Fals-Stewart W, Marks A P, Schafer J
University of California, San Diego School of Medicine.
J Nerv Ment Dis. 1993 Mar;181(3):189-93. doi: 10.1097/00005053-199303000-00007.
Outpatients with a primary DSM-III axis I diagnosis of obsessive-compulsive disorder (OCD: N = 93) were randomly assigned to one of three treatment groups: One group (N = 30) received 24 sessions of behavioral group therapy over a 12-week period; a second group (N = 31) received 24 individual behavior therapy sessions over the same treatment interval; and members of a control group (N = 32) received 24 individual sessions of progressive muscle relaxation. The Yale-Brown Obsessive-Compulsive Scale was administered before treatment at 2-week intervals during treatment, and at 6-month follow-up to measure changes in distress caused by OCD symptoms. The Beck Depression Inventory and the Self-Rating Anxiety Scale were also administered at pretreatment, posttreatment, and 6-month follow-up. Both individual and group interventions proved to be equally effective at reducing distress caused by OCD symptoms, general depression, and anxiety by the end of treatment, although patients in the individual behavior therapy condition demonstrated faster reductions in OCD symptom severity. Patients in the group and individual behavioral interventions were able to maintain their gains at 6-month follow-up. Implications of these findings for outpatient treatment are discussed.
主要诊断为《精神疾病诊断与统计手册》第三版轴I强迫症(OCD:N = 93)的门诊患者被随机分配到三个治疗组之一:一组(N = 30)在12周内接受24次行为团体治疗;第二组(N = 31)在相同治疗期间接受24次个体行为治疗;对照组成员(N = 32)接受24次渐进性肌肉松弛个体治疗。在治疗前、治疗期间每2周以及6个月随访时使用耶鲁-布朗强迫症量表来测量强迫症症状引起的痛苦变化。在治疗前、治疗后以及6个月随访时还使用了贝克抑郁量表和自评焦虑量表。个体和团体干预在治疗结束时对于减轻强迫症症状、一般性抑郁和焦虑引起的痛苦同样有效,尽管接受个体行为治疗的患者强迫症症状严重程度下降得更快。接受团体和个体行为干预的患者在6个月随访时能够维持治疗效果。讨论了这些研究结果对门诊治疗的意义。