Objective: Comorbid severe depressive symptomatology can predict negative treatment outcome for OCD. Dysfunctional beliefs could moderate this relationship, improving the understanding of mechanisms responsible for this poorer response. The aim of the current study was: a) to investigate differences in dysfunctional belief severity between inpatients with severe, refractory OCD with or without comorbid severe depressive symptoms; b) to evaluate whether a residential behavioural treatment could attenuate the negative influence of severe depressive symptoms on outcome of resistant OCD. Method: Participants included 38 inpatients (mean age= 35.40, SD= 10.75) with a primary refractory OCD (Y-BOCS mean= 28.40, SD= 6.90), of which 17 (44.73%) had comorbid severe depressive symptoms (BDI-II> 30). Yale-Brown Obsessive Compulsive Scale, Obsessive Belief Questionnaire-87 and Beck Depression Inventory-II were administered at pre- and post-treatment. A residential behavioural treatment with daily and prolonged exposure and response prevention was delivered in combination with medications for 5 weeks. Results: Inpatients with comorbid severe depressive symptoms had significantly higher OCD symptoms severity [F(1, 36)= 12.80, p<.05], Intolerance for uncertainty [F(1, 36)= 8.41, p<.05] and Overestimation of threat [F(1, 36)= 5.99, p<.05] than those less depressed or non-depressed. Overestimation of threat was the unique significant predictor of a negative treatment response (β= .11, p< .05). Neither a main effect of comorbid severe depressive symptoms and no interaction effects of comorbid severe depressive symptoms with dysfunctional beliefs predicted outcome. Conclusions: These results seem consistent with previous findings, in which Intolerance for uncertainty and Overestimation of threat could be maintaining transdiagnostic factors involved in diseases with chronic course, both psychological and physical. Future longitudinal studies are needed. However, those cognitive factors do not seem to moderate the negative influence of comorbid severe depression on outcome of OCD. Residential behavioural treatment for OCD seems to improve the negative treatment response of severely depressed inpatients. These findings could be attributed to the behavioural activation components of the residential treatment format. Conversely, future research should evaluate additional treatment components for improving the negative impact of Overestimation of threat on outcome.
Do dysfunctional belief moderate the negative influence of comorbid severe depression on outcome of residential treatment for refractory OCD? A pilot study / Pozza A.; Coradeschi D.; Dettore D.. - In: CLINICAL NEUROPSYCHIATRY. - ISSN 1724-4935. - STAMPA. - 10:(2013), pp. 73-83.
Do dysfunctional belief moderate the negative influence of comorbid severe depression on outcome of residential treatment for refractory OCD? A pilot study.
POZZA, ANDREA;DETTORE, DAVIDE
2013
Abstract
Objective: Comorbid severe depressive symptomatology can predict negative treatment outcome for OCD. Dysfunctional beliefs could moderate this relationship, improving the understanding of mechanisms responsible for this poorer response. The aim of the current study was: a) to investigate differences in dysfunctional belief severity between inpatients with severe, refractory OCD with or without comorbid severe depressive symptoms; b) to evaluate whether a residential behavioural treatment could attenuate the negative influence of severe depressive symptoms on outcome of resistant OCD. Method: Participants included 38 inpatients (mean age= 35.40, SD= 10.75) with a primary refractory OCD (Y-BOCS mean= 28.40, SD= 6.90), of which 17 (44.73%) had comorbid severe depressive symptoms (BDI-II> 30). Yale-Brown Obsessive Compulsive Scale, Obsessive Belief Questionnaire-87 and Beck Depression Inventory-II were administered at pre- and post-treatment. A residential behavioural treatment with daily and prolonged exposure and response prevention was delivered in combination with medications for 5 weeks. Results: Inpatients with comorbid severe depressive symptoms had significantly higher OCD symptoms severity [F(1, 36)= 12.80, p<.05], Intolerance for uncertainty [F(1, 36)= 8.41, p<.05] and Overestimation of threat [F(1, 36)= 5.99, p<.05] than those less depressed or non-depressed. Overestimation of threat was the unique significant predictor of a negative treatment response (β= .11, p< .05). Neither a main effect of comorbid severe depressive symptoms and no interaction effects of comorbid severe depressive symptoms with dysfunctional beliefs predicted outcome. Conclusions: These results seem consistent with previous findings, in which Intolerance for uncertainty and Overestimation of threat could be maintaining transdiagnostic factors involved in diseases with chronic course, both psychological and physical. Future longitudinal studies are needed. However, those cognitive factors do not seem to moderate the negative influence of comorbid severe depression on outcome of OCD. Residential behavioural treatment for OCD seems to improve the negative treatment response of severely depressed inpatients. These findings could be attributed to the behavioural activation components of the residential treatment format. Conversely, future research should evaluate additional treatment components for improving the negative impact of Overestimation of threat on outcome.File | Dimensione | Formato | |
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