PMID- 26717540
OWN - NLM
STAT- MEDLINE
DCOM- 20160506
LR  - 20181113
IS  - 1555-2101 (Electronic)
IS  - 0160-6689 (Print)
IS  - 0160-6689 (Linking)
VI  - 76
IP  - 12
DP  - 2015 Dec
TI  - Predicting course of illness in patients with severe obsessive-compulsive 
      disorder.
PG  - e1605-10
LID - 10.4088/JCP.14m09468 [doi]
AB  - OBJECTIVE: Few data are available to inform clinical expectations about course 
      and prognosis of severe obsessive-compulsive disorder (OCD). Such information is 
      necessary to guide clinicians and to inform criteria for invasive interventions 
      for severe and intractable OCD. This study sought to examine course and 
      prospective predictors of a chronic course in patients with severe OCD over 5 
      years. METHOD: A selected subset of adults in the Brown Longitudinal 
      Obsessive-Compulsive Study (BLOCS) was included. Adult BLOCS participants were 
      enrolled between 2001 and 2006. All participants in the current study (N = 113) 
      had DSM-IV OCD diagnosis, severe OCD symptoms at baseline, and at least 1 year of 
      follow-up data. RESULTS: Cox proportional hazard models were used to examine the 
      general pattern of course in the severe OCD sample based on Longitudinal Interval 
      Follow-Up Evaluation (LIFE) psychiatric status ratings, as well as test 
      predictors of chronically severe course. Results indicated that approximately 
      half of patients with severe OCD at baseline had illness drop to a moderate or 
      lower range of severity during 5 years of follow-up (50.4%) and that marked 
      improvement was rare after 3 years of severe illness. The only unique predictor 
      of a more chronically severe course was patient report of ever having been 
      housebound for a week or more due to OCD symptoms (P < .05). CONCLUSIONS: 
      Findings of this study were 3-fold: (1) half of participants with severe OCD have 
      symptom improvement over 5 years of follow-up, (2) the majority of participants 
      that drop out of the severe range of symptom severity do so within the first 3 
      years of follow-up, and (3) patient-reported history of being housebound for 1 
      week or more due to OCD is a significant predictor of OCD's remaining severe over 
      the 5-year follow-up.
CI  - (c) Copyright 2015 Physicians Postgraduate Press, Inc.
FAU - Garnaat, Sarah L
AU  - Garnaat SL
AD  - Butler Hospital OCD Research, 345 Blackstone Blvd, Providence, RI 02906 
      Sarah_Garnaat@brown.edu.
FAU - Boisseau, Christina L
AU  - Boisseau CL
FAU - Yip, Agustin
AU  - Yip A
FAU - Sibrava, Nicholas J
AU  - Sibrava NJ
FAU - Greenberg, Benjamin D
AU  - Greenberg BD
FAU - Mancebo, Maria C
AU  - Mancebo MC
FAU - McLaughlin, Nicole C R
AU  - McLaughlin NC
FAU - Eisen, Jane L
AU  - Eisen JL
FAU - Rasmussen, Steven A
AU  - Rasmussen SA
LA  - eng
GR  - R01 MH060218/MH/NIMH NIH HHS/United States
GR  - R01MH0602/MH/NIMH NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - J Clin Psychiatry
JT  - The Journal of clinical psychiatry
JID - 7801243
SB  - IM
MH  - Adult
MH  - Chronic Disease
MH  - Female
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Obsessive-Compulsive Disorder/*diagnosis
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - *Severity of Illness Index
MH  - Time Factors
PMC - PMC4989860
MID - NIHMS786535
COIS- None of the authors has any financial conflicts of interest to disclose.
EDAT- 2015/12/31 06:00
MHDA- 2016/05/07 06:00
PMCR- 2016/08/18
CRDT- 2015/12/31 06:00
PHST- 2014/08/25 00:00 [received]
PHST- 2015/01/09 00:00 [accepted]
PHST- 2015/12/31 06:00 [entrez]
PHST- 2015/12/31 06:00 [pubmed]
PHST- 2016/05/07 06:00 [medline]
PHST- 2016/08/18 00:00 [pmc-release]
AID - 10.4088/JCP.14m09468 [doi]
PST - ppublish
SO  - J Clin Psychiatry. 2015 Dec;76(12):e1605-10. doi: 10.4088/JCP.14m09468.