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Self-Stigma and Treatment Effectiveness in Patients with SSRI Non-Responsive Obsessive-Compulsive Disorder
Psychology Research and Behavior Management ( IF 2.8 ) Pub Date : 2021-02-05 , DOI: 10.2147/prbm.s287419 Marie Ociskova 1 , Jan Prasko 1, 2, 3 , Jakub Vanek 1 , Michaela Holubova 4 , Frantisek Hodny 1 , Klara Latalova 1 , Krystof Kantor 1 , Vlastimil Nesnidal 1
Psychology Research and Behavior Management ( IF 2.8 ) Pub Date : 2021-02-05 , DOI: 10.2147/prbm.s287419 Marie Ociskova 1 , Jan Prasko 1, 2, 3 , Jakub Vanek 1 , Michaela Holubova 4 , Frantisek Hodny 1 , Klara Latalova 1 , Krystof Kantor 1 , Vlastimil Nesnidal 1
Affiliation
Purpose: Obsessive compulsive disorder (OCD) is a debilitating mental disorder that often takes a chronic course. One of the factors influencing the treatment effectiveness in anxiety and depressive disorders is the self-stigma. This study focused on the relationship between the self-stigma, symptomatology, and therapeutic outcomes in patients with OCD.
Patients and Methods: Ninety-four inpatients with OCD, who did not sufficiently respond to at least one selective serotonin reuptake inhibitor trial, participated in the study. They attended a six-week therapeutic program consisting of exposure and response prevention, transdiagnostic group cognitive behavioral therapy, individual sessions, mental imagery, relaxation, sport, and ergotherapy. The participants completed several scales: the Internalized Stigma of Mental Illness Scale (ISMI), the self-report Yale-Brown Obsessive Compulsive Scale (Y-BOCS-SR), Beck Anxiety Scale (BAI), Beck Depression Scale-II (BDI-II), and Dissociative Experiences Scale (DES). A senior psychiatrist filled in the Clinical Global Impression (CGI-S).
Results: The average scales’ scores considerably declined in all measurements except for DES. The self-stigma positively correlated with all psychopathology scales. It was also higher in patients with a comorbid personality disorder (PD). The higher self-stigma predicted a lower change in compulsion, anxiety, and depressive symptoms but not the change of obsessions or the overall psychopathology.
Conclusion: The self-stigma presents an important factor connected to higher severity of OCD. It is also a minor predictor of a lower change in symptomatology after combined treatment.
Keywords: obsessive compulsive disorder, self-stigma, exposure and response prevention, cognitive behavioral therapy, non-response
中文翻译：
SSRI 无反应强迫症患者的自我污名和治疗效果
目的：强迫症 (OCD) 是一种使人衰弱的精神障碍，通常呈慢性病程。影响焦虑症和抑郁症治疗效果的因素之一是自我污名。本研究侧重于强迫症患者的自我污名、症状和治疗结果之间的关系。
患者和方法：94 名强迫症住院患者参与了这项研究，他们对至少一种选择性血清素再摄取抑制剂试验没有充分反应。他们参加了一个为期六周的治疗计划，包括暴露和反应预防、跨诊断组认知行为疗法、个人会议、心理意象、放松、运动和运动疗法。参与者完成了几个量表：精神疾病内化污名量表（ISMI）、自我报告耶鲁-布朗强迫症量表（Y-BOCS-SR）、贝克焦虑量表（BAI）、贝克抑郁量表-II（BDI- II) 和分离体验量表 (DES)。一位高级精神科医生填写了临床总体印象 (CGI-S)。
结果：除 DES 外，所有测量的平均量表分数均显着下降。自我污名与所有精神病理学量表呈正相关。患有共病人格障碍（PD）的患者也更高。较高的自我污名预示着强迫、焦虑和抑郁症状的变化较小，但不是强迫观念或整体精神病理学的变化。
结论：自我污名是与强迫症严重程度较高相关的重要因素。它也是联合治疗后症状变化较小的次要预测因子。
关键词：强迫症，自我污名，暴露和反应预防，认知行为疗法，无反应
更新日期：2021-02-05
Patients and Methods: Ninety-four inpatients with OCD, who did not sufficiently respond to at least one selective serotonin reuptake inhibitor trial, participated in the study. They attended a six-week therapeutic program consisting of exposure and response prevention, transdiagnostic group cognitive behavioral therapy, individual sessions, mental imagery, relaxation, sport, and ergotherapy. The participants completed several scales: the Internalized Stigma of Mental Illness Scale (ISMI), the self-report Yale-Brown Obsessive Compulsive Scale (Y-BOCS-SR), Beck Anxiety Scale (BAI), Beck Depression Scale-II (BDI-II), and Dissociative Experiences Scale (DES). A senior psychiatrist filled in the Clinical Global Impression (CGI-S).
Results: The average scales’ scores considerably declined in all measurements except for DES. The self-stigma positively correlated with all psychopathology scales. It was also higher in patients with a comorbid personality disorder (PD). The higher self-stigma predicted a lower change in compulsion, anxiety, and depressive symptoms but not the change of obsessions or the overall psychopathology.
Conclusion: The self-stigma presents an important factor connected to higher severity of OCD. It is also a minor predictor of a lower change in symptomatology after combined treatment.
Keywords: obsessive compulsive disorder, self-stigma, exposure and response prevention, cognitive behavioral therapy, non-response
中文翻译：
SSRI 无反应强迫症患者的自我污名和治疗效果
目的：强迫症 (OCD) 是一种使人衰弱的精神障碍，通常呈慢性病程。影响焦虑症和抑郁症治疗效果的因素之一是自我污名。本研究侧重于强迫症患者的自我污名、症状和治疗结果之间的关系。
患者和方法：94 名强迫症住院患者参与了这项研究，他们对至少一种选择性血清素再摄取抑制剂试验没有充分反应。他们参加了一个为期六周的治疗计划，包括暴露和反应预防、跨诊断组认知行为疗法、个人会议、心理意象、放松、运动和运动疗法。参与者完成了几个量表：精神疾病内化污名量表（ISMI）、自我报告耶鲁-布朗强迫症量表（Y-BOCS-SR）、贝克焦虑量表（BAI）、贝克抑郁量表-II（BDI- II) 和分离体验量表 (DES)。一位高级精神科医生填写了临床总体印象 (CGI-S)。
结果：除 DES 外，所有测量的平均量表分数均显着下降。自我污名与所有精神病理学量表呈正相关。患有共病人格障碍（PD）的患者也更高。较高的自我污名预示着强迫、焦虑和抑郁症状的变化较小，但不是强迫观念或整体精神病理学的变化。
结论：自我污名是与强迫症严重程度较高相关的重要因素。它也是联合治疗后症状变化较小的次要预测因子。
关键词：强迫症，自我污名，暴露和反应预防，认知行为疗法，无反应
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