Cognitive behaviour therapy and medication in the treatment of obsessive-compulsive disorder.
OBJECTIVE
To compare cognitive behaviour therapy (CBT) with CBT plus medication; medication alone; and placebo in the treatment of adult obsessive-compulsive disorder (OCD).


METHODS
Forty-eight participants (43 completers) were recruited into two protocols. In the first protocol, 21 people with OCD were randomly allocated to either a standard medication (fluvoxamine) or standard placebo condition for a 5-month period. Both these groups subsequently received CBT for a further 5 months. In the second protocol, 22 people with OCD received CBT, one group was already stabilized on an antidepressant of choice; the second group was drug naïve.


RESULTS
All active treatments, but not the placebo, showed clinical improvement. There was no difference in treatment response to CBT regardless of whether participants had previously received medication or placebo.


CONCLUSIONS
CBT has a more specific antiobsessional effect than medication but CBT plus medication shows greatest overall clinical improvement in mood.
O'Connor
K P
KP
Fernand-Seguin Research Centre, Louis-H. Lafontaine Hospital, Montreal, QC, Canada. kieron.oconnor@umontreal.ca
Aardema
F
F
Robillard
S
S
Guay
S
S
Pélissier
M-C
MC
Todorov
C
C
Borgeat
F
F
Leblanc
V
V
Grenier
S
S
Doucet
P
P
D000328:Adult; D000704:Analysis of Variance; D000928:Antidepressive Agents / Q000627:therapeutic use*; D002170:Canada; D003071:Cognition / Q000187:drug effects; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D010919:Placebos / Q000008:administration & dosage; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000928:Antidepressive Agents; D010919:Placebos