Tuesday, October 18, 2016

People With OCD May Prefer Psychotherapy to Medications

Although it is well known that patient preferences for treatment can influence outcomes, few studies have explored treatment preferences among individuals with anxiety disorders such as obsessive-compulsive disorder (OCD). A study published yesterday in Psychiatric Services in Advance suggests that people with OCD may prefer psychotherapy to medications, both as a first-line therapy and augmenting agent.

A total of 216 adults who self-reported at least moderate OCD symptoms completed an online survey developed by researchers at Columbia University. The survey asked participants to choose their preferred evidence-based treatments, rate acceptability of novel treatments, and answer questions regarding their treatment history, current OCD symptoms and severity, and more.

The study participants reported a slightly higher preference for exposure and response prevention (EX/RP) therapy (55%) than serotonin reuptake inhibitors (SRIs, 45%) as a first-line treatment. Additional analysis revealed that those who preferred SRIs were in treatment at the time of the survey, were receiving SRIs as their treatment, and reported a positive experience with treatment overall and with medications.

Participants significantly preferred EX/RP (68%) to antipsychotic medications (31%) when used to augment SRI response. Compared with those who preferred antipsychotics, those who preferred EX/RP were younger, more likely to be female, and more likely to be taking benzodiazepines. 

Among novel OCD treatments, behavioral interventions (such as acceptance and commitment therapy and Kundalini yoga) were rated as more acceptable than medical procedures (deep brain stimulation and gamma knife surgery).

“Our findings highlight the importance of patient-level characteristics, beliefs about treatment, and past experience as factors that influence preferences for OCD treatment,” the authors wrote. “Given EX/RP’s efficacy, both as monotherapy and as a strategy to augment SRI response, and our finding that individuals preferred EX/RP whether or not they were taking SRIs, efforts to increase access to this treatment are warranted.

To read more on the topic of OCD treatments, see the Psychiatric News article “Antidepressants May Inhibit D-Cycloserine From Improving Symptoms in People With OCD.”

(Image: iStock/shironosov)


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