†The first two authors contribute equally.
Academic Editor: Rafael Franco
Background: Exposure and response prevention (ERP) is a form of
cognitive behavioral therapy that can effectively relieve obsessive-compulsive
symptoms and tic symptoms in patients with obsessive-compulsive disorder (OCD)
and Tourette syndrome (TS). However, the effect size of ERP-based therapy is
still unclear. Methods: In this study, we performed a meta-analysis to
identify the efficacy of ERP-based therapy for individuals with OCD and TS. The
standard mean difference (SMD) with a 95% confidence interval (CI) was
calculated to assess the effect size of the efficacy for ERP-based therapy. We
used subgroup and meta-regression analyses to explore the heterogeneity of the
pooled SMD of ERP-based therapy for OCD. We also summarized the neuroimaging
studies for ERP-based therapy for OCD. This meta-analysis was registered within
the International Platform of Registered Systematic Review and Meta-analysis
Protocols (number: INPLASY2021120112). Results: A total of 18 studies
including a total of 1057 patients with OCD and 3 studies including 267 with
TS/chronic tic disorder were identified. We did not observe any indication of
publication bias using Egger’s funnel plot (p = 0.41). We observed a
small-to-medium effect size of ERP for both OCD (SMD = –0.27, 95% CI: –0.53 to
–0.01) and TS/chronic tic disorder (SMD = –0.35, 95% CI: –0.59 to –0.1). We
found no heterogeneity of ERP-based therapy for OCD between the ERP-based therapy
subgroup and medicine subgroup in the subgroup analysis (p = 0.72). We
found no heterogeneity of ERP-based therapy for OCD between the child subgroup
and adult subgroup in the subgroup analysis (p = 0.37). We used
meta-regression analysis to identify the heterogeneity of ERP-based therapy for
OCD and found that the sessions of therapy and publication year did not account
for any significant heterogeneity (p
