A Randomized, Controlled Trial of Cognitive-Behavioral Therapy for Augmenting Pharmacotherapy in Obsessive-Compulsive Disorder
Open accessAbstract
Objective Although serotonin reuptake inhibitors (SRIs) are approved for the treatment of obsessive-compulsive disorder (OCD), most OCD patients who have received an adequate SRI trial continue to have clinically significant OCD symptoms. The purpose of this study was to examine the effects of augmenting SRIs with exposure and ritual prevention, an established cognitive-behavioral therapy (CBT) for OCD. Method A randomized, controlled trial was conducted at two academic outpatient clinics to compare the effects of augmenting SRIs with exposure and ritual prevention versus stress management training, another form of CBT. Participants were adult outpatients (N=108) with primary OCD and a Yale-Brown Obsessive Compulsive Scale total score > or = 16 despite a therapeutic SRI dose for at least 12 weeks prior to entry. Participants received 17 sessions of CBT (either exposure and ritual prevention or stress management training) twice a week while continuing SRI pharmacotherapy. Results Exposure and ritual prevention was superior to stress management training in reducing OCD symptoms. At week 8, significantly more patients receiving exposure and ritual prevention than patients receiving stress management training had a decrease in symptom severity of at least 25% (based on Yale-Brown Obsessive Compulsive Scale scores) and achieved minimal symptoms (defined as a Yale-Brown Obsessive Compulsive Scale score Conclusions Augmentation of SRI pharmacotherapy with exposure and ritual prevent…
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Simpson et al. found patients on stable dose of SRIs experienced greater symptom reduction after additional 17 weeks of ERP compared to augmentation with stress management training.
“Simpson et al.[23] found that patients on a stable dose of SRIs experienced greater symptom reduction after additional treatment with 17 weeks of ERP compared to those who received augmentation with stress management training”
From Exposure and response prevention for obsessive-compulsive disorder: A review and new directions (2019) · cites this paper as [23]
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- Authors
- Simpson, H. B., Foa, E. B., Liebowitz, M. R., Ledley, D. R., Huppert, J. D., Cahill, S., Vermes, D., Schmidt, A. B., Hembree, E., Franklin, M., Campeas, R., Hahn, C.-G., & Petkova, E.
- Affiliations
- New York State Psychiatric Institute (US)
- ORCID
- Venue
- American Journal of Psychiatry
- Published
- 2008-05
- Volume
- 165
- Issue
- 5
- Pages
- 621-630
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC3945728
- OpenAlex
- W2149291650
- Cited by
- 316
- References
- 16
- Citations by year
- 2026: 8 · 2025: 6 · 2024: 8 · 2023: 13 · 2022: 16 · 2021: 9 · 2020: 18 · 2019: 16 · 2018: 11 · 2017: 19 · 2016: 13 · 2015: 22 · 2014: 21 · 2013: 15 · 2012: 56
- FWCI
- 24.17
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH045404, R01MH-45404, K23MH001907, K23 MH-01907, R01MH045436, R01MH-45436)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- obsessive-compulsive disorder, cognitive behavioral therapy, exposure and response prevention, stress management training, augmentation therapy, serotonin reuptake inhibitors, pharmacotherapy, treatment-resistant OCD, symptom severity
- MeSH terms
- Adolescent, Adult, Aged, Chromatography, Gas, Clomipramine, Combined Modality Therapy, Female, Humans, Male, Middle Aged, Obsessive-Compulsive Disorder, Cognitive Behavioral Therapy, Selective Serotonin Reuptake Inhibitors, Diagnostic and Statistical Manual of Mental Disorders
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