View Clinical Trial (Medical Research Study)
Stepped Care for Obsessive-Compulsive Disorder
| City: |
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Hartford |
| State: |
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Connecticut |
| Zip Code: |
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06106 |
| Conditions: |
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Obsessive-Compulsive Disorder |
| Purpose: |
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This study will determine the effectiveness and cost-effectiveness of a stepped-care
treatment program for people with obsessive-compulsive disorder.
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| Study Summary: |
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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.
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| Criteria: |
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Inclusion Criteria:
- Primary diagnosis of OCD of moderate or greater severity
- Presence of OCD symptoms for at least 1 year
Exclusion Criteria:
- History of psychotic or developmental disorder
- Uncontrolled bipolar disorder
- Serious suicide risk
- Prior history of adequate CBT, including exposure and response prevention
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| NCT ID: |
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NCT00316355 |
| Primary Contact: |
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Principal Investigator
David F. Tolin, PhD
Institute of Living/Hartford Hospital
Christina Ryan, BA
Phone: 860-545-7685
Email: cryan02@harthosp.org
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| Backup Contact: |
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Email: dtolin@harthosp.org
David F. Tolin, PhD
Phone: 860-545-7685
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| Location Contact: |
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Hartford, Connecticut 06106
United States
Sara Whiting, BA
Phone: 860-545-7685
Email: swhiting@harthosp.org
Site Status: Recruiting |
| Data Source: |
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ClinicalTrials.gov |
| Date Processed: |
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May 22, 2013 |
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