Manjula M, Sudhir Paulomi M
Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India.
Indian J Psychiatry. 2019 Jan;61(Suppl 1):S104-S113. doi: 10.4103/psychiatry.IndianJPsychiatry_531_18.
New-wave behavioral therapies in obsessive-compulsive disorders (OCDs) comprise of third-wave therapies and newer cognitive therapies (CTs). This review covers outcome studies published in English until December 2017. A total of forty articles on mindfulness-based CT, metacognitive therapy, acceptance and commitment therapy, and danger ideation reduction therapy in the form of single-case studies, case series, open-label trials, two-group comparison studies, and randomized controlled studies were included. Results show that studies on these therapies are limited in number. Methodological limitations including lack of active control groups, randomized controlled trials, small sample sizes, and short follow-up periods were also noted. However, the available literature demonstrates the feasibility and utility of these therapies in addressing the issues unresolved by exposure and response prevention (ERP) and cognitive behavior therapy (CBT). These therapies were often combined with traditional ERP and CBT based on the profile and response of the client; hence, it is unclear whether they can be used as standalone therapies in the larger segment of the OCD population. Supplementary use of these strategies alongside established therapies could provide better utilization of resources. In view of the need for such integration, further research is warranted. The use of sound methodologies and establishing the mechanism of action of these therapies would assist in choosing the techniques for integration.
强迫症（OCD）中的新浪潮行为疗法包括第三波疗法和更新的认知疗法（CTs）。本综述涵盖了截至2017年12月以英文发表的疗效研究。总共纳入了40篇关于基于正念的认知疗法、元认知疗法、接纳与承诺疗法以及危险观念减少疗法的文章，这些文章形式包括单病例研究、病例系列、开放标签试验、两组比较研究和随机对照研究。结果显示，关于这些疗法的研究数量有限。还指出了方法学上的局限性，包括缺乏活性对照组、随机对照试验、样本量小以及随访期短。然而，现有文献证明了这些疗法在解决暴露与反应阻止法（ERP）和认知行为疗法（CBT）未解决问题方面的可行性和实用性。这些疗法通常根据患者的情况和反应与传统的ERP和CBT相结合；因此，尚不清楚它们是否可以作为强迫症患者群体中更大部分人群的独立疗法使用。在既定疗法的基础上补充使用这些策略可以更好地利用资源。鉴于需要这种整合，有必要进行进一步研究。使用合理的方法并确定这些疗法的作用机制将有助于选择整合技术。
