Combined CBT, SSRI Treatment May Be More Effective for OCD

Cognitive behavioral therapy (CBT) combined with selective serotonin reuptake inhibitor (SSRI) treatment may alleviate clinical symptoms associated with obsessive-compulsive disorder (OCD), and do so more effectively than medication alone, according to results from a multicenter randomized controlled trial published in the Journal of Affective Disorders.

The study included 167 patients (aged 16-65 years) with OCD, recruited from outpatient clinics at 3 tertiary psychiatric hospitals and 1 general hospital in China from April 2010 to August 2013. Investigators compared 2 groups of patients: those receiving CBT combined with medication (n=92) and those receiving medication alone (n=75). Patients in the medication group received sertraline (100-200 mg/day), fluvoxamine (150-300 mg/day), or paroxetine (40-60 mg/day). Investigators assessed patients’ symptoms and social functioning at baseline and at 4, 8, 12, and 24 weeks.

After 24 weeks, more patients receiving combined therapy (82.6%) achieved response than those receiving medication only (52.0%). Response was defined as a decrease in symptom severity of at least 35%, based on a patient’s total score on the Yale-Brown Obsessive-Compulsive Scale. In both groups, Clinical Global Impression Scale for Severity and Global Assessment of Functioning scores decreased. However, there were no significant differences in total reduction of symptoms, as measured by the Hamilton Anxiety Rating Scale.

The study was limited by the lack of consideration of medication types and dosages and the absence of a CBT-only group. In addition, the study integrated Chinese culture into the practice of CBT, which might have affected outcomes.

“CBT combined with medication may be effective in alleviating symptoms and social functioning impairment associated with OCD, and is more effective than medication alone in China, particularly for the treatment of compulsive behaviours,” researchers concluded.


Meng FQ, Han HY, Luo J, et al. Efficacy of cognitive behavioural therapy with medication for patients with obsessive-compulsive disorder: a multicentre randomised controlled trial in China [published online April 22, 2019]. J Affect Disord. doi:10.1016/j.jad.2019.04.090