In:
Psychotherapy and Psychosomatics, S. Karger AG, Vol. 91, No. 2 ( 2022), p. 123-135
Abstract:
〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Cognitive-behavioral therapy (CBT) for obsessive-compulsive disorder (OCD) has proven its efficacy in randomized controlled trials (RCTs). 〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 To test generalizability to routine care settings, we conducted an effectiveness study to provide naturalistic outcome data and their predictors. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Pre-post changes in symptoms and impairment as well as response rates were determined in a naturalistic OCD sample (intention-to-treat, ITT, 〈 i 〉 n 〈 /i 〉 = 393). Patients received individual CBT for OCD adopting an exposure-based, non-manualized treatment format. Linear and logistic regression analyses were applied to identify associations of sociodemographic and clinical variables with symptom change. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Effect size in ITT patients amounted to 〈 i 〉 d 〈 /i 〉 = 1.47 in primary outcome (Yale-Brown Obsessive-Compulsive Scale, Y-BOCS). Remission rates were 46.3% (ITT), 52.0% (completers), and 18.2% (non-completers). The rates of treatment response without remission, no change, and deterioration in the ITT sample were 13.2, 38, and 3%, respectively. Initial symptom severity, comorbid personality disorder, and unemployment were associated with a poorer outcome, and previous medication with a better outcome. Comorbid depressive and anxiety disorders as well as other clinical or sociodemographic variables showed no effects on symptom change. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Outcomes in this large observational trial in a naturalistic setting correspond to available RCT findings suggesting that CBT for OCD should be strongly recommended for dissemination in routine care. Targets for further research include early prediction of non-response and development of alternative treatment strategies for patients who respond insufficiently.
Type of Medium:
Online Resource
ISSN:
0033-3190
,
1423-0348
Language:
English
Publisher:
S. Karger AG
Publication Date:
2022
detail.hit.zdb_id:
1472321-9
SSG:
5,2
SSG:
15,3
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