title: Efficacy of mindfulness-integrated cognitive behavior therapy in patients with predominant obsessions.
abstract: BACKGROUND
  Cognitive behavior therapy (CBT) involving exposure and response prevention is the gold standard psychotherapeutic intervention for obsessive-compulsive disorder (OCD). However, applying traditional CBT techniques to treat patients with predominant obsessions (POs) without covert compulsions is fraught with problems because of inaccessibility of mental compulsions. In this context, we examined the efficacy of mindfulness-integrated CBT (MICBT) in patients with POs without prominent overt compulsions.
  
  
  METHODS
  Twenty-seven patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of OCD were recruited from the specialty OCD clinic and the behavior therapy services of a tertiary care psychiatric hospital over 14 months. Patients had few or no overt compulsions and were free of medication or on a stable medication regimen for at least 2 months prior to baseline assessment. All patients received 12-16 sessions of MICBT on an outpatient basis. An independent rater (psychiatrist) administered the Yale-Brown Obsessive-Compulsive Scale (YBOCS) and the Clinical Global Impression Scale at baseline, mid- and post-treatment, and at 3-month follow-up.
  
  
  RESULTS
  Of the 27 patients, 18 (67%) achieved remission (55% reduction in the YBOCS severity score) at 3-month follow-up. The average mean percentage reduction of obsessive severity at postintervention and 3-month follow-up was 56 (standard deviation [SD] = 23) and 63 (SD = 21), respectively.
  
  
  CONCLUSIONS
  Our study demonstrates that MICBT is efficacious in treating patients with POs without prominent overt compulsions. The results of this open-label study are encouraging and suggest that a larger randomized controlled trial examining the effects of MICBT may now be warranted.
authors.affiliation: Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
authors.forename: Ajay
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
authors.forename: Mahendra P
authors.initials: MP
authors.lastname: Sharma
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
authors.forename: Janardhanan C
authors.initials: JC
authors.lastname: Narayanaswamy
authors.affiliation: Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
authors.forename: Thennarasu
authors.initials: T
authors.lastname: Kandavel
authors.affiliation: Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
authors.forename: Y C
authors.initials: YC
authors.lastname: Janardhan Reddy
keywords: Cognitive behavior therapy; mindfulness meditation; mindfulness-integrated cognitive behavior therapy; obsessions; obsessive-compulsive disorder