Cognitive Remediation Therapy Does Not Enhance Treatment Effect in Obsessive-Compulsive Disorder and Anorexia Nervosa: A Randomized Controlled Trial.

Autor:	van Passel B; Overwaal Center for Anxiety Disorders, OCD, and PTSD, Pro Persona Institute for Integrated Mental Health Care, Nijmegen, The Netherlands, b.van.passel@propersona.nl.; Behavioral Science Institute, Radboud University, Nijmegen, The Netherlands, b.van.passel@propersona.nl., Danner UN; Altrecht Eating Disorders Rintveld, Zeist, The Netherlands.; Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands., Dingemans AE; Rivierduinen Eating Disorders Ursula, Leiden, The Netherlands.; Institute of Psychology, Leiden University, Leiden, The Netherlands., Aarts E; Department of Methodology and Statistics, Utrecht University, Utrecht, The Netherlands., Sternheim LC; Altrecht Eating Disorders Rintveld, Zeist, The Netherlands.; Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands., Becker ES; Behavioral Science Institute, Radboud University, Nijmegen, The Netherlands., van Elburg AA; Altrecht Eating Disorders Rintveld, Zeist, The Netherlands.; Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands., van Furth EF; Rivierduinen Eating Disorders Ursula, Leiden, The Netherlands.; Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands., Hendriks GJ; Overwaal Center for Anxiety Disorders, OCD, and PTSD, Pro Persona Institute for Integrated Mental Health Care, Nijmegen, The Netherlands.; Behavioral Science Institute, Radboud University, Nijmegen, The Netherlands.; Radboud University Medical Center, Department of Psychiatry, Radboud University, Nijmegen, The Netherlands., Cath DC; Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands.; Altrecht Academic Anxiety Center, Utrecht, The Netherlands.; GGz Drenthe, Department of Specialist Training, Rijksuniversiteit Groningen and University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands.
Jazyk:	angličtina
Zdroj:	Psychotherapy and psychosomatics [Psychother Psychosom] 2020; Vol. 89 (4), pp. 228-241. Date of Electronic Publication: 2020 Feb 19.
DOI:	10.1159/000505733
Abstrakt:	Background: Guideline-recommended therapies are moderately successful in the treatment of obsessive-compulsive disorder (OCD) and anorexia nervosa (AN), leaving room for improvement. Cognitive inflexibility, a common trait in both disorders, is likely to prevent patients from engaging in treatment and from fully benefiting from existing therapies. Cognitive remediation therapy (CRT) is a practical augmentation intervention aimed at ameliorating this impairing cognitive style prior to disorder-specific therapy. Objective: To compare the effectiveness of CRT and a control treatment that was not aimed at enhancing flexibility, named specialized attention therapy (SAT), as add-ons to treatment as usual (TAU). Methods: In a randomized controlled multicenter clinical trial, 71 adult patients with OCD and 61 with AN were randomized to ten twice-weekly sessions with either CRT or SAT, followed by TAU. Patients were evaluated at baseline, post-CRT/SAT, and after 6 and 12 months, with outcomes being quantified using the Yale-Brown Obsessive Compulsive Scale for OCD and the Eating Disorder Examination Questionnaire for AN. Results: Across study groups, most importantly CRT+TAU was not superior to control treatment (SAT)+TAU in reducing OCD and AN pathology. Contrary to expectations, SAT+TAU may have been more effective than CRT+TAU in patients being treated for OCD. Conclusions: CRT did not enhance the effect of TAU for OCD and AN more than SAT. Unexpectedly, SAT, the control condition, may have had an augmentation effect on TAU in OCD patients. Although this latter finding may have been due to chance, the effect of SAT delivered as a pretreatment add-on intervention for adults with OCD and AN merits future efforts at replication. (© 2020 S. Karger AG, Basel.)
Databáze:	MEDLINE
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