Predictors of response to cognitive behavioural therapy (CBT) for individuals with obsessive-compulsive disorder (OCD): a systematic review

Abstract

Background: Cognitive behavioural therapy (CBT) is considered the first-line treatment for obsessive-compulsive disorder (OCD). However, some individuals with OCD remain symptomatic following CBT, and therefore understanding predictors of outcome is important for informing treatment recommendations.

Aims: The current study aimed to provide the first synthesis of predictors of outcome following CBT for OCD in adults with a primary diagnosis of OCD, as classified by DSM-5.

Method: Eight studies (n=359; mean age range=29.2-37.7 years; 55.4% female) were included in the systematic review.

Results: Congruent with past reviews, there was great heterogeneity of predictors measured across the included studies. Therefore, a narrative synthesis of findings was conducted. Findings from this systematic review indicated that some OCD-related pre-treatment variables (i.e. pre-treatment severity, past CBT treatment, and levels of avoidance) and during treatment variables (i.e. poor working alliance and low treatment adherence) may be important to consider when making treatment recommendations. However, the results also indicate that demographic variables and psychological co-morbidities may not be specific predictors of treatment response.

Conclusions: These findings add to the growing body of literature on predictors of CBT treatment outcomes for individuals with OCD.

Keywords: CBT; cognitive behavioural therapy; obsessive-compulsive disorder; predictors; treatment outcome.