Terapia cognitivo-conductual grupal por videoconferencia para el trastorno obsesivo-compulsivoEstudio piloto
- Inés Gil Delgado 1
- Laura Zaragoza 2
- Pablo Pelayo 3
- Lorena García Fernández 2
- Elena Cabedo 4
- María Roncero 4
- Gemma García Soriano 4
- 1 Centro de Salud Mental Alicante Santa Faz, Hospital Universitario San Juan de Alicante, Alicante, España
- 2 Servicio de Psiquiatría, Hospital Universitario San Juan de Alicante, Alicante, España
- 3 Centro de Salud Mental Campoamor, Hospital General Universitario Dr. Balmis, Alicante, España
- 4 Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Universidad de Valencia, Valencia, España
ISSN: 1136-5420
Año de publicación: 2023
Volumen: 28
Número: 1
Páginas: 1-11
Tipo: Artículo
Otras publicaciones en: Revista de psicopatología y psicología clínica
Resumen
El objetivo de este trabajo fue explorar la viabilidad, aceptación y eficacia de la terapia cognitivo-conductual grupal (TCCG) para el trastorno obsesivo-compulsivo (TOC) aplicada mediante videoconferencia. Ocho pacientes con TOC recibieron TCCG por videoconferencia. Se evaluaron la gravedad de los síntomas, ansiedad, depresión, calidad de vida y opinión sobre el tratamiento. Los pacientes asistieron a más del 90% de las sesiones y se mostraron satisfechos con el tratamiento. La gravedad de los síntomas obsesivo-compulsivos se redujo de forma significativa (p = 0.012; g = 1.56). Así mismo, mejoraron los niveles de depresión (p = .025; g = 1.5) y la calidad de vida (p = .017; g = 1.52). Este estudio sugiere que la TCCG aplicada por videoconferencia es un tratamiento viable, bien aceptado por los pacientes y que podría mejorar la sintomatología obsesivo-compulsiva. Son necesarios más estudios para seguir profundizando sobre la eficacia de la TCCG aplicada por videoconferencia para el TOC.
Referencias bibliográficas
- Ackerman, D. L., & Greenland, S. (2002). Multivariate meta analysis of controlled drug studies for obsessivecompulsive disorder. Journal of Clinical Psychopharmacology, 22(3), 309317. http://dx.doi.org/10.1097/00004714200206000 00012
- American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). https://doi. org/10.1176/appi.books.9780890425596
- Arnáez, S., García-Soriano, G., y Belloch, A. (2015). Contenidos obsesivos, miedo a la enfermedad y asco. Revista de Psicopatología y Psicología Clínica, 20, 3340. https://doi. org/10.5944/rppc.vol.1.num.1.2015.14406
- Banbury, A., Nancarrw, S., Dart, J., Gray, L., & Parkinson, L. (2018). Telehealth interventions delivering homebased support group videoconferencing: Systematic review. Journal of Medical Internet Research, 20(2), e8090. http://dx.doi. org/10.2196/jmir.8090
- Barlow, D. H., Farchione, T. J., Fairholme, C. P., Ellard, K. K., Boisseau, C. L., Allen, L. B., & EhrenreichMay, J. (2016). Protocolo unificado para el tratamiento transdiagnóstico de los trastornos emocionales. Alianza Editorial.
- Batastini, A. B., Paprzycki, P., Jones, A. C. T., & MacLean, N. (2020). Are videoconferenced mental and behavioral health services just as good as inperson? A metaanalysis of a fast growing practice. Clinical Psychology Review, 83, 101944. http://dx.doi.org/10.1016/j.cpr.2020.101944
- Beck, A. T., & Steer, R. A. (1993). Beck Anxiety Inventory: BAI. Psychological Corporation.
- Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory-II. The Psychological Corporation.
- Belloch, A., Cabedo, E., y Carrió, C. (2011). TOC. Obsesiones y compulsiones: tratamiento cognitivo. Alianza Editorial.
- Belloch, A., Cabedo, E., Carrió, C., FernándezAlvarez, H., García, F., & Larsson, C. (2011). Group versus individual cognitive treatment for obsessivecompulsive disorder: Changes in non OCD symptoms and cognitions at posttreatment and oneyear followup. Psychiatry Research, 187(12), 174179. http:// dx.doi.org/10.1016/j.psychres.2010.10.015
- Belloch, A., Fornés, G., Carrasco, A., LópezSolá, C., Alonso, P., & Menchón, J. M. (2016). Incompleteness and not just right experiences in the explanation of obsessivecompulsive disorder. Psychiatry Research, 236, 18. https://doi. org/10.1016/j.psychres.2016.01.012
- Belloch, A., Valle, G., Morillo, C., Carrió, C., & Cabedo, E. (2009). To seek advice or not to seek advice about the problem: The helpseeking dilemma for obsessive–compulsive disorder. Social Psychiatry and Psychiatric Epidemiology, 44(4), 257– 264. http://dx.doi.org/10.1007/s0012700804230
- BelottoSilva, C., Diniz, J. B., Malavazzi, D. M., Valério, C., Fossaluza, V., Borcato, S., Seixas, A. A., Morelli, D., Miguel, E. C., & Shavitt, R. G. (2012). Group cognitivebehavioral therapy versus selective serotonin reuptake inhibitors for obsessivecompulsive disorder: A practical clinical trial. Journal of Anxiety Disorders, 26(1), 2531. http://dx.doi. org/10.1016/j.janxdis.2011.08.008
- Bobes, J., Gonzalez, M. P., Bascaran, M. T., Arango, C., Saiz, P. A., & Bousono, M. (2001). Quality of life and disability in patients with obsessivecompulsive disorder. European Psychiatry, 16(4), 239245. http://dx.doi.org/10.1016/S0924 9338(01)005715
- Borkovec, T. D., & Nau, S. D. (1972). Credibility of analogue therapy rationales. Journal of Behavior Therapy and Experimental Psychiatry, 3(4), 257260. http://dx.doi. org/10.1016/00057916(72)900456
- Cabedo, E., Belloch, A., Carrió, C., Larsson, C., Fernández Alvarez, H., & García, F. (2010). Group versus individual cognitive treatment for obsessivecompulsive disorder: Changes in severity at posttreatment and oneyear followup. Behavioural and Cognitive Psychotherapy, 38(2), 227232. http://dx.doi.org/10.1017/S135246580999066X
- Comeche, M. I., Díaz, M. I., y Vallejo, M. A. (1995). Cuestionarios, Inventarios y Escalas. Ansiedad, Depresión y Habilidades Sociales. UNED Fundación UniversidadEmpresa.
- Cordioli, A. V., Heldt, E., Bochi, D. B., Margis, R., de Sousa, M. B., Tonello, J. F., & Kapczinski, F. (2002). Cognitive behavioral group therapy in obsessivecompulsive disorder: A clinical trial. Revista Brasileira de Psiquiatria, 24(3), 113 120. https://doi.org/10.1590/S151644462002000300004
- Fernández-Álvarez, J., & FernándezÁlvarez, H. (2021). Videoconferencing psychotherapy during the pandemic: Exceptional times with enduring effects?. Frontiers in Psychology, 12, 589536. http://dx.doi.org/10.3389/ fpsyg.2021.589536
- Ferrando, L., Bobes, J., Gibert, J., Soto, M., y Soto, O. (2000). MINI Entrevista Neuropsiquiátrica Internacional. Instituto IAP. www.fundacionforo.com/pdfs/mini.pdf
- Fonseca-Pedrero, E., Pérez-Álvarez, M., Al-Halabí, S., Inchausti, F., Muñiz, J., López-Navarro, E., Pérez de Albéniz, A., Lucas Molina, B., Debbané, M., Bobes-Bascarán, M. T., Gimeno Peón, A., Prado-Abril, J., Fernández-Álvarez, J., Rodriguez Testal., J. F., González, D., Díez-Gómez, A., García Montes, J. M, García Cerdán, L., Osma, J., … Marrero, R. J. (2021). Tratamientos psicológicos empíricamente apoyados para adultos: Una revisión selectiva. Psicothema, 33(2), 188197. http://dx.doi.org/10.7334/psicothema2020.426
- Franklin, M. E., Abramowitz, J. S., Kozak, M. J., Levitt, J. T., & Foa, E. B. (2000). Effectiveness of exposure and ritual prevention for obsessivecompulsive disorder: Randomized compared with nonrandomized samples. Journal of Consulting and Clinical Psychology, 68(4), 594602. http://dx.doi. org/10.1037/0022006X.68.4.594
- García-Soriano, G., Rufer, M., Delsignore, A., & Weidt, S. (2014). Factors associated with nontreatment or delayed treatment seeking in OCD sufferers: A review of the literature. Psychiatry Research, 220, 1–10. http://dx.doi.org/10.1016/j. psychres.2014.07.009
- Gentry, M. T., Lapid, M. I., Clark, M. M., & Rummans, T. A. (2018). Evidence for telehealth groupbased treatment: A systematic review. Journal of Telemedicine and Telecare, 25(6), 327342. http://dx.doi.org/10.1177/1357633X18775855
- Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Delgado, P., Heninger, G. R., & Charney, D. S. (1989). The YaleBrown ObsessiveCompulsive Scale: II. Validity. Archives of General Psychiatry, 46(11), 10121016. http:// dx.doi.org/10.1001/archpsyc.1989.01810110048007
- Goodman, W. K., Price, L. H., Rasmussen, S. A., Mazure, C., Fleischmann, R. L., Hill, C. L., Heninger, G.R., & Charney, D. S. (1989). The YaleBrown Obsessive Compulsive Scale: I. Development, use, and reliability. Archives of General Psychiatry, 46(11), 10061011. http://dx.doi.org/10.1001/ archpsyc.1989.01810110048007
- Himle, J. A., Van Etten, M., & Fischer, D. J. (2003). Group cognitive behavioral therapy for obsessivecompulsive disorder: A review. Brief Treatment and Crisis Intervention, 3(2), 217229. http://dx.doi.org/10.1093/brieftreatment/ mhg016
- Hirschtritt, M. E., Bloch, M. H., & Mathews, C. A. (2017). Obsessivecompulsive disorder: Advances in diagnosis and treatment. JAMA, 317(13), 13581367. http://dx.doi. org/10.1001/jama.2017.2200
- Hollander, E., Stein, D. J., Kwon, J. H., Rowland, C., Wong, C. M., Broatch, J., & Himelein, C. (1997). Psychosocial function and economic costs of obsessivecompulsive disorder. CNS spectrums, 2(10), 1625. http://dx.doi.org/10.1017/ S1092852900011068
- Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59(1), 1219. http://dx.doi.org/10.1037/10109 042
- Jónsson, H., & Hougaard, E. (2009). Group cognitive behavioural therapy for obsessive–compulsive disorder: A systematic review and metaanalysis. Acta Psychiatrica Scandinavica, 119(2), 98106. https://doi.org/10.1111/j.16000447.2008. 01270.x10.1111/j.16000447.2008.01270.x
- Kayser, R. R., Gershkovich, M., Patel, S., & Simpson, H. B. (2021). Integrating videoconferencing into treatment for obsessivecompulsive disorder: Practical strategies with case examples. Psychiatric Services, 72(7), 840844. http://dx.doi. org/10.1176/appi.ps.202000558
- Kohn, R., Saxena, S., Levav, I., & Saraceno, B. (2004). The treatment gap in mental health care. Bulletin of the World Health Organization, 82, 858866. https://apps.who.int/iris/ handle/10665/269274
- Lantarón-Imedio, P., Pina-Camacho, M. R., Moya-Diago, M. L., Pascual-Vera, B., Mateu, C., García-Trilles, E., & Carrió, C. (2021). Efficacy of cognitivebehavioral therapy for insomnia: Implementation of a group format in the Spanish National Health System. Revista de Psicopatología y Psicología Clínica, 26(3), 173–180. https://doi.org/10.5944/rppc.29423
- Leeuwerik, T., Cavanagh, K., & Strauss, C. (2019). Patient adherence to cognitive behavioural therapy for obsessive compulsive disorder: A systematic review and metaanalysis. Journal of Anxiety Disorders, 68, 102135. http://dx.doi. org/10.1016/j.janxdis.2019.102135
- Marques, L., LeBlanc, N. J., Wegarden, H. M., Timpano, K. R., Jenike, M., & Wilhelm, S. (2010). Barriers to treatment and service utilization in an internet sample of individuals with obsessive–compulsive symptoms. Depression and Anxiety, 27(5), 470–475. http://dx.doi.org/10.1002/da.20694
- Mataix-Cols, D., de la Cruz, L. F., & Rück, C. (2020). When improving symptoms is not enough - Is it time for next generation interventions for obsessivecompulsive disorder? JAMA Psychiatry, 77(1), 910. http://dx.doi.org/10.1001/ jamapsychiatry.2019.2335
- Mataix-Cols, D., Rauch, S., Baer, L., Eisen, J., Shera, D., & Goodman, W. (2002). Symptom stability in adult obsessive compulsive disorder: Data from a naturalistic twoyear followup study. American Journal of Psychiatry, 159(2), 263–268. http://dx.doi.org/10.1176/appi.ajp.159.2.263
- Mezzich, G., Juan, E., Cohen, N., & Ruipérez, M. A. (1999). An efficient and culturally informed Quality of Life Index: Preliminary presentation and validation. [Ponencia de congreso]. XI World Congress of Psychiatry, Hamburg.
- Milosevic, I., Cameron, D. H., Milanovic, M., McCabe, R. E., & Rowa, K. (2021). Facetoface versus video teleconference group cognitive behavioural therapy for anxiety and related disorders: A preliminary comparison. The Canadian Journal of Psychiatry, 07067437211027319. http://dx.doi. org/10.1177/07067437211027319
- National Institute for Health and Clinical Excellence (2005). Obsessive–compulsive disorder: Core interventions in the treatment of obsessive–compulsive disorder and body dysmorphic disorder CG31. National Institute for Health and Clinical Excellence.
- Nicolini, H., Herrera, K., Paez, F., Sánchez de Carmona, M., Orozco, B., y Lodeiro, G. (1996). Traducción al español y confiabilidad de la Escala YaleBrown para el trastorno obsesivocompulsivo. Salud Mental, 5(19), 1316.
- Olatunji, B. O., Davis, M. L., Powers, M. B., & Smits, J. A. (2013). Cognitivebehavioral therapy for obsessive compulsive disorder: A metaanalysis of treatment outcome and moderators. Journal of Psychiatric Research, 47(1), 33 41. http://dx.doi.org/10.1016/j.jpsychires.2012.08.020
- Osma, J., Suso-Ribera, C., García-Palacios, A., Crespo-Delgado, E., Robert-Flor, C., Sánchez-Guerrero, A., Ferreres-Galan, V., Pérez-Ayerra, L., Malea-Fernández, A., & Torres-Alfosea, M. Á. (2018). Efficacy of the unified protocol for the treatment of emotional disorders in the Spanish public mental health system using a group format: Study protocol for a multicenter, randomized, noninferiority controlled trial. Health and Quality of Life Outcomes, 16, 46. https://doi.org/10.1186/ s1295501808662
- Öst, L. G., Havnen, A., Hansen, B., & Kvale, G. (2015). Cognitive behavioral treatments of obsessive–compulsive disorder. A systematic review and metaanalysis of studies published 19932014. Clinical Psychology Review, 40, 156169. http:// dx.doi.org/10.1016/j.cpr.2015.06.003
- Pascual-Vera, B., y Belloch, A. (2018). El carácter transdiagnóstico de las intrusiones mentales: Una revisión y una propuesta basada en datos. Revista de Psicopatología y Psicología Clínica, 23(2), 135–147. https://doi.org/10.5944/rppc.vol.23. num.2.2018.20738
- Pinto, A., Mancebo, M. C., Eisen, J. L., Pagano, M. E., & Rasmussen, S. A. (2006). The Brown longitudinal obsessive compulsive study: Clinical features and symptoms of the sample at intake. Journal of Clinical Psychiatry, 67(5), 703– 711. http://dx.doi.org/10.4088/JCP.v67n0503
- Pozza, A., & Dettore, D. (2017). Dropout and efficacy of group versus individual cognitive behavioural therapy: What works best for obsessivecompulsive disorder? A systematic review and metaanalysis of direct comparisons. Psychiatry Research, 258, 2436. http://dx.doi.org/10.1016/j.psychres.2017.09.056
- Rosa-Alcázar, A. I., Sánchez-Meca, J., Gómez-Conesa, A., & Marín-Martínez, F. (2008). Psychological treatment of obsessivecompulsive disorder: A metaanalysis. Clinical Psychology Review, 28(8), 13101325. http://dx.doi. org/10.1016/j.cpr.2008.07.001
- Ruscio, A. M., Stein, D. J., Chiu, W. T., & Kessler, R. C. (2010). The epidemiology of obsessivecompulsive disorder in the National Comorbidity Survey Replication. Molecular Psychiatry, 15(1), 5363. http://dx.doi.org/10.1038/ mp.2008.94
- Sammons, M. T., VandenBos, G. R., & Martin, J. N. (2020). Psychological practice and the COVID19 crisis: A rapid response survey. Journal of Health Service Psychology, 46, 51–57. http://dx.doi.org/10.1007/s42843020000132
- Sanz, J., Perdigón, A. L., y Vázquez, C. (2003). Adaptación española del Inventario para la Depresión de Beck II (BDIII): 2. Propiedades psicométricas en población general. Clínica y Salud, 14, 249–280. https://www.redalyc.org/articulo. oa?id=180617972001
- Scholl, J., Kohls, E., Görges, F., Steinbrecher, M., Baldofski, S., Moessner, M., & Rummel-Kluge, C. (2021). Acceptability and feasibility of the transfer of facetoface group therapy to online group chats in a psychiatric outpatient setting during the COVID19 pandemic: Longitudinal observational study. JMIR Formative Research, 5(7), e27865. http://dx.doi. org/10.2196/27865
- Schwartze, D., Barkowski, S., Burlingame, G. M., Strauss, B., & Rosendahl, J. (2016). Efficacy of group psychotherapy for obsessivecompulsive disorder: A metaanalysis of randomized controlled trials. Journal of ObsessiveCompulsive and Related Disorders, 10, 4961. http://dx.doi. org/10.1016/j.jocrd.2016.05.001
- Sheehan, D., Janavs, J., Baker, R., Harnett-Sheehan, K., Knapp, E., Sheehan, M., Lecrubier, Y., Weiller, E., Hergueta, T., Amorim, P., Bonora, L. I., & Lépine, J. P. (1999). The Mini International Neuropsychiatric Interview (MINI). English version 5.0.0. DSMIV. Journal of Clinical Psychiatry, 60(18), 3962.
- Sousa, M. B., Isolan, L. R., Oliveira, R. R., Manfro, G. G., & Cordioli, A. V. (2006). A randomized clinical trial of cognitive behavioral group therapy and sertraline in the treatment of obsessivecompulsive disorder. Journal of Clinical Psychiatry, 67(7), 11331139. http://dx.doi.org/10.4088/jcp.v67n0717
- Stobie, B., Taylor, T., Quigley, A., Ewing, S., & Salkovskis, P. M. (2007). “Contents may vary”: A pilot study of treatment histories of OCD patients. Behavioural and Cognitive Psychotherapy, 35(3), 273282. http://dx.doi.org/10.1017/ S135246580700358X
- Storch, E. A., Caporino, N. E., Morgan, J. R., Lewin, A. B., Rojas, A., Brauer, L., & Murphy, T. K. (2011). Preliminary investigation of webcamera delivered cognitive–behavioral therapy for youth with obsessive–compulsive disorder. Psychiatry Research, 189 (3), 407–412. http://dx.doi. org/10.1016/j.psychres.2011.05.047
- Thomas, N., McDonald, C., de Boer, K., Brand, R. M., Nedeljkovic, M., & Seabrook, L. (2021). Review of the current empirical literature on using videoconferencing to deliver individual psychotherapies to adults with mental health problems. Psychology and Psychotherapy: Theory, Research and Practice, 94(3), 854883. http://dx.doi. org/10.1111/papt.12332
- Torres, A. R., Prince, M. J., Bebbington, P. E., Bhugra, D. K., Brugha, T. S., Farrell, M., Jenkins, R., Lewis, G., Meltzer, H., & Singleton, N. (2007). Treatment seeking by individuals with obsessivecompulsive disorder from the British Psychiatric Morbidity Survey of 2000. Psychiatric Services, 58(7), 977982. http://dx.doi.org/10.1176/ps.2007.58.7.977
- Vogel, P. A., Solem, S., Hagen, K., Moen, E. M., Launes, G., Håland, Å. T., Hansen, B., & Himle, J. A. (2014). A pilot randomized controlled trial of videoconferenceassisted treatment for obsessivecompulsive disorder. Behaviour Research and Therapy, 63, 162168. http://dx.doi. org/10.1016/j.brat.2014.10.007
- Wind, T. R., Rijkeboer, M., Andersson, G., & Riper, H. (2020). The COVID19 pandemic: The “black swan” for mental health care and a turning point for ehealth. Internet Interventions, 20,100317. http://dx.doi.org/10.1016/j. invent.2020.100317
- Wootton, B. M. (2016). Remote cognitivebehavior therapy for obsessive–compulsive symptoms: A metaanalysis. Clinical Psychology Review, 43, 103113. http://dx.doi.org/10.1016/j. cpr.2015.10.001
- Yalom, I. (1975). Theory and practice of group psychotherapy. Basic Books.