The brown longitudinal obsessive compulsive study: treatments received and patient impressions of improvement.
OBJECTIVE
The primary aim of this study was to assess the extent to which individuals with obsessive-compulsive disorder (OCD) received recommended doses of treatment and perceived a response to these treatments.


METHODS
Participants were 293 adults with primary OCD (DSM-IV) who were enrolled in the Brown Longitudinal Obsessive Compulsive Study, a naturalistic, prospective study of course in OCD. Data were collected at intake interviews between June 2001 and October 2004. Patient impressions of response to treatments received were assessed using the Clinical Global Impressions-Improvement Scale-patient version.


RESULTS
Of the 182 participants taking recommended doses of serotonin reuptake inhibitors (SRIs) at intake, 112 (62%) rated themselves as being very much or much improved. The remaining participants rated themselves as minimally improved, unchanged, or worse while taking recommended doses of SRIs. These participants (N = 70) reported receiving their current SRI for a mean (SD) of 2.7 (3.2) years. Twelve (29%) of the 42 participants receiving neuroleptic augmentation of SRIs reported a response. Thirty-eight percent of the sample received the recommended number of 13 sessions of cognitive-behavioral therapy (CBT) lifetime. Only 24% reported completing a continuous course of 13 weekly sessions. Eighteen (67%) of the 27 participants who received a course of CBT in the past year rated themselves as very much or much improved.


CONCLUSIONS
In this large, naturalistic study of OCD, over one third of participants receiving recommended doses of SRIs did not perceive substantial long-term benefit from pharmaco-therapy. Relatively few participants received recommended doses of CBT. Clinical implications and future directions are discussed.
Mancebo
Maria C
MC
Butler Hospital, Providence, RI 02906, USA. maria_mancebo@brown.edu
Eisen
Jane L
JL
Pinto
Anthony
A
Greenberg
Benjamin D
BD
Dyck
Ingrid R
IR
Rasmussen
Steven A
SA
D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy*; D017060:Patient Satisfaction; D011619:Psychotropic Drugs / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D011619:Psychotropic Drugs; D017367:Selective Serotonin Reuptake Inhibitors