Outcomes of Group Cognitive Behavioural Psychotherapy for Adult Obsessive-Compulsive Disorder: A Systematic Review and Meta-Analysis

Obsessive-Compulsive Disorder (OCD) is a condition characterized by distressing intrusive thoughts and compulsive behaviours (American Psychiatric Association, 2013), which affects about 1% of the general population (Crino et al., 2005). Consistent research has suggested that individual psychotherapy using cognitive behavioural techniques produces symptom improvement in approximately 75% of patients with OCD (Gava et al., 2009). However, only 25% of cases achieve full remission, whereas 25% prematurely drop out, mainly due to the effort and perceived distress associated with this kind of treatment (Fisher &and Wells, 2005). In addition, those patients who achieve remission do not necessarily reach a satisfactory level of quality of life at post-treatment; thus, relapses after a successful treatment are frequent, particularly at long-term assessments. Group Cognitive Behavioural Psychotherapy (GCBT) may be an alternative treatment option, which could improve quality of life and reduce relapses at long-term assessments. Some research evaluated the effectiveness of GCBT for OCD at immediate post-treatment (Jónsson & Hougaard, 2009). Despite some initial findings, studies have produced inconsistent evidence on maintenance of gains after GCBT and no meta-analysis has been conducted to assess outcomes at follow-up. This chapter will present a systematic review and meta-analysis of controlled trials assessing the efficacy of GCBT for OCD. The first section will present the most recent literature on GCBT for OCD, the second one will report methods and results of the systematic review and meta-analysis study. For the meta-analysis, studies will be included if they used a controlled design testing efficacy of GCBT on OCD symptoms, comorbid depression, comorbid anxiety at post-treatment and follow-up. GCBT is defined as group psychotherapy using exposure and response prevention (ERP) and/or cognitive restructuring. Efficacy will be assessed separately for two different comparators: wait-list control conditions or no treatment conditions and individual cognitive behavioural psychotherapy (ICBT) conditions. Follow-up assessments will be pooled in one time-point. Only studies using validated outcome measures will be included. The systematic review will be conducted using random-effect meta-analyses. Online databases (PubMed, Scopus, Cochrane Library, Science Direct) and trial registries will be searched, corresponding authors will be contacted and conference proceedings will be hand-searched to locate published and unpublished studies.