Assessments Y-BOCS-SR and Global Assessment of Functioning (GAF) were assessed before treatment and after 7, 14, 21 days, and 1, 3, 6, and 12 months of treatment. Y-BOCS was translated into Chinese with high reliability and validity in 1996 (Zhang et al. 1996) and widely used. GAF proved to be a reliable and valid measurement of social–occupational–psychological functioning (Jones et al. 1995; Soderberg et al. 2005). Y-BOCS-SR was also used to assess prognosis. Many

studies Inhibitors,research,lifescience,medical accepted a lower standard of ≥25% decrease in Y-BOCS-SR as a response to treatment (Hollander et al. 2010). In this study, response to treatment was defined as a 35% decrease in Y-BOCS-SR score from baseline. Remission was defined as ≥80% decrease in Y-BOCS-SR score

from baseline. Relapse was defined as loss of responder status for longer Inhibitors,research,lifescience,medical than 2 weeks (Foa and Kozak 1996). The OCD residual symptoms were self-rated by patients. A set of consecutive integers from 0 to 100% was given to patients who were directed to indicate by what percentage symptoms were improving. A score of 0% meant symptoms were completely relieved; a score of 100% meant the severity of symptoms had not changed after treatment compared with pretreatment. Patients could Inhibitors,research,lifescience,medical produce scores greater than 100% if the symptoms became more serious after treatment. The GAF scale was used to access an individual’s overall level of functioning in carrying out daily activities as a biological activity predictor of treatment outcome. GAF is a continuous measure (from 0 to 100) used by

clinicians and physicians to subjectively rate social, Inhibitors,research,lifescience,medical occupational, and psychological functioning (Schorre and Vandvik 2004). The GAF is constructed as an overall measure of how patients are doing and rates psychological, social, Inhibitors,research,lifescience,medical and occupational functioning, covering the range from positive mental health to severe psychopathology (Aas 2011). Despite its widespread use, the GAF may have its limitations. One major limitation of GAF is that it combines several dimensions of psychopathology on a single 100-point scale, specifically combining symptoms Drug_discovery and social, occupational functioning (Goldman 2005). To solve the problem, we rated the GAF separately and focused primarily on the social and occupational functioning. Although GAF can be valued either as a single score (the severe of the symptom and functioning) or separate scores for symptoms and functioning (Aas 2011), when the GAF is http://www.selleckchem.com/products/Imatinib(STI571).html scored separately, it can be scored reliably (Niv et al. 2007). Quality control Therapists providing CBT received training and supervision before participating in the study. Training included procedure review and completion of at least one training case under supervision. During the study, weekly group supervision for each treatment was held. Only experienced therapists, who displayed excellent protocol adherence in the training program, were involved in the study.