Flygare Oskar, Wallert John, Chen Long-Long, Fernández de la Cruz Lorena, Lundström Lina, Mataix-Cols David, Rück Christian, Andersson Erik
Karolinska Institutet and Stockholm Health Care Services.
Karolinska Institutet and Stockholm Health Care Services.
Behav Ther. 2023 Jan;54(1):43-50. doi: 10.1016/j.beth.2022.06.009. Epub 2022 Jul 15.
In clinical trials of obsessive-compulsive disorder (OCD), clinical outcomes are generally measured using lengthy clinician-administered interviews. However, in routine clinical practice, many clinicians lack the time to administer such instruments. This study evaluated cutoffs for treatment response and remission in OCD using the self-rated Obsessive-Compulsive Inventory-Revised (OCI-R). Data from 349 patients in three clinical trials of cognitive-behavioral therapy for OCD were pooled for analysis. The OCI-R was compared to gold-standard criteria for response and remission based on the clinician-administered Yale-Brown Obsessive Compulsive Scale and the Clinical Global Impression Scale. The results showed that a ≥40% reduction on the OCI-R was the optimal cutoff for treatment response, with a sensitivity of 0.72 and a specificity of 0.79. For remission status, the optimal cutoff was ≤8 points on the OCI-R, with a sensitivity of 0.57 and specificity of 0.83. Results from additional analyses using the 12-item version of the OCI were similar. These cutoffs provide a simple and time-efficient way to help determine treatment response and remission in OCD when the administration of clinician-administered instruments is unfeasible.
在强迫症(OCD)的临床试验中,临床结果通常使用冗长的临床医生主导的访谈来衡量。然而,在常规临床实践中,许多临床医生没有时间使用此类工具。本研究使用自评的修订版强迫观念与强迫行为量表(OCI-R)评估了强迫症治疗反应和缓解的临界值。对三项强迫症认知行为治疗临床试验中349名患者的数据进行汇总分析。将OCI-R与基于临床医生主导的耶鲁-布朗强迫量表和临床总体印象量表的反应和缓解的金标准进行比较。结果显示,OCI-R降低≥40%是治疗反应的最佳临界值,敏感性为0.72,特异性为0.79。对于缓解状态,最佳临界值是OCI-R≤8分,敏感性为0.57,特异性为0.83。使用OCI的12项版本进行的其他分析结果相似。当临床医生主导的工具不可行时,这些临界值提供了一种简单且省时的方法来帮助确定强迫症的治疗反应和缓解情况。