Naturalistic course of obsessive compulsive disorder and comorbid depression - Longitudinal results of a prospective follow-up study of 74 actively treated patients

Seventy-four patients who met DSM-III-R criteria for obsessive compulsive d isorder (OCD) were studied in a prospective follow-up study in order to inv estigate course and prognosis of OCD with or without comorbid depressive sy mptomatology. Subjects were examined three times: at admission (baseline), 6 months later (follow-up 1) and 12 months after follow-up 1 (follow-up 2). At admission, 51 (72.9%) OCD patients were assessed as depressive by the H amilton Depression Scale score. Between admission and follow-up 1, all pati ents received behavior therapy and a serotonin reuptake inhibitor, between follow-up 1 and follow-up 2 they received different kinds of treatment in o rder to maximize therapeutic effects. A 25 % Yale-Brown Obsessive-Compulsiv e Sea le (Y-BOCS) score reduction from admission to follow-up 2 and in addi tion, a total Y-BOCS score of below 16 at follow-up 2 was defined as 'good prognosis course'. The results obtained showed that OCD patients who follow ed a good prognosis course, showed no significant depressive symptomatology at follow-up 2 (p = 0.001). These results imply that patients with a diagn osis of OCD may present depression at admission and/or follow-up 1; however , if OC symptomatology decreases longitudinally, depressive symptoms disapp ear too. We may assume that OCD is dominant over depression, and it seems t hat a comorbid depression does not have any major influence on the prognosi s of OCD. Copyright (C) 2000 S.Karger AG, Basel.