Exposure-Based Video Therapy for Obsessive-Compulsive Disorder and Posttraumatic-Stress Disorder: Clinical Outcomes from a Large Real-World Sample of Adults

Abstract Objective Obsessive-compulsive disorder (OCD) and posttraumatic-stress disorder (PTSD) are often comorbid. While exposure-based treatments can be effective for each, given that comorbid OCD and PTSD symptoms often interact dynamically, concurrent treatment may be most beneficial. The aim of the current analysis was to examine the naturalistic effectiveness of concurrently-delivered exposure and response prevention (ERP) and prolonged exposure (PE) therapy among individuals with comorbid OCD and PTSD. Methods Adult patients ( N =181) diagnosed with comorbid OCD and PTSD were treated with concurrent ERP and PE as part of a video therapy service specializing in treating comorbid OCD and PTSD. Treatment outcomes for both conditions were assessed at three timepoints: (1) at session 20, (2) at session 40, and (3) the final assessment timepoint completed by each patient. Results At all three timepoints, there were significant reductions in OCD and PTSD symptoms. By the final timepoint, median percent improvement was 40.9% [IQR: 11.5-70.7%] for PTSD and 50.0% [IQR: 25-67.6%] for OCD. By the final timepoint, 67.4% of patients met criteria for a full PTSD response, 64.1% met criteria for a full OCD response, and 49.2% met criteria for a full response for both conditions. Analyses of secondary treatment outcomes showed significant reductions in depressive and anxiety symptoms, disability, and showed improvements in quality of life. Conclusion Concurrent ERP and PE, delivered remotely via video therapy in a real-world setting, appears to be a clinically effective treatment approach for individuals with comorbid OCD and PTSD.