Ebrahimi Amrollah, Nasre Esfahan Elham, Akuchekian Shahla, Izadi Razieh, Shaneh Elham, Mahaki Behzad
Department of Health Psychology, Behavioural Sciences Research Centre, Medicine School, Isfahan University of Medical Science, Isfahan, Iran.
Behavioural Sciences Research Center, Student Research Committee, Isfahan University of Medical Science, Isfahan, Iran.
J Res Med Sci. 2022 Feb 18;27:9. doi: 10.4103/jrms.jrms_449_21. eCollection 2022.
Acceptance and commitment therapy (ACT) is one of the newest treatment strategies that has been developed rapidly to improve the treatment of patients with obsessive-compulsive disorder (OCD). The aim of this study was to evaluate and compare the effect of ACT and selective serotonin reuptake inhibitors (SSRIs) drugs on the severity of depression symptoms and quality of life (QOL) in obsessive-compulsive patients.
A randomized clinical trial with a control group was conducted including 27 patients with OCD. Based on the Diagnostic and Statistical Manual of Mental Disorders-5 criteria for OCD diagnosis, participants were recruited from Tamasha Counseling Center and obsessive-compulsive clinic in the Psychosomatic Research Center in Isfahan, Iran. Selected patients were allocated to two groups (14 in ACT the group and 13 in the drug group with SSRI with a simple random sampling method. ACT group was treated by an ACT therapist in eight 1-h sessions. Data were collected by the World Health Organization QOL Questionnaire (WHOQOL-BREF) and Depression subscale of DASS-42 at admission, after the intervention, and 3 months thereafter. Therapists and evaluators were blind to each other's work. Data were analyzed using analysis of variance with repeated measures method using IBM SPSS Statistics software (V 23, IBM Corporation, Armonk, NY, USA).
Results revealed that both treatments (ACT and SSRIs drug therapy) had significant impacts on reducing depression subscales scores and increasing WHOQOL-BREF scores at posttreatment ( < 0.05). There were no significant differences in QOL scores between the two groups after the intervention and follow-up ( > 0.05). Nevertheless, drug therapy presented a significantly greater improvement in depression scores of patients than those resulting from ACT ( = 0.005). The persistence of treatment effects continued after 3 months (follow-up) in both groups.
ACT is equal to SSRIs drug therapy in terms of improving QOL in patients with OCD. However, SSRIs are more effective in treating depression in obsessive-compulsive patients. It may be presumed that ACT without any chemical side effect is equal to drug and is preferred for patients who either cannot use drugs or prefer not to have a drug treatment.
接纳与承诺疗法（ACT）是最新发展起来的治疗策略之一，用于快速改善强迫症（OCD）患者的治疗效果。本研究旨在评估和比较ACT与选择性5-羟色胺再摄取抑制剂（SSRIs）药物对强迫症患者抑郁症状严重程度和生活质量（QOL）的影响。
进行一项含对照组的随机临床试验，纳入27例强迫症患者。根据《精神疾病诊断与统计手册》第5版中强迫症的诊断标准，从伊朗伊斯法罕心身研究中心的塔玛莎咨询中心和强迫症诊所招募参与者。采用简单随机抽样法将入选患者分为两组（ACT组14例，药物组13例，药物组使用SSRI）。ACT组由一名ACT治疗师进行为期8节、每节1小时的治疗。在入院时、干预后及此后3个月通过世界卫生组织生活质量问卷（WHOQOL-BREF）和DASS-42抑郁分量表收集数据。治疗师和评估人员对彼此的工作不知情。使用IBM SPSS Statistics软件（V 23, IBM Corporation, Armonk, NY, USA）采用重复测量方差分析方法对数据进行分析。
结果显示两种治疗方法（ACT和SSRIs药物治疗）在治疗后均对降低抑郁分量表得分及提高WHOQOL-BREF得分有显著影响（P<0.05）；干预和随访后两组生活质量得分无显著差异（P>0.05）。然而，药物治疗使患者抑郁得分改善程度显著大于ACT治疗（P = 0.005）；两组在3个月（随访）后治疗效果持续存在。
在改善强迫症患者生活质量方面，ACT与SSRIs药物治疗效果相当。然而，SSRIs在治疗强迫症患者抑郁方面更有效。可以推测，无任何化学副作用的ACT等同于药物治疗且更适合那些无法使用药物或不愿接受药物治疗的患者。
