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dc.contributor.authorFineberg, Naomi
dc.contributor.authorBaldwin, David
dc.contributor.authorDrummond, Lynne
dc.contributor.authorWyatt, Solange
dc.contributor.authorHanson, Jasmine
dc.contributor.authorGopi, Srinivas
dc.contributor.authorKaur, Sukhwinder
dc.contributor.authorReid, Jemma
dc.contributor.authorMarwah, Virender
dc.contributor.authorSachdev, Ricky
dc.contributor.authorPampaloni, Ilenia
dc.contributor.authorShahper, Sonia
dc.contributor.authorMpavaenda, Davis
dc.contributor.authorVarlakova, Yana
dc.contributor.authorIrvine, Karen
dc.contributor.authorMonji-Patel, Deela
dc.contributor.authorShodunke, Ayotunde
dc.contributor.authorDyer, Tony
dc.contributor.authorDymond, Amy
dc.contributor.authorBarton, Garry
dc.contributor.authorWellsted, David
dc.contributor.authorMason, Christopher
dc.contributor.authorO'Leary, Cliodhna
dc.date.accessioned2018-10-04T01:08:27Z
dc.date.available2018-10-04T01:08:27Z
dc.date.issued2018-11-01
dc.identifier.citationFineberg , N , Baldwin , D , Drummond , L , Wyatt , S , Hanson , J , Gopi , S , Kaur , S , Reid , J , Marwah , V , Sachdev , R , Pampaloni , I , Shahper , S , Mpavaenda , D , Varlakova , Y , Irvine , K , Monji-Patel , D , Shodunke , A , Dyer , T , Dymond , A , Barton , G , Wellsted , D , Mason , C & O'Leary , C 2018 , ' Optimal treatment for obsessive compulsive disorder : A randomized controlled feasibility study of the clinical-effectiveness and cost-effectiveness of cognitive-behavioural therapy, selective serotonin reuptake inhibitors and their combination in the management of obsessive compulsive disorder ' , International Clinical Psychopharmacology , vol. 33 , no. 6 , pp. 334-348 . https://doi.org/10.1097/YIC.0000000000000237
dc.identifier.issn0268-1315
dc.identifier.otherPURE: 14995752
dc.identifier.otherPURE UUID: f1fe0657-df5f-414a-b9f2-4ee0d64e7086
dc.identifier.otherScopus: 85054509939
dc.identifier.urihttp://hdl.handle.net/2299/20684
dc.description.abstractEstablished treatments for obsessive compulsive disorder (OCD) include cognitive behaviour therapy (CBT) and selective serotonin reuptake inhibitor (SSRI) medication. Combined treatment may outperform monotherapy, but few studies have investigated this. A total of 49 community-based adults with OCD were randomly assigned to CBT, SSRI, or SSRI+CBT. Sertraline (50–200 mg/day) was given as the SSRI for 52 weeks. A 16-h-manualized individual CBT was delivered over 8 weeks with four follow-up sessions. Assessors were ‘blinded’ to treatment allocation. A preliminary health economic evaluation was conducted. At week 16, combined treatment (n=13) was associated with the largest improvement, sertraline (n=7) the next largest and CBT (n=9) the smallest on the observed case analysis. The effect size (Cohen’s d) comparing the improvement in Yale Brown Obsessive Compulsive Scale on CBT versus combined treatment was −0.39 and versus sertraline was −0.27. Between 16 and 52 weeks, the greatest clinical improvement was seen with sertraline, but participant discontinuation prevented reliable analysis. Compared with sertraline, the mean costs were higher for CBT and for combined treatment. The mean Quality Adjusted Life Year scores for sertraline were 0.1823 (95% confidence interval: 0.0447–0.3199) greater than for CBT and 0.1135 (95% confidence interval: -0.0290–0.2560), greater than for combined treatment. Combined treatment appeared the most clinically effective option, especially over CBT, but the advantages over SSRI monotherapy were not sustained beyond 16 weeks. SSRI monotherapy was the most cost-effective. A definitive study can and should be conducted.en
dc.format.extent15
dc.language.isoeng
dc.relation.ispartofInternational Clinical Psychopharmacology
dc.rights/dk/atira/pure/core/openaccesspermission/open
dc.subjectcognitive behaviour therapy
dc.subjectfeasibility
dc.subjecthealth economic
dc.subjectobsessive-compulsive disorder
dc.subjectrandomized
dc.subjectsertraline
dc.subjectPsychiatry and Mental health
dc.subjectPharmacology (medical)
dc.titleOptimal treatment for obsessive compulsive disorder : A randomized controlled feasibility study of the clinical-effectiveness and cost-effectiveness of cognitive-behavioural therapy, selective serotonin reuptake inhibitors and their combination in the management of obsessive compulsive disorderen
dc.contributor.institutionDepartment of Clinical and Pharmaceutical Sciences
dc.contributor.institutionCentre for Health Services and Clinical Research
dc.contributor.institutionUniversity of Hertfordshire
dc.contributor.institutionSchool of Life and Medical Sciences
dc.contributor.institutionCentre for Research in Psychology and Sport Sciences
dc.contributor.institutionBasic and Clinical Science Unit
dc.contributor.institutionHealth Research Methods Unit
dc.description.statusPeer reviewed
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85054509939&partnerID=8YFLogxK
dc.relation.schoolSchool of Life and Medical Sciences
dc.description.versiontypeFinal Published version
dcterms.dateAccepted2018-07-04
rioxxterms.versionVoR
rioxxterms.versionofrecordhttps://doi.org/10.1097/YIC.0000000000000237
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue
herts.rights.accesstypeopenAccess


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