Treatment histories of individuals with severe obsessive-compulsive disorder seeking treatment in an outpatient setting in Iceland

Abstract

Background: Obsessive-compulsive disorder (OCD) is a debilitating mental health disorder. Cognitive behavioural therapy (CBT) with exposure and response prevention (ERP) is an effective treatment for OCD, but few individuals seeking treatment access it, and for those who gain access, important CBT components are often missing. Aims: This study has two aims. Firstly, to explore treatment histories of individuals on a waiting list for, or having recently initiated treatment, for OCD at Landspítali – The National University Hospital of Iceland. Secondly, to evaluate the effectiveness of CBT with ERP at Landspítali. Method: Two patients who had recently initiated CBT with ERP for OCD were interviewed with a standardized interview for treatment history evaluation. Interviews were carried out between March 2024 and May 2024. For evaluating the effectiveness of CBT with ERP, data was analyzed for 22 participants who sought treatment between April 2021 and October 2023. Results: Findings from the interviews indicated that most recent previous psychological therapy lacked some key components of CBT with ERP. Speculations were raised about the importance of adequate first CBT treatment sought and its impact on treatment component attitudes. When examining CBT outcomes, a significant reduction in OCD symptoms and symptom severity was demonstrated post-treatment.Conclusions: This study provided insights into present and missing key components of CBT with ERP treatment through treatment histories and demonstrated that CBT with ERP is an effective treatment for individuals with long-term and severe OCD in Iceland. Further studies are needed to evaluate treatment histories from a larger sample and the effectiveness of CBT with ERP for OCD in Iceland in controlled conditions.