Comparative study of eicacy of behaviour therapy, cognitive therapy and SSRI on obsessive compulsive disorder

The heterogeneity of OCD has various mixed indings related to the treatment procedures, psychological, pharmacological, and other choices. Hence, this study was planned not only to examine eicacies of various treatment procedures but importantly to propose a possible treatment hierarchy and choices based on eicacy and acceptability in Indian settings for the management of Obsessive Compulsive Disorder. Participants were adult with OCD (N=32) selected from OPD level and randomly assigned to four treatment groups; a). SSRI and ERP (Habituation only) b). SSRI with Cognitive therapy (except Exposure), c) Cognitive Therapy with ERP (ERP both as habituation and restructuring tool) inally, d) SSRI alone. Y-BOCS was used for pre and post treatment measure. Participants received 18 exposure sessions, 16 cognitive sessions and SSRI varyingly for four as per treatment group. Result of the study shows ERP, CT without ERP and SSRI all are efective treatment modules in OCD. The most eicacious treatment procedures in order of hierarchy are ERP with SSRI, CT with ERP, SSRI with CT and SSRI alone respectively. ERP with CT is as efective as ERP with SSRI. ERP when used as a process of “habituation” is more eicacious in terms of treatment outcomes but when ERP used as both habituation and cognitive restructuring tool is more tolerable and acceptable by patients and also not prone to dropouts. ERP appears to be helpful whether or not patients are receiving SSRI. ERP alone or CBT alone is more eicacious than SSRI alone.