title: Maintenance treatment for obsessive-compulsive disorder: findings from a naturalistic setting.
abstract: BACKGROUND
  Although the utility of medication in the acute treatment of adult obsessive-compulsive disorder (OCD) is well-established, the role of maintenance therapy is not as well-studied. This study examines the efficacy of long-term treatment for, and predictors of, stability in medicated patients with adult OCD.
  
  
  METHODS
  Using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), we retrospectively evaluated 84 OCD patients who responded to a 10- to 12-week, open-label, acute treatment in a naturalistic clinic setting. Patients were followed based on their medication response for 1 to 92 months (mean 34.3), or until they terminated therapy. We evaluated Y-BOCS scores every 6 months or sooner, if clinically indicated.
  
  
  RESULTS
  Of the 84 patients, 39 (46.4%) responded, having relapsed within a 5-year period. Predictors of longer duration of stability were adjunctive cognitive-behavioral therapy (CBT), lack of comorbid disorders, lower Y-BOCS score after treatment, and larger decrease in Y-BOCS score during treatment phase.
  
  
  CONCLUSIONS
  Our results show the importance of maintenance treatment of OCD, noting the benefits of long-term response to adjunctive CBT and of achieving maximal acute response. It is becoming crucial to develop larger maintenance studies with more uniform design to better assess the natural course of treated OCD and improve treatment strategies.
authors.affiliation: New York Medical College, Richmond University Medical Center and Freedom From Fear, Staten Island, NY, USA. E-mail: waguih.ishak@cshs.org.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Peselow
authors.forename: Demetria R
authors.initials: DR
authors.lastname: Pizano
authors.forename: Waguih William
authors.initials: WW
authors.lastname: IsHak
mesh_terms: D015928:Cognitive Behavioral Therapy; D006801:Humans; D009771:Obsessive-Compulsive Disorder / Q000628:therapy*; D064792:Pragmatic Clinical Trials as Topic; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D016896:Treatment Outcome