Effects of axis I and II comorbidity on behavior therapy outcome for obsessive-compulsive disorder and agoraphobia
Abstract
The impact of concurrent axis I diagnoses and axis II traits on the efficacy of a 22-session exposure-based treatment program for 43 outpatients with panic disorder and agoraphobia (PDA) and 63 with obsessive-compulsive disorder (OCD) was examined. Trained interviewers used the Structured Clinical Interview for DSM-III-R (SCID) to assess axis I diagnoses and the SCID-II to identify the number of axis II criteria met for anxious, dramatic, and odd clusters. Among axis I diagnoses, secondary major depressive disorder (MDD), dysthymia, social phobia, and generalized anxiety disorder (GAD) were present in sufficient numbers to study their effects on treatment outcome. Outcomes were assessed on self-rated target fears and functioning and on a behavioral avoidance test at post-treatment and at 6 months follow-up. Only GAD comorbidity predicted dropout, whereas MDD and all three personality cluster traits predicted post-treatment outcomes. Follow-up analyses showed significant effects of MDD and GAD, but axis II cluster criteria were not predictive.
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It was previously found that comorbid depression led to greater improvement in ACT and for CBT, depression either led to poorer outcome or had no association with outcome.
“It was previously found that comorbid depression led to greater improvement in ACT (Wolitzky-Taylor et al., 2012) and for CBT, depression either led to poorer outcome (Chambless, Tran, & Glass, 1997; Steketee, Chambless, & Tran, 2001) or had no association with outcome (Kampman, Keijsers, Hoogduin, & Hendriks, 2008; Schuurmans et al., 2009).”
From Randomized controlled trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia: Outcomes and moderators (2014) · cites this paper as Steketee, Chambless, & Tran, 2001
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- Authors
- Steketee, G., Chambless, D. L., & Tran, G. Q.
- Affiliations
- Boston University (US)
- Venue
- Comprehensive Psychiatry
- Publisher
- Elsevier BV
- Published
- 2001-01
- Volume
- 42
- Issue
- 1
- Pages
- 76-86
- ISSN
- 0010-440X (ISSN-L)
- OpenAlex
- W2051915160
- Cited by
- 161
- References
- 0
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 6 · 2022: 2 · 2021: 7 · 2020: 6 · 2019: 4 · 2018: 5 · 2017: 7 · 2016: 5 · 2015: 13 · 2014: 6 · 2013: 12 · 2012: 12
- FWCI
- 8.78
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Comprehensive Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- National Institute of Mental Health (R01MH044190)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- obsessive-compulsive disorder, agoraphobia, panic disorder, comorbidities, Axis I diagnoses, exposure therapy, major depressive disorder, generalized anxiety disorder, dysthymia, social anxiety disorder, treatment discontinuation, avoidance behavior
- MeSH terms
- Adolescent, Adult, Agoraphobia, Anxiety Disorders, Behavior Therapy, Combined Modality Therapy, Major Depressive Disorder, Desensitization, Psychologic, Female, Follow-Up Studies, Humans, Male, Middle Aged, Obsessive-Compulsive Disorder, Comorbidity, Panic Disorder, Treatment Outcome, Selective Serotonin Reuptake Inhibitors
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