Cognitive-Behavioural Therapy of Obsessive-Compulsive Disorder in Oral Lichen Planus: A Case Study

In this single-case study, the clinical effectiveness of a cognitive-behavioural programme for the treatment of a subject affected with oral lichen planus and showing an obsessive-compulsive disorder is appraised. The condition was distinguished by irrational thoughts related to the disease and self-checking rituals concerning the state of the patient's mouth. These rituals provoked bucal mucosa membrane irritation, resulting in the deterioration of lichen lesions and an increase in their severity, impeding the action of pharmacological treatment. The intervention process was developed over the course of a month and a half, and in two clearly differentiated phases. First, an initial assessment was made over 15 days, with the purpose of obtaining data about type and frequency of the ritualistic behaviour as well as about the irrational thoughts and subjective anxiety level. Second, the treatment phase was carried out intensively for a month. Therapeutic procedures included exposure techniques, self-instructional training and response prevention. The results show significant differences between baseline and treatment phases in self-checking behaviour frequency, mean time spent on the rituals and subjective anxiety level. In addition, 1 and 9 months follow-up data are presented, showing that therapeutic gains were maintained.