title: Change in obsessive-compulsive symptoms mediates subsequent change in depressive symptoms during exposure and response prevention.
abstract: OBJECTIVE
  The current study examines the temporal relationship between changes in obsessive-compulsive symptoms and changes in depressive symptoms during exposure and response prevention (EX/RP) therapy for obsessive-compulsive disorder (OCD).
  
  
  METHODS
  Participants were 40 adults (53% female) who received EX/RP in a randomized controlled trial comparing serotonin reuptake inhibitor (SRI) augmentation strategies. Participants completed clinician-administered assessments of OCD (Yale-Brown Obsessive Compulsive Scale) and depressive symptoms (Hamilton Depression Rating Scale) every four weeks from baseline to 32-week follow-up.
  
  
  RESULTS
  Lagged multilevel mediational analyses indicated that change in OCD symptoms accounted for 65% of subsequent change in depressive symptoms. In contrast, change in depressive symptoms only partially mediated subsequent change in OCD symptoms, accounting for 20% of the variance in outcome.
  
  
  CONCLUSIONS
  These data indicate that reductions in co-morbid depressive symptoms during EX/RP for OCD are largely driven by reductions in obsessive-compulsive symptoms.
authors.affiliation: Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: zandberg@mail.med.upenn.edu.
authors.forename: Laurie J
authors.initials: LJ
authors.lastname: Zandberg
authors.affiliation: Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Yinyin
authors.initials: Y
authors.lastname: Zang
authors.affiliation: Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Carmen P
authors.initials: CP
authors.lastname: McLean
authors.affiliation: Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Yeh
authors.affiliation: New York State Psychiatric Institute, New York, NY, USA; Department of Psychiatry, Columbia University, New York, NY, USA.
authors.forename: Helen Blair
authors.initials: HB
authors.lastname: Simpson
authors.affiliation: Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Edna B
authors.initials: EB
authors.lastname: Foa
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D003863:Depression / Q000188:drug therapy* / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D007171:Implosive Therapy / Q000379:methods*; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy / Q000517:prevention & control / Q000628:therapy*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D012720:Severity of Illness Index
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors
keywords: CBT; Depression; Exposure and response prevention; Mediation; Obsessive-compulsive disorder
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