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Efficacy of mindfulness-integrated cognitive behavior therapy in patients with predominant obsessions

Ajay Kumar, Mahendra P. Sharma, Janardhanan C. Narayanaswamy, Thennarasu Kandavel, Y. C. Janardhan Reddy

Indian Journal of Psychiatry March 11, 2026 DOI: 10.4103/0019-5545.196723 (opens in new tab) via DOAJ

Summary

AI-generated from the abstract

Mindfulness-integrated cognitive behavior therapy (MICBT) reduced obsessive-compulsive disorder symptoms in patients with predominant obsessions and few or no overt compulsions. Of 27 patients, 18 (67%) achieved remission—defined as a 55% reduction in Yale–Brown Obsessive-Compulsive Scale severity score—at 3-month follow-up. The average reduction in obsessive severity was 56% at post-treatment and 63% at follow-up. The authors conclude that MICBT is efficacious for this population and call for a larger randomized controlled trial.

Study at a glance

Characteristics Open-label study Randomized Peer reviewed
Sample size 27
Population Patients with DSM-IV diagnosis of obsessive-compulsive disorder with predominant obsessions and few or no overt compulsions, recruited from a specialty OCD clinic and behavior therapy services of a tertiary care psychiatric hospital
Intervention Mindfulness-integrated cognitive behavior therapy
Dose 12–16 sessions
Duration 12–16 session intervention, 3-month follow-up
Keywords Cognitive behavior therapy Mindfulness meditation Obsessions Obsessive-compulsive disorder
Key finding Mindfulness-integrated cognitive behavior therapy reduced obsessive-compulsive disorder severity, with 67% of patients achieving remission at 3-month follow-up.

Abstract

Background: Cognitive behavior therapy (CBT) involving exposure and response prevention is the gold standard psychotherapeutic intervention for obsessive-compulsive disorder (OCD). However, applying traditional CBT techniques to treat patients with predominant obsessions (POs) without covert compulsions is fraught with problems because of inaccessibility of mental compulsions. In this context, we examined the efficacy of mindfulness-integrated CBT (MICBT) in patients with POs without prominent overt compulsions. Materials and Methods: Twenty-seven patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of OCD were recruited from the specialty OCD clinic and the behavior therapy services of a tertiary care psychiatric hospital over 14 months. Patients had few or no overt compulsions and were free of medication or on a stable medication regimen for at least 2 months prior to baseline assessment. All patients received 12–16 sessions of MICBT on an outpatient basis. An independent rater (psychiatrist) administered the Yale–Brown Obsessive-Compulsive Scale (YBOCS) and the Clinical Global Impression Scale at baseline, mid- and post-treatment, and at 3-month follow-up. Results: Of the 27 patients, 18 (67%) achieved remission (55% reduction in the YBOCS severity score) at 3-month follow-up. The average mean percentage reduction of obsessive severity at postintervention and 3-month follow-up was 56 (standard deviation [SD] = 23) and 63 (SD = 21), respectively. Conclusions: Our study demonstrates that MICBT is efficacious in treating patients with POs without prominent overt compulsions. The results of this open-label study are encouraging and suggest that a larger randomized controlled trial examining the effects of MICBT may now be warranted.

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