BACKGROUND: The present study examined sudden gains during treatment for obsessive-compulsive disorder (OCD) and their relationship to short- and long-term outcome. METHODS:Ninety-one individuals (age 19-64) completed eithercognitive treatment, exposure treatment, or their combination with fluvoxamine for OCD. Participants' obsessive-compulsive symptoms were assessed before each weekly treatment session. In addition, obsessive-compulsive and depressive symptoms were assessed pre treatment and post treatment as well as 12 months following treatment termination. RESULTS:Sudden gains were found among 34.1% of participants and constituted 65.5% of the total reduction in obsessive-compulsive symptoms. Compared to individuals who did not experience sudden gains, individuals who experienced sudden gains reported lower levels of OCD symptoms post treatment, and this was maintained during follow-up. CONCLUSIONS:Sudden gains are common in treatments for OCD and are predictive of treatment outcome and follow-up. Sudden gains mark a distinct trajectory of response to treatment for OCD. Individuals with sudden gains greatly improve during treatment and maintain their gains during follow-up, whereas individuals without sudden gains improve to a significantly lesser extent. Thus, treatment planning and development can benefit from considering sudden gains and the intra-individual course of improvement.
RCT Entities:
BACKGROUND: The present study examined sudden gains during treatment for obsessive-compulsive disorder (OCD) and their relationship to short- and long-term outcome. METHODS: Ninety-one individuals (age 19-64) completed either cognitive treatment, exposure treatment, or their combination with fluvoxamine for OCD. Participants' obsessive-compulsive symptoms were assessed before each weekly treatment session. In addition, obsessive-compulsive and depressive symptoms were assessed pre treatment and post treatment as well as 12 months following treatment termination. RESULTS:Sudden gains were found among 34.1% of participants and constituted 65.5% of the total reduction in obsessive-compulsive symptoms. Compared to individuals who did not experience sudden gains, individuals who experienced sudden gains reported lower levels of OCD symptoms post treatment, and this was maintained during follow-up. CONCLUSIONS:Sudden gains are common in treatments for OCD and are predictive of treatment outcome and follow-up. Sudden gains mark a distinct trajectory of response to treatment for OCD. Individuals with sudden gains greatly improve during treatment and maintain their gains during follow-up, whereas individuals without sudden gains improve to a significantly lesser extent. Thus, treatment planning and development can benefit from considering sudden gains and the intra-individual course of improvement.
Authors: Rachel M Butler; Emily B O'Day; Simona C Kaplan; Michaela B Swee; Arielle Horenstein; Amanda S Morrison; Philippe R Goldin; James J Gross; Richard G Heimberg Journal: Behav Res Ther Date: 2019-08-09
Authors: Erik Hedman; Mats Lekander; Brjánn Ljótsson; Nils Lindefors; Christian Rück; Stefan G Hofmann; Erik Andersson; Gerhard Andersson; Stefan M Schulz Journal: Behav Res Ther Date: 2014-01-11
Authors: Linsey M Utzinger; Andrea B Goldschmidt; Ross D Crosby; Carol B Peterson; Stephen A Wonderlich Journal: Int J Eat Disord Date: 2015-08-31 Impact factor: 4.861