Comparative Efficacy Of Exposure And Response Prevention (ERP) vs. Cognitive Therapy (CT) In Outpatient Settings For OCD

Obsessive-Compulsive Disorder (OCD) is a prevalent and debilitating psychiatric condition characterized by persistent, intrusive thoughts and repetitive behaviors that significantly impact quality of life and functional capacity. While both Exposure and Response Prevention (ERP) and Cognitive Therapy (CT) are established treatments for OCD, a need remains for direct comparisons of their effectiveness, particularly in outpatient settings, to optimize treatment strategies. This study aimed to compare the efficacy of ERP versus CT in treating OCD within outpatient settings. This randomized controlled trial (RCT) involved ۱۸۰ participants diagnosed with OCD who were randomly assigned to either a ۱۶-week ERP or CT treatment protocol in outpatient settings. Participants were included based on DSM-۵ criteria and Y-BOCS scores, while those with comorbid psychotic disorders or acute suicide risk were excluded. While both treatments significantly reduced OCD symptoms, ERP demonstrated a statistically significantly greater reduction in Y-BOCS scores compared to CT at the end of the ۱۶-week treatment period (Mean Y-BOCS reduction in ERP=۱۴.۵, SD=۵.۲; Mean Y-BOCS reduction in CT=۱۰.۳, SD=۴.۸; p = ۰.۰۳). Both treatments were associated with significant improvements in depressive symptoms and quality of life, with no statistically significant difference between the groups (BDI-II reduction, p=۰.۱۲; Q-LES-Q increase, p=۰.۰۹). The gains achieved during the active treatment phase were largely maintained at the ۳ and ۶-month follow-up assessments for both ERP and CT. However, at the ۱۲-month follow-up, a slight increase in Y-BOCS scores was observed in both groups. ERP may be considered as the first-line treatment option for individuals with OCD seeking outpatient care, though CT remains an effective alternative. Future research should focus on identifying predictors of differential treatment response and exploring combined or novel treatment approaches.