Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Depress Anxiety. 2011 Jul;28(7):574-81. doi: 10.1002/da.20843. Epub 2011 Jun 16.
Despite improved treatment options, many people with obsessive-compulsive disorder (OCD) do not seek or even actively avoid therapy due to shame or fear of stigmatization. Self-help treatment is increasingly acknowledged as a means to "treat the untreated" and to motivate patients for face-to-face psychotherapy. Our group has gathered preliminary evidence for the efficacy of a novel self-help approach entitled association splitting (AS) aimed at the reduction of obsessions.
For this study, a total of 46 participants with a likely diagnosis of OCD were randomly allocated to either AS or a waitlist control (WL). Treatment consisted of the self-study of a manual sent via e-mail. At baseline and four weeks later symptoms were assessed online using the self-report version of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Obsessive-Compulsive Inventory-Revised (OCI-R), and the Beck Depression Inventory (BDI).
A total of 74% of the initial sample took part in the re-assessment. Results were in accordance with prior uncontrolled data indicating that AS is a feasible approach leading to a symptom decline of approximately 25% on the Y-BOCS. The technique also exerted a positive effect on depression (BDI) and the OCI-R subscale obsessive thoughts.
The study confirms the feasibility and efficacy of AS for a subgroup of patients with OCD. Ongoing studies explore whether short-term effects are maintained over time and whether therapist-guided therapy may enhance the efficacy of AS.
尽管治疗选择有所改善，但由于羞耻感或害怕污名化，许多强迫症（OCD）患者并未寻求治疗，甚至主动回避治疗。自助治疗越来越被认为是一种“治疗未治疗者”的方法，并能激励患者接受面对面的心理治疗。我们的小组已经收集了一种新的自助方法（称为联想分裂，AS）的初步疗效证据，该方法旨在减少强迫观念。
在这项研究中，共有 46 名可能患有 OCD 的参与者被随机分配到 AS 组或等待名单对照组（WL）。治疗包括通过电子邮件自学手册。在基线和四周后，使用耶鲁-布朗强迫症量表（Y-BOCS）、强迫症清单修订版（OCI-R）和贝克抑郁量表（BDI）的在线自我报告版本评估症状。
初始样本中有 74%的人参加了重新评估。结果与之前的非对照数据一致，表明 AS 是一种可行的方法，可使 Y-BOCS 的症状下降约 25%。该技术还对抑郁（BDI）和 OCI-R 强迫思维子量表产生了积极影响。
该研究证实了 AS 对 OCD 患者亚组的可行性和疗效。正在进行的研究探讨短期效果是否能长期维持，以及治疗师指导的治疗是否能增强 AS 的疗效。
