A randomized clinical trial of cognitive-behavioral group therapy and sertraline in the treatment of obsessive-compulsive disorder

• Published in: The journal of clinical psychiatry Vol. 67; no. 7; pp. 1133 - 1139
• Main Authors: SOUSA, Marcelo B, ISOLAN, Luciano R, OLIVEIRA, Renata R, MANFRO, Gisele G, CORDIOLI, Aristides V
• Format: Journal Article
• Language: English
• Published: Memphis, TN Physicians Postgraduate Press 01-07-2006
• Subjects: Adult; Adult and adolescent clinical studies; Ambulatory Care; Anxiety disorders. Neuroses; Behavior therapy. Cognitive therapy; Biological and medical sciences; Cognitive Behavioral Therapy; Female; Humans; Male; Medical sciences; Neuropharmacology; Obsessive-Compulsive Disorder - diagnosis; Obsessive-Compulsive Disorder - drug therapy; Obsessive-Compulsive Disorder - therapy; Obsessive-compulsive disorders; Pharmacology. Drug treatments; Psychiatric Status Rating Scales - statistics & numerical data; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychopharmacology; Psychotherapy, Group; Quality of Life; Serotonin Uptake Inhibitors - therapeutic use; Sertraline - therapeutic use; Severity of Illness Index; Treatment Outcome; Treatments; Obsessive compulsive disorder; Cognitive therapy; Serotonin; Psychotropic; Anxiety disorder; Group psychotherapy; Reuptake inhibitor; Sertraline; Selective serotonin reuptake inhibitor; Chemotherapy; Treatment; Neurotransmitter; Antidepressant agent; Clinical trial; Behavior therapy
• ISSN: 0160-6689; 1555-2101
• DOI: 10.4088/jcp.v67n0717

Cognitive-behavioral group therapy (CBGT) and serotonin reuptake inhibitors have proven efficacy in reducing symptoms of obsessive-compulsive disorder (OCD). There is no consensus about which of these forms of treatment is more effective. This study was conducted to evaluate the efficacy of CBGT as compared to that of sertraline in reducing OCD symptoms.
Fifty-six outpatients with an OCD diagnosis, according to DSM-IV criteria, participated in the randomized clinical trial: 28 took 100 mg/day of sertraline and 28 underwent CBGT for 12 weeks. Efficacy of treatments was rated according to the reduction in scores on the Yale-Brown Obsessive Compulsive Scale (YBOCS) and the Clinical Global Impressions-Severity of Illness scale. The trial was performed in 4 successive periods from March 2002 to December 2003.
Both treatments were effective, although patients treated with CBGT obtained a mean YBOCS reduction of symptoms of 44%, while those treated with sertraline obtained only a 28% reduction (p = .033). Cognitive-behavioral group therapy was also significantly more effective in reducing the intensity of compulsions (p = .030). Further, 8 patients (32%) treated with CBGT presented a complete remission of OCD symptoms (YBOCS score < or = 8) as compared to only 1 patient (4%) among those who received sertraline (p = .023).
Cognitive-behavioral group therapy and sertraline have shown to be effective in reducing OCD symptoms. Nevertheless, the rate of symptom reduction, intensity reduction of compulsions, and percentage of patients who obtained full remission were significantly higher in patients treated with CBGT.