Obsessive–compulsive disorder: A 3-year prospective follow-up study of patients treated with serotonin reuptake inhibitors

Catapano, Francesco; Perris, Francesco; Masella, Mariangela; Rossano, Flavia; Cigliano, Marco; Magliano, Lorenza; Maj, Mario

doi:10.1016/j.jpsychires.2005.04.010

Cited by 78 publications

(76 citation statements)

References 45 publications

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“…In the Yale cohort, 90 an initial good response to SSRIs was a good prognostic factor. In other studies, the presence of schizotypal 92 or obsessive-compulsive personality disorder 91 was associated with a poor prognosis.…”

Section: Natural History: Prognosismentioning

confidence: 76%

“…In another study from Italy, which included 55 outpatients with OCD treated with SSRIs, the rates for complete and partial remission at 3 years' follow-up were 22% and 34%, respectively. 92 The main conclusion that can be drawn from the above discussion is that remission rates in the modern era have not improved compared with those reported in earlier studies 88,89 despite the wide availability of effective treatments. It is difficult, however, to interpret this finding, as changes in diagnostic preferences or criteria may have resulted in non-comparable groups of patients being selected for inclusion in these studies.…”

Section: Natural History: Prognosismentioning

confidence: 85%

“…89,[92][93][94][95] In the Brown cohort, 91 patients with primary hoarding obsessions/ compulsions had a worse prognosis with very low remission rates, whereas patients with primary obsessions regarding an inflated sense of responsibility for harm had a better prognosis. In the Yale cohort, 90 an initial good response to SSRIs was a good prognostic factor.…”

Section: Natural History: Prognosismentioning

confidence: 99%

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A systematic review of the clinical effectiveness and cost-effectiveness of pharmacological and psychological interventions for the management of obsessive–compulsive disorder in children/adolescents and adults

Skapinakis

Caldwell

Hollingworth

et al. 2016

Health Technol Assess

100

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BackgroundObsessive–compulsive disorder (OCD) is a relatively common and disabling condition.ObjectivesTo determine the clinical effectiveness, acceptability and cost-effectiveness of pharmacological and psychological interventions for the treatment of OCD in children, adolescents and adults.Data sourcesWe searched the Cochrane Collaboration Depression, Anxiety and Neurosis Trials Registers, which includes trials from routine searches of all the major databases. Searches were conducted from inception to 31 December 2014.Review methodsWe undertook a systematic review and network meta-analysis (NMA) of the clinical effectiveness and acceptability of available treatments. Outcomes for effectiveness included mean differences in the total scores of the Yale–Brown Obsessive–Compulsive Scale or its children’s version and total dropouts for acceptability. For the cost-effectiveness analysis, we developed a probabilistic model informed by the results of the NMA. All analyses were performed using OpenBUGS version 3.2.3 (members of OpenBUGS Project Management Group; seewww.openbugs.net).ResultsWe included 86 randomised controlled trials (RCTs) in our systematic review. In the NMA we included 71 RCTs (54 in adults and 17 in children and adolescents) for effectiveness and 71 for acceptability (53 in adults and 18 in children and adolescents), comprising 7643 and 7942 randomised patients available for analysis, respectively. In general, the studies were of medium quality. The results of the NMA showed that in adults all selective serotonin reuptake inhibitors (SSRIs) and clomipramine had greater effects than drug placebo. There were no differences between SSRIs, and a trend for clomipramine to be more effective did not reach statistical significance. All active psychological therapies had greater effects than drug placebo. Behavioural therapy (BT) and cognitive therapy (CT) had greater effects than psychological placebo, but cognitive–behavioural therapy (CBT) did not. BT and CT, but not CBT, had greater effects than medications, but there are considerable uncertainty and methodological limitations that should be taken into account. In children and adolescents, CBT and BT had greater effects than drug placebo, but differences compared with psychological placebo did not reach statistical significance. SSRIs as a class showed a trend for superiority over drug placebo, but the difference did not reach statistical significance. However, the superiority of some individual drugs (fluoxetine, sertraline) was marginally statistically significant. Regarding acceptability, all interventions except clomipramine had good tolerability. In adults, CT and BT had the highest probability of being most cost-effective at conventional National Institute for Health and Care Excellence thresholds. In children and adolescents, CBT or CBT combined with a SSRI were more likely to be cost-effective. The results are uncertain and sensitive to assumptions about treatment effect and the exclusion of trials at high risk of bias.LimitationsThe majority of psychological trials included patients who were taking medications. There were few studies in children and adolescents.ConclusionsIn adults, psychological interventions, clomipramine, SSRIs or combinations of these are all effective, whereas in children and adolescents, psychological interventions, either as monotherapy or combined with specific SSRIs, were more likely to be effective. Future RCTs should improve their design, in particular for psychotherapy or combined interventions.Study registrationThe study is registered as PROSPERO CRD42012002441.Funding detailsThe National Institute for Health Research Health Technology Assessment programme.

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Section: Natural History: Prognosismentioning

confidence: 76%

Section: Natural History: Prognosismentioning

confidence: 85%

Section: Natural History: Prognosismentioning

confidence: 99%

See 1 more Smart Citation

A systematic review of the clinical effectiveness and cost-effectiveness of pharmacological and psychological interventions for the management of obsessive–compulsive disorder in children/adolescents and adults

Skapinakis

Caldwell

Hollingworth

et al. 2016

Health Technol Assess

100

View full text Add to dashboard Cite

show abstract

“…Research has focused on identifying factors associated with response to treatment in order to improve treatment outcomes for those with OCD, and there is evidence that poorer outcome after treatment for OCD is associated with longer time from treatment onset to seeking treatment (Catapano et al 2006;Hollander et al 2002;Steketee et al 1999); higher symptom severity when treatment commences (Catapano et al 2006;Hollander et al 2002;Steketee et al 1999); and having religious OCD symptoms.…”

Section: Introductionmentioning

confidence: 99%

Exploring Professional Help Seeking in Practicing Muslim Women with Obsessive Compulsive Disorder Washing Subtype in Australia

2017

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Religion and religious practices can affect Obsessive Compulsive Disorder (OCD) symptom expression and influence the way that people with OCD seek advice or treatment. This study investigated the expression of OCD symptoms and help seeking for religious OCD symptoms among practicing Muslim women. Method: Five practicing Muslim women aged 33 to 45 years who had immigrated to Australia from Iran, Iraq, Turkey, and Afghanistan and were diagnosed with OCD washing subtype (OCD-W) took part in semi-structured interviews. Data Analysis: Thematic Analysis within a scientific realist framework was employed. Results: The most common compulsions reported by participants were performing excessive washing and repeating rituals before prayer, and these behaviours were carried out to prevent being punished by God. All participants had sought help for their OCD symptoms from an Imam before seeking help from a mental health professional, and the delay between symptom onset and OCD diagnosis by a psychiatrist ranged from 5 to 13 years. Conclusion: Effective evidence-based interventions for OCD are available and increasing awareness of OCD symptoms and treatment among Imams has the potential to reduce the delay between symptom onset and access to treatment for practicing Muslims who seek help and support.

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“…9 In a recent study, Catapano et al evaluated the long-term course of OCD in patients treated with SSRIs and found that the cumulative probability of achieving full remission three years after treatment was of 38%. 10 On the other hand, the discontinuation of the treatment with anti-obsessive medication was associated with a relapse rate of 90% or more. 11 The aim of this study was to investigate whether the results observed with cognitive-behavioral group therapy (CBGT) in OCD patients at the end of the treatment were maintained after two years.…”

Section: Introductionmentioning

confidence: 99%

Full remission and relapse of obsessive-compulsive symptoms after cognitive-behavioral group therapy: a two-year follow-up

Braga

Manfro

Niederauer

et al. 2010

Rev. Bras. Psiquiatr.

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Objective: The aim of this study was to assess whether the results obtained with 12 sessions of cognitive-behavioral group therapy with obsessive-compulsive patients were maintained after two years, and whether the degree of symptom remission was associated with relapse. Method: Forty-two patients were followed. The severity of symptoms was measured at the end of cognitive-behavioral group therapy and at 18 and 24 months of follow-up. The assessment scales used were the Yale-Brown Obsessive-Compulsive Scale, Clinical Global Impression, Beck Depression Inventory, and Beck Anxiety Inventory. Results: The reduction in symptom severity observed at the end of treatment was maintained during the two-year follow-up period (F = 57.881; p < 0.001). At the end of the treatment, 9 (21.4%) patients presented full remission, 22 (52.4%) presented partial remission, and 11 (26.2%) had unchanged scores in the Yale-Brown Obsessive-Compulsive Scale. After two years, 13 patients (31.0%) presented full remission, 20 (47.6%) had partial remission, and 9 (21.4%) had unchanged Yale-Brown ObsessiveCompulsive Scalescores. The full remission of symptoms at the end of the treatment was a protective factor against relapse (χ 2 = 4,962; df = 1; p = 0.026). Conclusion: Our findings underscore the importance of attaining full remission of obsessive-compulsive symptoms during treatment and the need for new therapeutic strategies to achieve this. (F = 57,881; p < 0,001 Descriptors

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Obsessive–compulsive disorder: A 3-year prospective follow-up study of patients treated with serotonin reuptake inhibitors

Cited by 78 publications

References 45 publications

A systematic review of the clinical effectiveness and cost-effectiveness of pharmacological and psychological interventions for the management of obsessive–compulsive disorder in children/adolescents and adults

A systematic review of the clinical effectiveness and cost-effectiveness of pharmacological and psychological interventions for the management of obsessive–compulsive disorder in children/adolescents and adults

Exploring Professional Help Seeking in Practicing Muslim Women with Obsessive Compulsive Disorder Washing Subtype in Australia

Full remission and relapse of obsessive-compulsive symptoms after cognitive-behavioral group therapy: a two-year follow-up

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