TY - JOUR
T1 - Quality of life outcomes in patients with obsessive-compulsive disorder
T2 - Relationship to treatment response and symptom relapse
AU - Hollander, Eric
AU - Stein, Dan J.
AU - Fineberg, Naomi A.
AU - Marteau, Florence
AU - Legault, Mark
PY - 2010/6
Y1 - 2010/6
N2 - Objective: Data were analyzed from 2 prospective, double-blind, placebo-controlled trials of escitalopram in obsessive-compulsive disorder (OCD) to characterize the baseline levels of functional disability and impairment in health-related quality of life (HRQoL) and to assess the relationship between treatment outcomes (response or relapse) and disability or HRQoL. Method: Data from a 24-week, placebocontrolled, fixed-dose trial (N = 466) of escitalopram (10-20 mg/d) or paroxetine (40 mg/d) and from a 40-week, flexible-dose (escitalopram 10-20 mg/d), placebo-controlled relapse-prevention trial (N = 468) were analyzed. Obsessive-compulsive disorder symptoms (DSM-IV criteria) were assessed using the Yale-Brown Obsessive Compulsive Scale (YBOCS), functioning was assessed using the Sheehan Disability Scale (SDS), and HRQoL was assessed using the Medical Outcomes Study Short Form (SF-36). Baseline data were pooled for patients across both studies. For patients in the fixed-dose study, SDS and SF-36 scores were compared across treatment groups and for responders versus nonresponders. In the relapse-prevention trial, SDS and SF-36 scores were compared for relapsed versus nonrelapsed patients. Results: Patients with more severe baseline symptoms (YBOCS ≥ 27) reported significantly greater impairment on the SDS (P <.001) and SF-36 (except for bodily pain). Patients receiving escitalopram or paroxetine reported significant improvements on most SF-36 dimensions and on the SDS compared to placebo; however, improvements in work-related functioning were seen earlier for patients receiving escitalopram (20 mg/d). At the study endpoints, SDS and SF-36 scores were significantly better for patients who were responders (versus nonresponders) and for patients who did not relapse (versus relapsers). Conclusions: Obsessive-compulsive disorder is associated with significant impairment in functioning and HRQoL. Significant differences in disability and HRQoL between responders and non-responders or relapsers and nonrelapsers suggest a relationship between symptomatic and functional outcomes. Trial Registration: lundbecktrials.com Identifiers: 10205 and 10193.
AB - Objective: Data were analyzed from 2 prospective, double-blind, placebo-controlled trials of escitalopram in obsessive-compulsive disorder (OCD) to characterize the baseline levels of functional disability and impairment in health-related quality of life (HRQoL) and to assess the relationship between treatment outcomes (response or relapse) and disability or HRQoL. Method: Data from a 24-week, placebocontrolled, fixed-dose trial (N = 466) of escitalopram (10-20 mg/d) or paroxetine (40 mg/d) and from a 40-week, flexible-dose (escitalopram 10-20 mg/d), placebo-controlled relapse-prevention trial (N = 468) were analyzed. Obsessive-compulsive disorder symptoms (DSM-IV criteria) were assessed using the Yale-Brown Obsessive Compulsive Scale (YBOCS), functioning was assessed using the Sheehan Disability Scale (SDS), and HRQoL was assessed using the Medical Outcomes Study Short Form (SF-36). Baseline data were pooled for patients across both studies. For patients in the fixed-dose study, SDS and SF-36 scores were compared across treatment groups and for responders versus nonresponders. In the relapse-prevention trial, SDS and SF-36 scores were compared for relapsed versus nonrelapsed patients. Results: Patients with more severe baseline symptoms (YBOCS ≥ 27) reported significantly greater impairment on the SDS (P <.001) and SF-36 (except for bodily pain). Patients receiving escitalopram or paroxetine reported significant improvements on most SF-36 dimensions and on the SDS compared to placebo; however, improvements in work-related functioning were seen earlier for patients receiving escitalopram (20 mg/d). At the study endpoints, SDS and SF-36 scores were significantly better for patients who were responders (versus nonresponders) and for patients who did not relapse (versus relapsers). Conclusions: Obsessive-compulsive disorder is associated with significant impairment in functioning and HRQoL. Significant differences in disability and HRQoL between responders and non-responders or relapsers and nonrelapsers suggest a relationship between symptomatic and functional outcomes. Trial Registration: lundbecktrials.com Identifiers: 10205 and 10193.
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U2 - 10.4088/JCP.09m05911blu
DO - 10.4088/JCP.09m05911blu
M3 - Article
C2 - 20492845
AN - SCOPUS:77953760019
SN - 0160-6689
VL - 71
SP - 784
EP - 792
JO - Journal of Clinical Psychiatry
JF - Journal of Clinical Psychiatry
IS - 6
ER -