Self-Stigma and Treatment Effectiveness in Patients with SSRI Non-Responsive Obsessive-Compulsive Disorder

Abstract

Marie Ociskova,1 Jan Prasko,1– 3 Jakub Vanek,1 Michaela Holubova,4 Frantisek Hodny,1 Klara Latalova,1 Krystof Kantor,1 Vlastimil Nesnidal1 1Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University in Olomouc, University Hospital in Olomouc, Olomouc, The Czech Republic; 2Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic; 3Institute for Postgraduate Education in Health Care, Prague, The Czech Republic; 4Department of Psychiatry, Hospital Liberec, Prague, The Czech RepublicCorrespondence: Jan PraskoDepartment of Psychiatry, Faculty of Medicine and Dentistry, University Hospital Olomouc, Olomouc, The Czech RepublicTel [phone]Email [email protected]: Obsessive compulsive disorder (OCD) is a debilitating mental disorder that often takes a chronic course. One of the factors influencing the treatment effectiveness in anxiety and depressive disorders is the self-stigma. This study focused on the relationship between the self-stigma, symptomatology, and therapeutic outcomes in patients with OCD.Patients and Methods: Ninety-four inpatients with OCD, who did not sufficiently respond to at least one selective serotonin reuptake inhibitor trial, participated in the study. They attended a six-week therapeutic program consisting of exposure and response prevention, transdiagnostic group cognitive behavioral therapy, individual sessions, mental imagery, relaxation, sport, and ergotherapy. The participants completed several scales: the Internalized Stigma of Mental Illness Scale (ISMI), the self-report Yale-Brown Obsessive Compulsive Scale (Y-BOCS-SR), Beck Anxiety Scale (BAI), Beck Depression Scale-II (BDI-II), and Dissociative Experiences Scale (DES). A senior psychiatrist filled in the Clinical Global Impression (CGI-S).Results: The average scales’ scores considerably declined in all measurements except for DES. The self-stigma positively correlated with all psychopathology scales. It was also higher in patients with a comorbid personality disorder (PD). The higher self-stigma predicted a lower change in compulsion, anxiety, and depressive symptoms but not the change of obsessions or the overall psychopathology.Conclusion: The self-stigma presents an important factor connected to higher severity of OCD. It is also a minor predictor of a lower change in symptomatology after combined treatment.Keywords: obsessive compulsive disorder, self-stigma, exposure and response prevention, cognitive behavioral therapy, non-response

Keywords

• obsessive compulsive disorder / self-stigma / exposure and response prevention / cognitive behavioral therapy / non-response