Highly efficacious cognitive-coping therapy for overt or covert compulsions

• The effects of pCCT on OCD with overt or covert compulsions were investigated.
• pCCT had similar effects on covert compulsions and overt compulsions.
• pCCT significantly reduced symptoms of covert and overt compulsions.
• pCCT for OCD had higher efficacy than pharmacotherapy plus psychological support.
• pCCT had higher effect size, response rate and remission rate than PPS.
• These findings suggested that pCCT might be a potential option for adult OCD.

Pharmacotherapy and cognitive-behavioral therapy (CBT) present limitations when they are used to treat obsessive–compulsive disorder (OCD), a severe and debilitating psychiatric disorder. To search for more efficacious treatment, we investigated the effects of pharmacotherapy plus cognitive-coping therapy (pCCT) on adult OCD patients with overt or covert compulsions. Two hundred and fifteen OCD patients were randomized into pharmacotherapy plus psychological support (PPS, n=107) and pCCT (n=108). The Yale–Brown Obsessive Compulsive Scale (Y–BOCS) was used to measure severity of symptoms in the OCD patients. The Y–BOCS scores were significantly lower in pCCT than in PPS in both acute term (<3 months) and long-term follow-up. In pCCT, severity of symptoms was not different between those with covert compulsions and those with overt compulsions, but was significantly reduced at any post-treatment time-point. Y–BOCS scores in the two subtype compulsions were significantly lower in pCCT than in PPS at any post-treatpost-treatment time-point. Compared with PPS, effect size, response rate and remission rate were significantly higher in pCCT. Our findings corroborated with the hypothesis that pCCT could efficaciously treat OCD with overt compulsions or covert compulsion, suggesting that pCCT might be a potential option for adult OCD.