[Remission, Response and its Prediction after Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder in an...

Cognitive-behavioral therapy, including exposure and response management, is considered the first-choice psychotherapy for obsessive-compulsive disorder. In this study, the therapy outcome of 799 patients was examined in the context of inpatient cognitive-behavioral psychotherapy. Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was used as the central outcome measure. Therapy outcome was defined in effect sizes (ES) as well as in remission and response rates. In the pre-post comparison of Y-BOCS, the ES was 1.32. Response was classified according to two different definitions: the reliable change index (RCI) and the percental symptom improvement (PSI). The rates of response were 75.5% (RCI) and 37% (PSI). The rates of remission were 39.3% based on RCI and 32.2% based on PSI. 10.4 % of the participating patients finished the treatment prematurely. The risk of dropout was increased in male gender as well as in patients who were additionally treated with neuroleptics. The negative impact of neuroleptics on the outcome of therapy indicates that such medication should be used critically as part of exposure treatment.