Obsessive-compulsive disorder and body dysmorphic disorder: treatment (NICE guideline CG31)
CG31 built a stepped-care model around a single therapeutic core: CBT incorporating exposure and response prevention (ERP), with an SSRI as the pharmacological alternative and the two combined where impairment is severe. Intensity is matched to functional impairment rather than symptom count, and clomipramine remains the second-line drug. It is one of the oldest guidelines still current in this collection; NICE last reviewed it in 2024 without updating it, so the evidence below is thin by design and the 2016 network meta-analysis postdates it.
Esta norma cita 2 dos 62 ensaios marcantes do nosso registo de Psiquiatria e psicoterapia.
Exposure and response prevention (adults)1
- 2005Foa EX/RPPsiquiatria · POC · EX/PREm 122 adultos com perturbação obsessivo-compulsiva, a exposição intensiva com prevenção de resposta superou a resposta de clomipramina, a sua combinação ou placebo.
Children & young people1
- 2004POTSPsiquiatria · POC · PediátricoEm 112 crianças e adolescentes com TOC, TCC isolada ou combinada com sertralina obtiveram maior remissão às 12 semanas do que sertralina ou placebo isolados.
Published since the guideline1
- 2016Skapinakis NMAPsiquiatria · POC · Meta-análiseEm adultos e crianças com TOC, as terapias psicológicas (predominantemente EX/PR) obtiveram maior redução de sintomas do que qualquer ISRS individualmente comparado.