Intensive cognitive behavioural therapy for obsessive-compulsive disorder: A systematic review and meta-analysis

Jónsson, Hjörtur H.; Kristensen, Maria; Arendt, Mikkel

doi:10.1016/j.jocrd.2015.04.004

Cited by 48 publications

(38 citation statements)

References 52 publications

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“…Furthermore, the different symptom trends at follow-up between studies might be explained by differences in treatment duration. The increase in symptoms at 3-month follow-up is in line with the meta-analytic findings of Jónsson et al (2015) , suggesting that there could be more relapse in patients receiving intensive treatment. Jónsson et al (2015) compared treatment effects of intensive outpatient CBT with standard weekly CBT.…”

Section: Discussionsupporting

confidence: 81%

“…The increase in symptoms at 3-month follow-up is in line with the meta-analytic findings of Jónsson et al (2015) , suggesting that there could be more relapse in patients receiving intensive treatment. Jónsson et al (2015) compared treatment effects of intensive outpatient CBT with standard weekly CBT. They found a significantly larger post-treatment effect in the intensive treatment condition, but this difference was no longer present at 3-month follow-up.…”

Section: Discussionsupporting

confidence: 81%

“…Consequently, the primary aim of this study was to explore the 6-month effectiveness of a brief psychological (no changes in medication) inpatient treatment format with duration of 3 weeks. In light of recent research on intensive treatment formats (e.g., Jónsson et al, 2015 ), it was hypothesized that obsessive-compulsive symptoms would show a significant reduction from admission to discharge, with some deterioration between discharge and 6-month follow-up. As a secondary outcome measure, the outcome pattern of depressive symptoms was examined; the hypothesis being that depressive symptoms would show a similar pattern as obsessive-compulsive symptoms.…”

Section: Introductionmentioning

confidence: 99%

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Three-Week Inpatient Treatment of Obsessive-Compulsive Disorder: A 6-Month Follow-Up Study

et al. 2018

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Background: Specialized inpatient or residential treatment might be an alternative treatment approach for patients with obsessive-compulsive disorder (OCD) that do not respond satisfactorily to the standard outpatient treatment formats.Method: The aim of this open trial was to investigate the 6-month effectiveness of a 3-week inpatient treatment of OCD, where exposure with response prevention (ERP) was the main treatment intervention. The sample consisted of 187 adult patients with OCD, all with previous treatment attempts for OCD.Results: The sample showed significant reductions in symptoms of OCD and depression. The effect sizes were large for obsessive-compulsive symptoms and moderate to large for depressive symptoms. At discharge, 79.7% of the intent-to-treat (ITT) group were classified as treatment responders (≥35% reduction in Y-BOCS scores). However, some participants experienced relapse, as 61.5% of the ITT group were classified as treatment responders at 6-month follow-up. Antidepressant use appeared not to influence the outcome. Only pre-treatment levels of obsessive-compulsive symptoms emerged as a significant predictor of relapse.Conclusion: The 3-week inpatient programme produced similar treatment effects as previous inpatient and residential studies of longer duration (2 – 3 months). The results suggest that patients with severe OCD can be treated efficiently using this brief inpatient format. However, better relapse prevention interventions are needed.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

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Three-Week Inpatient Treatment of Obsessive-Compulsive Disorder: A 6-Month Follow-Up Study

et al. 2018

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“…A combination of all the above programs is a time-intensive residential, home-based or outpatient program which provides, on average, 16 hours of intensive CBT over one or two weeks (Abramowitz, Foa, & Franklin, 2003;Jónsson, Kristensena, & Arendtc, 2015;Oldfield, Salkovskis, & Taylor, 2011;Storch et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Outcomes for residential or inpatient intensive treatment of obsessive–compulsive disorder: A systematic review and meta-analysis

Veale

Miles

Gledhill

et al. 2016

Journal of Obsessive-Compulsive and Related Disorders

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a b s t r a c tLittle data exist to inform the treatment of severe or treatment refractory obsessive-compulsive disorder (OCD) in an inpatient or residential setting. We aimed to determine effect size of inpatient, residential or day-patient program in people with OCD. Studies were selected if they were conducted in an inpatient, day-patient or residential setting; were using the Yale Brown Obsessive Compulsive Scale (Y-BOCS) as an outcome measure; treatment included cognitive behavior therapy; it involved adult patients; and had a sample size of at least 20. We identified 19 studies with a total of 2306 participants at admission. We extracted the mean and standard deviation pre-admission and at discharge. The overall reduction was 10.7 points (95% CI: 9.8-11.5, z¼ 24.2 po0.001) with an effect size, Hedges g, of 1.87. Being married or cohabiting consistently predicted better outcomes, and symptoms of hoarding or comorbid alcohol misuse consistently predicted worse outcomes. Clients with severe or treatment refractory OCD can make significant improvements with intensive residential or inpatient therapy but little is known either about its long term benefits or cost effectiveness compared with an alternative. Programs are offered internationally with a variety of inclusion criteria. We discuss how such programs might be optimized.

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“…The use of aCBT in the treatment of anxiety and depression is generally under-utilised (Jónsson, Kristensen, & Arendt, 2015). There is currently only a small amount of research that demonstrates the efficacy of outpatient aCBT for the anxiety and related disorders and this literature generally focusses on social anxiety disorder (Chaker, Hofmann, & Hoyer, 2010;Donovan, Cobham, Waters, & Occhipinti, 2014;Mörtberg, Berglund, & Sundin, 2005;Mörtberg, Clark, Sundin, & Åberg Wistedt, 2007), obsessive-compulsive disorder (Foa et al, 2005;Storch et al, 2007), and post-traumatic stress disorder (Ehlers et al, 2014).…”

mentioning

confidence: 99%

Accelerated outpatient individual cognitive‐behaviour therapy for panic disorder: A case study

Wootton

MacGregor

2018

Clinical Psychologist

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Objective Panic disorder (PD) is a common mental health condition which causes substantial disability. It is well known that cognitive‐behavioural therapy (CBT) is an effective treatment for PD and this treatment is generally provided in 8–14 weekly sessions. A small number of preliminary studies have now investigated the efficacy of accelerated or intensive CBT in the treatment of PD and have found promising results. However, many of these existing treatment formats do not allow for optimal learning, since sessions are administered daily which does not allow time for the client to practice the skills between sessions. Method The aim of this study was to investigate the feasibility of an accelerated CBT (aCBT) approach where treatment was provided three times per week (90‐min sessions) over a two‐week period (six sessions in total) using a case study design. The participant completed a structured diagnostic interview to confirm diagnosis and outcome measures were administered at baseline, post‐treatment, and three‐month follow‐up. Results The results indicated that the participant significantly reduced symptoms of PD over a two‐week period and no longer met diagnostic criteria for PD at three‐month follow‐up. Importantly, the participant also found the treatment format to be highly acceptable. Conclusions The results demonstrate the preliminary acceptability and efficacy of this aCBT approach in the treatment of PD.

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Intensive cognitive behavioural therapy for obsessive-compulsive disorder: A systematic review and meta-analysis

Cited by 48 publications

References 52 publications

Three-Week Inpatient Treatment of Obsessive-Compulsive Disorder: A 6-Month Follow-Up Study

Three-Week Inpatient Treatment of Obsessive-Compulsive Disorder: A 6-Month Follow-Up Study

Outcomes for residential or inpatient intensive treatment of obsessive–compulsive disorder: A systematic review and meta-analysis

Accelerated outpatient individual cognitive‐behaviour therapy for panic disorder: A case study

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