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Chronic obsessive–compulsive disorder: prognostic factors

Published online by Cambridge University Press:  09 January 2018

Lucas J. B. van Oudheusden*
Affiliation:
Department of Psychiatry and EMGOInstitute, VU-University Medical Center, Academic Outpatient Clinic for Anxiety Disorders, GGZinGeest, Amsterdam, The Netherlands
Merijn Eikelenboom
Affiliation:
Department of Psychiatry and EMGOInstitute, VU-University Medical Center, Academic Outpatient Clinic for Anxiety Disorders, GGZinGeest, Amsterdam, The Netherlands
Harold J. G. M. van Megen
Affiliation:
Innova Research Centre, Mental Health Care Institute GGZ Centraal, Ermelo, The Netherlands
Henny A. D. Visser
Affiliation:
Innova Research Centre, Mental Health Care Institute GGZ Centraal, Ermelo, The Netherlands
Koen Schruers
Affiliation:
Research School for Mental Health and Neuroscience, Maastricht University and Mondriaan Academic Anxiety Center, Maastricht, The Netherlands
Gert-Jan Hendriks
Affiliation:
Department of Psychiatry, Center for Anxiety Disorders ‘Overwaal’, Institute for Integrated Mental Health Care Pro Persona, Behavioural Science Institute, Radboud University, Radboud University Medical Center, Nijmegen, the Netherlands
Nic van der Wee
Affiliation:
Department of Psychiatry, Leiden Center for Brain and Cognition and Leiden Center for Translational Neuroscience, Leiden University Medical Center, Leiden, the Netherlands
Adriaan W. Hoogendoorn
Affiliation:
Department of Psychiatry and EMGOInstitute, VU-University Medical Center, Academic Outpatient Clinic for Anxiety Disorders, GGZinGeest, Amsterdam, The Netherlands
Patricia van Oppen
Affiliation:
Department of Psychiatry and EMGOInstitute, VU-University Medical Center, Academic Outpatient Clinic for Anxiety Disorders, GGZinGeest, Amsterdam, The Netherlands
Anton J. L. M. van Balkom
Affiliation:
Department of Psychiatry and EMGOInstitute, VU-University Medical Center, Academic Outpatient Clinic for Anxiety Disorders, GGZinGeest, Amsterdam, The Netherlands
*
Author for correspondence: Lucas J. B. van Oudheusden, E-mail: l.oudheusden@ggzingeest.nl

Abstract

Background

The course of illness in obsessive–compulsive disorder (OCD) varies significantly between patients. Little is known about factors predicting a chronic course of illness. The aim of this study is to identify factors involved in inducing and in maintaining chronicity in OCD.

Methods

The present study is embedded within the Netherlands Obsessive Compulsive Disorder Association (NOCDA) study, an ongoing multicenter naturalistic cohort study designed to identify predictors of long-term course and outcome in OCD. For this study, 270 subjects with a current diagnosis of OCD were included. Chronicity status at 2-year follow-up was regressed on a selection of baseline predictors related to OCD, to comorbidity and to stress and support.

Results

Psychotrauma [odds ratio (OR) 1.98, confidence interval (CI) 1.22–3.22, p = 0.006], recent negative life events (OR 1.42, CI 1.01–2.01, p = 0.043), and presence of a partner (OR 0.28, CI 0.09–0.85, p = 0.025) influenced the risk of becoming chronic. Longer illness duration (OR 1.46, CI 1.08–1.96, p = 0.013) and higher illness severity (OR 1.09, CI 1.03–1.16, p = 0.003) increased the risk of remaining chronic.

Conclusions

External influences increase the risk of becoming chronic, whereas the factors involved in maintaining chronicity are illness-related. As the latter are potentially difficult to modify, treatment should be devoted to prevent chronicity from occurring in the first place. Therapeutic strategies aimed at alleviating stress and at boosting social support might aid in achieving this goal.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2018 

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