Obsessive-compulsive disorder misdiagnosis among mental healthcare providers in Latin America

Perez, Mayra I.; Limon, Danica L.; Candelari, Abigail E.; Cepeda, Sandra L.; Ramírez, Ana C.; Guzick, Andrew G.; Kook, Minjee; Ariza, Valérie La Buissonnière; Schneider, Sophie C.; Goodman, Wayne K.; Storch, Eric A.

doi:10.1016/j.jocrd.2021.100693

Cited by 14 publications

(12 citation statements)

References 22 publications

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“…Although the current literature on this topic is limited, it is evident that cultural norms, beliefs, and values can significantly influence the experience of OCD, as well as the interpretation of symptoms by affected individuals, their communities, and mental health professionals. The latter continues to misidentify OCD symptoms, highlighting the need for further education and training in the field ( 27 ). Clinicians should approach OCD, as well as mental health in general, by taking into consideration the sociocultural context of the patient.…”

Section: Discussionmentioning

confidence: 99%

Variations in obsessive compulsive disorder symptomatology across cultural dimensions

Hassan,

El Hayek,

de Filippis

et al. 2024

Front. Psychiatry

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Section: Discussionmentioning

confidence: 99%

Variations in obsessive compulsive disorder symptomatology across cultural dimensions

Hassan,

El Hayek,

de Filippis

et al. 2024

Front. Psychiatry

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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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“…Clinic-based studies are needed to better understand clinical reasoning and other diagnostic processes in practice. However, complementary evidence about clinical reasoning comes from vignette-based studies that experimentally manipulate patient characteristics, symptom presentation and specific instructions for diagnostic reasoning 52–58. In a separate section below, we discuss further details of potential interventions to enhance the diagnostic process.…”

Section: Conceptualising and Measuring Diagnostic Errorsmentioning

confidence: 99%

Diagnostic error in mental health: a review

Bradford,

Meyer,

Khan

et al. 2024

BMJ Qual Saf

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Diagnostic errors are associated with patient harm and suboptimal outcomes. Despite national scientific efforts to advance definition, measurement and interventions for diagnostic error, diagnosis in mental health is not well represented in this ongoing work. We aimed to summarise the current state of research on diagnostic errors in mental health and identify opportunities to align future research with the emerging science of diagnostic safety. We review conceptual considerations for defining and measuring diagnostic error, the application of these concepts to mental health settings, and the methods and subject matter focus of recent studies of diagnostic error in mental health. We found that diagnostic error is well understood to be a problem in mental healthcare. Although few studies used clear definitions or frameworks for understanding diagnostic error in mental health, several studies of missed, wrong, delayed and disparate diagnosis of common mental disorders have identified various avenues for future research and development. Nevertheless, a lack of clear consensus on how to conceptualise, define and measure errors in diagnosis will pose a barrier to advancement. Further research should focus on identifying preventable missed opportunities in the diagnosis of mental disorders, which may uncover generalisable opportunities for improvement.

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Obsessive-compulsive disorder misdiagnosis among mental healthcare providers in Latin America

Cited by 14 publications

References 22 publications

Variations in obsessive compulsive disorder symptomatology across cultural dimensions

Variations in obsessive compulsive disorder symptomatology across cultural dimensions

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

Diagnostic error in mental health: a review

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