An 11- to 13-Year Follow-Up of 75 Subjects With Obsessive-Compulsive Disorder
J Clin Psychiatry 2005;66(6):744-749
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: There is a paucity of data on the
long-term course and outcome of obsessive-compulsive disorder
(OCD). Available data suggest that OCD runs a chronic course with
waxing and waning severity. However, most previous studies
included severely ill patients who were often clinically referred
and hospitalized. The present study reports the course and
outcome of OCD in patients who were largely outpatient,
self-referred, and drug-naive.
Method: Seventy-five of the 105 subjects (71%)
with DSM-IV-diagnosed OCD were followed up 11 to 13 years after
initial consultation in 1991 and 1992 at a major psychiatric
hospital in India. A majority were self-referred (N = 63, 84%),
drug-naive (N = 54, 72%), and outpatients (N = 60, 80%). The
follow-up evaluations were carried out by experienced clinicians
using various scales and structured instruments. The course and
outcome were determined according to predefined criteria.
Multinomial logistic regression analysis was performed to
identify potential predictors of outcome.
Results: A majority of subjects were adequately
treated with medications (N = 57, 76%). Out of 75 subjects, only 18
subjects (24%) had clinical OCD. Overall, 57 subjects (76%) had a
favorable outcome: 32 subjects (43%) had no OCD and 25 (33%) had
subclinical OCD. Mixed OCD and any Axis I lifetime comorbidity
predicted "clinical OCD" outcome.
Conclusions: Outcome of OCD is better than
generally assumed, and the findings of this study offer a new
perspective on the long-term outcome of OCD. Poor outcome in
previous studies may have been due to the inclusion of severely
and chronically ill patients.