Psychopharmacological Treatment Response in Obsessive Compulsive Patients With Autogenous and Reactive Obsessions

Abstract

Objective: It has been suggested that obsessions related with different cognitive process can be discriminated as autogenous and reactive obsessions. This study aimed to compare treatment response to psychopharmacological interventions of the OCD patients with autogenous and reactive obsessions. Methods: Using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Hamilton Depression Rating Scale (HDRS) and White Bear Suppression Inventory we assessed 20 patients with auotogenous obsessions (Autogenous group, AG) and 22 patients with reactive obsessions (Reactive group, RG) who met the DSM-IV criteria for OCD. The patients were consecutively assigned to receive either sertraline (100-200 mg/day), fluvoxamine (200-300 mg/day) or paroxetine (40-80 mg/day). We reassessed 80% of the initial AG (n=16) and 68% of initial RG (n=15) after 12 weeks. Results: The YBOCS obsession, compulsion, total scores, HDRS and WBSI scores at follow-up in both AG and RG were significantly lower than at baseline scores. The mean differences from baseline to follow up for obsession severity and suppression tendency in the AG were significantly higher than RG. The relationships between mean differences from baseline to follow up assessments on severity of obsessions, depressive symptoms and suppression tendency were found to be significant in the AG. Mean difference from baseline to follow up assessments on severity of obsessions were significantly associated with mean difference for compulsion severity in the RG. Conclusions: Discrimination for obsessions based on autogenous versus reactive may have implications for identifying psychopathological mechanisms implicated in the OCD, and for understanding variability in treatment response.