Sapana R Patel1, Hanga Galfavy1, Marcia B Kimeldorf1, Lisa B Dixon1, Helen Blair Simpson1. 1. Dr. Patel, Dr. Dixon, and Dr. Simpson are with the Department of Psychiatry and Dr. Galfavy is with the Department of Biostatistics, all at Columbia University, New York City (e-mail: sp2309@columbia.edu ). Dr. Patel, Dr. Dixon, and Dr. Simpson are also with the New York State Psychiatric Institute, New York City. Dr. Kimeldorf is with the Department of Psychiatry, Harlem Hospital Center, New York City.
Abstract
OBJECTIVE: This study examined preferences for and acceptability of treatments for obsessive-compulsive disorder (OCD). METHODS: Through an online survey, adults who self-reported OCD chose their preferred evidence-based treatments, rated acceptability of novel treatments, and answered open-ended questions about their preferences. Analyses examined associations between demographic, clinical, and treatment variables and first-line and augmentation treatment preferences. Latent class analysis (LCA) explored whether distinct profiles among participants predicted preferences. Data from open-ended questions were analyzed by using qualitative methods. RESULTS: Among 216 adults with at least moderate OCD symptoms, first-line preferences for exposure and response prevention (EX/RP) and serotonin reuptake inhibitor (SRI) medications were similar (55% and 45%). However, EX/RP was significantly preferred over antipsychotic medication as an augmentation treatment for SRIs (68% and 31%; p<.001). Regarding first-line preferences, no factors were associated with EX/RP preference, but participants who preferred SRIs were currently receiving OCD treatment (p=.011) or taking SRIs (p<.001) and reported a positive treatment experience overall (p=.043) and with medications (p<.001). Participants who preferred EX/RP as augmentation treatment were younger (p<.001) and female (p=.021) and taking benzodiazepines (p=.050). LCA analyses generated two distinct profiles, one of which preferred SRIs: those with a history of OCD diagnosis and treatment, higher income, and private insurance (p=.001). For novel treatments, acceptance and commitment therapy was the most acceptable and deep brain stimulation the least. CONCLUSIONS: Preferences for OCD treatments varied by individual characteristics. Future research should examine whether incorporating preferences into treatment planning has an impact on clinical care.
OBJECTIVE: This study examined preferences for and acceptability of treatments for obsessive-compulsive disorder (OCD). METHODS: Through an online survey, adults who self-reported OCD chose their preferred evidence-based treatments, rated acceptability of novel treatments, and answered open-ended questions about their preferences. Analyses examined associations between demographic, clinical, and treatment variables and first-line and augmentation treatment preferences. Latent class analysis (LCA) explored whether distinct profiles among participants predicted preferences. Data from open-ended questions were analyzed by using qualitative methods. RESULTS: Among 216 adults with at least moderate OCD symptoms, first-line preferences for exposure and response prevention (EX/RP) and serotonin reuptake inhibitor (SRI) medications were similar (55% and 45%). However, EX/RP was significantly preferred over antipsychotic medication as an augmentation treatment for SRIs (68% and 31%; p<.001). Regarding first-line preferences, no factors were associated with EX/RP preference, but participants who preferred SRIs were currently receiving OCD treatment (p=.011) or taking SRIs (p<.001) and reported a positive treatment experience overall (p=.043) and with medications (p<.001). Participants who preferred EX/RP as augmentation treatment were younger (p<.001) and female (p=.021) and taking benzodiazepines (p=.050). LCA analyses generated two distinct profiles, one of which preferred SRIs: those with a history of OCD diagnosis and treatment, higher income, and private insurance (p=.001). For novel treatments, acceptance and commitment therapy was the most acceptable and deep brain stimulation the least. CONCLUSIONS: Preferences for OCD treatments varied by individual characteristics. Future research should examine whether incorporating preferences into treatment planning has an impact on clinical care.
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Authors: Sapana R Patel; Michael G Wheaton; Erik Andersson; Christian Rück; Andrew B Schmidt; Christopher N La Lima; Hanga Galfavy; Olivia Pascucci; Robert W Myers; Lisa B Dixon; Helen Blair Simpson Journal: Behav Ther Date: 2017-09-15
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