Patient preferences for obsessive-compulsive disorder treatment.
OBJECTIVE
To explore preferences for the treatment of obsessive-compulsive disorder (OCD). We hypothesized that OCD patients will select a combination of medication and psychotherapy as their most preferred choice overall.


METHODS
The authors designed a treatment-preference survey using 2 health economics methods, forced-choice and contingent-ranking methods, to elicit preferences for OCD treatment available in mainstream care (serotonin reuptake inhibitors [SRIs], exposure and response prevention [EX/RP], and their combination) and for novel treatments under development at OCD research clinics. This survey was given by telephone to 89 individuals with OCD who called the OCD research clinic at the New York State Psychiatric Institute between July 2008 and January 2009. Diagnosis of OCD was based on a telephone screening evaluation adapted from the Structured Clinical Interview for DSM-IV Axis I Disorders.


RESULTS
Most participants chose combination treatment (43%) or EX/RP (42%) over SRI medication (16%). Participants ranked investigational psychotherapy as their most-preferred novel treatment (endorsed by 48% of participants) and deep brain stimulation as their least-preferred novel treatment (endorsed by 77% of participants). Qualitative data suggest that prior treatment experience, concerns about medications, and logistical and practical concerns about treatment regimens affect preferences.


CONCLUSIONS
Patients with OCD have identifiable treatment preferences. In this sample of convenience, most preferred either combination treatment or psychotherapy. Future studies should investigate prospectively what modifies these preferences and how these preferences affect treatment outcome.
Columbia University, Department of Psychiatry, College of Physicians and Surgeons, New York State Psychiatric Institute, New York, NY 10032, USA. sp2309@columbia.edu
Sapana R
SR
Patel
Helen Blair
HB
Simpson
D000328:Adult; D001294:Attitude to Health; D003131:Combined Modality Therapy; D003625:Data Collection; D046690:Deep Brain Stimulation; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D057240:Patient Preference / Q000523:psychology; D011613:Psychotherapy; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012737:Sex Factors; D016896:Treatment Outcome
D017367:Selective Serotonin Reuptake Inhibitors