The following is a summary of “Patient adherence as a predictor of acute and long-term outcomes in concentrated exposure treatment for difficult-to-treat obsessive-compulsive disorder,” published in the April 2024 issue of Psychiatry by Tjelle et al.

Exposure and response prevention (ERP) is the most recommended first-line psychotherapy for obsessive-compulsive disorder (OCD). However, not all patients benefit from it; some don’t respond well, while some relapse. 

Researchers conducted a retrospective study to determine how well patients followed ERP tasks in concentrated exposure treatment (cET) after not responding or relapsing. 

They studied 163 adults with challenging OCD, where everyone received cET over 4 days. Assessment of patients’ adherence was done using the Patient EX/RP Adherence Scale (PEAS-P) on days 2-3. Independent evaluators rated OCD severity after treatment at 3-month and 1-year follow-ups. 

The results showed that PEAS-P scored during treatment linked with OCD severity at post-treatment, 3-month, and 1-year follow-ups. Higher PEAS-P scores predicted OCD severity at 12 months, accounting for other factors. Adherence predicted work and social functioning at the 1-year follow-up. 

Investigators concluded that sticking to ERP tasks during short cET sessions strongly connects to better OCD symptoms and functioning long-term. Monitoring adherence could help spot patients at risk and improve treatment outcomes for those with resistant OCD.

Source: bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-05780-6