Acceptance and Commitment Therapy in SSRI-Resistant Obsessive Compulsive Disorder
Study Details
Study Description
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.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
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.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Acceptance 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. |
Behavioral: Acceptance 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.
|
| Active Comparator: Aripiprazole Patients randomized to aripiprazole group will be treated with aripiprazole at the dose of 10-20mg/day for 8 weeks. |
Drug: Aripiprazole
Patients randomized to aripiprazole group will be treated with aripiprazole at the dose of 10-20mg/day for 8 weeks.
|
| Other: Stress 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. |
Behavioral: Stress 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.
|
Outcome Measures
Primary Outcome Measures
- Yale Brown Obsessive Compulsive Scale [0,8week]
Change from baseline Y-BOCS score at 8 weeks
Secondary Outcome Measures
- Beck Depression Inventory-II [0,8week]
- Acceptance and Action Questionnaire [0,8week]
- Treatment Evaluation Inventory-Short Form [0,8week]
- Basic life sign [0,8week]
- BMI [0,8week]
- Abnormal Involuntary Movement Scale [0,8week]
Eligibility Criteria
Criteria
Inclusion Criteria:
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age between 18 and 65;
-
no less than 9 years in education;
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a DSM-IV diagnosis of OCD
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moderately symptomatic (Yale-Brown Obsessive Compulsive Scale score≥16)
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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:
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with comorbid Axis I psychiatric disorders
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drug abuse in the last 3 months
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HAMD>25
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too severe to receive ACT or evaluation
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at high risk of suicide
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pregnant or prepare for pregnancy
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with somatic disorder
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received aripiprazole(≥10mg for 8weeks) or ACT(8 times within 2 months) before
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treated with no more than one kind of SSRI before
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- Shanghai Mental Health Center
Investigators
- Study Director: Zhen Wang, Ph.D M.D, Shanghai Mental Health Center
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- SMHC-OCD-002