Combination of behaviour therapy with fluvoxamine in comparison with behaviour therapy and placebo -: Results of a multicentre study
Combination of behaviour therapy with fluvoxamine in comparison with behaviour therapy and placebo -: Results of a multicentre study
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DOI：
10.1192/s0007125000297924
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发表时间：
1998-08-01
影响因子：
10.5
通讯作者：
Berger, M
中科院分区：
文献类型：
--
作者：
Hohagen, F;Winkelmann, G;Berger, M
目的探讨多模式行为疗法（multi-modalbehaviortherapy，BT）联合氟伏沙明（fluvoxamine）治疗重度强迫症（obsessivedisorder，OCD）的疗效。方法采用随机、双盲设计，30例患者接受BT联合安慰剂治疗，30例患者接受BT联合氟伏沙明治疗，疗程均为9周（最大剂量300 mg，平均剂量288.1 mg）。BT包括暴露与反应预防，认知重建和替代behaviors.Results两组治疗后表现出非常显着的症状减轻的发展。在强迫方面，两组之间没有显著差异。氟伏沙明和BT组的强迫症明显比安慰剂和BT组减少。此外，根据先前定义的反应标准，BT+氟伏沙明组显示出显著更高的反应率（87.5 v. 60%）。严重抑郁症患者与强迫症接受BT加安慰剂提出了一个显着更糟糕的治疗结果（Y-BOCS分数）比所有其他groups.Conclusions结果表明，BT应结合氟伏沙明时，强迫症占主导地位的临床图片，当继发性抑郁症是存在的。
Background We investigated whether the combination of muti-modal behaviour therapy (BT)with fluvoxamine is superior to BT and placebo in the acute treatment of severely iii in-patients with obsessive-compulsive disorder (OCD).Method In a randomised, double-blind design, 30 patients were treated for nine weeks with BT plus placebo and 30 patients with BT plus fluvoxamine (maximum dosage 300 mg, mean dose 288.1 mg). BT included exposure with response prevention, cognitive restructuring and development of alternative behaviours.Results Both groups showed a highly significant symptom reduction after treatment. There were no significant differences between the groups concerning compulsions. Obsessions were significantly more reduced in the fluvoxamine and BT group than in the placebo and BT group. Furthermore, the group BT plus fluvoxamine showed a significantly higher response rate (87.5 v. 60%) according to a previously defined response criterion. Severely depressed patients with OCD receiving BT plus placebo presented a significantly worse treatment outcome (Y-BOCS scores) than all other groups.Conclusions The results suggest that BT should be combined with fluvoxamine when obsessions dominate the clinical picture and when a secondary depression is present.