Comparison of clinical characteristics in episodic and chronic obsessive–compulsive disorder

Tükel, Raşit; Oflaz, Serap; Özyıldırım, İlker; Aslantaş, Banu; Ertekin, Erhan; Sözen, Atiye; Alyanak, Filiz; Atlı, Hatice

doi:10.1002/da.20234

Cited by 33 publications

(24 citation statements)

References 17 publications

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“…Some outcome studies have found that severity was not predictive of long-term outcome. 2,4 Our finding that severity is significantly associated with a lower likelihood of remission is consistent with a number of studies, 17,19 including a recent study that, like our study, was naturalistic and used multiple time points to assess course. 21 …”

Section: Discussionsupporting

confidence: 90%

“…4,14–19 Four prospective studies in particular have reported on the long-term course of treatment-seeking adults with OCD in naturalistic clinical settings. 14–16,18 Rates of achieving at least partial remission (subclinical OCD symptoms) range from 52% of 66 outpatients treated over a 2-year prospective period in a US OCD specialty clinic 15 to 76% of 75 patients followed up 11–13 years after initial treatment at a psychiatric hospital in India.…”

mentioning

confidence: 99%

“…On the basis of previous findings, 13,15 we hypothesized that a substantial proportion of subjects would improve to the point of partial remission (subclinical symptoms), but full remission (no symptoms) would be observed less frequently. On the basis of our clinical experience and a review of putative predictors of outcome in OCD, 17,19–21 we also hypothesized that greater symptom severity and the presence of hoarding as principal obsession would be associated with a lower likelihood of remission of OCD. Finally, consistent with previous findings that poor insight in OCD does not predict treatment response, 22 we hypothesized that the presence of poor insight would not be associated with likelihood of remission.…”

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confidence: 99%

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A 2-Year Prospective Follow-Up Study of the Course of Obsessive-Compulsive Disorder

Eisen¹,

Pinto²,

Mancebo³

et al. 2010

J. Clin. Psychiatry

149

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Background Surprisingly little is known about the long-term course of obsessive-compulsive disorder (OCD). This prospective study presents 2-year course findings, as well as predictors of course, from the Brown Longitudinal Obsessive Compulsive Study, the first comprehensive prospective investigation of the observational course of OCD in a large clinical sample. Method The sample included 214 treatment-seeking adults with DSM-IV OCD at intake who identified OCD as the most problematic disorder over their lifetime. Subjects were enrolled from 2001–2004. At annual interviews, data on weekly OCD symptom status were obtained using the Longitudinal Interval Follow-Up Evaluation. Probabilities of full remission and partial remission over the first 2 years of collected data and potential predictors of remission were examined. Results The probability of full remission from OCD was 0.06, and the probability of partial remission was 0.24. Of the 48 subjects whose OCD symptoms partially or fully remitted, only 1 relapsed within the first 2 years. Earlier age at onset of OCD, greater severity of symptoms at intake, older age at intake, and being male were associated with a decreased likelihood of remission. Insight, diagnostic comorbidity, and treatment were not found to be associated with the likelihood of achieving full or partial remission. Conclusions Though one-quarter of the sample had periods of subclinical OCD symptoms during the prospective period, full remission was rare, consistent with the view of OCD as a chronic and persistent illness. Age at onset, OCD symptom severity, current age, and sex emerged as potent predictors of course.

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Section: Discussionsupporting

confidence: 90%

mentioning

confidence: 99%

mentioning

confidence: 99%

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A 2-Year Prospective Follow-Up Study of the Course of Obsessive-Compulsive Disorder

Eisen¹,

Pinto²,

Mancebo³

et al. 2010

J. Clin. Psychiatry

149

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“…Using the bipolar spectrum concept in the general population (48), a study reported 53.3% and 30% of BD-OCD and BD-II-OCD patients respectively (15). In hospital-based studies, the lifetime prevalence of comorbid BD in OCD adult patients ranged between 7% and 55.8% (17,(49)(50)(51)(52)(53)(54)(55)(56)(57). When restricting the analysis to studies with sample size greater than 250, the BD-OCD prevalence range was narrower (11-15.7%) (17,51,53), and the mean prevalence rate of BD-I comorbidity was 3.7%, while BD-II was 9.5% (17,51,53,58).…”

Section: Included Studiesmentioning

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

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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.

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“…They suggested the stable traits may relate more to genetics and biology and constitute prime targets for biological treatments, whereas the latter may relate more to nurture and learning and represent targets for psychosocial interventions. 43 Similarities have been noted between the course of OCPD and OCD, with onset relatively early in life 77 and a chronic, fluctuating course 78,79 (although a subsample of OCD with episodic illness has also been described). A retrospective, long-term study directly comparing first psychiatric admissions diagnosed with OCD or OCPD showed similar levels of diagnostic stability over up to 8 years of follow-up.…”

Section: Coursementioning

confidence: 94%

Obsessive-compulsive (anankastic) personality disorder: toward the ICD-11 classification

Fineberg

Reghunandanan

Kolli

et al. 2014

Rev. Bras. Psiquiatr.

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Obsessive-compulsive personality disorder (OCPD) is an early-onset disorder characterized by perfectionism, need for control, and cognitive rigidity. Its nosological status is currently under review. Historically, OCPD has been conceptualized as bearing a close relationship with obsessivecompulsive disorder (OCD). In this article, we discuss the diagnosis of OCPD in anticipation of its review for the ICD-11, from the perspective of clinical utility, global applicability, and research planning. Considering the recent establishment of an obsessive-compulsive and related disorders (OCRD) category in DSM-5, we focus on the relationship between OCPD and the disorders that are currently thought to bear a close relationship with OCD, including DSM-5 OCRD, and other compulsive disorders such as eating disorder and autistic spectrum disorder (that were not included in the DSM-5 OCRD category), as well as with the personality disorders, focusing on nosological determinants such as phenomenology, course of illness, heritability, environmental risk factors, comorbidity, neurocognitive endophenotypes, and treatment response. Based on this analysis, we attempt to draw conclusions as to its optimal placement in diagnostic systems and draw attention to key research questions that could be explored in field trials.

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Comparison of clinical characteristics in episodic and chronic obsessive–compulsive disorder

Cited by 33 publications

References 17 publications

A 2-Year Prospective Follow-Up Study of the Course of Obsessive-Compulsive Disorder

A 2-Year Prospective Follow-Up Study of the Course of Obsessive-Compulsive Disorder

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

Obsessive-compulsive (anankastic) personality disorder: toward the ICD-11 classification

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