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Klinik für Psychiatrie und Psychotherapie

Research group Külz

Efficacy of Mindfulness Based Cognitive Therapy (MBCT) in patients with obsessive-compulsive disorder

Cognitive behavioural therapy (CBT) with exposure and response prevention (ERP) represents the first line treatment for patients with obsessive-compulsive disorder (OCD). However, despite the effectiveness of this approach, many patients suffer from a chronic course of OCD. An open pilot study by our research group recently showed that Mindfulness Based Cognitive Therapy (MBCT) is feasible in patients with OCD and that the program might be effective in reducing residual OCD symptoms after CBT. We now aim at systematically evaluating MBCT as a treatment option for patients who are still symptomatic after CBT with ERP, hypothesizing a reduction of remaining symptoms.

In a prospective, bicentric, assessor-blinded, randomized, actively controlled, DFG-funded clinical trial, 128 participants will be randomly assigned to either 8 sessions of MBCT or psycho-educative coaching group (CG) as an active control condition. The main hypothesis is that MBCT leads to a significantly greater reduction of OC-symptoms than CG. The severity of OC symptoms as a primary outcome, depressive symptoms, the quality of life and further outcome parameters will be assessed at baseline, post treatment and at 6- and 12-months follow up.

Table: Contents and objectives of the MBCT program for patients with obsessive-compulsive disorder

Mindfulness contents OCD-specific contents
ElementsObjectivesElementsObjectives
The body scan Becoming aware of the body and bodily sensations Introducing metaphors such as “The spectacles of OCD” Illustrating selective attention and cognitive distortion in OCD
Guided sitting meditation Dealing with arising physical sensations, thoughts and feelings Discussing the cognitive model of Salkovskis Clarifying the impact of the subjective appraisal of intrusive thoughts
The three-minute breathing space Facilitating an accepting way of focusing on present thoughts, feelings and physical sensations  Reviewing neurobiological perspectives of OCD Encouraging disidentification with obsessive thoughts and impulses
Yoga and mindful movement exercises Becoming aware of bodily sensations through movement Identifying typical obsessive beliefs Inviting to take a step back and questioning the veracity of one’s appraisals
Mindfulness in everyday live Integrating the application of mindfulness skills into routine activities such as eating or brushing teeth Creating a relapse prevention plan Developing strategies how to deal with individual OCD triggers and detecting early warning signals for relapse

Project Members

  • Dr. Anne Katrin Külz (project leader)
  • Dipl.-Psych. Sarah Landmann  

  • Lara Wieland
  • Magdalena Schmidt-Ott

 

Cooperations

  • Prof. Steffen Moritz, Hamburg
  • Prof. Thomas Heidenreich, Esslingen

Klinik für Psychiatrie und Psychotherapie

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79104 Freiburg

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