The Brown Longitudinal Obsessive Compulsive Study

Pinto, Anthony; Mancebo, Maria C.; Eisen, Jane L.; Pagano, Maria E.; Rasmussen, S.

doi:10.4088/jcp.v67n0503

Cited by 333 publications

(107 citation statements)

References 43 publications

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“…In women, the prevalence of eating disorders was increased (26% of the sample). Data from the Brown cohort 68 showed that a minority of patients (< 10%) had not experienced any other disorder in their life. As reported elsewhere, depression was the most common comorbid condition (67% lifetime prevalence and 15% current episode).…”

Section: Aetiologymentioning

confidence: 99%

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: Aetiologymentioning

confidence: 99%

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

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“…Indication for this hypothesis comes from studies that utilized structured interviews and DSM-IV criteria demonstrating cooccurrence rates that range between 23 and 45 % [21,49,[52][53][54]. Lower co-occurrence rates were found in (earlier) studies in which DSM-III, DSM-III-R or ICD-10-criteria were utilized as well as clinical judgments, questionnaires, and semistructured interviews for diagnostic assessment purposes [e.g.…”

Section: Ocpd and Obsessive-compulsive Disordermentioning

confidence: 99%

“…Further evidence for an overlap between OCD and OCPD originates from studies showing significantly higher cooccurrence rates between OCPD and OCD than between OCPD and the general population [21,22] or other mental disorders [52,58] (for contradictory findings, see Albert et al, 2004 [21]) (for more details, see Table 1). Even more evidence comes from studies demonstrating (significantly) higher comorbidity rates between OCPD and OCD than between other personality disorders and OCD [22,53,54,56,59,60]. Moreover, studies investigating similarities and differences between both disorders specified that (pure) obsessions as well as contamination and cleaning-related symptoms seem to be specific for individuals with OCD, whilst rigidity and excessive self-control were found to be specific for individuals with OCPD [8•, 48].…”

Section: Ocpd and Obsessive-compulsive Disordermentioning

confidence: 99%

Obsessive–Compulsive Personality Disorder: a Current Review

Diedrich¹,

Voderholzer

2015

Curr Psychiatry Rep

109

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This review provides a current overview on the diagnostics, epidemiology, co-occurrences, aetiology and treatment of obsessive-compulsive personality disorder (OCPD). The diagnostic criteria for OCPD according to the recently published Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) include an official set of criteria for clinical practice and a new, alternative set of criteria for research purposes. OCPD is a personality disorder prevalent in the general population (3-8 %) that is more common in older and less educated individuals. Findings on sex distribution and course of OCPD are inconsistent. OCPD is comorbid with several other medical and psychological conditions. As for causes of OCPD, most empirical evidence provides support for disturbed attachment as well as the heritability of OCPD. So far, cognitive (behavioural) therapy is the best validated treatment of OCPD. Self-esteem variability, stronger early alliances as well as the distress level seem to predict cognitive (behavioural) therapy outcome. Future research is needed to further advance knowledge in OCPD and to resolve inconsistencies.

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“…The resulting consequences reflect in the long delay from the onset of the disorder until the first treatment, on average 11 years [19]. Thus, there is a demand for new developments in the psychotherapeutic care of OCD.…”

mentioning

confidence: 99%

No Talking, Just Writing! Efficacy of an Internet-Based Cognitive Behavioral Therapy with Exposure and Response Prevention in Obsessive Compulsive Disorder

Herbst

Voderholzer

Thiel

et al. 2014

Psychother Psychosom

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Background: Many patients with obsessive-compulsive disorder (OCD) do not receive first-line treatment according to the current guidelines (cognitive behavioral therapy with exposure and response prevention, CBT with ERP) due to barriers to treatment. Internet-based therapy is designed to overcome these barriers. The present study evaluates the efficacy of an Internet-based writing therapy with therapeutic interaction based on the concept of CBT with ERP for patients with OCD. Methods: Thirty-four volunteers with OCD according to DSM-IV-criteria were included in the trial and randomized according to a waiting-list control design with follow-up measures at 8 weeks and 6 months. The intervention consisted of 14 sessions, either starting directly after randomization or with an 8-week delay. Main outcome measure was the change in the severity of OCD symptoms (Yale-Brown Obsessive Compulsive Scale Self-Rating, Y-BOCS SR, and Obsessive-Compulsive Inventory-Revised, OCI-R). Results: Obsessive-compulsive symptoms were significantly improved in the treatment group compared to the waiting-list control group with large effect sizes of Cohen's d = 0.82 (Y-BOCS SR) and d = 0.87 (OCI-R), using an intention-to-treat analysis. This effect remained stable at 6-month follow-up. Only 4 participants (12%) dropped out prematurely from the study. Of the 30 completers, 90% rated their condition as improved and would recommend the program to their friends. Conclusions: Internet-based writing therapy led to a significant improvement of obsessive-compulsive symptoms. Even though replications with larger sample sizes are needed, the results support the notion that Internet-based approaches have the potential for improving the treatment situation for patients with OCD.

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The Brown Longitudinal Obsessive Compulsive Study

Cited by 333 publications

References 43 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

Obsessive–Compulsive Personality Disorder: a Current Review

No Talking, Just Writing! Efficacy of an Internet-Based Cognitive Behavioral Therapy with Exposure and Response Prevention in Obsessive Compulsive Disorder

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