Expectancy and Compliance as Predictors of Outcome in Obsessive-Compulsive Disorder

Forty-nine obsessive-compulsive ritualizers had clomipramine and live exposure in a randomized controlled design. The effect on outcome of pre-treatment expectations from psychological and from drug treatment and of subsequent compliance with exposure instructions was studied. Exposure instructions led to greater pre-treatment expectations than did anti-exposure instructions, but this did not affect outcome, suggesting that the effect of exposure was not due to expectation. Initially, more ill patients expected more from drug but improved less. Compliance with psychological treatment did not predict better improvement, but most patients were fairly compliant.