Department of Psychology, Humboldt University of Berlin, Berlin, Germany.
Department of Psychology, Humboldt University of Berlin, Berlin, Germany
BMJ Open. 2024 Nov 1;14(10):e090431. doi: 10.1136/bmjopen-2024-090431.
While cognitive-behavioural therapy (CBT) for obsessive-compulsive disorder (OCD) and anxiety disorders (ADs) has been proven to be effective and is commonly recommended, a considerable proportion of patients remain symptomatic, do not respond to treatment or discontinue it. Thus, augmentation strategies aimed at enhancing CBT outcomes are essential to reduce the burden of OCD and ADs on patients and society. Various augmentation strategies for CBT in OCD and ADs have been investigated, yet it remains unclear if they show robust beneficial effects beyond first-line CBT. With this systematic review and meta-analysis, we will provide an overview and critically assess the efficacy of non-pharmacological augmentation strategies in addition to first-line CBT treatment for symptom reduction, response rates and dropout rates in individuals with OCD or ADs.
We will screen PubMed, Embase, PsycArticles, PsycInfo, CINAHL, PSYNDEX and Cochrane Register of Controlled Trials without restrictions on publication dates or languages. Additionally, forward, and backward searches of included studies and systematic reviews will be conducted. Two reviewers will independently screen the studies, extract data and assess the methodological quality of the studies. We will exclusively include randomised controlled trials. The primary outcomes will be symptom severity and response rates. Dropout rates will serve as a secondary outcome. Moreover, we will provide a narrative review of the results. We will use subgroup and meta-regression analyses to identify potential moderators and sources of between-study heterogeneity. We will use the Grading of Recommendations Assessment, Development and Evaluation system to assess the overall quality of evidence.
Ethical approval is not required. Results will be published in a peer-reviewed journal.
CRD42024561027.
认知行为疗法（CBT）已被证明对强迫症（OCD）和焦虑症（AD）有效，并且被广泛推荐，然而，相当一部分患者仍存在症状，对治疗无反应或中断治疗。因此，旨在增强 CBT 疗效的增强策略对于减轻 OCD 和 AD 给患者和社会带来的负担至关重要。已经研究了各种针对 OCD 和 AD 的 CBT 增强策略，但目前尚不清楚它们是否在一线 CBT 治疗之外显示出强大的有益效果。通过这项系统评价和荟萃分析，我们将概述并批判性评估除一线 CBT 治疗外，非药物增强策略在减少 OCD 或 AD 患者症状、反应率和脱落率方面的疗效。
我们将无限制地在 PubMed、Embase、PsycArticles、PsycInfo、CINAHL、PSYNDEX 和 Cochrane 对照试验登记处筛选研究，不限制发表日期或语言。此外，还将对纳入研究和系统评价进行正向和反向搜索。两名审查员将独立筛选研究、提取数据并评估研究的方法学质量。我们将专门纳入随机对照试验。主要结局将是症状严重程度和反应率。脱落率将作为次要结局。此外，我们将对结果进行叙述性综述。我们将使用亚组和荟萃回归分析来确定潜在的调节因素和研究间异质性的来源。我们将使用推荐评估、制定和评估系统（Grading of Recommendations Assessment, Development and Evaluation system）评估证据的总体质量。
不需要伦理批准。结果将发表在同行评议的期刊上。
PROSPERO 注册号：CRD42024561027。
