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The long-term association of OCD and depression and its moderators: A four-year follow up study in a large clinical sample

Published online by Cambridge University Press:  23 March 2020

L. Tibi ,
P. van Oppen ,
A.J.L.M. van Balkom ,
M. Eikelenboom ,
J. Rickelt ,
K.R.J. Schruers  and
G.E. Anholt
L. Tibi*
Affiliation:
Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
P. van Oppen
Affiliation:
Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, GGZ InGeest, Amsterdam, the Netherlands
A.J.L.M. van Balkom
Affiliation:
Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, GGZ InGeest, Amsterdam, the Netherlands
M. Eikelenboom
Affiliation:
Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, GGZ InGeest, Amsterdam, the Netherlands
J. Rickelt
Affiliation:
Department of Psychiatry & Neuropsychology, School of Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, the Netherlands
K.R.J. Schruers
Affiliation:
Department of Psychiatry & Neuropsychology, School of Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands Mondriaan Mental Health Center, Maastricht, the Netherlands Department of Health Psychology, University of Leuven, Belgium
G.E. Anholt
Affiliation:
Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
*
* Corresponding author. E-mail address:tibi@post.bgu.ac.il
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Abstract

Background:

Depression is the most common comorbidity in obsessive-compulsive disorder (OCD). However, the mechanisms of depressive comorbidity in OCD are poorly understood. We assessed the directionality and moderators of the OCD-depression association over time in a large, prospective clinical sample of OCD patients.

Methods:

Data were drawn from 382 OCD patients participating at the Netherlands Obsessive-Compulsive Disorder Association (NOCDA) study. Cross-lagged, structural equation modeling analyses were used to assess the temporal association between OCD and depressive symptoms. Assessments were conducted at baseline, two-year and four-year follow up. Cognitive and interpersonal moderators of the prospective association between OCD and depressive symptoms were tested.

Results:

Cross-lagged analyses demonstrated that OCD predicts depressive symptoms at two-year follow up and not vice a versa. This relationship disappeared at four-year follow up. Secure attachment style moderated the prospective association between OCD and depression.

Conclusions:

Depressive comorbidity in OCD might constitute a functional consequence of the incapacitating OCD symptoms. Both OCD and depression symptoms demonstrated strong stability effects between two-year and four-year follow up, which may explain the lack of association between them in that period. Among OCD patients, secure attachment represents a buffer against future depressive symptoms.

Keywords

Obsessive-compulsive disorderDepressionComorbidityLongitudinalModerators
Type
Original article
Information
European Psychiatry , Volume 44 , July 2017 , pp. 76 - 82
Copyright
Copyright © European Psychiatric Association 2017

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