Obsessive-compulsive disorder (OCD) is described as a chronic condition. However, relatively little is known about predictors affecting its long-term outcome.

To examine the contribution of clinical and interpersonal determinants in predicting remission status of 254 OCD patients at one-year follow-up (FU1).

We used the baseline and FU1 data of The Netherlands obsessive-compulsive disorder association (NOCDA) study. Clinical predictors were chronicity level, depressive and obsessive-compulsive symptom severity. Suspected interpersonal factors included attachment style, social support and expressed emotion. Remission status was defined using the Yale-Brown obsessive-compulsive symptom (Y-BOCS) scale. χ2 tests and ANOVAs were used for bivariate analyses, followed by multivariate multinomial logistic regression analyses to assess main effects and interactions in predicting remission status at FU1.

Bivariate tests demonstrated significant differences in remission status as a function of chronicity level, depressive and obsessive-compulsive symptom severity and social support. Regression analyses revealed that increased baseline OCD severity reduced the odds for both partial and full remission at FU1 (OR = .87, 95%CI = .82–93, P < 0.001). Increased depressive severity at baseline reduced the odds for partial remission at FU1 (OR = .95, 95%CI = .91–.98, P < 0.01). Interactions analyses demonstrated that the adverse effects of OCD severity on partial remission disappeared at the presence of secure attachment (IOR = 1.11, 95%CI = 1.05–1.24, P < 0.05) and high social support (IOR = .88, 95%CI = .78–98, P < 0.05).

The contribution of clinical severity is critical for understanding the prognosis of OCD. The interpersonal context of OCD patients may mitigate the unfavorable effect of severity on outcome, thus should be addressed in treatment.

The authors have not supplied their declaration of competing interest.