Ambulante verhaltenstherapeutische Gruppentherapie bei Zwangsstörungen – ein effektiver Behandlungsansatz?

Abstract

In addition to specific therapeutic effects, cognitivebehaviouraltreatment of obsessive-compulsive disorder (OCD) in agroup setting may offer considerable economic advantages. Thisexplorative study evaluates the effectiveness of a standardized cognitive-behavioural short-term group therapy. In order to provide criteriafor a differentiated assignment to different treatments and toadjust treatment programmes for patients at risk for treatment failure,predictors for therapy outcome were investigated. Patients andMethods: 45 OCD patients who completed a 10-session (150 mineach) symptom-focused outpatient cognitive-behavioural grouptherapy were examined before and after treatment. Results: Thegroup therapy significantly improved average ratings of obsessivecompulsivesymptoms and general psychological distress. Definingtherapy response as a 35% decline of the Yale-Brown ObsessiveCompulsive Scale total score, 31% of the patients could benefitfrom treatment. ‘Clinically significant’ symptom reduction wasachieved by only 16% of the patients. The predictor analysis suggeststhat even patients with complex disorders reduce their symptomssignificantly during group treatment. Treatment response wasneither influenced by initial symptom severity, duration of illnessand depressive symptoms nor by level of education. Only dependentpersonality traits were identified as risk factors for negativetreatment outcome. Conclusions: The group programme hasproven to be as effective for a broad spectrum of OCD patients asother group concepts described in the literature. The rather low responserates suggest that a short group intervention may not beequivalent to long-term individual cognitive-behavioural therapy.Short-term group therapy could possibly rather be used as a specificpreparation for individual cognitive-behavioural therapy.