Clinical Predictors of Drug Response in Obsessive-Compulsive Disorder

Erzegovesi, Stefano; Cavallini, Maria Cristina; Cavedini, Paolo; Diaferia, Giuseppina; Locatelli, Marco; Bellodi, Laura

doi:10.1097/00004714-200110000-00006

Cited by 203 publications

(176 citation statements)

References 24 publications

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“…Drug response could be an important feature to classify patients; it is well known that as many as 40-60% of OCD patients may not respond to an adequate treatment with an SSRI. 16,25 Defining the treat- ment response as a reduction of the YBOCS total scores Ͼ 35%, our sample shows a response rate of 56.6%, which is in accord with the literature's data. Nevertheless, using the 35% YBOCS reduction for defining a responder patient, even though useful in clinical practice, could be not adequate for a genetic approach.…”

Section: Discussionsupporting

confidence: 90%

“…25 Enrollment criteria are extensively reported in the paper by Erzegovesi et al 25 No concomitant therapy was allowed during the whole treatment period, either pharmacological or non-pharmacological. As for non-pharmacological therapy, no form of psychotherapy was allowed (eg, exposure to response prevention or cognitive therapy).…”

Section: Subjects and Treatmentmentioning

confidence: 99%

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Obsessive-Compulsive Disorder, 5-HTTLPR polymorphism and treatment response

et al. 2002

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Recently, a role for a functional polymorphism within the promoter region of the serotonin transporter gene (5-HTTLPR) in conferring susceptibility to Obsessive Compulsive Disorder (OCD) has been suggested. The aim of this study was to test the hypothesis that allelic variation of the 5-HTTLPR could be associated with OCD susceptibility or influence the drug response in OCD. One hundred and eighty-one OCD patients were recruited; 92 patients underwent a standardized treatment with fluvoxamine. No significant differences in allele/genotype distribution of the 5-HTTLPR were found between 191 controls and OCD. No differences in fluvoxamine response in the three genotypes groups in OCD were found, considering Yale-Brown Obsessive Compulsive Scale (YBOCS) total scores. Nevertheless, a significant time per genotype interaction was found for the YBOCS subtotal compulsion scores. Considering patients without tic disorder co-diagnosis, a significant time per genotype interaction for both YBOCS total scores and compulsion scores was found

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Section: Discussionsupporting

confidence: 90%

Section: Subjects and Treatmentmentioning

confidence: 99%

Obsessive-Compulsive Disorder, 5-HTTLPR polymorphism and treatment response

et al. 2002

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“…Serotonin reuptake inhibitorss are considered the most effective and well-established pharmacotherapy for the treatment of OCD. [19][20][21] However, 40-60% of OCD patients do not respond adequately to SRI therapy [22][23][24] and an even greater proportion of patients fail to experience complete remission of their symptoms. 25 Even those patients who are judged to be clinical responders based on stringent response criteria (i.e., typically a greater than 25 or 35% decline in Y-BOCS rating) continue to experience significant impairment from their residual OCD symptoms.…”

Section: Introductionmentioning

confidence: 99%

A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder

Bloch

Landeros-Weisenberger

et al. 2006

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As many as half of obsessive-compulsive disorder (OCD) patients treated with an adequate trial of serotonin reuptake inhibitors (SRIs) fail to fully respond to treatment and continue to exhibit significant symptoms. Many studies have assessed the effectiveness of antipsychotic augmentation in SRI-refractory OCD. In this systematic review, we evaluate the efficacy of antipsychotic augmentation in treatment-refractory OCD. The electronic databases of PubMed, PsychINFO (1967PsychINFO ( -2005, Embase (1974Embase ( -2000 and the Cochrane Central Register of Controlled Trials (CENTRAL, as of 2005, Issue 3) were searched for relevant double-blind trials using keywords 'antipsychotic agents' or 'neuroleptics' and 'obsessive-compulsive disorder'. Search results and analysis were limited to double-blind, randomized control trials involving the adult population. The proportion of subjects designated as treatment responders was defined by a greater than 35% reduction in Yale Brown Obsessive-Compulsive Scale (Y-BOCS) rating during the course of augmentation therapy. Nine studies involving 278 participants were included in the analysis. The meta-analysis of these studies demonstrated a significant absolute risk difference (ARD) in favor of antipsychotic augmentation of 0.22 (95% confidence interval (CI): 0.13, 0.31). The subgroup of OCD patients with comorbid tics have a particularly beneficial response to this intervention, ARD = 0.43 (95% CI: 0.19, 0.68). There was also evidence suggesting OCD patients should be treated with at least 3 months of maximaltolerated therapy of an SRI before initiating antipsychotic augmentation owing to the high rate of treatment response to continued SRI monotherapy (25.6%). Antipsychotic augmentation in SRI-refractory OCD is indicated in patients who have been treated for at least 3 months of maximal-tolerated therapy of an SRI. Unfortunately, only one-third of treatment-refractory OCD patients show a meaningful treatment response to antipsychotic augmentation. There is sufficient evidence in the published literature, demonstrating the efficacy of haloperidol and risperidone, and evidence regarding the efficacy of quetiapine and olanzapine is inconclusive. Patients with comorbid tics are likely to have a differential benefit to antipsychotic augmentation.

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“…13 It should be noted that these OC symptom dimensions have been shown to be, variously, temporally stable; 16,17 similar at different ages; 18,19 useful in the identification of genetic and neurobiological factors; 14,20 and helpful in determining treatment strategies. [21][22][23] Despite the great potential for a better understanding of the etiology of OCD, there have been very few studies investigating the neuropsychological performance of patients by OC symptom dimension. In the present study, we sought to identify associations between strategic planning and specific OC symptom dimensions.…”

Section: Introductionmentioning

confidence: 99%

Influence of specific obsessive-compulsive symptom dimensions on strategic planning in patients with obsessive-compulsive disorder

Pinto

Iêgo

Nunes

et al. 2011

Rev. Bras. Psiquiatr.

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OBJECTIVE: This study investigates obsessive-compulsive disorder patients in terms of strategic planning and its association with specific obsessive-compulsive symptom dimensions. METHOD: We evaluated 32 obsessive-compulsive disorder patients. Strategic planning was assessed by the Rey-Osterrieth Complex Figure Test, and the obsessive-compulsive dimensions were assessed by the Dimensional Yale-Brown Obsessive-Compulsive Scale. In the statistical analyses, the level of significance was set at 5%. We employed linear regression, including age, intelligence quotient, number of comorbidities, the Yale-Brown Obsessive-Compulsive Scale score, and the Dimensional Yale-Brown Obsessive-Compulsive Scale. RESULTS: The Dimensional Yale-Brown Obsessive-Compulsive Scale "worst-ever" score correlated significantly with the planning score on the copy portion of the Rey-Osterrieth Complex Figure Test (r = 0.4, p = 0.04) and was the only variable to show a significant association after linear regression (β = 0.55, t = 2.1, p = 0.04). Compulsive hoarding correlated positively with strategic planning (r = 0.44, p = 0.03). None of the remaining symptom dimensions presented any significant correlations with strategic planning. CONCLUSION: We found the severity of obsessive-compulsive symptoms to be associated with strategic planning. In addition, there was a significant positive association between the planning score on the copy portion of the Rey-Osterrieth Complex Figure Test copy score and the hoarding dimension score on the Dimensional Yale-Brown Obsessive-Compulsive Scale. Our results underscore the idea that obsessive-compulsive disorder is a heterogeneous disorder and suggest that the hoarding dimension has a specific neuropsychological profile. Therefore, it is important to assess the peculiarities of each obsessive-compulsive symptom dimension.

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Clinical Predictors of Drug Response in Obsessive-Compulsive Disorder

Cited by 203 publications

References 24 publications

Obsessive-Compulsive Disorder, 5-HTTLPR polymorphism and treatment response

Obsessive-Compulsive Disorder, 5-HTTLPR polymorphism and treatment response

A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder

Influence of specific obsessive-compulsive symptom dimensions on strategic planning in patients with obsessive-compulsive disorder

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