Metacognitive Therapy (MCT), Fluvoxamine, and Combined Treatment in Improving Obsessive-Compulsive, Depressive and Anxiety Symptoms in Patients with Obsessive-Compulsive Disorder (OCD)

Objective: Although treatments with demonstrated efficacy exist for Obsessive-compulsive disorder (OCD); researches on the effectiveness of combined treatment versus psychotherapy or drug treatment are controversial. The aim of this study was to compare the efficacy of Metacognitive therapy (MCT), fluvoxamine and the combination of MCT with fluvoxamine treatment in treating patients with OCD. Methods: Twenty-one outpatients meeting DSM-IV-TR criteria for OCD without any other axis I and II disorder were randomly assigned to one of three treatment conditions for 10 weeks of treatment: MCT, fluvoxamine, and combined treatment group. The Yale-Brown Obsessive-compulsive scale (Y-BOCS), Beck depression inventory-II-second edition (BDI-II), and Beck anxiety inventory (BAI) were administered at pretreatment and post-treatment. Group differences were examined using chi-square (for gender and marital status), one-way analysis of variance (ANOVAs) and one-way analysis of covariance (ANCOVAs) statistical procedures on each of the outcome measures using the SPSS-16 statistical package. Results: Nineteen patients completed this study. All patients in MCT and combined treatment groups showed significant improvement at post-treatment. ANCOVA results showed that MCT and combined treatment lead to a more significant improvement in the severity of OCD symptoms (p<0.001), depression (p<0.001), and anxiety (p<0.001) than fluvoxamine treatment. There were no significant differences between MCT and combined therapy (all p>0.05). Conclusion: It seems that adding drugs to treatment does not increase the efficacy of metacognitive therapy.