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Early Compliance and Other Factors Predicting Outcome of Exposure for Obsessive–Compulsive Disorder

Published online by Cambridge University Press:  02 January 2018

L. M. Ito
Affiliation:
Dept Psiquiatria, Hospital das Clinicas de FMUSP, Rua Ovidio Pires de Campos s/n, caixa postal 8091, Cerquerira Cezar, São Paulo S.P., Brazil
I. M. Marks*
Affiliation:
Institute of Psychiatry
*
Isaac Marks, Institute of Psychiatry, London SE5 8AF

Abstract

Background

Identifying predictors of treatment outcome can suggest ways to improve treatment delivery and understanding of its mechanism of action.

Method

Predictors of treatment outcome were sought among 46 out-patients with obsessive–compulsive disorder who completed a nine-week randomised controlled trial of two forms of exposure therapy with ritual prevention.

Results

In both exposure conditions the best predictor of good outcome at the end of treatment (week 9) and of follow-up (week 32) was early compliance in doing exposure homework within a week of starting treatment. A weaker predictor of good outcome at follow-up was within-session reduction in anxiety from weeks 0 to 4.

Conclusion

The strongest and most consistent predictor of better outcome to weeks 9 and 32 was compliance with exposure and ritual prevention in the first week of treatment.

Type
Papers
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

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References

Anath, J., Pecknold, J. C., van den Steen, N., et al (1981) Double-blind study of clomipramine and amitriptyline in obsessive neurosis. Progress in Neuropsychopharmacology, 5, 257262.CrossRefGoogle Scholar
Basoglu, M., Lax, T., Kasvikis, Y., et al (1988) Predictors of improvement in OCD. Journal of Anxiety Disorders, 2, 299317.Google Scholar
Beck, A. T., Rial, W. Y. & Rickels, K. (1974) Short-form of the Depression Inventory: Cross-validation. Psychological Reports, 34, 11841186.Google Scholar
Boulougouris, J. C. (1977) Variables affecting outcome in obsessive–compulsive patients treated by flooding. In The Treatment of Phobias and OCD (eds Boulougouris, J. C. & Rabavilas, A.). New York: Pergamon.Google Scholar
Buchanan, A. W., Ko, S. M. & Marks, I. M. (1996) What predicts improvement and compliance during the behavioural treatment of obsessive–compulsive dissorder? Anxiety, 2, 2227.3.0.CO;2-F>CrossRefGoogle Scholar
Castle, J. D., Deals, A., Marks, I. M., et al (1994) Prediction of outcome of behavioural psychotherapy for OCD: An analysis of 219 outpatients. Acta Psychiatrica Scandinavica, 89, 393398.CrossRefGoogle Scholar
De Araujo, L. A., Ito, L., Marks, I. M., et al (1995) Does imagined exposure to the consequences of not rituatising enhance live exposure for OCD? A controlled study. I: Main outcome. British Journal of Psychiatry, 167, 6570.Google Scholar
Foa, E. B. (1979) Failure in treating obsessive–compulsives. Behaviour Research and Therapy, 16, 391399.CrossRefGoogle Scholar
Foa, E. B., Grayson, J. B., Steketee, G. S., et al (1983) Success and failure in the behavioural treatment of obsessive–compulsives. Journal of Consulting Clinical Psychology, 51, 287297.Google Scholar
Flament, M. F., Rapoport, J. L., Berg, C. J., et al (1985) Clompramine treatment of childhood OCD: A double-blind controlled study. Archives of General Psychiatry, 42, 977983.Google Scholar
Gelder, M. G. & Marks, I. (1966) Severe agoraphobia: A controlled prospective trial of behaviour therapy. British Journal of Psychiatry, 112, 309319.Google Scholar
Goodman, W. K., Price, L. H., Rasmussen, S. A., et al (1989) The Yale Brown Obsessive Compulsive Scale (YBOCS). Archives of General Psychiatry. 46, 10061016.CrossRefGoogle Scholar
Hamilton, M. (1969) Standardized assessment and recording of depressive symptoms. Psychiatria, Neurologia, Neurochirurgia, 72, 201205.Google ScholarPubMed
Insel, T. R., Murphy, D. L. & Cohen, R. M. (1983) OCD: A double-blind trial of clomipramine and clorgyline. Archives of General Psychiatry, 40, 605612.Google Scholar
Ito, L. M., De Araujo, L. A., Marks, I. M., et al (1995) Beliefs and resistance in OCD. Observations from a controlled study. Journal of Anxiety Disorders, 9, 269282.CrossRefGoogle Scholar
Lax, T., Basoglu, M. & Marks, I. M. (1992) Expectancy and compliance as predictors of outcome in OCD. Behavioural Psychotherapy, 20, 257266.Google Scholar
Lelliott, P. T., Noshirvani, H. F., Basoglu, M., et al (1988) Obsessive–compulsive beliefs and treatment outcome. Psychological Medicine, 18, 697702.Google Scholar
Marks, I. M. (1980) Living with Fear. New York: McGraw-Hill.Google Scholar
Marks, I. M. (1986) Behavioural Psychotherapy: Pocket Book of Clinical Management. Bristol: John Wright.Google Scholar
Marks, I. M. (1987) Fears, Phobias and Rituals. New York: Oxford University Press.Google Scholar
Marks, I. M., Hodgson, R. & Rachman, S. (1975) Treatment of chronic obsessive compulsive neurosis by in vivo exposure. British Journal of Psychiatry, 127, 349364.Google Scholar
Marks, I. M., Stern, R. S., Mawson, D., et al (1980) Clomipramine and exposure for obsessive–compulsive rituals: I. British Journal of Psychiatry, 136, 125.Google Scholar
Marks, I. M., Swinson, R. P., Basoglu, M., et al (1993) Alprazolam and exposure alone and combined in panic disorder with agoraphobia: A controlled study in London and Toronto. British Journal of Psychiatry, 162, 776787.Google Scholar
Mavissakalian, M. & Michelson, L. (1983) Tricyclic antidepressants in obsessive–compulsive disorder: Anti-obsessional or antidepressant agents? Journal of Nervous and Mental Disease, 171, 301306.Google Scholar
Mavissakalian, M., Turner, S. M., Michelson, L., et al (1985) Tricyclic antidepressants in OCD. American Journal of Psychiatry, 142, 572576.Google Scholar
Skelton, J. L. & Levy, R. L. (1979) Home practice activities and compliance: Two sources of variance in behaviour and research. Journal of Applied Behavioral Analysis, 12, 324.Google Scholar
SPSS-PC+ (1988) Advanced Statistics V2.0 System Version 3.1. SPSS Inc., Michigan Ave., Chicago.Google Scholar
Thoren, P., Asberg, M. & Cronholm, B. (1980) Clomipramine treatment of OCD. Archives of General Psychiatry, 37, 12811285.Google Scholar
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