A pilot randomized controlled trial of aerobic exercise as an adjunct to OCD treatment

Abstract

Objective The purpose of the current study was to conduct a randomized controlled trial testing the efficacy of aerobic exercise for decreasing OCD symptom severity, other mental health outcomes, and increasing exercise behaviors and cardiorespiratory fitness among individuals with OCD. Method Fifty-six patients (64% female; mean age = 38.8 years) with OCD and a Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score of 16 or greater despite engaging in OCD treatment were randomized to 12-weeks of supervised plus home-based moderate-intensity aerobic exercise (AE; n=28) or to 12-weeks of health education sessions (HE; n=28). Results Random intercepts mixed models examined differences between conditions at post-treatment. Though no difference between conditions on outcomes was observed, both AE and HE showed significant reduction in OCD symptom severity, depression and anxiety at post-treatment. Relative to HE, significant increases were noted in amount of exercise and cardiorespiratory fitness for those in the AE condition. At post-treatment, 30.4% of the AE condition (7 of 23) were treatment-responders (using the commonly accepted measure of 35% symptom reduction from baseline). In the HE condition, 7.7% of the sample (2 of 26) met this criterion at post-treatment. Conclusion The results of this preliminary study suggest that exercise and health-focused interventions may be beneficial adjuncts to existing OCD treatment. Future studies with larger samples are needed to more definitively answer questions the efficacy of AE for reducing OCD symptoms and improving related clinical outcomes.

Acute effects of aerobic exercise on negative affect and obsessions and compulsions in individuals with obsessive-compulsive disorder

“…One participant randomized to HEC did not start treatment, thus a total of 55 cases were utilized in analyses. Design details, intervention descriptions, and participants characteristics have been published elsewhere (Abrantes et al, 2017b). In brief, participants currently receiving OCD treatment but with a Yale-Brown Obsessive Compulsive Scale (Goodman et al, 1989b) scores ≥ 16 who were physically inactive (less than 60 minutes of aerobic exercise per week in the last 3 months) were eligible to participate.…”

“…Model Covariates.-Based on documented baseline differences between groups on the Y-BOCS, BDI, and BAI (Abrantes et al, 2017b) these baseline scores were entered as covariates. As reported in parent trial, concurrent behavioral and pharmacological treatment for OCD did not differ between conditions and was not included as covariate in this study.…”

“…Therefore, novel augmentation treatments are of increased interest including brain stimulation (Narayanaswamy et al, 2015) and pharmacotherapy (Simpson et al, 2013). One promising approach in reducing OCD symptomatology is aerobic exercise (Abrantes et al, 2017b;Brown et al, 2007;Lancer et al, 2007;Rector et al, 2015). In a randomized clinical trial, we tested the efficacy of a 12-week aerobic exercise intervention versus a health education contact control for augmenting cognitive-behavioral therapy for OCD (Abrantes et al, 2017b).…”

“…One promising approach in reducing OCD symptomatology is aerobic exercise (Abrantes et al, 2017b;Brown et al, 2007;Lancer et al, 2007;Rector et al, 2015). In a randomized clinical trial, we tested the efficacy of a 12-week aerobic exercise intervention versus a health education contact control for augmenting cognitive-behavioral therapy for OCD (Abrantes et al, 2017b). While both conditions were associated with lower OCD severity, patients in the exercise condition demonstrated a trend toward higher rates of treatment response, defined by 35% reduction in OCD symptoms.…”

Perceived physical health in obsessive-compulsive disorder: a protocol for a systematic review and meta-analysis

“…A value close to 0 indicates homogeneity, whereas values of 25%–50%, 50%–75% and 75%–100% indicate low, moderate and high heterogeneity, respectively. The Q index is computed by summing the squared deviations of each study’s effect estimate from the overall effect estimate while weighting the contribution of each study by its inverse variance 42. In the case of homogeneity among the effect sizes, the Q statistic follows a χ 2 distribution with k − 1 df, k being the number of studies.…”