Sousa Marcelo B, Isolan Luciano R, Oliveira Renata R, Manfro Gisele G, Cordioli Aristides V
Postgraduate Program in Medical Science, Psychiatry, Federal University of Rio Grande do Sul and the Anxiety Disorder Program, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
J Clin Psychiatry. 2006 Jul;67(7):1133-9. doi: 10.4088/jcp.v67n0717.
Cognitive-behavioral group therapy (CBGT) and serotonin reuptake inhibitors have proven efficacy in reducing symptoms of obsessive-compulsive disorder (OCD). There is no consensus about which of these forms of treatment is more effective. This study was conducted to evaluate the efficacy of CBGT as compared to that of sertraline in reducing OCD symptoms.
Fifty-six outpatients with an OCD diagnosis, according to DSM-IV criteria, participated in the randomized clinical trial: 28 took 100 mg/day of sertraline and 28 underwent CBGT for 12 weeks. Efficacy of treatments was rated according to the reduction in scores on the Yale-Brown Obsessive Compulsive Scale (YBOCS) and the Clinical Global Impressions-Severity of Illness scale. The trial was performed in 4 successive periods from March 2002 to December 2003.
Both treatments were effective, although patients treated with CBGT obtained a mean YBOCS reduction of symptoms of 44%, while those treated with sertraline obtained only a 28% reduction (p = .033). Cognitive-behavioral group therapy was also significantly more effective in reducing the intensity of compulsions (p = .030). Further, 8 patients (32%) treated with CBGT presented a complete remission of OCD symptoms (YBOCS score < or = 8) as compared to only 1 patient (4%) among those who received sertraline (p = .023).
Cognitive-behavioral group therapy and sertraline have shown to be effective in reducing OCD symptoms. Nevertheless, the rate of symptom reduction, intensity reduction of compulsions, and percentage of patients who obtained full remission were significantly higher in patients treated with CBGT.
认知行为团体治疗（CBGT）和血清素再摄取抑制剂已被证明在减轻强迫症（OCD）症状方面具有疗效。对于这两种治疗方式哪种更有效尚无共识。本研究旨在评估CBGT与舍曲林相比在减轻OCD症状方面的疗效。
56名根据《精神疾病诊断与统计手册》第四版（DSM-IV）标准诊断为OCD的门诊患者参与了随机临床试验：28人每日服用100毫克舍曲林，28人接受为期12周的CBGT。根据耶鲁-布朗强迫症量表（YBOCS）和临床总体印象-疾病严重程度量表的得分降低情况对治疗效果进行评估。该试验于2002年3月至2003年12月分4个连续阶段进行。
两种治疗均有效，不过接受CBGT治疗的患者YBOCS症状平均减轻了44%，而接受舍曲林治疗的患者仅减轻了28%（p = 0.033）。认知行为团体治疗在减轻强迫行为强度方面也显著更有效（p = 0.030）。此外，接受CBGT治疗的8名患者（32%）OCD症状完全缓解（YBOCS评分≤8），而接受舍曲林治疗的患者中只有1名（4%）完全缓解（p = 0.023）。
认知行为团体治疗和舍曲林已证明在减轻OCD症状方面有效。然而，接受CBGT治疗的患者在症状减轻率、强迫行为强度降低以及完全缓解患者的百分比方面显著更高。
