Group Acceptance and Commitment Therapy versus Cognitive Behavioral Therapy/Exposure Response Prevention for Obsessive Compulsive Disorder: A Block Randomized Controlled Trial.

IF 17.4 1区 医学 Q1 PSYCHIATRY
Psychotherapy and Psychosomatics Pub Date : 2025-01-01 Epub Date: 2025-02-21 DOI:10.1159/000544070
S K K Nielsen, A C Stuart, C Winding, M Øllgaard, K Wolitzky-Taylor, S I F Daniel, S Vangkilde, N Rosenberg, I Hageman, M B Jørgensen
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引用次数: 0

Abstract

Introduction: Acceptance and commitment therapy (ACT) may be as effective for treating obsessive compulsive disorder (OCD) as the gold standard treatment, cognitive behavioral therapy (CBT) with exposure response prevention (ERP), but ACT has never been directly compared to CBT/ERP in a randomized control trial. This study aimed to compare the efficacy of group-based ACT and CBT/ERP in two outpatient mental health service clinics for adults with OCD.

Methods: A total of 176 patients with OCD participated in a single-blinded, non-inferiority, block randomized controlled trial (RCT). Patients were assigned to either the ACT (n = 101) or CBT/ERP (n = 75) groups for 14 weekly sessions. The primary outcome was the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score at post-treatment and at the 6-month follow-up with prespecified non-inferiority criteria. Quality of life, measured using the Quality of Life Inventory (QOLI), was the secondary outcome.

Results: Linear mixed models showed that Y-BOCS scores in the ACT group were non-inferior to those in the CBT/ERP group both post-treatment and at 6, and 12 months of follow-up. QOLI scores also showed no significant differences in ACT compared to CBT/ERP across the three measurement points.

Conclusion: This RCT demonstrated that group-delivered ACT is non-inferior to CBT/ERP in reducing OCD symptoms and improving the quality of life of patients with OCD in outpatient mental health services. These findings suggest that ACT may serve as a viable alternative to CBT/ERP in adults with OCD in outpatient mental health settings, although further replication is necessary.

群体接受和承诺治疗与认知行为治疗/暴露反应预防治疗强迫症:一项区域随机对照试验。
简介:接受与承诺疗法(ACT)在治疗强迫症(OCD)方面可能与金标准疗法——认知行为疗法(CBT)加暴露反应预防(ERP)一样有效,但ACT从未在随机对照试验中直接与CBT/ERP进行比较。目的:比较基于团体的ACT和CBT/ERP在两家成人强迫症门诊治疗中的效果。方法:对176例强迫症患者进行单盲、非劣效、分组随机对照试验。患者被分配到ACT组(n = 101)或CBT/ERP组(n = 75),为期14周。主要结果是治疗后和6个月随访时的耶鲁-布朗强迫症量表(Y-BOCS)评分,随访时采用预先指定的非劣效性标准。使用生活质量量表(QOLI)测量的生活质量是次要结果。结果:线性混合模型显示,ACT组在治疗后、随访6个月和12个月时的Y-BOCS评分均不低于CBT/ERP组。QOLI得分也显示ACT与CBT/ERP在三个测量点上没有显著差异。结论:本随机对照试验表明,在门诊精神卫生服务中,小组给予ACT在减轻强迫症症状和改善强迫症患者生活质量方面不逊色于CBT/ERP。这些研究结果表明,ACT可能作为一种可行的替代CBT/ERP在成人强迫症门诊精神卫生机构,尽管进一步的复制是必要的。
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来源期刊
Psychotherapy and Psychosomatics
Psychotherapy and Psychosomatics 医学-精神病学
CiteScore
29.40
自引率
6.10%
发文量
46
期刊介绍: Psychotherapy and Psychosomatics is a reputable journal that has been published since 1953. Over the years, it has gained recognition for its independence, originality, and methodological rigor. The journal has been at the forefront of research in psychosomatic medicine, psychotherapy research, and psychopharmacology, and has contributed to the development of new lines of research in these areas. It is now ranked among the world's most cited journals in the field. As the official journal of the International College of Psychosomatic Medicine and the World Federation for Psychotherapy, Psychotherapy and Psychosomatics serves as a platform for discussing current and controversial issues and showcasing innovations in assessment and treatment. It offers a unique forum for cutting-edge thinking at the intersection of medical and behavioral sciences, catering to both practicing clinicians and researchers. The journal is indexed in various databases and platforms such as PubMed, MEDLINE, Web of Science, Science Citation Index, Social Sciences Citation Index, Science Citation Index Expanded, BIOSIS Previews, Google Scholar, Academic Search, and Health Research Premium Collection, among others.
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