The Effectiveness of Group Cognitive Behavioral Therapy in Treating Obsessive-Compulsive Disorder in Women with Multiple Sclerosis (MS)

A randomized double-blind controlled trial

Authors

  • Azizreza Ghasemzadeh Lecturer in Rehabilitation Science, University of Applied Sciences, Tehran Welfare Organization, Tehran, Iran

Keywords:

Multiple Sclerosis, Obsessive-Compulsive Disorder, Cognitive-Behavioral Therapy, Women

Abstract

Background: Obsessive-compulsive disorder (OCD) is one of the most prevalent psychiatric disorders and can cause problems for individuals in all aspects of life, including social and personal dimensions. 

Objective: To study the effect of group cognitive-behavioral therapy on the reduction of OCD symptoms in female participants with multiple sclerosis (MS).

Methods: This double-blind randomized control trial was conducted from May 2012 to December 2014. The participants included 75 patients with MS who suffered from OCD and were referred to the Loghman Hakim and Imam Khomeini hospitals in Tehran, Iran. Thirty participants had been diagnosed through Yale-Brown Obsessive-Compulsive Symptoms (Y-BOCS). The participants were randomly divided into an experimental group (n=15) and a control group (n=15). Eleven sessions of cognitive-behavioral therapy were provided for the experimental group. Patients in the control group continued with their normal living. Hypotheses were tested using an analysis of covariance (ANCOVA).

Results: A significant reduction was found in the experimental group’s obsessive-compulsive symptoms after cognitive-behavioral therapy (p<0.001). In addition, mean scores for participants in the experimental group were significantly lower than for those in the control group (p=0.000).

Conclusion: It can be inferred that cognitive-behavioral therapy could considerably reduce OCD symptoms in women with MS. The application of this method by therapists, especially Iranian clinicians, is recommended. 

Trial registration: The trial is registered at the Thai Clinical Trial Registry (clinicaltrials.in.th) with the TCR identification number TCTR20150927001.

Funding: The authors received no financial support for the research, authorship, and/or publication of this article.

References

Jenike MA. Clinical practice. Obsessive-compulsive disorder. N Engl J Med. 2004; 350: 256-259. doi:

1056/NEJMcp031002, PMID: 14724305.

Ruscio A, Stein D, Chiu W, Kessler R. The epidemiology of obsessive-compulsive disorder in the National

Comorbidity Survey Replication. Mol Psychiatry. 2008; 15(1): 53-63. doi: 10.1038/mp.2008.94, PMID:

Mohammadi MR, Davidian H, Noorbala AA, Malekafzali H, Naghavi HR, Pouretemad HR, et al. An

epidemiological study of psychiatric disorders in Iran. Hakim Research Journal. 2003; 6: 55-64.

Clark DA. Cognitive behavior therapy for obsessions and compulsions: New applications and Emerging

trends. J Contemp Psychother. 2000; 30: 129-47. doi: 10.1023/A:1026562628287.

Steketee G. Treatment of obsessive-compulsive disorder. New York: Guilford Press; 1993. PMCid:

PMC3323077.

George M, Kellner C, Fossey M. Obsessive-Compulsive Symptoms in a Patient with Multiple Sclerosis. J

Nerv Ment Dis. 1989; 177(5): 304. doi: 10.1097/00005053-198905000-00010, PMID: 2708974.

Douzenis A, Michalopoulou PG, Voumvourakis C, Typaldou M, Michopoulos I, Lykouras L. Obsessive- compulsive disorder associated with parietal white matter multiple sclerosis plaques. World J Biol

Psychiatry. 2009; 10: 956–60. doi: 10.1080/15622970701762528, PMID: 19995223.

Hoekstra P, Minderaa R. Tic disorders and obsessive-compulsive disorder: Is autoimmunity involved? Int

Rev Psychiatry. 2005; 17(6): 497-502. doi: 10.1080/02646830500382003, PMID: 16401548.

Clark, David A. Cognitive-Behavioral Therapy for OCD. New York: Guilford Press, 2004. Print.

Sookman, Debbie, Gail Steketee. Directions in Specialized Cognitive Behavior Therapy For Resistant

Obsessive-Compulsive Disorder: Theory And Practice Of Two Approaches. Cogn Behav Pract. 2007:

(1): 1-17. doi: 10.1016/j.cbpra.2006.09.002.

Freeston MH, Léger E, Ladouceur R. Cognitive Therapy Of Obsessive Thoughts. Cogn Behav Pract. 2001;

(1): 61-78. doi: 10.1016/S1077-7229(01)80045-6.

Faull M, Joseph S, Meaden A, Lawrence T. Obsessive Beliefs And Their Relation To Obsessive– Compulsive Symptoms. Clin Psychol Psychother . 2004;11(3): 158-67. doi: 10.1002/cpp.403.

Tolin DF, Woods CM, Abramowitz JS. Relationship between obsessive beliefs and obsessive- Compulsive

symptoms. Cognitive Ther Res . 2003; 27 (6): 657-669. doi: 10.1023/A:1026351711837

. Goodman WK, Rasmussen SA, Price LH, Mazure L, Heninger GR, Charney D. Yale-Brown Obsessive- compulsive Scale (Y-BOCS). Verhaltenstherapie. 1991; 1(3): 226-33. doi: 10.1159/000257973.

Dadfar M, Bolhari J, Malakouti K, Bayan Zadeh A. An examination of the phenomenology of obsessive- compulsive disorder. The Quarterly Journal of thought and behavior (Andeeshe va Raftar). 2001; 7: 27-32.

Goodman WK1, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, et al. The Yale-Brown

Obsessive Compulsive Scale. I. Development, use, and reliability. Arch Gen Psychiatry. 1989

Nov;46(11):1006-11.PMid: 2684084.

Messinis L, Kosmidis MH, Lyros E, Papathanasopoulos P. Assessment and rehabilitation of cognitive

impairment in multiple sclerosis. Int Rev Psychiatry. 2010; 22(1): 22-34. doi:

3109/09540261003589372, PMID: 20233112.

Jónsson H, Hougaard E. Group Cognitive Behavioural Therapy For Obsessive-Compulsive Disorder: A

Systematic Review And Meta-Analysis. Acta Psychiatr Scand. 2009; 119(2): 98-106, doi: 10.1111/j.1600- 0447.2008.01270.x, PMID: 18822090.

Chosak A, Marques L, Fama J, Renaud S, Wilhelm S . Cognitive Therapy For Obsessive-Compulsive

Disorder: A Case Example. Cogn Behav Pract. 2009; 16(1): 7-17. doi: 10.1016/j.cbpra.2008.01.005.

Tolin DF, Brady RE, Hannan S. Obsessional Beliefs And Symptoms Of Obsessive–Compulsive Disorder

In A Clinical Sample. J Psychopathol Behav . 2007; 30(1): 31-42. doi: 10.1007/s10862-007-9076-7.

Moulding R, Anglim J, Nedeljkovic M, Doron G, Kyrios M, Ayalon A. The Obsessive Beliefs

Questionnaire (OBQ): Examination In Nonclinical Samples And Development Of A Short Version.

Assessment. 2011; 18(3): 357-74. doi: 10.1177/1073191110376490, PMID: 20634421.

Belloch A, Morillo C, Luciano JV, García-Soriano G, Cabedo E, Carrió C. Dysfunctional Belief Domains

Related To Obsessive-Compulsive Disorder: A Further Examination Of Their Dimensionality And

Specificity. Span J Psychol. 2010; 13(1): 376-88. doi: 10.1017/S1138741600003930, PMID: 20480704.

Published

2022-03-07

Issue

Section

Articles