PREDICTORS OF TREATMENT OUTCOME IN THE BEHAVIORAL TREATMENT OF OBSESSIVE-COMPULSIVE DISORDER

Background. An investigation to determine which prognostic variables a re associated with behavioural treatment failure in obsessive-compulsi ve disorder (OCD). Empirically established prognostic variables measur ed at the start of treatment may lead to adjusted treatment programmes for these patients. Method. Forty patients, diagnosed with OCD, recei ved a standardised treatment consisting of 18 sessions in vivo exposur e and response prevention. Compulsive behaviour (MOCI) and obsessive f ear (ADS) were the outcome measures. Prognostic variables included wer e initial severity of OC complaints, initial level of depression, prob lem duration, patients' motivation for treatment, quality of the thera peutic relationship, and marital dissatisfaction. Results. Greater ini tial severity of complaints (P<0.01), and depression (P=0.03) predicte d poorer outcome for compulsive behaviour. Greater initial severity of complaints (P<0.01), and the conjoint Variables higher level of depre ssion, longer problem duration, poorer motivation for treatment, and d issatisfaction with the therapeutic relationship predicted poorer outc ome for obsessive fear (P<0.01). Conclusions. The complaint-related va riables of initial severity, initial depression, and problem duration, and the non-specific treatment variables of patients' motivation and quality of the therapeutic relationship, affect behavioural treatment outcome in OCD.