The role of mood disorders in the longitudinal course of obsessive-compulsive disorder: Preliminary data from a 20-year prospective follow-up study

Abstract

Introduction Although OCD is believed to have a chronic course, little research has been conducted on this, and there are discrepant findings. Studies over the last years have found that a significant proportion of patients with OCD shows symptomatic remission over long term, however there are significant variations in sampling, clinical characteristics, follow-up, and outcome assessments. Objectives The present prospective study aims to examine rates of OCD remission after 20 years of follow up and to explore demographic and clinical predictors of remission. Methods The study sample consists of adult patients with a principal OCD diagnosis and Y-BOCS total score ≥16, who have been referred to the Department of Neuroscience, University of Turin (Italy). OCD symptoms were assessed every 5 years over the 20-year follow-up period. Course data were examined using standard survival analysis methods; Cox proportional hazards regression was used to estimate relative hazards for predictors of remission. Results There were 360 participants in the study. At year 20, the 28.7 % of the total sample showed OCD remission. Predictor of remission were female gender, lower Y-BOCS mean scores at study entry, longer duration of illness and comorbidity with major depressive disorder. No specific predictors of full remission were found. Lower Y-BOCS mean scores and comorbid bipolar disorder predicted partial remission. Conclusions This study suggests that a significant proportion of patients with OCD shows remission. Future studies are needed to clearly identify predictors of remission. Disclosure No significant relationships.

Keywords

• obsessive compulsive disorder
• follow-up
• mood disorders
• remission