[Mindfulness-based interventions in obsessive-compulsive disorder: Mechanisms of action and presentation of a pilot study].
M Gasnier, A Pelissolo, Guido Bondolfi, S Pelissolo, M Tomba, L Mallet, K N'diaye
L'Encephale December 2017 DOI: 10.1016/j.encep.2016.10.004 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Pilot study Peer reviewed |
|---|---|
| Population | OCD patients in two clinical centers |
| Interventions | Mindfulness-based cognitive therapy (MBCT) Mindfulness-based stress reduction (MBSR) |
| Topics | Meditation |
| Keywords | Obsessive-compulsive disorder Pilot study Trouble obsessionnel compulsif Étude pilote |
| Key points | The pilot study demonstrated the feasibility of mindfulness-based therapy in OCD patients, with results tending to show greater effectiveness in younger patients with less severe forms of OCD. The authors propose a cognitive model where mindfulness corrects cognitive biases while ERP addresses behavioral aspects, and suggest MBCT as a maintenance treatment to prevent relapse. |
Abstract
Obsessive-compulsive disorder (OCD) is a frequent and severe disease, potentially inducing a major impairment for the patient and burden for their family. Recent research in psychiatry and neuroscience have led to better comprehension of the disease's mechanisms and helped to improve its treatment. However, a large proportion of patients have refractory symptoms, including for traditional cognitive and behavioral therapy by exposure and response prevention (ERP), leading clinicians to look for new treatments. Mindfulness-based interventions (MBI) are a new type of approach, initially based on Buddhist meditation, which aims to provide better consciousness of the present moment. It has been successfully developed in some psychiatric diseases and other general medical conditions such as chronic pain. The two main programs using mindfulness meditation, Mindfulness-based stress reduction (MBSR) and Mindfulness-based cognitive therapy (MBCT), have shown effectiveness for the reduction of depressive and anxiety symptoms and relapses of depressive episodes in unipolar depression. It has no side effects and is well tolerated by patients. Its action relies on the specific correction of cognitive deficits in attention, emotion regulation and executive functions which are shared by OCD, GAD and depression. For OCD, we make the hypothesis that Mindfulness-Based Interventions could reduce the cognitive bias specifically existing in this pathology, such as dysfunctional beliefs, and therefore improve the symptoms. This article first reviews the existing literature on clinical trials involving Mindfulness-Based Interventions in OCD which comprises a small number of clinical studies based on very different types of protocols. At this time, and due to the lack of gold-standard studies with a large number of patients, no proof of the efficiency of mindfulness-based interventions in OCD has been shown. In a second section, following our hypothesis on the mechanisms of specific and non-specific action of this therapy in OCD, we propose a cognitive model of mindfulness-based therapy action in OCD involving the correction of OCD's cognitive bias. In this model, mindfulness-based therapy is supposed to treat specifically the cognitive aspects of the disease, while ERP is focused on its behavioral part. Then we present a clinical study aiming to prove the feasibility and the interest of the use of mindfulness in OCD, carried out in two different clinical centers. One of them used MBCT while the second used MBSR. Its results show the feasibility of mindfulness-based therapy in OCD patients and tend to prove that it could be more effective in young patients suffering from less severe forms of OCD. In parallel, attention tests and fMRI scans were done at the beginning and at the end of the therapy. Their results will be published separately. We also discuss the putative role of a specific form of MBCT adapted for OCD, specifically for its benefits in psychoeducation, which could reduce the dysfunctional beliefs present in OCD patients. Finally, we propose a therapeutic strategy in which the MBCT could complement the classical ERP therapy, as a "maintenance" treatment, aiming to extend the relapse of OCD symptoms. This article is a step further in the use of mindfulness-based therapy for OCD which could be added to the existing treatments reducing the patient's symptoms and improving their quality of life.
Comparable studies
Other non-randomized and open-label trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Mindfulness-Based Stress Reduction in Relation to Quality of Life, Mood, Symptoms of Stress, and Immune Parameters in Breast and Prostate Cancer Outpatients Early-stage breast and prostate cancer patients | 2003 | Pre-post intervention study | n = 59 |
| Exploring self‐compassion and empathy in the context of mindfulness‐based stress reduction (MBSR) Community sample | 2010 | Pre-post intervention study | |
| Mindfulness-Based Stress Reduction Lowers Psychological Distress In Medical Students Second-year medical students | 2003 | Prospective nonrandomized cohort-controlled study | n = 302 |
| Intensive meditation training, immune cell telomerase activity, and psychological mediators. Retreat participants and matched controls | 2011 | Controlled trial with wait-list control group | n = 60 |
| The Effectiveness of Mindfulness Training for Children with ADHD and Mindful Parenting for their Parents Children aged 8-12 with ADHD and their parents | 2011 | Within-group waitlist controlled trial | n = 22 |
Citations in the library
Cited by 5
- Mindfulness-based cognitive therapy for obsessive-compulsive disorder: Study protocol for a randomized controlled trial with functional magnetic resonance imaging and a 6-month follow-up Journal of Health Psychology July 5, 2018
- The Boy Who Grew a New Brain: Understanding this Miracle from a Neuro-Quantum Perspective NeuroQuantology June 26, 2018
- Effects of Mindfulness Therapy on Stress Biomarkers and Psychological Symptoms in Women With Recurrent Pregnancy Loss: A Randomized Clinical Trial Stress and Health October 1, 2026
- Mindfulness as Adjuvant Treatment for Obsessive‐Compulsive Disorder: An Integrative Review Revista Portuguesa de Psiquiatria e Saúde Mental June 16, 2023
- Mindfulness-Based Cognitive Therapy for Unmedicated Obsessive-Compulsive Disorder: A Randomized Controlled Trial With 6-Month Follow-Up. Frontiers in Psychiatry 2021
Cites 16
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- Mindfulness-based cognitive therapy for depression August 21, 2006
- Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse JAMA Psychiatry April 28, 2016
- Mental Training Affects Distribution of Limited Brain Resources PLoS Biology May 4, 2007
- Minding one’s emotions: Mindfulness training alters the neural expression of sadness. Emotion February 1, 2010
and 11 more in the library