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Predictors of course in obsessive–compulsive disorder: logistic regression versus Cox regression for recurrent events

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Kempe PT, van Oppen P, de Haan E, Twisk JWR, Sluis A, Smit JH, van Dyck R, van Balkom AJLM. Predictors of course in obsessive–compulsive disorder: logistic regression versus Cox regression for recurrent events. Objective: 

Two methods for predicting remissions in obsessive–compulsive disorder (OCD) treatment are evaluated. Y-BOCS measurements of 88 patients with a primary OCD (DSM-III-R) diagnosis were performed over a 16-week treatment period, and during three follow-ups. Method: 

Remission at any measurement was defined as a Y-BOCS score lower than thirteen combined with a reduction of seven points when compared with baseline. Logistic regression models were compared with a Cox regression for recurrent events model. Results: 

Logistic regression yielded different models at different evaluation times. The recurrent events model remained stable when fewer measurements were used. Higher baseline levels of neuroticism and more severe OCD symptoms were associated with a lower chance of remission, early age of onset and more depressive symptoms with a higher chance. Conclusion: 

Choice of outcome time affects logistic regression prediction models. Recurrent events analysis uses all information on remissions and relapses. Short- and long-term predictors for OCD remission show overlap.

Keywords: follow-up studies; forecasting; obsessive–compulsive disorder; remission induction; treatment outcome

Document Type: Research Article


Affiliations: 1: Department of Psychiatry and Institute for Research in Extramural Medicine, VU University Medical Center, GGZ Buitenamstel 2: Department of Child and Adolescent Psychiatry, University of Amsterdam, Academic Medical Center 3: Department of Clinical Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands

Publication date: September 1, 2007

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