title: Sudden gains in the treatment of obsessive-compulsive disorder.
abstract: BACKGROUND
  The present study examined sudden gains during treatment for obsessive-compulsive disorder (OCD) and their relationship to short- and long-term outcome.
  
  
  METHODS
  Ninety-one individuals (age 19-64) completed either cognitive treatment, exposure treatment, or their combination with fluvoxamine for OCD. Participants' obsessive-compulsive symptoms were assessed before each weekly treatment session. In addition, obsessive-compulsive and depressive symptoms were assessed pre treatment and post treatment as well as 12 months following treatment termination.
  
  
  RESULTS
  Sudden gains were found among 34.1% of participants and constituted 65.5% of the total reduction in obsessive-compulsive symptoms. Compared to individuals who did not experience sudden gains, individuals who experienced sudden gains reported lower levels of OCD symptoms post treatment, and this was maintained during follow-up.
  
  
  CONCLUSIONS
  Sudden gains are common in treatments for OCD and are predictive of treatment outcome and follow-up. Sudden gains mark a distinct trajectory of response to treatment for OCD. Individuals with sudden gains greatly improve during treatment and maintain their gains during follow-up, whereas individuals without sudden gains improve to a significantly lesser extent. Thus, treatment planning and development can benefit from considering sudden gains and the intra-individual course of improvement.
authors: Department of Psychology, Boston University, Boston, Mass. 02215, USA. iaderka@bu.edu
authors: Idan M
authors: IM
authors: Aderka
authors: Gideon E
authors: GE
authors: Anholt
authors: Anton J L M
authors: AJ
authors: van Balkom
authors: Johannes H
authors: JH
authors: Smit
authors: Haggai
authors: H
authors: Hermesh
authors: Patricia
authors: P
authors: van Oppen
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003863:Depression / Q000523:psychology*; D005260:Female; D016666:Fluvoxamine / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007171:Implosive Therapy; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000523:psychology / Q000628:therapy*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012044:Regression Analysis; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D013997:Time Factors; D055815:Young Adult
chemical_list: D016666:Fluvoxamine; D017367:Selective Serotonin Reuptake Inhibitors