Prazeres Angélica Marques, Souza Wanderson Fernandes de, Fontenelle Leonardo F
Programa de Pesquisa em Ansiedade e Depressão, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Braz J Psychiatry. 2007 Sep;29(3):262-70. doi: 10.1590/s1516-44462006005000046. Epub 2007 Sep 18.
To perform a systematic review of controlled trials and meta-analysis that involved cognitive and/or behavioral treatment for obsessive-compulsive disorder.
A systematic review of randomized controlled trials and meta-analysis published on the last decade and indexed on Medline and PsycInfo.
Studies have confirmed that exposure and response prevention and cognitive therapy are effective methods for the treatment of obsessive-compulsive disorder in children, adolescents and adults. Among adults, the combined use of serotonin-reuptake inhibitors and exposure and response prevention or cognitive therapy was not associated with any additional therapeutic effect. Among children, the combination of serotonin-reuptake inhibitors and exposure and response prevention are superior to either treatment alone. Exposure and response prevention associated with cognitive therapy may result in significant benefits to patients with predominant obsessive thoughts and its group modality also reduces obsessive-compulsive symptoms.
At the present time, cognitive and behavioral therapies have shown to be highly effective psychotherapeutic approaches for the treatment of obsessive-compulsive disorder. Nevertheless, more studies are still needed, mainly those focusing on long-term follow-up, group-treatment and the combined use with serotonin-reuptake inhibitors.
对涉及强迫症认知和/或行为治疗的对照试验及荟萃分析进行系统评价。
对过去十年发表并被Medline和PsycInfo索引的随机对照试验及荟萃分析进行系统评价。
研究证实，暴露与反应阻止法及认知疗法是治疗儿童、青少年和成人强迫症的有效方法。在成人中，5-羟色胺再摄取抑制剂与暴露与反应阻止法或认知疗法联合使用未显示出任何额外治疗效果。在儿童中，5-羟色胺再摄取抑制剂与暴露与反应阻止法联合使用优于单独使用任何一种治疗方法。与认知疗法相结合的暴露与反应阻止法可能对以强迫观念为主的患者产生显著益处，其团体治疗形式也可减轻强迫症状。
目前，认知和行为疗法已被证明是治疗强迫症的高效心理治疗方法。然而，仍需要更多研究，主要是聚焦于长期随访、团体治疗以及与5-羟色胺再摄取抑制剂联合使用的研究。
