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Evaluation of a naturalistic maintenance program in the treatment of obsessive-compulsive disorder: A preliminary investigation

McKay, Dean ; Todaro, John F. ; Neziroglu, Fugen ; Yaryura-Tobias, J.A. ;
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    Abstract Although exposure with response prevention has been shown to be effective in the treatment of obsessive-compulsive disorder (OCD), it appears that many patients either continue to struggle with symptoms or relapse following trials of behavior therapy. In an effort to reduce the risk of relapse, a maintenance program was designed for OCD patients based upon the format suggested by Öst. Six consecutively referred patients who met criteria for OCD and received intensive treatment participated. The initial treatment phase was 4 weeks of intensive behavior therapy, with sessions occurring five times per week, 90 min per session. There was a total of 20 sessions in the treatment phase. The maintenance phase lasted 6 months. Following this, there was a 6-month follow-up. Interrupted time-series analyses indicate that patients were albe to maintain treatment gains and continue to improve and remain stable at 6-month follow-up. However, depression levels did not remain stable, and patients suffered depressive symptom relapse. This indicates that a maintenance program is a pragmatic method of preventing relapse in patients with OCD, although symptoms of depression are likely to require more direct attention.


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