The Metacognitive Training for obsessive-compulsive disorder: A pilot study
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The Metacognitive Training for obsessive-compulsive disorder: A pilot study Franziska Miegel 1 Lena Jelinek 1
&
Cüneyt Demiralay 1 & Anna Sure 1 & Steffen Moritz 1 & Birgit Hottenrott 1 & Barbara Cludius 1,2 &
Accepted: 28 October 2020 # The Author(s) 2020
Abstract More than 50% of patients with obsessive-compulsive disorder (OCD) do not receive first-line psychological treatment such as cognitive-behavioral therapy with exposure and response prevention. To narrow this treatment gap, there is an urgent need for therapies that are easy to disseminate and highly accepted by patients. The aim of the present pilot study was to evaluate the effectiveness of the Metacognitive Group Training for OCD (MCT-OCD). Fifty patients with OCD participated in the MCT-OCD for 4 weeks during their inpatient stay in a single-arm pilot trial. Patients were assessed before and after the intervention and filled out an online survey 6 months after post assessment. Results showed a decrease in obsessive compulsive symptoms according to the YaleBrown Obsessive Compulsive Scale (primary outcome) from baseline to post assessment with a large effect size. Symptom reduction remained stable over 6 months and was positively correlated with appraisal ratings of the training. The reduction in frequency of obsessive compulsive symptoms, distress due to obsessive compulsive symptoms, cognitive biases, and depressive symptoms remained stable over 6 months after the intervention. Our findings tentatively imply that the MCT-OCD is a promising treatment for OCD patients. A randomized controlled trial is thus warranted to further clarify the efficacy of the MCT-OCD. Trial Registration: German Clinical Trials Register (DRKS-ID: DRKS00012531), date of registration: 16.06.2017. Keywords Intervention . Cognitions . Psychotherapy . Anxiety . Metacognition
Introduction Obsessive-compulsive disorder (OCD) is a mental disorder with a lifetime prevalence of 2–3% (Kessler et al., 2012). The disorder often has a chronic course (van Oudheusden et al., 2018), and patients with OCD frequently report a low quality of life (Moritz et al., 2005; Remmerswaal et al., 2016). The first-line psychological treatment is cognitive-behavioral therapy (CBT) with exposure and response prevention (Ex/RP; Skapinakis et al., 2016), which has shown to be effective with large effect sizes (Hedges’ g = 1.31; Öst et al., 2015). Group settings are increasingly recommended to serve the high number of patients and reduce treatment
* Franziska Miegel [email protected] 1
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
2
Department of Clinical Psychology and Psychotherapy, Ludwig-Maximilians University, Leopoldstr. 13, 80802 Munich, Germany
costs (Kordon et al., 2014; Sousa et al., 2006). A recent metaanalysis (Schwartze et al., 2016) showed that group CBT for OCD was as effective as individual therapy and pharmacotherapy and superior to wait-list control (Hedges’ g = 0.97, 95% CI 0.58; 1.37, p < .001, k =
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