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

Published online by Cambridge University Press:  15 April 2020

J. Prasko
Affiliation:
Department of Psychiatry, University Hospital Olomouc, Medical Faculty, University Palacky Olomouc, Olomouc
M. Raszka
Affiliation:
Prague Psychiatric Centre
J. Koprivova
Affiliation:
Prague Psychiatric Centre
J. Vyskocilova
Affiliation:
Department of Psychiatry, Charles University in Prague, Prague, Czech Republic
D. Kamaradova
Affiliation:
Department of Psychiatry, University Hospital Olomouc, Medical Faculty, University Palacky Olomouc, Olomouc
A. Grambal
Affiliation:
Department of Psychiatry, University Hospital Olomouc, Medical Faculty, University Palacky Olomouc, Olomouc
T. Diveky
Affiliation:
Department of Psychiatry, University Hospital Olomouc, Medical Faculty, University Palacky Olomouc, Olomouc

Abstract

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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.

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Copyright © European Psychiatric Association 2012
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P-140 - Level of Dissociation Predicts the Therapeutic Response to Cognitive Behavioral Therapy in Patients Sufering With Obsessive Compulsive Disorder Resistant to Psychopharmacscs
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P-140 - Level of Dissociation Predicts the Therapeutic Response to Cognitive Behavioral Therapy in Patients Sufering With Obsessive Compulsive Disorder Resistant to Psychopharmacscs
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P-140 - Level of Dissociation Predicts the Therapeutic Response to Cognitive Behavioral Therapy in Patients Sufering With Obsessive Compulsive Disorder Resistant to Psychopharmacscs
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