Efficacy of cognitive-behavior therapy on the tratment of obsessive-compulsive disorder: a review

Abstract

Aim of this work is to present a series of data about the behavioral and cognitive therapy for obsessive compulsive disorder and to suggest some methodological and clinical implications. As such, we reviewed 29 articles in english language from the end of seventies to 1993, pointing out the following aspects: attrition, drop-out, short and long terms success rates. Further, we presented our results by distinguishing among behavior therapy vs. behavior therapy with antidepressants. From a methodological perspective we underline the need to present data in form of patients' improvement rate, because this way seems us the clearest one for evaluating the real efficacy of therapy. Results show that the treatment of choice for obsessive-compulsive is exposure with response prevention: this treatment offer the best results in individual format. 7 out 10 patients who finish the psychotherapy obtain a significant clinical improvement which is maintained up to two years from the end of the therapy. Behavior therapy with antidepressants is not better than behavior therapy alone and we suggest to use it in presence of severe depression, suicidal ideation, obsessions alone or overvalued ideation. The results obtained with cognitive therapy up to now don't justify the exclusive use of this therapy model. Finally, we stress the difficulty to evaluate the patients' clinical improvement for the lack of reliable instruments to assess obsessions and compulsions.