Effects of OCD Treatment on Quality and Functionality of Life

OKB'de Tedavinin Yaşam Kalitesi ve İşlevselliği Üzerindeki Etkisi

Obsessive-Compulsive Disorder (OCD) is a condition that is related to significant disruptions in the functioning of many fields (work, home and social life), and this condition causes serious deteriorations in the significant parts of daily life. When the correlation between OCD and impaired functionality and quality of life (QL) is taken into consideration, it is important to analyze whether evidence-based treatments lead to recovery for OCD.

While the quality of life (QL) is a structure that covers how satisfied or dissatisfied that one is with their life, functionality is related to how well an individual could perform in various fields of daily life compared to their own standards.

The severity of OCD is measured through the Obsessive-Compulsive Inventory-Revised (OCI-R) and Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), which are self-report scales.

The clinical study, in which the exposure/response prevention (EX/RP) therapy was compared to the use of risperidone or placebo, included 100 random adult participants who used stable doses of SRI and were diagnosed with OCD. While the use of SRI by the participants remained in the same dose, the participants were randomized via risperidone, EX/RP or placebo. Evaluations were carried out for the OCD symptoms and QL/functionality of the patients at the beginning, during and in the aftermath of the treatment.

All participants gathered regularly with a psychiatrist for the medicine management purposes; the people who took risperidone or placebo visited the psychiatrist once in every 1-2 weeks while the patients taking EX/RP visited the psychiatrist once in every 4 weeks during the treatment. Using a multi-level modeling, the changes in the QL/functionality were assessed during the treatment, and the changes in between the treatment conditions were concluded.

Improvements in the QL/functionality were significantly higher in those who received the EX/RP treatment, compared to those who received the risperidone treatment. When compared to placebo, the EX/RP showed a better performance on the functionality scale; however, it did not show any significant difference on the QL scale.

Higher levels of improvement in individual OCI-R were associated with greater improvements in the QL/functionality, independently of the conditions. When considered jointly, it can be seen that both OCD and QL/functionality improved throughout the treatment and that the decrease in the severity of the OCD symptoms predicted the improvements in the QL and functionality. Additionally, the Y-BOCS scores were found to have achieved an intermediate level of improvement in the QL in all treatment circumstances, therefore those with higher Y-BCOS scores showed the greatest improvements in the QL in time. The improvements in the QL/functionality were associated with the decrease in the severity of the OCD symptoms.

Specifically, patients with more severe OCD symptoms tend to show a worse QL and functionality. It shows the seriously negative correlation between the severity of OCD and the QL.

REFERENCES:
Asnaani, A., Kaczkurkin, A. N., Alpert, E., McLean, C. P., Simpson, H. B., & Foa, E. B. (2017). The effect of treatment on quality of life and functioning in OCD. Comprehensive Psychiatry, 73, 7–14. doi:10.1016/j.comppsych.2016.10.004

Prof. Dr. Kemal Arıkan
Psychiatrist