Sommaire
obsessive compulsive disorder (ocd)
Troubles obsessionnels compulsifs : évaluation de l'acupuncture
1. Systematic Reviews and Meta-Analysis
1.1. Generic Acupuncture
1.1.1. Sarris 2012
Sarris J, Camfield D, Berk M. Complementary medicine, self-help, and lifestyle interventions for obsessive compulsive disorder (ocd) and the ocd spectrum: a systematic review. J Affect Disord. 2012. 138(3):213-21. [168240].
| Background | In Obsessive Compulsive Disorder (OCD) current standard pharmacotherapies may be of limited efficacy. Non-conventional interventions such as Complementary and Alternative Medicine (CAM), self-help techniques, and lifestyle interventions are commonly used by sufferers of OCD, however to date no systematic review of this specific area exists. |
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| Methods | We conducted a systematic review of studies using CAM, self-help, and lifestyle interventions for treatment of OCD and trichotillomania (TTM). PubMed, PsycINFO, China Academic Journals Full-text Database, The Cochrane Library and CINAHL were searched (up to Jan 11th 2011), for controlled clinical trials using non-conventional interventions for OCD. A quality analysis using a purpose-designed scale and an estimation of effect sizes (Cohen's d) where data was available, were also calculated. |
| Results | The literature search revealed 14 studies that met inclusion criteria. Methodological quality of nutraceutical studies (nutrients and herbal medicines) were rated as high (mean 8.6/10), whereas mind-body or self-help studies were poorer (mean 6.1/10). In OCD, tentative evidentiary support from methodologically weak studies was found for mindfulness meditation (d=0.63), electroacupuncture (d=1.16), and kundalini yoga (d=1.61). Better designed studies using the nutrient glycine (d=1.10), and traditional herbal medicines milk thistle (insufficient data for calculating d) and borage (d=1.67) also revealed positive results. A rigorous study showed that N-acetylcysteine (d=1.31) was effective in TTM, while self-help technique “movement decoupling” also demonstrated efficacy (d=0.94). Mixed evidence was found for myo-inositol (mean d=0.98). Controlled studies suggest that St John's wort, EPA, and meridian-tapping are ineffective in treating OCD. |
| Conclusions | While several studies were positive, these were un-replicated and commonly used small samples. This precludes firm confidence in the strength of clinical effect. Preliminary evidence however is encouraging, and more rigorous research of some of the more hypothesis-based interventions in the treatment of OCD and TTM may be indicated. |
2. Clinical Practice Guidelines
| ⊕ positive recommendation (regardless of the level of evidence reported) Ø negative recommendation (or lack of evidence) |
2.1. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) 2026 ⊕
Van Ameringen M, Fineberg NA, Ravindran A, Arnold PD, Beaulieu S, Brakoulias V, Brietzke E, Dowlati Y, Drummond LM, Ferretti CJ, Feusner JD, Freire RCR, Frey BN, Gardiner S, Geller DA, Giacobbe P, Bergmann CG, Grassi G, Greenberg E, Hollander E, Hopkinson P, Kennedy SH, Lam RW, Lochner C, McGuire JF, McQuay S, Menchon JM, Milev R, Minuzzi L, Mojgani J, Mpavaenda DN, Nicolini H, Pallanti S, Pampaloni I, Parikh SV, Patterson B, Ravindran L, Reid J, Rodriguez CI, Samaan Z, Schaffer A, Smigielski L, Taylor VH, Tourjman SV, van Roessel P, Vigod SN, Walitza S, Yatham LN, Zohar J, Zugliani M, Dell'Osso BM. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) 2025 international guidelines for the management of patients with obsessive-compulsive disorder. J Psychiatr Res. 2026 Aug;199:404-488. https://doi.org/10.1016/j.jpsychires.2025.12.039
| Transcutaneous Electrical Acupoint Stimulation (TEAS). Level of Evidence: Level 2. Line of Treatment: third line |
Supporting evidence:
- Feng B, Zhang ZJ, Zhu RM, Yuan GZ, Luo LY, McAlonan GM, Xu FZ, Chen J, Liu LY, Lv YY, Wong HK, Zhang Y, Zhu LX. Transcutaneous electrical acupoint stimulation as an adjunct therapy for obsessive-compulsive disorder: A randomized controlled study. J Psychiatr Res. 2016 Sep;80:30-37. https://doi.org/10.1016/j.jpsychires.2016.05.015
