Patterns of remission and relapse in obsessive-compulsive disorder: A 2-year prospective study

Objective: This study examined the course of illness in patients with obses sive-compulsive disorder (OCD) over a 2-year period. Method: Sixty-six patients with a primary diagnosis of DSM-III-R OCD were f ollowed prospectively for 2 years. Baseline information was collected on de mographic characteristics, Axis I and II diagnoses, and severity of OCD sym ptoms. Follow-up measures obtained at 3, 6, 12, and 24 months after baselin e assessment included information on symptomatic and diagnostic status as w ell as behavioral and somatic treatments received. Results: The probability of full remission from OCD over the 2-year period was 12%. The probability of partial remission was 47%. After achieving remi ssion from OCD, the probability of relapse was 48%. No factors were identif ied that significantly predicted full or partial remission. Seventy-seven p ercent (N = 51) of the subjects received a serotonin reuptake inhibitor (SR I) for greater than or equal to 12 weeks, and 68% (N = 45) received medium- to-high doses of SRIs for greater than or equal to 12 weeks. Only 18% recei ved a full trial of behavior therapy. Conclusion: Despite exposure to at least 1 adequate trial of an SRI, the li kelihood of full remission of OCD in this study was low. Results of this st udy also suggest that behavior therapy may be underutilized.