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Int J Psychiatry Clin Pract. 2018 Mar;22(1):40-46. doi: 10.1080/13651501.2017.1351991. Epub 2017 Jul 25.

Relationships between obsessive-compulsive disorder, depression and functioning before and after exposure and response prevention therapy.

Author information

1
a Department of Psychiatry , University of California Los Angeles , Los Angeles , CA , USA.
2
b Semel Institute for Neuroscience and Human Behavior , University of California Los Angeles , Los Angeles , CA , USA.
3
c David Geffen School of Medicine , University of California Los Angeles , Los Angeles , CA , USA.

Abstract

OBJECTIVE:

Obsessive-compulsive disorder (OCD) is associated with impaired functioning and depression. Our aim was to examine relationships between OCD symptoms, depression and functioning before and after exposure and response prevention (ERP), a type of cognitive-behavioural therapy for OCD, specifically examining whether functioning, depression and other cognitive factors like rumination and worry acted as mediators.

METHODS:

Forty-four individuals with OCD were randomised to 4 weeks of intensive ERP treatment first (n = 23) or waitlist then treatment (n = 21). We used a bootstrapping method to examine mediation models.

RESULTS:

OCD symptoms, depression and functioning significantly improved from pre- to post-intervention. Functioning mediated the relationship between OCD symptoms and depression and the relationship between functioning and depression was stronger at post-treatment. Depression mediated the relationship between OCD symptoms and functioning, but only at post-intervention. Similarly, rumination mediated the relationship between OCD symptoms and depression at post-intervention.

CONCLUSIONS:

Our findings suggest that after ERP, relationships between depression and functioning become stronger. Following ERP, treatment that focuses on depression and functioning, including medication management for depression, cognitive approaches targeting rumination, and behavioural activation to boost functionality may be important clinical interventions for OCD patients.

KEYWORDS:

Cogntive-behavioural therapy; depression; global functioning; mediation; obsessive-compulsive disorder

PMID:
28691550
PMCID:
PMC5777899
DOI:
10.1080/13651501.2017.1351991
[Indexed for MEDLINE]
Free PMC Article

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