SHOULD TREATMENT DISTINGUISH ANXIOGENIC FROM ANXIOLYTIC OBSESSIVE-COMPULSIVE RUMINATIONS - RESULTS OF A PILOT CONTROLLED-STUDY AND OF A CLINICAL AUDIT

In a small pilot controlled study over 8 weeks, 12 obsessive-compulsiv e ruminators listened for 2 h daily to their own audiotaped voice eith er (1) describing their anxiogenic thoughts (exposure) but omitting an xiolytic thoughts (mental/cognitive rituals), or (2) reading neutral p rose or poetry. Taking all patients, both groups improved similarly. H owever, exposure patients who became anxious early in exposure slightl y more improved. Consistent with this, in a clinical audit of 57 rumin ators treated by trainee clinicians over 12 years, outcome improved si gnificantly once practice changed so that exposure only involved anxio genic thoughts, not anxiolytic thoughts, the latter being stopped.