Obsesif Kompulsif Bozuklukta Metakognitif Terapinin Etkililiği Üzerine Sistematik Derleme
A Systematic Review on the Efficacy of Metacognitive Therapy in Obsessive Compulsive Disorder

Summary/Abstract: Obsessive-compulsive disorder (OCD) is a chronic psychiatric condition with a lifetime prevalence of approximately 2-3%, causing substantial functional impairment. Exposure and response prevention (ERP), a form of cognitive behavioral therapy, is considered the first-line treatment for OCD, yet it is limited by treatment refusal, high dropout rates, and the substantial therapist time it requires. Metacognitive Therapy (MCT), developed by Adrian Wells, offers an alternative approach that targets metacognitive beliefs about thoughts (e.g., thought-fusion beliefs, beliefs about the necessity of rituals) rather than the content of thoughts. The aim of this systematic review is to examine randomized controlled trial (RCT) findings on the effectiveness of MCT-based interventions for OCD. The search identified 6 RCTs published between 2010 and 2024, with sample sizes ranging from 19 to 79 adult participants. The findings indicate that MCT consistently reduces obsessive-compulsive symptoms and performs comparably to ERP (with one trial statistically establishing non-inferiority), while requiring considerably less therapist contact time. MCT was also found to be feasible in a group format and to provide additional benefit when combined with pharmacotherapy. However, the small number of available trials, limited sample sizes, the concentration of studies in Iran, Germany, and the Netherlands, and the absence of an adequately powered RCT in children and adolescents represent important limitations of the current evidence base.

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