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Long-term course and outcome of obsessive-compulsive patientsafter cognitive-behavioral therapy in combination with eitherfluvoxamine or placebo : A 7-year follow-up of a randomized double-blind trial

Rufer, M. ; Hand, I. ; Alsleben, H. ; Braatz, A. ; Ortmann, J. ; Katenkamp, B. ; Fricke, S. ; Peter, H.

In: European Archives of Psychiatry and Clinical Neuroscience, 2005, vol. 255, no. 2, p. 121-128

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    Titre
    • Long-term course and outcome of obsessive-compulsive patientsafter cognitive-behavioral therapy in combination with eitherfluvoxamine or placebo
      A 7-year follow-up of a randomized double-blind trial
    Auteur
    • Rufer, M.. University Hospital of Hamburg, Centre of Psychosocial Medicine Dept. of Psychiatry and Psychotherapy, Hamburg
    • Hand, I.. University Hospital of Hamburg, Centre of Psychosocial Medicine Dept. of Psychiatry and Psychotherapy, Hamburg
    • Alsleben, H.. University Hospital of Hamburg, Centre of Psychosocial Medicine Dept. of Psychiatry and Psychotherapy, Hamburg
    • Braatz, A.. University Hospital of Hamburg, Centre of Psychosocial Medicine Dept. of Psychiatry and Psychotherapy, Hamburg
    • Ortmann, J.. University Hospital of Hamburg, Centre of Psychosocial Medicine Dept. of Psychiatry and Psychotherapy, Hamburg
    • Katenkamp, B.. University Hospital of Hamburg, Centre of Psychosocial Medicine Dept. of Psychiatry and Psychotherapy, Hamburg
    • Fricke, S.. University Hospital of Hamburg, Centre of Psychosocial Medicine Dept. of Psychiatry and Psychotherapy, Hamburg
    • Peter, H.. University Hospital of Hamburg, Centre of Psychosocial Medicine Dept. of Psychiatry and Psychotherapy, Hamburg
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • European Archives of Psychiatry and Clinical Neuroscience, 2005, vol. 255, no. 2, p. 121-128. Steinkopff-Verlag
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:316536
    Summary
    Longitudinal studies with very long follow-up periods of patients with obsessive-compulsive disorder (OCD) who have received adequate treatment are rare. In the current study, 30 of 37 inpatients (81%) with severe OCD were followed up 6-8 years after treatment with cognitive-behavioral therapy (CBT) in combination with either fluvoxamine or placebo in a randomized design. The significant improvements (with large effectsizes) in obsessive-compulsive symptoms from pre- to post-treatment (41% reduction on the Y-BOCS) remained stable at follow-up (45 %). Responder rates, defined as ≥35% reduction on the Y-BOCS, were 67% and 60%, respectively. Depressive symptoms decreased significantly not only from pre- to post-treatment but also during follow-up. Re-hospitalization, which occurred in 11 patients (37 %), was associated with more severe depressive symptoms at pre-treatment and living without a partner. Full symptom remission at follow-up, defined as both Y-BOCS total score ≤ 7 and no longer meeting diagnostic criteria for OCD, was achieved by 8 patients (27 %). Patients without full remission at follow-up had a significantly longer history of OCD, assessed at pretreatment, compared to remitted patients. The shortterm treatment outcome had no predictive value for the long-term course. Throughout the naturalistic follow-up, nearly all patients (29 patients) received additional psychotherapy and/or medication. This might indicate that such chronic OCD patients usually need additional therapeutic support after effective inpatient treatment to maintain their improvements over long periods