How effective are cognitive and behavioral treatments for obsessive-compulsive disorder? A clinical significance analysis.
Controlled outcome studies investigating the efficacy of psychological treatments for obsessive-compulsive disorder (OCD) have employed different methods of determining the clinical significance of treatment effects. This makes it difficult to draw conclusions regarding the absolute and relative efficacy of psychological treatments for OCD. To address this issue, standardized Jacobson methodology for defining clinically significant change was applied to recent psychological outcome trials for OCD. The proportion of asymptomatic patients following treatment was also calculated. When recovery is defined by Jacobson methodology, exposure and response prevention (ERP) appears the most effective treatment currently available (50-60% recovered). However, when the asymptomatic criterion is used as the index of outcome, ERP and cognitive therapy have low and equivalent recovery rates (approximately 25%).
Fisher
Peter L
PL
Department of Clinical Psychology, Rawnsley Building, Manchester Royal Infirmary, University of Manchester, Oxford Road, Manchester M13 9WL, UK. peteleofisher@hotmail.com
Wells
Adrian
A
D001521:Behavior Therapy / Q000379:methods*; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006801:Humans; D009771:Obsessive-Compulsive Disorder / Q000523:psychology / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome