title: A 2-year prospective follow-up study of the course of obsessive-compulsive disorder.
abstract: BACKGROUND
  Surprisingly little is known about the long-term course of obsessive-compulsive disorder (OCD). This prospective study presents 2-year course findings, as well as predictors of course, from the Brown Longitudinal Obsessive Compulsive Study, the first comprehensive prospective investigation of the observational course of OCD in a large clinical sample.
  
  
  METHODS
  The sample included 214 treatment-seeking adults with DSM-IV OCD at intake who identified OCD as the most problematic disorder over their lifetime. Subjects were enrolled from 2001-2004. At annual interviews, data on weekly OCD symptom status were obtained using the Longitudinal Interval Follow-Up Evaluation. Probabilities of full remission and partial remission over the first 2 years of collected data and potential predictors of remission were examined.
  
  
  RESULTS
  The probability of full remission from OCD was 0.06, and the probability of partial remission was 0.24. Of the 48 subjects whose OCD symptoms partially or fully remitted, only 1 relapsed within the first 2 years. Earlier age at onset of OCD, greater severity of symptoms at intake, older age at intake, and being male were associated with a decreased likelihood of remission. Insight, diagnostic comorbidity, and treatment were not found to be associated with the likelihood of achieving full or partial remission.
  
  
  CONCLUSIONS
  Though one-quarter of the sample had periods of subclinical OCD symptoms during the prospective period, full remission was rare, consistent with the view of OCD as a chronic and persistent illness. Age at onset, OCD symptom severity, current age, and sex emerged as potent predictors of course.
authors.affiliation: Department of Psychiatry and Human Behavior, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA. Jane_Eisen@brown.edu
authors.forename: Jane L
authors.initials: JL
authors.lastname: Eisen
authors.forename: Anthony
authors.initials: A
authors.lastname: Pinto
authors.forename: Maria C
authors.initials: MC
authors.lastname: Mancebo
authors.forename: Ingrid R
authors.initials: IR
authors.lastname: Dyck
authors.forename: Maria E
authors.initials: ME
authors.lastname: Orlando
authors.forename: Steven A
authors.initials: SA
authors.lastname: Rasmussen
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D017063:Outcome Assessment, Health Care; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012008:Recurrence; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome
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