A Randomized Controlled Trial of Japanese Patients with Obsessive-Compulsive Disorder – Effectiveness of Behavior Therapy and Fluvoxamine

Abstract

Background: The aim of this study was to confirm and compare the efficacy of fluvoxamine (the only licensed SSRI for treatment for OCD in Japan) and behavior therapy in treating Japanese patients with OCD. In addition, we investigated predictors of these treatments. Methods: Thirty-one outpatients meeting the DSM-III-R criteria for OCD without any axis I disorder were randomly assigned to one of three treatment conditions: BT (behavior therapy ± pill placebo), FLV [autogenic training (a psychological placebo for OCD) ± fluvoxamine] and control group [autogenic training (psychological placebo) ± pill placebo] for 12 weeks of treatment. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the Clinical Global Impression-Improvement Scale (CGI-I) were administered blindly at baseline and week 4, 8 and 12. Results: Twenty-eight patients completed this study. Patients in the BT and FLV groups showed significantly more improvement than those in the control group in the mean score of total Y-BOCS; moreover, the BT group showed significantly more reduction in total Y-BOCS score at the end of treatment than the FLV group (BT > FLV, p < 0.01). Patients with lower baseline total Y-BOCS, past history of a major depressive episode and absence of cleaning compulsion improved more with fluvoxamine. Conclusions: We confirmed the effectiveness of behavior therapy and fluvoxamine for Japanese patients with OCD. Behavior therapy improved the condition of OCD patients more than fluvoxamine.

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

“…One study compared CBT9pill placebo, autogenic training (a psychological placebo for OCD)9fluvoxamine and autogenic training9pill placebo. Patients in the CBT group had the highest improvement scores, followed by fluvoxamine, which was still significantly superior to placebo (Nakatani et al 2005).…”

“…The proportion of patients that relapsed was statistically significantly higher in the placebo group (Fineberg et al 2007) (A). Á Fluvoxamine was and found to be superior to placebo in DBPC studies (Goodman et al 1989b(Goodman et al , 1996Hohagen et al 1998;Nakatani et al 2005) and in clomipramine-controlled trials (Milanfranchi et al 1997;Mundo et al 2000). The slow-release form was also superior to placebo (Hollander et al 2003c).…”

Computerised Cognitive Behaviour Therapy for Obsessive-Compulsive Disorder: A Systematic Review

“…Although behaviour therapy and selective serotonin reuptake inhibitors are considered the most popular treatment options for OCD, a recent study found behaviour therapy much more effective than medication [2]. In terms of psychotherapy, cognitive behaviour therapy (CBT) for general anxiety disorders was found superior to other psychological therapies [3].…”

Cognitive versus Behavior Therapy: Processes of Change in the Treatment of Obsessive-Compulsive Disorder

“…A large body of evidence has accumulated to underpin the efficacy of ERP, which has become the preferred psychological treatment for OCD [3,4,5]. However, ERP is not entirely problem-free.…”