Improve Unmedicated Obsessive-Compulsive Disorder with Mindfulness
By John M. de Castro, Ph.D.
“a growing pool of research coming out over the last few years suggests that those who are adding mindfulness into treatment for OCD are on the right track.” – John Hershfield
Obsessive-Compulsive Disorder (OCD) sufferers have repetitive anxiety producing intrusive thoughts (obsessions) that result in repetitive behaviors to reduce the anxiety (compulsions). In a typical example of OCD, the individual is concerned about germs and is unable to control the anxiety that these thoughts produce. Their solution is to engage in ritualized behaviors, such as repetitive cleaning or hand washing that for a short time relieves the anxiety. The obsessions and compulsions can become so frequent that they become a dominant theme in their lives. Hence OCD drastically reduces the quality of life and happiness of the sufferer and those around them. About 2% of the population, 3.3 million people in the U.S., are affected at some time in their life.
Fortunately, Obsessive-Compulsive Disorder (OCD) can be treated, and many respond to Cognitive Behavioral Therapy (CBT). But some do not. Mindfulness training has been shown to be effective in treating OCD. Mindfulness-Based Cognitive Therapy (MBCT) involves the combination of mindfulness training and cognitive behavioral therapy. It contains sitting, walking and body scan meditations, and cognitive therapy that is designed to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. MBCT has been shown to reduce anxiety. So, it makes sense to examine the effectiveness of MBCT for Obsessive-Compulsive Disorder (OCD).
In today’s Research News article “Mindfulness-Based Cognitive Therapy for Unmedicated Obsessive-Compulsive Disorder: A Randomized Controlled Trial With 6-Month Follow-Up.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8369060/ ) Zhang and colleagues recruited adults diagnosed with Obsessive-Compulsive Disorder (OCD) and randomly assigned them to receive either drugs (SSRIs), or 10 weekly 150-minute sessions of Mindfulness-Based Cognitive Therapy (MBCT) or an active placebo control treatment, containing education about OCD, group support, and relapse prevention. They were measured before and after treatment and 6 months later for mindfulness, anxiety, depression, social function, and Obsessive-Compulsion severity.
They found that in comparison to baseline and the active placebo control group, both the drugs (SSRIs) and Mindfulness-Based Cognitive Therapy (MBCT) groups had significant improvements in Obsessive-Compulsion severity. But the differences were no longer significant at the 6-month follow-up where all groups were significantly improved. All groups had significant improvements in anxiety and depression that were maintained at the 6-month follow up.
These are interesting results that show that drugs (SSRIs) and Mindfulness-Based Cognitive Therapy (MBCT) improve OCD severity after treatment to a greater extent than the placebo group. But 6 months after treatment all groups had equivalent significant improvements on OCD and all groups had significant reductions in anxiety and depression at all post-treatment time points. In other words, drugs, MBCT, and placebo are all effective in improving the symptoms of OCD patients. But drugs and MBCT are slightly more effective immediately after treatment. This suggests that regardless of the actual treatment, OCD is improved if the patients believe that the treatment will improve their symptoms.
So, improve unmedicated obsessive-compulsive disorder with mindfulness
“Mindfulness requires you to be aware of intrusive thoughts or triggers, accept and possibly internally analyze any discomforts caused by such thoughts and resist the urge to respond with compulsions.” – NOCD
CMCS – Center for Mindfulness and Contemplative Studies
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Study Summary
Zhang, T., Lu, L., Didonna, F., Wang, Z., Zhang, H., & Fan, Q. (2021). Mindfulness-Based Cognitive Therapy for Unmedicated Obsessive-Compulsive Disorder: A Randomized Controlled Trial With 6-Month Follow-Up. Frontiers in psychiatry, 12, 661807. https://doi.org/10.3389/fpsyt.2021.661807
Abstract
Background: This was the first randomized controlled trial (RCT) designed to compare the efficacy of mindfulness-based cognitive therapy (MBCT) on unmedicated obsessive-compulsive disorder with that of the first-line treatment for OCD (SSRIs) or a placebo, as well as to analyze the treatment acceptability and safety of MBCT.
Methods: A total of 123 unmedicated OCD patients with mild to moderate symptoms were randomly assigned into selective serotonin reuptake inhibitors group (SSRIs group), MBCT group or psycho-education group (PE group), respectively. They were intervened for 10 weeks. The Yale–Brown Obsessive-Compulsive Scale (Y-BOCS) grade was the primary outcome, and Hamilton Depression Scale-24 (HAMD-24) and Hamilton Anxiety Scale (HAMA) grades were secondary outcomes to be measured at baseline, mid-intervention, post-intervention and 14, 22, and 34 weeks of follow-up. The Five Facet Mindfulness Questionnaire (FFMQ) and Sheehan Disability Scale (SDS) were used to assess mindfulness and social functions, respectively. In addition, treatment acceptability (dropout rate and frequency of occurrence) and safety [adverse event (AE)] of MBCT were investigated.
Results: Significant differences were detected in the treatment responses among SSRIs group, MBCT group and PE group. Notably, treatment responses were significantly better in the former two groups than that of PE group (χ2 = 6.448, p = 0.04), although we did not identify significant differences between SSRIs group and MBCT group (χ2 = 1.220, p = 0.543). Observed until 6 months of follow-up, there were no significant differences in treatment response among three groups. No AE was recorded in MBCT group.
Conclusion: MBCT is effective in the treatment of unmedicated OCD with mild to moderate symptoms comparable to that of SSRIs, which contributes to maintain the treatment outcomes at follow-up. Besides, MBCT is safe with a good clinical compliance.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8369060/