Intensive cognitive behavioural therapy for obsessive-compulsive disorder: A systematic review and meta-analysis

Forfatter(e)

Jonsson, H. Kristensen, M. Arendt, M.

År

2015

DOI

10.1016/j.jocrd.2015.04.004

Tidsskrift

Journal of Obsessive-Compulsive and Related Disorders

Sider

83-96

Kategori(er)

Tvangsforstyrrelser (OCD)

Tiltakstype(r)

Kognitiv atferdsterapi, atferdsterapi og kognitiv terapi

Abstract

Despite promising results from intensive formats of cognitive-behavioural therapy (CBT) for obsessive-compulsive disorder (OCD) the format is rarely used.

The aim of the study was to systematically review the literature within this area of research and provide a meta-analysis of the effectiveness of intensive CBT for youths or adults with OCD. The meta-analysis was based on 17 trials (11 adult and 6 youth) including a total of 646 participants. Large overall pre-post effect sizes (ES) of 2.44 (95% CI 2.03-2.85) for clinical ratings (n = 16) and 1.23 (95% CI 1.01-1.45) for self-reports (n = 5) were found (Hedges g).

Based on two comparative nonrandomized studies and one RCT, a larger post-treatment effect of intensive treatment compared to standard weekly or twice weekly CBT was found (between group ES = 0.39 (95% CI 0.05-0.74) for clinical ratings).

This difference was no longer present at 3 month follow-up, mainly due to slight deterioration among patients who had received intensive CBT while patients from weekly conditions changed little.

In sum, the meta-analysis indicates that intensive CBT is an effective treatment for youths and adults with OCD, and could be a promising format to enhance immediate treatment effects compared to standard CBT. Focus on how to maintain superior post-treatment effects of intensive CBT could be a promising research area.