Five-year course of obsessive-compulsive disorder: Predictors of remission and relapse

Jane L. Eisen, Nicholas J. Sibrava, Christina L. Boisseau, Maria C. Mancebo, Robert L. Stout, Anthony Pinto, Steven A. Rasmussen

Research output: Contribution to journalArticle

Abstract

Background: Obsessive-compulsive disorder (OCD) is a heterogeneous and disabling condition; however, no studies have examined symptom categories or subtypes as predictors of long-term clinical course in adults with primary OCD. Method: A total of 213 adults with DSM-IV OCD were recruited from several mental health treatment sites between July 2001 and February 2006 as part of the Brown Longitudinal Obsessive Compulsive Study, a prospective, naturalistic study of treatment-seeking adults with primary OCD. OCD symptoms were assessed annually over the 5-year follow-up period using the Longitudinal Interval Follow-Up Evaluation. Results: Thirty-nine percent of participants experienced either a partial (22.1%) or a full (16.9%) remission. Two OCD symptom dimensions impacted remission. Participants with primary obsessions regarding overresponsibility for harm were nearly twice as likely to experience a remission (P < .05), whereas only 2 of 21 participants (9.5%) with primary hoarding achieved remission. Other predictors of increased remission were lower OCD severity (P < .0001) and shorter duration of illness (P < .0001). Fifty-nine percent of participants who remitted subsequently relapsed. Participants with obsessivecompulsive personality disorder were more than twice as likely to relapse (P < .005). Participants were also particularly vulnerable to relapse if they experienced partial remission versus full remission (70% vs 45%; P < .05). Conclusions: The contributions of OCD symptom categories and comorbid obsessive-compulsive personality disorder are critically important to advancing our understanding of the prognosis and ultimately the successful treatment of OCD. Longer duration of illness was also found to be a significant predictor of course, highlighting the critical importance of early detection and treatment of OCD. Furthermore, having full remission as a treatment target is an important consideration for the prevention of relapse in this disorder.

Original languageEnglish (US)
Pages (from-to)233-239
Number of pages7
JournalJournal of Clinical Psychiatry
Volume74
Issue number3
DOIs
StatePublished - Mar 2013
Externally publishedYes

ASJC Scopus subject areas

  • Psychiatry and Mental health

Fingerprint Dive into the research topics of 'Five-year course of obsessive-compulsive disorder: Predictors of remission and relapse'. Together they form a unique fingerprint.

  • Cite this

    Eisen, J. L., Sibrava, N. J., Boisseau, C. L., Mancebo, M. C., Stout, R. L., Pinto, A., & Rasmussen, S. A. (2013). Five-year course of obsessive-compulsive disorder: Predictors of remission and relapse. Journal of Clinical Psychiatry, 74(3), 233-239. https://doi.org/10.4088/JCP.12m07657