Application of a staging model in patients with obsessive compulsive disorder: cross-sectional and follow-up results

Introduction: Obsessive Compulsive Disorder (OCD) is a prevalent and disabling condition with frequent chronic course. Staging models applied to psychiatric disorders seek to define their extent of progression at a particular timepoint and differentiate early, milder clinical phenomena from those characterizing illness progression and chronicity. In OCD patients a staging model has been recently proposed but not tested yet. This was the aim of the present study. Methods: From an overall sample of 198 OCD patients, recruited across two psychiatric clinics in Northern Italy, 70 patients on stable treatment completed a follow-up assessment ranging from 12 to 24 months. At follow-up initiation, patients had been divided in 4 staging groups, according to the model proposed by Fontenelle and Yucel. At the end of the follow-up, patients were subdivided in 3 groups (no stage change, improved stage or worsened stage) compared with statistical analyses. Results: At the end of the follow-up, 67.1% patients showed no stage changes, 24.3% a stage improvement and 8.6% a stage progression. Worsened patients showed higher rates of comorbid disorders and higher rates of unfavourable employment characteristics compared to the other subgroups (p<.05). Patients with worsened stage showed higher prevalence of somatic obsessions (p<.05), while patients with improved stage showed higher rates of magical thinking and violence/harm obsessions compared to other groups (p<.05). Discussion: Present results provide epidemiologic and clinical correlates of the first application of a staging model in a sample of OCD patients, encouraging further studies to assess the utility of this approach in the field.