PREDICTION OF OUTCOME AND EARLY VS. LATE IMPROVEMENT IN OCD PATIENTS TREATED WITH COGNITIVE-BEHAVIOR THERAPY AND PHARMACOTHERAPY

In this study, follow-up results of cognitive-behaviour therapy and of a combination of cognitive-behaviour therapy with a serotonergic anti depressant were determined. The study also examined factors that can p redict this treatment effect, both in the long term and in the short t erm. In addition, it investigated whether differential prediction is p ossible for cognitive-behaviour therapy vs. a combination of cognitive -behaviour therapy with a serotenergic antidepressant. A total of 99 p atients were included in the study. Treatment lasted 16 weeks, and a n aturalistic followup measurement was made 6 months later. Of the 70 pa tients who completed the treatment, follow-up information was availabl e for 61 subjects. Significant time effects were found on all outcome measures at both posttreatment measurement and follow-up. No differenc es in efficacy were found between the treatment conditions. Effectiven ess at post-treatment measurement appears to predict success at follow -up. However, 17 of the 45 non-responders at the post-treatment measur ement had become responders by the follow-up. The severity of symptoms , motivation for treatment and the dimensional score on the PDQ-R for cluster A personality disorder appear to predict treatment outcome. No predictors were found that related specifically to cognitive-behaviou r therapy or combined treatment. These results indicate that the effec tiveness of cognitive-behaviour therapy or a combination of cognitive- behaviour therapy and fluvoxamine at the posttreatment measurement is maintained at follow-up. However, non-response at post-treatment does not always imply non-response at follow-up. Patients with more severe symptoms need a longer period of therapy to become responders. Althoug h predictors for treatment success were found, no evidence was found t o determine the choice of one of the treatment modalities.