J Korean Neuropsychiatr Assoc.  2013 Nov;52(6):409-416.

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

• Kim JS
• Park HY
• Kim SN
• Shin MS
• Ha TH
• Kwon JS

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.

Keyword

Obsessive Compulsive Disorder; Cognitive behavioral therapy; Treatment non-completion; Factors associated with the non-completion

MeSH Terms

Cognitive Therapy*
Compliance*
Diagnosis
Fibrinogen
Humans
Marital Status
Obsessive Behavior
Obsessive-Compulsive Disorder*
Fibrinogen

Figure

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  Fig. 1 Changes of CGI-S scores of completers and non-completers at baseline and end-point. CGI-S : Clinical Global Impression-Severity.

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