Prognostic factors for the success of cognitive-behavior therapy in obsessive-compulsive disorders

Abstract

Cognitive-behavioral therapy has undoubtedly shown its efficiency in several areas of psycopathology. The next step, proving the qualitative and quantitative growth of cognitive-behavioral approach, deals with finding out prognostic factors. In our opinion, specific factors only could provide some clues about the therapy outcome, because if we take in consideration in the same time the factors pertaining to the different forms of therapy and disorders we should inquire into thousand of combinations. Therefore we show the results of a review about cognitive-behavioral therapy (a specific treatment) of obsessive compulsive disorder (a specific disorder). Such review cover the period from the end of seventies to 1993. We report, beyond the numerous clinical observations, a series of data about researches investigated: criteria for estabilishing the clinical improvement of patients, prognostic factors studied, instruments for measuring prognostic factors, prognostic factors concerning the improvement at the end of therapy or the long term maintenance of the improvement itself (up to three years from the end of the therapy), prognostic factors pertaining to drop-out. Results show that it .is possible to outline some prognostic factors and that it is crucial studying a combination of factors rather than single ones. Among the others, therapeutic relationship, personality disorders, "overvalued ideation", severe depression, the combination between type of compulsion and sex, severity and duration of symptoms seem to be relevant elements for the therapy outcome.

We offer also clinical suggestions concerning treatment outcomes.