Mindfulness-Based Cognitive Therapy: Efficacy and fMRI-based Response Predictors in a Group of OCD Patients

NCT ID: NCT03128749

Last Updated: 2018-01-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-01-11

Study Completion Date

2018-12-31

Brief Summary

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Obsessive-Compulsive Disorder (OCD) patients have a response rate of 50-60% to exposure and response prevention (ERP) therapy and SSRI antidepressants. Mindfulness-Based Cognitive Therapy (MBCT) consists of training the participant to non-react to negative thoughts and emotions. Applying MBCT to OCD patients may help them behave with equanimity in response to their obsessions, and therefore acknowledge them with the same attention and intention as they admit any other disturbing thought without reacting to it. MBCT has demonstrated effectiveness in major depression, but much less attention has been given to MBCT in OCD. ERP and MBCT, although sharing aspects like exposure, are based on different theoretic and therapeutic factors. EPR is based on a direct anxiety habituation process whereas MBCT trains a holistic manner of becoming familiarized with distressful thoughts and emotions while learning to develop a new relationship to them. Thus, MBCT may decrease anxiety indirectly through a major attention awareness and non-reactivity to thoughts and emotions.

OCD is characterized by altered cortical-striatal-thalamic-cortical (CSTC) circuit and default mode network (DMN) connectivity when performing different tasks and during the resting state. It has been establish that the ventral CSTC circuit is mostly associated with emotional processing, while the dorsolateral aspect of the CSTC circuit is preferentially involved in cognitive processing. In this regard, we hypothesized that clinical amelioration will be accompanied by a re-establishment of functional connectivity within dorsolateral and DMN circuits, which will in turn be associated with improvement of certain neuropsychological processes. CSTC and DMN circuits have also shown to be sensitive to prolonged stress situations. Specifically, childhood trauma has been related to larger brain volumes and it has been associated with different OCD clinical subtypes.

Aims: 1. To assess MBCT effectiveness in treatment non-naive OCD patients. 2. To study cognitive and neuropsychological characteristics that mediate or moderate MBCT response. 3. To examine the changes in cognitive, neuropsychological and neuroimaging patterns associated with an MBCT intervention. 4. To identify a brain biomarker for positive response to MBCT in non-naïve OCD patients. 5. To study cognitive, neuropsychological and early stress expousure mediators or moderators of functional changes in CSTC and DMN patterns in response to MBCT.

Detailed Description

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Conditions

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Obsessive-Compulsive Disorder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SEQUENTIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Caregivers Outcome Assessors

Study Groups

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Mindfulness Based Intervention

Mindfulness-based cognitive therapy (MBCT), adjusted to OCD patients, will be applied in 10 weekly sessions of 2 hours followed by an extra session 4 weeks later. The treatment will be applied in a group format of 10 to 12 patients.

These patients will be also attending to their regular psychiatric visits for medication control.

Group Type EXPERIMENTAL

Mindfulness Based Intervention

Intervention Type BEHAVIORAL

The mindfulness based intervention protocol used in this project is adapted from the original and validated MBCT program for depression (Segal, Williams \& Teasdale, 2002). Two more sessions, focused on obsessive symptoms specfic to each participant, will be included. Those two sessions will be adapted from the manual "The Mindfulness Workbook for OCD" (Hershfield and Corboy, 2013).

Treatment as Usual

Intervention Type DRUG

The psychiatric referee will follow OCD guidelines modifying or potentiating drug treatments if needed.

Treatment as Usual (TAU)

Patients will be attending to their regular psychiatric visits during the whole trial period.

Group Type ACTIVE_COMPARATOR

Treatment as Usual

Intervention Type DRUG

The psychiatric referee will follow OCD guidelines modifying or potentiating drug treatments if needed.

Interventions

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Mindfulness Based Intervention

The mindfulness based intervention protocol used in this project is adapted from the original and validated MBCT program for depression (Segal, Williams \& Teasdale, 2002). Two more sessions, focused on obsessive symptoms specfic to each participant, will be included. Those two sessions will be adapted from the manual "The Mindfulness Workbook for OCD" (Hershfield and Corboy, 2013).

Intervention Type BEHAVIORAL

Treatment as Usual

The psychiatric referee will follow OCD guidelines modifying or potentiating drug treatments if needed.

Intervention Type DRUG

Other Intervention Names

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MBCT TAU

Eligibility Criteria

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Inclusion Criteria

* Age frame: 18-50 years old.
* Principal Diagnosis: Obsessive compulsive disorder.
* Severity of OCD symptoms: between mild (Y-BOCS=9) and severe (Y-BOCS=32)
* Previous structured CBT or EPR, either in group or individual format, between 10 to 20 sessions.
* A maximum of three different pharmacological strategies.
* Minimum of IQ 85 measured by Vocabulary subtest (WAIS-IV).
* Minimum level of schooling: 14 years.
* To sign the informant consent.

Exclusion Criteria

* Organic pathology and/or neurological disorders such as brain injury or epilepsy.
* Recent suicide attempt/active suicidality
* Previous completion of an MBCT course (≥ 8 weeks)
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital Universitari de Bellvitge

OTHER

Sponsor Role collaborator

Children's Hospital Medical Center, Cincinnati

OTHER

Sponsor Role collaborator

University of Arizona

OTHER

Sponsor Role collaborator

Corporacion Parc Tauli

OTHER

Sponsor Role lead

Responsible Party

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Clara López-Solà

PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Clara López-Solà, PhD

Role: PRINCIPAL_INVESTIGATOR

Corporació Parc Taulí

Maria Serra-Blasco, PhD

Role: PRINCIPAL_INVESTIGATOR

Fundació Parc Taulí

Pino Alonso, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Bellvitge University Hospital

Marina López-Solà, PhD

Role: PRINCIPAL_INVESTIGATOR

Children's Hospital Medical Center, Cincinnati

Jessica Andrews-Hanna, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Arizona

Locations

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Corporacion Sanitaria Parc Taulí

Sabadell, Barcelona, Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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Clara López-Solà, PhD

Role: CONTACT

0034 93 723 10 10 ext. 22152

Maria Serra-Blasco, PhD

Role: CONTACT

0034 93 723 10 10 ext. 22068

Facility Contacts

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Clara Lopez-Solà, PhD

Role: primary

600458159

Maria Serra-Blasco, PhD

Role: backup

References

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Goldberg X, Soriano-Mas C, Alonso P, Segalas C, Real E, Lopez-Sola C, Subira M, Via E, Jimenez-Murcia S, Menchon JM, Cardoner N. Predictive value of familiality, stressful life events and gender on the course of obsessive-compulsive disorder. J Affect Disord. 2015 Oct 1;185:129-34. doi: 10.1016/j.jad.2015.06.047. Epub 2015 Jul 2.

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Serra-Blasco M, Miquel-Giner N, Vicent-Gil M, Porta-Casteras D, Martinez-Zalacain I, Cano M, De la Pena-Arteaga V, Mar-Barrutia L, Alemany-Navarro M, Soriano-Mas C, Lopez-Sola M, Andrews-Hanna JR, Portella MJ, Soler J, Cardoner N, Alonso P, Lopez-Sola C. Clinical and Neuroimaging Effects of Mindfulness-Based Cognitive Therapy for Symptomatic OCD Patients after First-Line Treatments: A Randomised Controlled Trial. Psychother Psychosom. 2025 Oct 20:1-32. doi: 10.1159/000548961. Online ahead of print.

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Miquel-Giner N, Vicent-Gil M, Martinez-Zalacain I, Porta-Casteras D, Mar L, Lopez-Sola M, Andrews-Hanna JR, Soriano-Mas C, Menchon JM, Cardoner N, Alonso P, Serra-Blasco M, Lopez-Sola C. Efficacy and fMRI-based response predictors to mindfulness-based cognitive therapy in obsessive-compulsive disorder: Study protocol for a randomised clinical trial. Span J Psychiatry Ment Health. 2023 January/March;18(1):6-12. doi: 10.1016/j.rpsm.2022.11.002. Epub 2022 Nov 17. English, Spanish.

Reference Type DERIVED
PMID: 37839958 (View on PubMed)

Other Identifiers

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CorporacionPT CIR2016/030

Identifier Type: -

Identifier Source: org_study_id

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