title: The effect of treatment on quality of life and functioning in OCD.
abstract: Given that obsessive compulsive disorder (OCD) is associated with impaired quality of life (QoL) and functioning, it is important examine whether therapeutic recovery from OCD leads to improvements on these important secondary outcomes. Only a few studies have examined how measures of OCD symptom severity relate to QoL and functioning among patients receiving treatment for OCD.
  
  
  
  OCD severity was measured with the Obsessive-Compulsive Inventory-Revised (OCI-R), a self-report scale of OCD, and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), an interview measure of OCD. Participants were 100 adults with a primary diagnosis of OCD on serotonin reuptake inhibitors (SRIs) enrolled in a randomized clinical trial comparing SRI augmentation with either exposure and response prevention (EX/RP) therapy, risperidone, or pill placebo. At baseline, mid-treatment, and post-treatment, patients completed assessments for OCD symptoms and QoL/functioning measures. Multilevel modeling was used to assess changes in QoL/functioning over the course of treatment and to compare such changes across treatment conditions.
  
  
  
  Improvements in QoL/functioning were significantly greater among those receiving EX/RP compared to those receiving risperidone. Compared to pill placebo, EX/RP performed better on measures of functioning but not QoL. Greater improvement in individual OCI-R scores was associated with greater improvements in QoL/functioning, regardless of condition. In addition, Y-BOCS scores appeared to moderate improvements in QoL over the course of all treatment conditions, such that those with higher Y-BOCS scores showed the greatest improvements in QoL over time.
  
  
  
  Improvements in QoL/functioning were associated with reduction in OCD symptom severity. The implications on OCD treatment and clinical research are discussed.
authors.affiliation: University of Pennsylvania, Philadelphia, PA. Electronic address: aasnaani@mail.med.upenn.edu.
authors.forename: Anu
authors.initials: A
authors.lastname: Asnaani
authors.affiliation: University of Pennsylvania, Philadelphia, PA.
authors.forename: Antonia N
authors.initials: AN
authors.lastname: Kaczkurkin
authors.affiliation: University of Pennsylvania, Philadelphia, PA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Alpert
authors.affiliation: University of Pennsylvania, Philadelphia, PA.
authors.forename: Carmen P
authors.initials: CP
authors.lastname: McLean
authors.affiliation: Columbia University, New York, NY; New York State Psychiatric Institute, New York, NY.
authors.forename: H Blair
authors.initials: HB
authors.lastname: Simpson
authors.affiliation: University of Pennsylvania, Philadelphia, PA.
authors.forename: Edna B
authors.initials: EB
authors.lastname: Foa
mesh_terms: D000328:Adult; D017281:Cost of Illness; D005260:Female; D006801:Humans; D007171:Implosive Therapy; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D018967:Risperidone / Q000627:therapeutic use; D057566:Self Report; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D018967:Risperidone; D017367:Selective Serotonin Reuptake Inhibitors