A randomized controlled trial of mindfulness-based cognitive therapy vs stress management training for obsessive-compulsive disorder.

Mindfulness Mindfulness based cognitive therapy Obsessive-compulsive disorder Randomized controlled trial

Journal

Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073

Informations de publication

Date de publication:
01 03 2021
Historique:
received: 17 08 2020
revised: 12 11 2020
accepted: 22 12 2020
pubmed: 6 1 2021
medline: 24 4 2021
entrez: 5 1 2021
Statut: ppublish

Résumé

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.

Sections du résumé

BACKGROUND
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).
METHODS
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.
RESULTS
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.
LIMITATIONS
Small sample size with a relatively high attrition in the control group. Lack of a cognitive behaviour therapy (CBT) control group.
CONCLUSIONS
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.

Identifiants

pubmed: 33401124
pii: S0165-0327(20)33172-4
doi: 10.1016/j.jad.2020.12.082
pii:
doi:

Types de publication

Journal Article Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

58-68

Informations de copyright

Copyright © 2021 Elsevier B.V. All rights reserved.

Auteurs

Sonal Mathur (S)

Department of Clinical Psychology, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bangalore, India. Electronic address: sonalmathurin@gmail.com.

Mahendra P Sharma (MP)

Department of Clinical Psychology, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bangalore, India. Electronic address: sharma.mahendra81@gmail.com.

Srinivas Balachander (S)

Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bangalore, 560029, India. Electronic address: srinivasbalachander@gmail.com.

Thennarasu Kandavel (T)

Department of Bio-Statistics, NIMHANS, Bangalore, India. Electronic address: kthenna@gmail.com.

Yc Janardhan Reddy (YJ)

Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bangalore, 560029, India. Electronic address: ycjreddy@gmail.com.

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