Obsessive-Compulsive Disorder
Conditions
Brief summary
The purpose of this study is to determine whether acceptance and commitment therapy is effective in the treatment of SSRIs-resistant obsessive- compulsive disorder.
Detailed description
The patients who were SSRI-resistant will be randomized to ACT, aripiprazole, or SMT. Independent evaluators, blind to treatment,will evaluate patients during the study.The Yale-Brown Obsessive Compulsive Scale (YBOCS)will be used to measure OCD severity.
Interventions
BEHAVIORALAcceptance and commitment therapy
Patients randomized to ACT will receive weekly 45-50 minute sessions delivered over 8 weeks by a therapist. ACT will include mindfulness,learning new methods to handle problems，acceptance of thoughts and feelings, learning to disempower thoughts and feelings, and values-based committed action.
DRUGAripiprazole
Patients randomized to aripiprazole group will be treated with aripiprazole at the dose of 10-20mg/day for 8 weeks.
BEHAVIORALStress management training
Patients randomized to SMT group will be received 2 introductory sessions and 15 treatment sessions. SMT will include training of stress manage-ment skills, progressive muscle relaxation,positive imagery, assertiveness training, and problem solving.
Sponsors
Shanghai Mental Health Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
1. age between 18 and 65; 2. no less than 9 years in education; 3. a DSM-IV diagnosis of OCD 4. moderately symptomatic (Yale-Brown Obsessive Compulsive Scale score≥16) 5. received at least two kinds of SSRIs at optimal dose for more than 12 weeks An optimal dose is described as following: clomipramine hydrochloride, at least 225 mg/d;fluoxetine, at least 60 mg/d; paroxetine hydrochloride, at least 60 mg/d; sertraline hydrochloride, at least 200 mg/d; fluvoxamine, at least 250 mg/d; citalopram hydrobromide,at least 60 mg/d; and escitalopram oxalate, at least 40 mg/d.Patients who are unable to tolerate the supposed optimal doses were also eligible if at their maximally tolerated dose.
Exclusion criteria
1. with comorbid Axis I psychiatric disorders 2. drug abuse in the last 3 months 3. HAMD\>25 4. too severe to receive ACT or evaluation 5. at high risk of suicide 6. pregnant or prepare for pregnancy 7. with somatic disorder 8. received aripiprazole(≥10mg for 8weeks) or ACT(8 times within 2 months) before 9. treated with no more than one kind of SSRI before
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Yale Brown Obsessive Compulsive Scale | 0,8week | Change from baseline Y-BOCS score at 8 weeks |
Secondary
| Measure | Time frame |
|---|---|
| Acceptance and Action Questionnaire | 0,8week |
| Treatment Evaluation Inventory-Short Form | 0,8week |
| Beck Depression Inventory | 0,8week |
| BMI | 0,8week |
| Abnormal Involuntary Movement Scale | 0,8week |
| Basic life sign | 0,8week |
Outcome results
None listed