The randomized controlled study of the effect of medication with cognitive behavioral therapy and medication on obsessive-compulsive disorder

Objective To compare the effect between the group of 5-selective serotonin reuptake inhibitor (SSRIs) treatment and the group of SSRIs combining cognitive behavioral therapy (CBT). Methods Eighty patients met the Diagnostic and Statistical Manual of Mental Disorders, Fourth edition criteria for obsessive-compulsive disorder were randomly designed to group of SSRIs (n=40), and combined therapy group (n=40). The Y-BOCS, HAMA, Global Assessment Function(GAF) were used to assess the efficacy blindly after 0, 4, 8, 12, 24, 36, 48 week treatment, influence factors of effect were evaluated using logistic regression analysis. Results At the end of 4th week, the Y-BOCS total score were lower than baseline in both groups (group of SSRIs: 20.8±7.0 vs. 23.7±6.3, t=3.46, P=0.001; group of combined therapy: 20.0±6.4 vs. 23.6±6.0, t=4.05, P=0.000). The comparision between groups showed that the Y-BOCS total scores and compulsion scores of two group had significant effects from 8th week to 48th week (Y-BOCS total scores: F=3.986-7.104, P=0.009-0.049; Y-BOCS compulsion scores: F=5.370-5.895, P=0.017-0.023), and the Y-BOCS obsession scores of two groups had a significant effect at the 48th week (F=5.523, P=0.021). Logistic regression analysis demonstrated that with CBT and the fourth week working had positid forecast on the prognosis of patients with long-term effect(OR=8.61, 9.25, both P<0.05). Conclusions SSRIs combining CBT could effectively alleviate symptoms of obsessive-compulsive disorder, and better than single SSRIs group, especially for compulsive behavior. The patients with CBT response at the fourth week can get better improvement in the subsequent treatment. Key words: Obsessive-compulsive disorder; Cognitive therapy; Drug therapy; Randomized controlled trial