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Maximizing remission from cognitive-behavioral therapy in medicated adults with obsessive-compulsive disorder.
Simpson, Helen B; Foa, Edna B; Wheaton, Michael G; Gallagher, Thea; Gershkovich, Marina; Schmidt, Andrew B; Huppert, Jonathan D; Campeas, Raphael B; Imms, Patricia A; Cahill, Shawn P; DiChiara, Christina; Tsao, Steven D; Puliafico, Anthony C; Chazin, Daniel; Asnaani, Anu; Moore, Kelly; Tyler, Jeremy; Steinman, Shari A; Sanchez-LaCay, Arturo; Capaldi, Sandy; Snorrason, Ivar; Turk-Karan, Elizabeth; Vermes, Donna; Kalanthroff, Eyal; Pinto, Anthony; Hahn, Chang-Gyu; Xu, Bin; Van Meter, Page E; Katechis, Martha; Scodes, Jennifer; Wang, Yuanjia.
Afiliação
  • Simpson HB; Department of Psychiatry, Columbia University, New York, NY, 10032, USA; New York State Psychiatric Institute, New York, NY, 10032, USA. Electronic address: Blair.Simpson@nyspi.columbia.edu.
  • Foa EB; Center for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA.
  • Wheaton MG; New York State Psychiatric Institute, New York, NY, 10032, USA; Barnard College, Columbia University, New York, NY, 10027, USA.
  • Gallagher T; Center for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA.
  • Gershkovich M; Department of Psychiatry, Columbia University, New York, NY, 10032, USA; New York State Psychiatric Institute, New York, NY, 10032, USA.
  • Schmidt AB; Department of Psychiatry, Columbia University, New York, NY, 10032, USA; New York State Psychiatric Institute, New York, NY, 10032, USA.
  • Huppert JD; The Hebrew University of Jerusalem, Israel.
  • Campeas RB; Department of Psychiatry, Columbia University, New York, NY, 10032, USA; New York State Psychiatric Institute, New York, NY, 10032, USA.
  • Imms PA; Center for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA.
  • Cahill SP; University of Wisconsin-Milwaukee, Milwaukee, WI, 53201, USA.
  • DiChiara C; Center for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA; Center for Anxiety and Behavior Therapy, Bryn Mawr, PA, 19010, USA.
  • Tsao SD; Center for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA; Center for Anxiety and Behavior Therapy, Bryn Mawr, PA, 19010, USA.
  • Puliafico AC; Department of Psychiatry, Columbia University, New York, NY, 10032, USA; New York State Psychiatric Institute, New York, NY, 10032, USA.
  • Chazin D; Center for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA.
  • Asnaani A; Center for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Psychology, University of Utah, Salt Lake City, UT, 84112, USA.
  • Moore K; Center for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA; Rutgers University/Biomedical Health Sciences New Brunswick, NJ, 08854, USA.
  • Tyler J; Center for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA.
  • Steinman SA; Department of Psychiatry, Columbia University, New York, NY, 10032, USA; New York State Psychiatric Institute, New York, NY, 10032, USA; Department of Psychology, WVU, Morgantown, WV, 26506, USA.
  • Sanchez-LaCay A; Department of Psychiatry, Columbia University, New York, NY, 10032, USA; New York State Psychiatric Institute, New York, NY, 10032, USA.
  • Capaldi S; Center for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA.
  • Snorrason I; Department of Psychiatry, Columbia University, New York, NY, 10032, USA; New York State Psychiatric Institute, New York, NY, 10032, USA; McLean Hospital/Harvard Medical School, Belmont, MA, 02478, USA.
  • Turk-Karan E; Center for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA.
  • Vermes D; Department of Psychiatry, Columbia University, New York, NY, 10032, USA; New York State Psychiatric Institute, New York, NY, 10032, USA.
  • Kalanthroff E; The Hebrew University of Jerusalem, Israel.
  • Pinto A; Department of Psychiatry, Columbia University, New York, NY, 10032, USA; New York State Psychiatric Institute, New York, NY, 10032, USA; Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, The Zucker Hillside Hospital, Glen Oaks, NY, 11004, USA.
  • Hahn CG; Center for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA.
  • Xu B; Department of Psychiatry, Columbia University, New York, NY, 10032, USA.
  • Van Meter PE; Department of Psychiatry, Columbia University, New York, NY, 10032, USA; New York State Psychiatric Institute, New York, NY, 10032, USA.
  • Katechis M; Department of Psychiatry, Columbia University, New York, NY, 10032, USA; New York State Psychiatric Institute, New York, NY, 10032, USA.
  • Scodes J; New York State Psychiatric Institute, New York, NY, 10032, USA.
  • Wang Y; Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA.
Behav Res Ther ; 143: 103890, 2021 08.
Article em En | MEDLINE | ID: mdl-34089924
ABSTRACT
Practice guidelines for adults with obsessive-compulsive disorder (OCD) recommend augmenting serotonin reuptake inhibitors (SRIs) with exposure and ritual prevention (EX/RP). However, fewer than half of patients remit after a standard 17-session EX/RP course. We studied whether extending the course increased overall remission rates and which patient factors predicted remission. Participants were 137 adults with clinically significant OCD (Yale-Brown Obsessive Compulsive Scale [Y-BOCS] score ≥18) despite an adequate SRI trial (≥12 weeks). Continuing their SRI, patients received 17 sessions of twice-weekly EX/RP (standard course). Patients who did not remit (Y-BOCS ≤12) received up to 8 additional sessions (extended course). Of 137 entrants, 123 completed treatment 49 (35.8%) remitted with the standard course and another 46 (33.6%) with the extended course. Poorer patient homework adherence, more Obsessive-Compulsive Personality Disorder (OCPD) traits, and the Brain-Derived Neurotrophic Factor (BDNF) Val66MET genotype were associated with lower odds of standard course remission. Only homework adherence differentiated non-remitters from extended course remitters. Extending the EX/RP course from 17 to 25 sessions enabled many (69.3%) OCD patients on SRIs to achieve remission. Although behavioral (patient homework adherence), psychological (OCPD traits), and biological (BDNF genotype) factors influenced odds of EX/RP remission, homework adherence was the most potent patient factor overall.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Terapia Cognitivo-Comportamental / Transtorno Obsessivo-Compulsivo Tipo de estudo: Guideline / Prognostic_studies Limite: Adult / Humans Idioma: En Revista: Behav Res Ther Ano de publicação: 2021 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Terapia Cognitivo-Comportamental / Transtorno Obsessivo-Compulsivo Tipo de estudo: Guideline / Prognostic_studies Limite: Adult / Humans Idioma: En Revista: Behav Res Ther Ano de publicação: 2021 Tipo de documento: Article