1,721,125 research outputs found
An exploratory study on obsessive-compulsive disorder with and without a familial component: are there any phenomenological differences?
No full textFamilial studies on obsessive-compulsive disorders (OCD) have suggested that OCD is a heterogeneous condition, with some cases being familial and others being isolated cases in their families. Nevertheless, no studies evaluated whether there are clinical differences between OCD cases with and without a familial component. The current report presents data on the prevalence of OCD in first-degree relatives of OCD probands and compares phenomenological characteristics of familial and non-familial OCD types. The family study and the family history methods were used to estimate the prevalence of OCD in first-degree relatives of 74 OCD probands. A statistical comparison between OCD probands with and without familial loading was performed using Pearson's chi(2) test, Fisher's exact test, or Student's t test when appropriate. The rate of OCD was 3.5% in directly interviewed first-degree relatives. Eleven percent of the probands had at least one family member with OCD. There were no differences between the two types of OCD (familial vs. non-familial) except for life events prior to the onset of OCD, which were more common and more severe in non-familial OCD subtypes. In conclusion, our results (1) confirm that there is a familial component in the expression of some forms of OCD and (2) indicate that familial OCD patients are not characterized by peculiar clinical features, but appear to have a lower threshold for precipitating events
Combining pharmacological and psychotherapeutic interventions for obsessive-compulsive disorder patients
No full textObject: The aim of the present paper is to answer the following questions: 1) does combining medication and CBT add benefits as compared to CBT alone? 2) Does adding CBT to medication give further improvement as compared to medication alone? 3) Do benefits of combination treatments persist over the long-term?
Method: We reviewed available data concerning combining medications (SRIs) and cognitive-behavior therapy (CBT) in the treatment of Obsessive-Compulsive Disorder (OCD). A separate analysis was made for studies which investigated combined treatments ab initio and for those which evaluated the efficacy of sequential treatments.
Results: We identified nine controlled studies which investigated the efficacy of combination treatments versus CBT alone and five which evaluated the efficacy of combination versus medications alone. Few studies investigated sequential treatments. Methodologies and results of these studies are presented and discussed.
Conclusions: The short-term or long-term treatment effect of CBT is not augmented by the addition of medication; a combination of CBT and medication might be superior to CBT alone when obsessions dominate the clinical picture and/or when a severe secondary depression is present. Children and adolescents with OCD could also benefit more from the combination treatment. The short-term treatment effect of antidepressants can be enhanced by the addition of CBT a) to augment the benefit from medication; b) to reduce the use of medication for those patients who are intolerant to side effects; 3) to prevent relapses for those patients who want to discontinue medication after short-term response. A sequential administration of CBT after medication might convert patients who failed to fully respond to medication in responders
Antipsychotic augmentation for treatment resistant obsessive-compulsive disorder: what if antipsychotic is discontinued?
No full text
Health-related quality of life among first-degree relatives of patients with obsessive-compulsive disorder in Italy
No full textOBJECTIVE: The aim of this study was, first, to examine health-related quality of life among relatives of Italian patients with obsessive-compulsive disorder and, second, to search for potential predictors of quality of life among these relatives. METHODS: Health-related quality of life was assessed among 64 non-psychiatrically ill family members of 48 patients with obsessive-compulsive disorder by using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the Structured Clinical Interview for DSM-IV Axis II Disorders were used to assess obsessive-compulsive disorder among the patients. Mean SF-36 scores of participants were compared with expected scores for 2,031 persons from the Italian general population (Italian norms) by using the one-sample t test. Correlates of health-related quality of life were examined by means of independent-sample t tests and Pearson correlations; variables significantly associated with SF-36 subscales were entered into a stepwise multiple linear regression analysis with the physical and mental components as dependent variables. RESULTS: Relatives of patients with obsessive-compulsive disorder showed a greater impairment in health-related quality of life in the SF-36 subscales of role limitations due to physical health, vitality, social functioning, role limitations due to emotional problems, and mental health. When a stepwise multiple linear regression analysis was performed with the physical component and the mental component of the SF-36 as dependent variables, female gender, older age, and the total score on the Family Accommodation Scale predicted a poorer score on the physical component, whereas the only predictor of a poorer score on the mental component was the patient's Y-BOCS total score. CONCLUSIONS: The study provides evidence that obsessive-compulsive disorder impairs health-related quality of life among family members of patients with obsessive-compulsive disorder, even among healthy family members. Involving family members in the treatment of obsessive-compulsive disorder could improve their perceived quality of life
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