title: Treatment of obsessive-compulsive disorder complicated by comorbid eating disorders.
abstract: OBJECTIVE
  Eating disorders and obsessive-compulsive disorder (OCD) commonly co-occur, but there is little data for how to treat these complex cases. To address this gap, we examined the naturalistic outcome of 56 patients with both disorders, who received a multimodal treatment program designed to address both problems simultaneously.
  
  
  METHODS
  A residential treatment program developed a cognitive-behavioral approach for patients with both OCD and an eating disorder by integrating exposure and response prevention (ERP) treatment for OCD with ERP strategies targeting eating pathology. Patients also received a supervised eating plan, medication management, and social support. At admission and discharge, patients completed validated measures of OCD severity (the Yale-Brown Obsessive-Compulsive Scale--Self Report [Y-BOCS-SR]), eating disorder severity (the Eating Disorders Examination-Questionnaire), and depressive severity (the Beck Depression Inventory II [BDI-II]). Body mass index (BMI) was also measured. Paired-sample t-tests examined change on these measures.
  
  
  RESULTS
  Between 2006 and 2011, 56 individuals completed all study measures at admission and discharge. Mean length of stay was 57 days (SD = 27). Most (89%) were on psychiatric medications. Significant decreases were observed in OCD severity, eating disorder severity, and depression. Those with bulimia nervosa showed more improvement than those with anorexia nervosa. BMI significantly increased, primarily among those underweight at admission.
  
  
  CONCLUSIONS
  Simultaneous treatment of OCD and eating disorders using a multimodal approach that emphasizes ERP techniques for both OCD and eating disorders can be an effective treatment strategy for these complex cases.
authors: Department of Psychiatry, Columbia University, New York, USA. simpson@nyspi.columbia.edu
authors: H Blair
authors: HB
authors: Simpson
authors: Chad T
authors: CT
authors: Wetterneck
authors: Shawn P
authors: SP
authors: Cahill
authors: Joanna E
authors: JE
authors: Steinglass
authors: Martin E
authors: ME
authors: Franklin
authors: Rachel C
authors: RC
authors: Leonard
authors: Theodore E
authors: TE
authors: Weltzin
authors: Bradley C
authors: BC
authors: Riemann
mesh_terms: D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D015992:Body Mass Index; D052018:Bulimia Nervosa / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy / Q000379:methods / Q000523:psychology; D003863:Depression / Q000150:complications / Q000628:therapy; D005260:Female; D006801:Humans; D007171:Implosive Therapy; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D011619:Psychotropic Drugs / Q000627:therapeutic use; D012114:Residential Treatment; D012720:Severity of Illness Index
chemical_list: D011619:Psychotropic Drugs