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Etkin RG, Bloch MH, Lebowitz ER. Family accommodation: a diagnostic feature of obsessive-compulsive disorder? Expert Rev Neurother 2024; 24:129-131. [PMID: 38258501 DOI: 10.1080/14737175.2024.2309239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/19/2024] [Indexed: 01/24/2024]
Affiliation(s)
- Rebecca G Etkin
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Michael H Bloch
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Eli R Lebowitz
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
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Skibniewska EM, Skibniewski M. Selenium Content in the Gonads of Healthy Cats ( Felis catus) and Cats with Impaired Homeostasis from the Warsaw Area (Poland). Animals (Basel) 2024; 14:440. [PMID: 38338083 PMCID: PMC10854887 DOI: 10.3390/ani14030440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/17/2024] [Accepted: 01/27/2024] [Indexed: 02/12/2024] Open
Abstract
The aim of the present study was to evaluate selenium content in the gonads of healthy cats and those with impaired homeostasis with the use of fluorescence spectroscopy. Higher concentrations of selenium were found in the gonads of the male domestic cats studied. The average content of this element in the testes of healthy males was: 0.59 mg·kg-1 while 0.47 mg·kg-1 wet weight was recorded in the ovaries of females. In the case of individuals with impaired homeostasis, higher values of selenium were found in the ovaries of obese females (0.40 mg·kg-1), while in the case of females with diagnosed malignancy of the mammary gland, the average values were lower and amounted to 0.31 mg·kg-1 wet weight of tissue. On the basis of statistical analysis, significant differences were found according to sex, age, and disturbed homeostasis of the individuals studied. An association was found between low Se in the gonads and obesity, as well as the presence of mammary gland neoplastic lesions. In addition, Se content was found to decrease with age in females, which can reduce resistance to oxidative stress.
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Affiliation(s)
- Ewa M. Skibniewska
- Department of Biology of Animal Environment, Institute of Animal Science, Warsaw University of Life Sciences, Ciszewskiego Street 8, 02-786 Warsaw, Poland
| | - Michał Skibniewski
- Department of Morphological Sciences, Institute of Veterinary Medicine, Warsaw University of Life Sciences, Nowoursynowska Street 159, 02-776 Warsaw, Poland;
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Ching THW, Amoroso L, Bohner C, D’Amico E, Eilbott J, Entezar T, Fitzpatrick M, Fram G, Grazioplene R, Hokanson J, Jankovsky A, Kichuk SA, Martins B, Patel P, Schaer H, Shnayder S, Witherow C, Pittenger C, Kelmendi B. Safety, feasibility, tolerability, and clinical effects of repeated psilocybin dosing combined with non-directive support in the treatment of obsessive-compulsive disorder: protocol for a randomized, waitlist-controlled trial with blinded ratings. Front Psychiatry 2024; 14:1278823. [PMID: 38264632 PMCID: PMC10803438 DOI: 10.3389/fpsyt.2023.1278823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/26/2023] [Indexed: 01/25/2024] Open
Abstract
Background To date, few randomized controlled trials of psilocybin with non-directive support exist for obsessive-compulsive disorder (OCD). Results and participant feedback from an interim analysis of an ongoing single-dose trial (NCT03356483) converged on the possibility of administering a higher fixed dose and/or more doses of psilocybin in future trials for presumably greater benefits. Objectives This trial aims to evaluate the safety, feasibility, tolerability, and clinical effects of two doses of psilocybin paired with non-directive support in the treatment of OCD. This trial also seeks to examine whether two doses of psilocybin lead to greater OCD symptom reduction than a single dose, and to elucidate psychological mechanisms underlying the effects of psilocybin on OCD. Design A randomized (1:1), waitlist-controlled design with blinded ratings will be used to examine the effects of two doses of oral psilocybin paired with non-directive support vs. waitlist control on OCD symptoms. An adaptive dose selection strategy will be implemented (i.e., first dose: 25 mg; second dose: 25 or 30 mg). Methods and analysis This single-site trial will enroll 30 adult participants with treatment-refractory OCD. Aside from safety, feasibility, and tolerability metrics, primary outcomes include OCD symptoms assessed on the Yale-Brown Obsessive-Compulsive Scale - Second Edition (Y-BOCS-II). A blinded independent rater will assess primary outcomes at baseline and the primary endpoint at the end of the second dosing week. Participants will be followed up to 12 months post-second dosing. Participants randomized to waitlist will be rescreened after 7 weeks post-randomization, and begin their delayed treatment phase thereafter if still eligible. Ethics Written informed consent will be obtained from participants. The institutional review board has approved this trial (protocol v. 1.7; HIC #2000032623). Discussion This study seeks to advance our ability to treat refractory OCD, and catalyze future research seeking to optimize the process of psilocybin treatment for OCD through understanding relevant psychological mechanisms.Clinical trial registration: ClinicalTrials.gov, identifier NCT05370911.
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Affiliation(s)
- Terence H. W. Ching
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Lucia Amoroso
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Calvin Bohner
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Elizabeth D’Amico
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Jeffrey Eilbott
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Tara Entezar
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Madison Fitzpatrick
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Geena Fram
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Rachael Grazioplene
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Jamila Hokanson
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Anastasia Jankovsky
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Stephen A. Kichuk
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Bradford Martins
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Prerana Patel
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Henry Schaer
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Sarah Shnayder
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Chelsea Witherow
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Christopher Pittenger
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Department of Psychology, Yale University, New Haven, CT, United States
- Center for Brain and Mind Health, Yale University School of Medicine, New Haven, CT, United States
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
| | - Benjamin Kelmendi
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
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Jelinek L, Schröder J, Bücker L, Miegel F, Baumeister A, Moritz S, Sibilis A, Schultz J. Improving adherence to unguided Internet-based therapy for obsessive-compulsive disorder: A randomized controlled trial. J Affect Disord 2023; 338:472-481. [PMID: 37348657 DOI: 10.1016/j.jad.2023.06.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 06/11/2023] [Accepted: 06/19/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND Adherence to internet-based cognitive-behavioral therapy (iCBT) is often low, possibly reducing its potential. The current study set out to test whether adherence and effects of unguided iCBT for obsessive-compulsive disorder (OCD) could be improved by varying the degree of autonomy in which modules are completed (free choice vs. fixed order). METHODS We randomized 151 individuals with OCD to either an unguided iCBT with a fixed (iCBTfixed) or a free-choice (iCBTfree+) order of the modules. We assessed participants at baseline (t0), eight weeks (t1), and 16 weeks (t2). Primary outcomes were adherence (utilization time, modules completed) and change in OCD severity (Y-BOCS). Secondary outcomes included depression, self-esteem, and treatment satisfaction. We calculated intent-to-treat (ITT) and complete case (CC) analyses. RESULTS Analyses showed that both iCBT programs significantly reduced OCD severity. While groups did not differ on the ITT analyses, for the CC analyses, a greater improvement was found in the iCBTfixed in comparison to the iCBTfree+ group regarding OCD severity and quality of life, with medium effect sizes from t0 to t1 (ηp2 = 0.067-0.077). Time of utilization and number of modules completed did not differ between groups. LIMITATIONS No placebo control group, short follow-up period, self-report assessment. CONCLUSIONS iCBT is effective in improving OCD. Despite similar adherence in the fixed versus the free-choice module order, the study offers tentative evidence that a fixed order of content is associated with better effects. More research on the effects of adherence on outcome is necessary.
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Affiliation(s)
- Lena Jelinek
- Department of Psychotherapy and Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Johanna Schröder
- Department of Psychotherapy and Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Institute for Clinical Psychology and Psychotherapy, Department of Psychology, Medical School Hamburg, Hamburg, Germany
| | - Lara Bücker
- Department of Psychotherapy and Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franziska Miegel
- Department of Psychotherapy and Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anna Baumeister
- Department of Psychotherapy and Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffen Moritz
- Department of Psychotherapy and Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Arne Sibilis
- Department of Psychotherapy and Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Josephine Schultz
- Department of Psychotherapy and Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Ching THW, Grazioplene R, Bohner C, Kichuk SA, DePalmer G, D’Amico E, Eilbott J, Jankovsky A, Burke M, Hokanson J, Martins B, Witherow C, Patel P, Amoroso L, Schaer H, Pittenger C, Kelmendi B. Safety, tolerability, and clinical and neural effects of single-dose psilocybin in obsessive-compulsive disorder: protocol for a randomized, double-blind, placebo-controlled, non-crossover trial. Front Psychiatry 2023; 14:1178529. [PMID: 37181888 PMCID: PMC10166878 DOI: 10.3389/fpsyt.2023.1178529] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 04/04/2023] [Indexed: 05/16/2023] Open
Abstract
Background Psilocybin may help treat obsessive-compulsive disorder (OCD). To date, only one open-label study of psilocybin for OCD exists, necessitating further investigation with a randomized controlled design. The neural correlates of psilocybin's effects on OCD have also not been studied. Objectives This first-of-its-kind trial aims to evaluate the feasibility, safety, and tolerability of psilocybin in the treatment of OCD, provide preliminary evidence on the effects of psilocybin on OCD symptoms, and elucidate neural mechanisms that may mediate psilocybin's effects on OCD. Design We use a randomized (1:1), double-blind, placebo-controlled, non-crossover design to examine the clinical and neural effects of either a single dose of oral psilocybin (0.25 mg/kg) or active placebo-control agent (250 mg of niacin) on OCD symptoms. Methods and analysis We are enrolling 30 adult participants at a single site in Connecticut, USA who have failed at least one trial of standard care treatment (medication/psychotherapy) for OCD. All participants will also receive unstructured, non-directive psychological support during visits. Aside from safety, primary outcomes include OCD symptoms over the past 24 h, assessed by the Acute Yale-Brown Obsessive-Compulsive Scale and Visual Analog Scale ratings. These are collected by blinded, independent raters at baseline and the primary endpoint of 48 h post-dosing. Total follow-up is 12 weeks post-dosing. Resting state neuroimaging data will be collected at baseline and primary endpoint. Participants randomized to placebo will be offered the chance to return for an open-label dose of 0.25 mg/kg. Ethics statement All participants will be required to provide written informed consent. The trial (protocol v. 5.2) was approved by the institutional review board (HIC #2000020355) and registered with ClinicalTrials.gov (NCT03356483). Discussion This study may represent an advance in our ability to treat refractory OCD, and pave the way for future studies of neurobiological mechanisms of OCD that may respond to psilocybin.
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Affiliation(s)
- Terence H. W. Ching
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Rachael Grazioplene
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Calvin Bohner
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Stephen A. Kichuk
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Giuliana DePalmer
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Elizabeth D’Amico
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Jeffrey Eilbott
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Anastasia Jankovsky
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Michelle Burke
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Jamila Hokanson
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Brad Martins
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Chelsea Witherow
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Prerana Patel
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Lucia Amoroso
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Henry Schaer
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Christopher Pittenger
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- Department of Psychology, Yale University, New Haven, CT, United States
- Center for Brain and Mind Health, Yale University School of Medicine, New Haven, CT, United States
- Child Study Center, Yale University School of Medicine, New Haven, CT, United States
| | - Benjamin Kelmendi
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
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Fontenelle LF, Nicolini H, Brakoulias V. Early intervention in obsessive-compulsive disorder: From theory to practice. Compr Psychiatry 2022; 119:152353. [PMID: 36341748 DOI: 10.1016/j.comppsych.2022.152353] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/03/2022] [Accepted: 10/24/2022] [Indexed: 01/31/2023] Open
Abstract
Obsessive-compulsive disorder (OCD) is frequent and often disabling. Yet, correct diagnosis and appropriate treatment implementation are usually delayed, with undesirable consequences. In this paper we review the rationale for early intervention in OCD and provide recommendations for early intervention services. Two scenarios are discussed, i.e., subclinical (prodromal) obsessive-compulsive symptoms (OCS) and full-blown OCD. Although the typical patient with OCD reports a long history of subclinical OCS, longitudinal studies suggest most individuals with OCS in the community do not convert to full-blown OCD. Thus, research on "at risk" phenotypes for OCD and how they should incorporate different risk factors (e.g., polygenic risk scores) are badly needed. For this specific scenario, preventative treatments that are cheap, well tolerated and highly scalable (e.g., lifestyle interventions) are of major interest. On the other hand, increasing evidence suggests OCD to be a progressive disorder and the severity and duration of illness to be associated with both biological changes and increased clinical complexity, including greater number of physical and psychiatric comorbidities, increased family accommodation and worse treatment response. Therefore, prompt identification and early treatment implementation for full-blown OCD are also critical for ethical, clinical and therapeutic reasons. Based on the existing findings, we argue that, regardless of focusing on subclinical OCS or clinical OCD, early intervention services need to target a childhood age group. In addition to delivering well established treatments to people with full-blown OCD early on their illness, early intervention services also need to provide psychoeducation for patients, families and teachers.
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Affiliation(s)
- Leonardo F Fontenelle
- Obsessive, Compulsive, and Anxiety Spectrum Research Program. Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil; D'Or Institute for Research and Education, Rio de Janeiro, Brazil; Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC, Australia.
| | - Humberto Nicolini
- Genomics of Psychiatric and Neurodegenerative Diseases Laboratory, National Institute of Genomic Medicine (INMEGEN), Mexico City, Mexico; Clinical Research, Carracci Medical Group, Mexico City, Mexico
| | - Vlasios Brakoulias
- Western Sydney Obsessive-Compulsive and Related Disorders Service, Western Sydney Local Health District Mental Health Service, Sydney, Australia; School of Medicine and Translational Health Research Institute, Western Sydney University, Sydney, Australia
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