Effectiveness of low-intensity cognitive-behavioral therapy for obsessive-compulsive disorder in routine psychiatric practice.

BACKGROUND

Cognitive-behavioral therapy (CBT) is a first-line treatment for obsessive-compulsive disorder (OCD). Exposure and response prevention (ERP), the principal CBT technique for OCD, involves repeated exposure to anxiety-provoking stimuli and habituation of anxiety responses. Although weekly CBT sessions over 10-12 weeks are recommended, real-world implementation is often constrained; Japanese health insurance permits shorter and less frequent sessions. However, the effectiveness of such low-intensity CBT (LiCBT) remains unclear.

METHODS

This exploratory study used data derived from a long-term prospective cohort. Eighteen adult outpatients received ERP-based CBT (≤ 16 sessions per year) under the national insurance framework. Pharmacotherapy, when present, remained unchanged during CBT. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Global Assessment of Functioning (GAF), State-Trait Anxiety Inventory (STAI), and Zung's Self-rating Depression Scale (SDS) were administered before and after treatment.

RESULTS

Participants received an average of 12.2 sessions. Significant reductions were observed in Y-BOCS total (t = 5.744, p < 0.001) and GAF scores improved significantly (t = -6.45, p < 0.001), accompanied by a significant reduction in STAI-trait (p = 0.03), whereas the score on STAI-state (p = 0.51) and SDS (p = 0.50) showed no significant change.

STUDY LIMITATIONS: Small sample size, single-site observational design, and absence of a control group.

CONCLUSION

LiCBT under Japan's health insurance framework is effective at significantly reducing OCD symptoms and improving global functioning with partial emotional benefits. These findings highlight the feasibility and flexibility of LiCBT as a practical, individualized, real-world treatment.