عنوان

اثربخشی درمان مبتنی بر پذیرش و تعهد در کاهش شدت علائم و بهبود کیفیت زندگی بیماران مبتلا به اختلال وسواس - اجبار

Text of Note

Introduction: The aim of this study was to investigate the effectiveness of acceptance and commitment therapy (ACT), in the treatment of adults with Obsessive- Compulsive Disorder(OCD). Method: 75 outpatients meeting DSM-IV-TR criteria for OCD were randomly assigned to one of three treatment conditions: ACT, treatment with clomipramine, and combined treatment. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Beck Depression Inventory-II-Second Edition (BDI-II), Thought Action Fusion Inventory (TAF), Qoality of life scale (QOLS),TCQ, and Acceptance and Action Questionnaire-II (AAQ-II) were administered at pre - , post-treatment an d the follow-up. 75 patients completed the study. Data were analyzed by one - way analysis of variance (ANOVAs( Bonferroni test, repeated measure ANOVAs, clinically significant change, and pre- to post-treatment percentage improvement. Results: repeated measure ANOVAs, Bonferroni test, and pre- to post-treatment and follow-up percentages improvement results showed that ACT and combined treatment lead to significant greater improvements in severity of obsessive - compulsive symptoms and experiential acceptance as compared to clomipramine alone at post-treatment and follow up. However, there were no significant differences between ACT and combined treatment in improving these symptoms. In addition, no significant differences were found between the groups in decreasing depression at post-treatment and the follow up stage. Clinically significant change and results also showed that, unlike the clomipramine, the ACT and combined treatment lead to more improvement in obsessive - compulsive symptoms. Analyses with the repeated measure ANOVA revealed that all the three treatment groups resulted in reductions in obsessive - compulsive symptoms, depression, TAF,thought control and experiential acceptance,. Furthermore, comparison of effect for the interaction between condition and time showed that the patients treated with ACT and combined treatment experienced a significantly further improvement in obsessive - compulsive symptoms and experiential acceptance from pre- to post-treatment as compared to those treated with clomipramine alone. Conclusion: ACT and combined treatment are more effective than clomipramine alone in treating obsessive - compulsive symptoms and experiential avoidance and TAF . However, it seems that adding clomipramine to ACT does not increase the effectiveness of ACT in the treatment adults with OCD in the short-time. Keywords: obsessive-compulsive disorder; acceptance and commitment therapy; clomipramine

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