Predictors of Treatment Outcome in the Behavioural Treatment of Obsessive-Compulsive Disorder

An investigation to determine which prognostic variables are associated with behavioural treatment failure in obsessive-compulsive disorder (OCD). Empirically established prognostic variables measured at the start of treatment may lead to adjusted treatment programmes for these patients. Forty patie...

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Bibliographic Details
Published in:British journal of psychiatry 1994-12, Vol.165 (6), p.781-786
Main Authors: Keijsers, Ger P. J., Hoogduin, Cees A. L., Schaap, Cas P. D. R.
Format: Article
Language:English
Subjects:
Adult
Behavior modification
Behavior Therapy
Complaints
Compulsions
Discontent
Fear
Fear & phobias
Female
Humans
Male
Medical prognosis
Mental depression
Middle Aged
Motivation
Neuroses
Obsessive compulsive disorder
Obsessive-Compulsive Disorder - diagnosis
Obsessive-Compulsive Disorder - psychology
Obsessive-Compulsive Disorder - therapy
Prevention programs
Prognosis
Psychiatric Status Rating Scales
Response prevention
Severity
Severity of Illness Index
Therapeutic alliances
Treatment Outcome
Treatment programs
Variables
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Summary:An investigation to determine which prognostic variables are associated with behavioural treatment failure in obsessive-compulsive disorder (OCD). Empirically established prognostic variables measured at the start of treatment may lead to adjusted treatment programmes for these patients. Forty patients, diagnosed with OCD, received a standardised treatment consisting of 18 sessions in vivo exposure and response prevention. Compulsive behaviour (MOCI) and obsessive fear (ADS) were the outcome measures. Prognostic variables included were initial severity of OC complaints, initial level of depression, problem duration, patients' motivation for treatment, quality of the therapeutic relationship, and marital dissatisfaction. Greater initial severity of complaints (P < 0.01), and depression (P = 0.03) predicted poorer outcome for compulsive behaviour. Greater initial severity of complaints (P < 0.01), and the conjoint variables higher level of depression, longer problem duration, poorer motivation for treatment, and dissatisfaction with the therapeutic relationship predicted poorer outcome for obsessive fear (P < 0.01). The complaint-related variables of initial severity, initial depression, and problem duration, and the non-specific treatment variables of patients' motivation and quality of the therapeutic relationship, affect behavioural treatment outcome in OCD.
ISSN:0007-1250
1472-1465
DOI:10.1192/bjp.165.6.781