Clinical features associated to refractory obsessive-compulsive disorder

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dc.contributor.authorFerrao, Ygor A.
dc.contributor.authorShavitt, Rosell G.
dc.contributor.authorBedin, Nadia R.
dc.contributor.authorde Mathis, Maria Eugenia
dc.contributor.authorLopes, Antonio Carlos
dc.contributor.authorFontenelle, Leonardo F.
dc.contributor.authorTorres, Albina Rodrigues [UNESP]
dc.contributor.authorMiguel, Euripedes C.
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionPROTOC
dc.contributor.institutionPresidente Vargas Hosp
dc.contributor.institutionUniversidade Federal do Rio de Janeiro (UFRJ)
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.date.accessioned2014-05-20T13:35:56Z
dc.date.available2014-05-20T13:35:56Z
dc.date.issued2006-08-01
dc.description.abstractSome 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.en
dc.description.affiliationUniv São Paulo, Sch Med, Dept Psychiat, São Paulo, Brazil
dc.description.affiliationPROTOC, Psychiat Inst Obsess Compuls Spectrum Program, São Paulo, Brazil
dc.description.affiliationPresidente Vargas Hosp, Psychiat Serv, Porto Alegre, RS, Brazil
dc.description.affiliationUniv Fed Rio de Janeiro, Inst Psychiat, Rio de Janeiro, Brazil
dc.description.affiliationUniv Estadual Paulista, Dept Neurol & Psychiat, Botucatu Fac Med, São Paulo, Brazil
dc.description.affiliationUnespUniv Estadual Paulista, Dept Neurol & Psychiat, Botucatu Fac Med, São Paulo, Brazil
dc.format.extent199-209
dc.identifierhttp://dx.doi.org/10.1016/j.jad.2006.04.019
dc.identifier.citationJournal of Affective Disorders. Amsterdam: Elsevier B.V., v. 94, n. 1-3, p. 199-209, 2006.
dc.identifier.doi10.1016/j.jad.2006.04.019
dc.identifier.issn0165-0327
dc.identifier.lattes3837157956819433
dc.identifier.urihttp://hdl.handle.net/11449/12370
dc.identifier.wosWOS:000239880600019
dc.language.isoeng
dc.publisherElsevier B.V.
dc.relation.ispartofJournal of Affective Disorders
dc.relation.ispartofjcr3.786
dc.relation.ispartofsjr2,053
dc.rights.accessRightsAcesso restrito
dc.sourceWeb of Science
dc.subjectobsessive-compulsive disorderpt
dc.subjecttreatment responsept
dc.subjectpredictive factorspt
dc.titleClinical features associated to refractory obsessive-compulsive disorderen
dc.typeArtigo
dcterms.licensehttp://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy
dcterms.rightsHolderElsevier B.V.
unesp.author.lattes3837157956819433[7]
unesp.author.orcid0000-0003-3770-5912[1]
unesp.author.orcid0000-0002-3075-6795[5]
unesp.author.orcid0000-0001-9075-8226[6]
unesp.author.orcid0000-0003-1072-5008[7]
unesp.campusUniversidade Estadual Paulista (Unesp), Faculdade de Medicina, Botucatupt

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