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Quality of life outcomes in patients with obsessive-compulsive disorder: relationship to treatment response and symptom relapse.
J Clin Psychiatry. 2010 Jun; 71(6):784-92.JC

Abstract

OBJECTIVE

Data were analyzed from 2 prospective, double-blind, placebo-controlled trials of escitalopram in obsessive-compulsive disorder (OCD) to characterize the baseline levels of functional disability and impairment in health-related quality of life (HRQoL) and to assess the relationship between treatment outcomes (response or relapse) and disability or HRQoL.

METHOD

Data from a 24-week, placebo-controlled, fixed-dose trial (N = 466) of escitalopram (10-20 mg/d) or paroxetine (40 mg/d) and from a 40-week, flexible-dose (escitalopram 10-20 mg/d), placebo-controlled relapse-prevention trial (N = 468) were analyzed. Obsessive-compulsive disorder symptoms (DSM-IV criteria) were assessed using the Yale-Brown Obsessive Compulsive Scale (YBOCS), functioning was assessed using the Sheehan Disability Scale (SDS), and HRQoL was assessed using the Medical Outcomes Study Short Form (SF-36). Baseline data were pooled for patients across both studies. For patients in the fixed-dose study, SDS and SF-36 scores were compared across treatment groups and for responders versus nonresponders. In the relapse-prevention trial, SDS and SF-36 scores were compared for relapsed versus nonrelapsed patients.

RESULTS

Patients with more severe baseline symptoms (YBOCS > or = 27) reported significantly greater impairment on the SDS (P < .001) and SF-36 (except for bodily pain). Patients receiving escitalopram or paroxetine reported significant improvements on most SF-36 dimensions and on the SDS compared to placebo; however, improvements in work-related functioning were seen earlier for patients receiving escitalopram (20 mg/d). At the study endpoints, SDS and SF-36 scores were significantly better for patients who were responders (versus nonresponders) and for patients who did not relapse (versus relapsers).

CONCLUSIONS

Obsessive-compulsive disorder is associated with significant impairment in functioning and HRQoL. Significant differences in disability and HRQoL between responders and nonresponders or relapsers and nonrelapsers suggest a relationship between symptomatic and functional outcomes.

TRIAL REGISTRATION

lundbecktrials.com Identifiers: 10205 and 10193.

Authors+Show Affiliations

Montefiore Medical Center University Hospital for Albert Einstein College of Medicine Child Psychiatry Annex, 111 E. 210th St, Bronx, NY 10467-2490, USA. eholland@montefiore.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20492845

Citation

Hollander, Eric, et al. "Quality of Life Outcomes in Patients With Obsessive-compulsive Disorder: Relationship to Treatment Response and Symptom Relapse." The Journal of Clinical Psychiatry, vol. 71, no. 6, 2010, pp. 784-92.
Hollander E, Stein DJ, Fineberg NA, et al. Quality of life outcomes in patients with obsessive-compulsive disorder: relationship to treatment response and symptom relapse. J Clin Psychiatry. 2010;71(6):784-92.
Hollander, E., Stein, D. J., Fineberg, N. A., Marteau, F., & Legault, M. (2010). Quality of life outcomes in patients with obsessive-compulsive disorder: relationship to treatment response and symptom relapse. The Journal of Clinical Psychiatry, 71(6), 784-92. https://doi.org/10.4088/JCP.09m05911blu
Hollander E, et al. Quality of Life Outcomes in Patients With Obsessive-compulsive Disorder: Relationship to Treatment Response and Symptom Relapse. J Clin Psychiatry. 2010;71(6):784-92. PubMed PMID: 20492845.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Quality of life outcomes in patients with obsessive-compulsive disorder: relationship to treatment response and symptom relapse. AU - Hollander,Eric, AU - Stein,Dan J, AU - Fineberg,Naomi A, AU - Marteau,Florence, AU - Legault,Mark, Y1 - 2010/05/04/ PY - 2009/12/14/received PY - 2010/02/11/accepted PY - 2010/5/25/entrez PY - 2010/5/25/pubmed PY - 2010/7/14/medline SP - 784 EP - 92 JF - The Journal of clinical psychiatry JO - J Clin Psychiatry VL - 71 IS - 6 N2 - OBJECTIVE: Data were analyzed from 2 prospective, double-blind, placebo-controlled trials of escitalopram in obsessive-compulsive disorder (OCD) to characterize the baseline levels of functional disability and impairment in health-related quality of life (HRQoL) and to assess the relationship between treatment outcomes (response or relapse) and disability or HRQoL. METHOD: Data from a 24-week, placebo-controlled, fixed-dose trial (N = 466) of escitalopram (10-20 mg/d) or paroxetine (40 mg/d) and from a 40-week, flexible-dose (escitalopram 10-20 mg/d), placebo-controlled relapse-prevention trial (N = 468) were analyzed. Obsessive-compulsive disorder symptoms (DSM-IV criteria) were assessed using the Yale-Brown Obsessive Compulsive Scale (YBOCS), functioning was assessed using the Sheehan Disability Scale (SDS), and HRQoL was assessed using the Medical Outcomes Study Short Form (SF-36). Baseline data were pooled for patients across both studies. For patients in the fixed-dose study, SDS and SF-36 scores were compared across treatment groups and for responders versus nonresponders. In the relapse-prevention trial, SDS and SF-36 scores were compared for relapsed versus nonrelapsed patients. RESULTS: Patients with more severe baseline symptoms (YBOCS > or = 27) reported significantly greater impairment on the SDS (P < .001) and SF-36 (except for bodily pain). Patients receiving escitalopram or paroxetine reported significant improvements on most SF-36 dimensions and on the SDS compared to placebo; however, improvements in work-related functioning were seen earlier for patients receiving escitalopram (20 mg/d). At the study endpoints, SDS and SF-36 scores were significantly better for patients who were responders (versus nonresponders) and for patients who did not relapse (versus relapsers). CONCLUSIONS: Obsessive-compulsive disorder is associated with significant impairment in functioning and HRQoL. Significant differences in disability and HRQoL between responders and nonresponders or relapsers and nonrelapsers suggest a relationship between symptomatic and functional outcomes. TRIAL REGISTRATION: lundbecktrials.com Identifiers: 10205 and 10193. SN - 1555-2101 UR - https://www.unboundmedicine.com/medline/citation/20492845/Quality_of_life_outcomes_in_patients_with_obsessive_compulsive_disorder:_relationship_to_treatment_response_and_symptom_relapse_ L2 - http://www.psychiatrist.com/jcp/article/pages/2010/v71n06/v71n0615.aspx DB - PRIME DP - Unbound Medicine ER -