Sudden gains in the treatment of obsessive-compulsive disorder

Idan M. Aderka, Gideon E. Anholt, Anton J.L.M. Van Balkom, Johannes H. Smit, Haggai Hermesh, Patricia Van Oppen

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


Background: The present study examined sudden gains during treatment for obsessive-compulsive disorder (OCD) and their relationship to short-and long-term outcome. Methods: Ninety-one individuals (age 19-64) completed either cognitive treatment, exposure treatment, or their combination with fluvoxamine for OCD. Participants' obsessive-compulsive symptoms were assessed before each weekly treatment session. In addition, obsessive-compulsive and depressive symptoms were assessed pre treatment and post treatment as well as 12 months following treatment termination. Results: Sudden gains were found among 34.1% of participants and constituted 65.5% of the total reduction in obsessive-compulsive symptoms. Compared to individuals who did not experience sudden gains, individuals who experienced sudden gains reported lower levels of OCD symptoms post treatment, and this was maintained during follow-up. Conclusions: Sudden gains are common in treatments for OCD and are predictive of treatment outcome and follow-up. Sudden gains mark a distinct trajectory of response to treatment for OCD. Individuals with sudden gains greatly improve during treatment and maintain their gains during follow-up, whereas individuals without sudden gains improve to a significantly lesser extent. Thus, treatment planning and development can benefit from considering sudden gains and the intra-individual course of improvement.

Original languageEnglish
Pages (from-to)44-51
Number of pages8
JournalPsychotherapy and Psychosomatics
Issue number1
StatePublished - 1 Dec 2011


  • Cognitive therapy
  • Exposure therapy
  • Long-term outcome
  • Obsessive-compulsive disorder
  • Sudden gains

ASJC Scopus subject areas

  • Clinical Psychology
  • Applied Psychology
  • Psychiatry and Mental health


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