title: Effectiveness of cognitive behavioral therapy and fluoxetine on sexual function of women with obsessive compulsive disorder: A double-blind randomized controlled trial.
abstract: BACKGROUND
  Obsessive compulsive disorder (OCD) is a mental health concern due to its various negative consequences, especially in sexual function. Therefore, the treatment of sexual dysfunction in women with OCD is important in order to improve the patient's marital function and mental health.
  
  
  OBJECTIVE
  To compare the sexual behavior and sexual and marital satisfaction in women with obsessive-compulsive disorder (OCD) before and after treatment with fluoxetine and cognitive behavior therapy.
  
  
  METHODS
  This randomized clinical trial was conducted at psychiatric and psychological counseling centers in Kashan (Iran) from January 2, 2014, to December 29, 2014. Fifty-eight women with OCD were included in the study. In order to compare the effectiveness of pharmacological treatment (fluoxetine) and psychological treatment, cognitive behavior therapy (CBT), 58 female patients with OCD (diagnosed based on DSM-IV-T criteria) were randomized equally to either fluoxetine (at a dose of 60-80 mg daily for 3 months) or CBT (10 45-minute sessions). OCD and sexual behavior status of the patients before and after the intervention was assessed with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and Female Sexual Function Index (FSFI) questionnaire, respectively. The data were analyzed using SPSS version 22. To compare changes between the two groups, an independent T-test was used. Finally, the effects of all potential factors on treatment outcome were analyzed using factorial ANCOVA.
  
  
  RESULTS
  The mean score for OCD in the fluoxetine group was 25.6 ± 4.8 at the beginning of the experiment and 18.79 ± 4.26 at the end of the study, while in the CBT group it was 25.6 ± 4.8 and 18.79 ± 4.26, respectively. No significant differences were found between two groups regarding obsession score changes. These scores in fluoxetine group were 58.1 and 52.8, respectively (p=0.046). There was a significant difference between the two groups in terms of sexual performance (p=0.003).
  
  
  CONCLUSIONS
  In this study, our findings demonstrate a significant reduction in symptom severity of OCD after treatment with fluoxetine and CBT, indicating CBT can be an alternative for fluoxetine therapy in such patients. Therefore, both pharmacotherapy and CBT can be used for this purpose in clinical practices, but more studies are needed.
  
  
  BACKGROUND
  The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT2013091014619N1.
  
  
  BACKGROUND
  The authors received no financial support for the research, authorship, and/or publication of this article.
authors.affiliation: M.D., Psychiatrist, Department of Psychiatry, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Sabetnejad
authors.affiliation: M.D., Psychiatrist, Assistant Professor, Department of Psychiatry, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Assarian
authors.affiliation: Ph.D., Psychologist, Associate Professor, Department of Clinical Psychology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
authors.forename: Abdollah
authors.initials: A
authors.lastname: Omidi
authors.affiliation: M.D., Psychiatry Resident, Department of Psychiatry, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Najarzadegan
keywords: Cognitive behavior therapy; Fluoxetine; Obsessive-compulsive disorder; Sexual behavior