Factors Associated with the Compliance of Cognitive Behavioral Therapy for Obsessive Compulsive Disorder / 신경정신의학

ABSTRACT

OBJECTIVES: Non-completion rate of cognitive behavioral therapy (CBT) for Obsessive Compulsive Disorder (OCD) was reported to be higher than expected and it could interfere with the effectiveness of treatment. The aim of this study was to investigate predictors of treatment non-completion and to compare the effectiveness of CBT for OCD between completers and non-completers. METHODS: We studied 107 patients with a principal diagnosis of OCD who initiated a 13-week CBT for OCD from June 2004 to June 2011. Demographic and clinical characteristics, psychiatric co-morbidity, and medication of 20 participants who did not complete therapy were compared with those of treatment completers (n=87). Clinical Global Impression scores were also compared between the two groups in order to evaluate the effect of CBT for OCD at the 13th week. RESULTS: The results showed a difference in marital status between treatment completers and non-completers more non-completers were not married (p=0.04). Patients with aggressive obsessions at baseline showed a trend (p=0.06) toward lower treatment completion than those with only non-aggressive obsession. In addition, the non-completer group showed a trend of not being medicated (p=0.08). No other differences were observed between completers and non-completers. The 13th week Clinical Global Impression-Improvement scores were significantly different ; completers (2.5+/-0.8) and non-completers (3.2+/-0.8) (p<0.001). CONCLUSION: In this study, we confirmed that CBT could affect symptom improvement of OCD and treatment non-completion interfered with effectiveness of CBT. However, in the current state of our knowledge, no factor is clinically applicable as a predictor of treatment non-completion. Therefore, these results suggest that clinicians should monitor compliance during CBT for OCD patients.