Stepped Care for Treating Obsessive-Compulsive Disorder

Status Completed

Clinical Trial Summary

This study will determine the effectiveness and cost-effectiveness of a stepped-care treatment program for people with obsessive-compulsive disorder.

Clinical Trial Description

Obsessive-Compulsive Disorder (OCD) is a chronic and debilitating anxiety disorder. People with OCD often experience recurrent unwanted thoughts, called obsessions, and repetitive behaviors, called compulsions. These thoughts and behaviors interfere with everyday life to a great extent. Currently, the most frequently used psychosocial treatment for OCD is cognitive-behavioral therapy (CBT) that incorporates exposure with ritual prevention (EX/RP). However, although effective, this treatment approach is largely inaccessible, time-consuming, labor-intensive, and expensive. A stepped-care approach to treating OCD may be more cost-effective and therefore more accessible for many individuals. Stepped-care CBT begins with the least expensive, least intrusive, most accessible option, and works up to the most expensive option if the less intrusive treatments do not work. This study will determine the benefits and cost-effectiveness of a stepped care treatment program for OCD.

Participants in this open label study will be randomly assigned to receive CBT for 6 to 14 weeks either through the stepped-care approach or immediately upon study entry. Participants will report to the study site for treatments and assessments on a regular basis, ranging from every 2 weeks to twice a week, depending on the stage of the study and the assigned treatment group. Stepped-care CBT will begin with self-administered EX/RP combined with counseling to address medication issues, life stress, and motivational enhancement. If ineffective, this treatment will be followed by therapist-administered EX/RP. OCD symptoms will be assessed at Week 6. Participants who have responded to treatment after 6 weeks will not receive further treatment. All others will continue for an additional 8 weeks. These participants' OCD symptoms will be assessed again at Week 14. Participants assigned to the stepped-care approach whose OCD symptoms improved initially, but relapsed without further treatment by the Week 14 evaluation will receive full-scale CBT. Outcomes will be assessed again at 1- and 3-month follow-up visits. ;

Study Design

Related Conditions & MeSH terms

Clinical Trial Details

NCT number	NCT00316355
Study type	Interventional
Source	Hartford Hospital
Contact
Status	Completed
Phase	N/A
Start date	June 2006
Completion date	January 2010

View Details

See also
Status	Clinical Trial	Phase
Recruiting	`NCT04934007` - Bilateral Lateral OFC rTMS in Obsessive Compulsive Disorder	N/A
Recruiting	`NCT04071990` - Family Involvement in CBGT of OCD: a Randomized Controlled Trial	N/A
Completed	`NCT02541968` - Internet-based vs Face-to-face Cognitive Behavioural Therapy for Obsessive-compulsive Disorder	N/A
Recruiting	`NCT05651295` - A Precision Medicine Approach to Target Engagement for Emotion Regulation	N/A
Recruiting	`NCT05391503` - Light Therapy for Obsessive-compulsive Disorder (OCD)	N/A
Recruiting	`NCT04539951` - Pragmatic Trial of Obsessive-compulsive Disorder	Phase 2
Completed	`NCT03416504` - Methods for Managing Intrusive Thoughts	N/A
Not yet recruiting	`NCT06029738` - Effect on Obsessive-Compulsive Beliefs and Symptoms of MCT-OCD	N/A
Recruiting	`NCT02844049` - European Study of Quality of Life in Resistant OCD Patients Treated by STN DBS	N/A
Terminated	`NCT02909660` - What Are You Looking for? Psychometric and Experimental Analyses of Reassurance Seeking in Obsessive-compulsive Disorder	N/A
Completed	`NCT02911324` - Cannabinoid Medication for Adults With OCD	Phase 1/Phase 2
Completed	`NCT02217995` - Mindfulness-Based Cognitive Therapy in a Clinical Sample of OCD Patients	N/A
Terminated	`NCT02234011` - A Trial of Intranasal Ketamine for the Treatment of Obsessive-Compulsive Disorder	Phase 2
Withdrawn	`NCT01953042` - Benefits of a Psychoeducation Program for Those Awaiting Treatment for OCD and OCD Spectrum Disorders	N/A
Completed	`NCT02655926` - Deep Brain Stimulation for Severe Obsessive Compulsive Disorder	N/A
Completed	`NCT00742664` - Behavioral Treatment of Obsessive-Compulsive Symptoms in Youth With Prader-Willi Syndrome: A Pilot Project	Phase 1/Phase 2
Completed	`NCT04919785` - Deep Brain Stimulation in Severe Obsessive-compulsive Disorder	N/A
Terminated	`NCT00758966` - Naltrexone SR and Fluoxetine Combination Therapy in Subjects With Obsessive-Compulsive Disorder	Phase 2
Completed	`NCT00523718` - Riluzole Augmentation in Treatment-refractory Obsessive-compulsive Disorder	Phase 2
Completed	`NCT00074815` - Treatment of Obsessive Compulsive Disorder in Children	Phase 3

Clinical trials are conducted in a series of steps, called phases - each phase is designed to answer a separate research question.

Phase 1: Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
Phase 2: The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.
Phase 3: The drug or treatment is given to large groups of people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.
Phase 4: Studies are done after the drug or treatment has been marketed to gather information on the drug's effect in various populations and any side effects associated with long-term use.