Circadian zeitgebers and treatment outcome in inpatient programs for obsessive compulsive disorder (OCD): a pilot study.

ABSTRACT

High rates of delayed sleep phase disorder have been observed in inpatients with obsessive compulsive disorder (OCD). Up to one-third of patients with OCD do not respond to treatment; therefore, new interventions or methods of enhancing current interventions are imperative. The theory of inpatient circadian care (TICC) posits that enhancing inpatient settings through environmental changes, such as, a set lights out time and consistent scheduling may facilitate symptom improvements in both medical and psychiatric illnesses. Symptom improvements related to these environmental changes have yet to be explored in inpatient and residential OCD treatment program outcomes. Therefore, data on OCD inpatient and residential programs were collected through a meta-analysis conducted by Veale and colleagues (2016). The programs listed in this meta-analysis were contacted to ask follow-up questions regarding their program's scheduling and lights out times. Programs who reported increased consistency in their patients' schedules were significantly more likely to be coded as obtaining treatment response (a post-treatment mean Y-BOCS score <16; X2 = 3.60, p = .05). Further, a Fisher's exact test indicated significant differences, in that 78% of programs with a set lights out time obtained treatment response compared to 0% of programs without a set lights out time. Programs who facilitate set lights out times and consistent schedules may improve treatment response for their patients with OCD, especially for the most severe cases.