OBJECTIVE: To identify neuropsychological predictors of treatment response to cognitive-behavioral therapy (CBT) and fluoxetine in treatment-naïve adults with obsessive-compulsive disorder (OCD). METHOD: Thirty-eight adult outpatients with OCD underwent neuropsychological assessment, including tasks of intellectual function, executive functioning and visual and verbal memory, before randomization to a 12-week clinical trial of eitherCBT or fluoxetine. Neuropsychological measures were used to identify predictors of treatment response in OCD. RESULTS: Neuropsychological measures that predicted a better treatment response to either CBT or fluoxetine were higher verbal IQ (Wechsler Abbreviated Scale of Intelligence) (p=0.008); higher verbal memory on the California Verbal Learning Test (p=0.710); shorter time to complete part D (Dots) (p<0.001), longer time to complete part W (Words) (p=0.025) and less errors on part C (Colors) (p<0.001) in the Victoria Stroop Test (VST). Fewer perseverations on the California Verbal Learning Test, a measure of mental flexibility, predicted better response to CBT, but worse response to fluoxetine (p=0.002). CONCLUSION: In general, OCD patients with better cognitive and executive abilities at baseline were more prone to respond to either CBT or fluoxetine. Our finding that neuropsychological measures of mental flexibility predicted response to treatment in opposite directions for CBT and fluoxetine suggests that OCD patients with different neuropsychological profiles may respond preferentially to one type of treatment versus the other. Further studies with larger samples of OCD patients are necessary to investigate the heuristic value of such findings in a clinical context.
RCT Entities:
OBJECTIVE: To identify neuropsychological predictors of treatment response to cognitive-behavioral therapy (CBT) and fluoxetine in treatment-naïve adults with obsessive-compulsive disorder (OCD). METHOD: Thirty-eight adult outpatients with OCD underwent neuropsychological assessment, including tasks of intellectual function, executive functioning and visual and verbal memory, before randomization to a 12-week clinical trial of either CBT or fluoxetine. Neuropsychological measures were used to identify predictors of treatment response in OCD. RESULTS: Neuropsychological measures that predicted a better treatment response to either CBT or fluoxetine were higher verbal IQ (Wechsler Abbreviated Scale of Intelligence) (p=0.008); higher verbal memory on the California Verbal Learning Test (p=0.710); shorter time to complete part D (Dots) (p<0.001), longer time to complete part W (Words) (p=0.025) and less errors on part C (Colors) (p<0.001) in the Victoria Stroop Test (VST). Fewer perseverations on the California Verbal Learning Test, a measure of mental flexibility, predicted better response to CBT, but worse response to fluoxetine (p=0.002). CONCLUSION: In general, OCDpatients with better cognitive and executive abilities at baseline were more prone to respond to either CBT or fluoxetine. Our finding that neuropsychological measures of mental flexibility predicted response to treatment in opposite directions for CBT and fluoxetine suggests that OCDpatients with different neuropsychological profiles may respond preferentially to one type of treatment versus the other. Further studies with larger samples of OCDpatients are necessary to investigate the heuristic value of such findings in a clinical context.
Authors: Michael W Otto; M Alexandra Kredlow; Jasper A J Smits; Stefan G Hofmann; David F Tolin; Rianne A de Kleine; Agnes van Minnen; A Eden Evins; Mark H Pollack Journal: Biol Psychiatry Date: 2015-09-25 Impact factor: 13.382
Authors: Nora Bunford; Autumn Kujawa; Kate D Fitzgerald; James E Swain; Gregory L Hanna; Elizabeth Koschmann; David Simpson; Sucheta Connolly; Christopher S Monk; K Luan Phan Journal: J Abnorm Child Psychol Date: 2017-02
Authors: Philip Lindner; Per Carlbring; Erik Flodman; Amanda Hebert; Stephanie Poysti; Filip Hagkvist; Robert Johansson; Vendela Zetterqvist Westin; Thomas Berger; Gerhard Andersson Journal: PeerJ Date: 2016-04-18 Impact factor: 2.984