TY - JOUR
T1 - Predictors of the 6-year outcome of obsessive-compulsive disorder
T2 - Findings from the Netherlands Obsessive-Compulsive Disorder Association study
AU - Tibi, Lee
AU - van Oppen, Patricia
AU - van Balkom, Anton J. LM
AU - Eikelenboom, Merijn
AU - Visser, Henny
AU - Anholt, Gideon E.
N1 - Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship and/or publication of this article: The research infrastructure needed to complete the baseline measurements was financed almost exclusively by the participating organizations: Academic department VU Medical Centre/GGZinGeest, Amsterdam, The Netherlands; Innova Research Centre, Mental Health Care Institute GGZ Centraal, Marinade Wolf Anxiety Research Centre, Ermelo, The Netherlands; Institute of Integrated Mental Health Care ‘Pro Persona’, ‘Overwaal’ Centre of Expertise for Anxiety Disorders OCD and PTSD Nijmegen, the Netherlands; Dimence, GGZ Overijssel; Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands; ‘Vincent van Gogh institute’ Mental Health Care Centre Noorden Midden-Limburg, Venray, The Netherlands; Academic Anxiety Center, PsyQ Maastricht University, Division Mental Health and Neuroscience, Maastricht, The Netherlands, except for the field work coordinator, which was financed by a research grant from ‘Stichting tot Steun VCVGZ’ (grant number 5.6.2.180505), awarded to P.v.O. and A.J.L.M.v.B. Publisher Copyright: © The Royal Australian and New Zealand College of Psychiatrists 2023.
PY - 2023/11
Y1 - 2023/11
N2 - Objective: Obsessive-compulsive disorder is characterized by a chronic course that can vary between patients. The knowledge on the naturalistic long-term outcome of obsessive-compulsive disorder and its predictors is surprisingly limited. The present research was designed to identify clinical and psychosocial predictors of the long-term outcome of obsessive-compulsive disorder. Methods: We included 377 individuals with a current diagnosis of obsessive-compulsive disorder, who participated in the Netherlands Obsessive Compulsive Disorder Association study, a multicenter naturalistic cohort study. Predictors were measured at baseline using self-report questionnaires and clinical interviews. Outcome was assessed using the Yale-Brown Obsessive Compulsive Scale at 2-, 4- and 6-year follow-up. Results: The overall course of obsessive-compulsive disorder was characterized by two prominent trends: the first reflected an improvement in symptom severity, which was mitigated by the second, worsening trend in the long term. Several determinants affected the course variations of obsessive-compulsive disorder, namely, increased baseline symptom severity, late age of onset, history of childhood trauma and autism traits. Conclusion: The long-term outcome of obsessive-compulsive disorder in naturalistic settings was characterized by an overall improvement in symptom severity, which was gradually halted to the point of increased worsening. However, after 6 years, the severity of symptoms remained below the baseline level. While certain determinants predicted a more favorable course, their effect diminished over time in correspondence to the general worsening trend. The results highlight the importance of a regular and continuous monitoring for symptom exacerbations as part of the management of the obsessive-compulsive disorder, regardless of the presence of putative predictors.
AB - Objective: Obsessive-compulsive disorder is characterized by a chronic course that can vary between patients. The knowledge on the naturalistic long-term outcome of obsessive-compulsive disorder and its predictors is surprisingly limited. The present research was designed to identify clinical and psychosocial predictors of the long-term outcome of obsessive-compulsive disorder. Methods: We included 377 individuals with a current diagnosis of obsessive-compulsive disorder, who participated in the Netherlands Obsessive Compulsive Disorder Association study, a multicenter naturalistic cohort study. Predictors were measured at baseline using self-report questionnaires and clinical interviews. Outcome was assessed using the Yale-Brown Obsessive Compulsive Scale at 2-, 4- and 6-year follow-up. Results: The overall course of obsessive-compulsive disorder was characterized by two prominent trends: the first reflected an improvement in symptom severity, which was mitigated by the second, worsening trend in the long term. Several determinants affected the course variations of obsessive-compulsive disorder, namely, increased baseline symptom severity, late age of onset, history of childhood trauma and autism traits. Conclusion: The long-term outcome of obsessive-compulsive disorder in naturalistic settings was characterized by an overall improvement in symptom severity, which was gradually halted to the point of increased worsening. However, after 6 years, the severity of symptoms remained below the baseline level. While certain determinants predicted a more favorable course, their effect diminished over time in correspondence to the general worsening trend. The results highlight the importance of a regular and continuous monitoring for symptom exacerbations as part of the management of the obsessive-compulsive disorder, regardless of the presence of putative predictors.
KW - Longitudinal
KW - obsessive-compulsive disorder
KW - predictors
KW - prognosis
UR - http://www.scopus.com/inward/record.url?scp=85159374307&partnerID=8YFLogxK
U2 - https://doi.org/10.1177/00048674231173342
DO - https://doi.org/10.1177/00048674231173342
M3 - Article
C2 - 37183408
SN - 0004-8674
VL - 57
SP - 1443
EP - 1452
JO - Australian and New Zealand journal of psychiatry
JF - Australian and New Zealand journal of psychiatry
IS - 11
ER -