title: Treatment of obsessive-compulsive disorder: personal follow-up of a 10-year material from an outpatient county clinic.
abstract: Individuals who suffer from obsessive-compulsive disorder (OCD) experience obsessive thoughts and/or urges to engage in compulsive behaviours. The condition causes severe discomfort and, in many cases, leads to serious impairment in social and work-related functioning. During the past decade, the Department of Psychiatry at Førde Central Hospital has systematically offered a combination of exposure with response prevention and antidepressant medication to these patients. In this paper, we describe our treatment model, including two case histories, and evaluate the outcome of the first 25 patients, who were included in this prospective study. They were evaluated at the onset, at the end of treatment and at follow-up, 1-10 years after treatment cessation. We employed the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Obsessive-Compulsive Checklist (OCC) and Beck Depression Inventory (BDI). The mean scores for obsessions, compulsions and depression were significantly reduced after treatment. Further improvement occurred during the follow-up period. Effect sizes were above 1.3 on all instruments. Eleven participants were gainfully employed prior to treatment, 14 at the end of treatment and 18 at follow-up. The study included few participants, and rates of improvement were not compared with a control group. We therefore cannot conclude that the positive changes were caused by the treatment, but lasting spontaneous remission among patients suffering from OCD is rare. The study shows that a county outpatient psychiatric unit can utilize methods that have previously been shown to be effective in highly specialized treatment facilities, with good results.
authors.affiliation: Department of Psychiatry, Helse Førde, Førde, Norway. thorbjorn.olsen@helse-forde.no
authors.forename: Thorbjørn
authors.initials: T
authors.lastname: Olsen
authors.forename: Alice Houston
authors.initials: AH
authors.lastname: Mais
authors.forename: Truls
authors.initials: T
authors.lastname: Bilet
authors.forename: Egil W
authors.initials: EW
authors.lastname: Martinsen
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D003156:Community Mental Health Services; D003710:Demography; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D010353:Patient Education as Topic; D010775:Photic Stimulation; D011379:Prognosis; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014743:Videotape Recording
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors