Predictors of course in obsessive-compulsive disorder: logistic regression versus Cox regression for recurrent events.
OBJECTIVE
Two methods for predicting remissions in obsessive-compulsive disorder (OCD) treatment are evaluated. Y-BOCS measurements of 88 patients with a primary OCD (DSM-III-R) diagnosis were performed over a 16-week treatment period, and during three follow-ups.


METHODS
Remission at any measurement was defined as a Y-BOCS score lower than thirteen combined with a reduction of seven points when compared with baseline. Logistic regression models were compared with a Cox regression for recurrent events model.


RESULTS
Logistic regression yielded different models at different evaluation times. The recurrent events model remained stable when fewer measurements were used. Higher baseline levels of neuroticism and more severe OCD symptoms were associated with a lower chance of remission, early age of onset and more depressive symptoms with a higher chance.


CONCLUSIONS
Choice of outcome time affects logistic regression prediction models. Recurrent events analysis uses all information on remissions and relapses. Short- and long-term predictors for OCD remission show overlap.
Kempe
P T
PT
Department of Psychiatry and Institute for Research in Extramural Medicine, VU University Medical Center, GGZ Buitenamstel, The Netherlands.
van Oppen
P
P
de Haan
E
E
Twisk
J W R
JW
Sluis
A
A
Smit
J H
JH
van Dyck
R
R
van Balkom
A J L M
AJ
D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D001521:Behavior Therapy; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003863:Depression / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D003887:Desensitization, Psychologic; D016666:Fluvoxamine / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D009497:Neurotic Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data*; D010555:Personality Inventory / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D011594:Psychometrics; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence
D014151:Anti-Anxiety Agents; D016666:Fluvoxamine