Evidence map›Paper›PMID 34089924›Full record

ArticleBehaviour research and therapy2021

Maximizing remission from cognitive-behavioral therapy in medicated adults with obsessive-compulsive disorder.

Helen B Simpson, Edna B Foa, Michael G Wheaton, Thea Gallagher, Marina Gershkovich, Andrew B Schmidt, Jonathan D Huppert, Raphael B Campeas, Patricia A Imms, Shawn P Cahill and 21 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Behaviour research and therapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
2.5field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 32 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

31 authors at 12 institutions in 2 countries.

Helen B SimpsonDepartment of Psychiatry, Columbia University, New York, NY, 10032, USA; New York State Psychiatric Institute, New York, NY, 10032, USA. Electronic address: Blair.Simpson@nyspi.columbia.edu.
Edna B FoaCenter for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA.
Michael G WheatonNew York State Psychiatric Institute, New York, NY, 10032, USA; Barnard College, Columbia University, New York, NY, 10027, USA.
Thea GallagherCenter for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA.
Marina GershkovichDepartment of Psychiatry, Columbia University, New York, NY, 10032, USA; New York State Psychiatric Institute, New York, NY, 10032, USA.
Andrew B SchmidtDepartment of Psychiatry, Columbia University, New York, NY, 10032, USA; New York State Psychiatric Institute, New York, NY, 10032, USA.
Jonathan D HuppertThe Hebrew University of Jerusalem, Israel.
Raphael B CampeasDepartment of Psychiatry, Columbia University, New York, NY, 10032, USA; New York State Psychiatric Institute, New York, NY, 10032, USA.
Patricia A ImmsCenter for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA.
Shawn P CahillUniversity of Wisconsin-Milwaukee, Milwaukee, WI, 53201, USA.
Christina DiChiaraCenter for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA; Center for Anxiety and Behavior Therapy, Bryn Mawr, PA, 19010, USA.
Steven D TsaoCenter for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA; Center for Anxiety and Behavior Therapy, Bryn Mawr, PA, 19010, USA.
Anthony C PuliaficoDepartment of Psychiatry, Columbia University, New York, NY, 10032, USA; New York State Psychiatric Institute, New York, NY, 10032, USA.
Daniel ChazinCenter for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA.
Anu AsnaaniCenter for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Psychology, University of Utah, Salt Lake City, UT, 84112, USA.
Kelly MooreCenter for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA; Rutgers University/Biomedical Health Sciences New Brunswick, NJ, 08854, USA.
Jeremy TylerCenter for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA.
Shari A SteinmanDepartment of Psychiatry, Columbia University, New York, NY, 10032, USA; New York State Psychiatric Institute, New York, NY, 10032, USA; Department of Psychology, WVU, Morgantown, WV, 26506, USA.
Arturo Sanchez-LaCayDepartment of Psychiatry, Columbia University, New York, NY, 10032, USA; New York State Psychiatric Institute, New York, NY, 10032, USA.
Sandy CapaldiCenter for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA.
Ivar SnorrasonDepartment of Psychiatry, Columbia University, New York, NY, 10032, USA; New York State Psychiatric Institute, New York, NY, 10032, USA; McLean Hospital/Harvard Medical School, Belmont, MA, 02478, USA.
Elizabeth Turk-KaranCenter for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA.
Donna VermesDepartment of Psychiatry, Columbia University, New York, NY, 10032, USA; New York State Psychiatric Institute, New York, NY, 10032, USA.
Eyal KalanthroffThe Hebrew University of Jerusalem, Israel.
Anthony PintoDepartment of Psychiatry, Columbia University, New York, NY, 10032, USA; New York State Psychiatric Institute, New York, NY, 10032, USA; Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, The Zucker Hillside Hospital, Glen Oaks, NY, 11004, USA.
Chang-Gyu HahnCenter for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, 19104, USA.
Bin XuDepartment of Psychiatry, Columbia University, New York, NY, 10032, USA.
Page E Van MeterDepartment of Psychiatry, Columbia University, New York, NY, 10032, USA; New York State Psychiatric Institute, New York, NY, 10032, USA.
Martha KatechisDepartment of Psychiatry, Columbia University, New York, NY, 10032, USA; New York State Psychiatric Institute, New York, NY, 10032, USA.
Jennifer ScodesNew York State Psychiatric Institute, New York, NY, 10032, USA.
Yuanjia WangDepartment of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA.
New York Psychoanalytic Society and Institute · USUniversity of Pennsylvania · USBryn Mawr College · USColumbia University · USHebrew University of Jerusalem · ILMcLean Hospital · USNew York State Psychiatric InstituteRutgers, The State University of New Jersey · USUniversity of Utah · USUniversity of Wisconsin–Milwaukee · USWest Virginia University Hospitals · USZucker Hillside Hospital · US

Funding

Maximizing Treatment Outcome in OCDR01MH045404 · NIMH · UNIVERSITY OF PENNSYLVANIA · PI FOA, EDNA B · 1990 to 2016
$5.3M
Maximizing Treatment Outcome in OCDR01MH045436 · NIMH · NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC · PI SIMPSON, HELEN BLAIR · 1990 to 2015
$5.0M
NIMH NIH HHS R01 MH045404NIMH NIH HHS R01 MH045436
6 · The paper itself

Abstract

Practice guidelines for adults with obsessive-compulsive disorder (OCD) recommend augmenting serotonin reuptake inhibitors (SRIs) with exposure and ritual prevention (EX/RP). However, fewer than half of patients remit after a standard 17-session EX/RP course. We studied whether extending the course increased overall remission rates and which patient factors predicted remission. Participants were 137 adults with clinically significant OCD (Yale-Brown Obsessive Compulsive Scale [Y-BOCS] score ≥18) despite an adequate SRI trial (≥12 weeks). Continuing their SRI, patients received 17 sessions of twice-weekly EX/RP (standard course). Patients who did not remit (Y-BOCS ≤12) received up to 8 additional sessions (extended course). Of 137 entrants, 123 completed treatment: 49 (35.8%) remitted with the standard course and another 46 (33.6%) with the extended course. Poorer patient homework adherence, more Obsessive-Compulsive Personality Disorder (OCPD) traits, and the Brain-Derived Neurotrophic Factor (BDNF) Val66MET genotype were associated with lower odds of standard course remission. Only homework adherence differentiated non-remitters from extended course remitters. Extending the EX/RP course from 17 to 25 sessions enabled many (69.3%) OCD patients on SRIs to achieve remission. Although behavioral (patient homework adherence), psychological (OCPD traits), and biological (BDNF genotype) factors influenced odds of EX/RP remission, homework adherence was the most potent patient factor overall.

Indexed as

Cognitive Behavioral TherapyObsessive-Compulsive DisorderAdultCombined Modality TherapyHumansPatient ComplianceSelective Serotonin Reuptake InhibitorsTreatment OutcomeSelective Serotonin Reuptake InhibitorsCBTCognitive-behavioral therapyExposure and ritual preventionEX/RPObsessive-compulsive disorderOCD

Identifiers

PMID34089924
PMCPMC8241471
OpenAlexW3170833985

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.