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REVIEW
Darin D Dougherty, Brian P Brennan, S Evelyn Stewart, Sabine Wilhelm, Alik S Widge, Scott L Rauch
IMPORTANCE: Obsessive-compulsive disorder (OCD) is a common and often debilitating psychiatric illness. Recent advances in the understanding of the neuroscience of OCD have provided valuable insights that have begun to transform the way we think about the management of this disorder. This educational review provides an integrated neuroscience perspective on formulation and treatment planning for patients with OCD. The article is organized around key neuroscience themes most relevant for OCD...
October 1, 2018: JAMA Psychiatry
#2
REVIEW
Matthew E Hirschtritt, Michael H Bloch, Carol A Mathews
IMPORTANCE: Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder associated with significant impairment and a lifetime prevalence of 1% to 3%; however, it is often missed in primary care settings and frequently undertreated. OBJECTIVE: To review the most current data regarding screening, diagnosis, and treatment options for OCD. EVIDENCE REVIEW: We searched PubMed, EMBASE, and PsycINFO to identify randomized controlled trials (RCTs), meta-analyses, and systematic reviews that addressed screening and diagnostic and treatment approaches for OCD among adults (≥18 years), published between January 1, 2011, and September 30, 2016...
April 4, 2017: JAMA
#3
JOURNAL ARTICLE
Gustaf Brander, Mina Rydell, Ralf Kuja-Halkola, Lorena Fernández de la Cruz, Paul Lichtenstein, Eva Serlachius, Christian Rück, Catarina Almqvist, Brian M D'Onofrio, Henrik Larsson, David Mataix-Cols
Importance: Perinatal complications may increase the risk of obsessive-compulsive disorder (OCD). Previous reports were based on small, retrospective, specialist clinic-based studies that were unable to rigorously control for unmeasured environmental and genetic confounding. Objective: To prospectively investigate a wide range of potential perinatal risk factors for OCD, controlling for unmeasured factors shared between siblings in the analyses. Design, Setting, and Participants: This population-based birth cohort study included all 2 421 284 children from singleton births in Sweden from January 1, 1973, to December 31, 1996, who were followed up through December 31, 2013...
November 1, 2016: JAMA Psychiatry
#4
JOURNAL ARTICLE
Premika S W Boedhoe, Lianne Schmaal, Yoshinari Abe, Stephanie H Ameis, Paul D Arnold, Marcelo C Batistuzzo, Francesco Benedetti, Jan C Beucke, Irene Bollettini, Anushree Bose, Silvia Brem, Anna Calvo, Yuqi Cheng, Kang Ik K Cho, Sara Dallaspezia, Damiaan Denys, Kate D Fitzgerald, Jean-Paul Fouche, Mònica Giménez, Patricia Gruner, Gregory L Hanna, Derrek P Hibar, Marcelo Q Hoexter, Hao Hu, Chaim Huyser, Keisuke Ikari, Neda Jahanshad, Norbert Kathmann, Christian Kaufmann, Kathrin Koch, Jun Soo Kwon, Luisa Lazaro, Yanni Liu, Christine Lochner, Rachel Marsh, Ignacio Martínez-Zalacaín, David Mataix-Cols, José M Menchón, Luciano Minuzzi, Takashi Nakamae, Tomohiro Nakao, Janardhanan C Narayanaswamy, Fabrizio Piras, Federica Piras, Christopher Pittenger, Y C Janardhan Reddy, Joao R Sato, H Blair Simpson, Noam Soreni, Carles Soriano-Mas, Gianfranco Spalletta, Michael C Stevens, Philip R Szeszko, David F Tolin, Ganesan Venkatasubramanian, Susanne Walitza, Zhen Wang, Guido A van Wingen, Jian Xu, Xiufeng Xu, Je-Yeon Yun, Qing Zhao, Paul M Thompson, Dan J Stein, Odile A van den Heuvel
OBJECTIVE: Structural brain imaging studies in obsessive-compulsive disorder (OCD) have produced inconsistent findings. This may be partially due to limited statistical power from relatively small samples and clinical heterogeneity related to variation in illness profile and developmental stage. To address these limitations, the authors conducted meta- and mega-analyses of data from OCD sites worldwide. METHOD: T1 images from 1,830 OCD patients and 1,759 control subjects were analyzed, using coordinated and standardized processing, to identify subcortical brain volumes that differ between OCD patients and healthy subjects...
January 1, 2017: American Journal of Psychiatry
#5
REVIEW
Nabil Benzina, Luc Mallet, Eric Burguière, Karim N'Diaye, Antoine Pelissolo
Obsessive-compulsive disorder (OCD) is a mental disorder featuring obsessions (intrusive thoughts) and compulsions (repetitive behaviors performed in the context of rigid rituals). There is strong evidence for a neurobiological basis of this disorder, involving limbic cortical regions and related basal ganglion areas. However, more research is needed to lift the veil on the precise nature of that involvement and the way it drives the clinical expression of OCD. Altered cognitive functions may underlie the symptoms and thus draw a link between the clinical expression of the disorder and its neurobiological etiology...
September 2016: Current Psychiatry Reports
#6
REVIEW
Clement Hamani, Julie Pilitsis, Anand I Rughani, Joshua M Rosenow, Parag G Patil, Konstantin S Slavin, Aviva Abosch, Emad Eskandar, Laura S Mitchell, Steven Kalkanis
BACKGROUND: It is estimated that 40% to 60% of patients with obsessive-compulsive disorder (OCD) continue to experience symptoms despite adequate medical management. For this population of treatment-refractory patients, promising results have been reported with the use of deep brain stimulation (DBS). OBJECTIVE: To conduct a systematic review of the literature and develop evidence-based guidelines on DBS for OCD. METHODS: A systematic literature search was undertaken using the PubMed database for articles published between 1966 and October 2012 combining the following words: "deep brain stimulation and obsessive-compulsive disorder" or "electrical stimulation and obsessive-compulsive disorder...
October 2014: Neurosurgery
#7
COMPARATIVE STUDY
Luke J Norman, Christina Carlisi, Steve Lukito, Heledd Hart, David Mataix-Cols, Joaquim Radua, Katya Rubia
IMPORTANCE: Patients with attention-deficit/hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD) share impaired inhibitory control. However, it is unknown whether impairments are mediated by shared or disorder-specific neurostructural and neurofunctional abnormalities. OBJECTIVE: To establish shared and disorder-specific structural, functional, and overlapping multimodal abnormalities in these 2 disorders through a voxel-based meta-analytic comparison of whole-brain gray matter volume (GMV) and functional magnetic resonance imaging (fMRI) studies of inhibition in patients with ADHD and OCD...
August 1, 2016: JAMA Psychiatry
#8
MULTICENTER STUDY
Jean-Paul Fouche, Stefan du Plessis, Coenie Hattingh, Annerine Roos, Christine Lochner, Carles Soriano-Mas, Joao R Sato, Takashi Nakamae, Seiji Nishida, Jun Soo Kwon, Wi Hoon Jung, David Mataix-Cols, Marcelo Q Hoexter, Pino Alonso, Stella J de Wit, Dick J Veltman, Dan J Stein, Odile A van den Heuvel
BACKGROUND: There is accumulating evidence for the role of fronto-striatal and associated circuits in obsessive-compulsive disorder (OCD) but limited and conflicting data on alterations in cortical thickness. AIMS: To investigate alterations in cortical thickness and subcortical volume in OCD. METHOD: In total, 412 patients with OCD and 368 healthy adults underwent magnetic resonance imaging scans. Between-group analysis of covariance of cortical thickness and subcortical volumes was performed and regression analyses undertaken...
January 2017: British Journal of Psychiatry
#9
REVIEW
Tomohiro Nakao, Kayo Okada, Shigenobu Kanba
Obsessive-compulsive disorder (OCD) was previously considered refractory to most types of therapeutic intervention. There is now, however, ample evidence that selective serotonin reuptake inhibitors and behavior therapy are highly effective methods for treatment of OCD. Furthermore, recent neurobiological studies of OCD have found a close correlation between clinical symptoms, cognitive function, and brain function. A large number of previous neuroimaging studies using positron emission tomography, single-photon emission computed tomography or functional magnetic resonance imaging (fMRI) have identified abnormally high activities throughout the frontal cortex and subcortical structures in patients with OCD...
August 2014: Psychiatry and Clinical Neurosciences
#10
REVIEW
Wayne K Goodman, Dorothy E Grice, Kyle A B Lapidus, Barbara J Coffey
This article reviews the clinical features and neurochemical hypotheses of obsessive-compulsive disorder (OCD) with a focus on the serotonin system. In DSM-5, OCD was moved from the anxiety disorders to a new category of Obsessive-Compulsive and Related Disorders. OCD is a common, typically persistent disorder marked by intrusive and disturbing thoughts (obsessions) and repetitive behaviors (compulsions) that the person feels driven to perform. The preferential efficacy of serotonin reuptake inhibitors (SRIs) in OCD led to the so-called serotonin hypothesis...
September 2014: Psychiatric Clinics of North America
#11
REVIEW
Martin E Franklin, Edna B Foa
Obsessive compulsive disorder (OCD) is characterized by the presence of intrusive, anxiety-provoking thoughts, images, or impulses along with repetitive behaviors or mental acts designed to reduce obsessional distress. OCD is associated with significant functional impairment, psychiatric comorbidity, and compromised quality of life. Fortunately, substantive progress has been made in the past several decades in the development and empirical evaluation of treatments for OCD across the developmental spectrum. The current review begins with a discussion of the clinical presentation of OCD and psychological theories regarding its etiology and maintenance...
2011: Annual Review of Clinical Psychology
#12
JOURNAL ARTICLE
Eesha Sharma, Kandavel Thennarasu, Y C Janardhan Reddy
OBJECTIVE: To study the long-term rate and predictors of remission in adults with obsessive-compulsive disorder (OCD), using meta-analysis. DATA SOURCES: The MEDLINE database was searched to May 2013 using the search terms obsessive-compulsive disorder, prospective, outcome study, clinical course, remission, prognosis, follow-up, and long-term and limits for language (English), species (humans), and age (adults). This was supplemented by manual bibliographic cross-referencing...
September 2014: Journal of Clinical Psychiatry
#13
REVIEW
Naomi A Fineberg, Samar Reghunandanan, Helen B Simpson, Katharine A Phillips, Margaret A Richter, Keith Matthews, Dan J Stein, Jitender Sareen, Angus Brown, Debbie Sookman
This narrative review gathers together a range of international experts to critically appraise the existing trial-based evidence relating to the efficacy and tolerability of pharmacotherapy for obsessive compulsive disorder in adults. We discuss the diagnostic evaluation and clinical characteristics followed by treatment options suitable for the clinician working from primary through to specialist psychiatric care. Robust data supports the effectiveness of treatment with selective serotonin reuptake inhibitors (SSRIs) and clomipramine in the short-term and the longer-term treatment and for relapse prevention...
May 30, 2015: Psychiatry Research
#14
REVIEW
Jonathan S Abramowitz, Ryan J Jacoby
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders includes a new class of obsessive-compulsive and related disorders (OCRDs) that includes obsessive-compulsive disorder (OCD) and a handful of other putatively related conditions. Although this new category promises to raise awareness of underrecognized and understudied problems, its empirical validity and practical utility are questionable. This article reviews the phenomenology of OCD and then presents a critical analysis of the arguments underlying the new OCRD class...
2015: Annual Review of Clinical Psychology
#15
JOURNAL ARTICLE
Stian Solem, Kristen Hagen, Christoffer Wenaas, Åshild T Håland, Gunvor Launes, Patrick A Vogel, Bjarne Hansen, Joseph A Himle
BACKGROUND: Research is scarce with regard to the role of psychotic and schizotypal symptoms in treatment of obsessive-compulsive disorder (OCD). The aim of the current study was to investigate the occurrence and specificity of psychotic and schizotypal symptoms among non-psychotic OCD patients, and to examine whether such symptoms was associated with response to exposure and response prevention (ERP), and whether ERP for OCD had an impact on psychotic and schizotypal symptoms. METHODS: Non-psychotic OCD patients (n = 133) and a general non-psychotic psychiatric outpatient sample (n = 110) were assessed using self-report inventories before and after psychological treatment...
May 28, 2015: BMC Psychiatry
#16
JOURNAL ARTICLE
Kenneth A Kobak, Revere Greist, David M Jacobi, Hollie Levy-Mack, John H Greist
BACKGROUND: The purpose of the study was to examine the impact of computerized cognitive behavior therapy (CBT) self-help treatment for obsessive-compulsive disorder (OCD) (BT Steps) both alone and when supported by coaching from either a lay non-therapist coach or an experienced CBT therapist. METHODS: Eighty-seven subjects with clinically significant OCD were recruited through newspaper ads and randomly assigned to receive 12 weeks of treatment with either BT Steps alone (n = 28), BT Steps with non-therapist coaching (n = 28), or BT Steps with CBT therapist coaching (n = 31)...
2015: Annals of General Psychiatry
#17
REVIEW
Michael H Bloch, Eric A Storch
OBJECTIVE: To review the assessment and treatment of treatment-refractory pediatric obsessive-compulsive disorder (OCD). METHOD: A PubMed search was conducted to identify controlled trials in pediatric OCD. In addition, practice guidelines for the treatment of adults and children were further reviewed for references in treatment-refractory OCD across the lifespan. RESULTS: Pharmacotherapy with selective serotonin reuptake inhibitors (SSRIs) and cognitive-behavioral therapy (CBT) were found to be effective treatments for pediatric OCD...
April 2015: Journal of the American Academy of Child and Adolescent Psychiatry
#18
JOURNAL ARTICLE
Heidi A Browne, Stefan N Hansen, Joseph D Buxbaum, Shannon L Gair, Judith B Nissen, Kathrine H Nikolajsen, Diana E Schendel, Abraham Reichenberg, Erik T Parner, Dorothy E Grice
IMPORTANCE: Tourette syndrome/chronic tic disorder (TS/CT) and obsessive-compulsive disorder (OCD) overlap in their phenomenological features and often co-occur in affected individuals and families. Understanding how these disorders cluster in families provides important clinical information and is an important step in understanding the causes of these disorders. OBJECTIVE: To determine familial recurrence for TS/CT and OCD using a national epidemiologic sample...
April 2015: JAMA Psychiatry
#19
JOURNAL ARTICLE
James Allen Wilcox
Obsessive Compulsive Disorder (OCD) is a psychiatric disorder with considerable morbidity and mortality. This condition disables many individuals and is often refractory to treatment. Research suggests that serotonin plays a role in OCD symptom reduction. We present a case of an individual who successfully used psilocybin, a serotonergic agent, to reduce the core symptoms of OCD for several years. Although not endorsing this form of treatment, we feel that the successful use of this agent highlights the role of serotonergic factors in OCD and the need for further, legitimate research into the value of psilocybin in the treatment of anxiety disorders...
November 2014: Journal of Psychoactive Drugs
#20
REVIEW
Jon E Grant
A 19-year-old man is brought to his primary physician by his father, who explains that his son washes his hands a hundred times a day, will not touch anything that has been touched by someone else without scrubbing it first, and has a fear of germs that has left him isolated in his bedroom, unable to eat, and wishing he were dead. Although the father reports that his son has always been finicky, this problem started approximately 2 years ago and has gradually become completely disabling. How should this patient be evaluated and treated?...
August 14, 2014: New England Journal of Medicine
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