Relationship between cognitive behavioural group theraphy and neurocognitive functions in obsessive compulsive disorder

INTRODUCTION: It has been shown in previous studies, that patients with Obsessive Compulsive Disorder (OCD), perform poorly in neuropsychological functions such as memory, attention and executive functions compared to healthy controls. There is limited data about improvement in neurocognitive functions after the pharmacotherapy or cognitive behavioral therapy. Besides, data about the efficacy of neurocognitive functions before treatment in terms of treatment response is contradictory. In OCD, it has been shown that 'advanced' theory of mind (ToM) abilities are deteriorated more than 'basic' ToM abilities. AIM: The primary aim of this study was to investigate whether there is a difference in social and neurocognitive performance between OCD-diagnosed individuals and healthy controls. Moreover we aimed to examine the relationship between pretreatment neurocognitive functions and treatment response and whether Cognitive Behavioral Group Therapy (CBGT) has a therapeutic effect on social and neurocognitive functions. METHOD: To evaluate neurocognitive functions before treatment, The Rey Auditory Verbal Learning Test (RAVLT), Stroop Test, Wisconsin Card Sorting Test (WCST), Trail Making Test (TMT) A ve B, to assess the theory of mind, the Reading the Mind in the Eyes Test (RMET) were applied to the participants. Ten sessions of CBGT were administered to the patient group once a week. After the therapy sessions were completed, social and neurocognitive tests were reapplied to all participants. Yale Brown Obsessive Compulsive Scale (YBOCS), Beck Depression Inventory (BDI), Obsessive Compulsive Inventory-Revised (OCE-R) ve Obsessive Beliefs Questionnaire-44 (OBQ-44) were applied to the patient group before and after treatment. For each participant, the Reliable Change Index was calculated to correct for practice effect. RESULTS: OCD group showed weaker performance in the tests; RAVLT (p=0,011), Stroop (p=0,009), WCST number of categories completed (p=0,014), total trials administered (p=0,033), perseveration errors (p=0,021), TMT-A (p=0,025) and TMT-B (p=0,006) compared to the healthy controls. RMET performances were similar in the patient and control groups. After 10 sessions of CBGT, scores of YBOC, BDI, OBQ and OCE-R were decreased. When results were corrected for practice effect, no improvement in social and neurocognitive test performance was found after the treatment. There was no relationship between treatment response and pretreatment social and neurocognitive test performance. CONCLUSION: In this study, it was determined that patients with OCD showed poor performance compared to healthy controls in attention, verbal memory, cognitive flexibility, set shifting, cognitive inhibition and processing speed. After 10 sessions of CBGT, obsessive- compulsive and depressive symptom severity was decreased. There was no change in neurocognitive performance after cognitive behavioral group therapy. Besides, there was no relationship between cognitive functions and treatment response. Individuals with OCD have performed similarly to healthy controls in terms of ToM. Key Words: Cognitive Behavioral Group Therapy, CBGT, Neurocognition, Theory of Mind, Social Cognition