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Abstract

第115巻第9号

Definition of Treatment—refractory Obsessive—compulsive Disorder based on Cognitive Behavioral Thetapy
Eiji SHIMIZU
Department of Cognitive Behavioral Physiology, Research Center for Child Mental Development, Chiba University, Graduate School of Medicine
Psychiatria et Neurologia Japonica 115: 975-980, 2013

 Several lines of evidence have shown that cognitive behavioral therapy(CBT)is more effective than pharmacotherapy for people with obsessive‒compulsive disorder(OCD). Not only pharmacotherapy‒resistant but also CBT‒resistant OCD should be defined. After reviewing previous studies, patients with treatment‒refractory OCD may be required to show severe symptoms with a score of at least 28 on the Yale‒Brown Obsessive‒Compulsive Scale(Y‒BOCS)even after therapy, and have at least a 5‒year history of OCD. I propose CBT‒RESISTANT OCD as a term to describe cases of OCD that do not respond to adequate standard CBT of at least 30 hours. Moreover, CBT‒REFRACTORY OCD can only be determined if a person has tried intensive CBT(including exposure and ritual prevention for 4 weeks, followed by eight weekly maintenance session)of at least 40 hours after standard CBT.

Keywords:obsessive‒compulsive disorder, cognitive‒behavioral therapy, exposure and response prevention, treatment‒resistant, treatment‒refractory>
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