Abstract
BackgroundThe Bergen 4-day treatment (B4DT) is a concentrated exposure-based treatment for patients with Obsessive-Compulsive Disorder (OCD) delivered during four consecutive days. The B4DT has in a number of effectiveness studies demonstrated promising results as approximately 90% of patients gain reliable clinical change post-treatment and nearly 70% are recovered on a long-term basis.MethodsThe current study is the first randomized controlled trial evaluating the effects of the B4DT. Forty-eight patients diagnosed with OCD were randomized to B4DT, self-help (SH), or waiting list (WL) with 16 patients in each condition. All participants randomized to the B4DT underwent the treatment without any attrition.ResultsThe B4DT yielded significantly better effects than control conditions on measures of OCD, depression, and generalized anxiety. The response rate (≥35% reduction of the individual patient’s pre-treatment Y-BOCS score) was 93.8% in B4DT, 12.5% in SH and 0% in WL, while remission rate (response criterion is fulfilled and the post-treatment Y-BOCS score is ≤12 points) was 62.5%, 6.3%, and 0%, respectively. Furthermore, patients who had received the B4DT, showed improved work- and social functioning. None of the patients treated with B4DT showed signs of deterioration. In comparison, one patient in the SH condition was in remission, and one showed significant clinical improvement, whereas the remaining showed no change.ConclusionThe results indicate that the B4DT is an effective treatment for patients suffering from OCD.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NCT02886780.
Highlights
Cognitive behavior therapy (CBT) including exposure and response prevention (ERP) is widely recognized as the treatment of choice for patients suffering from obsessive-compulsive disorder (OCD; Öst et al, 2015)
Forty-eight patients diagnosed with OCD were randomized to Bergen 4-day treatment (B4DT), self-help (SH), or waiting list (WL) with 16 patients in each condition
The results indicate that the B4DT is an effective treatment for patients suffering from OCD
Summary
Data Thirty-eight (79%) of the participants were female, and the mean age of the participants was 30 years, 31 (64%) were single. The LET intervention One of the main features of the B4DT is to teach the patients to approach whatever elicits OCD-related anxiety or discomfort, and to help them systematically learn how to “LEan into The anxiety” (LET-technique) instead of employing obvious or subtle avoidance During the exposures, their task is to clearly demonstrate that they are doing something that is incompatible with practicing OCD-behaviors. We used hierarchical linear modeling (HLM) with random intercepts to compare the two exposure based interventions (B4DT and SH) with the WL control condition These models estimate effects for change from pre-treatment to post-treatment. As there were significant differences between conditions on PHQ-9, the pre-treatment score was included as a covariate in the HLMs. A HLM was used to examine if the effect from the B4DT would be maintained at the 3month and 6-month follow-ups. Fisher’s exact probability test (2-tailed) was used to compare differences between the treatment conditions on dichotomous variables
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