2003 OCF Grant

A systematic investigation of intensive residential management for severe obsessive compulsive disorder: Predictors of short and long-term outcome

S. Evelyn Stewart, MD

Massachusetts General Hospital/Harvard Medical School (Belmont, MA)

Award Amount: $32,450

At the time of this study, intensive residential treatment (IRT; a therapy module for severe, treatment-resistant OCD) was recently developed and showed promise for treating serious OCD.

Multiple studies by Dr. Stewart and her team stemmed from this grant, which aimed to examine the efficacy of IRT and understand what made it effective in the short and long terms. One study with 402 patients with severe OCD who spent an average of 66 days in IRT demonstrated a 30.1% decrease in symptoms (measured by the Y-BOCS) — a clinically significant improvement (Stewart et al., 2005). Another study in 476 patients with severe OCD found that, following an average of 61 days in IRT, 59.3% of the patients saw a marked decrease in symptoms; this decrease was associated with female gender, higher functioning before IRT, and lower severity of OCD before starting IRT — the best predictor of a successful IRT completion (Stewart et al., 2006). Finally, a follow-up of 61 OCD patients who completed IRT found that treatment gains were sustained on average one month, three months, and six months following treatment (Stewart et al. 2009).

This grant aided in establishing the research program for the McLean OCD Institute and building a data registry.


Resulting Publications:

*Stewart, S.E., Stack, D.E., Farrell, C., Pauls, D.L., & Jenike, M.A. (2005). Effectiveness of intensive residential treatment (IRT) for severe, refractory obsessive-compulsive disorder. Journal of Psychiatric Research, 39, 603-609. doi:10.1016/j.psychires.2005.01.004

*Stewart, S.E., Yen, C-H., Stack, D.E., & Jenike, M.A. (2006). Outcome predictors for severe obsessive-compulsive patients in intensive residential treatment. Journal of Psychiatric Research, 40, 511-519. doi:10.1016/j.jpsychires.2005.08.007 

*Stewart, S. E., Stack, D. E., Tsilker, S., Alosso, J., Stephansky, M., Hezel, D. M., Jenike, E. A., Haddad, S. A., Kant, J., & Jenike, M. A. (2009). Long-term outcome following Intensive Residential Treatment of Obsessive-Compulsive Disorder. Journal of Psychiatric research43(13), 1118–1123. doi:10.1016/j.jpsychires.2009.03.012