Determining prognostic variables of treatment outcome in obsessive-compulsive disorder: effectiveness and its predictors in routine clinical care.

Content Provider	Europe PMC
Author	Herzog, Philipp Osen, Bernhard Stierle, Christian Middendorf, Thomas Voderholzer, Ulrich Koch, Stefan Feldmann, Matthias Rief, Winfried Brakemeier, Eva-Lotta
Abstract	The objectives of this study were to investigate the naturalistic effectiveness of routine inpatient treatment for patients with obsessive–compulsive disorder (OCD) and to identify predictors of treatment outcome. A routinely collected data set of 1,596 OCD inpatients (M = 33.9 years, SD = 11.7; 60.4% female) having received evidence-based psychotherapy based on the cognitive–behavioral therapy (CBT) in five German psychotherapeutic clinics was analyzed. Effect sizes (Hedges' g) were calculated for several outcome variables to determine effectiveness. Predictor analyses were performed on a subsample (N = 514; M = 34.3 years, SD = 12.2; 60.3% female). For this purpose, the number of potential predictors was reduced using factor analysis, followed by multiple regression analysis to identify robust predictors. Effect sizes of various outcome variables could be classified as large (g = 1.34 of OCD–symptom change). Predictors of changes in OCD and depressive symptoms were symptom severity at admission and general psychopathological distress. In addition, patients with higher social support and more washing compulsions benefited more from treatment. Subgroup analyses showed a distinct predictor profile of changes in compulsions and obsessions. The results indicate that an evidence-based psychotherapy program for OCD can be effectively implemented in routine inpatient care. In addition to well-established predictors, social support, and washing compulsions in particular were identified as important positive predictors. Specific predictor profiles for changes in obsessions and compulsions are discussed.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00406-021-01284-6.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC8866294&blobtype=pdf
ISSN	09401334
Journal	European Archives of Psychiatry and Clinical Neuroscience [Eur Arch Psychiatry Clin Neurosci]
Volume Number	272
DOI	10.1007/s00406-021-01284-6
PubMed Central reference number	PMC8866294
Issue Number	2
PubMed reference number	34218306
e-ISSN	14338491
Language	English
Publisher	Springer Berlin Heidelberg
Publisher Date	2021-07-03
Publisher Place	Berlin/Heidelberg
Access Restriction	Open
Rights License	Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. © The Author(s) 2021
Subject Keyword	Obsessive–compulsive disorder Effectiveness Predictors Patient characteristics Prognostic variables
Content Type	Text
Resource Type	Article
Subject	Biological Psychiatry Pharmacology (medical) Psychiatry and Mental Health