Towards Remission and Full Recovery From Obsessive-compulsive Disorder

What this study is about

Obsessive-compulsive disorder (OCD) is a disabling psychiatric illness that is characterized by distressing obsessional thoughts and time-consuming compulsive rituals. Exposure and Response Prevention (ERP) is a first-line psychological treatment of choice that requires patients to face their fears by being exposed to feared stimuli. This treatment has been shown to reduce symptoms in a significant proportion of patients. However, it is considered a difficult treatment and only a minority reach remission. Residual symptoms typically remain, or reappear after treatment, which is a risk for relapse. Inference-based Cognitive Behavioral Therapy (I-CBT) is a promising evidence-based treatment developed to overcome these limitations. I-CBT has already been found to be as effective as ERP and significantly more acceptable and easier to adhere to. There is also evidence that I-CBT is more effective for subgroups of patients. Consequently, the current research project is focused on improving treatments outcomes for those provide those who have previously unable to reach remission of their symptoms with ERP. Following an initial treatment with ERP, those that have been unable to reach remission, will be randomized to either I-CBT or more ERP. It is expected that I-CBT will be significantly more effective than providing patients with more of the same. In addition, the study aims to predict treatment outcome in order to be able to tell in advance which patients do not respond to ERP. The project is designed to maximize beneficial health outcomes with a stepped-care approach to treatment, but also to work towards a more personalized choice by being able to match patients in advance with the treatment that works best for them

Who can join (things the study team will check)

✅ You may be able to join if…

• a primary diagnosis of OCD according to DSM-5 criteria.
• a score ≥ 18 on the Y-BOCS
• age ≥ 18.
• no change in medication during the 8 weeks before treatment for antidepressants (4 weeks for anxiolytics).
• willingness to keep medication stable while participating in the study.
• not undergoing a concurrent psychological treatment.
• access to a computer or phone with internet access.

🚫 You may not be able to join if…

• evidence of a high level of suicidal ideation, suicidal intent or previous suicide attempts.
• past or present psychotic or bipolar disorder.
• neurocognitive disorder, pervasive developmental disorder or intellectual disability of a severity judged to significantly interfere with treatment and/or requiring treatment first.
• substance abuse disorder of a severity judged to significantly interfere with treatment and/or requiring treatment first.

Where this trial is running

• Institut universitaire en santé mentale de Montréal, Montreal, Quebec, Canada

Who to contact

Frederick Aardema, PhD · 514-662-5116 · faardema@gmail.com

It's completely normal to call and ask questions before deciding anything. Mention the study ID: NCT06318806.