The Study of the Pathogenesis and Cognitive Behavioral Group Therapy in Obsessive-Compulsive Disorder
Condition: Obsessive-Compulsive Disorder
MeSH terms: Compulsive Personality Disorder; Obsessive-Compulsive Disorder
Study type: Interventional

Summary: 
      This study intends to explore the pathogenesis of obsessive-compulsive disorder(OCD) by using
      biological technologies such as genetics and imaging, and to evaluate the efficacy of group
      cognitive behavioural therapy in OCD among the Chinese people. We also prepare to explore the
      synergistic effect of the pharmacological treatment combined with group cognitive behavioural
      therapy in OCD, and to find the biological and psychological index which can predict curative
      effect.

      This research includes case control study and randomized controlled single-blind study. At
      baseline, we compare the dimensions of clinical symptoms, genetics and imaging between OCD
      patients and healthy controls. The OCD patients are randomly assigned into pharmacological
      treatment, psychological treatment or pharmacological combined with psychological treatment
      for a 12-week treatment. After a 12-week treatment, the OCD patients will be divided into
      valid and invalid groups according to the results of our randomized controlled study by
      researchers: to our valid group, patients will continue the current treatment, and to the
      invalid psychological or pharmacological treatment group, patients will have a 12-week
      combined treatment. From the baseline, we will have a 9-month follow up for both OCD patients
      and healthy controls.
    

Detailed description: 
      1. Case control study: At baseline, comparing the dimensions of clinical symptoms, genetics
           and imaging between OCD patients and healthy controls who were chosen into our study.

        2. Randomized controlled single-blind study: The OCD patients are randomly assigned into
           pharmacological treatment, psychological treatment or pharmacological combined with
           psychological treatment. Psychological treatment: every six or so patients can establish
           a closed structured group. Each group will be treated for 12 sessions, for once a week,
           120 minutes at a time. The 1-3 session will be psychological education on the topic of
           OCD and cognitive behavioral therapy; The 4-6 and 8-10 session will do step by step
           exposure and response prevention(ERP) training; the 7th an 11th session will invite
           family members or other caregivers of OCD patients for a education about OCD cognitive
           behavioral therapy to facilitate patients to complete ERP homework and give them some
           social supports; the final session will be self treatment evaluation and long-term
           treatment guidance. Pharmacological treatment: This study choose the SSRIs(Selective
           Serotonin Reuptake Inhibitor:sertraline, fluvoxamine, initial dose of 50 mg, the dose
           can be adjusted once a week, and the maximum dose should under the instruments )
           approved by SFDA(China Food and Drug Administration) for OCD treatment which will last
           12 weeks. Patients with sleep disorder can combined with Benzodiazepines less than two
           consecutive weeks; combination with other psychotropic drugs are forbidden.
           Pharmacological combined with psychological treatment: every six or so patients can
           establish a closed structured group which is same as the psychological treatment group;
           patients start to take medicine at the same time, use of the medicine is same as the
           pharmacological treatment group.

        3. Follow-up study: After finishing the 12-week treatment, the OCD patients will be into a
           6-month follow-up. Patients who are satisfied with pharmacological and/or psychological
           treatment will continue the current treatment, while others' follow-up treatment and
           specific treatment ways will be decided by researchers through the results of of our
           randomized controlled study. Our randomized controlled study results will be divided
           into valid and invalid groups. To the invalid psychological or pharmacological treatment
           group, patients will have a 12-week combined treatment which means invalid
           pharmacological treatment need to combine with psychological treatment and invalid
           psychological treatment need to combine with pharmacological treatment. Invalid
           pharmacological combined with psychological treatment should adjust the medicine (change
           with sertraline/fluvoxamine) and go on the psychological treatment. After the baseline
           assessment, OCD patients will have a follow-up evaluation at the 16th, 24th, and 36th
           week, while the healthy control will have a follow-up evaluation at the 12th and 36th
           week.
    

Intervention name(s): cognitive behavioral group therapy; sertraline, fluvoxamine; cognitive behavioral group therapy and drug therapy
Intervention type(s): Behavioral; Drug; Other
Intervention description(s): Establish closed every collection of six or so patients structured group. Each group patients were treated for 12 times, once a week, 120 minutes at a time.
Treatment for 1 to 3 times to obsessive-compulsive disorder and cognitive behavioral therapy as the theme of psychological education; 4 to 6, 8 to 10 times exposed step by step and reaction treatment and prevention of training;7 and 11 times invite patients family members or other caregivers, make education about obsessive-compulsive disorder cognitive behavioural therapy, to promote patients exposed response prevention homework completion and social support; The 12th time treatment is self assessment and treatment guidelines for a long time.; Select specified drugs (sertraline, fluvoxamine); Select specified drugs (sertraline, fluvoxamine) and start group cognitive behavior therapy for 12 weeks at the same time
Intervention MeSH terms: Fluvoxamine; Sertraline
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Treatment
Keywords: pathogenesis; cognitive behavioral group therapy