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A Journal on Psychiatry, Psychology and Psychopharmacology
Official Journal of the Italian Society of Social Psychiatry
Indexed/Abstracted in: EMBASE, e-psyche, PsycINFO, Scopus, Emerging Sources Citation Index
Minerva Psichiatrica 2001 December;42(4):299-304
Behavior therapy for obsessive-compulsive disorder
Bertoli C., Saracco P., Maina G., Bogetto F.
Despite advances in pharmacotherapy for obsessive-compulsive disorder (OCD), pharmacological treatments are not always effective. Estimates for SSRI and clomipramine are that approximately between 50-60% of patients respond, and that responders achieve, on average, about a 30-40% reduction in symptoms. Because of these limitations, behavioral treatment has been proposed, alone or combined with pharmacoterapy, for OCD patients. A reviews the existing literature on this topic is made. Behavioral therapy consists of many techniques, but results underline that exposure and response prevention are more effective than other behavioral methods in OCD patients. Exposure therapy was found to help mainly in reducing anxiety, whereas response prevention had its greatest effect in reducing rituals. Personal clinical experience and research findings suggest that behavior therapy achieves strong therapeutic changes in OCD patients; it produces the largest improvements in behavioral rituals, such as compulsive cleaning or checking. Recent studies have found that 65% to 75% of patients with these symptoms obtained a remarkable improvement after behavioral treatment and nearly all patients maintained it at follow-up after 2 years or more. Problems with this kind of therapy are: 20% to 30% of patients refuse the behavior treatment, whereas the drop-out rate averages 20%. Moreover, positive and negative predictors of treatment outcome are reported.
Although behavior therapy is shown to be essential for the treatment of OCD, further studies are necessary for a better definition.