Journal ArticleDOI
Escitalopram in obsessive-compulsive disorder: response of symptom dimensions to pharmacotherapy.
Dan J. Stein,Paul D. Carey,Christine Lochner,Soraya Seedat,Naomi A. Fineberg,Elisabeth Wreford Andersen +5 more
TLDR
Escitalopram shows good efficacy across the range of OCD symptom dimensions, andHoarding/symmetry may be particularly characteristic of an early-onset group of OCD patients, with the involvement of neurotransmitters other than serotonin.Abstract:
Introduction: There is a substantial body of evidence that obsessive-compulsive disorder (OCD) symptoms can be grouped into a series of discrete dimensions, and some evidence that not all OCD symptom dimensions respond equally well to pharmacologic or psychotherapeutic intervention. The response of OCD symptom dimensions to 12 weeks of treatment with escitalopram or placebo was investigated. Methods: Data from a randomized, double-blind, placebo-controlled study of escitalopram in 466 adults with OCD were analyzed. Exploratory factor analysis of individual items of the Yale-Brown Obsessive-Compulsive Scale checklist was performed and subscale scores based on the extracted factors were determined. Analyses of covariance were undertaken to determine whether inclusion of each subscale score in these models impacted on the efficacy of escitalopram versus placebo. Results: Exploratory factor analysis of individual Yale-Brown Obsessive-Compulsive Scale items yielded 5 factors (contamination/cleaning, harm/checking, hoarding/symmetry, religious/sexual, and somatic/hypochondriacal). Analyses of covariance including all the subscales demonstrated that escitalopram was more effective than placebo. There was a significant interaction for the hoarding/symmetry factor, which was associated with a poor treatment response. Conclusion: Escitalopram shows good efficacy across the range of OCD symptom dimensions. Nevertheless, hoarding/symmetry was associated with a poorer treatment response. Hoarding/symmetry may be particularly characteristic of an early-onset group of OCD patients, with the involvement of neurotransmitters other than serotonin. Further work is needed to delineate fully the subtypes of OCD, and their correlates with underlying psychobiology and treatment responsivity.read more
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Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders
Martin A Katzman,Pierre Bleau,Pierre Blier,Pratap Chokka,Kevin Kjernisted,Michael Van Ameringen +5 more
TL;DR: These guidelines were developed by Canadian experts in anxiety and related disorders through a consensus process based on global impression of efficacy, effectiveness, and side effects, using a modified version of the periodic health examination guidelines.
Journal ArticleDOI
Obsessive-compulsive disorder: a review of the diagnostic criteria and possible subtypes and dimensional specifiers for dsm-v
James F. Leckman,Damiaan Denys,H. Blair Simpson,David Mataix-Cols,Eric Hollander,Sanjaya Saxena,Euripedes Constantino Miguel,Scott L. Rauch,Wayne K. Goodman,Katharine A. Phillips,Dan J. Stein,Dan J. Stein +11 more
TL;DR: A number of changes to the existing diagnostic criteria for OCD are proposed, and these proposed criteria may change as the DSM‐V process progresses.
Journal ArticleDOI
Refining the diagnostic boundaries of compulsive hoarding: A critical review
Alberto Pertusa,Randy O. Frost,Miguel A. Fullana,Miguel A. Fullana,Jack Samuels,Gail Steketee,David F. Tolin,Sanjaya Saxena,James F. Leckman,David Mataix-Cols +9 more
TL;DR: Growing evidence from epidemiological, phenomenological, neurobiological, and treatment studies suggests that compulsive hoarding may be best classified as a discrete disorder with its own diagnostic criteria.
Journal ArticleDOI
Should an obsessive–compulsive spectrum grouping of disorders be included in DSM‐V?
Katharine A. Phillips,Dan J. Stein,Scott L Rauch,Eric Hollander,Brian A. Fallon,Arthur Barsky,Naomi Fineberg,David Mataix-Cols,Ygor Arzeno Ferrão,Sanjaya Saxena,Sabine Wilhelm,Megan M. Kelly,Megan M. Kelly,Lee Anna Clark,Anthony Pinto,O. Joseph Bienvenu,Joanne Farrow,James Leckman +17 more
TL;DR: The preliminary recommendation is that an OC‐spectrum grouping of disorders be included in DSM‐V and consideration be given to including this group of disorders within a larger supraordinate category of “Anxiety and Obsessive–Compulsive Spectrum Disorders.”
Journal ArticleDOI
Symptom dimensions in OCD: item-level factor analysis and heritability estimates.
Hilga Katerberg,Kevin L. Delucchi,S. Evelyn Stewart,Christine Lochner,Damiaan Denys,Denise Egan Stack,J. Michael Andresen,Jon E. Grant,Suck Won Kim,Kyle A. Williams,Johan A. den Boer,Anton J.L.M. van Balkom,Johannes H. Smit,Patricia van Oppen,Annemiek Polman,Michael A. Jenike,Dan J. Stein,Dan J. Stein,Carol A. Mathews,Danielle C. Cath +19 more
TL;DR: In this article, the authors conducted several factor analyses of the Yale-Brown Obsessive Compulsive Scale checklist (YBOCS-CL) to reduce the phenotypic heterogeneity of OCD for genetic, clinical and translational studies.
References
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The Yale-Brown Obsessive Compulsive Scale: I. Development, Use, and Reliability
Wayne K. Goodman,Lawrence H. Price,Steven A. Rasmussen,Carolyn M. Mazure,Roberta L. Fleischmann,Candy L. Hill,George R. Heninger,Dennis S. Charney +7 more
TL;DR: In a study involving four raters and 40 patients with obsessive-compulsive disorder at various stages of treatment, interrater reliability for the total Yale-Brown Scale score and each of the 10 individual items was excellent, with high degree of internal consistency among all item scores demonstrated with Cronbach's alpha coefficient.
Journal ArticleDOI
The Epidemiology of Obsessive-Compulsive Disorder in Five US Communities
TL;DR: The prevalence of obsessive-compulsive disorder was measured in five US communities among more than 18,500 persons in residential settings as part of the National Institute of Mental Health--sponsored Epidemiologic Catchment Area program, finding rates about 25 to 60 times greater than had been estimated on the basis of previous studies of clinical populations.