CLINICAL PREDICTORS OF LONG-TERM OUTCOME IN OBSESSIVE-COMPULSIVE DISORDER

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorJAKUBOVSKI, Ewgeni
dc.contributor.authorDINIZ, Juliana B.
dc.contributor.authorVALERIO, Carolina
dc.contributor.authorFOSSALUZA, Victor
dc.contributor.authorBELOTTO-SILVA, Cristina
dc.contributor.authorGORENSTEIN, Clarice
dc.contributor.authorMIGUEL, Euripedes
dc.contributor.authorSHAVITT, Roseli G.
dc.date.accessioned2014-01-28T22:26:36Z
dc.date.available2014-01-28T22:26:36Z
dc.date.issued2013
dc.description.abstractBackground: The purpose of this study was to investigate demographic and clinical factors associated with the long-term outcome of obsessive-compulsive disorder (OCD). Methods: A hundred ninety-six previously untreated patients with DSM-IV criteria OCD completed a 12-week randomized open trial of group cognitive-behavioral therapy (GCBT) or fluoxetine, followed by 21 months of individualized, uncontrolled treatment, according to international guidelines for OCD treatment. OCD severity was assessed using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) at different times over the follow-up period. Demographics and several clinical variables were assessed at baseline. Results: Fifty percent of subjects improved at least 35% from baseline, and 21.3% responded fully (final Y-BOCS score < or = 8). Worse prognosis was associated with earlier age at onset of OCD (P = 0.045), longer duration of illness (P = 0.001) presence of at least one comorbid psychiatric disorder (P = 0.001), comorbidity with a mood disorder (P = 0.002), higher baseline Beck-Depression scores (P = 0.011), positive family history of tics (P = 0.008), and positive family history of anxiety disorders (P = 0.008). Type of initial treatment was not associated with long-term outcome. After correction for multiple testing, the presence of at least one comorbid disorder, the presence of a depressive disorder, and duration of OCD remained significant. Conclusions: Patients under cognitive-behavioral or pharmacological treatment improved continuously in the long run, regardless of initial treatment modality or degree of early response, suggesting that OCD patients benefit from continuous treatment. Psychiatric comorbidity, especially depressive disorders, may impair the long-term outcome of OCD patients. Depression and Anxiety 30:763-772, 2013. (C) 2012 Wiley Periodicals, Inc.
dc.description.indexMEDLINE
dc.identifier.citationDEPRESSION AND ANXIETY, v.30, n.8, p.763-772, 2013
dc.identifier.doi10.1002/da.22013
dc.identifier.issn1091-4269
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/4218
dc.language.isoeng
dc.publisherWILEY-BLACKWELL
dc.relation.ispartofDepression and Anxiety
dc.rightsrestrictedAccess
dc.rights.holderCopyright WILEY-BLACKWELL
dc.subjectobsessive-compulsive disorder
dc.subjectfollow-up studies
dc.subjectdrug therapy
dc.subjectcognitive therapy
dc.subjectfluoxetine
dc.subject.otherserotonin reuptake inhibitors
dc.subject.otherbehavioral group-therapy
dc.subject.otherfollow-up
dc.subject.othercontrolled-trial
dc.subject.othercomorbid depression
dc.subject.othertreatment-response
dc.subject.otherdouble-blind
dc.subject.otherclomipramine
dc.subject.other2-year
dc.subject.otheronset
dc.subject.wosPsychology, Clinical
dc.subject.wosPsychiatry
dc.subject.wosPsychology
dc.titleCLINICAL PREDICTORS OF LONG-TERM OUTCOME IN OBSESSIVE-COMPULSIVE DISORDER
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.affiliation.countryAlemanha
hcfmusp.affiliation.countryisode
hcfmusp.author.externalJAKUBOVSKI, Ewgeni:Heidelberg Univ, Dept Psychol, Heidelberg, Germany
hcfmusp.citation.scopus71
hcfmusp.contributor.author-fmusphcJULIANA BELO DINIZ
hcfmusp.contributor.author-fmusphcCAROLINA VALERIO BARROS
hcfmusp.contributor.author-fmusphcCRISTINA BELOTTO DA SILVA
hcfmusp.contributor.author-fmusphcCLARICE GORENSTEIN
hcfmusp.contributor.author-fmusphcEURIPEDES CONSTANTINO MIGUEL FILHO
hcfmusp.contributor.author-fmusphcROSELI GEDANKE SHAVITT
hcfmusp.description.beginpage763
hcfmusp.description.endpage772
hcfmusp.description.issue8
hcfmusp.description.volume30
hcfmusp.origemWOS
hcfmusp.origem.pubmed23109056
hcfmusp.origem.scopus2-s2.0-84881478070
hcfmusp.origem.wosWOS:000322583800009
hcfmusp.publisher.cityHOBOKEN
hcfmusp.publisher.countryUSA
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