Long-term follow-up and predictors of clinical outcome in obsessive-compulsive patients treated with serotonin reuptake inhibitors and behavioral therapy

被引:180
作者
Alonso, P
Menchon, JM
Pifarre, J
Mataix-Cols, D
Torres, L
Salgado, P
Vallejo, J
机构
[1] Ciudad Sanitaria & Univ Vall Hebron, Dept Psychiat, Hosp Principes Espana, Obsess Compuls Disorder Clin & Res Unit, Barcelona 08907, Spain
[2] Univ Barcelona, Dept Psychiat & Clin Psychobiol, Barcelona, Spain
关键词
D O I
10.4088/JCP.v62n07a06
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
Background: The objective of this study was to examine the long-term course of obsessive-compulsive disorder (OCD) in patients treated with serotonin reuptake inhibitors (SRIs) and behavioral therapy and to identify predictors of clinical outcome. Method: Sixty outpatients meeting DSM-III-R or DSM-IV criteria for OCD were followed up for 1 to 5 years (mean = 2.5 years). All of them received prolonged pharmacologic therapy with an SRI. Results: Thirty-seven patients (61.7%) completed an adequate behavioral treatment. At long-term assessment, 22 patients (36.7%) exhibited a global Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score greater than 16 or a final reduction in Y-BOCS global score of less than 35% and were considered nonresponders. Patients who completed behavioral therapy showed a significant decrease in Y-BOCS compulsions subscale score (p = .01), whereas no significant differences in either Y-BOCS global or obsessions subscale scores between those who did and those who did not undergo behavioral therapy were detected. Obsessions of sexual/religious content were the unique factor related to a poorer long-term outcome. Conclusion: A substantial number of OCD patients showed persistent disabling symptoms at the long-term follow-up in spile of combined pharmacologic and behavioral treatment. Major benefits from behavioral therapy appeared to be the improvement of ritualistic behaviors. Sexual/religious obsessions predicted poorer long-term outcome, whereas shortterm response to SRI treatment failed to achieve predictive value in the long-term course of OCD.
引用
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页码:535 / 540
页数:6
相关论文
共 37 条
  • [1] Clinical characteristics of response to fluoxetine treatment of obsessive-compulsive disorder
    Ackerman, DL
    Greenland, S
    Bystritsky, A
    [J]. JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY, 1998, 18 (03) : 185 - 192
  • [2] ALARCON RD, 1993, J CLIN PSYCHOPHARM, V13, P210
  • [3] A FOLLOW-UP OF ADOLESCENTS WITH OBSESSIVE-COMPULSIVE DISORDER
    ALLSOPP, M
    VERDUYN, C
    [J]. BRITISH JOURNAL OF PSYCHIATRY, 1989, 154 : 829 - 834
  • [4] ANDREASEN NC, 1977, ARCH GEN PSYCHIAT, V34, P1229
  • [5] BAER L, 1992, ARCH GEN PSYCHIAT, V49, P862
  • [6] Baer L, 1998, OBSESSIVE COMPULSIVE
  • [7] CHILDHOOD OBSESSIVE COMPULSIVE DISORDER - A 2-YEAR PROSPECTIVE FOLLOW-UP OF A COMMUNITY SAMPLE
    BERG, CZ
    RAPOPORT, JL
    WHITAKER, A
    DAVIES, M
    LEONARD, H
    SWEDO, SE
    BRAIMAN, S
    LENANE, M
    [J]. JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY, 1989, 28 (04) : 528 - 533
  • [8] BERRIOS G E, 1989, British Journal of Psychiatry, V154, P17
  • [9] Hoarding and treatment response in 38 nondepressed subjects with obsessive-compulsive disorder
    Black, DW
    Monahan, P
    Gable, J
    Blum, N
    Clancy, G
    Baker, P
    [J]. JOURNAL OF CLINICAL PSYCHIATRY, 1998, 59 (08) : 420 - 425
  • [10] LONG-TERM COURSE OF OBSESSIVE-COMPULSIVE DISORDER TREATED IN ADOLESCENCE
    BOLTON, D
    LUCKIE, M
    STEINBERG, D
    [J]. JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY, 1995, 34 (11) : 1441 - 1450