Home | Subscribe to the Journal  |  Sign up for E-Lerts to your inbox
This entire article is available in PDF format to paid subscribers (certain restrictions apply).
If you have not already registered for Full Text Access to The Journal, then visit our registration page.

A Randomized Clinical Trial of Cognitive-Behavioral Group Therapy and Sertraline in the Treatment of Obsessive-Compulsive Disorder

Marcelo B. Sousa, M.D., M.Sc.; Luciano R. Isolan, M.D.; Renata R. Oliveira, M.D.; Gisele G. Manfro, M.D., Ph.D.; and Aristides V. Cordioli, M.D., Ph.D.

Background: Cognitive-behavioral group therapy (CBGT) and serotonin reuptake inhibitors have proven efficacy in reducing symptoms of obsessive-compulsive disorder (OCD). There is no consensus about which of these forms of treatment is more effective. This study was conducted to evaluate the efficacy of CBGT as compared to that of sertraline in reducing OCD symptoms.

Method: Fifty-six outpatients with an OCD diagnosis, according to DSM-IV criteria, participated in the randomized clinical trial: 28 took 100 mg/day of sertraline and 28 underwent CBGT for 12 weeks. Efficacy of treatments was rated according to the reduction in scores on the Yale-Brown Obsessive Compulsive Scale (YBOCS) and the Clinical Global Impressions-Severity of Illness scale. The trial was performed in 4 successive periods from March 2002 to December 2003.

Results: Both treatments were effective, although patients treated with CBGT obtained a mean YBOCS reduction of symptoms of 44%, while those treated with sertraline obtained only a 28% reduction (p = .033). Cognitive-behavioral group therapy was also significantly more effective in reducing the intensity of compulsions (p = .030). Further, 8 patients (32%) treated with CBGT presented a complete remission of OCD symptoms (YBOCS score < = 8) as compared to only 1 patient (4%) among those who received sertraline (p = .023).

Conclusion: Cognitive-behavioral group therapy and sertraline have shown to be effective in reducing OCD symptoms. Nevertheless, the rate of symptom reduction, intensity reduction of compulsions, and percentage of patients who obtained full remission were significantly higher in patients treated with CBGT.

(J Clin Psychiatry 2006;67:1133-1139)

Received Oct. 12, 2005; accepted Feb. 7, 2006. From the Postgraduate Program in Medical Science, Psychiatry, Federal University of Rio Grande do Sul and the Anxiety Disorder Program, Hospital de Clínicas de Porto Alegre (Drs. Sousa, Isolan, Oliveira, Manfro, and Cordioli); and the Department of Psychiatry, Federal University of Rio Grande do Sul (Dr. Cordioli), Porto Alegre, Brazil.

This research was supported by a grant from Coordenação de Aperfeiçoamento de Ensino Superior (CAPES), Brasília, and by the Fundação de Incentivo à Pesquisa e a Eventos (FIPE) at the Hospital de Clínicas de Porto Alegre, Brazil. The sertraline used in this study was provided by Pfizer Inc, New York, N.Y.

This study was presented, in part, in a poster session at the 22nd Brazilian Psychiatry Congress; October 13-16, 2004; Salvador, Brazil.

The authors report no additional financial affiliations or other relationships relevant to the subject of this article.

The authors thank Ana Seganfredo, M.D., for statistical assistance, and Euripedes Miguel, M.D., Ph.D., for writing assistance.

Corresponding author and reprints: Aristides V. Cordioli, M.D., Ph.D., Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, Room 400N, Porto Alegre, RS, Brazil 90035-903 (e-mail: acordioli@terra.com.br).

Home | Subscribe to the Journal  |  Sign up for E-Lerts to your inbox