Obsessive compulsive disorder is characterized by variable success to treatment, presenting on a bell-curve continuum.

Obsessive compulsive disorder is characterized by variable success to treatment, presenting on a bell-curve continuum.

Answer:

Twenty to 30% of patients have significant improvement, 40–50% have moderate improvement, and 20–40% remain ill or even develop worsening symptoms. Which of the following is best correlated with the most optimistic treatment outcomes?

Of all the possible answers, a patient with a co-morbid psychiatric condition is best correlated with most optimistic treatment outcomes for Obsessive Compulsive Disorder. People with a co-morbid psychiatric disorder are more likely to seek treatment and benefit from it. It could be a learning difficulty, bipolar disorder or an eating disorder; patients that suffer from these conditions are often helped by behavioral therapy. Patients that suffer from depression may be helped by SSRI’s (Selective Serotonin Reuptake Inhibitors) such as Prozac. People with anxiety disorders have little success in getting better but certain types of behavioral therapy help them get better too.

The most optimistic treatment outcomes for OCD are associated with which of the following characteristics?

It is well-accepted that obsessive compulsive disorder (OCD) treatment outcomes are variable, with significant variability between cases. Although there have been many theories proposed describing why this may be the case, most researchers tend to agree that it’s because OCD is not one disease, but instead a collection of several related disorders that fall under the umbrella term of Obsessive Compulsive Disorder. In essence, different treatment approaches work better for different people than others.

According to the most recent review of treatment outcomes in OCD, abstaining completely from performing compulsions is associated with the best treatment success.

Cognitive behavioral therapy modification of the exposure response prevention (ERP) is the most effective treatment for OCD. Studies have shown that as many as 70% of patients exhibit a remission of symptoms in up to 40 weeks after treatment. Among these 70%, exposures are usually decreased and responses prevention is sustained over time. In contrast, around 50% of patients who receive pharmacologic treatment experience a similar success rate following short term use of medication.

Many people with OCD will seek a combination of medication and psychotherapy. Treatment outcomes are best when medication is combined with cognitive-behavioral therapy, or CBT. When a person learns to identify and change their negative behavior patterns, they are able to experience lower levels of symptom severity and improved quality of life.

Treatment of obsessive-compulsive disorder (OCD) can be more effective when it includes a method of behavior therapy and is coupled with pharmacotherapy. Behavioral methods, such as treating compulsions with a competing response and strengthening the patient’s ability to resist compulsions, may be performed at home, while pharmacotherapy aims at reducing anxiety. In the current issue of Biological Psychiatry, Drs. Jeffrey Schwartz and Giuseppe Bogetti presented the findings from their meta-analysis on predictors of treatment outcomes in OCD. They found that patients with higher baseline Yale-Brown Obsessive-Compulsive Scale scores were more likely to respond to treatment than patients with lower baseline YBOCS scores. Additionally, previously treated patients did not have better treatment outcomes than newly diagnosed patients.”

If your symptoms improve, there is a positive correlation between OCD treatment and the number of sites of OCD symptoms, otherwise known as the “Y-BOCS”.

Question:

Obsessive compulsive disorder is characterized by variable success to treatment, presenting on a bell-curve continuum. Twenty to 30% of patients have significant improvement, 40–50% have moderate improvement, and 20–40% remain ill or even develop worsening symptoms. Which of the following is best correlated with the most optimistic treatment outcomes?

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