Obsessive-compulsive disorder and comorbidity - Results from a 12-month behavioral group therapy

Behavioral therapy with 'exposure and response prevention' and the pharmaco logical treatment with SSRI's (selective serotonin reuptake inhibitors) hav e been found effective in the treatment of obsessive-compulsive disorder. T he data concerning the effectiveness and outcome of group therapy, employin g these treatment strategies, are rare and very heterogeneous. In our treat ment program we have developed a concept for a 12-month outpatient group th erapy (45 sessions) for 10 patients, addressing the reduction of obsessive- compulsive symptoms and other psychopathologic symptoms of comorbid disorde rs as well. After 12 months of treatment, the Y-BOCS total score was reduce d by greater than or equal to 50% in 3 patients and by greater than or equa l to 25% in 5 patients. Compulsions and rituals were improved by greater th an or equal to 50% in 7 patients and 30% in 1 patient. Obsessions were redu ced by greater than or equal to 50 and greater than or equal to 25% in 3 pa tients, respectively. On the self-rating scales a marked reduction in HZI ( Hamburg obsessive-compulsive Inventory) was achieved in dimension A (contro lling behavior) and in dimension D (counting, touching and talking behavior ) and in SCL-90-R subscales 'obsessive-compulsive symptoms' and 'paranoia'. The other dimensions remained essentially unchanged in group-statistics. F inally, the effectiveness and limitations of our concept, the course of sym ptomatology during treatment, the detailed results, and the patients' asses sment concerning importance of different treatment: elements are discussed.