Source: Radiology  |  Posted 4 years ago

By Jill Stein

ST. LOUIS, MO -- April 2, 2007 -- Investigators reported early favourable results using an intensive inpatient programme to treat adolescents with obsessive-compulsive disorder (OCD) who failed conventional outpatient treatment.

"Our data show that inpatient treatment for OCD in an adolescent population is very effective in reducing symptom severity," said senior investigator Throstur Bjorgvinsson, PhD, program director, Obsessive-Compulsive Disorder Treatment Program, Menninger Clinic, Houston, Texas, United States, said at the 27[^]th[] Annual Meeting of the Anxiety Disorders Association of America (ADAA).

"In addition, we found a reduction in the strength of belief in constructs hypothesised to be important in the maintenance of this disorder," he said during a presentation on March 31[^]st[].

For the trial, the researchers analysed data in 23 patients from 12 to 17 years of age who had completed treatment at the Menninger Clinic OCD program where patients are provided with 24-hour care that includes behavioural interventions, medication management, and milieu treatment. Patients and staff set measurable goals collaboratively to reduce obsessions, compulsions, and avoidance behaviours.

Participants were evaluated at enrolment in the program and at discharge on a variety of measures, including OCD severity, other anxiety constructs, depression, OCD-specific beliefs (e.g., uncertainty, thought-action-fusion), and quality of life. Patients typically require about 2 months to complete treatment.

Results showed that most of the outcome measures decreased significantly from admission to discharge, including scores on the Children's Yale-Brown Obsessive-Compulsive Scale ([]P[] < .001), Thought Action Fusion ([]P[] < .001), Obsessive Belief Questionnaire ([]P[] = .005), Obsessive Belief Questionnaire ([]P[] < .001), State Trait Anxiety Inventory ([]P[] = .01),and State Trait Anxiety Inventory ([]P[] = .004).

While overall depression scores did not decrease significantly during treatment, there was a trend towards reduction in depression from the time of admission to discharge.

Dr. Bjorgvinsson pointed out that diagnoses in the study were based on clinical interviews and consensus reached by the treatment team, which may represent a possible study limitation. Future research, he added, should use structured clinical interview measures.

Finally, he noted that at least a third of patients do not show clinically significant improvements with conventional outpatient therapy.

[Presentation title: Treatment Outcome for Adolescent OCD in an Inpatient Setting. Abstract P55]