Abstract
Aims and methodTo establish whether cognitive-behavioural therapy (CBT) with response and exposure prevention (ERP) is effective in individuals with obsessive–compulsive disorder (OCD). Twenty-four patients with OCD, divided into four groups, participated in ten sessions of group CBT. All patients completed the Yale–Brown Obsessive–Compulsive Scale (Y-BOCS), the Maudsley Obsessive–Compulsive Inventory (MOCI), the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI) pre- and post-treatment.ResultsThe mean (s.d.) YBOC score post-treatment was 17.1 (5.8). This was significantly lower than the mean (s.d.) YBOC pre-treatment (24.7 (6.1); t = 8.4, d.f. = 23, P < 0.005). A significant reduction was also observed in relation to all other rating scales.Clinical implicationsCognitive–behavioural therapy for OCD delivered in a group setting is a clinically effective and acceptable treatment for patients. The use of group-based CBT is an effective means to improve access to psychotherapy.
Highlights
Clinical implications Cognitive-behavioural therapy for obsessivecompulsive disorder (OCD) delivered in a group setting is a clinically effective and acceptable treatment for patients
It is generally accepted that this patient group needs access to cognitive-behavioural therapy (CBT)/exposure prevention (ERP),[22] many patients are denied this form of treatment because of the scarcity of trained CBT therapists
It has been suggested that CBT could be applied in groups, with results equivalent to those of individual treatment, when the number of sessions is comparable with that usually provided for individual patients in controlled research (i.e. 12-20 sessions).[1]
Summary
There was no statistically significant difference between high- (750800 mg/day) and low-dose (300-400 mg/day) quetiapine in terms of the response rate, change in positive symptoms score and the discontinuation rates either as a result of lack of response or adverse effects. Clinical implications Combined evidence from fixed-dose trials does not support the prevalent practice of targeting the higher dose of quetiapine for optimal treatment response in schizophrenia. There is uncertainty around the optimal dose of quetiapine in the treatment of schizophrenia. Clinicians in practice prescribe quetiapine at substantially higher dose than that established in clinical trials.[1] In a recent comprehensive review,[2] the authors concluded that the balance of evidence does not support the belief that higher dosages are required
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