Course and outcome of obsessive–compulsive disorder

Sharma, Eesha; Math, Suresh Bada

doi:10.4103/psychiatry.indianjpsychiatry_521_18

Cited by 39 publications

(30 citation statements)

References 84 publications

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“…Finally, sometimes a watchful, waiting approach could be beneficial. The course of OCD is heterogeneous with two major phenotypes emerging chronic and episodic (47). The chronic course indicates symptom persistence which can be waxing and waning nature, but without complete relief from symptoms.…”

Section: Treatment-refractory Ocdmentioning

confidence: 99%

Refractory Gilles de la Tourette Syndrome—Many Pieces That Define the Puzzle

et al. 2020

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Gilles de la Tourette syndrome (GTS) is a childhood onset neuropsychiatric disorder characterized by the presence of motor and vocal tics. The clinical spectrum of GTS is heterogeneous and varies from mild cases that do not require any medical attention to cases that are refractory to standard treatments. One of the unresolved issues is the definition of what constitutes treatment-refractory GTS. While for some other neuropsychiatric disorders, such as obsessive–compulsive disorder (OCD), a clear definition has been established, there is still no consensus with regard to GTS. One important issue is that many individuals with GTS also meet criteria for one or more other neurodevelopmental and neuropsychiatric disorders. In many individuals, the severity of these comorbid conditions contributes to the degree to which GTS is treatment refractory. The scope of this paper is to present the current state-of-the-art regarding refractory GTS and indicate possible approaches to define it. In closing, we discuss promising approaches to the treatment of individuals with refractory GTS.

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Section: Treatment-refractory Ocdmentioning

confidence: 99%

Refractory Gilles de la Tourette Syndrome—Many Pieces That Define the Puzzle

et al. 2020

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“…At the follow-up visit, the majority of patients was still these results underlined how targeted treatment may improve the clinical picture, being OCD a disease with a mainly chronic course, but positively influenced by pharmacological treatment. Other authors showed that even more serious stages may be considered as expressions of temporary exacerbations of the disorder and not as a stable condition (10). Ultimately, a notable consideration is that the application of a staging model to OCD patients reveals that patients can indeed move bidirectionally through different stages during a follow-up observation period.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical staging is based on the concept that psychiatric illnesses progress over time through consecutive stages, characterized by symptoms of increased intensity: from stage 0 (increased risk, asymptomatic) to stage 4 (severe illness) and it seeks to define both the disease progression and the differentiation of milder clinical phenomena from more severe presentations (12,13). Potential advantages in the use of staging models are represented by the timing improvement of therapeutic interventions -assessed in relation to their ability to prevent/delay the progression of illness from earlier to later stages -and the promotion of a better therapeutic personalization (10). Staging models have been proposed and applied to different mental disorders, such as schizophrenia and psychotic spectrum disorders (11), bipolar disorders (13) and, more recently, in OCD as well (15,16).…”

Section: Introductionmentioning

confidence: 99%

“…8,9 Full-blown OCD shows chronic/progressive course in the majority of published reports, although a waning and waxing/fluctuant course and an episodic course have also been described. 10 In this scenery, the growing interest in staging methods in psychiatry may play a relevant role in defining prognosis and treatment of OCD, even in the early stages or in subthreshold forms of the disease. 11 Clinical staging is based on the concept that psychiatric illnesses progress over time through consecutive stages, characterized by symptoms of increased intensity-from stage 0 (increased risk, asymptomatic) to stage 4 (severe illness)-and it seeks to define both the disease progression and the differentiation of milder clinical phenomena from more severe presentations.…”

Section: Introductionmentioning

confidence: 99%

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Application of a staging model in patients with obsessive–compulsive disorder: cross-sectional and follow-up results

et al. 2020

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Introduction Obsessive-compulsive disorder (OCD) is a prevalent and disabling condition with frequent chronic course. Staging models applied to psychiatric disorders seek to define their extent of progression at a particular time-point and differentiate early, milder clinical phenomena from those characterizing illness progression and chronicity. In OCD patients, a staging model has been recently proposed but not tested yet. This was the aim of the present study. Methods From an overall sample of 198 OCD patients, recruited across two psychiatric clinics in Northern Italy, 70 patients on stable treatment completed a follow-up assessment ranging from 12 to 24 months. At follow-up initiation, patients had been divided into four staging groups, according to the model proposed by Fontenelle and Yucel. At the end of the follow-up, patients were subdivided into three groups (no stage change, improved stage, or worsened stage) compared with statistical analyses. Results At the end of the follow-up, 67.1% patients showed no stage changes, 24.3% a stage improvement, and 8.6% a stage progression. Worsened patients showed higher rates of comorbid disorders and higher rates of unfavorable employment characteristics compared to the other subgroups (P < .05). Patients with worsened stage showed higher prevalence of somatic obsessions (P < .05), while patients with improved stage showed higher rates of magical thinking and violence/harm obsessions compared to other groups (P < .05). Discussion The present results provide epidemiologic and clinical correlates of the first application of a staging model in a sample of OCD patients, encouraging further studies to assess the utility of this approach in the field.

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“…Clinical guidelines advise cognitive behavioral therapy (CBT) including exposure and response prevention (ERP) for mild functional impairment and selective serotonin reuptake inhibitors (SSRIs) and/or CBT for those with moderate functional impairment (3). At least half of patients who receive treatment will experience long-term remission as a result (4). A shorter duration of illness with early treatment consistently correlates with higher remission rates and more positive outcomes (4-6) whereas help-seeking delays are associated with greater illness severity, additional psychiatric comorbidity, and more significant functional impairment (7), illustrating the importance of early diagnosis and evidence-based intervention.…”

Section: Introductionmentioning

confidence: 99%

Help-Seeking Intention in Obsessive-Compulsive Disorder: Predictors and Barriers in South Africa

et al. 2021

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Introduction: Many individuals with obsessive-compulsive disorder (OCD) delay seeking help, leading to greater illness severity, additional comorbidity, and increased functional impairment. Patterns of help-seeking for OCD have however not yet been described in South Africa, a low-and middle-income country with many health service challenges. Using the health belief model as a conceptual framework, study aims were to identify predictors of and barriers to help-seeking among South Africans with OCD.Methods: Fifty adults with OCD completed an online survey to assess (1) socio-demographic characteristics, (2) OCD symptom severity, (3) treatment barriers, (4) perceived treatment benefits, (5) self-efficacy, and (6) help-seeking intention. Multiple linear regression analysis was used to establish predictors of help-seeking intention. Descriptive statistics were used to determine the most endorsed help-seeking barriers.Results: 42.6% of the variance in help-seeking intention was explained by the investigated constructs (R2 = 0.426, F = 4.45 and p < 0.01). Perceived treatment benefits were the only significant predictor of help-seeking intention (B = 1.37, t = 5.16, and p < 0.01). More than a third (36%) of the sample endorsed wanting to handle the problem independently as a significant barrier, followed by treatment concerns (26%), affordability (22%), and shame (20%).Conclusion: An innovative analysis of help-seeking patterns suggested that perceived treatment benefits were the only significant predictor of help-seeking intention among South African adults with OCD. Psychoeducation and mental health literacy programmes may be useful in increasing public appreciation of the benefits of OCD treatment, and in mitigating key help-seeking barriers.

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Course and outcome of obsessive–compulsive disorder

Cited by 39 publications

References 84 publications

Refractory Gilles de la Tourette Syndrome—Many Pieces That Define the Puzzle

Refractory Gilles de la Tourette Syndrome—Many Pieces That Define the Puzzle

Application of a staging model in patients with obsessive–compulsive disorder: cross-sectional and follow-up results

Help-Seeking Intention in Obsessive-Compulsive Disorder: Predictors and Barriers in South Africa

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