Department of Clinical Psychology National Institute of Mental Health & Neuro Sciences, Hosur Road, Bangalore, India.
J Anxiety Disord. 2011 Oct;25(7):939-45. doi: 10.1016/j.janxdis.2011.05.007. Epub 2011 Jun 1.
Evidence of efficacy of cognitive behavior therapy (CBT) in obsessive-compulsive disorder (OCD) non-responsive to multiple trials of serotonin reuptake inhibitors (SRI) is limited. We examined the efficacy of CBT in 31 adult patients with DSM-IV OCD who were non-responders to at least two SRI trials. They received 20-25 sessions of CBT over 3-month duration. The primary outcome measure was "response" to treatment [Clinical Global Impressions-Improvement score 1 or 2 and ≥35% reduction in Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) severity score]. Patients were assessed at baseline, post-treatment and at 3-, 6- and 12-month follow-up. Twenty-six (84%) patients completed treatment and number of responders at post-treatment, 3-, 6- and 12-month follow-up were 23 (74%), 20 (64%), 20 (64%) and 19 (61%) respectively. Quality of homework compliance and baseline Y-BOCS severity predicted remission (Y-BOCS<16) to CBT. CBT is useful in OCD non-responsive to multiple trials of SRI.
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证据表明，对于多次抗抑郁剂治疗反应不佳的强迫症（OCD）患者，认知行为疗法（CBT）的疗效有限。我们研究了 CBT 对 31 名 DSM-IV 强迫症成年患者的疗效，这些患者对至少两种抗抑郁剂治疗反应不佳。他们接受了为期 3 个月、共 20-25 次的 CBT 治疗。主要疗效指标为“治疗反应”[临床总体印象改善评分 1 或 2 分，且耶鲁-布朗强迫症量表（Y-BOCS）严重程度评分至少降低 35%]。患者在基线、治疗后以及 3、6 和 12 个月随访时接受评估。26 名（84%）患者完成了治疗，治疗后、3、6 和 12 个月随访时的应答者分别为 23 名（74%）、20 名（64%）、20 名（64%）和 19 名（61%）。家庭作业依从性和基线 Y-BOCS 严重程度可预测 CBT 缓解（Y-BOCS<16）。CBT 对多次抗抑郁剂治疗反应不佳的 OCD 患者有效。
