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To determine the effectiveness of cognitive behavioural therapy for patients with obsessive-compulsive disorder (OCD) without overt compulsive rituals.
Randomised controlled trial.
29 referred or self referred patients (mean age 36 y, 55% men) who were diagnosed with OCD based on the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition, revised; used cognitive neutralising activities; had no overt compulsions or compulsions functionally related to the target obsession; and did not meet diagnostic criteria for substance abuse disorder, psychotic disorders, organic mental disorder, paraphilia, or impulse control disorders and completed a pretreatment assessment. Patients with mood or anxiety disorders secondary to OCD, and those receiving medication at a stable dosage for ≥12 weeks, were eligible.
Patients allocated to treatment (n=15) met with trained therapists twice weekly for 1.5 hour sessions and received a standardised programme (a cognitive account of obsessions, training in exposure and response prevention, cognitive restructuring, and instruction in relapse prevention). Therapy termination was based on clinical improvement or a maximum of 40 sessions. Follow up sessions were held at 1, 2, and 3 months, and a booster session occurred at 6 months. Patients allocated …
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