Clinical features associated to refractory obsessive-compulsive disorder
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Data
2006-08-01
Autores
Ferrao, Ygor A.
Shavitt, Rosell G.
Bedin, Nadia R.
de Mathis, Maria Eugenia
Lopes, Antonio Carlos
Fontenelle, Leonardo F.
Torres, Albina Rodrigues [UNESP]
Miguel, Euripedes C.
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Título de Volume
Editor
Elsevier B.V.
Resumo
Some patients with obsessive-compulsive disorder (OCD) exhibit an unsatisfactory reduction in symptom severity despite being treated with all the available therapeutic alternatives. The clinical variables associated with treatment-refractoriness in OCD are inconsistently described in the literature.Methods: To investigate factors associated with treatment-reftactoriness of patients with OCD, we conducted a case-control study, comparing 23 patients with treatment-refractory OCD to 26 patients with treatment-responding OCD.Results: the factors associated with refractoriness of OCD were higher severity of symptoms since the onset of OCD (P < 0.001), chronic course (p=0.003), lack of a partner (p=0.037), unemployment (p=0.025), low economic status (p=0.015), presence of obsessive-compulsive symptoms of sexual/religious content (p=0.043), and higher scores on family accommodation (P < 0.001). Only the three latter variables remained significantly associated with treatment-reftactoriness after regression analyses. Limitations: small sample size, the biases and drawbacks inherent to a case-control study, and the inclusion criteria used to define the study groups may have limited the generalisation of the results.Conclusion: A major strength of this study is the systematic and structured evaluation of a vast array of variables related to the clinical expression of OCD, including epigenetic factors and ratings derived from instruments evaluating family accommodation. The presence of sexual/religious symptoms, low economic status and high modification on family function due to OCD were independently associated with, treatment-refractoriness. Future longitudinal studies are warranted to verify if these variables represent predictive factors of treatment non-response. (c) 2006 Elsevier B.V. All rights reserved.
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Palavras-chave
obsessive-compulsive disorder, treatment response, predictive factors
Como citar
Journal of Affective Disorders. Amsterdam: Elsevier B.V., v. 94, n. 1-3, p. 199-209, 2006.