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Eur Psychiatry. 2017 Jul;44:76-82. doi: 10.1016/j.eurpsy.2017.03.009. Epub 2017 Apr 7.

The long-term association of OCD and depression and its moderators: A four-year follow up study in a large clinical sample.

Author information

1
Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Electronic address: tibi@post.bgu.ac.il.
2
Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, GGZ InGeest, Amsterdam, the Netherlands.
3
Department of Psychiatry & Neuropsychology, School of Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands; Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, the Netherlands.
4
Department of Psychiatry & Neuropsychology, School of Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands; Mondriaan Mental Health Center, Maastricht, the Netherlands; Department of Health Psychology, University of Leuven, Belgium.
5
Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

Abstract

BACKGROUND:

Depression is the most common comorbidity in obsessive-compulsive disorder (OCD). However, the mechanisms of depressive comorbidity in OCD are poorly understood. We assessed the directionality and moderators of the OCD-depression association over time in a large, prospective clinical sample of OCD patients.

METHODS:

Data were drawn from 382 OCD patients participating at the Netherlands Obsessive-Compulsive Disorder Association (NOCDA) study. Cross-lagged, structural equation modeling analyses were used to assess the temporal association between OCD and depressive symptoms. Assessments were conducted at baseline, two-year and four-year follow up. Cognitive and interpersonal moderators of the prospective association between OCD and depressive symptoms were tested.

RESULTS:

Cross-lagged analyses demonstrated that OCD predicts depressive symptoms at two-year follow up and not vice a versa. This relationship disappeared at four-year follow up. Secure attachment style moderated the prospective association between OCD and depression.

CONCLUSIONS:

Depressive comorbidity in OCD might constitute a functional consequence of the incapacitating OCD symptoms. Both OCD and depression symptoms demonstrated strong stability effects between two-year and four-year follow up, which may explain the lack of association between them in that period. Among OCD patients, secure attachment represents a buffer against future depressive symptoms.

KEYWORDS:

Comorbidity; Depression; Longitudinal; Moderators; Obsessive-compulsive disorder

PMID:
28545012
DOI:
10.1016/j.eurpsy.2017.03.009
[Indexed for MEDLINE]

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