A 1-Year Naturalistic Follow-Up of Patients With Compulsive Shopping Disorder
J Clin Psychiatry 2003;64(8):946-950
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Compulsive shopping disorder is
increasingly recognized as a treatable impulse-control disorder.
We report the first long-term, naturalistic follow-up of patients
with compulsive shopping disorder, which examined the course of
illness over 1 year in a cohort that had completed up to 3 months
of open-label treatment with citalopram, 20 mg/day to 60 mg/day.
In that trial, 17 (71%) of 24 subjects who met McElroy and
colleagues' diagnostic criteria for compulsive shopping disorder
were responders (Clinical Global Impressions-Improvement scale
rating of much or very much improved and Yale-Brown Obsessive
Compulsive Scale-Shopping Version score decrease of >= 50%).
Method: Follow-up interviews occurred 3, 6, 9,
and 12 months after study end. Data gathered included comorbid
conditions, estimated total debt, 2-week spending, whether the
patient was taking citalopram, and illness versus remission
status. Remission was defined as no longer meeting diagnostic
criteria for compulsive shopping disorder. Data were gathered
between March 2000 and January 2002.
Results: Of responders at trial end, 81%
(13/16), 71% (10/14), 71% (10/14), and 73% (11/15) were in
remission at 3, 6, 9, and 12 months. Mean 2-week compulsive
shopping expenditures decreased from $773 (median = $500) at
baseline to $351 (median = $0) at month 12, and mean total debt
decreased from $17,833 (median = $20,000) to $16,752 (median =
$14,000). No clear association was seen between taking citalopram
and remission status (p = .55, p = .08, p = .58, and p = .60 at
3, 6, 9, and 12 months, respectively; Fisher exact test). The
majority of trial nonresponders remained ill at each follow-up
Conclusion: An acute response to citalopram
predicts a greater likelihood of continued remission over
1 year, although the mechanisms that maintain remission require