BOCS total score from baseline (24.6) to 3-year follow-up (5.0; p =
.001), with a mean decrease of 5.9 from after treatment to 3-year follow-up. Three years after treatment, 90% (n = 242) of participants were rated as
responders and 73% were in clinical remission. The duration of treatment did not influence the symptom level at 3-year follow-up (p = .998) and no
significant difference was found (p = .169) between the extended treatment conditions. Conclusion(s): The results suggest that evidence-based
treatment for pediatric OCD has long-term positive effects, whether a first step of manual-based CBT or extended treatment with CBT or sertraline.
The improvements were maintained, and the symptoms decreased further during follow-up and were, after 3 years, similarly independent of treatment
duration and form of extended treatment. Clinical trial registration information: Nordic Long-term Obsessive-Compulsive Disorder (OCD) Treatment
Study; www.controlled-trials.com; ISRCTN66385119. Copyright © 2019 American Academy of Child and Adolescent Psychiatry
Journal of the American Academy of Child and Adolescent Psychiatry., 58(2) : 244-
253
- Year: 2019
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: Treatment resistant/treatment refractory
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Sun, M., Rith-Najarian, L. R., Williamson, T. J., Chorpita, B. F.
Our aim was to investigate whether
four treatment features (i.e., the inclusion of parental involvement, goal-setting strategies, maintenance/relapse prevention sessions, the addition
of booster sessions) were associated with posttreatment and follow-up effect size of youth cognitive behavioral therapies (yCBTs) for anxiety,
depression, posttraumatic stress disorder, and obsessive-compulsive disorder in age groups spanning young children to adolescents. We conducted a
random-effects meta-analysis of 106 yCBTs tested in 76 randomized clinical trials from the PracticeWise Database to examine average effects of yCBTs
posttreatment and at a later follow-up assessment. We coded the use of parental involvement, goal setting, booster sessions, and maintenance/relapse
prevention in each yCBT and conducted random-effects meta-regression analyses to investigate whether these treatment features were associated with
yCBT effects at posttreatment as well as at follow-up. Overall, yCBTs produced large pre- to posttreatment effects (d = 1.05), 95% confidence
interval [0.94, 1.15], and larger pre- to follow-up effects (d = 1.29), 95% confidence interval [1.18, 1.40]. Metaregression results indicated that
parental involvement was significantly associated with larger pre- to posttreatment effect sizes as well as pre- to follow-up effect sizes. Booster
sessions, goal setting, and maintenance/relapse prevention were not significantly related to effect sizes at posttreatment or follow-up. Parental
involvement may be helpful for maximizing long-term effectiveness of yCBT. Future studies should investigate for whom and under what conditions
inclusion of yCBT treatment features is related to the durability of treatment gains.
Journal of clinical child and adolescent
psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division
53, 48(Supplement1) : S269-S283
- Year: 2019
- Problem: Anxiety Disorders (any), Obsessive Compulsive Disorder, Post Traumatic Stress Disorder, Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder), Relapse prevention
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other service delivery and improvement
interventions
Jacoby, R. J., Abramowitz, J. S., Blakey, S. M., Reuman, L.
Background and objectives: Although research suggests that introducing varying
levels of fear during exposure enhances outcomes for some anxiety-related problems, this has not been examined in the context of obsessions. The
current preliminary study tested the hypothesis that introducing variability in exposure intensity would improve long-term outcomes relative to
traditional gradual (hierarchical) exposure Methods: Adults (N = 40) with a moderately distressing unacceptable obsessional thought were randomly
assigned in parallel to four twice-weekly sessions of: (a) gradual exposure (EXP-G; n = 19) emphasizing hierarchical exposure completion, or (b)
variable exposure (EXP-V; n = 21) emphasizing variability in exposure intensity Results: There were no significant differences in pre to post changes
between groups using self-report, interview, or behavioral outcomes (as evaluated by an independent assessor blind to treatment condition). Group
comparisons at 3-month follow-up did not reach statistical significance but were moderate in magnitude. Specifically, as measured by clinical
interview (the Yale-Brown Obsessive-Compulsive Scale; primary outcome) and self-report, individuals in the EXP-G group maintained gains at 3-month
follow-up, while the EXP-V group continued to improve. Treatment expectancies and satisfaction were comparable for both groups. Five participants
withdrew from the EXP-G condition, and none withdrew from the EXP-V condition. In contrast to previous studies, variability in subjective and
physiological fear during exposure did not predict outcomes Limitations: The study employed an analogue sample with moderate unacceptable obsessions,
and results should be replicated in clinical samples Conclusion(s): Variable exposure warrants future study to understand the mechanisms, moderators,
and implications of this novel approach Copyright © 2019 Elsevier Ltd
Journal of Behavior Therapy and Experimental Psychiatry, 64 : 54-
63
- Year: 2019
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Exposure therapy, Exposure
and response prevention, Other service delivery and improvement
interventions
Shabani, M. J., Mohsenabadi, H., Omidi, A., Lee, E. B., Twohig, M. P., Ahmadvand, A., Zanjani, Z.
Conducted in Iran, participants included 69 adolescents with obsessive-compulsive disorder (OCD) who were on a stable selective
serotonin reuptake inhibitor (SSRI) dose and were randomly assigned to one of three conditions: group acceptance and commitment therapy (ACT)+SSRI,
group cognitive behavioral therapy (CBT)+SSRI, or continued SSRI treatment. Assessment occurred at pre-, post-treatment, and three-month follow-up
and included the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), Children's Depression Inventory (CDI), Avoidance and Fusion
Questionnaire for Youth (AFQ-8), Valued Living Questionnaire (VLQ), and Child and Adolescent Mindfulness Measure (CAMM). ACT + SSRI and CBT + SSRI
conditions demonstrated significant reductions in OCD severity that were maintained at follow-up compared to the continued SSRI condition. All
conditions demonstrated significant reductions in depression that were maintained at follow-up. The ACT + SSRI condition demonstrated significant
improvement in psychological flexibility, mindfulness, and valued living that were maintained at follow-up compared to the CBT + SSRI and continued
SSRI conditions. Findings indicate that ACT + SSRI is comparably effective as CBT + SSRI at treating adolescent OCD. However, ACT + SSRI appears to
differ from CBT + SSRI on changes in psychological flexibility, mindfulness, and valued living, indicating potential differences in mechanism of
change. Copyright © 2019 Elsevier Inc.
Journal of
Obsessive-Compulsive and Related Disorders, 22 (no pagination)(100440) :
- Year: 2019
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Antidepressants
(any), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Acceptance & commitment therapy
(ACT)
Gowda, S. M., Narayanaswamy,
J. C., Hazari, N., Bose, A., Chhabra, H., Balachander,
S., Bhaskarapillai, B., Shivakumar, V., Venkatasubramanian, G., Reddy, Y. C. J.
Background: A significant proportion of obsessive compulsive disorder (OCD)
patients do not respond to specific serotonin reuptake inhibitors (SSRIs). There is a need to evaluate novel treatment options for OCD. Objective(s):
In this double blinded, randomized, sham controlled study, we investigated the efficacy of add-on transcranial direct current stimulation (tDCS) in
reducing the symptoms in SSRI-resistant OCD patients by employing anodal pre-supplementary motor area (pre-SMA) stimulation. Method(s): Twenty-five
patients with DSM-IV OCD having persistent symptoms despite adequate and stable treatment with at least one SSRI were randomly allocated to receive
20 min of verum (active) 2-mA tDCS or sham stimulation twice daily on 5 consecutive days [anode over Pre-SMA; cathode over right supra-orbital area].
Response to treatment was defined as at least 35% reduction in the Yale-Brown Obsessive-Compulsive Scale (YBOCS) total score along with a Clinical
Global Impression - Improvement (CGI-I) score of 1 (very much improved) or 2 (much improved). Result(s): The response rate was significantly greater
in the verum tDCS(4 out of 12) compared to sham-tDCS (0 out of 13) [Fisher's exact test, p = 0.04]. Repeated measures analysis of variance with tDCS
type (verum vs. sham) as between subjects factor showed that there was a significant tDCS-type X time-point interaction with significantly greater
reduction of YBOCS total score [F (1,22) = 4.95,p = 0.04,partial-eta2 = 0.18] in verum-tDCS group. Conclusion(s): The results of this RCT
suggest that tDCS may be effective in treating SSRI-resistant OCD. Future studies should examine the efficacy in larger samples of OCD and explore
other potential target regions using randomized sham-controlled designs, in addition to examining the sustainability of the beneficial effects. Trial
registration: Clinical Trials Registry India (http://ctri.nic.in/Clinicaltrials/login.php): Registration Number- CTRI/2016/04/006837). Copyright ©
2019 Elsevier Inc.
Brain Stimulation, 12(4) : 922-929
- Year: 2019
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: Treatment resistant/treatment refractory
-
Treatment and intervention: Biological Interventions
(any), Other biological interventions
Zheng, H.
More
effective, tolerable interventions for treatment-refractory obsessive-compulsive disorder (OCD) are needed. Preliminary findings encourage optimism
that methylphenidate augmentation may be of benefit in the treatment of OCD. To test modulator methylphenidate (MPH) of extended-release formulations
(MPH-ER) a safe and effective add-on therapy for refractory OCD, a pilot randomized, placebo-controlled, double-blind trial was conducted at an
outpatient, single-center academic setting. Participants included 44 adults with serotonin reuptake inhibitor (SRI) treatment-refractory OCD and
receiving a stable fluvoxamine pharmacotherapy with Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores higher than 20. Data were analyzed in the
intention-to-treat sample. All subjects were randomized into two parallel groups to receive fluvoxamine (250 mg daily) plus MPH-ER (36 mg daily) or
fluvoxamine (250 mg daily) plus identical placebo tablets under double-blind conditions and followed for 8 weeks. Forty-four patients (29 [66%] men),
with a mean (SD) age of 24.7 (6) years participated; with a mean (SD) duration of episode 5.7 (3) were randomized and forty-one finished the trial.
In the intention-to-treat analysis, the improvement in the Y-BOCS total score and Y-BOCS obsession subscale score was more prominent in the
fluvoxamine and MPH-ER group compared with those receiving placebo (P <.001). Additionally, cumulative response rates were higher in the MPH-ER vs
placebo groups (59% vs 5%; P <.001). MPH-ER was well tolerated; No subjects dropped out due to side effects. In summary, combined treatment with
MPH-ER demonstrated an enhanced clinical rate of response compared to placebo. Further trials should examine MPH-ER efficacy in a larger sample
Copyright © 2018 Elsevier Ltd
European Neuropsychopharmacology, 29(3) : 397-
404
- Year: 2019
- Problem: Anxiety Disorders (any), Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder), Treatment resistant/treatment refractory
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Antidepressants
(any), Other biological interventions