Efficacy of Behavior therapy in obsessive-compulsive disorder

As demonstrated in recent randomized controlled trials cognitive-behavioral treatment (CBT) of patients with obsessive-compulsive disorder (OCD) is highly effective. Effect sizes range between 1.0 and 1.5. Similar efficacy has been shown in children and adolescents. There are almost no placebo effects observed. About half the treated patients achieve clinical significant change. However, numerous patients do not benefit from therapy and need improved therapies. The combination of drug treatment and cognitive-behavioral interventions adds some effect in highly depressed OCD patients. CBT lowers the rate of relapses after drug discontinuation. At present, there is no evidence for further additive effects. Cost-effective and easily accessible therapy variants like group therapy, internet-, phone-, or video-based interventions have been developed and studied quite recently. Results are promising so far. Worse outcome of CBT is predicted by low compliance, higher severity of illness, severe comorbid depression, comorbid schizotypal personality disorder, and hoarding symptoms. Besides improvement of intervention techniques, better availability of adequate therapy must be an aim in the future.