Full remission and relapse of obsessive-compulsive symptoms after cognitive-behavioral group therapy: a two-year follow-up

Abstract

Objective: The aim of this study was to assess whether the results obtained with 12 sessions of cognitive-behavioral group therapy with obsessive-compulsive patients were maintained after two years, and whether the degree of symptom remission was associated with relapse. Method: Forty-two patients were followed. The severity of symptoms was measured at the end of cognitive-behavioral group therapy and at 18 and 24 months of follow-up. The assessment scales used were the Yale-Brown Obsessive-Compulsive Scale, Clinical Global Impression, Beck Depression Inventory, and Beck Anxiety Inventory. Results: The reduction in symptom severity observed at the end of treatment was maintained during the two-year follow-up period (F = 57.881; p < 0.001). At the end of the treatment, 9 (21.4%) patients presented full remission, 22 (52.4%) presented partial remission, and 11 (26.2%) had unchanged scores in the Yale-Brown Obsessive-Compulsive Scale. After two years, 13 patients (31.0%) presented full remission, 20 (47.6%) had partial remission, and 9 (21.4%) had unchanged Yale-Brown ObsessiveCompulsive Scalescores. The full remission of symptoms at the end of the treatment was a protective factor against relapse (χ 2 = 4,962; df = 1; p = 0.026). Conclusion: Our findings underscore the importance of attaining full remission of obsessive-compulsive symptoms during treatment and the need for new therapeutic strategies to achieve this. (F = 57,881; p < 0,001 Descriptors

Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders

“…Follow-up studies suggest that the benefits of CBT are maintained at one to five years of follow-up [664,695,702-704]. …”

Cognitive-behavioral therapy of a case of obsessive-compulsive disorder

“…A significant percentage of clients may even achieve full remission of symptoms by employing exclusively psychological means such as ERP therapy or CBT, which, in conjunction with anti-obsessive drugs, comprise the front line of treatment for OCD. The study conducted by Braga, Manfro, Niederauer and Cordioli (2010) highlights the need to develop therapeutic strategies that aim at the full remission of OC symptoms, since, by the end of the treatment, it provides protection against relapse.…”

“…During the gaps between sessions and the discharge process, the client should be prepared for the possibility of relapse by training the early perception of symptoms (Vivan et al, 2011). According to Braga et al (2010), whenever there is full remission of OC symptoms at the end of the treatment, the chances of a relapse are significantly reduced.…”

Standard and Innovative Strategies in Cognitive Behavior Therapy

“…Several studies have proved the efficacy of group CBT in the treatment of OC as similar to individual ERP therapy or similar to sertraline (Fals- Stewart et al, 1993;Cordioli et al, 2003;Sousa et al, 2006;Jonsson et al, 2009;Jonsson et al, 2011). Follow-up studies have proven that its effects are maintained in the long run, after discharge (Braga et al, 2010;Borges et al, 2011). Group CBT presents a more favorable cost/benefit relation; with costs five times lower than individual therapy, besides making the treatment available to a larger number of people.…”