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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Risk factors for early treatment discontinuation in patients with obsessive-compulsive disorder

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Author(s):
Diniz, Juliana Belo [1] ; Malavazzi, Dante Marino [1] ; Fossaluza, Victor [2, 1] ; Belotto-Silva, Cristina [1] ; Borcato, Sonia [1] ; Pimentel, Izabel [1] ; Miguel, Euripedes Constantino [1] ; Shavitt, Roseli Gedanke [1]
Total Authors: 8
Affiliation:
[1] Univ Sao Paulo, Sch Med Hosp Clin, Dept & Inst Psychiat, Sao Paulo - Brazil
[2] Univ Sao Paulo, Math & Stat Inst, Sao Paulo - Brazil
Total Affiliations: 2
Document type: Journal article
Source: Clinics; v. 66, n. 3, p. 387-393, 2011.
Web of Science Citations: 9
Abstract

INTRODUCTION: In obsessive-compulsive disorder, early treatment discontinuation can hamper the effectiveness of first-line treatments. OBJECTIVE: This study aimed to investigate the clinical correlates of early treatment discontinuation among obsessive-compulsive disorder patients. METHODS: A group of patients who stopped taking selective serotonin reuptake inhibitors (SSRIs) or stopped participating in cognitive behavioral therapy before completion of the first twelve weeks (total n = 41; n = 16 for cognitive behavioral therapy and n = 25 for SSRIs) were compared with a paired sample of compliant patients (n = 41). Demographic and clinical characteristics were obtained at baseline using structured clinical interviews. Chisquare and Mann-Whitney tests were used when indicated. Variables presenting a p value <0.15 for the difference between groups were selected for inclusion in a logistic regression analysis that used an interaction model with treatment dropout as the response variable. RESULTS: Agoraphobia was only present in one (2.4%) patient who completed the twelve-week therapy, whereas it was present in six (15.0%) patients who dropped out (p = 0.044). Social phobia was present in eight (19.5%) patients who completed the twelve-week therapy and eighteen (45%) patients who dropped out (p = 0.014). Generalized anxiety disorder was present in eight (19.5%) patients who completed the twelve-week therapy and twenty (50%) dropouts (p = 0.004), and somatization disorder was not present in any of the patients who completed the twelveweek therapy; however, it was present in six (15%) dropouts (p = 0.010). According to the logistic regression model, treatment modality (p = 0.05), agoraphobia, the Brown Assessment of Beliefs Scale scores (p = 0.03) and the Beck Anxiety Inventory (p = 0.02) scores were significantly associated with the probability of treatment discontinuation irrespective of interactions with other variables. DISCUSSION AND CONCLUSION: Early treatment discontinuation is a common phenomenon in obsessive-compulsive disorder patients from our therapeutic setting. Psychiatric comorbidities were associated with discontinuation rates of specific treatments. Future studies might use this information to improve management for increased compliance and treatment effectiveness. (AU)

FAPESP's process: 06/50273-0 - Pharmacological augmentation strategies in treatment of resistant obsessive-compulsive disorder: a double-blind placebo-controlled trial
Grantee:Juliana Belo Diniz
Support Opportunities: Scholarships in Brazil - Doctorate (Direct)