Cognitive Behavior Therapy for Obsessive-Compulsive Disorder with Co-Morbid Personality Disorder: A Case Series

Background – There have been contrasting results regarding the influence of co-morbid personality disorder (PD) on cognitive behaviour therapy (CBT) outcomes for anxiety disorders. This case series examines the efficacy and challenges of CBT for patients with obsessive-compulsive disorder (OCD) and comorbid PD. Case Series: For the present case series, three individuals with the diagnosis of OCD were selected. They also presented with comorbid obsessive compulsive PD (OCPD), anxious avoidant PD, and dependent PD, respectively, as assessed by the ICD-10 International Personality Disorder Examination (IPDE). The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was administered to assess the severity of OCD in the patients. They underwent a variable number of CBT sessions. Results: Pre- and post-intervention analyses showed reductions in Y-BOCS scores across the baseline, 2-month, and 4-month follow-ups, along with improvements in functioning, as evidenced by patient and informant feedback pre- and post-intervention. However, the patient with co-morbid OCPD had a fluctuating course of treatment outcome, and his poorer motivation and preoccupation with details interfered with the course of therapy. Conclusion: CBT treatment plans of such groups of patients should be individualized to address the issues posed by comorbidity.