Thus, imaginal exposure seemed to contribute to the maintenance of treatment gains. In a second study, Foa et al25 compared the

efficacy of imaginal exposure with that of in-vivo exposure. OCD outpatients with checking rituals were randomly assigned to one of two treatment conditions: imaginal or in-vivo exposure. Ritual prevention was not included in the treatments. Both treatments involved 15 120-minute sessions over 3 weeks, and two home visits in the fourth week. Patients improved significantly in their OCD symptoms and continued to improve at follow-up (an average of 10 months Inhibitors,research,lifescience,medical post-treatment). No significant differences between treatments emerged at post-test or follow-up.

Inhibitors,research,lifescience,medical The authors concluded that both imaginal and in-vivo exposure offered clinically significant and lasting benefits to patients with OCD. In sum, although imaginal exposure does not appear essential for immediate outcome, it may enhance longterm maintenance and can be used as an adjunct to invivo exposure for patients who manifest fear of “disastrous consequences” Inhibitors,research,lifescience,medical such as burglary in the absence of checking door locks and windows. The relative effects of exposure and ritual prevention To examine the relative effects of exposure and ritual prevention, Foa et al26 randomly assigned patients with contamination obsessions and washing rituals to treatment by exposure only (EX), ritual prevention only (RP), or their combination (EX/RP). Each treatment was conducted intensively (15 daily, 120-minute sessions conducted over 3 weeks) followed by a home visit. Patients in all conditions Inhibitors,research,lifescience,medical improved at both post-treatment and follow-up. However, patients in the EX/RP treatment Inhibitors,research,lifescience,medical (combining EX and RP) showed superior outcome on almost every symptom measure compared with EX-only or RP-only treatments. This superior outcome of the combined

treatment was found at both post-treatment and follow-up. When comparing the outcome of EX only with that of RP only, patients who received EX reported lower anxiety when SAR405838 confronting feared contaminants than patients who had received RP, whereas the RP group reported greater decreases in urges to ritualize than did the EX patients. Thus, it appeared that EX and RP differentially many affected OCD symptoms. The findings from this study clearly suggest that exposure and ritual prevention should be implemented concurrently; treatments that do not include both components yield inferior outcome. The relative efficacy of medication, EX/RP, and their combination Parallel to the development of effective cognitive behavioral therapy for OCD, there was a development of medication treatment for the disorder. Clomipramine was the first medication that showed efficacy in reducing OCD symptoms.