Mindfulness-based cognitive therapy in obsessive-compulsive disorder: protocol of a randomized controlled trial

Area of Science:

• Psychiatry
• Clinical Psychology
• Behavioral Therapy

Background:

• Obsessive-compulsive disorder (OCD) is a chronic and disabling condition.
• Cognitive behavioral therapy (CBT) with or without SSRIs is a primary treatment, but up to one-third of patients show insufficient response.
• Mindfulness-based cognitive therapy (MBCT) offers a potential adjunctive or alternative approach for non-responders.

Purpose of the Study:

• To evaluate the efficacy of MBCT compared to a psycho-educative coaching control group (OCD-EP) in reducing obsessive-compulsive symptoms in patients with inadequate response to CBT.
• To assess the long-term effects of MBCT on symptom severity at 6- and 12-month follow-ups.
• To explore MBCT's impact on secondary outcomes including depressive symptoms, quality of life, metacognitive beliefs, self-compassion, and mindful awareness.

Main Methods:

• A prospective, bicentric, assessor-blinded, randomized, actively-controlled clinical trial.
• 128 participants diagnosed with OCD (DSM-IV) and partial or no response to CBT were recruited.
• Participants were randomized to either an 8-week MBCT group intervention or an OCD-EP control group, with 120-minute weekly sessions.

Main Results:

• Hypothesized superiority of MBCT over OCD-EP in reducing obsessive-compulsive symptoms as measured by the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS).
• Evaluation of secondary outcomes including depressive symptoms, quality of life, metacognitive beliefs, self-compassion, and mindful awareness.
• Assessment of approach-avoidance tendencies using a dedicated task.

Conclusions:

• This study aims to clarify the therapeutic benefits of MBCT for OCD patients who have not fully benefited from standard CBT.
• It represents the first randomized controlled trial to specifically assess MBCT's effects on symptom severity and related psychological parameters in OCD.
• Findings will inform treatment guidelines for refractory OCD cases.