Patterns of remission and relapse in obsessive-compulsive disorder: A 2-year prospective study

Objective: This study examined the course of illness in patients with obsessive-compulsive disorder (OCD) over a 2-year period. Method: Sixty-six patients with a primary diagnosis of DSM-III-R OCD were followed prospectively for 2 years. Baseline information was collected on demographic characteristics, Axis I and II diagnoses, and severity of OCD symptoms. Follow-up measures obtained at 3, 6, 12, and 24 months after baseline assessment included information on symptomatic and diagnostic status as well as behavioral and somatic treatments received. Results: The probability of full remission from OCD over the 2-year period was 12%. The probability of partial remission was 47%. After achieving remission from OCD, the probability of relapse was 48%. No factors were identified that significantly predicted full or partial remission. Seventy-seven percent (N = 51) of the subjects received a serotonin reuptake inhibitor (SRI) for greater than or equal to 12 weeks, and 68% (N = 45) received medium-to-high doses of SRIs for greater than or equal to 12 weeks. Only 18% received a full trial of behavior therapy. Conclusion: Despite exposure to at least 1 adequate trial of an SRI, the likelihood of full remission of OCD in this study was low. Results of this study also suggest that behavior therapy may be underutilized.