اثر مهار کننده های انتخابی بازجذب سروتونین بر روی همجوشی افکار-عمل، متاشناختی و سرکوب افکار در اختلال وسواس

We aimed to assess whether cognitive processes change over time in patients with obsessive-compulsive disorder (OCD) receiving selective serotonin reuptake inhibitors without cognitive behavioral therapy and to investigate the factors associated with probable cognitive changes.

Cognitive models in obsessive-compulsive disorder (OCD) are interested in what processes and structures of the information processing system account for the persistence, uncontrollability, aversiveness, and idiosyncratic nature of obsessional phenomena [1]. Several researchers have explored the thought suppression theory, focusing on its role in the exacerbation of intrusive thoughts [2], [3] and [4]. According to this theory, efforts at controlling thoughts may result in a paradoxical increase in thought frequency. Another cognitive theory germane to development of obsessions, described as thought-action fusion (TAF), is defined as the belief that specific intrusive thoughts can directly influence the relevant external event and/or the belief that having these intrusive thoughts is morally equivalent to carrying out a prohibited action [3] and [5]. Recently, metacognitive theory as the tendency to focus attention on and monitor thinking has been proposed to explain how intrusive thoughts or doubts activate metabeliefs and emotional reactions [6] and [7]. Although different cognitive factors have been suggested to explain the emergence and maintenance of OCD, the cognitive predictors of outcome in OCD patients having treatment have scarcely been reported in the literature. It is reasonable that putative cognitive processes associated with OCD may change during cognitive therapy. Consistent with this hypothesis, several studies found that cognitive behavioral therapy (CBT) produced significant changes in measures of obsessional conviction and beliefs [8] and [9]. In addition, good response to exposure and response prevention (ERP) treatment was found to be associated with reduction in metacognitions [10]. Whereas pharmacologic and cellular actions of selective serotonin reuptake inhibitors (SSRIs) are relatively well characterized, there is little understanding of how such effects act to improve OC symptoms and how to influence cognitive appraisals. Given that SSRIs are known as effective treatments for OCD [11], [12] and [13], the current study explored whether cognitive appraisals change over time in the OCD patients receiving SSRIs but not CBT. In addition, we aimed to investigate whether a probable change in cognitive domains is related with comorbid depression and specific symptom categories.

Sociodemographic characteristics for each group are presented in Table 1. The mean age of the final sample (n = 55) was 27.7 ± 8.5 years; 58.2% (n = 32) of the patients were women, and 41.8% (n = 23) were men.