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. (C) 2017 Elsevier Masson SAS. All rights reserved.
Original language | English |
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Pages (from-to) | 76-82 |
Number of pages | 7 |
Journal | European Psychiatry |
Volume | 44 |
DOIs | |
Publication status | Published - Jul 2017 |
Keywords
- Obsessive-compulsive disorder
- Depression
- Comorbidity
- Longitudinal
- Moderators
- OBSESSIVE-COMPULSIVE DISORDER
- RESPONSE PREVENTION
- COMORBID DEPRESSION
- ANXIETY DISORDERS
- ATTACHMENT STYLES
- EXPRESSED EMOTION
- MAJOR DEPRESSION
- COGNITIVE THEORY
- SYMPTOMS
- INVENTORY