title: Treatment of severe, treatment-refractory obsessive-compulsive disorder: a study of inpatient and community treatment.
abstract: BACKGROUND
  This research reports on a prospective outcome study of two cohorts of patients with severe, chronic, resistant obsessive-compulsive disorder (OCD).
  
  
  METHODS
  One cohort consisted of a total of 52 patients treated in an inpatient setting, while the second group comprised 65 patients treated in a community-outpatient setting. Treatment consistent primarily of intensive graded exposure and self-imposed response prevention augmented with cognitive restructuring.
  
  
  RESULTS
  The groups demonstrated significant improvement over the course of treatment. In the inpatient and community groups, there was significant improvement over the first 12 weeks of treatment, and further improvement between 12 and 24 weeks.
  
  
  CONCLUSIONS
  These results suggest that even for patients who have demonstrated treatment-resistance, there may be benefit in intensive behavioral treatment of OCD. In addition it was found that even for those patients with the most profound refractory OCD and complicating factors inpatient stays of up to 24 weeks were effective in reducing symptoms.
authors.affiliation: School of Psychology at Griffith University, Southport, Australia.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Boschen
authors.forename: Lynne M
authors.initials: LM
authors.lastname: Drummond
authors.forename: Anusha
authors.initials: A
authors.lastname: Pillay
mesh_terms: D000328:Adult; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy / Q000379:methods / Q000706:statistics & numerical data; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000523:psychology / Q000628:therapy*; D010045:Outpatients; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000592:standards / Q000706:statistics & numerical data; D012111:Residence Characteristics; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult