The Efficacy and Neural Correlates of ERP-based Therapy for OCD & TS: A Systematic Review and Meta-Analysis.

Abstract

BACKGROUND:

Exposure and response prevention (ERP) is a form of cognitive behavioral therapy that can effectively relieve obsessive-compulsive symptoms and tic symptoms in patients with obsessive-compulsive disorder (OCD) and Tourette syndrome (TS). However, the effect size of ERP-based therapy is still unclear.

METHODS:

In this study, we performed a meta-analysis to identify the efficacy of ERP-based therapy for individuals with OCD and TS. The standard mean difference (SMD) with a 95% confidence interval (CI) was calculated to assess the effect size of the efficacy for ERP-based therapy. We used subgroup and meta-regression analyses to explore the heterogeneity of the pooled SMD of ERP-based therapy for OCD. We also summarized the neuroimaging studies for ERP-based therapy for OCD. This meta-analysis was registered within the International Platform of Registered Systematic Review and Meta-analysis Protocols (number: INPLASY2021120112).

RESULTS:

A total of 18 studies including a total of 1057 patients with OCD and 3 studies including 267 with TS/chronic tic disorder were identified. We did not observe any indication of publication bias using Egger's funnel plot (p = 0.41). We observed a small-to-medium effect size of ERP for both OCD (SMD = -0.27, 95% CI: -0.53 to -0.01) and TS/chronic tic disorder (SMD = -0.35, 95% CI: -0.59 to -0.1). We found no heterogeneity of ERP-based therapy for OCD between the ERP-based therapy subgroup and medicine subgroup in the subgroup analysis (p = 0.72). We found no heterogeneity of ERP-based therapy for OCD between the child subgroup and adult subgroup in the subgroup analysis (p = 0.37). We used meta-regression analysis to identify the heterogeneity of ERP-based therapy for OCD and found that the sessions of therapy and publication year did not account for any significant heterogeneity (p > 0.05). The neurological mechanism of EPR-based therapy is unclear, but it may lie in changes in the prefrontal cortex and anterior cingulate cortex.

CONCLUSIONS:

In conclusion, we found that ERP-based therapy is effective for patients with OCD and TS/chronic tic disorder. We suggest a combination with other therapies and the development of online ERP services that might prove a promising new direction for healthcare providers.

• Authors: Junjuan Yan, Linyu Cui, Mengyu Wang, Yonghua Cui, Ying Li
• Journal: Journal of integrative neuroscience (J Integr Neurosci) Vol. 21 Issue 3 Pg. 97 (May 17 2022) ISSN: 0219-6352 [Print] Singapore
• PMID: 35633178 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)
• Copyright: © 2022 The Author(s). Published by IMR Press.

Topics

• Adult
• Child
• Family
• Gyrus Cinguli
• Humans
• Obsessive-Compulsive Disorder (diagnosis, psychology, therapy)
• Tic Disorders
• Tourette Syndrome (diagnosis, psychology, therapy)