Predictors of response to exposure and response prevention for obsessive-compulsive disorder

Abstract

Background Cognitive behavioral therapy (CBT), which includes exposure and response prevention (ERP), is effective in improving symptoms of obsessive-compulsive disorder (OCD). However, whether poor cognitive functions and autism spectrum disorder (ASD) traits affect the therapeutic response of patients with OCD to CBT remains unclear. This study aimed to identify factors predictive of the therapeutic response of Japanese patients with OCD to ERP. Methods Forty-two Japanese outpatients with OCD were assessed using the Wechsler Adult Intelligence Scale-III (WAIS-III), Yale-Brown Obsessive-Compulsive Scale, Patient Health Questionnaire 9-item scale, and Autism Spectrum Quotient (AQ) at pre- and post-treatment. We used multiple regression analyses to estimate the effect on therapeutic response change. The treatment response change was set as a dependent variable in multiple regression analyses. Results Multiple regression analyses showed that among independent variables, communication skill as an AQ sub-scale and Letter Number Sequencing as a WAIS-III sub-test predict the therapeutic response to ERP. Conclusions Our results suggest that diminished working memory (Letter Number Sequencing), poor communication skill may undermine responsiveness to ERP among patients with OCD. Trial registration: UMIN, UMIN00024087. Registered 20 September 2016 - Retrospectively registered (including retrospective data), https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&recptno=R000027729&type=summary&language=J