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Related Experiment Videos

Response versus remission in obsessive-compulsive disorder.

Helen Blair Simpson1, Jonathan D Huppert, Eva Petkova

  • 1New York State Psychiatric Institute, New York, NY 10032, USA. simpson@nyspi.cpmc.columbia.edu

The Journal of Clinical Psychiatry
|March 29, 2006
PubMed
Summary

Exposure and ritual prevention (EX/RP) with or without clomipramine (CMI) significantly improved obsessive-compulsive disorder (OCD) outcomes compared to CMI alone. However, many patients do not achieve full remission with evidence-based treatments.

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Neuroscience

Background:

  • Obsessive-compulsive disorder (OCD) is a debilitating mental health condition.
  • Effective treatments are crucial for improving patient outcomes and quality of life.

Purpose of the Study:

  • To evaluate the efficacy of exposure and ritual prevention (EX/RP) compared to clomipramine (CMI) and placebo in treating adults with OCD.
  • To determine response and remission rates in OCD patients undergoing different treatment regimens.

Main Methods:

  • A multisite, randomized, controlled trial involving 122 adults diagnosed with OCD.
  • Treatments included EX/RP, CMI, a combination of EX/RP+CMI, and pill placebo (PBO) over 12 weeks.
  • Response defined as symptom decrease; remission as minimal symptoms post-treatment, using various established criteria.

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Main Results:

  • Significant differences in response and remission rates were observed across the four treatment groups (p<.05).
  • EX/RP and EX/RP+CMI demonstrated significantly higher responder and remission rates compared to PBO.
  • While CMI showed some improvement over PBO, EX/RP-based treatments were superior, particularly when remission was defined by a Yale-Brown Obsessive Compulsive Scale (YBOCS) score of 12 or less.

Conclusions:

  • Exposure and ritual prevention (EX/RP), with or without clomipramine (CMI), offers superior treatment outcomes for OCD patients without comorbid depression compared to CMI monotherapy.
  • Despite the effectiveness of evidence-based treatments like EX/RP, a significant proportion of OCD patients do not achieve complete remission.