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Metacognitive beliefs predict early response to pharmacological treatment in patients with obsessive-compulsive disorder

 Chun Il Park  ;  Hae Won Kim  ;  Sumoa Jeon  ;  Eun Hee Hwang  ;  Jee In Kang  ;  Se Joo Kim 
 PSYCHOPHARMACOLOGY, Vol.237(11) : 3489-3496, 2020-11 
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Early response ; Metacognition ; OCD ; Positive beliefs about worry ; Serotonin reuptake inhibitor
Rationale: Metacognitions, beliefs that monitor or control thoughts and coping, are considered to be important components for development and maintenance of obsessive-compulsive disorder (OCD). Objectives: This study prospectively investigated whether metacognitive beliefs can predict early treatment response after serotonin reuptake inhibitor (SRI) initiation in patients with OCD. Methods: Drug-naïve or medication-free patients with OCD (N = 156) were assessed for various characteristics, including metacognitions. In total, 132 patients were followed for 4 weeks, and their clinical responses to pharmacological treatment were assessed using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Early treatment response was defined as a 20% or greater reduction from the baseline Y-BOCS score at 4 weeks. Logistic and linear regression analyses were performed to identify major determinants for the early treatment outcome. Results: Among participants with OCD, 53 patients (40.15%) were early responders. The logistic regression model revealed two significant predictors, age (beta = - 0.113, p < 0.001) and "positive beliefs about worry," which refers to metacognitive beliefs concerning the benefits of engaging in worry (beta = - 0.067, p = 0.001), for identifying early responders. Moreover, in the linear regression model, lower "positive beliefs about worry" was also shown as a significant predictor for the degree of better early improvement (beta = - 0.566, p = 0.001). Conclusions: These results suggest that lower metacognition of "positive beliefs about worry" predicts improvement of obsessive-compulsive symptoms seen early on in the SRI treatment, and that pathological metacognitive belief would lead to delayed response to SRI treatment in OCD.
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1. College of Medicine (의과대학) > Dept. of Psychiatry (정신과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Medical Education (의학교육학과) > 1. Journal Papers
Yonsei Authors
Kang, Jee In(강지인) ORCID logo https://orcid.org/0000-0002-2818-7183
Kim, Se Joo(김세주) ORCID logo https://orcid.org/0000-0002-5438-8210
Kim, Hae Won(김혜원) ORCID logo https://orcid.org/0000-0002-9321-8361
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