Long-term outcome of CBT in adults with OCD and comorbid ASD: A naturalistic follow-up study

Abstract

Obsessive-compulsive disorder (OCD) and autism spectrum disorders (ASD) are highly comorbid. In adults with OCD, cognitive-behavioral therapy (CBT) has been extensively demonstrated to be an effective treatment. However, to date, no follow-up studies exist regarding the long-term outcome of CBT in adults with OCD with comorbid ASD in a regular and naturalistic clinical setting. In the current study, we aimed to study the long-term outcome of CBT among OCD patients with and without ASD. In total, 30 patients diagnosed with OCD who received CBT at a naturalistic psychiatric clinic in Japan were included in the follow-up study. The patients were divided into two groups: OCD with ASD and OCD without ASD. The results revealed no group differences regarding age, gender and OCD symptom severity at baseline. The Yale-Brown Obsessive-Compulsive Scale total score (primary outcome) at follow-up showed decreased severity of symptoms in both groups, thus indicating both groups responded to CBT. However, no significant differences were evident between the groups. Overall, the results suggest that even adults with OCD with comorbid ASD benefit from CBT. A survey on patients’ impressions of treatment effect at follow-up showed high rates of satisfaction with CBT and most participants attributed their improvement to CBT as opposed to pharmacological treatment. This study showed the outcome differences of OCD symptom dimensions in OCD with ASD patients compared with the OCD without ASD patients. These differences suggest the need for developing adapted CBT for adults with OCD with ASD and for optimizing the treatment and their lives.