Efficacy of Exposure and Response Prevention(ERP) and SSRIs in Chinese OCD Patients
Condition: Obsessive-Compulsive Disorder; Anxiety Disorders; Mental Disorders
MeSH terms: Anxiety Disorders; Compulsive Personality Disorder; Obsessive-Compulsive Disorder; Mental Disorders
Study type: Interventional
Phase: Phase 4

Summary: 
      The purpose of this study is to evaluate the efficiency of SSRIs（Selective Serotonin Reuptake
      Inhibitor） ,ERP（Exposure and Response Prevention） and the combination of the two therapies
      for OCD(Obsessive-Compulsive Disorder) patients ,at the same time, to find out the biological
      or psychological predictors of treatment response in Chinese population.
    

Detailed description: 
      Although Selective Serotonin Reuptake Inhibitors(SSRIs) and Cognitive Behavior Therapy (CBT)
      including Exposure and Response Prevention(ERP) are two kinds of the first line treatments
      for OCD(Obsessive-Compulsive Disorder) according to APA（American Psychological
      Association）guideline. Both of the treatments are effective, but few research has been done
      to find out who are more responsive to one treatment than the other. The aim of our research
      is to evaluate the efficiency of SSRIs ,ERP and the combination of the two therapies for OCD
      patients ,at the same time, to find out the biological and psychological predictors of
      treatment response in Chinese population.

      This is a randomized, single-blind, cross-over design study.Approximately 60 patients will be
      randomized to SSRIs or ERP group. Neuropsychological assessment and fMRI(Functional Magnetic
      Resonance Imaging） will be performed at baseline,during the treatment and at the end of the
      study. The research has two period. In the first period(before week 8) ,the patients will
      have monotherapy. In the second period(after week 8), rates of improvement based on the
      YBOCS(Yale-Brown Obsessive Compulsive Scale) scores will be assessed. The patient will be
      considered responsive to treatment when he or she has a reduction in YBOCS score ≥ 35% of the
      score at the baseline.If the patient is responsive to the treatment that he or she has
      received at the first 8 weeks,he or she will continue to follow the previous treatment
      strategy.If not,the patient will have a combination of SSRIs and ERP treatment for another 8
      weeks. The follow-up period will last up to 6 months.The result of the study will improve our
      knowledge about the efficacy of the two first line treatments .Also,it will help us to find
      out the predictors of the outcome of the two different kinds of treatments.Strategy of
      clinical treatment of OCD will be more individualized in the future.
    

Intervention name(s): Fluoxetine; Sertraline; Paroxetine; Citalopram; Fluvoxamine; Exposure and Response Prevention
Intervention type(s): Drug; Drug; Drug; Drug; Drug; Behavioral
Intervention description(s): The dosage depends on clinician's judgement ,but not over the maximum tolerated dosage.; The dosage depends on clinician's judgement ,but not over the maximum tolerated dosage.; The dosage depends on clinician's judgement ,but not over the maximum tolerated dosage.; The dosage depends on clinician's judgement ,but not over the maximum tolerated dosage.; The dosage depends on clinician's judgement ,but not over the maximum tolerated dosage.; 8 exposure and response prevention (ERP) sessions,once a week
Other intervention name(s): Prozac; Zoloft; Seroxat; Cipramil; Luvox; Exposure and Rituals Prevention
Intervention MeSH terms: Fluvoxamine; Sertraline; Fluoxetine; Paroxetine; Citalopram
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Cognitive Behavior Therapy; Exposure and Response/Ritual Prevention; Selective Serotonin Reuptake Inhibitors; Psychotherapy; Pharmacotherapy; Citalopram; Fluoxetine; Paroxetine; Sertraline; Fluvoxamine; fMRI; Stop Signal Task