Reducing anxiety and depression in OCD: a randomized controlled trial of exposure and response prevention therapy

Obsessive-compulsive disorder (OCD) frequently co-occurs with anxiety and depression, intensifying psychological distress and functional impairment. Although exposure and response prevention (ERP) is well established for treating core OCD symptoms, its effects on these common comorbid emotional disturbances remain underexplored. This study aimed to evaluate rigorously the effectiveness of ERP in reducing both anxiety and depressive symptoms in adults with OCD.

In a randomized controlled trial at Razi Clinic, Tabriz, Iran (April 2022-May 2023), 50 adults (18-60 years) meeting DSM-5 criteria for OCD were recruited and randomly assigned to either an ERP intervention group or a wait-list control group (n = 25 each). Both groups completed the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) at baseline and after intervention. The ERP group received eight weekly 90-minute sessions. Data were analyzed using analysis of covariance (ANCOVA), controlling for baseline scores.

The ERP group demonstrated a significant reduction in anxiety scores, decreasing from 33.80 ± 4.15 to 24.24 ± 3.80 after treatment (p = .030), and in depression scores from 31.15 ± 3.20 to 17.44 ± 3.60 (p < .001). These improvements likely reflect ERP's capacity to decrease avoidance behaviors and enhance emotion regulation.

ERP is an effective evidence-based intervention not only for OCD's core symptoms but also for co-occurring anxiety and depression. Incorporating ERP into routine clinical practice may therefore yield broader emotional benefits for individuals with OCD.