Bergen 4-day treatment (b4dt) for obsessive-compulsive disorder – an observational pilot study of a treatment protocol in finland

Background: Bergen 4-Day Treatment (B4DT) is a concentrated exposure treatment developed to treat obsessive-compulsive disorder (OCD) that has proven to be highly acceptable and effective in several countries. The objective of this pilot study was to investigate the feasibility and preliminary treatment responses of this promising treatment in a Finnish healthcare setting. Methods: A Finnish therapist team was trained in collaboration with Norwegian B4DT therapists and developers of the method. Twenty psychiatric outpatients diagnosed with OCD and with previous OCD-specific treatment without adequate response received B4DT in HUS Helsinki University Hospital in 2022. Main outcome measure was the self-report version of Yale-Brown Obsessive-Compulsive Scale (Y-BOCS-SR) at 10 days and three months after the treatment. Before the treatment, 55% of the patients were classified as having severe to extreme OCD (Y-BOCS-SR score 26-40). Results: At the 10-day follow-up, 56% of the treated patients reported clinically significant (≥35%) reduction in their OCD symptoms and 28% were in remission or had only minor symptoms (Y-BOCS-SR score ≤13). At three-month follow-up, the numbers were 58% and 30%, respectively. Additionally, less anxiety and depressive symptoms, sleeping problems, and better psychosocial functioning and general wellbeing were reported after the treatment. Most of the patients were highly satisfied with the given treatment (Client Satisfaction Questionnaire, CSQ-8, mean score 29.2 on scale 0-32). Conclusions: B4DT can be successfully implemented in a Finnish healthcare setting. Both patient and employee satisfaction were high. Our treatment results were somewhat more modest compared to the Norwegian studies of B4DT, in which the patient outcome has been remarkably good. However, there is a need for more detailed RCT research comparing the B4DT with other treatment options available.