Management of Obsessive Compulsive Disorder

Bouvard, Martine; Milliery, Maud; Cottraux, Jean

doi:10.1159/000076452

Cited by 7 publications

(6 citation statements)

References 35 publications

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“…Nevertheless, it has often been the criterion of choice in previous treatment studies of OCD [e. g., 22,29] and therefore, it is useful for comparing results of different OCD studies. The responder rates of 67 % for short-term outcome and 60 % for long-term outcome in our study are in line with numerous previous studies which demonstrated short-and long-term responder rates of 50-80 % after CBT alone or in combination with (S)SRIs [2,5]. The clinical relevance of our long-term responder rate is supported by the results of the patients' self-ratings: Similar to the responder-rate, 57 % of patients rated themselves as "much improved" or "very much improved" at the 7-year follow-up compared to pre-treatment and the long-term responders rated themselves highly significantly better than the non-responders.…”

Section: Long-term Course and Outcomesupporting

confidence: 92%

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

Rufer

Hand

Alsleben

et al. 2004

Eur Arch Psychiatry Clin Neurosci

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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.

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Section: Long-term Course and Outcomesupporting

confidence: 92%

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

Rufer

Hand

Alsleben

et al. 2004

Eur Arch Psychiatry Clin Neurosci

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“…In some cases, symptom reduction could be better explained by cognitive changes or by changes in self-efficacy. This makes cognitive therapy a promising alternative or additional treatment strategy [9]. …”

Section: Introductionmentioning

confidence: 99%

Metacognitive Therapy versus Exposure and Response Prevention for Pediatric Obsessive-Compulsive Disorder

Simons

Schneider

Herpertz‐Dahlmann

2006

Psychother Psychosom

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Background: Exposure with ritual prevention (ERP) is the psychotherapeutic treatment of choice for pediatric obsessive-compulsive disorder (OCD). In the present study, a new treatment rationale – metacognitive therapy (MCT) for children – was developed and evaluated. Methods: Ten children and adolescents with OCD were randomly assigned to either MCT or ERP therapy condition. Patients were assessed before and after treatment and at the 3-month and 2-year follow-up by means of symptom severity interviews. Depressive symptoms were also assessed. Manualized treatment involved up to 20 sessions on a weekly basis. Results: We found clinically and statistically significant improvements in symptom severity after treatment. At the 3-month and 2-year follow-up, the attained improvements during treatment were retained. Conclusions:Despite some methodological limitations, results showed that MCT proved to be a promising psychotherapeutic alternative to the well-established ERP in the treatment of pediatric OCD. Further investigations into the efficacy of MCT are necessary to answer questions as to the working mechanisms underlying therapy for OCD.

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“…Bouvard et al [8] addressed the management of obsessive-compulsive disorder, integrating research evidence with the clinical experience; Goodwin et al [9] evaluated the risk of depression in the community; Porcelli et al [10] found that assessment based on clinimetric principles could entail prognostic value in patients with functional gastrointestinal disorders; Prins et al [11] highlighted the role of social support in the persistence of complaints in chronic fatigue syndrome; Slade et al [12] addressed the relationship between patient needs and quality of life, and Mataix-Cols et al [13] dealt with the sensitivity of a commonly used rating scale.…”

Section: Introductionmentioning

confidence: 99%