Abstract
BackgroundA high number of patients with obsessive-compulsive disorder (OCD) do not receive cognitive-behavioral therapy with exposure and response prevention, which is the most effective treatment for OCD. Therefore, Metacognitive Training for OCD (MCT-OCD) was developed, which is a structured group therapy aiming at the modification of dysfunctional (meta-)cognitive biases, beliefs and coping styles. It can be administered by less trained personnel, thus may reach a higher number of patients.An uncontrolled pilot study (MCT-OCD pilot version) provided first evidence that the training is highly accepted by patients; OC symptoms decreased with a high effect size (η2partial = 0.50). The aim of the present study is to address the shortcomings of the pilot study (e.g., no control group) and to assess the efficacy of the revised version of the MCT-OCD in the framework of a randomized controlled trial.MethodsEighty patients with OCD will be recruited. After a blinded assessment at baseline (−t1), patients will be randomly assigned either to the intervention group (MCT-OCD; n = 40) or to a care as usual control group (n = 40). The MCT-OCD aims to enhance patients’ metacognitive competence in eight modules by addressing dysfunctional (meta-)cognitive biases and beliefs associated with OCD (e.g., intolerance of uncertainty). After 8 weeks, patients will be invited to a post assessment (t1), and then they will receive a follow-up online questionnaire 3 months following t1 (t2). The primary outcome is the Y-BOCS total score, and the secondary outcomes include the HDRS, OCI-R, OBQ-44, MCQ-30, WHOQOL-BREF, BDI-II, and subjective appraisal ratings of the MCT-OCD. We expect that OC symptoms will decrease more in the intervention group compared with the care as usual control group from –t1 to t1 and that treatment gains will be maintained until t2.DiscussionThe planned study is the first to investigate the MCT-OCD, a promising new treatment, in a randomized controlled trial. The MCT-OCD may help to overcome existing treatment barriers for patients with OCD.Trial registrationGerman Registry for Clinical Studies (DRKS00013539), 22.02.2018.
Highlights
A high number of patients with obsessive-compulsive disorder (OCD) do not receive cognitivebehavioral therapy with exposure and response prevention, which is the most effective treatment for OCD
For heuristic purposes and in order to classify the constructs into the different elements of the metacognitive training for OCD (MCT-OCD), which is described below, we think it is necessary to distinguish between beliefs, metacognitive beliefs, cognitive biases, and coping strategies
Aim of the present study The present study aims to evaluate the efficacy of the Metacognitive Training for psychosis (MCT)-OCD versus a care as usual control group for patients with OCD
Summary
A high number of patients with obsessive-compulsive disorder (OCD) do not receive cognitivebehavioral therapy with exposure and response prevention, which is the most effective treatment for OCD. Metacognitive Training for OCD (MCT-OCD) was developed, which is a structured group therapy aiming at the modification of dysfunctional (meta-)cognitive biases, beliefs and coping styles. It can be administered by less trained personnel, may reach a higher number of patients. Obsessive-compulsive disorder (OCD) is characterized by intrusive, repetitive, and perturbing thoughts (i.e., obsessions such as the fear of being infected by germs when touching a door handle) that usually evoke negative feelings (e.g., fear or disgust) [1] These negative emotions are reduced or occur less frequently, respectively upon execution of compulsive behavior that is ritualized and repetitive (e.g., excessive hand washing) and of avoidance behavior (e.g., pushing the door handle down with one’s elbow), but these behaviors maintain OC symptoms over the long term. The boundaries of these concepts (beliefs, metacognitive beliefs, cognitive biases, and coping strategies) are blurred
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