Can memory and executive functions in patients with obsessive-compulsive disorder predict
outcome of cognitive behavioural therapy?
Sammanfattning
Background: Most studies find that patients with obsessive-compulsive disorder (OCD) have
impaired memory and executive functions. Cognitive behavioural therapy (CBT) is the recommended
psychotherapeutic treatment of patients with OCD. We hypothesized that impairments in memory and
executive functions would predict poor outcome of CBT. Aim: To investigate whether memory and
executive functions in patients with OCD could predict outcome of CBT. Methods: We assessed 39
patients with OCD before CBT with neuropsychological tests of memory and executive functions, the
Hamilton Depression Rating Scale, and the Global Assessment of Functioning Scale. Furthermore, we
assessed severity of OCD symptoms before and after CBT using the Yale-Brown Obsessive
Compulsive Scale. Results: There were no statistically significant differences between recovered
(41%) and non-recovered patients (59%) on any neuropsychological test variables or on any baseline
demographic variables. Furthermore, change in OCD symptoms was not predicted by
neuropsychological test performances or baseline severity of OCD symptoms. The only statistically
significant finding was that non-recovered patients had lower social functioning before CBT than
recovered patients (p = 0.018, d = 0.797). Conclusions: Memory and executive functions in patients
with OCD could not predict outcome of CBT, but level of social functioning may be a predictor of CBT
outcome. Some of the main clinical implications are that we cannot use memory and executive
functions, or baseline severity of OCD symptoms to determine which patients should be offered CBT.