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. 2021 Feb 5:14:85-97.
doi: 10.2147/PRBM.S287419. eCollection 2021.

Self-Stigma and Treatment Effectiveness in Patients with SSRI Non-Responsive Obsessive-Compulsive Disorder

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
Affiliations

Self-Stigma and Treatment Effectiveness in Patients with SSRI Non-Responsive Obsessive-Compulsive Disorder

Marie Ociskova et al. Psychol Res Behav Manag. .

Abstract

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: cognitive behavioral therapy; exposure and response prevention; non-response; obsessive compulsive disorder; self-stigma.

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Conflict of interest statement

The authors declare no conflicts of interest in this work.

Figures

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Figure 1
Flowchart of the enrollment process.
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