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Predictors of response to group cognitive-behavioral therapy in the treatment of obsessive-compulsive disorder

Published online by Cambridge University Press:  16 April 2020

Andréa Litvin Raffin ,
Jandyra Maria Guimarães Fachel ,
Ygor Arzeno Ferrão ,
Fernanda Pasquoto de Souza  and
Aristides Volpato Cordioli
Andréa Litvin Raffin*
Affiliation:
Graduate Program in Medical Sciences: Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos 2400, CEP 90035-003Porto Alegre, RS, Brazil
Jandyra Maria Guimarães Fachel
Affiliation:
Department of Statistics, Institute of Mathematics, Universidade Federal do Rio Grande do Sul (UFRGS), Av. Bento Gonçalves, 9500, Prédio 43-111, CEP 91509-900Porto Alegre, RS, Brazil
Ygor Arzeno Ferrão
Affiliation:
Graduate Program, Centro Universitário Metodista, Instituto de Porto Alegre (IPA), Rua Cel. Joaquim Pedro Salgado, 80, CEP 90420-060, Porto Alegre, RS, Brazil
Fernanda Pasquoto de Souza
Affiliation:
Graduate Program in Medical Sciences: Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos 2400, CEP 90035-003Porto Alegre, RS, Brazil
Aristides Volpato Cordioli
Affiliation:
Anxiety Disorders Program, Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, CEP 90035-003, Porto Alegre, RS, Brazil Hospital de Clínicas de Porto Alegre (HCPA), CEP 90430-180, Porto Alegre, RS, Brazil
*
*Corresponding author. Serviço de Psiquiatria/Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Sala 400N, CEP 90035-903 Porto Alegre, RS, Brazil. Tel.: +55 51 2101 8294/+55 51 3308 5161; fax: +55 51 2101 8493/+55 51 3308 5232. E-mail address: alitvin@terra.com.br (A.L. Raffin).
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Abstract

Purpose

To identify the presence of factors associated with treatment outcome in patients under group cognitive-behavioral therapy (GCBT) for obsessive-compulsive disorder (OCD).

Subjects and methods

This study evaluated 181 patients with OCD that attended a 12-session weekly GCBT program. Response criteria were: ≥35% reduction in Y-BOCS scores and global improvement score of the Clinical Global Impression (CGI) ≤ 2 at post-treatment evaluation. Sociodemographic data, OCD characteristics, and treatment data were studied.

Results

In the bivariate analysis, the following variables showed statistical significance (p < 0.20) to enter the regression model: being woman (p = 0.074), greater insight (p = 0.017) and better quality of life (QOL) in all domains before treatment (p = 0.053), overall severity of disease according to the CGI (p = 0.007), number of associated comorbidities (p = 0.063), social phobia (p = 0.044), and dysthymia (p = 0.072). In the final regression model, these variables were associated with response to GCBT: female gender (p = 0.021); WHOQOL-BREF psychological domain (p = 0.011); insight (p = 0.042); and global improvement score of the CGI severity-scale before therapy (p = 0.045).

Conclusion

Special attention should be paid to patients with poor insight, increasing the cognitive aspects of the therapy in an attempt to modify the rigidity and fixity of their beliefs. In addition, male patients should be more observed, since they showed lower chance of response to GCBT when compared to women. Patients with more severe global symptoms (CGI) are poorer responders to GCBT, which indicates that not only obsessive-compulsive symptoms (OCS) should be evaluated, since other symptoms, such as depression and anxiety, may affect the treatment; therefore, an attempt to reduce these symptoms, prior to the treatment of OCD, should be considered as an option in some cases.

Keywords

Obsessive-compulsive disorderPredictors of responseCognitive-behavioral therapyGroup therapy
Type
Original article
Information
European Psychiatry , Volume 24 , Issue 5 , June 2009 , pp. 297 - 306
Copyright
Copyright © Elsevier Masson SAS 2009

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Footnotes

*

There are no conflicts of interest associated with the publication of this article.

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