A systematic review of misdiagnosis in those with obsessive-compulsive disorder

Stahnke, Brittany

doi:10.1016/j.jadr.2021.100231

Cited by 13 publications

(7 citation statements)

References 16 publications

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“…Nonetheless, despite its relevance, it is still difficult to make a proper diagnosis because of the vast range of manifestations and overlap among the symptoms that may exist even inside the same cultural group, making these symptoms somewhat elusive to behavioral inspection [ 4 , 5 , 6 ]. In fact, despite the availability of numerous disorder assessment scales, the misdiagnosis rates are still high, with some reports indicating that over one third of patients are misdiagnosed [ 7 , 8 , 9 , 10 ]. This has obvious consequences on the patient’s well-being.…”

Section: Introductionmentioning

confidence: 99%

The Role of Alpha Oscillations among the Main Neuropsychiatric Disorders in the Adult and Developing Human Brain: Evidence from the Last 10 Years of Research

et al. 2022

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Alpha oscillations (7–13 Hz) are the dominant rhythm in both the resting and active brain. Accordingly, translational research has provided evidence for the involvement of aberrant alpha activity in the onset of symptomatological features underlying syndromes such as autism, schizophrenia, major depression, and Attention Deficit and Hyperactivity Disorder (ADHD). However, findings on the matter are difficult to reconcile due to the variety of paradigms, analyses, and clinical phenotypes at play, not to mention recent technical and methodological advances in this domain. Herein, we seek to address this issue by reviewing the literature gathered on this topic over the last ten years. For each neuropsychiatric disorder, a dedicated section will be provided, containing a concise account of the current models proposing characteristic alterations of alpha rhythms as a core mechanism to trigger the associated symptomatology, as well as a summary of the most relevant studies and scientific contributions issued throughout the last decade. We conclude with some advice and recommendations that might improve future inquiries within this field.

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Section: Introductionmentioning

confidence: 99%

The Role of Alpha Oscillations among the Main Neuropsychiatric Disorders in the Adult and Developing Human Brain: Evidence from the Last 10 Years of Research

et al. 2022

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“…The development of this guideline seemed justified considering the level of severity and impairment associated with OCD, as well as the relatively low rates of diagnosis and delivery of evidence-based treatments to patients with OCD worldwide. 14 , 15 Moreover, the latest Brazilian clinical guideline for the treatment of OCD was published more than 10 years ago, in 2011. 16…”

Section: Methodsmentioning

confidence: 99%

Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders guidelines for the treatment of adult obsessive-compulsive disorder. Part I: pharmacological treatment

Oliveira¹,

Barros²,

Mathis³

et al. 2023

Brazilian Journal of Psychiatry

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Objectives: To summarize evidence-based pharmacological treatments and provide guidance on clinical interventions for adult patients with obsessive-compulsive disorder (OCD). Methods: The American Psychiatric Association (APA) guidelines for the treatment of OCD (2013) were updated with a systematic review assessing the efficacy of pharmacological treatments for adult OCD, comprising monotherapy with selective serotonin reuptake inhibitors (SSRIs), clomipramine, serotonin and norepinephrine reuptake inhibitors (SNRIs), and augmentation strategies with clomipramine, antipsychotics, and glutamate-modulating agents. We searched for the literature published from 2013-2020 in five databases, considering the design of the study, primary outcome measures, types of publication, and language. Selected articles had their quality assessed with validated tools. Treatment recommendations were classified according to levels of evidence developed by the American College of Cardiology and the American Heart Association (ACC/AHA). Results: We examined 57 new studies to update the 2013 APA guidelines. High-quality evidence supports SSRIs for first-line pharmacological treatment of OCD. Moreover, augmentation of SSRIs with antipsychotics (risperidone, aripiprazole) is the most evidence-based pharmacological intervention for SSRI-resistant OCD. Conclusion: SSRIs, in the highest recommended or tolerable doses for 8-12 weeks, remain the first-line treatment for adult OCD. Optimal augmentation strategies for SSRI-resistant OCD include low doses of risperidone or aripiprazole. Pharmacological treatments considered ineffective or potentially harmful, such as monotherapy with antipsychotics or augmentation with ketamine, lamotrigine, or N-acetylcysteine, have also been detailed.

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“…This is alarming as approximately 19%–25% of those with OCD report unwanted sexual obsessions (Grant et al, 2006; Hunt, 2020; Williams & Farris, 2011). When misdiagnoses occur, individuals may experience worsening symptoms, delays in proper treatment, inappropriate involvement of authorities, or involuntary admission to mental health facilities (Glazier et al, 2013; Stahnke, 2021; Veale et al, 2009).…”

Section: Public Attitudes and Misidentification Of Ocd Symptomsmentioning

confidence: 99%

Overcoming the forbidden: Identification and stigma of unacceptable thoughts in obsessive–compulsive disorder.

Coles,

Lahey,

Fawcett

et al. 2023

Stigma and Health

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Obsessive-compulsive disorder (OCD) is a heterogeneous condition, with lesser known symptom presentations not met with the same acceptance or media/educational focus as contamination or symmetry. Distressing, unwanted, and ego-dystonic thoughts with sexual, aggressive, or religious themes (unacceptable thought OCD; UT-OCD) have been found to be especially misidentified by professionals and the general public alike. The present study explores misidentification of-and stigma toward-UT-OCD through an online survey. Students (n = 335) and community members (n = 77) were given vignettes describing an individual with religious, aggressive, sexual (child or nonchild focused), or contamination obsessions, followed by a Diagnostic and Attribution Questionnaire. UT-OCD vignettes were significantly more likely to be misdiagnosed (59.9%) and stigmatized than those presenting with contamination OCD (27.1%). People may be less likely to offer help to those with UT-OCD and express more fear if OCD symptom content involves a perceived threat of harm toward others. These findings suggest that not all OCD symptoms are identified or perceived equally. Stigma can be reduced if OCD symptoms are correctly identified. Therefore, education and awareness campaigns should highlight the broad range of prevailing OCD symptom presentations. Clinical Impact StatementThe present study suggests that unacceptable thought obsessive-compulsive disorder (OCD) is significantly more likely to be misidentified and stigmatized than contamination OCD. Fear/danger and lack of willingness to help contribute most to stigmatizing beliefs. However, identifying symptoms as OCD can help decrease stigma. Education campaigns should address misconceptions surrounding OCD symptom presentations through more versatile representations of OCD in the media and educational settings. Increasing awareness is crucial for those struggling with OCD to minimize barriers to treatment.

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A systematic review of misdiagnosis in those with obsessive-compulsive disorder

Cited by 13 publications

References 16 publications

The Role of Alpha Oscillations among the Main Neuropsychiatric Disorders in the Adult and Developing Human Brain: Evidence from the Last 10 Years of Research

The Role of Alpha Oscillations among the Main Neuropsychiatric Disorders in the Adult and Developing Human Brain: Evidence from the Last 10 Years of Research

Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders guidelines for the treatment of adult obsessive-compulsive disorder. Part I: pharmacological treatment

Overcoming the forbidden: Identification and stigma of unacceptable thoughts in obsessive–compulsive disorder.

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