Duration of untreated illness of patients with obsessive-compulsive disorder in Japan

Duration of Untreated Illness in Obsessive-Compulsive Disorder and its Associated Factors

Introduction

The period before effective treatment is administered, is known as the duration of untreated illness (DUI). It has been found to relate to prognoses and sensitivity to treatment. The DUI is yet to be fully investigated in relation to obsessive-compulsive disorder (OCD).

Method

The present study examined a sample of 89 patients who presented with OCD over a span of two years and who were treated at a clinic in Khartoum, the capital city of Sudan. We examined the mean DUI before the patients received an effective psychiatric intervention. We also gauged different sociodemographic and clinical presentations associated with DUI.

Results

The sample comprised 55 male (61.8%) and 34 female patients (38.2%). Around 75% were single (N = 67); 34 participants (38.2%) were students; 28 (31.5%) were employed; and 27 (30.3%) were unemployed. The mean age of the participants was 27.12 years (SD ± 8.72) and the mean age at the first onset of the disorder was 21.72 years (SD ± 7.51). The mean of DUI was 5.41 years (SD ± 5.53). There was no significant difference in DUI in respect of age or gender. It was significantly longer in unemployed patients (7.59 years ± 5.93) than in employed (6.37 years ± 6.64) or students (2.88 years ± 2.59); p = 0.002. Married OCD patients had a longer DUI than single patients.

Conclusion

The present study highlighted a considerable delay before OCD patients received effective treatment. Although many intractable cultural and socioeconomic factors were tested, the strongest associations were found to be unemployment and marital status.

Latency to selective serotonin reuptake inhibitor vs benzodiazepine treatment in patients with panic disorder: a naturalistic study

BACKGROUND

Panic disorder (PD) is a prevalent and impairing anxiety disorder with previous reports suggesting that the longer the condition remains untreated, the greater the likelihood of nonresponse. However, patients with PD may wait for years before receiving a guideline-recommended pharmacological treatment. The widespread prescription of benzodiazepines (BDZ) for managing anxiety symptoms and disorders might delay the administration of pharmacotherapy according to guidelines (eg, selective serotonin reuptake inhibitors, SSRIs). The present study aimed to determine the mean duration of untreated illness (DUI) in a sample of PD patients, to quantify and compare DUI-SSRI to DUI-BDZ, and to compare findings with those from previous investigations.

METHODS

Three hundred and fourteen patients with a Diagnostic and Statistical Manual of Mental Disorders, fifth edition diagnosis of PD were recruited from an Italian outpatient psychotherapy unit, and epidemiological and clinical variables were retrieved from medical records. Descriptive statistical analyses were undertaken for sociodemographic and clinical variables, Wilcoxon matched-pair signed rank test was applied to compare the distribution of DUI-SSRI vs DUI-BDZ, and Welch's t test was performed to compare findings with those from previous studies.

RESULTS

The mean DUI-SSRI of the total sample was 64.25 ± 112.74 months, while the mean DUI-BDZ was significantly shorter (35.09 ± 78.62 months; P < 0.0001). A significantly longer DUI-SSRI, compared to findings from previous studies, was also observed.

CONCLUSIONS

The present results confirm a substantial delay in implementing adequate pharmacological treatments in patients with PD, and highlight the discrepancy between recommendations from international treatment guidelines and common clinical practice in relation to BDZ prescription.

Obsessive-Compulsive Disorder with Psychotic Features: Is It a Clinical Entity?

(1) Background: Even though the comorbidity of obsessive-compulsive disorder (OCD) and a psychotic disorder (PD), such as schizophrenia, is being increasingly recognized, the impact of this comorbidity on the clinical presentation, including insight into obsessive-compulsive symptoms and the functioning of OCD, remains unclear. (2) Methods: To investigate clinical differences between OCD patients with and without PD, 86 Japanese outpatients who met the DSM-IV-TR criteria for OCD were recruited and divided into two groups: 28 OCD patients with PD, and 58 OCD patients without PD. The two groups were cross-sectionally compared in terms of their sociodemographic profiles and clinical characteristics, including the DSM-IV-TR insight specifier and the Global Assessment of Functioning (GAF). (3) Results: The results showed that OCD patients with PD scored lower on both the insight and GAF assessments. (4) Conclusions: The present study suggests that comorbid PD in OCD is a clinical entity.