Predictors of EX/RP alone versus EX/RP with medication for adults with OCD: Does medication status moderate outcomes?

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2023-10-01 DOI:10.1016/j.jocrd.2023.100850

Michael G. Wheaton , Benjamin Rosenfield , David Rosenfield , Rachel Marsh , Edna B. Foa , H. Blair Simpson

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引用次数: 0

Abstract

Exposure and response prevention (EX/RP) can be delivered as monotherapy or to augment serotonin reuptake inhibitors (SRIs). While both options are considered effective OCD treatments, responses are heterogenous. Substantial work has investigated EX/RP predictors to account for this variability, with mixed findings. Little research has studied whether EX/RP predictors may differ in medicated versus non-medicated samples (i.e., medication status as a moderator). We pooled data from two clinical trials conducted concurrently in the same specialty OCD clinic. One enrolled patients who were on stable SRI doses (EX/RP as SRI augmentation, n = 58) while the other enrolled non-medicated patients (EX/RP monotherapy, n = 38). Both trials used the same manualized EX/RP protocol and blinded independent evaluators. LASSO regression derived predictors and moderators of outcome. Improvement did not significantly differ between the EX/RP alone group and the SRI + EX/RP group. In both groups, higher baseline OCD severity and worse quality of life predicted poorer outcome. OCPD traits moderated results: Patients with more severe OCPD traits had better outcomes from EX/RP monotherapy than those receiving EX/RP with SRIs. Patient adherence to EX/RP homework mediated the associations between the baseline variables and outcome. The effect of OCPD traits on outcome warrants future study to improve care.

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EX/RP单独与EX/RP联合药物治疗成人强迫症的预测因素:药物状态是否会缓和结局?

暴露和反应预防(EX/RP)可以作为单一疗法或增加血清素再摄取抑制剂(SRIs)。虽然这两种选择都被认为是有效的强迫症治疗方法，但反应却各不相同。对EX/RP预测因子进行了大量的研究，以解释这种可变性，结果好坏参半。很少有研究研究EX/RP预测因子是否可能在药物和非药物样本中有所不同(即，药物状态作为调节因素)。我们汇集了在同一专业强迫症诊所同时进行的两项临床试验的数据。一组患者采用稳定的SRI剂量(EX/RP作为SRI增强剂，n = 58)，另一组患者采用非药物治疗(EX/RP单药治疗，n = 38)。两项试验均采用相同的手动EX/RP方案和盲法独立评估者。LASSO回归得到了预测因子和调节因子。单纯EX/RP组和SRI + EX/RP组的改善无显著差异。在两组中，较高的强迫症严重程度和较差的生活质量预示着较差的结果。OCPD特征缓和了结果:具有更严重OCPD特征的患者接受EX/RP单药治疗的结果优于接受EX/RP联合SRIs的患者。患者对EX/RP作业的依从性介导了基线变量和结果之间的关联。OCPD特征对预后的影响值得进一步研究以改善护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.