BEHAVIORAL THERAPY AND SEROTONIN REUPTAKE INHIBITOR PHARMACOTHERAPY IN THE TREATMENT OF OBSESSIVE–COMPULSIVE DISORDER: A SYSTEMATIC REVIEW AND META-ANALYSIS OF HEAD-TO-HEAD RANDOMIZED CONTROLLED TRIALS

摘要: Background Effective treatments for obsessive–compulsive disorder (OCD) include behavioral therapy (exposure and response/ritual prevention cognitive therapy) serotonin-reuptake inhibitors (SRIs); however, the relative efficacy of these is not well established. We sought to review evidence from head-to-head randomized-controlled trials (RCTs) SRIs in treatment OCD. Methods A systematic search multiple databases was conducted first available date June 30, 2012, RCTs OCD among outpatients, comparing SRIs, alone or combined. Two independent reviewers evaluated studies eligibility risk bias. The main outcome measure posttreatment mean Yale-Brown Obsessive–Compulsive Scale (YBOCS) score. Results We identified 2,186 unique articles. Fifteen articles were included, describing 13 RCTs. Pooled standardized difference (SMD; 95% confidence intervals) YBOCS score significantly favored over (0.37; 0.10, 0.64; P = .007), but a subset that used selective (0.22; −0.02, 0.47; .070). Within individual trials, effect sizes combination plus an SRI SRI, therapy, alone. Conclusions This provides that, outpatients with OCD, more effective than overall, SRIs. Furthermore, alone. These data may be inform development evidence-based guidelines; are also needed further evaluate interventions.