Outcomes for residential or inpatient intensive treatment of obsessive-compulsive disorder: A systematic review and meta-analysis

D. Veale*, I. Naismith, S. Miles, L. J. Gledhill, G. Stewart, J. Hodsoll

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

45 Citations (Scopus)
5425 Downloads (Pure)

Abstract

Little data exist to inform the treatment of severe or treatment refractory obsessive-compulsive disorder (OCD) in an inpatient or residential setting. We aimed to determine effect size of inpatient, residential or day-patient program in people with OCD. Studies were selected if they were conducted in an inpatient, day-patient or residential setting; were using the Yale Brown Obsessive Compulsive Scale (Y-BOCS) as an outcome measure; treatment included cognitive behavior therapy; it involved adult patients; and had a sample size of at least 20. We identified 19 studies with a total of 2306 participants at admission. We extracted the mean and standard deviation pre-admission and at discharge. The overall reduction was 10.7 points (95% CI: 9.8-11.5, z=24.2 p<0.001) with an effect size, Hedges g, of 1.87. Being married or cohabiting consistently predicted better outcomes, and symptoms of hoarding or comorbid alcohol misuse consistently predicted worse outcomes. Clients with severe or treatment refractory OCD can make significant improvements with intensive residential or inpatient therapy but little is known either about its long term benefits or cost effectiveness compared with an alternative. Programs are offered internationally with a variety of inclusion criteria. We discuss how such programs might be optimized.

Original languageEnglish
Pages (from-to)38-49
Number of pages12
JournalJournal of Obsessive Compulsive and Related Disorders
Volume8
Early online date30 Nov 2015
DOIs
Publication statusPublished - 1 Jan 2016

Keywords

  • Cognitive behavior therapy
  • Day-patient
  • Inpatient
  • Meta-analysis
  • Obsessive-compulsive disorder
  • Residential
  • Systematic review

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