Dissociation was not associated with worse treatment outcome to cognitive behavioral therapy in patients with obsessive-compulsive disorder
Abstract
Obsessive-compulsive disorder (OCD) is refractory to therapeutic interventions in 40-60%. Dissociation is one of the potential clinical negative predictors of treatment outcome.
The aim of the present study was to evaluate whether more severe dissociation is associated with worse treatment outcome after cognitive behavioral therapy (CBT) in patients with OCD. The study sample comprised 44 patients with OCD (25 females) and 45 healthy controls (30 females).
The patients underwent systematic group CBT for 6-8 weeks. Dissociation was assessed with by the Dissociative Experiences Scale (DES) at the beginning of the therapy.
The severity of psychopathology in patients with OCD was assessed with use of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Beck Depression Inventory-II (BDI-II), and the Beck Anxiety Inventory (BAI) at the beginning and at the end of the treatment. The severity of OCD symptoms significantly decreased as a result of the therapy.
The treatment outcome was not associated with the severity of dissociation at the beginning of the treatment. Absolute, but not relative decrease of OCD symptoms was associated with the level of OCD symptoms at the beginning of the therapy.
Patients had higher DES and SDQ-20 scores than healthy subjects. SDQ-20, unlike the DES score, correlated with the severity of OCD symptoms in patients.
The severity of dissociative symptoms before the treatment was not associated with a change of OCD symptom severity after CBT. As dissociation is associated with anxiety and depressive symptoms, further investigation of the influence of dissociative states on the change of anxiety-depressive symptoms in a wider clinical spectrum of patients is needed.