OCD and anxiety disorders
Treatment response in OCD is defined as a 35% reduction on the Y-BOCS. However, scores indicating treatment response and remission on the FOCI have not yet been established. Using ROC analysis, this study found a 25% reduction on the FOCI best corresponds to a 35% reduction on the Y-BOCS. As the FOCI is a shorter, less time-intensive measure that imposes less burden on clients and clinicians, we hope establishing treatment response indicators is a first step to precede the FOCI being used more widely as an outcome measure in services.
We know little about how symptoms of obsessive-compulsive disorder and depression interact during a psychological therapy. Previous studies suggest that reductions in the severity of deression are driven by reductions in OCD, implying that it is sufficient to target the OCD alone as a means to reduce symptoms of both disorders. However, due to the exclusion of individuals with severe depression and limitations of the statistical approaches used in previous research, support for this conclusion is limited. This study re-examined the interaction between symptoms of OCD and depression during therapy using more robust statistical methods in a sample of individuals with a full range of severity of depression. Participants were 137 adults in a specialist residential unit with a primary diagnosis of OCD. They completed the Florida Obsessive Compulsive Inventory and Patient Health Questionnaire for depression weekly. All participants received a 12 to 16-week residential program. The relationship between severity of OCD and depression was examined using a random intercept cross-lagged panel model. Both cross-lagged paths were significant, with prior levels of OCD influencing subsequent levels of depression, and prior levels of depression influencing subsequent levels of OCD. Contrary to previous findings, which suggest that the influence of OCD on depression is far greater than the reverse, our findings suggest that OCD and depression influence each other equally. If anything, the influence of depression on OCD is more consistent than vice-versa. As improvements in mood can help to improve symptoms of OCD, it appears important to target depression concurrently during treatment for OCD. This would be a new treatment target for improvement outcomes in OCD.