Intensive Cognitive-Behavioral Therapy For Obsessive-Compulsive Disorder

NCT01368510 | Completed

• 1 other identifier: R01MH085900
• Study Type: interventional
• Target: 75
• Locations: 1 country
• Sites: 1

Brief Summary

Even with the best available treatments for obsessive-compulsive disorder (OCD), most patients only partially recover and many patients do not respond at all. Such incomplete and inadequate response contributes to greater public health costs in terms of morbidity and patient care expenses. This study aims for a better understanding of abnormal brain chemistry in OCD and how it is affected by cognitive-behavioral therapy (CBT) in order to develop novel therapies and improve the success of existing therapies. The main hypothesis is that CBT will change levels of the excitatory neurotransmitter glutamate in OCD patients in a region of the brain involved in OCD known as the cingulate cortex.

Conditions

Obsessive-Compulsive Disorder (OCD)

Keywords

obsessive-compulsive disorder (OCD); cognitive-behavioral therapy (CBT); magnetic resonance spectroscopy (MRS); glutamate; cingulate gyrus

Outcome Measures

Primary Outcomes (1)

• MRSI glutamate

  Regional concentration of glutamate in brain, as measured by magnetic resonance spectroscopic imaging (MRSI)

  4 weeks

Secondary Outcomes (1)

• Y-BOCS

  4 weeks

Study Arms (3)

OCD Active CBT

EXPERIMENTAL

Adults with obsessive-compulsive disorder (OCD) will be treated with cognitive-behavioral therapy (CBT) from the time of enrollment.

Behavioral: Intensive Cognitive Behavioral Therapy (CBT)

OCD Waitlist

ACTIVE COMPARATOR

Adults with OCD will receive waitlist treatment at enrollment. Nonresponders will cross over to CBT.

Behavioral: Intensive Cognitive Behavioral Therapy (CBT); Behavioral: Waitlist

Healthy Control

NO INTERVENTION

Healthy control adults will be given no intervention.

Interventions

Intensive Cognitive Behavioral Therapy (CBT) BEHAVIORAL

Nondrug psychotherapy administered daily 5 days/week for 4 weeks

Also known as: Exposure and Response Prevention (ERP)

OCD Active CBT; OCD Waitlist

Waitlist BEHAVIORAL

Minimal contact waitlist weekly for 4 weeks

OCD Waitlist

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• meets DSM-IV-TR diagnostic criteria for OCD as primary (most severe) diagnosis based on Anxiety Disorders Interview Schedule (ADIS) Clinical Severity Rating
• reported DSM-IV-TR-threshold OCD symptom onset age 18 or later
• Yale-Brown Obsessive-Compulsive total score greater than or equal to 16
• fluent English speaker
• signed informed consent

You may not qualify if:

• IQ of less than 80 on the Wechsler Abbreviated Scales of Intelligence
• lifetime DSM-IV diagnosis of pervasive developmental disorder, mania, psychosis, conduct disorder, or substance dependence assessed through ADIS
• current DSM-IV diagnosis of major depressive disorder if ADIS CSR rating is 4 or higher (severe) or attention-deficit hyperactivity disorder
• primary compulsive hoarding
• any changes (dose or agent) in psychotropic medication for OCD or other psychiatric condition within 12 weeks prior to enrollment
• severe illness that requires immediate inpatient psychiatric intervention
• any serious psychiatric, psychosocial, or neurological condition requiring immediate treatment other than that provided in the current study
• any body metal (other than dental fillings), positive pregnancy test, or other MR scan contraindications
• prior trial of CBT for OCD, regardless of outcome
• medical conditions that affect cerebral metabolism (e.g., thyroid disorders or diabetes)

Sponsors & Collaborators

• University of California, Los Angeles: lead
• National Institute of Mental Health (NIMH): collaborator

Study Sites (1)

UCLA Obsessive-Compulsive Disorder Intensive Treatment Program

Los Angeles, California, 90024, United States

Location

Related Publications (2)

• Reggente N, Moody TD, Morfini F, Sheen C, Rissman J, O'Neill J, Feusner JD. Multivariate resting-state functional connectivity predicts response to cognitive behavioral therapy in obsessive-compulsive disorder. Proc Natl Acad Sci U S A. 2018 Feb 27;115(9):2222-2227. doi: 10.1073/pnas.1716686115. Epub 2018 Feb 12.

  PMID: 29440404 DERIVED

• Moody TD, Morfini F, Cheng G, Sheen C, Tadayonnejad R, Reggente N, O'Neill J, Feusner JD. Mechanisms of cognitive-behavioral therapy for obsessive-compulsive disorder involve robust and extensive increases in brain network connectivity. Transl Psychiatry. 2017 Sep 5;7(9):e1230. doi: 10.1038/tp.2017.192.

  PMID: 28872637 DERIVED

MeSH Terms

Conditions

Obsessive-Compulsive Disorder

Interventions

Waiting Lists

Condition Hierarchy (Ancestors)

Anxiety Disorders; Mental Disorders

Intervention Hierarchy (Ancestors)

Appointments and Schedules; Organization and Administration; Health Services Administration

Study Officials

• Joseph O'Neill, PhD

  UCLA Child Psychiatry

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Prof Child Psychiatry

Study Record Dates

• First Submitted: June 6, 2011
• First Posted: June 8, 2011
• Study Start: July 1, 2011
• Primary Completion: June 1, 2015
• Study Completion: June 1, 2015
• Last Updated: March 24, 2020

Record last verified: 2020-03

Locations

US (1)