Obsessive-compulsive disorder (OCD) affects an estimated 1% of the US population, and approximately 50% of cases are considered severe. Individuals with OCD have been reported to have significant functional disability and worse quality of life compared with those without the condition. First-line treatments — cognitive behavioral therapy (CBT) that includes exposure and response prevention, and selective serotonin reuptake inhibitors (SSRIs) — have been found to be effective for a portion of patients. However, previous findings show that partial remission occurs in approximately 40% of patients, of whom 60% experience relapse within 5 years of treatment. In addition, residual symptoms often continue to affect patients who do improve with treatment.
“There are a number of reasons for the high nonresponse and relapse rates,” said clinical psychologist Jonathan S. Abramowitz, PhD, a professor and associate chair of the Psychology and Neuroscience Department at the University of North Carolina at Chapel Hill. The possibilities include “failure to engage in the treatment, presence of severe depression or psychotic symptoms, and very poor insight into the senselessness of the obsessions and rituals,” he told Psychiatry Advisor. Additionally, clinicians may not fully understand how to structure psychological or pharmacologic treatments to allow for optimal results.