A PREDICTIVE STUDY OF OBSESSIVE-COMPULSIVE DISORDER RESPONSE TO CLOMIPRAMINE

Studies on predictive factors of the obsessive-compulsive disorder res ponse to pharmacologic treatment, specifically clomipramine, are relat ively scarce. Forty-five patients treated for a mean period of 18.6 mo nths were classified as having poor response, intermediate response an d excellent response, defined by change scores on the Yale-Brown Obses sive-Compulsive Scale. Poor and intermediate response patients were gr ouped together and compared with the excellent response subgroup. Univ ariate analysis showed length of illness, family history (siblings), i nitial compulsiveness score, and cleaning rituals as significant predi ctors. Two multiple regression analyses with these as independent or p redictive variables showed higher initial scores on the Yale-Brown Obs essive-Compulsive Scale associated with poorer response to treatment b ut, most importantly, cleaning rituals as a predictor of poor or modes t response to clomipramine. It may be important for the clinician to a ssess cleaning habits separately from the more frequently mentioned ob sessive-compulsive symptom, hand washing. This distinction may have im portant clinical, therapeutic, and prognostic implications.