Chun Il Park1,2, Hae Won Kim2,3, Sumoa Jeon2, Eun Hee Hwang2, Jee In Kang4,5, Se Joo Kim6,7. 1. Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea. 2. Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. 3. Department of Medical Education, Yonsei University College of Medicine, Seoul, Republic of Korea. 4. Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. jeeinkang@yuhs.ac. 5. Department of Psychiatry, Yonsei University College of Medicine, Yonsei-ro 50-1, Seodaemun-gu, Seoul, 03722, Republic of Korea. jeeinkang@yuhs.ac. 6. Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. kimsejoo@yuhs.ac. 7. Department of Psychiatry, Yonsei University College of Medicine, Yonsei-ro 50-1, Seodaemun-gu, Seoul, 03722, Republic of Korea. kimsejoo@yuhs.ac.
Abstract
RATIONALE: Metacognitions, beliefs that monitor or control thoughts and coping, are considered to be important components for development and maintenance of obsessive-compulsive disorder (OCD). OBJECTIVES: This study prospectively investigated whether metacognitive beliefs can predict early treatment response after serotonin reuptake inhibitor (SRI) initiation in patients with OCD. METHODS: Drug-naïve or medication-free patients with OCD (N = 156) were assessed for various characteristics, including metacognitions. In total, 132 patients were followed for 4 weeks, and their clinical responses to pharmacological treatment were assessed using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Early treatment response was defined as a 20% or greater reduction from the baseline Y-BOCS score at 4 weeks. Logistic and linear regression analyses were performed to identify major determinants for the early treatment outcome. RESULTS: Among participants with OCD, 53 patients (40.15%) were early responders. The logistic regression model revealed two significant predictors, age (beta = - 0.113, p < 0.001) and "positive beliefs about worry," which refers to metacognitive beliefs concerning the benefits of engaging in worry (beta = - 0.067, p = 0.001), for identifying early responders. Moreover, in the linear regression model, lower "positive beliefs about worry" was also shown as a significant predictor for the degree of better early improvement (beta = - 0.566, p = 0.001). CONCLUSIONS: These results suggest that lower metacognition of "positive beliefs about worry" predicts improvement of obsessive-compulsive symptoms seen early on in the SRI treatment, and that pathological metacognitive belief would lead to delayed response to SRI treatment in OCD.
RATIONALE: Metacognitions, beliefs that monitor or control thoughts and coping, are considered to be important components for development and maintenance of obsessive-compulsive disorder (OCD). OBJECTIVES: This study prospectively investigated whether metacognitive beliefs can predict early treatment response after serotonin reuptake inhibitor (SRI) initiation in patients with OCD. METHODS: Drug-naïve or medication-free patients with OCD (N = 156) were assessed for various characteristics, including metacognitions. In total, 132 patients were followed for 4 weeks, and their clinical responses to pharmacological treatment were assessed using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Early treatment response was defined as a 20% or greater reduction from the baseline Y-BOCS score at 4 weeks. Logistic and linear regression analyses were performed to identify major determinants for the early treatment outcome. RESULTS: Among participants with OCD, 53 patients (40.15%) were early responders. The logistic regression model revealed two significant predictors, age (beta = - 0.113, p < 0.001) and "positive beliefs about worry," which refers to metacognitive beliefs concerning the benefits of engaging in worry (beta = - 0.067, p = 0.001), for identifying early responders. Moreover, in the linear regression model, lower "positive beliefs about worry" was also shown as a significant predictor for the degree of better early improvement (beta = - 0.566, p = 0.001). CONCLUSIONS: These results suggest that lower metacognition of "positive beliefs about worry" predicts improvement of obsessive-compulsive symptoms seen early on in the SRI treatment, and that pathological metacognitive belief would lead to delayed response to SRI treatment in OCD.
Entities:
Keywords:
Early response; Metacognition; OCD; Positive beliefs about worry; Serotonin reuptake inhibitor
Authors: Inmaculada Concepción Martínez-Esparza; Ana I Rosa-Alcázar; Pablo J Olivares-Olivares; Ángel Rosa-Alcázar Journal: Int J Clin Health Psychol Date: 2022-05-25