Obsessive-compulsive severity spectrum in the community: prevalence, comorbidity, and course

Angst, Jules; Gamma, Alex; Endrass, Jérôme; Goodwin, Renée D.; Ajdacic, Vladeta; Eich, Dominique; Rössler, Wulf

doi:10.1007/s00406-004-0459-4

Cited by 223 publications

(169 citation statements)

References 54 publications

(46 reference statements)

Supporting

Mentioning

139

Contrasting

Unclassified

Order By: Relevance

“…Accordingly, in the follow-up study using the North-American ECA data, Crum and Anthony et al (1993) found that the risk of later OCD was increased for persons with phobic disorders. Accordingly, in their Swiss study, Angst et al (2004) found that the prevalence of OCD or obsessive-compulsive syndromes was significantly increased in the presence of panic disorder, panic attacks, social phobia, and generalized anxiety disorder. Since impairment is a criterion for OCD, one should be aware that the data about employment, marital and socioeconomic status, or even intelligence levels as correlates of this disorder might be somewhat circular and not very informative.…”

Section: Anxiety Disordersmentioning

confidence: 98%

See 1 more Smart Citation

The analytical epidemiology of obsessive–compulsive disorder: Risk factors and correlates

Fontenelle

Hasler²

2008

Progress in Neuro-Psychopharmacology and Biological Psychiatry

View full text Add to dashboard Cite

In this qualitative systematic review, we evaluate studies of the demographic, innate, and environmental risk factors and correlates associated with the development of Obsessive-Compulsive Disorder (OCD) in epidemiological samples. We found that a significant proportion of the studies indicate that late adolescence is a period of increased vulnerability for the development of OCD; that OCD affects predominantly female adults and male children and adolescents; that those who are unmarried or abusing drugs are more likely to present with OCD; that OCD is a familial and genetic disorder, particularly when one considers symptom dimensions instead of categorical diagnosis and when the disorder begins at an early age; and that individuals with OCD from the community, like those seen in clinical settings, may be especially prone to present psychiatric conditions such as mood and anxiety disorders. Although there are plenty of data on the correlates and risk factors of OCD in epidemiological samples, more research is needed on other potential risk factors, including obstetrical and pregnancy problems, pre-morbid neurocognitive functioning, and streptococcal infections, among others.

show abstract

Section: Anxiety Disordersmentioning

confidence: 98%

“…However, there are some epidemiological studies that report an earlier onset of symptoms. For example, Degonda et al (1993) and Angst et al (2004) found that 30% of the individuals from their Swiss sample had developed obsessive-compulsive symptoms by age 15, 50% by the age of 18, and 70% by age 20.…”

Section: Age and Age At Onsetmentioning

confidence: 99%

The analytical epidemiology of obsessive–compulsive disorder: Risk factors and correlates

Fontenelle

Hasler²

2008

Progress in Neuro-Psychopharmacology and Biological Psychiatry

View full text Add to dashboard Cite

show abstract

“…Among BD study populations, studies that only focused on BD-I, BD-II, or BD not otherwise specified (14) were included. Studies that considered subjects with bipolar and obsessive-compulsive spectrums were also included if diagnostic criteria used were specified (15)(16)(17). Participants of both sexes older than 6 years of age were considered.…”

Section: Inclusion Criteriamentioning

confidence: 99%

Diagnostic validity of comorbid bipolar disorder and obsessive–compulsive disorder: a systematic review

Amerio

Odone

Liapis

et al. 2014

Acta Psychiatr Scand

107

View full text Add to dashboard Cite

Diagnostic validity of comorbid bipolar disorder and obsessive-compulsive disorder: a systematic review Amerio A, Odone A, Liapis CC, Ghaemi SN. Diagnostic validity of comorbid bipolar disorder and obsessive-compulsive disorder: a systematic review.Objective: At least 50% of bipolar disorder (BD) patients have an additional diagnosis, one of the most difficult to manage being obsessive-compulsive disorder (OCD). Defining the nosology of BD-OCD comorbidity has important clinical implications, given that treatments for OCD can worsen BD outcomes. Method: A systematic review was conducted on: i) BD-OCD comorbidity lifetime prevalence and ii) on standard diagnostic validators: phenomenology, course of illness, heredity, biological markers, and treatment response. Relevant papers published through March 30th 2013 were identified searching the electronic databases MEDLINE, Embase, PsycINFO, and the Cochrane Library. Results: Sixty-four articles met inclusion criteria. Lifetime comorbidity prevalence was 11-21% in BD patients and 6-10% in OCD patients. Compared to non-comorbid subjects, BD-OCD has a more episodic course of OC symptoms (up to 75% vs. 3%), typically with worsening during depression (78%) and improvement during mania/hypomania (64%), as well as a higher total mean number of depressive episodes (8.9 AE 4.2 vs. 4.1 AE 2.7) and perhaps more antidepressant-induced mania/hypomania (39% vs. 9%). Conclusion: In this first systematic review of BD-OCD comorbidity, it appears that OC symptoms are usually secondary to BD, rather than representing a separate disease. • The evidence so far on BD-OCD nosology-mainly based on the course of illness-supports the view that the majority of cases of comorbid BD-OCD are in fact cases of BD. OC symptoms usually are secondary manifestations of depressive or manic mood episodes.• BD-OCD patients may respond for both groups of symptoms with adequate doses of mood stabilizers and atypical antipsychotics. Because of the risk of worsening BD via SRI-induced mania/hypomania, antidepressants should only be used in a minority of refractory OCD. Considerations• Course of illness is the only diagnostic validator that clearly supports the OCD-BD construct as a subtype of BD. Findings on the phenomenology, heredity, biological markers, and treatment were fragmented and heterogeneous and mainly suggested increased severity of illness or functioning without helping us to answer the nosological question.• The use of retrospective assessment scales with unclear sensitivity in discriminating true ego-dystonic obsessions from depressive ruminations may have biased results toward an overestimation of obsession's prevalence. In addition, small sample sizes, mainly from out-patients units, may have limited the generalizability of the results to a whole community.

show abstract

“…Once considered rare, recent epidemiological data suggest prevalence rates of OCD from 1.5 to 3.5% (Stein et al, 1997;Horwath and Weissman, 2000;Angst et al, 2004). Neuropsychiatric research of the past two decades with advanced neuroimaging techniques and neurophysiological and pharmacologic studies has provided growing evidence for a neurobiological basis of OCD (Goodman et al, 1992;Hollander et al, 1992;Insel, 1992;Prichep et al, 1993;Saxena et al, 1998;Saxena and Rauch, 2000).…”

Section: Introductionmentioning

confidence: 99%

Changes in Thalamus–Hypothalamus Serotonin Transporter Availability during Clomipramine Administration in Patients with Obsessive–Compulsive Disorder

Zitterl

Aigner

Stompe

et al. 2008

Neuropsychopharmacol

View full text Add to dashboard Cite

To the authors' knowledge there is as of yet no study demonstrating in vivo alterations in human serotonin transporters (SERT) during clomipramine treatment in patients with obsessive-compulsive disorder. The only study in which SERT binding has been investigated in obsessive-compulsive disorder (OCD) patients before and after treatment is a small pilot study by Stengler-Wenzke et al (2006), who treated five OCD patients with citalopram. In the study at hand, we measured transporter availability in the thalamus-hypothalamus with [ 123 I] b-CIT single photon emission computed tomography (SPECT) in 24 patients with DSM-IV OCD. All patients displayed prominent behavioral checking compulsions (OC-checkers). At baseline and upon medication after 12 weeks of treatment with clomipramine (150 mg daily) 24 non-depressed OC-checkers underwent a SPECT measurement of brain SERT availability using [ 123 I]-2b-carbomethoxy-3b-(4-iodophenyl)tropane. For quantification of brain serotonin transporter availability, a ratio of specific to nondisplaceable [ 123 I] b-CIT brain binding was used (BP ND ¼ (thalamus and hypothalamusÀcerebellum)/cerebellum). The SERT availability was compared between baseline and after treatment and correlated with severity of OC symptomatology and treatment response as assessed with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). After treatment with clomipramine patients showed a 48% reduced brain serotonin transporter availability in the thalamus-hypothalamus, as compared with values at baseline (0.72±0.12 vs 1.39±0.18, po0.001). Correlations between brain SERT availability and OC symptomatology (Y-BOCS scores) revealed significantly negative associations both at baseline and after treatment (r ¼ À0.46; po0.05 and r ¼ À0.53; po0.01 respectively). These data suggest that the SERT availability values could be considered a biological indicator of disease severity. Moreover, in search of predictors we found that higher pretreatment SERT availability significantly predicted better treatment response 12 weeks later (B ¼ 14.145 ± 4.514; t ¼ 3.133; p ¼ 0.005). These results provide further support for an important role of alterations in serotonergic neurons in the pathophysiology of OCD.

show abstract

Obsessive-compulsive severity spectrum in the community: prevalence, comorbidity, and course

Abstract: OCD and OCD are manifestations of a wide spectrum of severity with high prevalence and strong clinical validity. The long-term course is better than generally assumed.

Cited by 223 publications

References 54 publications

The analytical epidemiology of obsessive–compulsive disorder: Risk factors and correlates

The analytical epidemiology of obsessive–compulsive disorder: Risk factors and correlates

Diagnostic validity of comorbid bipolar disorder and obsessive–compulsive disorder: a systematic review

Changes in Thalamus–Hypothalamus Serotonin Transporter Availability during Clomipramine Administration in Patients with Obsessive–Compulsive Disorder

Contact Info

Product

Resources

About