Differential effects of sertraline and cognitive behavioural therapy on behavioural inhibition in patients with obsessive compulsive disorder.

Journal: International clinical psychopharmacology

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Affiliated Institutions:  Cornwall Partnership NHS Foundation Trust, Cornwall. Hertfordshire Partnership University NHS Foundation Trust. University of Hertfordshire, College Lane Campus, Hatfield, Hertfordshire. University of Southampton Faculty of Medicine, Southampton, UK. University of Cambridge Clinical Medical School, Addenbrookes Hospital.

Abstract summary 

Patients with obsessive compulsive disorder (OCD) randomised to sertraline, manualised cognitive behavioural therapy (CBT), or combination (sertraline + CBT), underwent cognitive assessment. Cognitive testing was conducted at baseline and at week 16. The stop signal reaction time task (SSRT) was used to evaluate motor impulsivity and attentional flexibility was evaluated using the intra/extra-dimensional set shifting task. Paired-samples t-tests or nonparametric variants were used to compare baseline and posttreatment scores within each treatment group. Forty-five patients were tested at baseline (sertraline n = 14; CBT n = 14; sertraline + CBT n = 17) and 23 patients at week 16 (sertraline n = 6; CBT n = 7; sertraline + CBT n = 10). The mean dosage of sertraline was numerically higher in those taking sertraline as a monotherapy (166.67 mg) compared with those taking sertraline in combination with CBT (100 mg). Analysis of pre-post treatment scores using an intent-to-treat-analysis found a significant reduction in the SSRT in those treated with sertraline, whilst there was no significant change on this task for those treated with CBT or the combination. This study found that motor inhibition improved significantly following sertraline monotherapy. Suboptimal sertraline dosing might explain the failure to detect an effect on motor inhibition in the group receiving combination of sertraline + CBT. Higher dose sertraline may have broader cognitive effects than CBT for OCD, motor impulsivity may have value as a measure of treatment outcome and, by extension, the SSRT could serve as a biomarker for personalising care.

Authors & Co-authors:  Reid Jemma E JE Pellegrini Luca L Drummond Lynne L Varlakova Yana Y Shahper Sonia S Baldwin David S DS Manson Christopher C Chamberlain Samuel R SR Robbins Trevor W TW Wellsted David D Fineberg Naomi A NA

Study Outcome 

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Citations :  Baldwin DS, Anderson IM, Nutt DJ, Allgulander C, Bandelow B, den Boer JA, et al. (2014). Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder: a revision of the 2005 guidelines from the British Association for Psychopharmacology. J Psychopharmacol 28:403–439.
Authors :  11
Identifiers
Doi : 10.1097/YIC.0000000000000548
SSN : 1473-5857
Study Population
Male,Female
Mesh Terms
Other Terms
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
England