No effect of adding brief dynamic therapy to pharmacotherapy in the treatment of obsessive-compulsive disorder with concurrent major depression

Psychother Psychosom. 2010;79(5):295-302. doi: 10.1159/000318296. Epub 2010 Jul 9.

Abstract

Background: Until now no studies have investigated the benefits of adding brief dynamic therapy (BDT) to medication in obsessive-compulsive disorder (OCD), while a number of recent investigations have demonstrated the efficacy of supplemental BDT among patients with major depressive disorders (MDD). The objective of the present study was to explore the efficacy of BDT combined with pharmacotherapy in comparison with pharmacotherapy alone in the treatment of OCD with concurrent MDD.

Methods: A 12-month randomized clinical trial compared a standard selective serotonin reuptake inhibitor treatment with (n = 27) or without (n = 30) supplemental BDT in patients with OCD and concurrent MDD. Supplemental BDT was added during the first 16-week trial; all patients continued to be treated with only pharmacotherapy in the following continuation phase. The primary efficacy assessments were the Yale-Brown Obsessive Compulsive Scale and the 17-item Hamilton Rating Scale for Depression; the secondary efficacy measures included the Clinical Global Impression scale and the Global Assessment of Functioning. The data analysis was conducted on the 'intent-to-treat (ITT) efficacy patient sample'.

Results: Fifty patients completed the study. No difference between the 2 treatment groups was found at any point by any assessment method in the ITT study sample.

Conclusions: Supplemental BDT in the treatment of patients with OCD with concurrent MDD who are receiving effective medication has no significant clinical effect on both obsessive and depressive symptoms.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Combined Modality Therapy
  • Depressive Disorder, Major / complications*
  • Depressive Disorder, Major / drug therapy
  • Depressive Disorder, Major / therapy
  • Female
  • Fluvoxamine / administration & dosage
  • Fluvoxamine / therapeutic use*
  • Humans
  • Male
  • Obsessive-Compulsive Disorder / complications*
  • Obsessive-Compulsive Disorder / drug therapy
  • Obsessive-Compulsive Disorder / therapy
  • Psychiatric Status Rating Scales
  • Psychotherapy, Brief* / methods
  • Selective Serotonin Reuptake Inhibitors / administration & dosage
  • Selective Serotonin Reuptake Inhibitors / therapeutic use*
  • Sertraline / administration & dosage
  • Sertraline / therapeutic use*
  • Treatment Outcome

Substances

  • Serotonin Uptake Inhibitors
  • Fluvoxamine
  • Sertraline