Maximizing Remission from Cognitive-Behavioral Therapy in Medicated Adults with Obsessive-Compulsive Disorder
| Autor: | Anthony C. Puliafico, Eyal Kalanthroff, Daniel Chazin, Patricia Imms, Anu Asnaani, Sandy Capaldi, Chang-Gyu Hahn, Shari A. Steinman, Elizabeth Turk-Karan, Marina Gershkovich, Steven D. Tsao, Martha Katechis, Jeremy Tyler, Andrew B. Schmidt, Bin Xu, Page E. Van Meter, Kelly Moore, Yuanjia Wang, Helen Blair Simpson, Jonathan D. Huppert, Christina DiChiara, Ivar Snorrason, Michael G. Wheaton, Anthony Pinto, Jennifer Scodes, Edna B. Foa, Raphael Campeas, Thea Gallagher, Shawn P. Cahill, Arturo Sanchez-Lacay, Donna Vermes |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Obsessive-Compulsive Disorder media_common.quotation_subject medicine.medical_treatment Experimental and Cognitive Psychology Article Odds Obsessive compulsive Internal medicine Medicine Obsessive compulsive scale Personality Humans media_common Patient factors Cognitive Behavioral Therapy business.industry Serotonin reuptake Combined Modality Therapy Cognitive behavioral therapy Psychiatry and Mental health Clinical Psychology Treatment Outcome Patient Compliance business Selective Serotonin Reuptake Inhibitors |
| Zdroj: | Behav Res Ther |
| Popis: | Practice guidelines for adults with obsessive-compulsive disorder (OCD) recommend augmenting serotonin reuptake inhibitors (SRIs) with exposure and ritual prevention (EX/RP). However, fewer than half of patients remit after a standard 17-session EX/RP course. We studied whether extending the course increased overall remission rates and which patient factors predicted remission. Participants were 137 adults with clinically significant OCD (Yale-Brown Obsessive Compulsive Scale [Y-BOCS] score ≥18) despite an adequate SRI trial (≥12 weeks). Continuing their SRI, patients received 17 sessions of twice-weekly EX/RP (standard course). Patients who did not remit (Y-BOCS ≤12) received up to 8 additional sessions (extended course). Of 137 entrants, 123 completed treatment: 49 (35.8%) remitted with the standard course and another 46 (33.6%) with the extended course. Poorer patient homework adherence, more Obsessive-Compulsive Personality Disorder (OCPD) traits, and the Brain-Derived Neurotrophic Factor (BDNF) Val66MET genotype were associated with lower odds of standard course remission. Only homework adherence differentiated non-remitters from extended course remitters. Extending the EX/RP course from 17 to 25 sessions enabled many (69.3%) OCD patients on SRIs to achieve remission. Although behavioral (patient homework adherence), psychological (OCPD traits), and biological (BDNF genotype) factors influenced odds of EX/RP remission, homework adherence was the most potent patient factor overall. |
| Databáze: | OpenAIRE |
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