Comparing the effectiveness of CBT and low-frequency rTMS in reducing symptom severity and depression and improving working memory in adults with OCD: a clinical trial

Arash Fazeli; Ahmad Zolghadriha; Reza Pirzeh; Atefeh Fatehi Chenar; Mohsen Dadashi

doi:10.1080/00207454.2023.2279500

Comparing the effectiveness of CBT and low-frequency rTMS in reducing symptom severity and depression and improving working memory in adults with OCD: a clinical trial

Int J Neurosci. 2023 Nov 8:1-12. doi: 10.1080/00207454.2023.2279500. Online ahead of print.

Authors

Arash Fazeli¹, Ahmad Zolghadriha², Reza Pirzeh², Atefeh Fatehi Chenar¹, Mohsen Dadashi³

Affiliations

¹ Department of Psychology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
² Department of Psychiatry, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
³ Department of Clinical Psychology, Social Determinants of Health Research Center, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.

PMID: 37938152
DOI: 10.1080/00207454.2023.2279500

Abstract

Objective: This study aims to compare the effectiveness of cognitive-behavioral therapy (CBT) and low-frequency (LF) repetitive transcranial magnetic stimulation (rTMS) in reducing symptom severity and depression and improving working memory in adults with obsessive-compulsive disorder (OCD).

Methods: This is a randomized clinical trial conducted on 24 adults with OCD, randomly assigned into two groups of CBT (n = 12, received CBT with exposure and response prevention (ERP) individually at 20 sessions) and rTMS (n = 12, received LF (1-Hz) rTMS over the right dorsolateral prefrontal cortex (DLPFC) at 10 sessions). They completed the Yale-Brown Obsessive Compulsive Scale, the Hamilton Depression Rating Scale, and two N-Back tasks before, immediately, and 1 month after interventions.

Results: Results showed a significant difference between the two methods in reducing the severity of OCD symptoms (p < 0.05) and depression (p = 0.002) immediately after interventions where the CBT with ERP was more effective, but no significant difference was found in terms of working memory (p > 0.05). No significant difference was found between groups in any study variables 1 month after interventions.

Conclusion: Individual CBT with ERP is superior to LF rTMS for reducing the severity of symptoms and depression in OCD patients. However, there is no difference between them in improving working memory.

Keywords: Cognitive-behavioral therapy; ID: IRCT20200805048316N1; Registration date: 05/11/2020; This study was registered by Iranian Registry of Clinical Trials (parallel; depression; https://en.irct.ir/trial/50734); obsessive–compulsive disorder; repetitive transcranial magnetic stimulation.