Effectiveness of Exposure/Response Prevention Plus Eye Movement Desensitization and Reprocessing in Improve Cognitive Components in Patients with Obsessive-Compulsive Disorder and Life Stressful Experiences: A Randomized Controlled Trial

This study aimed to evaluate the effectiveness of Exposure/Response Prevention (ERP) combined with Eye Movement Desensitization Reprocessing (EMDR) as a treatment for obsessive-compulsive disorder (OCD) patients who experienced stressful life events (SLEs), by comparison to ERP.

This randomized controlled trial was conducted on 60 OCD patients who experienced SLEs and were resistant to medication treatment. Participants were randomized to ERP plus EMDR (n=30) or ERP (n = 30) The Obsessive Beliefs Questionnaire (OBQ-44) were completed before, after the intervention, and after a 3-month follow-up period. Treatment completion was compared using chi‐square tests, analyses of covariance (ANCOVA), repeated measures analysis of variance (ANOVA), Bonferroni post hoc test, and Reliable Change Index (RCI).

Dropout was significantly higher in the ERP group (P ˂ 0.05). Reliable change index was significant in both intervention groups (RCI < 1.96). Repeated systematic analysis of variance in both protocols showed a significant effect (P ≤ 0.001) on the recovery of cognitive components of OCD. Analysis of covariance showed more efficacy of EMDR protocol plus ERP than ERP group in terms of over-importance of thoughts (P = 0.001). Bonferroni post hoc test showed a significant difference in the mean cognitive components of OCD in both groups at the post-test and 3-month follow-up compared to the pre-test (P ≤ 0.001).

The EMDR plus ERP protocol, compared with ERP protocol, has a higher rate of completion, efficacy, and clinical improvement in OCD cognitive components.