A randomized controlled trial of group cognitive-behavioral therapy and medication treatment for obsessive-compulsive disorder

Objective To explore the therapeutic effect of group cognitive-behavioral therapy (GCBT) for obsessive-compulsive disorder (OCD). Methods This study used a randomized controlled trial design to compare GCBT with routine medication treatment. Unmedicated ninety-four patients who met the inclusion criteria were recruited and randomly allocated to GCBT group (n=47) and drug treatment group (n=47) by a simple random grouping method using the RAND function in Excel software which generated a table of random numbers to form a random grouping sequence. Both groups were treated for 12 weeks. The average reduction rate and value of Y-BOCS, HAMA14 and HAMD24 were compared between the two groups, t-test,chi-square (χ2) test and variance analysis (ANOVA) were condulted to analyze data. Results (1) There was no significant difference between two groups in Y-BOCS and HAMA14 scores at baseline (t=0.281,P=0.779; t=0.795,P=0.429), but HAMD24 scores were significantly different (t=2.316, P<0.05). Sixteen patients in GCBT group and sixteen in drug treatment group dropped out of treatment, resulted a total drop-out rate of 34%. There was no significant difference in the drop-out rate between the two groups. (2) After 12-week treatment, the Y-BOCS scores decreased compared to pre-treatment in both groups. There was no statistical difference in the mean reduction rate ((37.0±27.4)% vs. (45.5±22.9)%) and score (9.0±6.3 vs.11.0±5.8) of Y-BOCS (F(1,62)=0.069, P=0.794; F(1,62)=0.001, P=0.975) before and after treatment between the two groups. There was no statistical difference in the effective and cure rate between the two groups (χ2=1.653, P=0.199; χ2=0.088, P=0.767) . (3) There was no significant difference in the mean reduction rate and score of HAMA14 (t=-0.922, P=0.362; t=1.082, P=0.286). (4) No significant difference was found regarding the mean reduction rate of HAMD24 between the two groups, but the mean reduction scores of HAMD24 in the medication group were significantly higher than those in GCBT group (t=2.239, P=0.029). Conclusion GCBT is equivalent to conventional medication treatment for obsessive-compulsive and anxiety symptoms for OCD patients, and medication treatment is superior to GCBT in depressive symptoms. Key words: Obsessive-compulsive disorder; Cognitive therapy; Group structure; Randomized controlled trials