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将神经心理教育、内在动机和隐喻内容与认知行为疗法相结合治疗强迫症的有效性:一项初步研究。

Effectiveness of Neuropsychoeducation, Intrinsic Motivation, and Metaphoric Content Integrated with Cognitive Behavioral Therapy in the Treatment of Obsessive-Compulsive Disorder: A Pilot Study.

作者信息

Madaan Atul, Mishra Mridula, Kochhar Shinu

机构信息

Department of Psychology, Lovely Professional University, Phagwara, Punjab, India.

Mittal School of Business, Lovely Professional University, Phagwara, Punjab, India.

出版信息

Ann Neurosci. 2023 Oct;30(4):230-235. doi: 10.1177/09727531231160356. Epub 2023 Apr 6.

Abstract

BACKGROUND

Obsessive-compulsive disorder (OCD) is considered frequent, unnecessary thoughts that lead to repetitive actions to lessen the apprehension provoked by thoughts; this repetitive sequence may further influence trouble in one's daily activities. The remedial procedure for OCD includes medication (such as SSRIs, anxiolytics, and antidepressants) with psychotherapy [such as cognitive behavioral therapy (CBT) and exposure response prevention (ERP)]. Previous investigations indicated that regardless of the trend of adopting CBT and ERP to treat OCD, only around half of the patients experienced a full reduction in symptoms.

PURPOSE

The ERP component in CBT has been termed as a challenging treatment as it contains threatening anxiety-provoking indications, and it has been reflected that between 25-30% of OCD patients reject the ERP treatment, and the refusal and dropout rates for ERP in OCD are higher than other interventions. Thus, in the present investigation, researchers developed a proposed therapy that includes neuropsychoeducation, intrinsic motivation, and metaphoric content integrated with CBT in addition to regular pharmacological management to treat OCD patients and validated the efficacy of the proposed therapy through psychometric ratings (Y-BOCS).

METHOD

In this pilot study, 10 cases of OCD received a 12-week proposed therapy program. The primary outcome was the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), which was assessed at baseline and post-treatment.

RESULTS

The present study's results revealed a significant decrease in scores on the obsessions and compulsions domains and overall total scores on Y-BOCS among OCD patients.

CONCLUSION

The findings show that this proposed therapy, which includes neuropsychoeducation, intrinsic motivation, and metaphors contents integrated with CBT in combination with pharmacological management, is effective in the treatment of OCD. Therefore, the proposed therapy may be beneficial in the treatment of OCD. It has far-reaching implications in the areas of clinical, psychiatry, and mental health.

摘要

背景

强迫症(OCD)被认为是频繁出现的、不必要的想法,这些想法会导致重复性动作,以减轻由这些想法引发的焦虑;这种重复序列可能会进一步影响一个人的日常活动。强迫症的治疗方法包括药物治疗(如选择性5-羟色胺再摄取抑制剂、抗焦虑药和抗抑郁药)和心理治疗[如认知行为疗法(CBT)和暴露反应阻止法(ERP)]。先前的调查表明,尽管采用CBT和ERP治疗强迫症的趋势明显,但只有大约一半的患者症状完全缓解。

目的

CBT中的ERP成分被认为是一种具有挑战性的治疗方法,因为它包含引发威胁性焦虑的指征,并且有研究表明,25%-30%的强迫症患者拒绝ERP治疗,强迫症患者对ERP的拒绝率和退出率高于其他干预措施。因此,在本研究中,研究人员开发了一种建议疗法,除常规药物治疗外,该疗法还包括神经心理教育、内在动机和与CBT相结合的隐喻内容,用于治疗强迫症患者,并通过心理测量评分(Y-BOCS)验证了该建议疗法的疗效。

方法

在这项初步研究中,10例强迫症患者接受了为期12周的建议治疗方案。主要结局指标是耶鲁-布朗强迫症量表(Y-BOCS),在基线和治疗后进行评估。

结果

本研究结果显示,强迫症患者的强迫观念、强迫行为领域得分以及Y-BOCS的总体总分均显著降低。

结论

研究结果表明,这种包括神经心理教育、内在动机和与CBT相结合的隐喻内容并联合药物治疗的建议疗法,对强迫症治疗有效。因此,该建议疗法可能对强迫症治疗有益。它在临床、精神病学和心理健康领域具有深远意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/102a/10662268/2314bdfabb04/10.1177_09727531231160356-fig1.jpg

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Early intervention for obsessive compulsive disorder: An expert consensus statement.强迫症的早期干预:专家共识声明。
Eur Neuropsychopharmacol. 2019 Apr;29(4):549-565. doi: 10.1016/j.euroneuro.2019.02.002. Epub 2019 Feb 14.

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