Symptom Presentation and Outcome of Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder.

TLDR

Previous research has classified OCD patients by obsession and compulsion themes, but mental compulsions have been inadequately assessed. The authors conducted two studies with 132 OCD patients, first categorizing them by symptom presentation—including mental compulsions—and then comparing cognitive‑behavioral therapy outcomes across symptom categories. They identified five symptom clusters—harming, contamination, hoarding, unacceptable thoughts, and symmetry—and found that mental compulsions were most common in patients with intrusive religious, violent, or sexual thoughts, while hoarding patients experienced poorer CBT outcomes.

Abstract

Previous researchers have classified obsessive-compulsive disorder (OCD) patients by the themes of their obsessions and compulsions (e.g., washing, checking); however, mental compulsions have not been adequately assessed in these studies. The authors conducted 2 studies using a large sample of OCD patients (N=132). In the 1st study, they categorized patients on the basis of symptom presentation, giving adequate consideration to mental compulsions. Five patient clusters were identified: harming, contamination, hoarding, unacceptable thoughts, and symmetry. Mental compulsions were most prevalent among patients with intrusive, upsetting religious, violent, or sexual thoughts. In the 2nd study, they compared response to cognitive-behavioral therapy across symptom categories, finding poorer outcomes among patients with hoarding symptoms compared with those with other symptom themes.