Objective The objective of this study was to characterise international trends in the use of psychotropic medication, psychological therapies, and novel therapies used to treat obsessive–compulsive disorder (OCD). Methods Researchers in the field of OCD were invited to contribute summary statistics on the characteristics of their samples. Consistency of summary statistics across countries was evaluated. Results The study surveyed 19 expert centres from 15 countries (Argentina, Australia, Brazil, China, Germany, Greece, India, Italy, Japan, Mexico, Portugal, South Africa, Spain, the United Kingdom, and the United States) providing a total sample of 7,340 participants. Fluoxetine (n = 972; 13.2%) and fluvoxamine (n = 913; 12.4%) were the most commonly used selective serotonin reuptake inhibitor medications. Risperidone (n = 428; 7.3%) and aripiprazole (n = 415; 7.1%) were the most commonly used antipsychotic agents. Neurostimulation techniques such as transcranial magnetic stimulation, deep brain stimulation, gamma knife surgery, and psychosurgery were used in less than 1% of the sample. There was significant variation in the use and accessibility of exposure and response prevention for OCD. Conclusions The variation between countries in treatments used for OCD needs further evaluation. Exposure and response prevention is not used as frequently as guidelines suggest and appears difficult to access in most countries. Updated treatment guidelines are recommended.
ObjectiveIn this study, we compared duration of untreated illness (DUI) in obsessive-compulsive disorder (OCD), panic disorder (PD), and social anxiety disorder (SAD) patients and investigated its correlates, both within specific diagnoses and across the whole sample.MethodsEighty-eight patients (33 OCD, 24 SAD, and 31 PD) had their diagnosis confirmed by the Mini International Neuropsychiatric Interview, were assessed for treatment-seeking variables, and were evaluated with instruments aimed at quantifying transdiagnostic features (i.e., the Cause subscale of the Illness Perception Questionnaire–Mental Health and the Anxiety Sensitivity Index–Revised) and severity of illness (i.e., Beck Depression and Anxiety Inventories, the Dimensional Obsessive-Compulsive Scale, the Panic and Agoraphobia Scale, and the Social Phobia Inventory).ResultsThe only differences between groups with short (<2 years) versus long (>2 years) DUI were greater fear of public display of anxiety in the first group and greater social avoidance in the second group. The DUI was significantly different between groups that sought treatment after the onset of illness, with OCD patients having longer DUI than PD patients and shorter DUI than SAD patients. Further, DUI correlated negatively with the perception of OCD being caused by stress and positively with severity of panic-related disability in SAD patients, but not in PD or OCD patients.ConclusionThere was substantial delay in treatment seeking among the anxiety and obsessive-compulsive disorder patients, particularly those with OCD or SAD. Perception of stress as a cause of OCD prompted treatment seeking, while severity of panic symptoms delayed treatment seeking.
Background Since the onset of the COVID-19 pandemic, concerns regarding its psychological effects on people with preexisting psychiatric disorders have been raised, particularly obsessive-compulsive disorder (OCD). Nevertheless, only a few longitudinal studies have been performed, and a more longstanding follow-up of a clinical sample is needed. In this study, our aim was to investigate the influence of the COVID-19 pandemic on symptom changes in a sample of Brazilian OCD patients for about a one-year period. Methods Thirty OCD outpatients seen in a specialized OCD clinic in Rio de Janeiro were evaluated at baseline and after one year (during the pandemic). Sociodemographic and clinical variables were collected along with a questionnaire aimed at quantifying the number of stressful events related to the COVID-19 pandemic. Comparisons between two time points (pre vs. during COVID-19) and two subgroups (patients with vs without worsening of symptoms) were carried out. Results As a group, OCD patients treated with SRIs had an overall stabilization of symptoms throughout the follow-up period, regardless of the number of stressful experiences related to coronavirus (median baseline YBOCS remained 22.0 at follow-up). In addition, when individually analyzed, even those who reported an increase in their symptoms did not describe a greater number of COVID-19 related events. Conclusions Patients with OCD, who were under treatment, did not show significant symptom deterioration as a result of the COVID-19 pandemic. Individual variations in OCD symptom severity did not seem to be related to experiences linked to coronavirus.
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