Multimodal Interventions for Obsessive-Compulsive Disorder: Efficacy of Exposure Therapy, Cognitive Approaches, and Pharmacological Treatment

Authors

  • Samra Zulfiqar Department of Humanities, COMSATS University Islamabad, Lahore, Pakistan
  • Maham Kanwal Department of Humanities, COMSATS University Islamabad, Lahore, Pakistan
  • Shumaila Pervaiz Department of Medicine and Dentistry, Faculty of Pharmacology, University of Alberta, Alberta, Canada
  • Shazia Azhar Institute of Medical Technology, Baqai Medical University, Karachi, Pakistan
  • Muhammad Hussain School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
  • Muhammad Umair Institute of Biochemistry, Biotechnology and Bioinformatics, The Islamia University of Bahawalpur, Pakistan

DOI:

https://doi.org/10.31580/pjmls.v7i3.3143

Keywords:

Cognitive therapy, Exposure therapy, Mental health, Multimodal interventions, Obsessive-compulsive disorder, Pharmacological treatment, Selective serotonin reuptake inhibitors (SSRIs), Symptom reduction

Abstract

Objective: The purpose of this systematic review is to review the effectiveness of multimodal therapies including exposure therapy, cognitive behavioral therapy, and pharmacotherapy for obsessive-compulsive disorder (OCD). 

Methodology: Following PRISMA guidelines, this systematic review evaluated the effectiveness of multimodal interventions for OCD, with a focus on exposure therapy, cognitive approaches, and pharmacological treatments. A search across databases, including PubMed, PsycINFO, and the Cochrane Library, identified 90 articles from 2010 to 2023. The inclusion criteria focused on studies that reported on the effectiveness of multimodal treatments for OCD in both adult and pediatric populations, while the exclusion criteria ruled out studies with fewer than 20 participants and single-modality studies. The quality of 40 studies was then examined using meta-analytic techniques, with the I² statistic used to assess heterogeneity. After evaluation with the Cochrane Risk of Bias Tool and the Newcastle-Ottawa Scale, 16 studies met the inclusion criteria. The table included only low to moderate risk of bias studies to produce high-quality evidence.

Results: Multimodal interventions lead to dramatic reductions in OCD symptom severity, and exposure therapy (ERP) improved compulsive behaviour (mean Y-BOCS reduction of 6.5, p < 0.01). ERP (3 sessions) combined with cognitive therapy was effective in decreasing obsessive thoughts (mean reduction of 4.3 points on Y-BOCS, p < 0.05). The combination of pharmacotherapy with ERP and cognitive therapy was most effective in producing substantial symptom control, increasing remission rates by 15% above that of ERP alone.

Conclusion: Integration of exposure therapy with cogitative and pharmacological therapy forms a very effective method of dealing with OCD, making multimodal antigrowth therapies possible. The multimodal intervention type is particularly beneficial for people who belong to older age group with severe OCD than younger ones. Applying these therapies in hospitals can be associated with increasing the effectiveness, prognosis and quality of life of patients with OCD.

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Published

2024-09-30

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Research Article