Original Articles

Combining transcranial magnetic stimulation and cognitive-behavioral therapy in treatment resistant obsessive-compulsive disorder


Uskudar University, Istanbul Neuropsychiatry Hospital


Uskudar University, Istanbul Neuropsychiatry Hospital


Hacettepe University, Department of Statistics


Uskudar University, Department of Psychology, Faculty of Human and Social Sciences

Alpha Psychiatry 2015; 16: 180-188
DOI: 10.5455/apd.160156
Read: 913 Downloads: 523 Published: 01 June 2015

Objective: A non-negligible percentage of patients with obsessive-compulsive disorder (OCD) do not respond satisfactorily to treatments. Inpatient cognitive-behavioral therapy (CBT) has provided some relief in even refractory and chronic patients. Repetitive transcranial magnetic stimulation (rTMS) has also provided promising results. However, no studies have combined these two strategies. Methods: Eighteen patients with treatment resistant and chronic OCD who had been hospitalized in order to receive pharmacotherapy, inpatient CBT and rTMS were evaluated on the Yale-Brown Obsession and Compulsion Scale (Y-BOCS) and the Hamilton Depression Rating Scale-17 (HDRS-17). rTMS was applied every day over the left dorsolateral prefrontal cortex for 5 days in a week with parameters of 25 Hz and 1000 pulses. Results: Y-BOCS scores decreased by 59.14%; from 30.72 ± 6.12 at admission to 12.55 ± 7.44 when discharged. HDRS-17 scores decreased by 56.80%; from 18.38 ± 3.94 at admission to 7.94 ± 5.70 at discharge. The mean numbers of rTMS and CBT sessions were 23.28 ± 6.78 and 17.17 ± 5.04 respectively. Discussion: The combination of pharmacotherapy, CBT and rTMS may be effective in treatment resistant and chronic OCD in the short term. [Anadolu Psikiyatri Derg 2015; 16(3.000): 180-188]

EISSN 2757-8038