Long?term course and outcome of obsessive?compulsive patients after cognitive?behavioral therapy in combination with either fluvoxamine or placebo

Abstract

Longitudinal studies with very long follow-up periods of patients with obsessive-compulsive disorder (OCD) who have received adequate treatment are rare. In the current study, 30 of 37 inpatients (81%) with severe OCD were followed up 6-8 years after treatment with cognitive-behavioral therapy (CBT) in combination with either fluvoxamine or placebo in a randomized design. The significant improvements (with large effectsizes) in obsessive-compulsive symptoms from pre- to post-treatment (41% reduction on the Y-BOCS) remained stable at follow-up (45 %). Responder rates, defined as > or = 35% reduction on the Y-BOCS, were 67% and 60%, respectively. Depressive symptoms decreased significantly not only from pre- to post-treatment but also during follow-up. Re-hospitalization, which occurred in 11 patients (37 %), was associated with more severe depressive symptoms at pre-treatment and living without a partner. Full symptom remission at follow-up, defined as both Y-BOCS total score < or = 7 and no longer meeting diagnostic criteria for OCD, was achieved by 8 patients (27 %). Patients without full remission at follow-up had a significantly longer history of OCD, assessed at pretreatment, compared to remitted patients. The shortterm treatment outcome had no predictive value for the long-term course. Throughout the naturalistic follow-up, nearly all patients (29 patients) received additional psychotherapy and/or medication. This might indicate that such chronic OCD patients usually need additional therapeutic support after effective inpatient treatment to maintain their improvements over long periods.

Full remission and relapse of obsessive-compulsive symptoms after cognitive-behavioral group therapy: a two-year follow-up

“…Additionally, Rufer et al in a 7-year follow-up after CBT in combination with either fluvoxamine or placebo, reported the maintenance of the results in 45% of the patients in the period. 17 In our study, an increase was observed in the number of patients who met full remission criteria during the follow-up period, from 9 patients (21.4%) immediately after treatment, to 13 (31.0%) in the 24 th month, an increase of 44.4%. The full remission rates were similar to those found in related studies, 5,17 but a little higher than those reported in others.…”

Exploring Professional Help Seeking in Practicing Muslim Women with Obsessive Compulsive Disorder Washing Subtype in Australia

“…It seems probable that some Imams may unintentionally provide suggestions that increase and aggravate the OCD symptoms of religious help seekers, which is consistent with the findings of Deacon, Vincent, and Zhang (Deacon et al 2013) among Christian clergy members. If these findings generalise beyond the sample examined here, then this would provide an important direction for targeting early intervention for Muslim women with OCD-W symptomatology, as shorter delays between emergence of symptoms and commencing treatment have been associated with better outcomes (Rufer et al 2005). More research examining the experience of Imams in regard to their understanding of OCD and also the nature of the advice provided to Muslim help-seekers regarding their religious OCD symptoms would be beneficial and could inform the development of strategies to overcome large delays in seeking appropriate treatment.…”

World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision

“…This might indicate that OCD patients usually require ongoing treatment to maintain their improvements over long periods (Rufer et al 2005).…”