Effectiveness of Exposure/Response Prevention Plus Eye Movement Desensitization and Reprocessing in Improve Cognitive Components in Patients with Obsessive-Compulsive Disorder and Life Stressful Experiences: A Randomized Controlled Trial

Introduction: This study aimed to evaluate the effectiveness of Exposure/Response Prevention (ERP) combined with Eye Movement Desensitization Reprocessing (EMDR) as a treatment for obsessive-compulsive disorder (OCD) patients who experienced stressful life events (SLEs), by comparison to ERP. Methods: This randomized controlled trial was conducted on 60 OCD patients who experienced SLEs and were resistant to medication treatment. Participants were randomized to ERP plus EMDR (n=30) or ERP (n = 30) The Obsessive Beliefs Questionnaire (OBQ-44) were completed before, after the intervention, and after a 3-month follow-up period. Treatment completion was compared using chi‐square tests, analyses of covariance (ANCOVA), repeated measures analysis of variance (ANOVA), Bonferroni post hoc test, and Reliable Change Index (RCI). Results: Dropout was significantly higher in the ERP group (P ˂ 0.05). Reliable change index was significant in both intervention groups (RCI < 1.96). Repeated systematic analysis of variance in both protocols showed a significant effect (P ≤ 0.001) on the recovery of cognitive components of OCD. Analysis of covariance showed more efficacy of EMDR protocol plus ERP than ERP group in terms of over-importance of thoughts (P = 0.001). Bonferroni post hoc test showed a significant difference in the mean cognitive components of OCD in both groups at the post-test and 3-month follow-up compared to the pre-test (P ≤ 0.001). Conclusions: The EMDR plus ERP protocol, compared with ERP protocol, has a higher rate of completion, efficacy, and clinical improvement in OCD cognitive components.