Utah State University, United States.
Utah State University, United States.
J Anxiety Disord. 2016 May;40:8-17. doi: 10.1016/j.janxdis.2016.03.006. Epub 2016 Mar 18.
The purposes of this review were to: 1) determine the attrition rates for exposure with response prevention (ERP) for obsessive-compulsive disorder (OCD), 2) compare them to those in other treatments for OCD, and 3) identify predictors of ERP attrition. A systematic literature search of randomized controlled trials for ERP for OCD yielded 21 studies, representing 1400 participants. Attrition data were extracted for individual treatment conditions. The weighted mean dropout rate for ERP was 14.7% (95% CI [11.4%, 18.4%]). This figure was not statistically different from that of comparison conditions (e.g., cognitive therapy; OR=0.67-2.22, all ps>0.15). Only two studies reported refusal rates for ERP (weighted mean=4.0%; 95% CI [0.7%, 9.2%]), which precluded calculation of a reliable refusal rate for ERP. Based on these figures, we estimated an overall attrition rate of 18.7% for ERP. Treatment experience, therapist qualification, and number of treatment sessions did not significantly predict dropout rate. Our review indicates that ERP may have treatment dropout rates similar to other treatments for OCD.
1）确定暴露反应预防疗法（ERP）治疗强迫症（OCD）的脱落率，2）将其与 OCD 的其他治疗方法进行比较，3）确定 ERP 脱落的预测因素。针对 ERP 治疗 OCD 的随机对照试验进行了系统的文献检索，共检索到 21 项研究，涉及 1400 名参与者。提取了各个治疗条件下的脱落数据。ERP 的加权平均脱落率为 14.7%（95%CI [11.4%，18.4%]）。这一数字与对照组（例如认知疗法）无统计学差异（OR=0.67-2.22，所有 p 值均大于 0.15）。仅有两项研究报告了 ERP 的拒绝率（加权平均=4.0%；95%CI [0.7%，9.2%]），这使得无法计算出 ERP 的可靠拒绝率。基于这些数据，我们估计 ERP 的总体脱落率为 18.7%。治疗经验、治疗师资质和治疗次数均未显著预测脱落率。本综述表明，ERP 治疗 OCD 的脱落率可能与其他治疗方法相似。
