Most OCD Patients Don’t Receive Cognitive Behavioral Therapy,
Even though it is Considered First Line Treatment

(New York, NY, June 12, 2006)--A new study published in this month’s Journal of Clinical Psychiatry reports that a majority of patients with obsessive-compulsive disorder (OCD) do not receive cognitive behavioral therapy (CBT), even though CBT is considered the most effective psychotherapy treatment there is for OCD and has been shown to be an effective OCD treatment either on its own or in conjunction with serotonin reuptake inhibitors or SRIs.
According to data culled from analyses of a survey of a national sample of psychiatrists who treat patients with OCD, a dismal 7.5% of patients received CBT, researchers at the New York State Psychiatric Institute/Columbia University Medical Center found.
“This finding substantiates earlier evidence pointing to a disconnect between what we know to be effective based on empirical evidence and the actual treatment provided in clinical practice,” said Dr. Blair Simpson, an OCD expert and one of the authors of the current study.
Obsessive-compulsive disorder is an anxiety disorder characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). People with OCD often feel the need to perform certain rituals (for example, counting or excessive hand washing) in order to experience any relief from their symptoms and will become increasingly anxious if these rituals are not performed. This anxiety can have tremendous negative impact on individuals’ personal and professional relationships. Research has shown that CBT is effective. A key component of the treatment is exposure, in which people confront the things they fear.
Serotonin reuptake inhibitors (SRIs) have also been shown to be an effective
option for OCD patients and the authors also sought to determine whether patients received adequate doses. “Sixty-five percent of patients received an SRI but only 39.4% of the sample of patients received an SRI at a dose thought to be most effective for OCD…” the authors wrote. They added “It is possible that some patients may be unable to tolerate high doses of SRIs, derived little benefit in the past from these doses, or simply refused to try them. However, none of the patients on lower SRI doses were receiving CBT to augment their response.”
While the authors acknowledge that some treatment providers may not be skilled in using CBT (and some patients may not want CBT), they owe it to their patients to advise them of all their options. “In some patients, CBT works better than SRIs. CBT is also a safe and effective way to enhance SRI response,” said Dr. Simpson.
The study results were based data for 123 patients and the 820 members of the American Psychiatric Institute for Research and Education (APIRE)’s Practice Research Network (PRN) Study of Psychiatric Patients and Treatments (1997 and 1999).

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