Follow-Up Studies in Obsessional Neurosis

Goodwin, Donald W.

doi:10.1001/archpsyc.1969.01740140054006

Cited by 207 publications

(71 citation statements)

References 11 publications

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“…Other retrospective studies from the same time period estimate that clinical improvement is experienced only by 32-74% of OCD patients who were followed up at time intervals of 5 years or longer. [12][13][14][15][16][17][18] The introduction of SRIs and behavioral therapy techniques have certainly improved clinical outcome in many patients. Serotonin reuptake inhibitorss are considered the most effective and well-established pharmacotherapy for the treatment of OCD.…”

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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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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“…1999;56:121-127 S EVERAL STUDIES have examined the prognosis of obsessive-compulsive disorder, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] but long-term studies are few, and most were published several decades ago. Studies with a mean follow-up of more than 10 years are rare [4][5][6]12,14,20,21 and are based mainly on retrospective information. The results from these studies are difficult to compare owing to differences in study populations, diagnostic criteria, inclusion criteria, criteria for improvement and deterioration, and uncertainty of information regarding lobotomized patients.…”

Section: Discussionmentioning

confidence: 99%

A 40-Year Follow-up of Patients With Obsessive-compulsive Disorder

Skoog¹,

Skoog²

1999

Arch Gen Psychiatry

522

209

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“…12 Most studies show a chronic course that extends across the lifetime with waxing and waning of symptoms, although in about 10% of cases there is a malignant deteriorating course. 9,13 Neurobiological evidence shows clearly that the serotonin system is important in OCD.This evidence has come from treatment response to serotonin reuptake inhibitors (SRIs), including studies of SRIs versus desipramine, which demonstrated the selective efficacy of SRIs, 14,15 as well as from pharmacological challenge studies and cerebrospinal fluid neurotransmitter metabolite studies. 16 There is also evidence, however, of a role for the dopamine system in OCD on the basis of both theory (derived from basic human and animal research) and the efficacy of dopaminergic augmentation in refractory OCD.…”

Section: Obsessive-compulsive Disordermentioning

confidence: 99%