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Predicting Therapy Outcome in Patients with Early and Late Obsessive-Compulsive Disorder (EOCD and LOCD)

Published online by Cambridge University Press:  02 October 2009

Judith Langner ,
Manuela Laws ,
Gisela Röper ,
Michael Zaudig ,
Walter Hauke  and
Christoph Piesbergen
Judith Langner
Affiliation:
Ludwig-Maximilians-Universität, Munich, Germany
Manuela Laws
Affiliation:
Ludwig-Maximilians-Universität, Munich, Germany
Gisela Röper*
Affiliation:
Ludwig-Maximilians-Universität, Munich, Germany
Michael Zaudig
Affiliation:
Psychosomatic Clinic, Windach, Germany
Walter Hauke
Affiliation:
Psychosomatic Clinic, Windach, Germany
Christoph Piesbergen
Affiliation:
Ludwig-Maximilians-Universität, Munich, Germany
*
Reprint requests to Gisela Roper, LMU-University of Munich, Department of Clinical Psychology, Leopoldstrasse 13, München 80802, Germany. E-mail: [email protected]
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Abstract

Background: Increasing attention has been given to subtyping OCD with respect to different clinical profiles, response to drug treatments, comorbidity and age of onset. There are a number of studies looking at predictors of treatment outcome in OCD, but so far not for OCD subtypes. Method: Prediction of outcome after cognitive-behavioural therapy was evaluated in 63 inpatients with early obsessive-compulsive disorder (EOCD ≤ 12 years of age) and 191 patients with late obsessive-compulsive disorder (LOCD > 15 years of age). Results: For EOCD patients factors predicting a good outcome included high motivation and high initial Y-BOCS scores. Factors associated with a bad outcome were higher age at assessment, a longer duration of psychiatric inpatient treatment before assessment and a low level of social functioning (BSS). For LOCD patients living in a stable relationship, high motivation and completing treatment predicted a favourable therapy outcome, while a low level of psychological functioning (BSS) and a longer duration of inpatient psychiatric treatment before assessment were associated with an undesirable therapy outcome. Conclusions: Subtyping OCD patients according to age of onset seems to be a promising avenue towards improving and developing more specified treatment programs.

Keywords

Obsessive-compulsive disorderpredictors for treatment outcomelate onsetearly onset
Type
Empirically Grounded Clinical Interventions
Information
Behavioural and Cognitive Psychotherapy , Volume 37 , Issue 5 , October 2009 , pp. 485 - 496
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2009

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References

Ackerman, D. L., Greenland, S., Bystritsky, A., Morgenstern, H. and Katz, J. (1994). Predictors of treatment response in obsessive-compulsive disorder: multivariate analyses from a multicenter trial of clomipramine. Journal of Psychopharmacology, 14, 247–254.Google ScholarPubMed
Arrindel, W. A., Basoglu, M., Lax, T., Emmelkamp, P. M. G., Kasvikis, Y., Sanderman, R. and Marks, I. M. (1986). Patterns and predictors of improvements in obsessive-compulsive disorders. Annals of General Psychiatry, 14, 561–571.Google Scholar
Barrett, P. M. and Healy, L. J. (2003). An examination of the cognitive processes involved in childhood obsessive-compulsive disorder. Behaviour Research and Therapy, 41, 285–289.Google Scholar
Basoglu, M., Lax, T., Kasvikis, Y. and Marks, I. M. (1988). Predictors of improvement in obsessive-compulsive disorder. Journal of Anxiety Disorders, 2, 299–317.CrossRefGoogle Scholar
Black, A. (1974). The natural history of obsessional neurosis. In Beech, H. R. (Ed.), Obsessional States (pp. 19–54). London: Methuen.Google Scholar
Beck, J. (1995). Cognitive Therapy: basics and beyond. New York: Guilford Press.Google Scholar
Brähler, E., Holling, H., Leutner, D. and Petermann, R. (2002). Brickenkamp Handbuch psychologischer und pädagogischer Tests. Göttingen: Hogrefe.Google Scholar
Brickenkamp, R. (Ed.) (1997). Handbuch psychologischer und pädagogischer Tests. Göttingen: Hogrefe.Google Scholar
Buchanan, A. W., Ko, S. M. and Marks, I. M. (1996). What predicts improvement and compliance during the behavioural treatment of obsessive-compulsive disorder? Anxiety, 2, 22–27.3.0.CO;2-F>CrossRefGoogle ScholarPubMed
Busatto, G. F., Buchpiguel, C. A., Zamignani, D. R., Garrido, G. E., Glabus, M. F. and Do Rosario-Campos, M. C. (2001). Regional cerebral abnormalities in early-onset obsessive-compulsive disorder: an exploratory SPECT study. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 347–354.CrossRefGoogle ScholarPubMed
Calamari, J. E., Wiegartz, P. S. and Janeck, A. S. (1999). Obsessive-compulsive disorder subgroups: a symptom-based clustering approach. Behaviour Research and Therapy, 37, 113–125.CrossRefGoogle ScholarPubMed
Castle, D. J., Deale, A., Marks, I. M., Cutts, F., Chadhoury, Y. and Stewart, A. (1994). Obsessive-compulsive disorder: prediction of outcome from behavioural psychotherapy. Acta Psychatrica Scandinavica, 89, 383–398.Google Scholar
De Araujo, L. A., Ito, L. M. and Marks, I. M. (1996). Early compliance and other factors predicting outcome of exposure for obsessive-compulsive disorder. British Journal of Psychiatry, 169, 747–752.Google Scholar
De Haan, E., van Oppen, P., van Balkom, A. J. L. M., Spinhoven, P., Hoogduin, K. A. L. and van Dyck, R. (1997). Prediction of outcome and early vs. late improvement in OCD patients treated with cognitive behaviour therapy and pharmacotherapy. Acta Psychiatrica Scandinavica, 96, 354–361.CrossRefGoogle ScholarPubMed
Delorme, R., Golmard, J. L., Chabane, N., Millet, B., Krebs, M. O., Mouren-Simeoni, M. C. and Leboyer, M. (2005). Admixture analysis of age at onset in obsessive-compulsive disorder. Psychological Medicine, 35, 237–243.CrossRefGoogle ScholarPubMed
Do Rosario-Campos, M. C., Leckman, J. L., Mercadante, M. T., Shavitt, R. G., Prado, H. S., Sada, P., Zamignani, D. and Miguel, E. C. (2001). Adults with early-onset obsessive-compulsive disorder. American Journal of Psychiatry, 158, 1899–1903.CrossRefGoogle Scholar
Dressen, L., Arntz, A., Luttels, C. and Sallaerts, S. (1994). Personality disorders do not influence the results of cognitive behaviour therapies for anxiety disorders. Comprehensive Psychiatry, 35, 265–274.CrossRefGoogle Scholar
Erikson, H. (1974). Dimensions of a New Identity. New York: Norton.Google Scholar
Foa, E. B., Grayson, J. B., Steketee, G. S., Doppelt, H. G., Turner, R. M. and Latimer, P. R. (1983). Success and failure in the behavioural treatment of obsessive-compulsives. Journal of Consulting and Clinical Psychology, 51, 287–297.CrossRefGoogle ScholarPubMed
Fontenelle, L. F., Mendlowicz, M. V., Marques, C. and Versiani, M. (2003). Early- and late-onset obsessive-compulsive disorder in adult patients: an exploratory clinical and therapeutic study. Journal of Psychiatric Research, 37, 127–133.Google Scholar
Geller, D. A., Biederman, J., Faraone, S., Agranat, A., Cradock, K., Hagermoser, L., Grace, K., Frazier, J. and Coffey, B. J. (2001). Developmental aspects of obsessive compulsive disorder: findings in children, adolescents, and adults. The Journal of Nervous and Mental Disease, 189, 471–477.Google Scholar
Goodman, W. K. (1992). Pharmacotherapy of OCD. In Hand, I., Goodman, W. and Evers, U. (Eds.), Zwangsstörungen. Neue Forschungsergebnisse (pp. 141–151). Berlin: Springer.Google Scholar
Goodman, W., Price, L. H., Rasmussen, S. A., Mazure, C., Fleischmann, R. N., Hill, C. L., Heninger, G. R. and Charney, D. S. (1989). The Yale-Brown Obsessive Compulsive Scale I: development, use and reliability. Archives of General Psychiatry, 46, 1006–1011.CrossRefGoogle ScholarPubMed
Hauke, W. (2002). Praxis des Reizkonfrontationstraining bei Zwangsstörungen. InZaudig, M., Hauke, W., and Hegerl, U. (Eds.), Die Zwangsstörung: Diagnostik und Therapie (pp. 125–141). Stuttgart: Schattauer.Google Scholar
Hauke, W. and Zaudig, M. (2002). Stationäre verhaltenstherapeutische Gruppentherapie bei Zwangsstörungen und das 3-Phasen-Modell. InZaudig, M., Hauke, W. and Hegerl, U. (Eds.), Die Zwangsstörung: Diagnostik und Therapie (pp. 143–157). Stuttgart: Schattauer.Google Scholar
Hemmings, S. M. J., Kinnear, C. J., Lochner, C., Neihaus, D. J. H., Knowles, J. A., Moolman-Smock, J. C., Carfield, V. A. and Stein, D. J. (2004). Early-versus late-onset obsessive-compulsive disorder: investigating genetic and clinical correlates. Psychiatry Research, 128, 175–182.CrossRefGoogle ScholarPubMed
Hermesh, H., Shahar, A. and Munitz, H. (1987). Obsessive-compulsive disorder and borderline personality disorder. American Journal of Psychiatry, 44, 120–121.Google Scholar
Hiss, H., Foa, E. B. and Kozak, M. J. (1994). Relapse prevention program for treatment of obsessive-compulsive disorder. Journal of Consulting and Clinical Psychology, 62, 801–808.Google Scholar
Jänsch, P., Zaudig, M., Röper, G., Hauke, W., Piesbergen, C. and Butollo, W. (2007). Der frühe Beginn der Zwangsstörung: Einfluss auf Symptomatik und Schweregrad. Verhaltenstherapie, 17, 37–43.CrossRefGoogle Scholar
Jaisoorya, T. S., Janardhan Reddy, Y. C. and Srinath, S. (2003). Is juvenile obsessive-compulsive disorder a developmental subtype of the disorder? European Child and Adolescent Psychiatry, 12, 290–297.Google Scholar
Kanfer, E. H., Reinecker, H. and Schmelzer, D. (2000). Selbstmanagement-Therapie (4th ed.). Berlin: Springer Verlag.CrossRefGoogle Scholar
Kegan, R. (1982). The Evolving Self. Cambridge, Mass: Harvard University Press.CrossRefGoogle Scholar
Leckman, J. F., Grice, D. E., Boardman, J., Zhang, H., Vitale, E., Bondi, C., Alsobrook, J., Peterson, B. S., Cohen, D. J., Rasmussen, S. A., Goodman, W. K., Mc Dougle, C. J. and Pauls, D. L. (1997). Symptoms of obsessive-compulsive disorder. American Journal of Psychiatry, 154, 911–917.Google ScholarPubMed
Leonard, H. L., Lenane, M. C., Rettew, D. C., Gershon, E. S. and Rapoport, J. L. (1992). Tics and tourette's disorder: a 2- to 7-year follow-up of 54 obsessive-compulsive children. American Journal of Psychiatry, 149, 1244–1251.Google ScholarPubMed
Loevinger, J. (1976). Ego Development: conceptions and theories. San Francisco: Jossey-Bass.Google Scholar
McDougle, C. J., Goodman, W. K., Leckman, J. F., Holzer, J. C., Baer, L. C., McCance-Katz, E., Heninger, G. R. and Price, L. H. (1993). Limited therapeutic effect of addition of buspirone in fluvoxamine-refractory obsessive compulsive disorder. American Journal of Psychiatry, 150, 647–649.Google ScholarPubMed
McDougle, C. J., Goodman, W. K., Leckman, J. F., Lee, N. C., Heninger, G. R. and Price, L. H. (1994). Haloperidol addition in fluvoxamine-refractory obsessive-compulsive disorder: a double-blind, placebo-controlled study in patients with and without tics. Archives of General Psychiatry, 51, 302–308.CrossRefGoogle ScholarPubMed
Miller, W. R. and Rollnick, S. (2002). Motivational Interviewing. New York: Guilford Press.Google Scholar
Millet, B., Kochman, F., Gallarda, T., Krebs, M. O., Demonfaucon, F., Barrot, I., Bourdel, M. C., Olie, J. P., Loo, H. and Hantouche, E. G. (2004). Phenomenological and comorbid features associated in obsessive-compulsive disorder: influence of age of onset. Journal of Affective Disorders, 79, 241–246.CrossRefGoogle ScholarPubMed
Minichiello, W. E., Baer, L. and Jenike, M. E. (1987). Schizotypal personality disorder: a poor prognostic indicator for behaviour therapy in the treatment of obsessive-compulsive disorder. Journal of Anxiety Disorders, 1, 273–276.CrossRefGoogle Scholar
Nestadt, G., Samuels, J., Riddle, M., Bienvenu, J., Liang, K., LaBuda, M., Walkup, J., Grados, M. and Hoehn-Saric, R. (2000). A family study of obsessive-compulsive disorder. Archives of General Psychiatry, 57, 358–363.Google Scholar
Noam, G. G. and Röper, G. (2001). Auf dem Weg zu entwicklungspsychologisch differentiellen Interventionen. InOerter, R., von Hagen, C., Röper, G. and Noam, G. G., Klinische Entwicklungs-psychologie. Weinheim: Beltz.Google Scholar
Noshirvani, H. F., Kasvikis, Y., Marks, I. M., Tsakiris, F. and Monteiro, W. O. (1991). Gender-divergent aetiological factors in obsessive-compulsive disorder. British Journal of Psychiatry, 158, 260–263.CrossRefGoogle ScholarPubMed
Pauls, D. L., Alsobrook, J. P., Goodman, W., Rasmussen, S. and Leckman, J. F. (1995). A family study of obsessive-compulsive disorder. American Journal of Psychiatry, 152, 76–84.Google ScholarPubMed
Rachman, S. (2006). Fear of Contamination: assessment and treatment. Oxford: Oxford University Press.CrossRefGoogle Scholar
Rachman, S. and Hodgson, R. J. (1980). Obsessions and Compulsions (1st ed., chapter 3). Eaglewood Cliffs, NJ: Prentice Hall.Google Scholar
Rasmussen, S. A. and Tsuang, M. T. (1987). Obsessive-compulsive disorder and borderline personality disorder. American Journal of Psychiatry, 144, 121–122.CrossRefGoogle Scholar
Ravizza, L., Barzega, G., Bellino, S., Bogetto, F. and Maina, G. (1995). Predictors of drug treatment response in obsessive-compulsive disorder. Journal of Clinical Psychiatry, 56, 368–373.Google ScholarPubMed
Reinecker, H. (1994). Zwänge. Diagnose, Theorien und Behandlung (2nd ed., chapter 6). Bern: Huber.Google Scholar
Riddle, M. (1998). Obsessive-compulsive disorder in children and adolescents. British Journal of Psychiatry, 173 (suppl. 35), 91–96.Google Scholar
Rauch, S. L., Savage, C. R., Alpert, N. M., Fischman, A. J. and Jenike, M. A. (1997). The functional neuroanatomy of anxiety: a study of three disorders using positron emission tomography and symptom provocation. Biological Psychiatry, 42, 446–452.CrossRefGoogle ScholarPubMed
Röper, G. (2001). Chronische innere Unsicherheit und ihre Bedeutung für die Entstehung der Zwangsstörung: ein klinisch-entwicklungspsychologisches Störungsmodell. In Röper, G., von-Hagen, C. and Noam, G. (Eds.), Entwicklung und Risiko. Perspektiven einer Klinischen Entwicklungs-psychologie (pp. 286–305). Stuttgart: Kohlhammer.Google Scholar
Schepank, H. (1995). Der Beeinträchtigungs-Schwere-Score (BSS). Göttingen: Beltz Test GmbH.Google Scholar
Skoog, G. and Skoog, I. (1999). A 40 year follow-up of patients with obsessive-compulsive disorder. Archives of General Psychiatry, 56, 121–127.CrossRefGoogle ScholarPubMed
Sobin, C., Blundell, M. L. and Karayiorgou, M. (2000). Phenotypic differences in early- and late-onset obsessive-compulsive disorder. Comprehensive Psychiatry, 41, 373–379.CrossRefGoogle ScholarPubMed
Steketee, G. and Shapiro, L. (1995). Predicting behavioural treatment outcome for agoraphobia and obsessive-compulsive disorder. Clinical Psychology Review, 15, 317–346.CrossRefGoogle Scholar
Steketee, G., Eisen, J., Dyck, I., Warshaw, M. and Rasmussen, S. A. (1999). Predictors of course in obsessive-compulsive disorder. Psychiatry Research, 89, 229–238.Google Scholar
Stewart, S. E., Geller, D. A., Jenike, M., Pauls, D., Shaw, D., Mullin, B. and Faraone, S. V. (2004). Long-term outcome of paediatric obsessive-compulsive disorder: a meta-analysis and qualitative review of the literature. Acta Psychiatrica Scandinavica, 110, 4–13.Google Scholar
Summerfeldt, L. J., Richter, M. A., Antony, M. M. and Swinson, R. P. (1999). Symptom structure in obsessive-compulsive disorder: a confirmatory factor-analytic study. Behaviour Research and Therapy, 37, 297–311.Google Scholar
Treadwell, K. R. H. and Tolin, D. R. (2007). Clinical challenges in the treatment of pediatric OCD. In Storch, E. A., Geffken, G. R. and Murphy, T. K.. Handbook of Child and Adolescent Obsessive-Compulsive Disorder. London: Lawrence Erlbaum.Google Scholar
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