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The Journal of Clinical Psychiatry Dec 2019Patients with obsessive-compulsive disorder (OCD) who do not respond adequately to serotonin reuptake inhibitor (SRI) therapy and cognitive behavioral therapy commonly... (Meta-Analysis)
Meta-Analysis Review
Patients with obsessive-compulsive disorder (OCD) who do not respond adequately to serotonin reuptake inhibitor (SRI) therapy and cognitive behavioral therapy commonly receive SRI augmentation in the form of an atypical antipsychotic drug. Memantine is another augmentation strategy that has been trialed. A recent systematic review and meta-analysis found very large improvements associated with memantine augmentation in OCD. Specifically, in 4 randomized controlled trials (RCTs), the response rate was 81% in 67 memantine-treated patients vs only 19% in 68 placebo-treated patients. The weighted mean difference between memantine and placebo groups was nearly 8 points on the Yale-Brown Obsessive Compulsive Scale. Such striking differences for intervention vs placebo in a difficult-to-treat disorder demand scrutiny. An examination of the RCTs on which the meta-analysis was based showed that all 4 RCTs emerged from the same geographical area, limiting the generalizability of the findings. Of greater concern, all 4 RCTs presented what were effectively completer analyses of data, compromising the scientific validity of the findings. There were several other concerns about the individual studies and about the meta-analysis, itself. Therefore, a reasonable conclusion is that, when the internal and external validity of studies in a meta-analysis are compromised, the findings and conclusions of the meta-analysis cannot be considered sound. It is concluded that, despite the very large benefits reportedly associated with memantine augmentation, the routine use of memantine as an augmentation agent for OCD cannot as yet be recommended.
Topics: Cognitive Behavioral Therapy; Combined Modality Therapy; Drug Therapy, Combination; Humans; Memantine; Obsessive-Compulsive Disorder; Randomized Controlled Trials as Topic; Selective Serotonin Reuptake Inhibitors
PubMed: 31846244
DOI: 10.4088/JCP.19f13163 -
Journal of Psychiatry & Neuroscience :... Nov 2018
Topics: Antipsychotic Agents; Child; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Obsessive-Compulsive Disorder; Psychiatric Status Rating Scales; Tics
PubMed: 30375839
DOI: 10.1503/jpn.180086 -
BMJ (Clinical Research Ed.) Aug 2006
Review
Topics: Biomedical Research; Cognitive Behavioral Therapy; Humans; Obsessive-Compulsive Disorder; Patient Selection; Practice Guidelines as Topic; Selective Serotonin Reuptake Inhibitors; Surveys and Questionnaires
PubMed: 16931840
DOI: 10.1136/bmj.333.7565.424 -
Breastfeeding Medicine : the Official... Mar 2022The purpose of this study was to examine associations between postpartum obsessive-compulsive (OC) symptoms, infant care and feeding worries, and breastfeeding...
The purpose of this study was to examine associations between postpartum obsessive-compulsive (OC) symptoms, infant care and feeding worries, and breastfeeding experiences in a sample of postpartum women. Women were recruited via an online U.S. research volunteer database and were eligible if they were aged 18-47 years, their primary language was English, they had an infant 2-6 months old, and tried breastfeeding the infant at least once. Participants completed a survey to assess breastfeeding experiences and practices, OC symptoms and other mental health conditions, and demographics. Modified Poisson regression and linear regression were used to estimate associations between clinically elevated OC symptoms, reported thoughts or worries about infant feeding and care, and breastfeeding experiences, problems, and duration. Of 232 participants, 32 (14%) had clinically elevated OC symptoms. These women had more perinatal OC symptoms (scoring 3.6 points higher on perinatal OC symptoms score [95% confidence interval {CI}: 0.4 to 6.9]), including symptoms specific to infant care and feeding [e.g., adjusted relative risk = 2.37, 95% CI:1.55 to 3.64], and more breastfeeding problems (adjusted β = 0.3, 95% CI: 0.0 to 0.2) than women with fewer OC symptoms. However, they did not report an overall worse breastfeeding experience (adjusted β = 0.4, 95% CI: -9.3 to 10.1). Adjusted models controlled for depressive symptoms. Obsessive thoughts and compulsions were common in this sample and extended to infant feeding activities. These symptoms were associated with more breastfeeding problems. Interactions in mother-infant dyads are critical because of lasting impacts on parent-child relationships and child development. Treating OC symptoms may foster healthier mother-infant relationships.
Topics: Adolescent; Adult; Anxiety; Breast Feeding; Female; Humans; Infant; Middle Aged; Mothers; Obsessive-Compulsive Disorder; Postpartum Period; Pregnancy; Young Adult
PubMed: 34870468
DOI: 10.1089/bfm.2021.0062 -
Asian Journal of Psychiatry Apr 2016Psychiatric comorbidity is extremely common. One of the most common and difficult to manage comorbid conditions is the co-occurrence of bipolar disorder (BD) and... (Review)
Review
Psychiatric comorbidity is extremely common. One of the most common and difficult to manage comorbid conditions is the co-occurrence of bipolar disorder (BD) and obsessive compulsive disorder (OCD). We updated our recent systematic review searching the electronic databases MEDLINE, Embase, and PsycINFO to investigate course of illness in BD-OCD patients. We identified a total of 13 relevant papers which found that the majority of comorbid OCD cases appeared to be related to mood episodes. OC symptoms in comorbid patients appeared more often during depressive episodes, and comorbid BD and OCD cycled together, with OC symptoms often remitting during manic/hypomanic episodes.
Topics: Bipolar Disorder; Comorbidity; Disease Progression; Humans; Obsessive-Compulsive Disorder
PubMed: 27025465
DOI: 10.1016/j.ajp.2016.01.009 -
Trends in Psychiatry and Psychotherapy Oct 2022Neuropsychological findings in obsessive-compulsive disorder (OCD) are mainly clustered around the role of memory and executive functions. However, outcomes vary across...
OBJECTIVE
Neuropsychological findings in obsessive-compulsive disorder (OCD) are mainly clustered around the role of memory and executive functions. However, outcomes vary across different OCD populations. In addition, the extent to which each of these factors can distinguish patients with OCD (PwOCD) from healthy individuals remains uncertain and attracts great attention. The present study aims to investigate the above issues.
METHOD
This was a cross-sectional study of 182 individuals (90 PwOCD and 92 matched healthy controls). After screening for inclusion and exclusion criteria, the participants were administered neuropsychological tests including, the Wechsler Memory Scale-III (WMS-III), the Wisconsin Card Sorting Test (WCST), and the Stroop Color-Word Test (SCWT). Data were analyzed to test the study hypotheses using comparison of means and regression analysis methods.
RESULTS
The results showed that PwOCD had poorer performance than the control group in Immediate Memory, General Memory, and Working Memory and also according to response inhibition indexes. The results also showed that General Memory and Reaction Time2 from the SCWT index could be predictive variables for discriminating between PwOCD and controls.
CONCLUSION
The findings of this study support the prior assumptions that PwOCD would have impaired memory dimensions and response inhibition, but did not support worse set-shifting performance. We also present an initial model for the predictive role of these neuropsychological variables in discriminating OCD from healthy individuals and increasing diagnostic accuracy.
Topics: Case-Control Studies; Cross-Sectional Studies; Executive Function; Humans; Neuropsychological Tests; Obsessive-Compulsive Disorder
PubMed: 33890432
DOI: 10.47626/2237-6089-2021-0243 -
Tijdschrift Voor Psychiatrie 2022OCD has an estimated lifetime prevalence of 2,3%, and is accompanied by several emotional, social and work impairments. Virtual reality is increasingly used in the...
BACKGROUND
OCD has an estimated lifetime prevalence of 2,3%, and is accompanied by several emotional, social and work impairments. Virtual reality is increasingly used in the context of mental health treatment and has recently been proposed as a possible tool for assessment and intervention in OCD.
AIM
To review the existing literature to investigate the role of virtual reality in the diagnosis/severity measurement and treatment of OCD.
METHOD
Systematic literature review using PubMed, Embase and PsycInfo databases.
RESULTS
We found 10 studies, of which 6 on diagnosis/severity measurement and 4 on treatment of OCD. Virtual reality can be a valuable objective tool in the diagnostic process of OCD. In addition, the anxiety level and the obsessive and compulsive symptoms decreased significantly in participants in virtual reality exposure therapy.
CONCLUSION
Further clinical studies with adequate power and design are needed to determine whether virtual reality offers an added value over clinical tools in terms of diagnosis and severity measurement, and whether virtual reality ERP is superior or at least equivalent to in vivo ERP.
Topics: Humans; Obsessive-Compulsive Disorder; Psychotherapy; Virtual Reality
PubMed: 36583276
DOI: No ID Found -
Comprehensive Psychiatry Nov 2022Obsessive-compulsive disorder (OCD) is frequent and often disabling. Yet, correct diagnosis and appropriate treatment implementation are usually delayed, with... (Review)
Review
Obsessive-compulsive disorder (OCD) is frequent and often disabling. Yet, correct diagnosis and appropriate treatment implementation are usually delayed, with undesirable consequences. In this paper we review the rationale for early intervention in OCD and provide recommendations for early intervention services. Two scenarios are discussed, i.e., subclinical (prodromal) obsessive-compulsive symptoms (OCS) and full-blown OCD. Although the typical patient with OCD reports a long history of subclinical OCS, longitudinal studies suggest most individuals with OCS in the community do not convert to full-blown OCD. Thus, research on "at risk" phenotypes for OCD and how they should incorporate different risk factors (e.g., polygenic risk scores) are badly needed. For this specific scenario, preventative treatments that are cheap, well tolerated and highly scalable (e.g., lifestyle interventions) are of major interest. On the other hand, increasing evidence suggests OCD to be a progressive disorder and the severity and duration of illness to be associated with both biological changes and increased clinical complexity, including greater number of physical and psychiatric comorbidities, increased family accommodation and worse treatment response. Therefore, prompt identification and early treatment implementation for full-blown OCD are also critical for ethical, clinical and therapeutic reasons. Based on the existing findings, we argue that, regardless of focusing on subclinical OCS or clinical OCD, early intervention services need to target a childhood age group. In addition to delivering well established treatments to people with full-blown OCD early on their illness, early intervention services also need to provide psychoeducation for patients, families and teachers.
Topics: Humans; Obsessive-Compulsive Disorder; Comorbidity
PubMed: 36341748
DOI: 10.1016/j.comppsych.2022.152353 -
Revista Brasileira de Psiquiatria (Sao... 2014
Topics: Diagnostic and Statistical Manual of Mental Disorders; Humans; Obsessive-Compulsive Disorder; Personality Disorders
PubMed: 25388606
DOI: 10.1590/1516-4446-2014-1531 -
Turkish Journal of Medical Sciences Apr 2023Family accommodation (FA) is associated with disease severity and response to treatment rates in patients with obsessive-compulsive disorder (OCD) and is therefore...
BACKGROUND
Family accommodation (FA) is associated with disease severity and response to treatment rates in patients with obsessive-compulsive disorder (OCD) and is therefore particularly important in this patient group. This study investigated the structure of FA and associated factors in a Turkish society sample.
METHODS
The study was carried out with 92 patients diagnosed with OCD for at least 1 year, who applied to Alanya ALKU Training and Research Hospital psychiatry outpatient clinic between February 2021 and March 2022. Sociodemographic data form, Family Accommodation Scale-Patient Form (FAS-PF), Dimensional Obsessive-Compulsive Scale (DOCS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Acceptance and Action Questionnaire (AAQ-II) were applied to all of the cases. Relatives filled out the Sociodemographic Data.
RESULTS
The mean age of the patients was 32.11 ± 11.56 years. Sixty-nine (75%) of the patients were women. Fifty (54.3%) patients weremarried. All participants reported FA behavior at least once in the previous week. FA exhibited no significant variation by sex (p = 0.679)or marital status (p = 0.256). Significant positive correlation was determined between DOCS-T (r = 0.370, p < 0.001), AAQ-II (r = 0.261, p = 0.013), BDI (r = 0.235, p = 0.024) and BAI (r = 0.342, p = 0.001) scores and the FAS-PF. In the regression analysis, only OCD disease severity predicted FA [(β = 0.295, p = 0.036, 95% confidence interval (95% CI) = 0.02 to 0.55)]. Higher FA scores were obtained in this study (23.93 ± 15.28) compared to previous research in Western societies (14.3 ± 15.2).
DISCUSSION
Clinicians should consider FA in the examination of OCD patients. High FA values for both frequency and severity suggestthat interventions directed toward FA may be associated with more positive outcomes in outpatient Turkish patients with OCD.
Topics: Humans; Female; Young Adult; Adult; Male; Obsessive-Compulsive Disorder; Surveys and Questionnaires; Patient Acuity; Marital Status; Psychiatric Status Rating Scales
PubMed: 37476870
DOI: 10.55730/1300-0144.5620