(PS7-D80) The Role of Intolerance of Uncertainty (IUS) in OCD Severity and Quality of Life (QLESQ): Data from a Naturalistic Follow-up Study

Intolerance of Uncertainty and Quality of Life: Key Predictors of Depression and OCD

Background:  Intolerance of Uncertainty (IUS) and Quality of Life (QoL) are crucial factors in Obsessive Compulsive Disorder (OCD) and Depression. Accordingly, symptoms reflect these transdiagnostic constructs. IUS has been shown to contribute to the link between neuroticism and both OCD and inaction in the face of uncertainty, while QoL mediates the link between neuroticism and depression. Individuals with OCD and comorbid psychiatric diagnoses, especially depression, exhibit the poorest QoL and functioning. Past research suggests IUS significantly coincides with symptom levels of OCD and depression, irrespective of other factors. OCD remission leads to improved QoL and functioning compared to those with current OCD. We predicted that Intolerance of Uncertainty (IUS) and Low Quality of life (QoL) impact OCD and depression symptoms. 

Methods: 552 patients with Obsessive Compulsive Disorder (OCD; n=553) were evaluated by clinicians in the outpatient setting (n=553, 280 men, 270 women, 2 other). Participants were between the ages of 14-80 Age (M=32). Assessment included several measures, including the Yale-Brown Obsessive Compulsive Scale (YBOCS), a 10-item, clinician-administered scale measuring symptom severity; the Intolerance of Uncertainty Scale (IUS), which measures aversive feelings toward uncertainty; the Quality of Life Enjoyment and Satisfaction Questionnaire (QLESQ), a self-report measure of QoL; the Quick Inventory of Depressive Symptomatology (QIDS), a self-report measure of depressive symptoms; and the Indecisiveness subscale of the Decisional Conflict Scale (IND15), a self-report measure of difficulty making decisions.

Results: Four linear regression models were used to examine relationships between intolerance of uncertainty, quality of life, OCD symptoms, and depressive symptoms, respectively. We found the Intolerance of Uncertainty Scale (IUS) significantly predicted (QLESQ) scores, F (234) = F 37.58, p < (.001). We found that the IUS significantly predicted Yale-Brown Obsessive Compulsive Scale (YBOCS) scores,  F (140) = F 37.7, p < (.001), and that QLESQ scores significantly predicted YBOCS scores, F (374) = F 41.1, p < (.001). Additionally, QLESQ and IUS scores showed significant relationships with Quick Inventory of Depressive Symptomatology (QIDS) scores, F (116) = F 23.2, p < (.001), F (116) = 23.2, p < (0.003). Lastly, QLESQ and QIDS scores showed a significant relationship, F (284) = F 83.4, p < (.001).

Conclusion: We show that IUS and QoL are important factors in predicting OCD symptoms and depression. Our results suggest that treatment approaches for OCD and depression that consider the impact of IUS and QoL on symptom perpetuation may be more effective in achieving remission and improving functioning and QoL compared to standard approaches. Further research is necessary to clarify the role of indecisiveness in OCD and Depression symptoms, and whether ACT-based approaches are effective in treating intolerance of uncertainty in OCD patients.