Long-Term Stability of Benefits of Cognitive Behavioral Therapy for Obsessive Compulsive Disorder Depends on Symptom Remission During Treatment
[Background] Cognitive behavioral therapy (CBT) is an effective treatment for obsessive-compulsive disorder (OCD) and may afford stable long-term improvements. It is not clear, however, how stability or symptom recurrence can be predicted at the time of termination of CBT. [Method] In a 1-year follo...
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| Format: | Article |
| Language: | English |
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PsychOpen GOLD/ Leibniz Institute for Psychology
2020-03-01
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| Series: | Clinical Psychology in Europe |
| Subjects: | |
| Online Access: | https://cpe.psychopen.eu/index.php/cpe/article/view/2785 |
| _version_ | 1797971165411540992 |
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| author | Björn Elsner Frieder Wolfsberger Jessica Srp Antonia Windsheimer Laura Becker Tanja Jacobi Norbert Kathmann Benedikt Reuter |
| author_facet | Björn Elsner Frieder Wolfsberger Jessica Srp Antonia Windsheimer Laura Becker Tanja Jacobi Norbert Kathmann Benedikt Reuter |
| author_sort | Björn Elsner |
| collection | DOAJ |
| description | [Background] Cognitive behavioral therapy (CBT) is an effective treatment for obsessive-compulsive disorder (OCD) and may afford stable long-term improvements. It is not clear, however, how stability or symptom recurrence can be predicted at the time of termination of CBT. [Method] In a 1-year follow-up intention-to-treat study with 120 OCD patients receiving individual CBT at a university outpatient unit, we investigated the predictive value of international consensus criteria for response only (Y-BOCS score reduction by at least 35%) and remission status (Y-BOCS score ≤ 12). Secondly, we applied receiver-operating characteristic (ROC) curves in order to find an optimal cut-off score to classify for deterioration and for sustained gains. [Results] Response only at post-treatment increased the likelihood of deterioration at follow-up compared to remission at an odds ratio of 8.8. Moreover, ROC curves indicated that a post-treatment score of ≥ 13 differentiated optimally between patients with and without symptom deterioration at follow-up assessment. The optimal cut-off score to classify for any sustained gains (response, remission, or both) at follow-up relative to baseline was 12. Importantly, previous findings of generally high long-term symptom stability after treatment in OCD could be replicated. [Conclusion] The findings highlight the clinical importance of reaching remission during CBT, and suggest that a recently published expert consensus for defining remission has high utility. |
| first_indexed | 2024-04-11T03:27:20Z |
| format | Article |
| id | doaj.art-bc70c59163434ca49ca8692bbfc2a214 |
| institution | Directory Open Access Journal |
| issn | 2625-3410 |
| language | English |
| last_indexed | 2024-04-11T03:27:20Z |
| publishDate | 2020-03-01 |
| publisher | PsychOpen GOLD/ Leibniz Institute for Psychology |
| record_format | Article |
| series | Clinical Psychology in Europe |
| spelling | doaj.art-bc70c59163434ca49ca8692bbfc2a2142023-01-02T07:10:34ZengPsychOpen GOLD/ Leibniz Institute for PsychologyClinical Psychology in Europe2625-34102020-03-012110.32872/cpe.v2i1.2785cpe.v2i1.2785Long-Term Stability of Benefits of Cognitive Behavioral Therapy for Obsessive Compulsive Disorder Depends on Symptom Remission During TreatmentBjörn Elsner0Frieder Wolfsberger1Jessica Srp2Antonia Windsheimer3Laura Becker4Tanja Jacobi5Norbert Kathmann6Benedikt Reuter7Department of Psychology, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Psychology, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Psychology, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Psychology, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Psychology, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Psychology, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Psychology, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany[Background] Cognitive behavioral therapy (CBT) is an effective treatment for obsessive-compulsive disorder (OCD) and may afford stable long-term improvements. It is not clear, however, how stability or symptom recurrence can be predicted at the time of termination of CBT. [Method] In a 1-year follow-up intention-to-treat study with 120 OCD patients receiving individual CBT at a university outpatient unit, we investigated the predictive value of international consensus criteria for response only (Y-BOCS score reduction by at least 35%) and remission status (Y-BOCS score ≤ 12). Secondly, we applied receiver-operating characteristic (ROC) curves in order to find an optimal cut-off score to classify for deterioration and for sustained gains. [Results] Response only at post-treatment increased the likelihood of deterioration at follow-up compared to remission at an odds ratio of 8.8. Moreover, ROC curves indicated that a post-treatment score of ≥ 13 differentiated optimally between patients with and without symptom deterioration at follow-up assessment. The optimal cut-off score to classify for any sustained gains (response, remission, or both) at follow-up relative to baseline was 12. Importantly, previous findings of generally high long-term symptom stability after treatment in OCD could be replicated. [Conclusion] The findings highlight the clinical importance of reaching remission during CBT, and suggest that a recently published expert consensus for defining remission has high utility.https://cpe.psychopen.eu/index.php/cpe/article/view/2785obsessive-compulsive disordery-bocscut-off scoreexpert consensusfollow-up |
| spellingShingle | Björn Elsner Frieder Wolfsberger Jessica Srp Antonia Windsheimer Laura Becker Tanja Jacobi Norbert Kathmann Benedikt Reuter Long-Term Stability of Benefits of Cognitive Behavioral Therapy for Obsessive Compulsive Disorder Depends on Symptom Remission During Treatment Clinical Psychology in Europe obsessive-compulsive disorder y-bocs cut-off score expert consensus follow-up |
| title | Long-Term Stability of Benefits of Cognitive Behavioral Therapy for Obsessive Compulsive Disorder Depends on Symptom Remission During Treatment |
| title_full | Long-Term Stability of Benefits of Cognitive Behavioral Therapy for Obsessive Compulsive Disorder Depends on Symptom Remission During Treatment |
| title_fullStr | Long-Term Stability of Benefits of Cognitive Behavioral Therapy for Obsessive Compulsive Disorder Depends on Symptom Remission During Treatment |
| title_full_unstemmed | Long-Term Stability of Benefits of Cognitive Behavioral Therapy for Obsessive Compulsive Disorder Depends on Symptom Remission During Treatment |
| title_short | Long-Term Stability of Benefits of Cognitive Behavioral Therapy for Obsessive Compulsive Disorder Depends on Symptom Remission During Treatment |
| title_sort | long term stability of benefits of cognitive behavioral therapy for obsessive compulsive disorder depends on symptom remission during treatment |
| topic | obsessive-compulsive disorder y-bocs cut-off score expert consensus follow-up |
| url | https://cpe.psychopen.eu/index.php/cpe/article/view/2785 |
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