Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Canada.
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada.
Clin Psychol Psychother. 2017 Sep;24(5):1109-1120. doi: 10.1002/cpp.2076. Epub 2017 Feb 13.
A significant number of obsessive-compulsive disorder (OCD) patients continue to experience symptoms that interfere with their functioning following cognitive behavioural therapy (CBT). Providing an additional augmentation treatment following CBT could help reduce these residual symptoms. Mindfulness interventions that facilitate less reactivity to thoughts and feelings may be helpful for patients suffering from residual OCD symptoms. The purpose of the current randomized waitlist control trial was to evaluate the feasibility and impact of providing an 8-week mindfulness-based cognitive therapy (MBCT) intervention following completion of a CBT intervention to OCD patients who continued to suffer from significant symptoms. Results indicated that compared to the waitlist control group, MBCT participants reported decreases in OCD symptoms (d = 1.38), depression symptoms (d = 1.25), anxiety symptoms (d = 1.02), and obsessive beliefs (d = 1.20) along with increases in self-compassion (d = 0.77) and mindfulness skills (d = 0.77). Additionally, participants reported high levels of satisfaction with the MBCT intervention. The results suggest that the use of MBCT for OCD as an augmentation therapy is acceptable to patients who continue to suffer from OCD symptoms after completing CBT and provides some additional relief from residual symptoms.
Mindfulness interventions teach skills that facilitate disengaging from cognitive routines and accepting internal experience, and these skills may be valuable in treating obsessive-compulsive disorder (OCD), as individuals describe getting "stuck" in repetitive thoughts and consequent rituals. The results of this study suggest that teaching mindfulness skills using an 8-week mindfulness-based cognitive therapy (MBCT) intervention provides an added benefit (decreases in OCD, depression, and anxiety symptoms) for patients with OCD who have completed a cognitive behavioural therapy intervention and continued to suffer from significant symptoms. Participation in MBCT was also associated with increases in mindfulness skills including increased ability to be nonjudgmental and nonreactive. By fostering a nonjudgmental stance towards intrusive thoughts, mindfulness may discourage suppression and avoidance of thoughts and this could lead to increased habituation and a decreased reliance on compulsions. The use of MBCT as an augmentation treatment should be further explored to elucidate whether this treatment is beneficial for preventing relapse of OCD and could be compared against further cognitive behavioural therapy to see if offering participants a different and theoretically compelling intervention, such as MBCT, would outperform "more of the same" for individuals with OCD.
许多强迫症（OCD）患者在接受认知行为疗法（CBT）后，仍然存在干扰其功能的症状。在 CBT 之后提供额外的增强治疗可能有助于减轻这些残留症状。促进对思想和感觉反应性降低的正念干预可能对患有残留 OCD 症状的患者有帮助。目前这项随机候补对照试验的目的是评估在 OCD 患者完成 CBT 干预后，为继续患有明显症状的患者提供为期 8 周的正念认知疗法（MBCT）干预的可行性和影响。结果表明，与候补对照组相比，MBCT 参与者报告 OCD 症状（d=1.38）、抑郁症状（d=1.25）、焦虑症状（d=1.02）和强迫信念（d=1.20）减少，同时自我同情（d=0.77）和正念技能（d=0.77）增加。此外，参与者报告对 MBCT 干预的满意度很高。结果表明，将 MBCT 用于 OCD 作为增强治疗，对于那些在完成 CBT 后仍患有 OCD 症状的患者是可以接受的，并为残留症状提供了一些额外的缓解。
正念干预教授的技能可以促进从认知常规中解脱出来并接受内在体验，这些技能在治疗强迫症（OCD）方面可能很有价值，因为个体描述自己“陷入”重复的思想和随之而来的仪式中。这项研究的结果表明，使用 8 周的正念认知疗法（MBCT）干预教授正念技能为已经完成认知行为疗法干预但仍有明显症状的 OCD 患者提供了额外的益处（OCD、抑郁和焦虑症状减少）。MBCT 的参与也与正念技能的增加有关，包括提高非评判和非反应的能力。通过对侵入性思维采取非评判的态度，正念可能会阻止对思维的抑制和回避，从而导致习惯化增加和对强迫的依赖减少。应该进一步探索使用 MBCT 作为增强治疗的方法，以阐明这种治疗是否有益于预防 OCD 的复发，并且可以与进一步的认知行为疗法进行比较，看看为参与者提供一种不同的、理论上引人注目的干预措施，如 MBCT，是否比 OCD 患者的“更多相同”表现更好。
