Effektivität psychologischer Therapien von spezifischer Phobie und Zwangsstörung: Meta-Analysen auf Störungsebene

Abstract

Efficacy of Psychological Treatments for Specific Phobia and Obsessive Compulsive Disorder The present study compares the efficacy of 8 different psychological treatments for specific phobia, or 5 for obsessive-compulsive disorder, respectively, in a meta-analysis of 32 studies that included 80 treatment interventions. Pre-post effect sizes were calculated for 5 clinical outcome variables: main symptoms, general anxiety, depression, impairment and general psychopathology. Long-term outcome has been investigated up to 2 years past interventions. For specific phobia, most psychological interventions namely desensitization, exposure, applied relaxation, applied tension and cognitive therapy, yielded high effect sizes (ES) between 1.42 and 2.06 for main symptoms. Long-term follow-ups have been investigated for exposure and applied relaxation and tension for which treatment gains were stable up to 1 year past interventions. In part, the analyzed treatments have proven their efficacy only for a subgroup of specific phobias: desensitization has been investigated mainly in the treatment of dental phobia, applied tension in the treatment of blood- and injection phobia. In the treatment of obsessive-compulsive disorder, cognitive-behavioral therapy yielded the highest ES for main symptoms (ES = 1.84). The ES for exposure was lower (ES = 1.44), but did not differ statistically from the effect of cognitive-behavioral therapy. Treatment gains for both were maintained up to 2 years past interventions.