Article2002

Comorbid Posttraumatic Stress Disorder: Impact on Treatment Outcome for Obsessive-Compulsive Disorder

Beth S. Gershuny · Lee Baer · Michael A. Jenike · William E. Minichiello · Sabine Wilhelm

117 citations0/0 files storedAmerican Journal of Psychiatry

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Obsessive-Compulsive Spectrum Disorders Psychoanalysis and Psychopathology Research Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Abstract

OBJECTIVE: The study tested the effect of comorbid posttraumatic stress disorder (PTSD) on behavior therapy outcome for obsessive-compulsive disorder (OCD). METHOD: Subjects were 15 patients with treatment-refractory OCD who were admitted consecutively to a short-term residential facility. Eight met DSM-IV criteria for comorbid PTSD. Patients participated in coached and self-directed behavior treatments of exposure and response prevention as well as in group treatments targeting specific OCD symptoms and related difficulties. Severity of OCD and depression were assessed at admission and exit. RESULTS: Patients with comorbid PTSD showed no significant improvements in OCD and depression symptoms. OCD and depression symptoms improved significantly more in patients without comorbid PTSD than in patients with comorbid PTSD. CONCLUSIONS: Behavioral treatment (with or without medication) of OCD may be adversely affected by the presence of comorbid PTSD.

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References

1989The Yale-Brown Obsessive Compulsive Scale 1997The validation of a self-report measure of posttraumatic stress disorder: The Posttraumatic Diagnostic Scale.2002Effective Treatments for PTSD 1995Arousal, numbing, and intrusion: symptom structure of PTSD following assault 2000Effectiveness of exposure and ritual prevention for obsessive-compulsive disorder: Randomized compared with nonrandomized samples.1995Cingulotomy for Intractable Obsessive-compulsive Disorder 1999The role of traumatic experiences in the genesis of obsessive–compulsive disorder 2001Effects of axis I and II comorbidity on behavior therapy outcome for obsessive-compulsive disorder and agoraphobia

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