Determining prognostic variables of treatment outcome in obsessive–compulsive disorder: effectiveness and its predictors in routine clinical care

AbstractThe objectives of this study were to investigate the naturalistic effectiveness of routine inpatient treatment for patients with obsessive–compulsive disorder (OCD) and to identify predictors of treatment outcome. A routinely collected data set of 1,596 OCD inpatients (M = 33.9 years, SD = 11.7; 60.4% female) having received evidence-based psychotherapy based on the cognitive–behavioral therapy (CBT) in five German psychotherapeutic clinics was analyzed. Effect sizes (Hedges' g) were calculated for several outcome variables to determine effectiveness. Predictor analyses were performed on a subsample (N = 514; M = 34.3 years, SD = 12.2; 60.3% female). For this purpose, the number of potential predictors was reduced using factor analysis, followed by multiple regression analysis to identify robust predictors. Effect sizes of various outcome variables could be classified as large (g = 1.34 of OCD–symptom change). Predictors of changes in OCD and depressive symptoms were symptom severity at admission and general psychopathological distress. In addition, patients with higher social support and more washing compulsions benefited more from treatment. Subgroup analyses showed a distinct predictor profile of changes in compulsions and obsessions. The results indicate that an evidence-based psychotherapy program for OCD can be effectively implemented in routine inpatient care. In addition to well-established predictors, social support, and washing compulsions in particular were identified as important positive predictors. Specific predictor profiles for changes in obsessions and compulsions are discussed.

Download Full-text

Obsessive-compulsive Disorder

10.1093/med/9780190228163.001.0001 ◽

2017 ◽

Cited By ~ 7

Keyword(s):

Obsessive Compulsive Disorder ◽

Clinical Presentation ◽

Clinical Care ◽

Evidence Based ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Targeted Treatments ◽

Evidence Based Treatments ◽

Comprehensive Introduction ◽

Current Psychological

Obsessive-compulsive disorder (OCD) affects approximately 1 person in 40 and causes great morbidity and suffering worldwide. While much about this protean disorder remains unclear, our understanding has advanced along many fronts in recent decades, and evidence-based treatments can produce benefit in a majority of sufferers. This text brings together experts in all aspects of OCD, including clinical presentation, current psychological, genetic, and neurobiological understanding of its etiology and pathophysiology, and psychotherapeutic, pharmacological, and anatomically targeted treatments. OCD-related disorders and common comorbidities and their relationship to OCD itself are also discussed, as are theoretical and sociological issues. It is hoped that this text will provide a comprehensive introduction to the field for students, scientists and clinicians. By bringing together many different perspectives on OCD, we aim to encourage cross-disciplinary understanding, research, and advances in clinical care.

Download Full-text

Modelling a Multi-Dimensional Model of Memory Performance in Obsessive-Compulsive Disorder: A Multi-Level Meta-Analytic Review.

10.31234/osf.io/u4tqa ◽

2020 ◽

Author(s):

Sofia Persson ◽

Alan Yates ◽

Klaus Kessler ◽

Ben Harkin

Keyword(s):

Executive Function ◽

Obsessive Compulsive Disorder ◽

Memory Load ◽

Memory Performance ◽

Effect Sizes ◽

Driving Mechanism ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Analytic Review ◽

Multi Level

Even though memory performance is a commonly researched aspect of Obsessive-Compulsive Disorder (OCD), a coherent and unified explanation of the role of specific cognitive factors has remained elusive. To address this, the present meta-analysis examined the predictive validity of Harkin and Kessler’s (2011) Executive Function (E), Binding Complexity (B) and Memory Load (L) Classification System with regards to affected vs. unaffected memory performance in OCD. We employed a multi-level meta-analytic approach (Viechtbauer, 2010) to accommodate the interdependent nature of the EBL model and interdependency of effect sizes (305 effect sizes from 144 studies, including 4424 OCD patients). Results revealed that the EBL model predicted memory performance, i.e., as EBL demand increases, those with OCD performed progressively worse on memory tasks. Executive function was the driving mechanism behind the EBL’s impact on OCD memory performance and negated effect size differences between visual and verbal tasks in those with OCD. Comparisons of sub-task effect sizes were also generally in accord with the cognitive parameters of the EBL taxonomy. We conclude that standardised coding of tasks along individual cognitive dimensions and multi-level meta-analyses provides a new approach to examine multi-dimensional models of memory and cognitive performance in OCD and other disorders.

Download Full-text

Predictors of treatment outcome in obsessive-compulsive disorder

Biological Psychiatry ◽

10.1016/0006-3223(91)90997-z ◽

1991 ◽

Vol 29 (9) ◽

pp. 56-57

Keyword(s):

Treatment Outcome ◽

Obsessive Compulsive Disorder ◽

Obsessive Compulsive ◽

Compulsive Disorder

Download Full-text

Exposure and Response Prevention as an Evidence-Based Treatment for Obsessive–Compulsive Disorder: Considerations for Social Work Practice

Clinical Social Work Journal ◽

10.1007/s10615-014-0483-4 ◽

2014 ◽

Vol 43 (1) ◽

pp. 38-49

Author(s):

Lindsay A. Bornheimer

Keyword(s):

Social Work ◽

Obsessive Compulsive Disorder ◽

Work Practice ◽

Social Work Practice ◽

Response Prevention ◽

Evidence Based ◽

Exposure And Response Prevention ◽

Obsessive Compulsive ◽

Evidence Based Treatment ◽

Compulsive Disorder

Download Full-text

Anxiety sensitivity does not predict treatment outcome or treatment length in obsessive-compulsive disorder and related anxiety disorders

Journal of Obsessive-Compulsive and Related Disorders ◽

10.1016/j.jocrd.2018.11.003 ◽

2019 ◽

Vol 21 ◽

pp. 18-25

Author(s):

Caroline M.B. Kwee ◽

Marcel A. van den Hout

Keyword(s):

Treatment Outcome ◽

Anxiety Disorders ◽

Obsessive Compulsive Disorder ◽

Anxiety Sensitivity ◽

Obsessive Compulsive ◽

Treatment Length ◽

Compulsive Disorder

Download Full-text

A Qualitative Study Exploring Neurodiversity Conference Themes, Representations and Evidence-Based Justifications for the Explicit Inclusion and Valuing of OCD

The International Journal of Information, Diversity, & Inclusion (IJIDI) ◽

10.33137/ijidi.v5i2.35067 ◽

2021 ◽

Vol 5 (2) ◽

pp. 111-138

Author(s):

Damian Mellifont

Keyword(s):

Qualitative Study ◽

Obsessive Compulsive Disorder ◽

Google Scholar ◽

Future Research ◽

Evidence Based ◽

Exploratory Research ◽

Obsessive Compulsive ◽

Compulsive Disorder

The inclusivity of neurodiversity conferences is a new field of research. Utilising Obsessive Compulsive Disorder (OCD) as an example, this study aims to critically investigate issues of inclusivity in the flyers advertising these conferences. This exploratory research is informed by 22 conference flyers and 14 scholarly articles retrieved from respective internet and Google Scholar enquiries. These articles offered evidence-based justifications for a greater inclusion of OCD-focused content in neurodiversity conferences. The study cautions that the lack of explicit inclusion of OCD as a topic among conferences can be harmful to persons who identify with this particular type of neurodivergence. This study offers a sound base from which future research focusing upon other forms of neurodivergence and issues of neurodiversity conference inclusivity and intersectionality can develop.

Download Full-text