Psychiatric Comorbidity in Patients with Ocd: Implications for Treatment Response After One Year Follow-Up

Abstract

Background: The present study aimed to investigate, prospectively, clinical and socio-demographic features that may influence response to OCD treatment in the long term. Methods: One hundred ninety-seven subjects, who received randomized treatment with group cognitive behavioral therapy (GCBT) or a selective serotonin reuptake inhibitor (SSRI) for the first 12 weeks have been studied. Non-responders to the initial treatment had their treatment tailored to individual conditions, according to international guidelines for the treatment of OCD. Treatment response, measured initially and after three, six and twelve months, was considered as a categorical [35% or greater reduction in baseline YBOCS scores plus a CGI-Improvement rating of better(2) or much better(1)] and as a continuous variable (percent reduction in baseline YBOCS scores). Results: After one year follow-up, better treatment response were associated with absence of psychiatric comorbidity (p= 0,0002) and, in particular, absence of a mood disorder (p=0,0004). Poorer outcome was associated to higher scores on Beck Depression Inventory (p=0,0012), number of psychiatric comorbidities (p=0,0015) and presence of obsessive thoughts of diverse content (p= 0,0117). Age at onset, male gender and family history of OCD were not associated with treatment response in this sample, and there was no influence of initial treatment modality on the long-term outcome. Conclusions: In this study, comorbidity number showed correlation with poorer treatment response. Additional studies will be necessary to enlighten if there is an early set point to determine treatment success or failure.