This material was presented in the 25th European Congress of Psychiatry which was organised by the European Psychiatry Association in Florence, Italy from 1-4th April 2017. I had access to the material as I attended the full Congress. Please note that this material remains the intellectual property of the European Psychiatry Association and its authors and any citation should include a full reference to it. For more information on the EPA and how to become a member, please visit: http://www.europsy.net/

1. PREDICTORS OF ONE-YEAR OUTCOME IN
OCD: THE ROLE OF INTERPERSONAL
VARIABLES
Lee Tibi Cohen
Under the supervision of Dr. Gideon Anholt
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3. Introduction
Long term outcome of OCD
• Chronic, fluctuating course (Bloch et al., 2014).
• Remission rates varied from 17% to 65% (e.g. Eisen et al., 2013).
• At least partly explained by methodological diversities
• Definition of remission; Study design ; Follow up duration
• Half of the patients achieve remission at ~five years (Sharma et
al., 2015).
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4. Introduction
• Predictors of long-term outcome in OCD
• What facilitates or hinders remission in OCD?
• Baseline severity of symptoms and chronicity (e.g. Catapano et al., 2006).
• Age of onset (Marcks et al., 2011).
• Personality disorder (Eisen et al., 2013).
• Unlikely that there is a single, direct association between a
certain predictor and the outcome of OCD.
• The role of moderators?
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5. Introduction
Interpersonal aspects of OCD
• Symptoms impair the sufferer's interpersonal relationship→
exacerbate symptoms (Abramowitz et al., 2013).
• Hostility towards the patient: expressed emotion (Cherian et al.,
2014).
• Perceived Social support: buffer against the ramifications of
stress (e.g. Brown & Harris, 1978).
• Attachment style: A positive association between OCD
symptoms and insecure attachment style (Doron et al., 2009, 2012).
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6. Aims of the study
• Examine remission rates at one-year FU in a large sample
of OCD patients
• Predictors of remission (severity, chronicity, age of onset,
interpersonal variables)
• Interpersonal moderators of the relationship predictors and
outcome
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7. Methods
• Collaboration with The Netherlands Obsessive
Compulsive Disorder Association (NOCDA) study :
• 400 OCD patients recruited from health care centers in
the Netherlands.
• Naturalistic, longitudinal design (6 year follow up).
• Self-report and interviews.
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8. Methods
• Predictors: Demographics, Y-BOCS severity scale , BDI,
Age of onset (≥20), chronicity, Level of Expressed Emotion
scale, Social Support Inventory, Relationship Questionnaire
• Remission status: YBOCS score at one-year FU: 0-7=full
remission, 8-15=partial remission, 16≤ no remission.
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9. Results
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Variable M (SD)/ %
Remission status: No remission 136 (53.5)
Partial remission 78 (30.7)
Full remission 40 (15.7)

10. *
OR 95% CI p
Full remission
Depression severity .98 .93-1.03 .40
OCD severity .87 .82-.93 <0.001
Social support .61 .22-1.68 .34
(Non)chronic OCD 1.34 .60-3.02 .22
Partial remission
Depression severity .95 .91-.98 .009
OCD severity .92 .87-.96 .001
Social support 1.03 .46-2.37 .92
(Non)chronic OCD 1.58 .84-2.97 .17
The reference category is the highest coded category of “no remission”.
SSI scores were reflected in the log transformation thus interpretation should be reversed.
Multivariate Multinomial logistic regression analysis (R2=0.23)

11. Results
• Interaction analyses
• OCD severity: A significant interaction effect was found for
secure attachment style, for the level of partial remission vs.
no remission (IOR=1.11, 95%CI=1.05-1.24, p<0.05)
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12. Results
• Interaction analyses
• OCD severity: A significant interaction effect was found for
perceived social support for the level of partial remission vs.
no remission (IOR=.88, 95%CI=.78-.98, p<0.05).
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13. Discussion
• Remission at one-year FU: More likely to expect partial
remission.
• Strong impact of severity on course, that be moderated by
improved interpersonal functioning.
• Target interpersonal difficulties to enhance ERP (Abramowitz et al.,
2013).
• Limitations: short FU period; no treatment control.
• Should be addressed in clinical practice to improve prognosis
of OCD.
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14. Thank you for listening!
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