The efficacy of brief strategic therapy in treating obsessive-compulsive disorder: a case series

BACKGROUND AND AIM: International guidelines indicate pharmacological therapy and cognitive-behavioral therapy (CBT) as gold standard treatments for obsessive-compulsive disorder (OCD). However, up to 40% patients do not fully respond to CBT, thus manifesting persistent symptomatology. Empirical research reported brief strategic therapy (BST) as a potential treatment for OCD. The aim of the present study is to evaluate the efficacy of BST in treating OCD and to identify the clinical characteristics associated to treatment-response. METHODS: a BST protocol was administered to patients with OCD. During a 24-weeks observational period, the following scales have been administered at the baseline and every 4 weeks: Yale Brown Obsessive-Compulsive scale (Y-BOCS), Clinical Global Impression (CGI), Global Assessment of Functioning (GAF), Quality of Life Index (QL-I), Medical Outcomes Study Short Form 12-item, Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM), Generalized Anxiety Disorder Scale (GAD-7), Patient Health Questionnaire - 9 (PHQ-9) and Somatic Symptom Scale-8 (SSS-8). RESULTS: eight patients completed the treatment and a subgroup of five patients obtained clinical remission, defined as Y-BOCS total score < 25. The repeated measures ANOVA showed a significant decreased of the Y-BOCS total scores (p<.001). Comparisons between the two subgroups (remitters vs. non-remitters) highlighted some potential baseline characteristics associated with remission: i.e., a higher mean level of anxiety, quality of life, physical health, and a lower mean level of somatic symptoms, as well as alower prevalence of personality disorders comorbidity. CONCLUSIONS: BST could be a useful therapeutic strategy in treating OCD patients. Further studies with larger samples and with long-term follow-up are needed to assess the post-treatment maintenance of clinical effects. (www.actabiomedica.it)