Patient Adherence to Cognitive Behavioural Therapy for Obsessive-Compulsive Disorder: A Systematic Review and Meta-analysis

Publication date: Available online 28 August 2019Source: Journal of Anxiety DisordersAuthor(s): Tamara Leeuwerik, Kate Cavanagh, Clara StraussAbstractWhilst Cognitive Behavioural Therapy (CBT) is the treatment of choice for obsessive-compulsive disorder (OCD), around half of the participants do not experience remission following treatment. As yet, there is no comprehensive systematic review of the extent to which patient non-adherence presents a challenge to the overall benefit of CBT for OCD. The aim of this systematic review and meta-analysis was to identify the magnitude, moderators and reasons for poor patient adherence to CBT for OCD in terms of: (1) treatment refusal; (2) treatment dropout; (3) session attendance/module completion, and (4) between-session CBT task adherence. Sociodemographic and clinical variables, treatment and study design characteristics were examined as moderators of adherence. The systematic search identified 123 studies including 5627 participants taking part in CBT or control conditions. A pooled rate of 15.6% of eligible patients refused CBT and a further 15.9% of treatment starters dropped out from treatment. Group CBT had significantly lower dropout rates than individually-delivered CBT. No other significant moderators were found. Most studies reported moderate to good adherence to between-session CBT tasks, which had a significant medium to large association with post-treatment OCD symptom reduction. Recommendations for enhanced measurement a...
Source: Journal of Anxiety Disorders - Category: Psychiatry Source Type: research

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This study aimed to identify predictors of relapse of anxiety after CBT for adult (18+) patients to enable the identification of "at-risk" patients who could potentially benefit from relapse prevention interventions. A systematic review and meta-analysis were conducted, including studies found in PsycINFO, PubMed, Scopus, and Web of Science, and through hand-searches of references lists and reverse citations. Nine studies met eligibility criteria (N = 532 patients). On average, 23.8% of patients experienced relapse following completion of CBT. A total of 21 predictors were identified and grouped into seven catego...
Source: Cognitive Behaviour Therapy - Category: Psychiatry & Psychology Authors: Tags: Cogn Behav Ther Source Type: research
Publication date: Available online 31 July 2020Source: Journal of Anxiety DisordersAuthor(s): Danielle E. Katz, Judith M. Laposa, Neil A. Rector
Source: Journal of Anxiety Disorders - Category: Psychiatry Source Type: research
CONCLUSION: There is limited evidence from randomised controlled trials which supports claims that computer- or Internet-delivered cognitive-behavioural therapy for anxiety disorders is not inferior to in-person delivery. Randomised controlled trials properly designed to test non-inferiority are needed before conclusions about the relative benefits of in-person and Internet- and computer-delivered cognitive-behavioural therapy can be made. PROSPERO: CRD420180961655-6. PMID: 31339342 [PubMed - as supplied by publisher]
Source: The Australian and New Zealand Journal of Psychiatry - Category: Psychiatry Authors: Tags: Aust N Z J Psychiatry Source Type: research
ConclusionReassurance seeking appears to be a common factor across anxiety disorders though the themes of the reassurance may differ. Further, reduction in excessive reassurance seeking may be an important component in treatment outcome.
Source: Journal of Anxiety Disorders - Category: Psychiatry Source Type: research
This article describes the use of a case formulation approach, integrating evidence-based treatment in the context of individual clinical traits. It focuses on the supplementation of cognitive behavioural therapy (CBT) with eye movement desensitization and reprocessing (EMDR) in the treatment of a young person, presenting with an initial diagnosis of obsessive-compulsive disorder (OCD). A case formulation suggested the possibility of a differential diagnosis of Adjustment Disorder, indicating the usefulness of the addition of EMDR sessions to process memories of severe bullying. Previous studies promote the idea of using E...
Source: Journal of Child and Adolescent Trauma - Category: Child Development Source Type: research
ConclusionsGuided ICBT for perfectionism improves associated psychopathology and transdiagnostic processes. ClinicalTrials.gov registration no. NCT02756871.
Source: Journal of Behavior Therapy and Experimental Psychiatry - Category: Psychiatry Source Type: research
AbstractDigital interventions for anxiety disorders have been well-researched over the past two decades. However, reviews to date have focused on internet-based cognitive behavioural therapy (iCBT), whereas other psychological interventions have received less attention. The aim of this review was therefore to evaluate the effectiveness of digitally delivered psychological therapies (CBT, Attention Bias Modification, Exposure Therapy, Applied Relaxation, Bibliotherapy, Psychodynamic Therapy, Mindfulness, Behavioural Stress Management, Counselling) compared with control conditions and/or other psychological interventions for...
Source: Psychiatric Quarterly - Category: Psychiatry Source Type: research
Another version of this new video-based smartphone intervention involved participants watching their own earlier hand washing By Emma Young Almost half of people with Obsessive Compulsive Disorder (OCD) have extreme fears about touching something they feel is “contaminated”. This can mean that after touching a doorknob, say, they then feel compelled to scrub their hands, in some cases even until they bleed. Conventional treatments, which often involve a combination of a prescription drug (typically an “SSRI”, such as Prozac) plus cognitive behavioural therapy (CBT), help only about 60 per cent of pe...
Source: BPS RESEARCH DIGEST - Category: Psychiatry & Psychology Authors: Tags: Mental health Source Type: blogs
Karen Morley blogs about her experience of seeking help for her Obsessive-Compulsive Disorder (OCD) and how finding and using Cochrane evidence was a turning point. This blog post was originally published onEvidently Cochrane.Without knowing what it was, I had experienced episodes of Obsessive-Compulsive Disorder (OCD) since I was an adolescent, usually when I was particularly stressed. But it was when I was caring full time for my mother, who had multiple conditions including dementia, that I had an unusually distressing episode of contamination-related OCD. When I took to the internet I was amazed to discover that the ob...
Source: Cochrane News and Events - Category: Information Technology Authors: Source Type: news
There’s misperception among some people today that psychotherapy isn’t effective for serious mental illness and therefore can’t be used to treat it. A person might say, “Well, I have severe depression and have tried therapy on multiple occasions, with little effect.” Lived experience is an important thing to take into consideration when choosing a treatment option. However, I believe it’s equally important to examine the research too, to see what science has to say to such questions. Can psychotherapy be used to treat serious mental illness, including clinical depression or obsessive-com...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: General Medications Mental Health and Wellness Psychotherapy Research Treatment efficacy of psychotherapy OCD treatment psychotherapy efficacy therapy for depression therapy for OCD Treatment For Depression Source Type: blogs
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