Abstract
BackgroundCognitive behavioral therapy (CBT), which includes exposure and response prevention (ERP), is effective in improving symptoms of obsessive-compulsive disorder (OCD). However, whether poor cognitive functions and autism spectrum disorder (ASD) traits affect the therapeutic response of patients with OCD to ERP-based CBT remains unclear. This study aimed to identify factors predictive of the therapeutic response of Japanese patients with OCD to ERP-based CBT.MethodsForty-two Japanese outpatients with OCD were assessed using the Wechsler Adult Intelligence Scale-III (WAIS-III), Yale-Brown Obsessive-Compulsive Scale, Patient Health Questionnaire 9-item scale, and Autism Spectrum Quotient (AQ) at pre- and post-treatment. We used multiple regression analyses to estimate the effect on therapeutic response change. The treatment response change was set as a dependent variable in multiple regression analyses.ResultsMultiple regression analyses showed that among independent variables, communication as an AQ sub-scale and Letter Number Sequencing as a WAIS-III sub-test predict the therapeutic response to ERP-based CBT .ConclusionsOur results suggest that diminished working memory (Letter Number Sequencing), poor communication skill (AQ sub-scale) may undermine responsiveness to ERP-based CBT among patients with OCD.Trial registrationUMIN, UMIN00024087. Registered 20 September 2016 - Retrospectively registered (including retrospective data).
Highlights
Cognitive behavioral therapy (CBT), which includes exposure and response prevention (ERP), is effective in improving symptoms of obsessive-compulsive disorder (OCD)
Multiple regression analysis was performed with sex, communication, attention switching, and Letter Number Sequencing as explanatory variables and the ERP-based CBT response change as the dependent variable
Multiple regression analyses showed that communication as an Autism Spectrum Quotient (AQ) sub-scale and Letter Number Sequencing as a WAIS-III sub-test were significant predictors of ERP-based CBT response, if sex and attention switching were excluded for a better fit (Table 3)
Summary
Cognitive behavioral therapy (CBT), which includes exposure and response prevention (ERP), is effective in improving symptoms of obsessive-compulsive disorder (OCD). Whether poor cognitive functions and autism spectrum disorder (ASD) traits affect the therapeutic response of patients with OCD to ERPbased CBT remains unclear. This study aimed to identify factors predictive of the therapeutic response of Japanese patients with OCD to ERP-based CBT. Numerous studies have been conducted on cognitive functions of individuals to account for their lack of response to CBT including ERP [8,9,10,11]. Neuropsychological functioning has so far been studied as a predictor of the responsiveness of patients with OCD to CBT including ERP, but the results are inconsistent [8,9,10,11]. Predictor variables of CBT including ERP for OCD can be classified into various categories [12]: demographic variables; OCD symptom characteristics such as severity; comorbidities and associated symptom severity; cognitive influences; motivational factors such as treatment expectations; treatment factors such as compliance and therapeutic alliance; biological factors; other factors such as personality, family dysfunction, and treatment-specific characteristic [12, 13]
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