Comorbid posttraumatic stress disorder: impact on treatment outcome for obsessive-compulsive disorder.
OBJECTIVE
The study tested the effect of comorbid posttraumatic stress disorder (PTSD) on behavior therapy outcome for obsessive-compulsive disorder (OCD).


METHODS
Subjects were 15 patients with treatment-refractory OCD who were admitted consecutively to a short-term residential facility. Eight met DSM-IV criteria for comorbid PTSD. Patients participated in coached and self-directed behavior treatments of exposure and response prevention as well as in group treatments targeting specific OCD symptoms and related difficulties. Severity of OCD and depression were assessed at admission and exit.


RESULTS
Patients with comorbid PTSD showed no significant improvements in OCD and depression symptoms. OCD and depression symptoms improved significantly more in patients without comorbid PTSD than in patients with comorbid PTSD.


CONCLUSIONS
Behavioral treatment (with or without medication) of OCD may be adversely affected by the presence of comorbid PTSD.
Gershuny
Beth S
BS
OCD Clinic and Research Unit, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, 02129, USA. gershuny@psych.mgh.harvard.edu
Baer
Lee
L
Jenike
Michael A
MA
Minichiello
William E
WE
Wilhelm
Sabine
S
D000328:Adult; D000368:Aged; D001521:Behavior Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D015897:Comorbidity; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D016896:Treatment Outcome
D011619:Psychotropic Drugs