Department of Clinical Psychology, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bangalore, India.
Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bangalore, 560029, India.
J Affect Disord. 2021 Mar 1;282:58-68. doi: 10.1016/j.jad.2020.12.082. Epub 2020 Dec 27.
Recently, mindfulness-based therapies have emerged as a treatment modality for OCD, but there is sparse controlled data. We report the efficacy of mindfulness-based cognitive therapy (MBCT) in treating OCD in comparison with stress management training (SMT).
60 outpatients with DSM-IV-TR OCD attending a specialty OCD clinic were randomly assigned in 1:1 ratio to either MBCT (n=30) or SMT (n= 30). Both the groups received 12 weekly sessions of assigned intervention. An independent blind rater assessed the primary outcome measure at baseline and at the end of 12 weeks.
Significantly greater proportion of patients responded to MBCT than to SMT (80% vs. 27%, P <0.001). In the linear mixed-effects modelling for intent-to-treat analysis, there was a significant reduction in the illness severity measured using the Yale-Brown Obsessive-Compulsive Scale, obsessive beliefs of 'responsibility/threat estimation' and 'perfectionism/intolerance of uncertainty' measured using the Obsessive Beliefs Questionnaire and anxiety.
Small sample size with a relatively high attrition in the control group. Lack of a cognitive behaviour therapy (CBT) control group.
Mindfulness-based cognitive therapy is efficacious in the treatment of OCD. Future studies should compare MBCT with CBT in larger representative samples and also examine the sustainability of change in longitudinal studies.
正念认知疗法（MBCT）作为强迫症（OCD）的一种治疗方法已经出现，但对照数据较少。我们报告了 MBCT 治疗 OCD 的疗效，并与应激管理训练（SMT）进行了比较。
60 名 DSM-IV-TR OCD 门诊患者被随机分配至 MBCT（n=30）或 SMT（n=30）组，每组 12 周，每周 1 次。独立盲法评估者在基线和 12 周结束时评估主要结局测量指标。
MBCT 组的患者比 SMT 组更有反应（80% vs. 27%，P<0.001）。意向治疗分析的线性混合效应模型显示，耶鲁-布朗强迫症量表（Yale-Brown Obsessive-Compulsive Scale）评估的疾病严重程度、强迫症信念问卷（Obsessive Beliefs Questionnaire）评估的“责任/威胁估计”和“完美主义/不确定性容忍度”信念以及焦虑均有显著降低。
样本量小，对照组脱落率较高。缺乏认知行为疗法（CBT）对照组。
MBCT 对 OCD 有效。未来的研究应在更大的代表性样本中比较 MBCT 与 CBT，并在纵向研究中检查变化的可持续性。
