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Risk factors for early treatment discontinuation in patients with obsessive-compulsive disorder

INTRODUCTION: In obsessive-compulsive disorder, early treatment discontinuation can hamper the effectiveness of first-line treatments. OBJECTIVE: This study aimed to investigate the clinical correlates of early treatment discontinuation among obsessive-compulsive disorder patients. METHODS: A group...

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Autores principales: Diniz, Juliana Belo, Malavazzi, Dante Marino, Fossaluza, Victor, Belotto-Silva, Cristina, Borcato, Sonia, Pimentel, Izabel, Miguel, Euripedes Constantino, Shavitt, Roseli Gedanke
Formato: Texto
Lenguaje:English
Publicado: Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3071996/
https://www.ncbi.nlm.nih.gov/pubmed/21552660
http://dx.doi.org/10.1590/S1807-59322011000300004
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author Diniz, Juliana Belo
Malavazzi, Dante Marino
Fossaluza, Victor
Belotto-Silva, Cristina
Borcato, Sonia
Pimentel, Izabel
Miguel, Euripedes Constantino
Shavitt, Roseli Gedanke
author_facet Diniz, Juliana Belo
Malavazzi, Dante Marino
Fossaluza, Victor
Belotto-Silva, Cristina
Borcato, Sonia
Pimentel, Izabel
Miguel, Euripedes Constantino
Shavitt, Roseli Gedanke
author_sort Diniz, Juliana Belo
collection PubMed
description INTRODUCTION: In obsessive-compulsive disorder, early treatment discontinuation can hamper the effectiveness of first-line treatments. OBJECTIVE: This study aimed to investigate the clinical correlates of early treatment discontinuation among obsessive-compulsive disorder patients. METHODS: A group of patients who stopped taking selective serotonin reuptake inhibitors (SSRIs) or stopped participating in cognitive behavioral therapy before completion of the first twelve weeks (total n = 41; n = 16 for cognitive behavioral therapy and n = 25 for SSRIs) were compared with a paired sample of compliant patients (n = 41). Demographic and clinical characteristics were obtained at baseline using structured clinical interviews. Chi-square and Mann-Whitney tests were used when indicated. Variables presenting a p value <0.15 for the difference between groups were selected for inclusion in a logistic regression analysis that used an interaction model with treatment dropout as the response variable. RESULTS: Agoraphobia was only present in one (2.4%) patient who completed the twelve-week therapy, whereas it was present in six (15.0%) patients who dropped out (p = 0.044). Social phobia was present in eight (19.5%) patients who completed the twelve-week therapy and eighteen (45%) patients who dropped out (p = 0.014). Generalized anxiety disorder was present in eight (19.5%) patients who completed the twelve-week therapy and twenty (50%) dropouts (p = 0.004), and somatization disorder was not present in any of the patients who completed the twelve-week therapy; however, it was present in six (15%) dropouts (p = 0.010). According to the logistic regression model, treatment modality (p = 0.05), agoraphobia, the Brown Assessment of Beliefs Scale scores (p = 0.03) and the Beck Anxiety Inventory (p = 0.02) scores were significantly associated with the probability of treatment discontinuation irrespective of interactions with other variables. DISCUSSION AND CONCLUSION: Early treatment discontinuation is a common phenomenon in obsessive-compulsive disorder patients from our therapeutic setting. Psychiatric comorbidities were associated with discontinuation rates of specific treatments. Future studies might use this information to improve management for increased compliance and treatment effectiveness.
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spelling pubmed-30719962011-04-08 Risk factors for early treatment discontinuation in patients with obsessive-compulsive disorder Diniz, Juliana Belo Malavazzi, Dante Marino Fossaluza, Victor Belotto-Silva, Cristina Borcato, Sonia Pimentel, Izabel Miguel, Euripedes Constantino Shavitt, Roseli Gedanke Clinics (Sao Paulo) Clinical Science INTRODUCTION: In obsessive-compulsive disorder, early treatment discontinuation can hamper the effectiveness of first-line treatments. OBJECTIVE: This study aimed to investigate the clinical correlates of early treatment discontinuation among obsessive-compulsive disorder patients. METHODS: A group of patients who stopped taking selective serotonin reuptake inhibitors (SSRIs) or stopped participating in cognitive behavioral therapy before completion of the first twelve weeks (total n = 41; n = 16 for cognitive behavioral therapy and n = 25 for SSRIs) were compared with a paired sample of compliant patients (n = 41). Demographic and clinical characteristics were obtained at baseline using structured clinical interviews. Chi-square and Mann-Whitney tests were used when indicated. Variables presenting a p value <0.15 for the difference between groups were selected for inclusion in a logistic regression analysis that used an interaction model with treatment dropout as the response variable. RESULTS: Agoraphobia was only present in one (2.4%) patient who completed the twelve-week therapy, whereas it was present in six (15.0%) patients who dropped out (p = 0.044). Social phobia was present in eight (19.5%) patients who completed the twelve-week therapy and eighteen (45%) patients who dropped out (p = 0.014). Generalized anxiety disorder was present in eight (19.5%) patients who completed the twelve-week therapy and twenty (50%) dropouts (p = 0.004), and somatization disorder was not present in any of the patients who completed the twelve-week therapy; however, it was present in six (15%) dropouts (p = 0.010). According to the logistic regression model, treatment modality (p = 0.05), agoraphobia, the Brown Assessment of Beliefs Scale scores (p = 0.03) and the Beck Anxiety Inventory (p = 0.02) scores were significantly associated with the probability of treatment discontinuation irrespective of interactions with other variables. DISCUSSION AND CONCLUSION: Early treatment discontinuation is a common phenomenon in obsessive-compulsive disorder patients from our therapeutic setting. Psychiatric comorbidities were associated with discontinuation rates of specific treatments. Future studies might use this information to improve management for increased compliance and treatment effectiveness. Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo 2011-03 /pmc/articles/PMC3071996/ /pubmed/21552660 http://dx.doi.org/10.1590/S1807-59322011000300004 Text en Copyright © 2011 Hospital das Clínicas da FMUSP http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Science
Diniz, Juliana Belo
Malavazzi, Dante Marino
Fossaluza, Victor
Belotto-Silva, Cristina
Borcato, Sonia
Pimentel, Izabel
Miguel, Euripedes Constantino
Shavitt, Roseli Gedanke
Risk factors for early treatment discontinuation in patients with obsessive-compulsive disorder
title Risk factors for early treatment discontinuation in patients with obsessive-compulsive disorder
title_full Risk factors for early treatment discontinuation in patients with obsessive-compulsive disorder
title_fullStr Risk factors for early treatment discontinuation in patients with obsessive-compulsive disorder
title_full_unstemmed Risk factors for early treatment discontinuation in patients with obsessive-compulsive disorder
title_short Risk factors for early treatment discontinuation in patients with obsessive-compulsive disorder
title_sort risk factors for early treatment discontinuation in patients with obsessive-compulsive disorder
topic Clinical Science
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3071996/
https://www.ncbi.nlm.nih.gov/pubmed/21552660
http://dx.doi.org/10.1590/S1807-59322011000300004
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