New treatment for obsessive-compulsive disorder

An innovative psychotherapeutic treatment protocol is presented in the current issue of Psychotherapy and Psychosomatics. Exposure and ritual prevention (ERP) treats obsessive-compulsive disorder (OCD), but only some patients achieve minimal symptoms at treatment completion. Since patient adherence to ritual prevention strongly predicts outcomes, improving patients' ability to inhibit compulsions may improve the exposure and ritual prevention outcome.

The personalized-computerized inhibitory training (P-CIT) seeks to improve the patient's ability to inhibit responses while exposed to images that were related to their specific OCD symptoms. In this study, P-CIT was initially tested on in 11 individuals with OCD, who had significant symptoms despite prior receiving high-quality exposure and ritual prevention therapy. First, patients trained with P-CIT (on their personal computer) for 7 consecutive days (three 15-min sessions/day). Next, while continuing with P-CIT training, patients completed eight 60-min in-person exposure and ritual prevention sessions with a trained therapist delivered over 2.5 weeks. Results showed that despite the high intensity of P-CIT and exposure and ritual prevention, 10 of 11 patients completed the study and found the procedures to be feasible and acceptable. In addition, despite prior trials of high-quality (and sometimes intense) exposure and ritual prevention, 9 of 10 patients responded to P-CIT plus exposure and ritual prevention. Patients also reported reductions in self-reported obsessive-compulsive beliefs.

Baes on these preliminary findings, P-CIT may help prepare the task control system for exposure and ritual prevention. Harnessing technology to improve psychotherapy, as in the case of P-CIT, is a promising avenue to increase access to and the effectiveness of mental health services.