Early Compliance and Other Factors Predicting Outcome of Exposure for Obsessive–Compulsive Disorder

1996 ◽  
Vol 169 (6) ◽  
pp. 747-752 ◽  
Author(s):  
L. A. De Araujo ◽  
L. M. Ito ◽  
I. M. Marks
Keyword(s):  
Treatment Outcome ◽  
Obsessive Compulsive Disorder ◽  
Controlled Trial ◽  
Obsessive Compulsive ◽  
Treatment Delivery ◽  
Compulsive Disorder ◽  
Good Outcome ◽  
End Of Treatment ◽  
Randomised Controlled

BackgroundIdentifying predictors of treatment outcome can suggest ways to improve treatment delivery and understanding of its mechanism of action.MethodPredictors of treatment outcome were sought among 46 out-patients with obsessive–compulsive disorder who completed a nine-week randomised controlled trial of two forms of exposure therapy with ritual prevention.ResultsIn both exposure conditions the best predictor of good outcome at the end of treatment (week 9) and of follow-up (week 32) was early compliance in doing exposure homework within a week of starting treatment. A weaker predictor of good outcome at follow-up was within-session reduction in anxiety from weeks 0 to 4.ConclusionThe strongest and most consistent predictor of better outcome to weeks 9 and 32 was compliance with exposure and ritual prevention in the first week of treatment.

scholarly journals Cognitive–behavioural therapy with post-session d-cycloserine augmentation for paediatric obsessive–compulsive disorder: pilot randomised controlled trial

2014 ◽  
Vol 204 (1) ◽  
pp. 77-78 ◽  
Author(s):  
David Mataix-Cols ◽  
Cynthia Turner ◽  
Benedetta Monzani ◽  
Kayoko Isomura ◽  
Caroline Murphy ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Obsessive Compulsive ◽  
Double Blind ◽  
Compulsive Disorder ◽  
Cognitive Behavioural ◽  
Randomised Controlled

SummaryA partial N-methyl-d-aspartate agonist, d-cycloserine, enhances fear extinction when given before or shortly after exposure to feared stimuli in animals. In this pilot double-blind placebo-controlled trial (trial number: ISRCTN70977225), 27 youth with obsessive–compulsive disorder were randomised to either 50mg d-cycloserine or placebo administered immediately after each of ten cognitive–behavioural therapy (CBT) sessions, primarily consisting of exposure and ritual prevention. Both groups improved significantly and maintained their gains at 1-year follow-up, with no significant advantage of d-cycloserine over placebo at any time point. The effects of CBT may not be augmented or accelerated when d-cycloserine is administered after sessions.

P.4.a.008 Clinical predictors of treatment outcome in obsessive-compulsive disorder: a two-year follow-up

2011 ◽  
Vol 21 ◽  
pp. S530
Author(s):  
R. Shavitt ◽  
C. Valerio ◽  
J.B. Diniz ◽  
V. Fossaluza ◽  
C. Belotto-Silva ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Obsessive Compulsive Disorder ◽  
Clinical Predictors ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

scholarly journals Does Concentrated Exposure Treatment for Obsessive-Compulsive Disorder Improve Insomnia Symptoms? Results From a Randomized Controlled Trial

2021 ◽  
Vol 12 ◽  
Author(s):  
Kristen Hagen ◽  
Håkon Nordahl ◽  
Gunvor Launes ◽  
Gerd Kvale ◽  
Lars-Göran Öst ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Obsessive Compulsive Disorder ◽  
Day Treatment ◽  
Controlled Trial ◽  
Obsessive Compulsive ◽  
Exposure Treatment ◽  
Compulsive Disorder ◽  
Randomized Controlled ◽  
Substantial Problem

Insomnia is a substantial problem in patients with obsessive-compulsive disorder (OCD). There is, however, a lack of studies investigating changes in concurrent symptoms of insomnia in OCD after concentrated treatment. A recent randomized controlled trial randomized participants to the Bergen 4-day treatment (B4DT, n = 16), or 12 weeks of unguided self-help (SH, n = 16), or waitlist (WL, n = 16). Patients from the SH- and WL-group who wanted further treatment after the 12 weeks were then offered the B4DT (total of 42 patients treated with the B4DT). There were no significant differences in symptoms of insomnia between the conditions at post-treatment, but a significant moderate improvement at 3-month follow-up for patients who received the B4DT. Insomnia was not associated with OCD-treatment outcome, and change in symptoms of insomnia was mainly related to changes in depressive symptoms. The main conclusion is that concentrated exposure treatment is effective irrespective of comorbid insomnia, and that insomnia problems are moderately reduced following treatment.

scholarly journals Treated depression in adolescents: predictors of outcome at 28 weeks

2009 ◽  
Vol 194 (4) ◽  
pp. 334-341 ◽  
Author(s):  
Paul Wilkinson ◽  
Bernadka Dubicka ◽  
Raphael Kelvin ◽  
Chris Roberts ◽  
Ian Goodyer
Keyword(s):  
Major Depression ◽  
Obsessive Compulsive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Adolescent Depression ◽  
Controlled Trial ◽  
Psychosocial Care ◽  
Behavioural Therapy ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

BackgroundThere is great heterogeneity of clinical presentation and outcome in paediatric depression.AimsTo identify which clinical and environmental risk factors at baseline and during treatment predicted major depression at 28-week follow-up in a sample of adolescents with depression.MethodOne hundred and ninety-two British adolescents with unipolar major depression were enrolled in a randomised controlled trial (the Adolescent Depression Antidepressants and Psychotherapy Trial, ADAPT). Participants were treated for 28 weeks with routine psychosocial care and selective serotonin reuptake inhibitors (SSRIs), with half also receiving cognitive–behavioural therapy (CBT). Full clinical and demographic assessment was carried out at baseline and 28 weeks.ResultsDepression at 28 weeks was predicted by the additive effects of severity, obsessive–compulsive disorder and suicidal ideation at entry together with presence of at least one disappointing life event over the follow-up period.ConclusionsClinicians should assess for severity, suicidality and comorbid obsessive–compulsive disorder at presentation and should monitor closely for subsequent life events during treatment.

scholarly journals Metacognitive Change During Exposure and Metacognitive Therapy in Obsessive-Compulsive Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
Jana Hansmeier ◽  
Anke Haberkamp ◽  
Julia A. Glombiewski ◽  
Cornelia Exner
Keyword(s):  
Treatment Outcome ◽  
Obsessive Compulsive Disorder ◽  
Pilot Trial ◽  
Post Treatment ◽  
Metacognitive Therapy ◽  
Obsessive Compulsive ◽  
Significant Interaction Effect ◽  
Compulsive Disorder ◽  
Patient Rating

Metacognitive therapy (MCT) has been shown to be a promising treatment approach for obsessive-compulsive disorder (OCD). The changeability of metacognitions by (metacognitive) treatment and its relevance to treatment outcome is, however, still unclear. The current study investigates, (1) if treatment with MCT or exposure and response prevention (ERP) in a randomized-controlled pilot trial (n = 24 patients with OCD) changes OCD-specific metacognitions of thought fusion beliefs, beliefs about rituals and stop signals, and (2) if these changes are relevant for the treatment outcome in terms of patient- and therapist-rated OCD symptoms. ANOVA with pretest, posttest and follow-up scores could show that all three metacognitions significantly decreased during both treatments. Regarding thought fusion beliefs, a significant interaction effect indicated a higher decrease after MCT than ERP treatment. In hierarchical regression analyses, changes in stop signals from pre- to post-treatment significantly predicted patient-rating OCD symptoms at post-treatment and follow-up at 3 months after treatment. These changes were even predictive of post-treatment outcome after controlling for general metacognitions and dysfunctional cognitive beliefs. These findings support the assumption that metacognitions can change during both treatments and that changes in stop signals might be relevant for the treatment outcome on the symptom level in OCD.

A Preliminary Examination of Acceptance and Commitment Therapy Versus Exposure and Response Prevention for Patients with Obsessive-Compulsive Disorder on an Optimal Dose of SSRIs: A Randomized Controlled Trial in Iran

2020 ◽  
pp. 014544552098297
Author(s):  
Mehdi Zemestani ◽  
Mojgan Salavati ◽  
Asrin Seyedolshohadayi ◽  
Julie M. Petersen ◽  
Clarissa W. Ong ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Obsessive Compulsive Disorder ◽  
Acceptance And Commitment Therapy ◽  
Controlled Trial ◽  
Exposure And Response Prevention ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Randomized Controlled ◽  
Acceptance And Commitment

This study compared the effects of adding acceptance and commitment therapy (ACT) or exposure and response prevention (ERP) to adults diagnosed with obsessive compulsive disorder (OCD) already on an optimal and stable dose of selective serotonin reuptake inhibitors (SSRIs). Forty adults on SSRIs who were diagnosed with OCD participated in a randomized controlled trial in Iran of 12 individual weekly sessions of either ACT+SSRI, ERP+SSRI, or continued SSRI only. The results showed significant reductions in OCD symptom severity in ACT+SSRI and ERP+SSRI conditions at posttreatment with significantly greater reductions in both conditions compared to SSRI-only at follow-up. Additionally, psychological inflexibility and use of thought control strategies significantly decreased in the ACT+SSRI condition at posttreatment and follow-up compared to the ERP+SSRI and SSRI conditions. Both conditions led to decreases in perceived importance of stop signals. Results provide cross-cultural support for the treatment of OCD using ACT and ERP as adjuncts to SSRI and modest process of change differences between ACT and ERP. Future directions and study limitations are discussed.

scholarly journals Treatment Adherence as Predictor of Outcome in Concentrated Exposure Treatment for Obsessive-Compulsive Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
Kristian Tjelle ◽  
Håvard Berg Opstad ◽  
Stian Solem ◽  
Gunvor Launes ◽  
Bjarne Hansen ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Obsessive Compulsive Disorder ◽  
Treatment Adherence ◽  
Well Being ◽  
Response Prevention ◽  
Exposure And Response Prevention ◽  
Obsessive Compulsive ◽  
Exposure Treatment ◽  
Compulsive Disorder

Background: The treatment of choice for obsessive-compulsive disorder (OCD) is exposure and response prevention (EX/RP). Previous studies have demonstrated that treatment adherence predicts treatment outcome for patients with OCD, but there is little knowledge on its role in concentrated exposure treatment for OCD.Method: In the present study, 42 patients received EX/RP treatment using the Bergen 4-day format. Adherence was measured with the Exposure and Response Prevention Adherence Scale (PEAS, rated both by patients and therapists) after the second and third day. Treatment outcome (symptoms of OCD, depression, anxiety, work- and social functioning, and well-being) was assessed at 3-month follow-up.Results: At follow-up, 71.4% were in remission. High adherence was reported (mean score of 6 on a 1–7 scale). The combination of patient- and therapist rated adherence was significantly associated with treatment outcome whilst controlling for age, sex, and pre-treatment scores. Patients with higher degree of adherence reported less symptoms, higher functioning, and more well-being at follow-up.Conclusions: The results of the present study indicated that adherence in concentrated exposure treatment is significantly associated with a wide range of treatment outcomes for OCD.

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