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强迫症认知行为团体治疗反应的神经心理学预测因素

NEUROPSYCHOLOGICAL PREDICTORS OF TREATMENT RESPONSE TO COGNITIVE BEHAVIORAL GROUP THERAPY IN OBSESSIVE-COMPULSIVE DISORDER.

作者信息

Braga Daniela T, Abramovitch Amitai, Fontenelle Leonardo F, Ferrão Ygor A, Gomes Juliana B, Vivan Analise S, Ecker Kimberly K, Bortoncello Cristiane F, Mittelman Andrew, Miguel Euripides C, Trentini Clarissa M, Cordioli Aristides V

机构信息

Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Rio Grande do Sul (RS), Brazil.

Department of Psychology, Texas State University, San Marcos, Texas, USA.

出版信息

Depress Anxiety. 2016 Sep;33(9):848-61. doi: 10.1002/da.22509. Epub 2016 Apr 21.

Abstract

BACKGROUND

The available research on the relationship between neuropsychological functioning and the therapeutic outcome of obsessive-compulsive disorder (OCD) has yielded inconsistent results. In this study, our aim was twofold. First, we sought to evaluate the effects of cognitive behavioral group therapy (CBGT) on neurocognitive functions in OCD patients. Second, we assessed the viability of neuropsychological test performance as a predictor of treatment response to CBGT.

METHODS

One hundred fifty carefully screened OCD patients were randomized to receive either 12-week CBGT (n = 75) or to remain on a waiting list (WL; n = 75) for the corresponding time. Forty-seven participants dropped out of the study, leaving 103 participants that were included in the analysis (CBGT, n = 61; WL, n = 42). Participants had several neuropsychological domains evaluated both at baseline and at end-point.

RESULTS

A significant difference in obsessive-compulsive, anxiety, and depression symptoms was observed between treated patients and controls favoring the CBGT group, but no significant differences were found on neuropsychological measures after 3 months of CBGT. In addition, there were no differences between treatment responders and nonresponders on all neuropsychological outcome measures. Employing a conservative alpha, neuropsychological test performance did not predict CBGT treatment response.

CONCLUSIONS

Although the CBGT group demonstrated significant improvement in OCD symptoms, no significant difference was found on all neuropsychological domains, and test performance did not predict treatment response.

摘要

背景

关于神经心理功能与强迫症(OCD)治疗结果之间关系的现有研究结果并不一致。在本研究中,我们有两个目标。首先,我们试图评估认知行为团体治疗(CBGT)对OCD患者神经认知功能的影响。其次,我们评估了神经心理测试表现作为CBGT治疗反应预测指标的可行性。

方法

150名经过仔细筛选的OCD患者被随机分为两组,一组接受为期12周的CBGT治疗(n = 75),另一组在相应时间内留在等待名单(WL;n = 75)上。47名参与者退出了研究,最终103名参与者纳入分析(CBGT组,n = 61;WL组,n = 42)。参与者在基线和终点时对多个神经心理领域进行了评估。

结果

在接受治疗的患者和对照组之间,观察到强迫症、焦虑和抑郁症状存在显著差异,CBGT组更具优势,但CBGT治疗3个月后,神经心理测量指标未发现显著差异。此外,在所有神经心理结果测量指标上,治疗反应者和无反应者之间没有差异。采用保守的α水平,神经心理测试表现不能预测CBGT治疗反应。

结论

尽管CBGT组在OCD症状方面有显著改善,但在所有神经心理领域未发现显著差异,且测试表现不能预测治疗反应。

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