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Title: Out-patient, multi-modal behaviour therapy for obsessive-compulsive disorder. Author: Hand I. Journal: Br J Psychiatry Suppl; 1998; (35):45-52. PubMed ID: 9829026. Abstract: BACKGROUND: With regard to long-term outcome, behaviour therapy is the first choice treatment for obsessive-compulsive disorder (OCD), with or without concomitant selective serotonin reuptake inhibitor (SSRI) medication. Yet, results from research trials, usually restricted to exposure with response-preventions and other symptom-directed techniques, may not be generalisable to people with OCD in community health care services. METHOD: For more than 20 years we have delivered out-patient behaviour therapy to unselected people with OCD from the community, including those with motivational and compliance problems. Prospective-retrospective follow-ups were carried out from 1-13 years after treatment. RESULTS: This paper describes the applied multi-modal, strategic-systemic behaviour therapy, and our partially new model of OCD. Compliant patients achieved the usual success rate of 65-70%, but this drops to 50% if all patients treated are included in the analysis. CONCLUSIONS: For major subgroups of OCD, behavior therapy is a very effective treatment modality. Exposure is essential, but additional ('causal') interventions are equally important in about half of the patients from unselected samples. Both behaviour therapy and drug-treatments need to be improved and predictive variables for outcome of either of them are urgently needed.[Abstract] [Full Text] [Related] [New Search]