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Mindfulness-based Cognitive Therapy for Obsessive-Compulsive Disorder

A Pilot Study

DIDONNA, FABRIZIO PsyD; LANFREDI, MARIANGELA PsyD; XODO, ERICA PsyD; FERRARI, CLARISSA PhD; ROSSI, ROBERTA PsyD; PEDRINI, LAURA PhD

Journal of Psychiatric Practice®: March 2019 - Volume 25 - Issue 2 - p 156–170
doi: 10.1097/PRA.0000000000000377
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Background: Cognitive-behavioral therapy (CBT) is the first-choice intervention for obsessive-compulsive disorder (OCD); however, a notable proportion of patients either do not respond to treatment or relapse after CBT. Mindfulness-based treatment has been suggested as an alternative or complementary therapeutic strategy for OCD. However, only a few studies have focused on its application in clinical samples.

Objective: To evaluate the impact of a new treatment, called “Mindfulness-based Cognitive Therapy for OCD.” It is an 11-session manualized group intervention that integrates elements of CBT, mindfulness, compassion-focused therapy, and acceptance and commitment therapy.

Methods: The program was delivered to 35 patients with a primary diagnosis of OCD.

Results: Participants demonstrated good adherence to the intervention. There was a significant reduction in mean total score on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS-TS) (P<0.001; Cohen d=−0.72). One third of the participants (n=13) showed at least a 25% reduction on the Y-BOCS-TS, and 40% of the sample (n=14) were assigned to a lower Y-BOCS severity category after treatment. Significant changes were also found in depression (P<0.001; d=−0.80), worry (P<0.001; d=−0.79), alexithymia (P<0.01; d=−0.41), dissociation (P<0.05; d=−0.46), and general psychopathology (P<0.001; d=−0.58). Repeated measures linear mixed models showed that OCD symptom reduction was associated with an increase in mindfulness skills, in particular on the acting with awareness (P=0.006), nonjudging (P=0.001), and nonreactivity (P=0.001) facets.

Conclusions: Overall, these findings are promising and they suggest that randomized controlled studies be conducted to test the effectiveness of this new treatment program for this challenging and disabling mental disorder.

DIDONNA: Unit for OCD, Department of Psychiatry, Villa Margherita Private Hospital, and Italian Institute for Mindfulness, Vicenza, Italy

LANFREDI, ROSSI, and PEDRINI: Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy

XODO: Italian Institute for Mindfulness, Vicenza, Italy

FERRARI: Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy

The authors declare no conflict of interest.

Please send correspondence to: Laura Pedrini, PhD, Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, Brescia 25125, Italy (e-mail: lpedrini@fatebenefratelli.eu).

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