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Five-Year Course of Obsessive-Compulsive Disorder: Predictors of Remission and Relapse [CME]
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Article Abstract Background: Obsessive-compulsive disorder (OCD) is a heterogeneous and disabling condition; however, no studies have examined symptom categories or subtypes as predictors of long-term clinical course in adults with primary OCD. Method: A total of 213 adults with DSM-IV OCD were recruited from several mental health treatment sites between July 2001 and February 2006 as part of the Brown Longitudinal Obsessive Compulsive Study, a prospective, naturalistic study of treatment-seeking adults with primary OCD. OCD symptoms were assessed annually over the 5-year follow-up period using the Longitudinal Interval Follow-Up Evaluation. Results: Thirty-nine percent of participants experienced either a partial (22.1%) or a full (16.9%) remission. Two OCD symptom dimensions impacted remission. Participants with primary obsessions regarding overresponsibility for harm were nearly twice as likely to experience a remission (P < .05), whereas only 2 of 21 participants (9.5%) with primary hoarding achieved remission. Other predictors of increased remission were lower OCD severity (P < .0001) and shorter duration of illness (P < .0001). Fifty-nine percent of participants who remitted subsequently relapsed. Participants with obsessive-compulsive personality disorder were more than twice as likely to relapse (P < .005). Participants were also particularly vulnerable to relapse if they experienced partial remission versus full remission (70% vs 45%; P < .05). Conclusions: The contributions of OCD symptom categories and comorbid obsessive-compulsive personality disorder are critically important to advancing our understanding of the prognosis and ultimately the successful treatment of OCD. Longer duration of illness was also found to be a significant predictor of course, highlighting the critical importance of early detection and treatment of OCD. Furthermore, having full remission as a treatment target is an important consideration for the prevention of relapse in this disorder. J Clin Psychiatry 2013;74(3):233-239 © Copyright 2013 Physicians Postgraduate Press, Inc. Submitted: January 17, 2012; accepted October 4, 2012 (doi:10.4088/JCP.12m07657). Corresponding author: Jane L. Eisen, MD, Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Butler Hospital, 345 Blackstone Blvd, Providence, RI 02906 (jane_eisen@brown.edu).
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Metadata
- Authors
- Eisen, J. L., Sibrava, N. J., Boisseau, C. L., Mancebo, M. C., Stout, R. L., Pinto, A., & Rasmussen, S. A.
- Affiliations
- Brown University (US)
- Corresponding author
- Eisen, Jane L.
- ORCID
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2013-03-15
- Volume
- 74
- Issue
- 03
- Pages
- 233-239
- ISSN
- 0160-6689 (ISSN-L)
- PMC
- PMC3899346
- OpenAlex
- W2157527535
- Cited by
- 248
- References
- 52
- Citations by year
- 2026: 27 · 2025: 25 · 2024: 17 · 2023: 14 · 2022: 21 · 2021: 24 · 2020: 21 · 2019: 23 · 2018: 21 · 2017: 11 · 2016: 15 · 2015: 14 · 2014: 9 · 2013: 6
- FWCI
- 16.32
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH060218, K23MH080221, K23MH091032)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- obsessive-compulsive disorder, long-term clinical course, remission, relapse, obsessive-compulsive personality disorder, hoarding, symptom subtypes, disease duration, disease severity, prognosis, treatment-seeking patients, early detection and treatment, relapse prevention, DSM-IV
- MeSH terms
- Adult, Behavioral Symptoms, Compulsive Behavior, Compulsive Personality Disorder, Female, Humans, Longitudinal Studies, Male, Middle Aged, Obsessive-Compulsive Disorder, Prognosis, Psychiatric Status Rating Scales, Remission Induction, Risk Factors, Time Factors, Comorbidity, Outcome Assessment, Health Care, Diagnostic and Statistical Manual of Mental Disorders, Secondary Prevention
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