Dataset Information

Predictors of response to exposure and response prevention-based cognitive behavioral therapy for obsessive-compulsive disorder.

ABSTRACT:

Background

Cognitive 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.

Methods

Forty-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.

Results

Multiple 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 .

Conclusions

Our 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 registration

UMIN, UMIN00024087 . Registered 20 September 2016 - Retrospectively registered (including retrospective data).

SUBMITTER: Hamatani S

PROVIDER: S-EPMC7473813 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Publications

Predictors of response to exposure and response prevention-based cognitive behavioral therapy for obsessive-compulsive disorder.

Hamatani Sayo S Tsuchiyagaito Aki A Nihei Masato M Hayashi Yuta Y Yoshida Tokiko T Takahashi Jumpei J Okawa Sho S Arai Honami H Nagaoka Maki M Matsumoto Kazuki K Shimizu Eiji E Hirano Yoshiyuki Y

BMC psychiatry 20200904 1

<h4>Background</h4>Cognitive 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.<h4>Methods</h4>Forty ...[more]

PMID: 32887553

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Project description:BackgroundCognitive behavioral therapy (CBT) is an effective, first-line treatment for pediatric obsessive-compulsive disorder (OCD). While neural predictors of treatment outcomes have been identified in adults with OCD, robust predictors are lacking for pediatric patients. Herein, we sought to identify brain structural markers of CBT response in youth with OCD.MethodsTwenty-eight children/adolescents with OCD and 27 matched healthy participants (7- to 18-year-olds, M = 11.71 years, SD = 3.29) completed high-resolution structural and diffusion MRI (all unmedicated at time of scanning). Patients with OCD then completed 12-16 sessions of CBT. Subcortical volume and cortical thickness were estimated using FreeSurfer. Structural connectivity (streamline counts) was estimated using MRtrix.ResultsThinner cortex in nine frontoparietal regions significantly predicted improvement in Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) scores (all ts > 3.4, FDR-corrected ps < .05). These included middle and superior frontal, angular, lingual, precentral, superior temporal, and supramarginal gyri (SMG). Vertex-wise analyses confirmed a significant left SMG cluster, showing large effect size (Cohen's d = 1.42) with 72.22% specificity and 90.00% sensitivity in predicting CBT response. Ten structural connections between cingulo-opercular regions exhibited fewer streamline counts in OCD (all ts > 3.12, Cohen's ds > 0.92) compared with healthy participants. These connections predicted post-treatment CY-BOCS scores, beyond pretreatment severity and demographics, though not above and beyond cortical thickness.ConclusionsThe current study identified group differences in structural connectivity (reduced among cingulo-opercular regions) and cortical thickness predictors of CBT response (thinner frontoparietal cortices) in unmedicated children/adolescents with OCD. These data suggest, for the first time, that cortical and white matter features of task control circuits may be useful in identifying which pediatric patients respond best to individual CBT.

Dataset Information

Predictors of response to exposure and response prevention-based cognitive behavioral therapy for obsessive-compulsive disorder.

Background

Methods

Results

Conclusions

Trial registration

Publications

Predictors of response to exposure and response prevention-based cognitive behavioral therapy for obsessive-compulsive disorder.

Similar Datasets

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