P-140 - Level of Dissociation Predicts the Therapeutic Response to Cognitive Behavioral Therapy in Patients Sufering With Obsessive Compulsive Disorder Resistant to Psychopharmacscs

Abstract

Background

The purpose of the present study is to examine the effectiveness of CBT on a sample of no selected, pharmacologically treatment-resistant OCD patients and to find the predictors of successful treatment in these conditions. The therapy was conducted in a naturalistic setting and systematic CBT steps were adapted to each patient. Pharmacologic treatment underwent no or minimal changes during the trial period. Outcome measures included the Y-BOCS, CGI, BDI, BAI, Somatoform Dissociation Questionaire, and Dissociative Experience Scale. The primary outcome measure for response was a rating of 25% improvement in Y-BOCS. There was border for remission -12 points or less on the same scale, and 1-2 points in CGI-S.

Results

As far 47 patients completed the trial. All patients finished minimum of 5 weeks of CBT and showed statistically significant improvement on all outcome measures. At the end of therapy 64.1% of patients were improved. 50% of patients reach remission according Y-BOCS and 40.4% according CGI. The main predictors of good therapeutic outcome were lower scores in Y-BOCS, good insight, high resistance against symptoms, low level of dissociation, and aggressive character of obsessions. The negative predictors were control/symmetry obsession and compulsions, and obsessive slowness and ambivalence.

Conclusion

CBT could be effectively used for medication-resistant OCD patients. There are some factors, like intensity of OCD symptoms, level of insight, resistance against symptoms, and level of dissociation, which could predict outcome of the therapy.