Abstract

COMPARATIVE STUDY METACOGNITIVE THERAPY VERSUS CLOMIPRAMINE AND COMBINED THERAPY IN THE IMPROVEMENT OF OBSESSIVE-COMPULSIVE AND ANXIETY SYMPTOMS IN PATIENTS WITH OBSESSIVE-COMPULSIVE DISORDER (OCD): A RANDOMIZED CLINICAL TRIAL

Najmeh Tavakkolian, Ali Nazeri Astaneh*, Mohammad Reza Najarzadegan, Neda Alibeigi

Abstract

Background: The aim of this study was to compare the efficacy of metacognitive therapy (MCT), Clomipramine and the combination of MCT with Clomipramine treatment in treating Iranian patients with OCD. Methods: This randomized clinical trial was conducted at referring to psychological- psychiatric centers of Tehran, Iran, from November 21, 2014 to January 20, 2015. Thirty nine outpatients meeting DSM-IV-TR criteria for OCD without any other axis I and II disorder were randomly assigned to one of three treatment conditions: MCT, Clomipramine and combined treatment. All the patients received 10 weeks of treatment. TheYale-Brown Obsessive-Compulsive Scale (Y-BOCS) and Beck Anxiety Inventory (BAI) were administered at pre-treatment and post-treatment. Data were analyzed by Kruskal Wallis test, clinically significant change, ANCOVA and pre- to post-treatment percentage improvement. Results: Results showed that the amount of reduction in symptoms of obsessive-compulsive was (%39.2) in the drug therapy group, in the meta-cognitive therapy group (%52.6) and in the combination group (%56.5) while reduction in level of anxiety in the medical treatment group was (%57.1), in the drug therapy group (%63.8) and in the combination therapy group (%59.6). All results were statistically significant (p = 0.01). There was clinically significant change results also showed that, unlike the Clomipramine, the MCT and combined treatment lead to more improvement in 10 weeks. Conclusion: MCT and combined treatment are more effective than Clomipramine. However in this study, due to the short duration of treatment and lack of prescription of medication with a maximum effective dose, the drug's efficacy results could not be generalized and long-term follow-up studies in this area is necessary to examine the problem more carefully.

Keywords: Obsessive-compulsive disorder; Metacognitive model; Metacognitive therapy; Clomipramine.