A 40 year follow-up of patients with obsessive-compulsive disorder. Arch Gen Psychiatry

Institute of Clinical Neuroscience, Department of Psychiatry, Sahlgrenska University Hospital, Göteborg University, Sweden.
Archives of General Psychiatry (Impact Factor: 14.48). 03/1999; 56(2):121-7. DOI: 10.1001/archpsyc.56.2.121
Source: PubMed

ABSTRACT The long-term course of obsessive-compulsive disorder is insufficiently known. We studied the course of this disorder in patients who were followed up for 40 years.
Patients admitted with a diagnosis of obsessive-compulsive disorder to the Department of Psychiatry, Sahlgrenska University Hospital, Göteborg, Sweden, between 1947 and 1953 were examined by an experienced psychiatrist using a semistructured interview between 1954 and 1956 (n=251). The diagnosis was made according to the criteria of Schneider. A reexamination was performed by the same psychiatrist between 1989 and 1993 (n=122). In another 22 patients, the necessary information was obtained from close informants and medical records. The response rate in surviving patients was 82%. The mean length of follow-up from onset was 47 years.
Improvement was observed in 83%, including recovery in 48% (complete recovery, 20%; recovery with subclinical symptoms, 28%). Among those who recovered, 38% had done so already in the 1950s. Forty-eight percent had obsessive-compulsive disorder for more than 30 years. Early age of onset, having both obsessive and compulsive symptoms, low social functioning at baseline, and a chronic course at the examination between 1954 and 1956 were correlated with a worse outcome. Magical obsessions and compulsive rituals were correlated with a worse course. Qualitative symptom changes within the obsessive-compulsive disorder occurred in 58% of the patients.
After several decades, most individuals with obsessive-compulsive disorder improve, although most patients continue to have clinical or subclinical symptoms.

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    • "The studies of psychosocial, symptomatic, and genetic factors on the treatment study will increase our understanding of OCD. In view of the high risk of chronic impairment and suffering in paediatric OCD these aspects need to be highlighted [73,74]. "
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    Child and Adolescent Psychiatry and Mental Health 12/2013; 7(1):41. DOI:10.1186/1753-2000-7-41
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    • "Patients with OCD suffer from recurrent, unwanted thoughts (obsessions) and repetitive, ritualized behaviour (compulsions), which are often intended to neutralize anxiety induced by the obsessions. OCD often evolves as a chronic illness [2] with severe occupational and social impairment. In the last two decades, various efficacious pharmacological and psychotherapeutic treatments for OCD have been extensively studied and well established [3]. "
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    Annals of General Psychiatry 12/2013; 12(1):41. DOI:10.1186/1744-859X-12-41 · 1.40 Impact Factor
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    • "Thus, conclusions about potential causal relationships between the administration of inpatient CBT and subsequent outpatient treatment, QoL improvements, and symptomatic changes cannot be drawn. We can nevertheless draw on solid data demonstrating that OCD is a chronic disorder which does not show considerable improvement over time without treatment [33,34]. Third, the current analysis is based on quality management data from our clinic that, within the period of observation, did not routinely include measures of OCD severity. "
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    Annals of General Psychiatry 02/2013; 12(1):4. DOI:10.1186/1744-859X-12-4 · 1.40 Impact Factor
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