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Echevarria MAN, Batistuzzo MC, Silva RMF, Brunoni AR, Sato JR, Miguel EC, Hoexter MQ, Shavitt RG. Increases in functional connectivity between the default mode network and sensorimotor network correlate with symptomatic improvement after transcranial direct current stimulation for obsessive-compulsive disorder. J Affect Disord 2024; 355:175-183. [PMID: 38548207 DOI: 10.1016/j.jad.2024.03.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 03/10/2024] [Accepted: 03/24/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Non-invasive neuromodulation is a promising intervention for obsessive-compulsive disorder (OCD), although its neurobiological mechanisms of action are still poorly understood. Recent evidence suggests that abnormalities in the connectivity of the default mode network (DMN) and the supplementary motor area (SMA) with other brain regions and networks are involved in OCD pathophysiology. We examined if transcranial direct current stimulation (tDCS) alters these connectivity patterns and if they correlate with symptom improvement in treatment-resistant OCD. METHODS In 23 patients from a larger clinical trial (comparing active tDCS to sham) who underwent pre- and post-treatment MRI scans, we assessed resting-state functional MRI (rs-fMRI) data. The treatment involved 30-minute daily tDCS sessions for four weeks (weekdays only), with the cathode over the SMA and the anode over the left deltoid. We conducted whole-brain connectivity analysis comparing active tDCS-treated to sham-treated patients. RESULTS We found that active tDCS, but not sham, led to connectivity increasing between the DMN and the bilateral pre/postcentral gyri (p = 0.004, FDR corrected) and temporal-auditory areas plus the SMA (p = 0.028, FDR corrected). Also, symptom improvement was directly associated with connectivity increasing between the left lateral sensorimotor network and the left precuneus (r = 0.589, p = 0.034). LIMITATIONS Limited sample size (23 participants with resting-state neuroimaging), inability to analyze specific OCD symptom dimensions (e.g., harm, sexual/religious, symmetry/checking, cleaning/contamination). CONCLUSIONS These data offer novel information concerning functional connectivity changes associated with non-invasive neuromodulation interventions in OCD and can guide new brain stimulation interventions in the framework of personalized interventions.
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Affiliation(s)
- M A N Echevarria
- LIM-23, Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil.
| | - M C Batistuzzo
- LIM-23, Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil; Department of Methods and Techniques in Psychology, Pontifical Catholic University, São Paulo, SP, Brazil
| | - R M F Silva
- LIM-23, Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil
| | - A R Brunoni
- LIM-23, Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil
| | - J R Sato
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, SP, Brazil
| | - E C Miguel
- LIM-23, Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil
| | - M Q Hoexter
- LIM-23, Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil
| | - R G Shavitt
- LIM-23, Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil
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Crowley JJ, Cappi C, Ochoa-Panaifo ME, Frederick RM, Kook M, Wiese AD, Rancourt D, Atkinson EG, Giusti-Rodriguez P, Anderberg JL, Abramowitz JS, Adorno VR, Aguirre C, Alves GS, Alves GS, Ancalade N, Arellano Espinosa AA, Arnold PD, Ayton DM, Barbosa IG, Castano LMB, Barrera CN, Berardo MC, Berrones D, Best JR, Bigdeli TB, Burton CL, Buxbaum JD, Callahan JL, Carneiro MCB, Cepeda SL, Chazelle E, Chire JM, Munoz MC, Quiroz PC, Cobite J, Comer JS, Costa DL, Crosbie J, Cruz VO, Dager G, Daza LF, de la Rosa-Gómez A, Del Río D, Delage FZ, Dreher CB, Fay L, Fazio T, Ferrão YA, Ferreira GM, Figueroa EG, Fontenelle LF, Forero DA, Fragoso DTH, Gadad BS, Garrison SR, González A, Gonzalez LD, González MA, Gonzalez-Barrios P, Goodman WK, Grice DE, Guintivano J, Guttfreund DG, Guzick AG, Halvorsen MW, Hovey JD, Huang H, Irreño-Sotomonte J, Janssen-Aguilar R, Jensen M, Jimenez Reynolds AZ, Lujambio JAJ, Khalfe N, Knutsen MA, Lack C, Lanzagorta N, Lima MO, Longhurst MO, Lozada Martinez DA, Luna ES, Marques AH, Martinez MS, de Los Angeles Matos M, Maye CE, McGuire JF, Menezes G, Minaya C, Miño T, Mithani SM, de Oca CM, Morales-Rivero A, Moreira-de-Oliveira ME, Morris OJ, Muñoz SI, Naqqash Z, Núñez Bracho AA, Núñez Bracho BE, Rojas MCO, Olavarria Castaman LA, Balmaceda TO, Ortega I, Patel DI, Patrick AK, Paz Y Mino M, Perales Orellana JL, Stumpf BP, Peregrina T, Duarte TP, Piacsek KL, Placencia M, Prieto MB, Quarantini LC, Quarantini-Alvim Y, Ramos RT, Ramos IC, Ramos VR, Ramsey KA, Ray EV, Richter MA, Riemann BC, Rivas JC, Rosario MC, Ruggero CJ, Ruiz-Chow AA, Ruiz-Velasco A, Sagarnaga MN, Sampaio AS, Saraiva LC, Schachar RJ, Schneider SC, Schweissing EJ, Seligman LD, Shavitt RG, Soileau KJ, Stewart SE, Storch SB, Strouphauer ER, Cuevas VT, Timpano KR, la Garza BTD, Vallejo-Silva A, Vargas-Medrano J, Vásquez MI, Martinez GV, Weinzimmer SA, Yanez MA, Zai G, Zapata-Restrepo LM, Zappa LM, Zepeda-Burgos RM, Zoghbi AW, Miguel EC, Rodriguez CI, Martinez Mallen MC, Moya PR, Borda T, Moyano MB, Mattheisen M, Pereira S, Lázaro-Muñoz G, Martinez-Gonzalez KG, Pato MT, Nicolini H, Storch EA. Latin American Trans-ancestry INitiative for OCD genomics (LATINO): Study protocol. Am J Med Genet B Neuropsychiatr Genet 2024; 195:e32962. [PMID: 37946624 PMCID: PMC11076176 DOI: 10.1002/ajmg.b.32962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 09/26/2023] [Accepted: 10/06/2023] [Indexed: 11/12/2023]
Abstract
Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder. Worldwide, its prevalence is ~2% and its etiology is mostly unknown. Identifying biological factors contributing to OCD will elucidate underlying mechanisms and might contribute to improved treatment outcomes. Genomic studies of OCD are beginning to reveal long-sought risk loci, but >95% of the cases currently in analysis are of homogenous European ancestry. If not addressed, this Eurocentric bias will result in OCD genomic findings being more accurate for individuals of European ancestry than other ancestries, thereby contributing to health disparities in potential future applications of genomics. In this study protocol paper, we describe the Latin American Trans-ancestry INitiative for OCD genomics (LATINO, https://www.latinostudy.org). LATINO is a new network of investigators from across Latin America, the United States, and Canada who have begun to collect DNA and clinical data from 5000 richly phenotyped OCD cases of Latin American ancestry in a culturally sensitive and ethical manner. In this project, we will utilize trans-ancestry genomic analyses to accelerate the identification of OCD risk loci, fine-map putative causal variants, and improve the performance of polygenic risk scores in diverse populations. We will also capitalize on rich clinical data to examine the genetics of treatment response, biologically plausible OCD subtypes, and symptom dimensions. Additionally, LATINO will help elucidate the diversity of the clinical presentations of OCD across cultures through various trainings developed and offered in collaboration with Latin American investigators. We believe this study will advance the important goal of global mental health discovery and equity.
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Affiliation(s)
- James J Crowley
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Carolina Cappi
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Departamento de Psiquiatria, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | | | - Renee M Frederick
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Minjee Kook
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Andrew D Wiese
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Diana Rancourt
- Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - Elizabeth G Atkinson
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Paola Giusti-Rodriguez
- Department of Psychiatry, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Jacey L Anderberg
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Jonathan S Abramowitz
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Victor R Adorno
- Hospital Psiquiátrico de Asunción, Direccion General, Asuncion, Central, Paraguay
| | - Cinthia Aguirre
- Departamento de Psiquiatría, Hospital Psiquiátrico de Asunción, Asuncion, Central, Paraguay
| | - Gilberto S Alves
- Hospital Nina Rodrigues/Universidade Federal do Maranhão (UFMA), Sao Luis do Maranhao, Maranhao, Brazil
| | - Gustavo S Alves
- Hospital Universitário Professor Edgard Santos, Serviço de Psiquiatria, Laboratório de Neuropsicofarmacologia-LANP, Universidade Federal da Bahia, Salvador, Bahia, Brazil
- Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Pós-Graduação em Medicina e Saúde, Salvador, Bahia, Brazil
| | - NaEshia Ancalade
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Paul D Arnold
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Daphne M Ayton
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Izabela G Barbosa
- Departamento de Saúde Mental da Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | | | - María Celeste Berardo
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - Dayan Berrones
- Department of Psychology, Rice University, Houston, Texas, USA
| | - John R Best
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tim B Bigdeli
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
- VA New York Harbor Healthcare System, Brooklyn, New York, USA
| | - Christie L Burton
- Department of Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Joseph D Buxbaum
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Maria Cecília B Carneiro
- Departamento de Psiquiatria e Medicina Legal, Universidade Federal do Paraná, Curitiba, Parana, Brazil
| | - Sandra L Cepeda
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Evelyn Chazelle
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - Jessica M Chire
- Instituto Nacional de Salud Mental "Honorio Delgado-Hideyo Noguchi", Dirección de Niños y Adolescentes Lima, Lima, Peru
| | | | | | - Journa Cobite
- Department of Counseling Psychology, University of Houston, Houston, Texas, USA
| | - Jonathan S Comer
- Department of Psychology, Florida International University, Miami, Florida, USA
| | - Daniel L Costa
- Departamento de Psiquiatria, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Jennifer Crosbie
- Department of Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Victor O Cruz
- Instituto Nacional de Salud Mental "Honorio Delgado-Hideyo Noguchi", Oficina Ejecutiva de Investigación, Lima, Lima, Peru
- School of Medicine, Universidad San Martin de Porres, Lima, Lima, Peru
| | - Guillermo Dager
- Corporación Universitaria Rafael Nuñez, Cartagena, Bolivar, Colombia
| | - Luisa F Daza
- Hospital Psiquiátrico Universitario Del Valle, Cali, Valle del Cauca, Colombia
| | - Anabel de la Rosa-Gómez
- Facultad de Estudios Superiores Iztacala, Tlalnepantla de Baz, Universidad Nacional Autónoma de México, Ciudad de Mexico, Mexico
| | | | - Fernanda Z Delage
- Departamento de Medicina Forense e Psiquiatria, Universidade Federal do Paraná, Curitiba, Parana, Brazil
| | - Carolina B Dreher
- Departamento de Psiquiatria, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Departamento de Psiquiatria, Clínica Médica, Porto Alegre, Rio Grande do Sul, Brazil
| | - Lucila Fay
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - Tomas Fazio
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - Ygor A Ferrão
- Departamento de Psiquiatria, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Gabriela M Ferreira
- Departamento de Medicina Forense e Psiquiatria, Universidade Federal do Paraná, Curitiba, Parana, Brazil
- Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Parana, Brazil
| | - Edith G Figueroa
- Departamento de Psiquiatría de Adultos, Instituto Nacional de Salud Mental "Honorio Delgado-Hideyo Noguchi", Lima, Lima, Peru
| | - Leonardo F Fontenelle
- Departamento de Psiquiatria e Medicina Legal, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
- Departamento de Psiquiatria, Instituto D'Or de Pesquisa e Ensino, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Diego A Forero
- Fundación Universitaria del Área Andina, Escuela de Salud y Ciencias del Deporte, Bogota, Bogota, Colombia
| | - Daniele T H Fragoso
- Departamento de Medicina Forense e Psiquiatria, Universidade Federal do Paraná, Curitiba, Parana, Brazil
| | - Bharathi S Gadad
- Department of Psychiatry, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | | | | | - Laura D Gonzalez
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - Marco A González
- Facultad de Estudios Superiores Iztacala, Tlalnepantla de Baz, Universidad Nacional Autónoma de México, Ciudad de Mexico, Mexico
| | - Polaris Gonzalez-Barrios
- Departamento de Psiquiatría, Universidad de Puerto Rico, San Juan, Puerto Rico, USA
- Universidad de Puerto Rico Campus de Ciências Médicas, San Juan, Puerto Rico, USA
| | - Wayne K Goodman
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Dorothy E Grice
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jerry Guintivano
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Andrew G Guzick
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Matthew W Halvorsen
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Joseph D Hovey
- Department of Psychological Science, The University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Hailiang Huang
- Broad Institute of MIT and Harvard, Stanley Center for Psychiatric Research, Cambridge, Massachusetts, USA
| | - Jonathan Irreño-Sotomonte
- Center for Mental Health-Cersame, School of Medicine and Health Sciences, Universidad del Rosario, Bogota, District of Colombia, Colombia
| | - Reinhard Janssen-Aguilar
- Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suarez, Subdirección de Psiquiatría, Ciudad de México, Ciudad de Mexico, Mexico
| | - Matias Jensen
- Centro de Neurociencias, Universidad de Valparaíso, Valparaiso, Chile
| | | | | | - Nasim Khalfe
- Baylor College of Medicine, School of Medicine, Houston, Texas, USA
| | - Madison A Knutsen
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
- Department of Psychology, Augustana College, Rock Island, Illinois, USA
| | - Caleb Lack
- Department of Psychology, University of Central Oklahoma, Edmond, Oklahoma, USA
| | - Nuria Lanzagorta
- Departamento de Investigación Clínica, Grupo Médico Carracci, Ciudad de México, Ciudad de Mexico, Mexico
| | - Monicke O Lima
- Departamento de Psiquiatria, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Melanie O Longhurst
- Department of Psychiatry, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | | | - Elba S Luna
- Instituto Nacional de Salud Mental "Honorio Delgado-Hideyo Noguchi", Oficina Ejecutiva de Investigación, Lima, Lima, Peru
| | - Andrea H Marques
- National Institute of Mental Heatlh (NIMH), Bethesda, Maryland, USA
| | - Molly S Martinez
- DFW OCD Treatment Specialists, Richardson, Texas, USA
- Specialists in OCD and Anxiety Recovery (SOAR), Richardson, Texas, USA
| | - Maria de Los Angeles Matos
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - Caitlyn E Maye
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Joseph F McGuire
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Gabriela Menezes
- Programa de Ansiedade, Obsessões e Compulsões, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Charlene Minaya
- Department of Psychology, Fordham University, New York, New York, USA
| | - Tomás Miño
- Centro de Neurociencias, Universidad de Valparaíso, Valparaiso, Chile
| | - Sara M Mithani
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | | | | | - Maria E Moreira-de-Oliveira
- Programa de Ansiedade, Obsessões e Compulsões, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Olivia J Morris
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Sandra I Muñoz
- Facultad de Estudios Superiores Iztacala, Tlalnepantla de Baz, Universidad Nacional Autónoma de México, Ciudad de Mexico, Mexico
| | - Zainab Naqqash
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | | | | | - Trinidad Olivos Balmaceda
- Centro Interdisciplinario de Neurociencia de Valparaíso, Universidad de Valparaíso, Valparaiso, Valparaiso, Chile
| | - Iliana Ortega
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Darpan I Patel
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Ainsley K Patrick
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mariel Paz Y Mino
- Clínica de Salud Mental USFQ, Universidad San Francisco de Quito, Quito, Pichincha, Ecuador
- Universidad San Francisco de Quito, Quito, Pichincha, Ecuador
| | - Jose L Perales Orellana
- Universidad Tegnológica Privada de Santa Cruz (UTEPSA), Santa Cruz de la Sierra, Andres Ibañez, Bolivia
| | - Bárbara Perdigão Stumpf
- Departamento de Saúde Mental da Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | | | | | - Maritza Placencia
- Departamento Académico de Ciencias Dinámicas, Universidad Nacional Mayor de San Marcos, Lima, Lima, Peru
| | - María Belén Prieto
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - Lucas C Quarantini
- Hospital Universitário Professor Edgard Santos, Serviço de Psiquiatria, Laboratório de Neuropsicofarmacologia-LANP, Universidade Federal da Bahia, Salvador, Bahia, Brazil
- Departamento de Neurociências e Saúde Mental, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Yana Quarantini-Alvim
- Hospital Universitário Professor Edgard Santos, Serviço de Psiquiatria, Laboratório de Neuropsicofarmacologia-LANP, Universidade Federal da Bahia, Salvador, Bahia, Brazil
- Faculdade Santa Casa, Faculdade de Psicologia, Salvador, Bahia, Brazil
| | - Renato T Ramos
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Iaroslava C Ramos
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Psychiatry, Frederick Thompson Anxiety Disorders Centre, Toronto, Ontario, Canada
| | - Vanessa R Ramos
- Departamento de Psiquiatria, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Kesley A Ramsey
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Elise V Ray
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Margaret A Richter
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Juan C Rivas
- Hospital Psiquiátrico Universitario Del Valle, Cali, Valle del Cauca, Colombia
- Departamento de Psiquiatría, Universidad del Valle, Cali, Valle del Cauca, Colombia
- Departamento de Psiquiatria, Universidad ICESI, Cali, Valle del Cauca, Colombia
- Departamento de Psiquiatria, Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
| | - Maria C Rosario
- Departamento de Psiquiatria da, Universidade Federal de São Paulo (UNIFESP), Sao Paulo, Sao Paulo, Brazil
| | - Camilo J Ruggero
- Department of Psychology, University of North Texas, Denton, Texas, USA
| | | | - Alejandra Ruiz-Velasco
- Department of Psychiatry, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - Melisa N Sagarnaga
- Facultad de Psicología, Universidad de Buenos Aires, Buenos Aires, Buenos Aires, Argentina
| | - Aline S Sampaio
- Hospital Universitário Professor Edgard Santos, Serviço de Psiquiatria, Laboratório de Neuropsicofarmacologia-LANP, Universidade Federal da Bahia, Salvador, Bahia, Brazil
- Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Pós-Graduação em Medicina e Saúde, Salvador, Bahia, Brazil
- Departamento de Neurociências e Saúde Mental, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Leonardo C Saraiva
- Departamento de Psiquiatria, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Russell J Schachar
- Department of Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Sophie C Schneider
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Ethan J Schweissing
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Laura D Seligman
- Department of Psychological Science, The University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Roseli G Shavitt
- Departamento de Psiquiatria, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Keaton J Soileau
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - S Evelyn Stewart
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
- BC Mental Health and Substance Use Services, Vancouver, British Columbia, Canada
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Shaina B Storch
- Washington University in St. Louis, St. Louis, Missouri, USA
| | | | - Vissente Tapia Cuevas
- Centro Interdisciplinario de Neurociencia de Valparaíso, Universidad de Valparaíso, Valparaiso, Valparaiso, Chile
| | - Kiara R Timpano
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | | | - Alexie Vallejo-Silva
- Center for Mental Health-Cersame, School of Medicine and Health Sciences, Universidad del Rosario, Bogota, District of Colombia, Colombia
| | - Javier Vargas-Medrano
- Department of Psychiatry, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - María I Vásquez
- Hospital Nacional Arzobispo Loayza, Servicio de Salud Mental, Lima, Lima, Peru
| | - Guadalupe Vidal Martinez
- Department of Psychiatry, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, USA
| | - Saira A Weinzimmer
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Mauricio A Yanez
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Gwyneth Zai
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Molecular Brain Sciences, Centre for Addiction and Mental Health, Neurogenetics Section, Toronto, Ontario, Canada
| | - Lina M Zapata-Restrepo
- Departamento de Psiquiatria, Fundación Valle del Lili, Cali, Valle del Cauca, Colombia
- Facultad de Ciencias de la Salud, Universidad ICESI, Cali, Valle, Colombia
- Department of Neurology, Global Brain Health Institute-University of California San Francisco, San Francisco, California, USA
| | - Luz M Zappa
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
- Departamento de Salud Mental, Hospital de Niños Ricardo Gutierrez, Buenos Aires, Buenos Aires, Argentina
- Hospital Universitario Austral, Materno Infantil, Buenos Aires, Buenos Aires, Argentina
| | - Raquel M Zepeda-Burgos
- Centro de Investigación en Ciencias y Humanidades, Universidad Dr. José Matías Delgado, Santa Tecla, La Libertad, El Salvador
| | - Anthony W Zoghbi
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
- Department of Psychiatry, New York State Psychiatric Institute, New York, New York, USA
| | - Euripedes C Miguel
- Departamento de Psiquiatria, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Carolyn I Rodriguez
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
- Department of Psychiatry, Temerty Faculty of Medicine, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | | | - Pablo R Moya
- Universidad de Valparaíso, Instituto de Fisiología Valparaiso, Valparaiso, Chile
- Centro Interdisciplinario de Neurociencia de Valparaiso (CINV), Valparaiso, Chile
| | - Tania Borda
- Instituto Realize, Buenos Aires, Buenos Aires, Argentina
- Facultad de Psicología, Universidad Catolica Argentina, Buenos Aires, Buenos Aires, Argentina
| | - María Beatriz Moyano
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
- Asociación de Psiquiatras Argentinos (APSA), Buenos Aires, Buenos Aires, Argentina
- Asociación de Psiquiatras Argentinos (APSA), Presidente del Capítulo de Investigacion en Psiquiatria, Buenos Aires, Buenos Aires, Argentina
| | - Manuel Mattheisen
- Department of Community Health and Epidemiology & Faculty of Computer Science, Dalhousie University, Halifax, Nova Scotia, Canada
- LMU Munich, Institute of Psychiatric Phenomics and Genomics (IPPG), Munich, Germany
| | - Stacey Pereira
- Baylor College of Medicine, Center for Medical Ethics and Health Policy, Houston, Texas, USA
| | - Gabriel Lázaro-Muñoz
- Center for Bioethics, Harvard University School of Medicine, Boston, Massachusetts, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Michele T Pato
- Department of Psychiatry, Rutgers University-Robert Wood Johnson Medical School, Piscataway, New Jersey, USA
| | - Humberto Nicolini
- Departamento de Psiquiatría, Ciudad de México, Grupo Médico Carracci, Ciudad de Mexico, Mexico
- Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Ciudad de México, Instituto Nacional de Medicina Genómica, Ciudad de Mexico, Mexico
| | - Eric A Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
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Ramakrishnan D, Farhat LC, Vattimo EFQ, Levine JLS, Johnson JA, Artukoglu BB, Landeros-Weisenberger A, Zangen A, Pelissolo A, de B Pereira CA, Rück C, Costa DLC, Mataix-Cols D, Shannahoff-Khalsa D, Tolin DF, Zarean E, Meyer E, Hawken ER, Storch EA, Andersson E, Miguel EC, Maina G, Leckman JF, Sarris J, March JS, Diniz JB, Kobak K, Mallet L, Vulink NCC, Amiaz R, Fernandes RY, Shavitt RG, Wilhelm S, Golshan S, Tezenas du Montcel S, Erzegovesi S, Baruah U, Greenberg WM, Kobayashi Y, Bloch MH. An evaluation of treatment response and remission definitions in adult obsessive-compulsive disorder: A systematic review and individual-patient data meta-analysis. J Psychiatr Res 2024; 173:387-397. [PMID: 38598877 DOI: 10.1016/j.jpsychires.2024.03.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 03/18/2024] [Accepted: 03/25/2024] [Indexed: 04/12/2024]
Abstract
INTRODUCTION Expert consensus operationalized treatment response and remission in obsessive-compulsive disorder (OCD) as a Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) reduction ≥35% and score ≤12 with ≤2 on Clinical Global Impressions Improvement (CGI-I) and Severity (CGI-S) scales, respectively. However, there has been scant empirical evidence supporting these definitions. METHODS We conducted a systematic review and an individual participant data meta-analysis of randomized-controlled trials (RCTs) in adults with OCD to determine optimal Y-BOCS thresholds for response and remission. We estimated pooled sensitivity/specificity for each percent reduction threshold (response) or posttreatment score (remission) to determine response and remission defined by a CGI-I and CGI-S ≤ 2, respectively. RESULTS Individual participant data from 25 of 94 eligible RCTs (1235 participants) were included. The optimal threshold for response was ≥30% Y-BOCS reduction and for remission was ≤15 posttreatment Y-BOCS. However, differences in sensitivity and specificity between the optimal and nearby thresholds for response and remission were small with some uncertainty demonstrated by the confidence ellipses. CONCLUSION While the empirically derived Y-BOCS thresholds in our meta-analysis differ from expert consensus, given the predominance of data from more recent trials of OCD, which involved more refractory participants and novel treatment modalities as opposed to first-line therapies, we recommend the continued use of the consensus definitions.
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Affiliation(s)
| | - Luis C Farhat
- Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Edoardo F Q Vattimo
- Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | | | - Jessica A Johnson
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Bekir B Artukoglu
- Department of Child and Adolescent Psychiatry, Baylor College of Medicine, Houston, TX, USA
| | | | - Abraham Zangen
- Department of Life Sciences and the Zelman Center for Neuroscience, Ben Gurion University, Be'er Sheva, Israel
| | - Antoine Pelissolo
- Psychiatry Department, Henri-Mondor University Hospitals, Faculty of Medicine, Créteil, France
| | - Carlos A de B Pereira
- Mathematics and Statistics Institute, Statistics Department, University of São Paulo, São Paulo, Brazil
| | - Christian Rück
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
| | - Daniel L C Costa
- Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - David Mataix-Cols
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
| | - David Shannahoff-Khalsa
- The Research Group for Mind-Body Dynamics, BioCircuits Institute and Center for Integrative Medicine, University of California San Diego, CA, USA; The Khalsa Foundation for Medical Science, Del Mar, CA, USA
| | - David F Tolin
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; The Institute of Living, Hartford, CT, USA
| | - Elham Zarean
- Department of Psychiatry, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Elisabeth Meyer
- Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Emily R Hawken
- Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Eric A Storch
- Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Erik Andersson
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
| | - Euripedes C Miguel
- Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Giuseppe Maina
- Rita Levi Montalcini Department of Neuroscience, University of Turin, Turin, Italy
| | - James F Leckman
- Child Study Center, Department of Pediatrics and Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Jerome Sarris
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Victoria, Australia; NICM Health Research Institute, Western Sydney University, NSW, Australia
| | - John S March
- Department of Psychiatry and Behavioral Sciences, Duke School of Medicine, Durham, NC, USA
| | - Juliana B Diniz
- Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | | | - Luc Mallet
- Medical-University Department of Psychiatry and Addictology, Henri Mondor - Albert Chenevier University Hospitals, Créteil, France
| | - Nienke C C Vulink
- The Rudolf Magnus Institute of Neuroscience, Department of Psychiatry, University Medical Center Utrecht (UMCU), Utrecht, the Netherlands
| | | | - Rodrigo Yacubian Fernandes
- The National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Roseli G Shavitt
- Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Sabine Wilhelm
- OCD and Related Disorders Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Shahrokh Golshan
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Sophie Tezenas du Montcel
- Sorbonne Universite, Institut du Cerveau Paris Brain Institute-ICM, Inserm, CNRS, AP-HP, Inria Aramis project-team, Paris, France
| | - Stefano Erzegovesi
- Department of Neurosciences, Eating Disorders Unit, IRCCS San Raffaele, Milano, Italy
| | - Upasana Baruah
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | | | - Yuki Kobayashi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Michael H Bloch
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
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Kim BG, Kim G, Abe Y, Alonso P, Ameis S, Anticevic A, Arnold PD, Balachander S, Banaj N, Bargalló N, Batistuzzo MC, Benedetti F, Bertolín S, Beucke JC, Bollettini I, Brem S, Brennan BP, Buitelaar JK, Calvo R, Castelo-Branco M, Cheng Y, Chhatkuli RB, Ciullo V, Coelho A, Couto B, Dallaspezia S, Ely BA, Ferreira S, Fontaine M, Fouche JP, Grazioplene R, Gruner P, Hagen K, Hansen B, Hanna GL, Hirano Y, Höxter MQ, Hough M, Hu H, Huyser C, Ikuta T, Jahanshad N, James A, Jaspers-Fayer F, Kasprzak S, Kathmann N, Kaufmann C, Kim M, Koch K, Kvale G, Kwon JS, Lazaro L, Lee J, Lochner C, Lu J, Manrique DR, Martínez-Zalacaín I, Masuda Y, Matsumoto K, Maziero MP, Menchón JM, Minuzzi L, Moreira PS, Morgado P, Narayanaswamy JC, Narumoto J, Ortiz AE, Ota J, Pariente JC, Perriello C, Picó-Pérez M, Pittenger C, Poletti S, Real E, Reddy YCJ, van Rooij D, Sakai Y, Sato JR, Segalas C, Shavitt RG, Shen Z, Shimizu E, Shivakumar V, Soreni N, Soriano-Mas C, Sousa N, Sousa MM, Spalletta G, Stern ER, Stewart SE, Szeszko PR, Thomas R, Thomopoulos SI, Vecchio D, Venkatasubramanian G, Vriend C, Walitza S, Wang Z, Watanabe A, Wolters L, Xu J, Yamada K, Yun JY, Zarei M, Zhao Q, Zhu X, Thompson PM, Bruin WB, van Wingen GA, Piras F, Piras F, Stein DJ, van den Heuvel OA, Simpson HB, Marsh R, Cha J. Correction: White matter diffusion estimates in obsessive-compulsive disorder across 1653 individuals: machine learning findings from the ENIGMA OCD Working Group. Mol Psychiatry 2024:10.1038/s41380-024-02494-9. [PMID: 38454086 DOI: 10.1038/s41380-024-02494-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Affiliation(s)
- Bo-Gyeom Kim
- Department of Psychology, College of Social Sciences, Seoul National University, Seoul, Republic of Korea
| | - Gakyung Kim
- Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea
| | - Yoshinari Abe
- Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Department of Psychiatry, Kyoto City, Japan
| | - Pino Alonso
- Bellvitge Biomedical Research Insitute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Stephanie Ameis
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Paul D Arnold
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Departments of Psychiatry and Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Srinivas Balachander
- OCD clinic, Department of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Nerisa Banaj
- Laboratory of Neuropsychiatry, Department of Clinical and Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Nuria Bargalló
- Center of Image Diagnostic, Hospital Clínic de Barcelona, Barcelona, Spain
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Marcelo C Batistuzzo
- Departamento e Instituto de Psiquiatria do Hospital das Clinicas, IPQ HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- Department of Methods and Techniques in Psychology, Pontifical Catholic University, São Paulo, SP, Brazil
| | - Francesco Benedetti
- Vita-Salute San Raffaele University, Milano, Italy
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Sara Bertolín
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
| | - Jan Carl Beucke
- Department of Psychology, Humboldt-Universitat zu Berlin, Berlin, Germany
- Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden
- Department of Medical Psychology, Medical School Hamburg, Hamburg, Germany
| | - Irene Bollettini
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Silvia Brem
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Brian P Brennan
- McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Jan K Buitelaar
- Radboudumc, Department of Cognitive Neuroscience, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands
| | - Rosa Calvo
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Miguel Castelo-Branco
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, 3000-548, Coimbra, Portugal
- Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, 3000-548, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, 3000-548, Coimbra, Portugal
| | - Yuqi Cheng
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Ritu Bhusal Chhatkuli
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University, Chiba University and University of Fukui, Suita, Japan
| | - Valentina Ciullo
- Laboratory of Neuropsychiatry, Department of Clinical and Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Ana Coelho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Beatriz Couto
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Sara Dallaspezia
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Benjamin A Ely
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Sónia Ferreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Martine Fontaine
- Columbia University Medical College, Columbia University, New York, NY, USA
| | - Jean-Paul Fouche
- SAMRC Genomics of Brain Disorders Unit, Department of Psychiatry, Cape Town, South Africa
| | - Rachael Grazioplene
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Patricia Gruner
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Kristen Hagen
- Hospital of Molde, Møre og Romsdal Hospital Trust, Molde, Norway
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway
| | - Bjarne Hansen
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway
- Centre for Crisis Psychology, University of Bergen, Bergen, Norway
| | - Gregory L Hanna
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University, Chiba University and University of Fukui, Suita, Japan
| | - Marcelo Q Höxter
- Departamento e Instituto de Psiquiatria do Hospital das Clinicas, IPQ HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Morgan Hough
- Highfield Unit Oxford, Warneford Hospital, Warneford Lane, Headington, Oxford, Oxfordshire, OX3 7JX, UK
| | - Hao Hu
- Shanghai Mental Health Center, Shanghai, China
| | - Chaim Huyser
- Levvel, academic center for child and adolescent care, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
| | - Toshikazu Ikuta
- Department of Communication Sciences and Disorders, University of Mississippi, Oxford, MS, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, Los Angeles, CA, USA
| | - Anthony James
- Department of Psychiatry University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
| | - Fern Jaspers-Fayer
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Selina Kasprzak
- Amsterdam UMC, Vrije Universteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Norbert Kathmann
- Department of Psychology, Humboldt-Universitat zu Berlin, Berlin, Germany
| | - Christian Kaufmann
- Department of Psychology, Humboldt-Universitat zu Berlin, Berlin, Germany
| | - Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kathrin Koch
- TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universitat Munchen, München, Germany
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Gerd Kvale
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
- Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea
| | - Luisa Lazaro
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Junhee Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Uijeongbu Eulji Medical Center, Uijeongbu, Republic of Korea
| | - Christine Lochner
- SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Jin Lu
- Department of Psychiatry, First Affiliated Hospitalof Kunming Medical University, Kunming, China
| | - Daniela Rodriguez Manrique
- TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universitat Munchen, München, Germany
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
- Graduate School of Systemic Neurosciences, Ludwig-Maximilians-University, Munich, Germany
| | - Ignacio Martínez-Zalacaín
- Bellvitge Biomedical Research Insitute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
- Department of Radiology, Bellvitge University Hospital, Barcelona, Spain
| | | | - Koji Matsumoto
- Chiba University Hospital, Chiba University, Chiba, Japan
| | - Maria Paula Maziero
- LIM 23, Instituto de Psiquiatria, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
- Faculty of Medicine, City University of Sao Paulo, Sao Paulo, Brazil
| | - Jose M Menchón
- Bellvitge Biomedical Research Insitute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Luciano Minuzzi
- Anxiety Treatment and Research Clinic, St. Joseph's Hamilton Healthcare, Hamilton, ON, Canada
- Dapartmente of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Pedro Silva Moreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Psychological Neuroscience Lab, CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Janardhanan C Narayanaswamy
- OCD clinic, Department of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Jin Narumoto
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ana E Ortiz
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Junko Ota
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University, Chiba University and University of Fukui, Suita, Japan
| | - Jose C Pariente
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Chris Perriello
- University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Departamento de Psicología Básica, Clínica y Psicobiología, Universitat Jaume I, Castelló de la Plana, Spain
| | - Christopher Pittenger
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
- Department of Psychology, Yale University, New Haven, CT, USA
- Child Study Center, Yale University, New Haven, CT, USA
- Center for Brain and Mind Health, Yale University, New Haven, CT, USA
| | - Sara Poletti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Eva Real
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Y C Janardhan Reddy
- OCD clinic, Department of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Daan van Rooij
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Department of Cognitive Neuroscience, Nijmegen, The Netherlands
| | - Yuki Sakai
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- ATR Brain Information Communication Research Laboratory Group, Kyoto, Japan
| | - João Ricardo Sato
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Santo André, Brazil
- Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Cinto Segalas
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Roseli G Shavitt
- Departamento de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Zonglin Shen
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University, Chiba University and University of Fukui, Suita, Japan
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Venkataram Shivakumar
- National Institute of Mental Health and Neurosciences, Department of Integrative Medicine, Bengaluru, India
| | - Noam Soreni
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Offord Centre for Child Studies, Hamilton, ON, Canada
| | - Carles Soriano-Mas
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Mafalda Machado Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, Department of Clinical and Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
- Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Science, Baylor College of Medicine, Houston, TX, USA
| | - Emily R Stern
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
- Clinical Research, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - S Evelyn Stewart
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- British Columbia Children's Hospital, Psychiatry, Vancouver, BC, Canada
- British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada
| | - Philip R Szeszko
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA
| | - Rajat Thomas
- Weill-Cornell Medicine Qatar, Education City, Doha, Qatar
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, Los Angeles, CA, USA
| | - Daniela Vecchio
- Laboratory of Neuropsychiatry, Department of Clinical and Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Ganesan Venkatasubramanian
- OCD clinic, Department of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Chris Vriend
- Amsterdam UMC, Vrije Universteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention program, Amsterdam, The Netherlands
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Zhen Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Anri Watanabe
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Lidewij Wolters
- Norwegian University of Science and Technology (NTNU), Faculty of Medicine, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Klostergata 46, 7030, Trondheim, Norway
| | - Jian Xu
- Department of Internal Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Kei Yamada
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Je-Yeon Yun
- Seoul National University Hospital, Seoul, Republic of Korea
- Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Mojtaba Zarei
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Qing Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xi Zhu
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, Los Angeles, CA, USA
| | - Willem B Bruin
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention program, Amsterdam, The Netherlands
- Amsterdam UMC, Universiteit van Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Guido A van Wingen
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention program, Amsterdam, The Netherlands
- Amsterdam UMC, Universiteit van Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Federica Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- SAMRC Unit on Risk & Resilience in Mental Disorders, Cape Town, South Africa
| | - Odile A van den Heuvel
- Amsterdam UMC, Vrije Universteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | | | - Rachel Marsh
- Columbia University Medical College, Columbia University, New York, NY, USA
| | - Jiook Cha
- Department of Psychology, College of Social Sciences, Seoul National University, Seoul, Republic of Korea.
- Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea.
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5
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Kim BG, Kim G, Abe Y, Alonso P, Ameis S, Anticevic A, Arnold PD, Balachander S, Banaj N, Bargalló N, Batistuzzo MC, Benedetti F, Bertolín S, Beucke JC, Bollettini I, Brem S, Brennan BP, Buitelaar JK, Calvo R, Castelo-Branco M, Cheng Y, Chhatkuli RB, Ciullo V, Coelho A, Couto B, Dallaspezia S, Ely BA, Ferreira S, Fontaine M, Fouche JP, Grazioplene R, Gruner P, Hagen K, Hansen B, Hanna GL, Hirano Y, Höxter MQ, Hough M, Hu H, Huyser C, Ikuta T, Jahanshad N, James A, Jaspers-Fayer F, Kasprzak S, Kathmann N, Kaufmann C, Kim M, Koch K, Kvale G, Kwon JS, Lazaro L, Lee J, Lochner C, Lu J, Manrique DR, Martínez-Zalacaín I, Masuda Y, Matsumoto K, Maziero MP, Menchón JM, Minuzzi L, Moreira PS, Morgado P, Narayanaswamy JC, Narumoto J, Ortiz AE, Ota J, Pariente JC, Perriello C, Picó-Pérez M, Pittenger C, Poletti S, Real E, Reddy YCJ, van Rooij D, Sakai Y, Sato JR, Segalas C, Shavitt RG, Shen Z, Shimizu E, Shivakumar V, Soreni N, Soriano-Mas C, Sousa N, Sousa MM, Spalletta G, Stern ER, Stewart SE, Szeszko PR, Thomas R, Thomopoulos SI, Vecchio D, Venkatasubramanian G, Vriend C, Walitza S, Wang Z, Watanabe A, Wolters L, Xu J, Yamada K, Yun JY, Zarei M, Zhao Q, Zhu X, Thompson PM, Bruin WB, van Wingen GA, Piras F, Piras F, Stein DJ, van den Heuvel OA, Simpson HB, Marsh R, Cha J. White matter diffusion estimates in obsessive-compulsive disorder across 1653 individuals: machine learning findings from the ENIGMA OCD Working Group. Mol Psychiatry 2024:10.1038/s41380-023-02392-6. [PMID: 38326559 DOI: 10.1038/s41380-023-02392-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 11/27/2023] [Accepted: 12/19/2023] [Indexed: 02/09/2024]
Abstract
White matter pathways, typically studied with diffusion tensor imaging (DTI), have been implicated in the neurobiology of obsessive-compulsive disorder (OCD). However, due to limited sample sizes and the predominance of single-site studies, the generalizability of OCD classification based on diffusion white matter estimates remains unclear. Here, we tested classification accuracy using the largest OCD DTI dataset to date, involving 1336 adult participants (690 OCD patients and 646 healthy controls) and 317 pediatric participants (175 OCD patients and 142 healthy controls) from 18 international sites within the ENIGMA OCD Working Group. We used an automatic machine learning pipeline (with feature engineering and selection, and model optimization) and examined the cross-site generalizability of the OCD classification models using leave-one-site-out cross-validation. Our models showed low-to-moderate accuracy in classifying (1) "OCD vs. healthy controls" (Adults, receiver operator characteristic-area under the curve = 57.19 ± 3.47 in the replication set; Children, 59.8 ± 7.39), (2) "unmedicated OCD vs. healthy controls" (Adults, 62.67 ± 3.84; Children, 48.51 ± 10.14), and (3) "medicated OCD vs. unmedicated OCD" (Adults, 76.72 ± 3.97; Children, 72.45 ± 8.87). There was significant site variability in model performance (cross-validated ROC AUC ranges 51.6-79.1 in adults; 35.9-63.2 in children). Machine learning interpretation showed that diffusivity measures of the corpus callosum, internal capsule, and posterior thalamic radiation contributed to the classification of OCD from HC. The classification performance appeared greater than the model trained on grey matter morphometry in the prior ENIGMA OCD study (our study includes subsamples from the morphometry study). Taken together, this study points to the meaningful multivariate patterns of white matter features relevant to the neurobiology of OCD, but with low-to-moderate classification accuracy. The OCD classification performance may be constrained by site variability and medication effects on the white matter integrity, indicating room for improvement for future research.
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Affiliation(s)
- Bo-Gyeom Kim
- Department of Psychology, College of Social Sciences, Seoul National University, Seoul, Republic of Korea
| | - Gakyung Kim
- Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea
| | - Yoshinari Abe
- Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Department of Psychiatry, Kyoto City, Japan
| | - Pino Alonso
- Bellvitge Biomedical Research Insitute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Stephanie Ameis
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Paul D Arnold
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Departments of Psychiatry and Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Srinivas Balachander
- OCD clinic, Department of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Nerisa Banaj
- Laboratory of Neuropsychiatry, Department of Clinical and Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Nuria Bargalló
- Center of Image Diagnostic, Hospital Clínic de Barcelona, Barcelona, Spain
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Marcelo C Batistuzzo
- Departamento e Instituto de Psiquiatria do Hospital das Clinicas, IPQ HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
- Department of Methods and Techniques in Psychology, Pontifical Catholic University, São Paulo, SP, Brazil
| | - Francesco Benedetti
- Vita-Salute San Raffaele University, Milano, Italy
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Sara Bertolín
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
| | - Jan Carl Beucke
- Department of Psychology, Humboldt-Universitat zu Berlin, Berlin, Germany
- Department of Clinical Neuroscience, Centre for Psychiatric Research and Education, Karolinska Institutet, Stockholm, Sweden
- Department of Medical Psychology, Medical School Hamburg, Hamburg, Germany
| | - Irene Bollettini
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Silvia Brem
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Brian P Brennan
- McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Jan K Buitelaar
- Radboudumc, Department of Cognitive Neuroscience, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands
| | - Rosa Calvo
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Miguel Castelo-Branco
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, 3000-548, Coimbra, Portugal
- Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, 3000-548, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, 3000-548, Coimbra, Portugal
| | - Yuqi Cheng
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Ritu Bhusal Chhatkuli
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University, Chiba University and University of Fukui, Suita, Japan
| | - Valentina Ciullo
- Laboratory of Neuropsychiatry, Department of Clinical and Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Ana Coelho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Beatriz Couto
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Sara Dallaspezia
- Psychiatry & Clinical Psychobiology Unit, Division of Neuroscience, Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Benjamin A Ely
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Sónia Ferreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Martine Fontaine
- Columbia University Medical College, Columbia University, New York, NY, USA
| | - Jean-Paul Fouche
- SAMRC Genomics of Brain Disorders Unit, Department of Psychiatry, Cape Town, South Africa
| | - Rachael Grazioplene
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Patricia Gruner
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Kristen Hagen
- Hospital of Molde, Møre og Romsdal Hospital Trust, Molde, Norway
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway
| | - Bjarne Hansen
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway
- Centre for Crisis Psychology, University of Bergen, Bergen, Norway
| | - Gregory L Hanna
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University, Chiba University and University of Fukui, Suita, Japan
| | - Marcelo Q Höxter
- Departamento e Instituto de Psiquiatria do Hospital das Clinicas, IPQ HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Morgan Hough
- Highfield Unit Oxford, Warneford Hospital, Warneford Lane, Headington, Oxford, Oxfordshire, OX3 7JX, UK
| | - Hao Hu
- Shanghai Mental Health Center, Shanghai, China
| | - Chaim Huyser
- Levvel, academic center for child and adolescent care, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
| | - Toshikazu Ikuta
- Department of Communication Sciences and Disorders, University of Mississippi, Oxford, MS, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, Los Angeles, CA, USA
| | - Anthony James
- Department of Psychiatry University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
| | - Fern Jaspers-Fayer
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Selina Kasprzak
- Amsterdam UMC, Vrije Universteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Norbert Kathmann
- Department of Psychology, Humboldt-Universitat zu Berlin, Berlin, Germany
| | - Christian Kaufmann
- Department of Psychology, Humboldt-Universitat zu Berlin, Berlin, Germany
| | - Minah Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kathrin Koch
- TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universitat Munchen, München, Germany
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
| | - Gerd Kvale
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
- Institute of Human Behavioral Medicine, SNU-MRC, Seoul, Republic of Korea
| | - Luisa Lazaro
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Junhee Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Uijeongbu Eulji Medical Center, Uijeongbu, Republic of Korea
| | - Christine Lochner
- SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Jin Lu
- Department of Psychiatry, First Affiliated Hospitalof Kunming Medical University, Kunming, China
| | - Daniela Rodriguez Manrique
- TUM-Neuroimaging Center (TUM-NIC) of Klinikum rechts der Isar, Technische Universitat Munchen, München, Germany
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Munich, Germany
- Graduate School of Systemic Neurosciences, Ludwig-Maximilians-University, Munich, Germany
| | - Ignacio Martínez-Zalacaín
- Bellvitge Biomedical Research Insitute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
- Department of Radiology, Bellvitge University Hospital, Barcelona, Spain
| | | | - Koji Matsumoto
- Chiba University Hospital, Chiba University, Chiba, Japan
| | - Maria Paula Maziero
- LIM 23, Instituto de Psiquiatria, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
- Faculty of Medicine, City University of Sao Paulo, Sao Paulo, Brazil
| | - Jose M Menchón
- Bellvitge Biomedical Research Insitute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Luciano Minuzzi
- Anxiety Treatment and Research Clinic, St. Joseph's Hamilton Healthcare, Hamilton, ON, Canada
- Dapartmente of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Pedro Silva Moreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Psychological Neuroscience Lab, CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Janardhanan C Narayanaswamy
- OCD clinic, Department of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Jin Narumoto
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ana E Ortiz
- Department of Child and Adolescent Psychiatry and Psychology, Institute of Neurosciences, Hospital Clínic Universitari, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Junko Ota
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University, Chiba University and University of Fukui, Suita, Japan
| | - Jose C Pariente
- Magnetic Resonance Image Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Chris Perriello
- University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Departamento de Psicología Básica, Clínica y Psicobiología, Universitat Jaume I, Castelló de la Plana, Spain
| | - Christopher Pittenger
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA
- Department of Psychology, Yale University, New Haven, CT, USA
- Child Study Center, Yale University, New Haven, CT, USA
- Center for Brain and Mind Health, Yale University, New Haven, CT, USA
| | - Sara Poletti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Eva Real
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Y C Janardhan Reddy
- OCD clinic, Department of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Daan van Rooij
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Department of Cognitive Neuroscience, Nijmegen, The Netherlands
| | - Yuki Sakai
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
- ATR Brain Information Communication Research Laboratory Group, Kyoto, Japan
| | - João Ricardo Sato
- Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Santo André, Brazil
- Big Data, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Cinto Segalas
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Roseli G Shavitt
- Departamento de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Zonglin Shen
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University, Chiba University and University of Fukui, Suita, Japan
- Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Venkataram Shivakumar
- National Institute of Mental Health and Neurosciences, Department of Integrative Medicine, Bengaluru, India
| | - Noam Soreni
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, Hamilton, Ontario, Canada
| | - Carles Soriano-Mas
- CIBER of Mental Health (CIBERSAM), Carlos III Health Institute, Madrid, Spain
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, Barcelona, Spain
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Mafalda Machado Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimaraes, Portugal
- Clinical Academic Center - Braga, Braga, Portugal
| | - Gianfranco Spalletta
- Laboratory of Neuropsychiatry, Department of Clinical and Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
- Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Science, Baylor College of Medicine, Houston, TX, USA
| | - Emily R Stern
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
- Clinical Research, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - S Evelyn Stewart
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- British Columbia Children's Hospital, Psychiatry, Vancouver, BC, Canada
- British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, BC, Canada
| | - Philip R Szeszko
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA
| | - Rajat Thomas
- Weill-Cornell Medicine Qatar, Education City, Doha, Qatar
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, Los Angeles, CA, USA
| | - Daniela Vecchio
- Laboratory of Neuropsychiatry, Department of Clinical and Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Ganesan Venkatasubramanian
- OCD clinic, Department of Psychiatry, National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore, India
| | - Chris Vriend
- Amsterdam UMC, Vrije Universteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention program, Amsterdam, The Netherlands
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Zhen Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Anri Watanabe
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Lidewij Wolters
- Norwegian University of Science and Technology (NTNU), Faculty of Medicine, Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU Central Norway), Klostergata 46, 7030, Trondheim, Norway
| | - Jian Xu
- Department of Internal Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Kei Yamada
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Je-Yeon Yun
- Seoul National University Hospital, Seoul, Republic of Korea
- Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Mojtaba Zarei
- Institute of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Qing Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xi Zhu
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, Los Angeles, CA, USA
| | - Willem B Bruin
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention program, Amsterdam, The Netherlands
- Amsterdam UMC, Universiteit van Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Guido A van Wingen
- Amsterdam Neuroscience, Compulsivity, Impulsivity & Attention program, Amsterdam, The Netherlands
- Amsterdam UMC, Universiteit van Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Federica Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Fabrizio Piras
- Laboratory of Neuropsychiatry, Department of Clinical and Neuroscience and Neurorehabilitation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- SAMRC Unit on Risk & Resilience in Mental Disorders, Cape Town, South Africa
| | - Odile A van den Heuvel
- Amsterdam UMC, Vrije Universteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | | | - Rachel Marsh
- Columbia University Medical College, Columbia University, New York, NY, USA
| | - Jiook Cha
- Department of Psychology, College of Social Sciences, Seoul National University, Seoul, Republic of Korea.
- Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea.
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6
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Vriend C, de Joode NT, Pouwels PJW, Liu F, Otaduy MCG, Pastorello B, Robertson FC, Ipser J, Lee S, Hezel DM, van Meter PE, Batistuzzo MC, Hoexter MQ, Sheshachala K, Narayanaswamy JC, Venkatasubramanian G, Lochner C, Miguel EC, Reddy YCJ, Shavitt RG, Stein DJ, Wall M, Simpson HB, van den Heuvel OA. Age of onset of obsessive-compulsive disorder differentially affects white matter microstructure. Mol Psychiatry 2024:10.1038/s41380-023-02390-8. [PMID: 38228890 DOI: 10.1038/s41380-023-02390-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 12/04/2023] [Accepted: 12/15/2023] [Indexed: 01/18/2024]
Abstract
Previous diffusion MRI studies have reported mixed findings on white matter microstructure alterations in obsessive-compulsive disorder (OCD), likely due to variation in demographic and clinical characteristics, scanning methods, and underpowered samples. The OCD global study was created across five international sites to overcome these challenges by harmonizing data collection to identify consistent brain signatures of OCD that are reproducible and generalizable. Single-shell diffusion measures (e.g., fractional anisotropy), multi-shell Neurite Orientation Dispersion and Density Imaging (NODDI) and fixel-based measures, were extracted from skeletonized white matter tracts in 260 medication-free adults with OCD and 252 healthy controls. We additionally performed structural connectome analysis. We compared cases with controls and cases with early (<18) versus late (18+) OCD onset using mixed-model and Bayesian multilevel analysis. Compared with healthy controls, adult OCD individuals showed higher fiber density in the sagittal stratum (B[SE] = 0.10[0.05], P = 0.04) and credible evidence for higher fiber density in several other tracts. When comparing early (n = 145) and late-onset (n = 114) cases, converging evidence showed lower integrity of the posterior thalamic radiation -particularly radial diffusivity (B[SE] = 0.28[0.12], P = 0.03)-and lower global efficiency of the structural connectome (B[SE] = 15.3[6.6], P = 0.03) in late-onset cases. Post-hoc analyses indicated divergent direction of effects of the two OCD groups compared to healthy controls. Age of OCD onset differentially affects the integrity of thalamo-parietal/occipital tracts and the efficiency of the structural brain network. These results lend further support for the role of the thalamus and its afferent fibers and visual attentional processes in the pathophysiology of OCD.
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Affiliation(s)
- Chris Vriend
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, and Department of Anatomy and Neuroscience, de Boelelaan 1117, Amsterdam, the Netherlands.
- Compulsivity, Impulsivity and Attention, Amsterdam Neuroscience, de Boelelaan 1117, Amsterdam, the Netherlands.
| | - Niels T de Joode
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, and Department of Anatomy and Neuroscience, de Boelelaan 1117, Amsterdam, the Netherlands
- Compulsivity, Impulsivity and Attention, Amsterdam Neuroscience, de Boelelaan 1117, Amsterdam, the Netherlands
| | - Petra J W Pouwels
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, de Boelelaan 1117, Amsterdam, the Netherlands
- Brain Imaging, Amsterdam Neuroscience, de Boelelaan 1117, Amsterdam, the Netherlands
| | - Feng Liu
- Columbia University Irving Medical Center, Columbia University, New York, NY, 10032, USA
- The New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Maria C G Otaduy
- LIM44, Hospital das Clinicas HCFMUSP, Instituto e Departamento de Radiologia da Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Bruno Pastorello
- LIM44, Hospital das Clinicas HCFMUSP, Instituto e Departamento de Radiologia da Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Frances C Robertson
- Cape Universities Body Imaging Centre, University of Cape Town, Cape Town, South Africa
| | - Jonathan Ipser
- SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Seonjoo Lee
- Columbia University Irving Medical Center, Columbia University, New York, NY, 10032, USA
- The New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Dianne M Hezel
- Columbia University Irving Medical Center, Columbia University, New York, NY, 10032, USA
- The New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Page E van Meter
- Columbia University Irving Medical Center, Columbia University, New York, NY, 10032, USA
- The New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Marcelo C Batistuzzo
- Obsessive-Compulsive Spectrum Disorders Program, LIM23, Hospital das Clinicas HCFMUSP, Instituto & Departamento de Psiquiatria da Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
- Department of Methods and Techniques in Psychology, Pontifical Catholic University, Sao Paulo, SP, Brazil
| | - Marcelo Q Hoexter
- LIM44, Hospital das Clinicas HCFMUSP, Instituto e Departamento de Radiologia da Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Karthik Sheshachala
- National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | | | | | - Christine Lochner
- SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Euripedes C Miguel
- Obsessive-Compulsive Spectrum Disorders Program, LIM23, Hospital das Clinicas HCFMUSP, Instituto & Departamento de Psiquiatria da Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Y C Janardhan Reddy
- National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Roseli G Shavitt
- Obsessive-Compulsive Spectrum Disorders Program, LIM23, Hospital das Clinicas HCFMUSP, Instituto & Departamento de Psiquiatria da Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Dan J Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Melanie Wall
- Columbia University Irving Medical Center, Columbia University, New York, NY, 10032, USA
- The New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Helen Blair Simpson
- Columbia University Irving Medical Center, Columbia University, New York, NY, 10032, USA
- The New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Odile A van den Heuvel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, and Department of Anatomy and Neuroscience, de Boelelaan 1117, Amsterdam, the Netherlands
- Compulsivity, Impulsivity and Attention, Amsterdam Neuroscience, de Boelelaan 1117, Amsterdam, the Netherlands
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7
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Lima MO, Saraiva LC, Ramos VR, Oliveira MC, Costa DLC, Fernandez TV, Crowley JJ, Storch EA, Shavitt RG, Miguel EC, Cappi C. Clinical characteristics of probands with obsessive-compulsive disorder from simplex and multiplex families. Psychiatry Res 2024; 331:115627. [PMID: 38113811 DOI: 10.1016/j.psychres.2023.115627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/14/2023] [Accepted: 11/24/2023] [Indexed: 12/21/2023]
Abstract
Genetic and non-genetic factors contribute to obsessive-compulsive disorder (OCD), with strong evidence of familial clustering. Genomic studies in psychiatry have used the concepts of families that are "simplex" (one affected) versus "multiplex" (multiple affected). Our study compares demographic and clinical data from OCD probands in simplex and multiplex families to uncover potential differences. We analyzed 994 OCD probands (501 multiplex, 493 simplex) from the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders (C-TOC). Clinicians administered the Structured Clinical Interview for DSM-IV (SCID-IV) to diagnose, Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) to assess severity, and Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS) to assess symptom dimensionality. Demographics, clinical history, and family data were collected. Compared to simplex probands, multiplex probands had earlier onset, higher sexual/religious and hoarding dimensions severity, increased comorbidity with other obsessive-compulsive-related disorders (OCRD), and higher family history of psychiatric disorders. These comparisons provide the first insights into demographic and clinical differences between Latin American simplex and multiplex families with OCD. Distinct clinical patterns may suggest diverse genetic and environmental influences. Further research is needed to clarify these differences, which have implications for symptom monitoring and management.
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Affiliation(s)
- Monicke O Lima
- Department & Institute of Psychiatry, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo (SP), Brazil
| | - Leonardo C Saraiva
- Department & Institute of Psychiatry, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo (SP), Brazil
| | - Vanessa R Ramos
- Department & Institute of Psychiatry, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo (SP), Brazil
| | - Melaine C Oliveira
- Department & Institute of Psychiatry, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo (SP), Brazil
| | - Daniel L C Costa
- Department & Institute of Psychiatry, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo (SP), Brazil
| | - Thomas V Fernandez
- Child Study Center and Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - James J Crowley
- Departments of Genetics and Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Eric A Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Roseli G Shavitt
- Department & Institute of Psychiatry, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo (SP), Brazil
| | - Euripedes C Miguel
- Department & Institute of Psychiatry, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo (SP), Brazil
| | - Carolina Cappi
- Department & Institute of Psychiatry, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo (SP), Brazil; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy, New York, NY, USA.
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8
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Bertolín S, Alonso P, Martínez-Zalacaín I, Menchón JM, Jimenez-Murcia S, Baker JT, Bargalló N, Batistuzzo MC, Boedhoe PSW, Brennan BP, Feusner JD, Fitzgerald KD, Fontaine M, Hansen B, Hirano Y, Hoexter MQ, Huyser C, Jahanshad N, Jaspers-Fayer F, Kuno M, Kvale G, Lazaro L, Machado-Sousa M, Marsh R, Morgado P, Nakagawa A, Norman L, Nurmi EL, O'Neill J, Ortiz AE, Perriello C, Piacentini J, Picó-Pérez M, Shavitt RG, Shimizu E, Simpson HB, Stewart SE, Thomopoulos SI, Thorsen AL, Walitza S, Wolters LH, Thompson PM, van den Heuvel OA, Stein DJ, Soriano-Mas C. Right Prefrontal Cortical Thickness Is Associated With Response to Cognitive-Behavioral Therapy in Children With Obsessive-Compulsive Disorder. J Am Acad Child Adolesc Psychiatry 2023; 62:403-414. [PMID: 36526161 PMCID: PMC10065927 DOI: 10.1016/j.jaac.2022.07.865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 07/26/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Cognitive-behavioral therapy (CBT) is considered a first-line treatment for obsessive-compulsive disorder (OCD) in pediatric and adult populations. Nevertheless, some patients show partial or null response. The identification of predictors of CBT response may improve clinical management of patients with OCD. Here, we aimed to identify structural magnetic resonance imaging (MRI) predictors of CBT response in 2 large series of children and adults with OCD from the worldwide ENIGMA-OCD consortium. METHOD Data from 16 datasets from 13 international sites were included in the study. We assessed which variations in baseline cortical thickness, cortical surface area, and subcortical volume predicted response to CBT (percentage of baseline to post-treatment symptom reduction) in 2 samples totaling 168 children and adolescents (age range 5-17.5 years) and 318 adult patients (age range 18-63 years) with OCD. Mixed linear models with random intercept were used to account for potential cross-site differences in imaging values. RESULTS Significant results were observed exclusively in the pediatric sample. Right prefrontal cortex thickness was positively associated with the percentage of CBT response. In a post hoc analysis, we observed that the specific changes accounting for this relationship were a higher thickness of the frontal pole and the rostral middle frontal gyrus. We observed no significant effects of age, sex, or medication on our findings. CONCLUSION Higher cortical thickness in specific right prefrontal cortex regions may be important for CBT response in children with OCD. Our findings suggest that the right prefrontal cortex plays a relevant role in the mechanisms of action of CBT in children.
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Affiliation(s)
- Sara Bertolín
- Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain; CIBERSAM, Barcelona, Spain
| | - Pino Alonso
- Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain; CIBERSAM, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - Ignacio Martínez-Zalacaín
- Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - Jose M Menchón
- Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain; CIBERSAM, Barcelona, Spain; University of Barcelona, Barcelona, Spain
| | - Susana Jimenez-Murcia
- Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain; University of Barcelona, Barcelona, Spain; CIBERobn, ISCIII, Spain
| | - Justin T Baker
- McLean Hospital, Belmont, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Nuria Bargalló
- CIBERSAM, Barcelona, Spain; University of Barcelona, Barcelona, Spain; Image Diagnostic Center, Hospital Clinic, Barcelona, Spain; Magnetic Resonance Image Core Facility (IDIBAPS), Barcelona, Spain
| | - Marcelo Camargo Batistuzzo
- Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil; Pontificial Catholic University of Sao Paulo, Brazil
| | | | - Brian P Brennan
- McLean Hospital, Belmont, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Jamie D Feusner
- University of California Los Angeles, Los Angeles, California; University of Toronto, Canada; Centre for Addiction and Mental Health, Toronto, Canada; Karolinksa Institutet, Stockholm, Sweden
| | - Kate D Fitzgerald
- Columbia University, New York; The New York State Psychiatric Institute, New York
| | - Martine Fontaine
- Columbia University Medical College, Columbia University, New York
| | - Bjarne Hansen
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway; Centre for Crisis Psychology, University of Bergen, Bergen, Norway
| | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, Chiba, Japan; United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| | - Marcelo Q Hoexter
- Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil; LiNC - Laboratory of Integrative Neuroscience of Universidade Federal de São Paulo (UNIFESP), Brazil
| | - Chaim Huyser
- Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, the Netherlands; Amsterdam UMC, Amsterdam, the Netherlands
| | - Neda Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Marina del Rey, California
| | - Fern Jaspers-Fayer
- University of British Columbia, Vancouver, Canada; British Columbia Children's Hospital Research Institute, Vancouver, Canada
| | - Masaru Kuno
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Gerd Kvale
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway; University of Bergen, Bergen, Norway
| | - Luisa Lazaro
- CIBERSAM, Barcelona, Spain; University of Barcelona, Barcelona, Spain; IDIBAPS, Barcelona, Spain; Hospital Clínic, Barcelona, Spain
| | - Mafalda Machado-Sousa
- Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal
| | - Rachel Marsh
- The New York State Psychiatric Institute, New York; Columbia University Medical College, Columbia University, New York
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal
| | - Akiko Nakagawa
- Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | | | - Erika L Nurmi
- University of California Los Angeles, Los Angeles, California
| | - Joseph O'Neill
- UCLA Division of Child and Adolescent Psychiatry, Los Angeles, California; UCLA Brain Research Institute, Los Angeles, California
| | - Ana E Ortiz
- IDIBAPS, Barcelona, Spain; Hospital Clínic, Barcelona, Spain
| | - Chris Perriello
- University of Illinois at Urbana Champaign, Champaign, Illinois
| | - John Piacentini
- UCLA Division of Child and Adolescent Psychiatry, Los Angeles, California; UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California
| | - Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal
| | - Roseli G Shavitt
- Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Eiji Shimizu
- Research Center for Child Mental Development, Chiba University, Chiba, Japan; United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
| | - Helen Blair Simpson
- The New York State Psychiatric Institute, New York; Columbia University Medical College, Columbia University, New York
| | - S Evelyn Stewart
- University of British Columbia, Vancouver, Canada; British Columbia Children's Hospital Research Institute, Vancouver, Canada; British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, Canada
| | - Sophia I Thomopoulos
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Marina del Rey, California
| | - Anders Lillevik Thorsen
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway; Centre for Crisis Psychology, University of Bergen, Bergen, Norway
| | - Susanne Walitza
- University Hospital of Psychiatry Zurich, University of Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Switzerland
| | - Lidewij H Wolters
- Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, the Netherlands
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Marina del Rey, California
| | - Odile A van den Heuvel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Dan J Stein
- SAMRC Unit on Risk and Resilience in Mental Disorders, Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Carles Soriano-Mas
- Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain; CIBERSAM, Barcelona, Spain; University of Barcelona, Barcelona, Spain.
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9
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Shavitt RG, Sheshachala K, Hezel DM, Wall MM, Balachander S, Lochner C, Narayanaswamy JC, Costa DLC, de Mathis MA, van Balkom AJLM, de Joode NT, Narayan M, van den Heuvel OA, Stein DJ, Miguel EC, Simpson HB, Reddy YCJ. Measurement fidelity of clinical assessment methods in a global study on identifying reproducible brain signatures of obsessive-compulsive disorder. Neuropsychology 2023; 37:330-343. [PMID: 36442004 PMCID: PMC10073274 DOI: 10.1037/neu0000849] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To describe the steps of ensuring measurement fidelity of core clinical measures in a five-country study on brain signatures of obsessive-compulsive disorder (OCD). METHOD We collected data using standardized instruments, which included the Yale-Brown Obsessive-Compulsive Scale (YBOCS), the Dimensional YBOCS (DYBOCS), the Brown Assessment of Beliefs Scale (BABS), the 17-item Hamilton Depression Scale (HAM-D), the Hamilton Anxiety Scale (HAM-A), and the Structured Clinical Interview for DSM-5 (SCID). Steps to ensure measurement fidelity included translating instruments, developing a clinical decision manual, and continuing reliability training with 11-13 transcripts of each instrument by 13 independent evaluators across sites over 4 years. We use multigroup confirmatory factor analysis (MGCFA) to report interrater reliability (IRR) among the evaluators and factor structure for each scale in 206 participants with OCD. RESULTS The overall IRR for most scales was high (ICC > 0.94) and remained good to excellent throughout the study. Consistent factor structures (configural invariance) were found for all instruments across the sites, while similarity in the factor loadings for the items (metric invariance) could be established only for the DYBOCS and the BABS. CONCLUSIONS It is feasible to achieve measurement fidelity of clinical measures in multisite, multilinguistic global studies, despite the challenges inherent to such endeavors. Future studies should not only report IRR but also consider reporting methods of standardization of data collection and measurement invariance to identify factor structures of core clinical measures. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Roseli G Shavitt
- Obsessive-Compulsive Spectrum Disorders Program (PROTOC-IPq-HCFMUSP)
| | | | | | | | | | - Christine Lochner
- South African Medical Research Council Unit on Risk and Resilience in Mental Disorders
| | | | - Daniel L C Costa
- Obsessive-Compulsive Spectrum Disorders Program (PROTOC-IPq-HCFMUSP)
| | | | | | | | | | | | - Dan J Stein
- South African Medical Research Council Unit on Risk and Resilience in Mental Disorders
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10
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Pouwels PJW, Vriend C, Liu F, de Joode NT, Otaduy MCG, Pastorello B, Robertson FC, Venkatasubramanian G, Ipser J, Lee S, Batistuzzo MC, Hoexter MQ, Lochner C, Miguel EC, Narayanaswamy JC, Rao R, Janardhan Reddy YC, Shavitt RG, Sheshachala K, Stein DJ, van Balkom AJLM, Wall M, Simpson HB, van den Heuvel OA. Global multi-center and multi-modal magnetic resonance imaging study of obsessive-compulsive disorder: Harmonization and monitoring of protocols in healthy volunteers and phantoms. Int J Methods Psychiatr Res 2023; 32:e1931. [PMID: 35971639 PMCID: PMC9976605 DOI: 10.1002/mpr.1931] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 06/13/2022] [Accepted: 06/22/2022] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES We describe the harmonized MRI acquisition and quality assessment of an ongoing global OCD study, with the aim to translate representative, well-powered neuroimaging findings in neuropsychiatric research to worldwide populations. METHODS We report on T1-weighted structural MRI, resting-state functional MRI, and multi-shell diffusion-weighted imaging of 140 healthy participants (28 per site), two traveling controls, and regular phantom scans. RESULTS Human image quality measures (IQMs) and outcome measures showed smaller within-site variation than between-site variation. Outcome measures were less variable than IQMs, especially for the traveling controls. Phantom IQMs were stable regarding geometry, SNR, and mean diffusivity, while fMRI fluctuation was more variable between sites. CONCLUSIONS Variation in IQMs persists, even for an a priori harmonized data acquisition protocol, but after pre-processing they have less of an impact on the outcome measures. Continuous monitoring IQMs per site is valuable to detect potential artifacts and outliers. The inclusion of both cases and healthy participants at each site remains mandatory.
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Affiliation(s)
- Petra J. W. Pouwels
- Department of Radiology and Nuclear MedicineAmsterdam UMCVrije Universiteit AmsterdamAmsterdam NeuroscienceAmsterdamThe Netherlands
| | - Chris Vriend
- Department of PsychiatryDepartment of Anatomy and NeuroscienceAmsterdam UMCVrije Universiteit AmsterdamAmsterdam NeuroscienceAmsterdamThe Netherlands
| | - Feng Liu
- Columbia University Irving Medical CenterColumbia UniversityNew York State Psychiatric InstituteNew YorkNYUSA
| | - Niels T. de Joode
- Department of PsychiatryDepartment of Anatomy and NeuroscienceAmsterdam UMCVrije Universiteit AmsterdamAmsterdam NeuroscienceAmsterdamThe Netherlands
| | - Maria C. G. Otaduy
- Department of RadiologyLIM44, InstituteHospital Das Clinicas‐HCFMUSPUniversity of Sao Paulo Medical SchoolSao PauloBrazil
| | - Bruno Pastorello
- Department of RadiologyLIM44, InstituteHospital Das Clinicas‐HCFMUSPUniversity of Sao Paulo Medical SchoolSao PauloBrazil
| | - Frances C. Robertson
- Cape Universities Body Imaging CentreUniversity of Cape TownCape TownSouth Africa
| | | | - Jonathan Ipser
- Department of PsychiatrySAMRC Unit on Risk & Resilience in Mental DisordersNeuroscience InstituteUniversity of Cape TownCape TownSouth Africa
| | - Seonjoo Lee
- Columbia University Irving Medical CenterColumbia UniversityNew York State Psychiatric InstituteNew YorkNYUSA
| | - Marcelo C. Batistuzzo
- Obsessive‐Compulsive Spectrum Disorders ProgramDepartmento de Psiquiatria da Faculdade de MedicinaLIM23Hospital Das Clinicas HCFMUSPUniversidade de São PauloSao PauloSPBrazil
- Department of Methods and Techniques in PsychologyPontifical Catholic UniversitySao PauloSPBrazil
| | - Marcelo Q. Hoexter
- Obsessive‐Compulsive Spectrum Disorders ProgramDepartmento de Psiquiatria da Faculdade de MedicinaLIM23Hospital Das Clinicas HCFMUSPUniversidade de São PauloSao PauloSPBrazil
| | - Christine Lochner
- Department of PsychiatrySAMRC Unit on Risk & Resilience in Mental DisordersStellenbosch UniversityCape TownSouth Africa
| | - Euripedes C. Miguel
- Obsessive‐Compulsive Spectrum Disorders ProgramDepartmento de Psiquiatria da Faculdade de MedicinaLIM23Hospital Das Clinicas HCFMUSPUniversidade de São PauloSao PauloSPBrazil
| | | | - Rashmi Rao
- National Institute of Mental Health & Neurosciences (NIMHANS)BangaloreIndia
| | | | - Roseli G. Shavitt
- Obsessive‐Compulsive Spectrum Disorders ProgramDepartmento de Psiquiatria da Faculdade de MedicinaLIM23Hospital Das Clinicas HCFMUSPUniversidade de São PauloSao PauloSPBrazil
| | | | - Dan J. Stein
- Department of PsychiatrySAMRC Unit on Risk & Resilience in Mental DisordersNeuroscience InstituteUniversity of Cape TownCape TownSouth Africa
| | - Anton J. L. M. van Balkom
- Department of PsychiatryAmsterdam UMCVrije UniversiteitAmsterdam Public Health Research InstituteSpecialised Mental Health CareAmsterdamThe Netherlands
| | - Melanie Wall
- Columbia University Irving Medical CenterColumbia UniversityNew York State Psychiatric InstituteNew YorkNYUSA
| | - Helen Blair Simpson
- Columbia University Irving Medical CenterColumbia UniversityNew York State Psychiatric InstituteNew YorkNYUSA
| | - Odile A. van den Heuvel
- Department of PsychiatryDepartment of Anatomy and NeuroscienceAmsterdam UMCVrije Universiteit AmsterdamAmsterdam NeuroscienceAmsterdamThe Netherlands
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Crowley JJ, Cappi C, Ochoa-Panaifo ME, Frederick RM, Kook M, Wiese AD, Rancourt D, Atkinson EG, Giusti-Rodriguez P, Anderberg JL, Abramowitz JS, Adorno VR, Aguirre C, Alves GS, Alves GS, Ancalade N, Espinosa AAA, Arnold PD, Ayton DM, Barbosa IG, Castano LMB, Barrera CN, Prieto MB, Berardo MC, Berrones D, Best JR, Bigdeli TB, Burton CL, Callahan JL, Carneiro MCB, Cepeda SL, Chazelle E, Chire JM, Munoz MC, Quiroz PC, Cobite J, Comer JS, Costa DL, Crosbie J, Cruz VO, Dager G, Daza LF, de la Rosa-Gómez A, Del Río D, Delage FZ, Dreher CB, Fay L, Fazio T, Ferrão YA, Ferreira GM, Figueroa EG, Fontenelle LF, Forero DA, Fragoso DT, Gadad BS, Garrison SR, González A, Gonzalez LD, González MA, Gonzalez-Barrios P, Goodman W, Guintivano J, Guttfreund DG, Guzick AG, Halvorsen MW, Hovey JD, Janssen-Aguilar R, Jensen M, Reynolds AZJ, Lujambio JAJ, Khalfe N, Knutsen MA, Lack C, Lanzagorta N, Lima MO, Longhurst MO, Martinez DAL, Luna ES, Marques AH, Martinez M, de Los Angeles Matos M, Maye CE, McGuire JF, Menezes G, Minaya C, Miño T, Mithani SM, de Oca CM, Morales-Rivero A, Moreira-de-Oliveira ME, Morris OJ, Muñoz SI, Naqqash Z, Bracho AAN, Bracho BEN, Rojas MCO, Castaman LAO, Ortega I, Patel DI, Patrick AK, Mino MPY, Orellana JLP, Stumpf BP, Peregrina T, Duarte TP, Piacsek KL, Placencia M, Quarantini LC, Quarantini-Alvim Y, Ramos RT, Ramos IC, Ramos VR, Ramsey KA, Ray EV, Richter MA, Riemann BC, Rivas JC, Rosario MC, Ruggero CJ, Ruiz-Chow AA, Ruiz-Velasco A, Sampaio AS, Saraiva LC, Schachar RJ, Schneider SC, Schweissing EJ, Seligman LD, Shavitt RG, Soileau KJ, Stewart SE, Storch SB, Strouphauer ER, Timpano KR, Treviño-de la Garza B, Vargas-Medrano J, Vásquez MI, Martinez GV, Weinzimmer SA, Yanez MA, Zai G, Zapata-Restrepo LM, Zappa LM, Zepeda-Burgos RM, Zoghbi AW, Miguel EC, Rodriguez CI, Mallen MCM, Moya PR, Borda T, Moyano MB, Mattheisen M, Pereira S, Lázaro-Muñoz G, Martinez-Gonzalez KG, Pato MT, Nicolini H, Storch EA. Latin American Trans-ancestry INitiative for OCD genomics (LATINO): Study Protocol. medRxiv 2023:2023.02.23.23286373. [PMID: 37131804 PMCID: PMC10153323 DOI: 10.1101/2023.02.23.23286373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder. Worldwide, its prevalence is ~2% and its etiology is mostly unknown. Identifying biological factors contributing to OCD will elucidate underlying mechanisms and might contribute to improved treatment outcomes. Genomic studies of OCD are beginning to reveal long-sought risk loci, but >95% of the cases currently in analysis are of homogenous European ancestry. If not addressed, this Eurocentric bias will result in OCD genomic findings being more accurate for individuals of European ancestry than other ancestries, thereby contributing to health disparities in potential future applications of genomics. In this study protocol paper, we describe the Latin American Trans-ancestry INitiative for OCD genomics (LATINO, www.latinostudy.org). LATINO is a new network of investigators from across Latin America, the United States, and Canada who have begun to collect DNA and clinical data from 5,000 richly-phenotyped OCD cases of Latin American ancestry in a culturally sensitive and ethical manner. In this project, we will utilize trans-ancestry genomic analyses to accelerate the identification of OCD risk loci, fine-map putative causal variants, and improve the performance of polygenic risk scores in diverse populations. We will also capitalize on rich clinical data to examine the genetics of treatment response, biologically plausible OCD subtypes, and symptom dimensions. Additionally, LATINO will help elucidate the diversity of the clinical presentations of OCD across cultures through various trainings developed and offered in collaboration with Latin American investigators. We believe this study will advance the important goal of global mental health discovery and equity.
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Affiliation(s)
- James J Crowley
- University of North Carolina at Chapel Hill, Department of Genetics, Chapel Hill, North Carolina, United States of America
- University of North Carolina at Chapel Hill, Department of Psychiatry, Chapel Hill, North Carolina, United States of America
| | - Carolina Cappi
- Icahn School of Medicine at Mount Sinai, Department of Psychiatry, New York City, New York, United States of America
- Universidade de São Paulo, Departamento de Psiquiatria, São Paulo, São Paulo, Brasil
| | | | - Renee M Frederick
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Minjee Kook
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Andrew D Wiese
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Diana Rancourt
- University of South Florida, Department of Psychology, Tampa, Florida, United States of America
| | - Elizabeth G Atkinson
- Baylor College of Medicine, Department of Molecular and Human Genetics, Houston, Texas, United States of America
| | - Paola Giusti-Rodriguez
- University of Florida College of Medicine, Department of Psychiatry, Gainesville, Florida, United States of America
| | - Jacey L Anderberg
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Jonathan S Abramowitz
- University of North Carolina at Chapel Hill, Department of Psychology and Neuroscience, Chapel Hill, North Carolina, United States of America
| | - Victor R Adorno
- Hospital Psiquiátrico de Asunción, Direccion General, Asunción, Central, Paraguay
| | - Cinthia Aguirre
- Hospital Psiquiátrico de Asunción, Departamento de Psiquiatría, Asunción, Central, Paraguay
| | - Gustavo S Alves
- Universidade Federal da Bahia, Hospital Universitário Professor Edgard Santos, Serviço de Psiquiatria, Laboratório de Neuropsicofarmacologia - LANP, Salvador, Bahia, Brasil
- Universidade Federal da Bahia, Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Salvador, Bahia, Brasil
| | - Gilberto S Alves
- Hospital Nina Rodrigues/Universidade Federal do Maranhão (UFMA), Sao Luis do Maranhão, Maranhão, Brasil
| | - NaEshia Ancalade
- University of North Carolina at Chapel Hill, Department of Genetics, Chapel Hill, North Carolina, United States of America
| | | | - Paul D Arnold
- University of Calgary, The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Calgary, Alberta, Canada
| | - Daphne M Ayton
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Izabela G Barbosa
- Universidade Federal de Minas Gerais, Departamento de Saúde Mental da Faculdade de Medicina, Belo Horizonte, Minas Gerais, Brasil
| | | | | | - María Belén Prieto
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - María Celeste Berardo
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - Dayan Berrones
- Rice University, Department of Psychology, Houston, Texas, United States of America
| | - John R Best
- University of British Columbia, Department of Psychiatry, Vancouver, British Columbia, Canada
| | - Tim B Bigdeli
- SUNY Downstate Health Sciences University, Department of Psychiatry and Behavioral Sciences, Brooklyn, New York, United States of America
- VA New York Harbor Healthcare System, Brooklyn, New York, United States of America
| | - Christie L Burton
- Hospital for Sick Children, Department of Neurosciences and Mental Health, Toronto, Ontario, Canada
| | - Jennifer L Callahan
- University of North Texas, Department of Psychology, Denton, Texas, United States of America
| | - Maria Cecília B Carneiro
- Universidade Federal do Paraná, Departamento de Psiquiatria e Medicina Legal, Curitiba, Paraná, Brasil
| | - Sandra L Cepeda
- University of Miami, Department of Psychology, Coral Gables, Florida, United States of America
| | - Evelyn Chazelle
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - Jessica M Chire
- Instituto Nacional de Salud Mental ""Honorio Delgado-Hideyo Noguchi"", Dirección de Niños y Adolescentes, Lima, Lima, Perú
| | | | | | - Journa Cobite
- University of Houston, Department of Counseling Psychology, Houston, Texas, United States of America
| | - Jonathan S Comer
- Florida International University, Department of Psychology, Miami, Florida, United States of America
| | - Daniel L Costa
- Universidade de São Paulo, Departamento de Psiquiatria, São Paulo, São Paulo, Brasil
| | - Jennifer Crosbie
- Hospital for Sick Children, Department of Neurosciences and Mental Health, Toronto, Ontario, Canada
- University of Toronto, Department of Psychiatry, Toronto, Ontario, Canada
| | - Victor O Cruz
- Instituto Nacional de Salud Mental ""Honorio Delgado-Hideyo Noguchi"", Oficina Ejecutiva de Investigación, Lima, Lima, Perú
- Universidad San Martin de Porres, School of Medicine, Lima, Lima, Perú
| | - Guillermo Dager
- Corporación Universitaria Rafael Nuñez, Cartagena, Bolivar, Colombia
| | - Luisa F Daza
- Hospital Psiquiátrico Universitario Del Valle, Cali, Valle del Cauca, Colombia
| | - Anabel de la Rosa-Gómez
- Universidad Nacional Autónoma de México, Facultad de Estudios Superiores Iztacala, Tlalnepantla de Baz, Ciudad de México, México
| | | | - Fernanda Z Delage
- Universidade Federal do Paraná, Departamento de Medicina Forense e Psiquiatria, Curitiba, Paraná, Brasil
| | - Carolina B Dreher
- Universidade Federal do Rio Grande do Sul, Departamento de Psiquiatria, Porto Alegre, Rio Grande do Sul, Brasil
- Universidade Federal de Ciências da Saúde de Porto Alegre, Departamento de Psiquiatria - Clínica Médica, Porto Alegre, Rio Grande do Sul, Brasil
| | - Lucila Fay
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - Tomas Fazio
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - Ygor A Ferrão
- Universidade Federal do Paraná de Porto Alegre, Departamento de Psiquiatria, Porto Alegre, Rio Grande do Sul, Brasil
| | - Gabriela M Ferreira
- Universidade Federal do Paraná, Departamento de Medicina Forense e Psiquiatria, Curitiba, Paraná, Brasil
- Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Parana, Brasil
| | - Edith G Figueroa
- Instituto Nacional de Salud Mental ""Honorio Delgado-Hideyo Noguchi"", Departamento de Psiquiatría de Adultos, Lima, Lima, Perú
| | - Leonardo F Fontenelle
- Universidade Federal do Rio de Janeiro, Departamento de Psiquiatria e Medicina Legal, Rio de Janeiro, Rio de Janeiro, Brasil
- Instituto D'Or de Pesquisa e Ensino, Departamento de Psiquiatria, Rio de Janeiro, Rio de Janeiro, Brasil
| | - Diego A Forero
- Fundación Universitaria del Área Andina, Escuela de Salud y Ciencias del Deporte, Bogotá, Bogotá, Colombia
| | - Daniele Th Fragoso
- Universidade Federal do Paraná, Departamento de Medicina Forense e Psiquiatria, Curitiba, Paraná, Brasil
| | - Bharathi S Gadad
- Texas Tech University Health Sciences Center El Paso, Department of Psychiatry, El Paso, Texas, United States of America
| | - Sheldon R Garrison
- Rogers Behavioral Health, Oconomowoc, Wisconsin, United States of America
| | | | - Laura D Gonzalez
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - Marco A González
- Universidad Nacional Autónoma de México, Facultad de Estudios Superiores Iztacala, Tlalnepantla de Baz, Ciudad de México, México
| | - Polaris Gonzalez-Barrios
- Universidad de Puerto Rico, Departamento de Psiquiatría, San Juan, Puerto Rico, Los Estados Unidos
- Universidad de Puerto Rico Campus de Ciências Médicas, San Juan, Puerto Rico, Los Estados Unidos
| | - Wayne Goodman
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Jerry Guintivano
- University of North Carolina at Chapel Hill, Department of Psychiatry, Chapel Hill, North Carolina, United States of America
| | | | - Andrew G Guzick
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Matthew W Halvorsen
- University of North Carolina at Chapel Hill, Department of Genetics, Chapel Hill, North Carolina, United States of America
| | - Joseph D Hovey
- The University of Texas Rio Grande Valley, Department of Psychological Science, Edinburg, Texas, United States of America
| | - Reinhard Janssen-Aguilar
- Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suarez, Subdirección de Psiquiatría, Ciudad de México, Ciudad de México, México
| | - Matias Jensen
- Universidad de Valparaíso, Centro de Neurociencias, Valparaíso, Valparaíso, Chile
| | - Alexandra Z Jimenez Reynolds
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | | | - Nasim Khalfe
- Baylor College of Medicine, School of Medicine, Houston, Texas, United States of America
| | - Madison A Knutsen
- Augustana College, Department of Psychology, Rock Island, Illinois, United States of America
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Caleb Lack
- University of Central Oklahoma, Department of Psychology, Edmond, Oklahoma, United States of America
| | - Nuria Lanzagorta
- Grupo Médico Carracci, Departamento de Investigación Clínica, Ciudad de México, Ciudad de México, México
| | - Monicke O Lima
- Universidade de São Paulo, Departamento de Psiquiatria, São Paulo, São Paulo, Brasil
| | - Melanie O Longhurst
- Texas Tech University Health Sciences Center El Paso, Department of Psychiatry, El Paso, Texas, United States of America
| | | | - Elba S Luna
- Instituto Nacional de Salud Mental ""Honorio Delgado-Hideyo Noguchi"", Oficina Ejecutiva de Investigación, Lima, Lima, Perú
| | - Andrea H Marques
- National Institute of Mental Heatlh (NIMH), Bethesda, Maryland, United States of America
| | - Molly Martinez
- DFW OCD Treatment Specialists, Richardson, Texas, United States of America
- Specialists in OCD and Anxiety Recovery (SOAR), Richardson, Texas, United States of America
| | - Maria de Los Angeles Matos
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
| | - Caitlyn E Maye
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Joseph F McGuire
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, Maryland, United States of America
| | - Gabriela Menezes
- Universidade Federal do Rio de Janeiro, Programa de Ansiedade, Obsessões e Compulsões, Rio de Janeiro, Rio de Janeiro, Brasil
| | - Charlene Minaya
- Fordham University, Department of Psychology, New York City, New York, United States of America
| | - Tomás Miño
- Universidad de Valparaíso, Centro de Neurociencias, Valparaíso, Valparaíso, Chile
| | - Sara M Mithani
- University of Texas Health Science Center at San Antonio, School of Nursing, San Antonio, Texas, United States of America
| | | | | | - Maria E Moreira-de-Oliveira
- Universidade Federal do Rio de Janeiro, Programa de Ansiedade, Obsessões e Compulsões, Rio de Janeiro, Rio de Janeiro, Brasil
| | - Olivia J Morris
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Sandra I Muñoz
- Universidad Nacional Autónoma de México, Facultad de Estudios Superiores Iztacala, Tlalnepantla de Baz, Ciudad de México, México
| | - Zainab Naqqash
- University of British Columbia, Department of Psychiatry, Vancouver, British Columbia, Canada
| | | | | | | | | | - Iliana Ortega
- University of Calgary, The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Calgary, Alberta, Canada
| | - Darpan I Patel
- University of Texas Health Science Center at San Antonio, School of Nursing, San Antonio, Texas, United States of America
| | - Ainsley K Patrick
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, Maryland, United States of America
| | - Mariel Paz Y Mino
- Universidad San Francisco de Quito, Clínica de Salud Mental USFQ, Quito, Pichincha, Ecuador
- Universidad San Francisco de Quito, Quito, Pichincha, Ecuador
| | - Jose L Perales Orellana
- Universidad Tegnológica Privada de Santa Cruz (UTEPSA), Santa Cruz de la Sierra, Andres Ibañez, Bolivia
| | - Bárbara Perdigão Stumpf
- Universidade Federal de Minas Gerais, Departamento de Saúde Mental da Faculdade de Medicina, Belo Horizonte, Minas Gerais, Brasil
| | | | | | - Kelly L Piacsek
- Rogers Behavioral Health, Oconomowoc, Wisconsin, United States of America
| | - Maritza Placencia
- Universidad Nacional Mayor de San Marcos, Departamento Académico de Ciencias Dinámicas, Lima, Lima, Perú
| | - Lucas C Quarantini
- Universidade Federal da Bahia, Departamento de Neurociências e Saúde Mental, Faculdade de Medicina da Bahia, Salvador, Bahia, Brasil
- Universidade Federal da Bahia, Hospital Universitário Professor Edgard Santos, Serviço de Psiquiatria, Laboratório de Neuropsicofarmacologia - LANP, Salvador, Bahia, Brasil
| | - Yana Quarantini-Alvim
- Universidade Federal da Bahia, Hospital Universitário Professor Edgard Santos, Serviço de Psiquiatria, Laboratório de Neuropsicofarmacologia - LANP, Salvador, Bahia, Brasil
- Faculdade Santa Casa, Faculdade de Psicologia, Salvador, Bahia, Brasil
| | - Renato T Ramos
- Sunnybrook Health Sciences Centre, Department of Psychiatry, Toronto, Ontario, Canada
- University of Toronto, Department of Psychiatry, Toronto, Ontario, Canada
| | - Iaroslava C Ramos
- Sunnybrook Health Sciences Centre, Department of Psychiatry, Toronto, Ontario, Canada
- Frederick Thompson Anxiety Disorders Centre, Department of Psychiatry, Toronto, Ontario, Canada
| | - Vanessa R Ramos
- Universidade de São Paulo, Departamento de Psiquiatria, São Paulo, São Paulo, Brasil
| | - Kesley A Ramsey
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, Maryland, United States of America
| | - Elise V Ray
- University of North Carolina at Chapel Hill, Department of Genetics, Chapel Hill, North Carolina, United States of America
| | - Margaret A Richter
- Sunnybrook Health Sciences Centre, Department of Psychiatry, Toronto, Ontario, Canada
- University of Toronto, Department of Psychiatry, Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | - Bradley C Riemann
- Rogers Behavioral Health, Oconomowoc, Wisconsin, United States of America
| | - Juan C Rivas
- Hospital Psiquiátrico Universitario Del Valle, Cali, Valle del Cauca, Colombia
- Universidad del Valle, Departamento de Psiquiatría, Cali, Valle del Cauca, Colombia
- Universidad ICESI, Departamento de Psiquiatria, Cali, Valle del Cauca, Colombia
- Fundación Valle del Lili, Departamento de Psiquiatria, Cali, Valle del Cauca, Colombia
| | - Maria C Rosario
- Departamento de Psiquiatria da Universidade Federal de São Paulo (UNIFESP), São Paulo, São Paulo, Brasil
| | - Camilo J Ruggero
- University of North Texas, Department of Psychology, Denton, Texas, United States of America
| | | | - Alejandra Ruiz-Velasco
- Texas Tech University Health Sciences Center El Paso, Department of Psychiatry, El Paso, Texas, United States of America
| | - Aline S Sampaio
- Universidade Federal da Bahia, Departamento de Neurociências e Saúde Mental, Faculdade de Medicina da Bahia, Salvador, Bahia, Brasil
- Universidade Federal da Bahia, Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Salvador, Bahia, Brasil
- Universidade Federal da Bahia, Hospital Universitário Professor Edgard Santos, Serviço de Psiquiatria, Laboratório de Neuropsicofarmacologia - LANP, Salvador, Bahia, Brasil
| | - Leonardo C Saraiva
- Universidade de São Paulo, Departamento de Psiquiatria, São Paulo, São Paulo, Brasil
| | - Russell J Schachar
- Hospital for Sick Children, Department of Neurosciences and Mental Health, Toronto, Ontario, Canada
- University of Toronto, Department of Psychiatry, Toronto, Ontario, Canada
| | - Sophie C Schneider
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Ethan J Schweissing
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Laura D Seligman
- The University of Texas Rio Grande Valley, Department of Psychological Science, Edinburg, Texas, United States of America
| | - Roseli G Shavitt
- Universidade de São Paulo, Departamento de Psiquiatria, São Paulo, São Paulo, Brasil
| | - Keaton J Soileau
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - S Evelyn Stewart
- University of British Columbia, Department of Psychiatry, Vancouver, British Columbia, Canada
- BC Mental Health and Substance Use Services, Vancouver, British Columbia, Canada
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Shaina B Storch
- Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Emily R Strouphauer
- Baylor College of Medicine, School of Medicine, Houston, Texas, United States of America
| | - Kiara R Timpano
- University of Miami, Department of Psychology, Coral Gables, Florida, United States of America
| | | | - Javier Vargas-Medrano
- Texas Tech University Health Sciences Center El Paso, Department of Psychiatry, El Paso, Texas, United States of America
| | - María I Vásquez
- Hospital Nacional Arzobispo Loayza, Servicio de Salud Mental, Lima, Lima, Perú
| | - Guadalupe Vidal Martinez
- Texas Tech University Health Sciences Center El Paso, Department of Psychiatry, El Paso, Texas, United States of America
| | - Saira A Weinzimmer
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Mauricio A Yanez
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
| | - Gwyneth Zai
- Centre for Addiction and Mental Health, Neurogenetics Section, Molecular Brain Sciences Department, Toronto, Ontario, Canada
- University of Toronto, Department of Psychiatry, Temerty Faculty of Medicine, Toronto, Ontario, Canada
| | - Lina M Zapata-Restrepo
- Fundación Valle del Lili, Departamento de Psiquiatria, Cali, Valle, Colombia
- Universidad ICESI, Facultad de Ciencias de la Salud, Cali, Valle, Colombia
- Global Brain Health Institute - University of California San Francisco, Department of Neurology, San Francisco, California, United States of America
| | - Luz M Zappa
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
- Hospital de Niños Ricardo Gutierrez, Departamento de Salud Mental, Buenos Aires, Buenos Aires, Argentina
- Hospital Universitario Austral, Materno Infantil, Buenos Aires, Buenos Aires, Argentina
| | - Raquel M Zepeda-Burgos
- Universidad Dr. José Matías Delgado, Centro de Investigación en Ciencias y Humanidades, Santa Tecla, La Libertad, El Salvador
| | - Anthony W Zoghbi
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
- New York State Psychiatric Institute, Department of Psychiatry, New York City, New York, United States of America
| | - Euripedes C Miguel
- Universidade de São Paulo, Departamento de Psiquiatria, São Paulo, São Paulo, Brasil
| | - Carolyn I Rodriguez
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, Stanford, California, United States of America
- Veterans Affairs Palo Alto Health Care System, Department of Psychiatry, Temerty Faculty of Medicine, Palo Alto, California, United States of America
| | | | - Pablo R Moya
- Universidad de Valparaíso, Instituto de Fisiología, Valparaíso, Valparaíso, Chile
- Centro Interdisciplinario de Neurociencia de Valparaiso (CINV), Valparaíso, Valparaíso, Chile
| | - Tania Borda
- Instituto Realize, Buenos Aires, Buenos Aires, Argentina
- Universidad Catolica Argentina, Facultad de Psicologia, Buenos Aires, Buenos Aires, Argentina
| | - María Beatriz Moyano
- Centro Interdisciplinario de Tourette, TOC, TDAH y Trastornos Asociados (CITA), Buenos Aires, Buenos Aires, Argentina
- Asociacion de Psiquiatras Argentinos (APSA), Buenos Aires, Buenos Aires, Argentina
- Asociacion de Psiquiatras Argentinos (APSA), Presidente del Capitulo de Investigacion en Psiquiatria, Buenos Aires, Buenos Aires, Argentina
| | - Manuel Mattheisen
- Dalhousie University, Department of Community Health and Epidemiology & Faculty of Computer Science, Halifax, Nova Scotia, Canada
- LMU Munich, Institute of Psychiatric Phenomics and Genomics (IPPG), Munich, Germany
| | - Stacey Pereira
- Baylor College of Medicine, Center for Medical Ethics and Health Policy, Houston, Texas, United States of America
| | - Gabriel Lázaro-Muñoz
- Harvard University School of Medicine, Center for Bioethics, Boston, Massachusetts, United States of America
- Massachusetts General Hospital, Department of Psychiatry, Boston, Massachusetts, United States of America
| | | | - Michele T Pato
- Rutgers University- Robert Wood Johnson Medical School, Department of Psychiatry, Piscataway, New Jersey, United States of America
| | - Humberto Nicolini
- Grupo Médico Carracci, Departamento de Psiquiatría, Ciudad de México, Ciudad de México, México
- Instituto Nacional de Medicina Genómica, Laboratorio de Genómica de Enfermedades Psiquiátricas y Neurodegenerativas, Ciudad de México, Ciudad de México, México
| | - Eric A Storch
- Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, Houston, Texas, United States of America
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12
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Shephard E, Stern ER, van den Heuvel OA, Costa DLC, Batistuzzo MC, Godoy PBG, Lopes AC, Brunoni AR, Hoexter MQ, Shavitt RG, Janardhan Reddy YC, Lochner C, Stein DJ, Simpson HB, Miguel EC. Expanding the heuristic neurocircuit-based taxonomy to guide treatment for OCD: reply to the commentary "Probing the genetic and molecular correlates of connectome alterations in obsessive-compulsive disorder". Mol Psychiatry 2022; 27:3560-3561. [PMID: 35665765 DOI: 10.1038/s41380-022-01645-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/10/2022] [Accepted: 05/23/2022] [Indexed: 02/08/2023]
Affiliation(s)
- Elizabeth Shephard
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil. .,Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK.
| | - Emily R Stern
- Department of Psychiatry, The New York University School of Medicine, New York, NY, USA.,Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Odile A van den Heuvel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Daniel L C Costa
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marcelo C Batistuzzo
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Priscilla B G Godoy
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Antonio C Lopes
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Andre R Brunoni
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marcelo Q Hoexter
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Roseli G Shavitt
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Y C Janardhan Reddy
- Department of Psychiatry OCD Clinic, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Christine Lochner
- SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Dan J Stein
- SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - H Blair Simpson
- Center for OCD and Related Disorders, New York State Psychiatric Institute and the Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Euripedes C Miguel
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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13
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Farhat LC, Vattimo EFQ, Ramakrishnan D, Levine JLS, Johnson JA, Artukoglu BB, Landeros-Weisenberger A, Asbahr FR, Cepeda SL, Comer JS, Fatori D, Franklin ME, Freeman JB, Geller DA, Grant PJ, Goodman WK, Heyman I, Ivarsson T, Lenhard F, Lewin AB, Li F, Merlo LJ, Mohsenabadi H, Peris TS, Piacentini J, Rosa-Alcázar AI, Rosa-Alcázar À, Rozenman M, Sapyta JJ, Serlachius E, Shabani MJ, Shavitt RG, Small BJ, Skarphedinsson G, Swedo SE, Thomsen PH, Turner C, Weidle B, Miguel EC, Storch EA, Mataix-Cols D, Bloch MH. Systematic Review and Meta-analysis: An Empirical Approach to Defining Treatment Response and Remission in Pediatric Obsessive-Compulsive Disorder. J Am Acad Child Adolesc Psychiatry 2022; 61:495-507. [PMID: 34597773 DOI: 10.1016/j.jaac.2021.05.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 05/05/2021] [Accepted: 09/21/2021] [Indexed: 02/01/2023]
Abstract
OBJECTIVE A lack of universal definitions for response and remission in pediatric obsessive-compulsive disorder (OCD) has hampered the comparability of results across trials. To address this problem, we conducted an individual participant data diagnostic test accuracy meta-analysis to evaluate the discriminative ability of the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) in determining response and remission. We also aimed to generate empirically derived cutoffs on the CY-BOCS for these outcomes. METHOD A systematic review of PubMed, PsycINFO, Embase and CENTRAL identified 5,401 references; 42 randomized controlled clinical trials were considered eligible, and 21 provided data for inclusion (N = 1,234). Scores of ≤2 in the Clinical Global Impressions Improvement and Severity scales were chosen to define response and remission, respectively. A 2-stage, random-effects meta-analysis model was established. The area under the curve (AUC) and the Youden Index were computed to indicate the discriminative ability of the CY-BOCS and to guide for the optimal cutoff, respectively. RESULTS The CY-BOCS had sufficient discriminative ability to determine response (AUC = 0.89) and remission (AUC = 0.92). The optimal cutoff for response was a ≥35% reduction from baseline to posttreatment (sensitivity = 83.9, 95% CI = 83.7-84.1; specificity = 81.7, 95% CI = 81.5-81.9). The optimal cutoff for remission was a posttreatment raw score of ≤12 (sensitivity = 82.0, 95% CI = 81.8-82.2; specificity = 84.6, 95% CI = 84.4-84.8). CONCLUSION Meta-analysis identified empirically optimal cutoffs on the CY-BOCS to determine response and remission in pediatric OCD randomized controlled clinical trials. Systematic adoption of standardized operational definitions for response and remission will improve comparability across trials for pediatric OCD.
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Affiliation(s)
- Luis C Farhat
- Faculdade de Medicina FMUSP, Universidade de São Paulo, Brazil
| | | | - Divya Ramakrishnan
- Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut
| | - Jessica L S Levine
- Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut
| | - Jessica A Johnson
- Columbia University New York, New York; Columbia School of Nursing, New York
| | | | | | | | | | - Jonathan S Comer
- Center for Children and Families, Florida International University, Miami, Florida
| | - Daniel Fatori
- Faculdade de Medicina FMUSP, Universidade de São Paulo, Brazil
| | - Martin E Franklin
- University of Pennsylvania, Philadelphia; Rogers Memorial Hospital, Oconomowoc, Wisconsin
| | - Jennifer B Freeman
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Daniel A Geller
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | | | | | - Isobel Heyman
- Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
| | - Tord Ivarsson
- Regional Center for Child and Youth Mental Health and Child Welfare, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Fabian Lenhard
- Centre for Psychiatry Research, Karolinska Institutet, Stockholm Health Care Services, Region Stockholm, Sweden
| | - Adam B Lewin
- University of South Florida, Hillsborough County
| | - Fenghua Li
- Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut
| | | | - Hamid Mohsenabadi
- Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, IR
| | - Tara S Peris
- Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles
| | - John Piacentini
- Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles
| | | | | | | | | | - Eva Serlachius
- Centre for Psychiatry Research, Karolinska Institutet, Stockholm Health Care Services, Region Stockholm, Sweden
| | - Mohammad J Shabani
- Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, IR
| | | | - Brent J Small
- School of Aging Studies, University of South Florida, Hillsborough County
| | | | | | - Per Hove Thomsen
- Regional Center for Child and Youth Mental Health and Child Welfare, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Aarhus University Hospital, Skejby, Denmark
| | - Cynthia Turner
- Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Bernhard Weidle
- Regional Center for Child and Youth Mental Health and Child Welfare, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; St. Olav's University Hospital, Trondheim, Norway
| | | | | | - David Mataix-Cols
- Centre for Psychiatry Research, Karolinska Institutet, Stockholm Health Care Services, Region Stockholm, Sweden
| | - Michael H Bloch
- Yale Child Study Center, Yale School of Medicine, New Haven, Connecticut.
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14
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Shavitt RG, van den Heuvel OA, Lochner C, Reddy YCJ, Miguel EC, Simpson HB. Editorial: Obsessive-compulsive disorder (OCD) across the lifespan: Current diagnostic challenges and the search for personalized treatment. Front Psychiatry 2022; 13:927184. [PMID: 36072456 PMCID: PMC9443072 DOI: 10.3389/fpsyt.2022.927184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 07/27/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Roseli G Shavitt
- Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Odile A van den Heuvel
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Department of Anatomy and Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Christine Lochner
- SA Medical Research Council Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Y C Janardhan Reddy
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Euripedes C Miguel
- Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Helen Blair Simpson
- New York State Psychiatric Institute, New York, NY, United States.,Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, United States
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15
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Shephard E, Stern ER, van den Heuvel OA, Costa DL, Batistuzzo MC, Godoy PB, Lopes AC, Brunoni AR, Hoexter MQ, Shavitt RG, Reddy JY, Lochner C, Stein DJ, Simpson HB, Miguel EC. Toward a neurocircuit-based taxonomy to guide treatment of obsessive-compulsive disorder. Mol Psychiatry 2021; 26:4583-4604. [PMID: 33414496 PMCID: PMC8260628 DOI: 10.1038/s41380-020-01007-8] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 12/11/2022]
Abstract
An important challenge in mental health research is to translate findings from cognitive neuroscience and neuroimaging research into effective treatments that target the neurobiological alterations involved in psychiatric symptoms. To address this challenge, in this review we propose a heuristic neurocircuit-based taxonomy to guide the treatment of obsessive-compulsive disorder (OCD). We do this by integrating information from several sources. First, we provide case vignettes in which patients with OCD describe their symptoms and discuss different clinical profiles in the phenotypic expression of the condition. Second, we link variations in these clinical profiles to underlying neurocircuit dysfunctions, drawing on findings from neuropsychological and neuroimaging studies in OCD. Third, we consider behavioral, pharmacological, and neuromodulatory treatments that could target those specific neurocircuit dysfunctions. Finally, we suggest methods of testing this neurocircuit-based taxonomy as well as important limitations to this approach that should be considered in future research.
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Affiliation(s)
- Elizabeth Shephard
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil. .,Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.
| | - Emily R. Stern
- Department of Psychiatry, The New York University School of Medicine, New York, USA.,Nathan Kline Institute for Psychiatric Research, Orangeburg, New York, USA
| | - Odile A. van den Heuvel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Daniel L.C. Costa
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marcelo C. Batistuzzo
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Priscilla B.G. Godoy
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Antonio C. Lopes
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Andre R. Brunoni
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marcelo Q. Hoexter
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Roseli G. Shavitt
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Janardhan Y.C Reddy
- Department of Psychiatry OCD Clinic, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Christine Lochner
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Dan J. Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - H. Blair Simpson
- Center for OCD and Related Disorders, New York State Psychiatric Institute and the Department of Psychiatry, Columbia University Irving Medical Center, New York New York
| | - Euripedes C. Miguel
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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16
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Shephard E, Batistuzzo MC, Hoexter MQ, Stern ER, Zuccolo PF, Ogawa CY, Silva RM, Brunoni AR, Costa DL, Doretto V, Saraiva L, Cappi C, Shavitt RG, Simpson HB, van den Heuvel OA, Miguel EC. Neurocircuit models of obsessive-compulsive disorder: limitations and future directions for research. Braz J Psychiatry 2021; 44:187-200. [PMID: 35617698 PMCID: PMC9041967 DOI: 10.1590/1516-4446-2020-1709] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/05/2021] [Indexed: 11/22/2022]
Affiliation(s)
- Elizabeth Shephard
- Universidade de São Paulo (USP), Brazil; Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, UK
| | - Marcelo C. Batistuzzo
- Universidade de São Paulo (USP), Brazil; Pontifícia Universidade Católica de São Paulo, Brazil
| | | | - Emily R. Stern
- The New York University School of Medicine, USA; Orangeburg, USA
| | | | | | | | | | | | | | | | - Carolina Cappi
- Universidade de São Paulo (USP), Brazil; Icahn School of Medicine at Mount Sinai, USA
| | | | - H. Blair Simpson
- New York State Psychiatric Institute, Columbia University Irving Medical Center (CUIMC), USA; CUIMC, USA
| | - Odile A. van den Heuvel
- Vrije Universiteit Amsterdam, The Netherlands; Vrije Universiteit Amsterdam, The Netherlands
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17
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Maziero MP, Seitz-Holland J, Cho KIK, Goldenberg JE, Tanamatis TW, Diniz JB, Cappi C, Alice de Mathis M, Otaduy MCG, da Graça Morais Martin M, de Melo Felipe da Silva R, Shavitt RG, Batistuzzo MC, Lopes AC, Miguel EC, Pasternak O, Hoexter MQ. Cellular and Extracellular White Matter Abnormalities in Obsessive-Compulsive Disorder: A Diffusion Magnetic Resonance Imaging Study. Biol Psychiatry Cogn Neurosci Neuroimaging 2021; 6:983-991. [PMID: 33862255 DOI: 10.1016/j.bpsc.2021.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/17/2021] [Accepted: 04/02/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND While previous studies have implicated white matter (WM) as a core pathology of obsessive-compulsive disorder (OCD), the underlying neurobiological processes remain elusive. This study used free-water (FW) imaging derived from diffusion magnetic resonance imaging to identify cellular and extracellular WM abnormalities in patients with OCD compared with control subjects. Next, we investigated the association between diffusion measures and clinical variables in patients. METHODS We collected diffusion-weighted magnetic resonance imaging and clinical data from 83 patients with OCD (56 women/27 men, age 37.7 ± 10.6 years) and 52 control subjects (27 women/25 men, age 32.8 ± 11.5 years). Fractional anisotropy (FA), FA of cellular tissue, and extracellular FW maps were extracted and compared between patients and control subjects using tract-based spatial statistics and voxelwise comparison in FSL Randomise. Next, we correlated these WM measures with clinical variables (age of onset and symptom severity) and compared them between patients with and without comorbidities and patients with and without psychiatric medication. RESULTS Patients with OCD demonstrated lower FA (43.4% of the WM skeleton), lower FA of cellular tissue (31% of the WM skeleton), and higher FW (22.5% of the WM skeleton) compared with control subjects. We did not observe significant correlations between diffusion measures and clinical variables. Comorbidities and medication status did not influence diffusion measures. CONCLUSIONS Our findings of widespread FA, FA of cellular tissue, and FW abnormalities suggest that OCD is associated with microstructural cellular and extracellular abnormalities beyond the corticostriatothalamocortical circuits. Future multimodal longitudinal studies are needed to understand better the influence of essential clinical variables across the illness trajectory.
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Affiliation(s)
- Maria Paula Maziero
- Laboratório de Investigações Médicas 23, Instituto de Psiquiatria, Hospital das Clinicas Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil; Faculty of Medicine, City University of São Paulo, São Paulo, Brazil.
| | - Johanna Seitz-Holland
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kang Ik K Cho
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Joshua E Goldenberg
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Taís W Tanamatis
- Laboratório de Investigações Médicas 23, Instituto de Psiquiatria, Hospital das Clinicas Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Juliana B Diniz
- Laboratório de Investigações Médicas 23, Instituto de Psiquiatria, Hospital das Clinicas Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Carolina Cappi
- Laboratório de Investigações Médicas 23, Instituto de Psiquiatria, Hospital das Clinicas Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Maria Alice de Mathis
- Laboratório de Investigações Médicas 23, Instituto de Psiquiatria, Hospital das Clinicas Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Maria C G Otaduy
- Laboratório de Investigações Médicas 44, Instituto de Radiologia, Hospital das Clinicas Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Maria da Graça Morais Martin
- Laboratório de Investigações Médicas 44, Instituto de Radiologia, Hospital das Clinicas Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Renata de Melo Felipe da Silva
- Laboratório de Investigações Médicas 23, Instituto de Psiquiatria, Hospital das Clinicas Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Roseli G Shavitt
- Laboratório de Investigações Médicas 23, Instituto de Psiquiatria, Hospital das Clinicas Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marcelo C Batistuzzo
- Laboratório de Investigações Médicas 23, Instituto de Psiquiatria, Hospital das Clinicas Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil; Department of Methods and Techniques in Psychology, Humanities and Health Sciences School, Pontifical Catholic University of São Paulo, São Paulo, Brazil
| | - Antonio C Lopes
- Laboratório de Investigações Médicas 23, Instituto de Psiquiatria, Hospital das Clinicas Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Eurípedes C Miguel
- Laboratório de Investigações Médicas 23, Instituto de Psiquiatria, Hospital das Clinicas Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Ofer Pasternak
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Marcelo Q Hoexter
- Laboratório de Investigações Médicas 23, Instituto de Psiquiatria, Hospital das Clinicas Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
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18
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Affiliation(s)
- Renata M Silva
- Programa Transtornos do Espectro Obsessivo-Compulsivo, Laboratório de Psicopatologia e Terapêutica Psiquiátrica (LIM-23), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Roseli G Shavitt
- Programa Transtornos do Espectro Obsessivo-Compulsivo, Laboratório de Psicopatologia e Terapêutica Psiquiátrica (LIM-23), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Daniel L Costa
- Programa Transtornos do Espectro Obsessivo-Compulsivo, Laboratório de Psicopatologia e Terapêutica Psiquiátrica (LIM-23), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
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19
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Vattimo EFQ, Dos Santos AC, Hoexter MQ, Frudit P, Miguel EC, Shavitt RG, Batistuzzo MC. Higher volumes of hippocampal subfields in pediatric obsessive-compulsive disorder. Psychiatry Res Neuroimaging 2021; 307:111200. [PMID: 33059948 DOI: 10.1016/j.pscychresns.2020.111200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 09/12/2020] [Accepted: 10/02/2020] [Indexed: 10/23/2022]
Abstract
Differences in hippocampus volume have been identified in adult patients with obsessive-compulsive disorder (OCD). However, the role of this limbic structure in pediatric patients is unclear. This study aimed to investigate the hippocampus and its subregions in a sample of 29 children and adolescents with OCD compared to 28 healthy controls, matched for age, sex, education, and IQ. Volumetric segmentation was performed using the Freesurfer software to calculate the volumes of the subregions that reflect the hippocampal cytoarchitecture. The volumes of three anatomic subregions (tail, body, and head) were also calculated. ANCOVA was performed to investigate differences of these volumes between patients and controls, controlling for total gray matter volume. After Bonferroni correction for multiple comparisons (p-value < 0.00556 for the body and < 0.00625 for the head structures), patients presented statistically significant larger volumes of the following structures: left subiculum body; left CA4 body; left GC-DG body; left molecular layer body; right parasubiculum; left CA4 head; left molecular layer head; right subiculum head and right molecular layer head. These enlarged volumes resulted in larger left and right whole hippocampi in patients, as well as bilateral hippocampal heads and left hippocampal body (all p-values < 0.00625). There were no associations between OCD severity and hippocampal volumes. These findings diverge from previous reports on adults and may indicate that larger hippocampal volumes could reflect an early marker of OCD, not present in adults.
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Affiliation(s)
- Edoardo F Q Vattimo
- Departamento de Psiquiatria, Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil
| | | | - Marcelo Q Hoexter
- Departamento de Psiquiatria, Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil
| | - Paula Frudit
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, SP, Brazil
| | - Euripedes C Miguel
- Departamento de Psiquiatria, Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil
| | - Roseli G Shavitt
- Departamento de Psiquiatria, Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil
| | - Marcelo C Batistuzzo
- Departamento de Psiquiatria, Faculdade de Medicina, Universidade de Sao Paulo, SP, Brazil; Departamento de Métodos e Técnicas, Curso de Psicologia da Faculdade de Ciências Humanas e da Saúde, Pontifícia Universidade Católica de São Paulo, SP, Brazil.
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20
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Vellozo AP, Fontenelle LF, Torresan RC, Shavitt RG, Ferrão YA, Rosário MC, Miguel EC, Torres AR. Symmetry Dimension in Obsessive-Compulsive Disorder: Prevalence, Severity and Clinical Correlates. J Clin Med 2021; 10:jcm10020274. [PMID: 33451078 PMCID: PMC7828517 DOI: 10.3390/jcm10020274] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/11/2021] [Accepted: 01/11/2021] [Indexed: 01/12/2023] Open
Abstract
Background: Obsessive–compulsive disorder (OCD) is a very heterogeneous condition that frequently includes symptoms of the “symmetry dimension” (i.e., obsessions and/or compulsions of symmetry, ordering, repetition, and counting), along with aggressive, sexual/religious, contamination/cleaning, and hoarding dimensions. Methods: This cross-sectional study aimed to investigate the prevalence, severity, and demographic and clinical correlates of the symmetry dimension among 1001 outpatients from the Brazilian Research Consortium on Obsessive–Compulsive Spectrum Disorders. The main assessment instruments used were the Dimensional Yale–Brown Obsessive–Compulsive Scale, the Yale–Brown Obsessive–Compulsive Scale, the USP-Sensory Phenomena Scale, the Beck Depression and Anxiety Inventories, the Brown Assessment of Beliefs Scale, and the Structured Clinical Interview for DSM-IV Axis I Disorders. Chi-square tests, Fisher’s exact tests, Student’s t-tests, and Mann–Whitney tests were used in the bivariate analyses to compare patients with and without symptoms of the symmetry dimension. Odds ratios (ORs) with confidence intervals and Cohen’s D were also calculated as effect size measures. Finally, a logistic regression was performed to control for confounders. Results: The symmetry dimension was highly prevalent (86.8%) in this large clinical sample and, in the logistic regression, it remained associated with earlier onset of obsessive–compulsive symptoms, insidious onset of compulsions, more severe depressive symptoms, and presence of sensory phenomena. Conclusions: A deeper knowledge about specific OCD dimensions is essential for a better understanding and management of this complex and multifaceted disorder.
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Affiliation(s)
- Aline P. Vellozo
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, Universidade Estadual Paulista—UNESP, Botucatu 18618-687, Brazil; (A.P.V.); (R.C.T.); (A.R.T.)
| | - Leonardo F. Fontenelle
- Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC 3168, Australia
- D’Or Institute for Research and Education & Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro 22290-140, Brazil
- Correspondence: ; Tel.: +61-3-990-29755
| | - Ricardo C. Torresan
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, Universidade Estadual Paulista—UNESP, Botucatu 18618-687, Brazil; (A.P.V.); (R.C.T.); (A.R.T.)
| | - Roseli G. Shavitt
- Obsessive-Compulsive Spectrum Disorders Program, Department and Institute of Psychiatry, University of São Paulo, São Paulo 05403-010, Brazil; (R.G.S.); (E.C.M.)
| | - Ygor A. Ferrão
- Department of Psychiatry, Federal University of Health Sciences of Porto Alegre, Porto Alegre 90570-080, Brazil;
| | - Maria C. Rosário
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo 04038-000, Brazil;
| | - Euripedes C. Miguel
- Obsessive-Compulsive Spectrum Disorders Program, Department and Institute of Psychiatry, University of São Paulo, São Paulo 05403-010, Brazil; (R.G.S.); (E.C.M.)
| | - Albina R. Torres
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, Universidade Estadual Paulista—UNESP, Botucatu 18618-687, Brazil; (A.P.V.); (R.C.T.); (A.R.T.)
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21
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Batistuzzo MC, Sottili BA, Shavitt RG, Lopes AC, Cappi C, de Mathis MA, Pastorello B, Diniz JB, Silva RMF, Miguel EC, Hoexter MQ, Otaduy MC. Lower Ventromedial Prefrontal Cortex Glutamate Levels in Patients With Obsessive-Compulsive Disorder. Front Psychiatry 2021; 12:668304. [PMID: 34168581 PMCID: PMC8218991 DOI: 10.3389/fpsyt.2021.668304] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/23/2021] [Indexed: 12/31/2022] Open
Abstract
Background: Recent studies using magnetic resonance spectroscopy (1H-MRS) indicate that patients with obsessive-compulsive disorder (OCD) present abnormal levels of glutamate (Glu) and gamma aminobutyric acid (GABA) in the frontal and striatal regions of the brain. These abnormalities could be related to the hyperactivation observed in cortico-striatal circuits of patients with OCD. However, most of the previous 1H-MRS studies were not capable of differentiating the signal from metabolites that overlap in the spectrum, such as Glu and glutamine (Gln), and referred to the detected signal as the composite measure-Glx (sum of Glu and Gln). In this study, we used a two-dimensional JPRESS 1H-MRS sequence that allows the discrimination of overlapping metabolites by observing the differences in J-coupling, leading to higher accuracy in the quantification of all metabolites. Our objective was to identify possible alterations in the neurometabolism of OCD, focusing on Glu and GABA, which are key neurotransmitters in the brain that could provide insights into the underlying neurochemistry of a putative excitatory/inhibitory imbalance. Secondary analysis was performed including metabolites such as Gln, creatine (Cr), N-acetylaspartate, glutathione, choline, lactate, and myo-inositol. Methods: Fifty-nine patients with OCD and 42 healthy controls (HCs) underwent 3T 1H-MRS in the ventromedial prefrontal cortex (vmPFC, 30 × 25 × 25 mm3). Metabolites were quantified using ProFit (version 2.0) and Cr as a reference. Furthermore, Glu/GABA and Glu/Gln ratios were calculated. Generalized linear models (GLMs) were conducted using each metabolite as a dependent variable and age, sex, and gray matter fraction (fGM) as confounding factors. GLM analysis was also used to test for associations between clinical symptoms and neurometabolites. Results: The GLM analysis indicated lower levels of Glu/Cr in patients with OCD (z = 2.540; p = 0.011). No other comparisons reached significant differences between groups for all the metabolites studied. No associations between metabolites and clinical symptoms were detected. Conclusions: The decreased Glu/Cr concentrations in the vmPFC of patients with OCD indicate a neurochemical imbalance in the excitatory neurotransmission that could be associated with the neurobiology of the disease and may be relevant for the pathophysiology of OCD.
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Affiliation(s)
- Marcelo C Batistuzzo
- Department & Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.,Department of Methods and Techniques in Psychology, Pontifical Catholic University, São Paulo, Brazil
| | - Bruna A Sottili
- Laboratory of Magnetic Resonance (LIM44), Department and Institute of Radiology, University of São Paulo (InRad-FMUSP), São Paulo, Brazil
| | - Roseli G Shavitt
- Department & Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Antonio C Lopes
- Department & Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Carolina Cappi
- Department & Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Maria Alice de Mathis
- Department & Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Bruno Pastorello
- Laboratory of Magnetic Resonance (LIM44), Department and Institute of Radiology, University of São Paulo (InRad-FMUSP), São Paulo, Brazil
| | - Juliana B Diniz
- Department & Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Renata M F Silva
- Department & Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Euripedes C Miguel
- Department & Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Marcelo Q Hoexter
- Department & Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.,Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Maria C Otaduy
- Laboratory of Magnetic Resonance (LIM44), Department and Institute of Radiology, University of São Paulo (InRad-FMUSP), São Paulo, Brazil
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Saraiva LC, Cappi C, Simpson HB, Stein DJ, Viswanath B, van den Heuvel OA, Reddy YCJ, Miguel EC, Shavitt RG. Cutting-edge genetics in obsessive-compulsive disorder. Fac Rev 2020; 9:30. [PMID: 33659962 PMCID: PMC7886082 DOI: 10.12703/r/9-30] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
This article reviews recent advances in the genetics of obsessive-compulsive disorder (OCD). We cover work on the following: genome-wide association studies, whole-exome sequencing studies, copy number variation studies, gene expression, polygenic risk scores, gene–environment interaction, experimental animal systems, human cell models, imaging genetics, pharmacogenetics, and studies of endophenotypes. Findings from this work underscore the notion that the genetic architecture of OCD is highly complex and shared with other neuropsychiatric disorders. Also, the latest evidence points to the participation of gene networks involved in synaptic transmission, neurodevelopment, and the immune and inflammatory systems in this disorder. We conclude by highlighting that further study of the genetic architecture of OCD, a great part of which remains to be elucidated, could benefit the development of diagnostic and therapeutic approaches based on the biological basis of the disorder. Studies to date revealed that OCD is not a simple homogeneous entity, but rather that the underlying biological pathways are variable and heterogenous. We can expect that translation from bench to bedside, through continuous effort and collaborative work, will ultimately transform our understanding of what causes OCD and thus how best to treat it.
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Affiliation(s)
- Leonardo Cardoso Saraiva
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Carolina Cappi
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Helen Blair Simpson
- Columbia University Irving Medical Center, Columbia University, New York, NY, 10032, USA
- The New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Dan J Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Biju Viswanath
- Molecular Genetics Laboratory, National Institute of Mental Health & Neurosciences (NIMHANS); Accelerator Program for Discovery in Brain disorders using Stem cells (ADBS) Laboratory, NIMHANS, Bangalore, India
| | - Odile A van den Heuvel
- Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Department of Psychiatry, Department of Anatomy & Neuroscience, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - YC Janardhan Reddy
- Obsessive-Compulsive Disorder (OCD) Clinic, Department of Psychiatry, NIMHANS, Bangalore, India
| | - Euripedes C Miguel
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Roseli G Shavitt
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
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23
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Destrée L, Albertella L, Torres AR, Ferrão YA, Shavitt RG, Miguel EC, Fontenelle LF. Social losses predict a faster onset and greater severity of obsessive-compulsive disorder. J Psychiatr Res 2020; 130:187-193. [PMID: 32828024 DOI: 10.1016/j.jpsychires.2020.07.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 07/09/2020] [Accepted: 07/20/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND While stressful life events increase the risk of developing a range of psychiatric disorders, including obsessive-compulsive disorder (OCD), their ability to precipitate specific obsessive-compulsive symptoms' dimensions is unknown. Here we aimed to evaluate the potential role of three different types of stressful life events, herein termed losses (death of a loved one, termination of a romantic relationship and severe illness) in predicting the speed of progression from subclinical to clinical OCD and the severity of specific OCD dimensions in a large multicentre OCD sample. METHODS Nine hundred and fifty-four OCD outpatients from the Brazilian OCD Research Consortium were included in this study. Several semi-structured and structured instruments were used, including the Structured Clinical Interview for DSM-IV Axis I Disorders, the Yale-Brown Obsessive-Compulsive Scale, the Dimensional Yale-Brown Obsessive-Compulsive Scale, the Brown Assessment of Beliefs Scale, the Beck Depression Inventory, the Beck Anxiety Inventory and the Yale OCD Natural History Questionnaire. Regression models investigated the interaction between types of loss and gender to predict speed of progression from subclinical obsessive-compulsive symptoms to OCD, and the severity of five symptom dimensions. RESULTS While termination of a relationship was associated with a faster speed of progression from subthreshold to clinical OCD, the death of a loved one was associated with increased severity of hoarding symptoms. There was also an interaction between gender and experiences of death, which predicted a faster speed of progression to OCD in males. CONCLUSIONS Stressful life events have the ability to accelerate the progression from subclinical to clinical OCD, as well as impact the severity of specific OCD dimensions. Gender also plays a role in both the progression and severity of symptoms. These findings suggest that stressful life events may represent a marker to identify individuals at risk of progressing to clinical OCD.
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Affiliation(s)
- Louise Destrée
- Brain & Mental Health Research Hub, Turner Institute for Brain and Mental Health, Monash University, Victoria, Australia
| | - Lucy Albertella
- Brain & Mental Health Research Hub, Turner Institute for Brain and Mental Health, Monash University, Victoria, Australia
| | - Albina R Torres
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, Universidade Estadual Paulista (Unesp), Brazil
| | - Ygor A Ferrão
- Department of Psychiatry, Federal University of Health Sciences of Porto Alegre (UFCSPA), Brazil
| | - Roseli G Shavitt
- Obsessive-Compulsive Spectrum Disorders Program (PROTOC), Department and Institute of Psychiatry, University of São Paulo (USP), Brazil
| | - Euripedes C Miguel
- Obsessive-Compulsive Spectrum Disorders Program (PROTOC), Department and Institute of Psychiatry, University of São Paulo (USP), Brazil
| | - Leonardo F Fontenelle
- Brain & Mental Health Research Hub, Turner Institute for Brain and Mental Health, Monash University, Victoria, Australia; Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, Universidade Estadual Paulista (Unesp), Brazil; Obsessive, Compulsive, and Anxiety Spectrum Research Program. Institute of Psychiatry, Federal University of Rio de Janeiro & D'Or Institute for Research and Education, Rio de Janeiro, Brazil.
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24
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Fatori D, Costa DL, Asbahr FR, Ferrão YA, Rosário MC, Miguel EC, Shavitt RG, Batistuzzo MC. Is it time to change the gold standard of obsessive-compulsive disorder severity assessment? Factor structure of the Yale-Brown Obsessive-Compulsive Scale. Aust N Z J Psychiatry 2020; 54:732-742. [PMID: 32475123 DOI: 10.1177/0004867420924113] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES The Yale-Brown Obsessive-Compulsive Scale has been considered the gold standard scale to assess obsessive-compulsive disorder severity. Previous studies using exploratory factor analysis and confirmatory factor analysis with this scale showed mixed findings in terms of factor structure and fit of models. Therefore, we used confirmatory factor analysis to compare different Yale-Brown Obsessive-Compulsive Scale models in a large sample aiming to identify the best model fit. METHODS We assessed adult obsessive-compulsive disorder patients (n = 955) using three measures: Yale-Brown Obsessive-Compulsive Scale severity ratings, the Dimensional Yale-Brown Obsessive-Compulsive Scale and the clinical global impression scale. We tested all factor structures reported by previous studies to investigate which model best fitted the data: one-factor, two-factor, three-factor and their equivalent high-order solutions. We also investigated Yale-Brown Obsessive-Compulsive Scale items correlations with scores from the other measures of obsessive-compulsive disorder severity. RESULTS Confirmatory factor analysis models presented mediocre to fair goodness-of-fit indexes. Severity items related to resistance to obsessions and compulsions presented low factor loadings. The model with the best fit indexes was a high-order model without obsessive-compulsive disorder resistance items. These items also presented small correlations with other obsessive-compulsive disorder severity measures. CONCLUSION The obsessive-compulsive disorder field needs to discuss further improvements in the Yale-Brown Obsessive-Compulsive Scale and/or continue to search for better measures of obsessive-compulsive disorder severity.
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Affiliation(s)
- Daniel Fatori
- Departamento de Psiquiatria (Department of Psychiatry), Faculdade de Medicina FMUSP, Universidade de Sao Paulo (University of Sao Paulo Medical School), São Paulo, Brazil
| | - Daniel Lc Costa
- Departamento de Psiquiatria (Department of Psychiatry), Faculdade de Medicina FMUSP, Universidade de Sao Paulo (University of Sao Paulo Medical School), São Paulo, Brazil
| | - Fernando R Asbahr
- Departamento de Psiquiatria (Department of Psychiatry), Faculdade de Medicina FMUSP, Universidade de Sao Paulo (University of Sao Paulo Medical School), São Paulo, Brazil
| | - Ygor A Ferrão
- Department of Psychiatry, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Maria Conceição Rosário
- Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Euripedes C Miguel
- Departamento de Psiquiatria (Department of Psychiatry), Faculdade de Medicina FMUSP, Universidade de Sao Paulo (University of Sao Paulo Medical School), São Paulo, Brazil
| | - Roseli G Shavitt
- Departamento de Psiquiatria (Department of Psychiatry), Faculdade de Medicina FMUSP, Universidade de Sao Paulo (University of Sao Paulo Medical School), São Paulo, Brazil
| | - Marcelo C Batistuzzo
- Departamento de Psiquiatria (Department of Psychiatry), Faculdade de Medicina FMUSP, Universidade de Sao Paulo (University of Sao Paulo Medical School), São Paulo, Brazil.,Department of Methods and Techniques, Psychology Course, Pontifical Catholic University of São Paulo, São Paulo, Brazil
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Fontenelle LF, Oldenhof E, Eduarda Moreira-de-Oliveira M, Abramowitz JS, Antony MM, Cath D, Carter A, Dougherty D, Ferrão YA, Figee M, Harrison BJ, Hoexter M, Soo Kwon J, Küelz A, Lazaro L, Lochner C, Marazziti D, Mataix-Cols D, McKay D, Miguel EC, Morein-Zamir S, Moritz S, Nestadt G, O'Connor K, Pallanti S, Purdon C, Rauch S, Richter P, Rotge JY, Shavitt RG, Soriano-Mas C, Starcevic V, Stein DJ, Steketee G, Storch EA, Taylor S, van den Heuvel OA, Veale D, Woods DW, Verdejo-Garcia A, Yücel M. A transdiagnostic perspective of constructs underlying obsessive-compulsive and related disorders: An international Delphi consensus study. Aust N Z J Psychiatry 2020; 54:719-731. [PMID: 32364439 DOI: 10.1177/0004867420912327] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND The Research Domain Criteria seeks to bridge knowledge from neuroscience with clinical practice by promoting research into valid neurocognitive phenotypes and dimensions, irrespective of symptoms and diagnoses as currently conceptualized. While the Research Domain Criteria offers a vision of future research and practice, its 39 functional constructs need refinement to better target new phenotyping efforts. This study aimed to determine which Research Domain Criteria constructs are most relevant to understanding obsessive-compulsive and related disorders, based on a consensus between experts in the field of obsessive-compulsive and related disorders. METHODS Based on a modified Delphi method, 46 experts were recruited from Australia, Africa, Asia, Europe and the Americas. Over three rounds, experts had the opportunity to review their opinion in light of feedback from the previous round, which included how their response compared to other experts and a summary of comments given. RESULTS Thirty-four experts completed round one, of whom 28 (82%) completed round two and 24 (71%) completed round three. At the final round, four constructs were endorsed by ⩾75% of experts as 'primary constructs' and therefore central to understanding obsessive-compulsive and related disorders. Of these constructs, one came from the Positive Valence System (Habit), two from the Cognitive Control System (Response Selection/Inhibition and Performance Monitoring) and the final construct was an additional item suggested by experts (Compulsivity). CONCLUSION This study identified four Research Domain Criteria constructs that, according to experts, cut across different obsessive-compulsive and related disorders. These constructs represent key areas for future investigation, and may have potential implications for clinical practice in terms of diagnostic processes and therapeutic management of obsessive-compulsive and related disorders.
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Affiliation(s)
- Leonardo F Fontenelle
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia.,D'Or Institute for Research and Education, D'Or São Luiz Network, Rio de Janeiro, Brazil.,Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Erin Oldenhof
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Maria Eduarda Moreira-de-Oliveira
- D'Or Institute for Research and Education, D'Or São Luiz Network, Rio de Janeiro, Brazil.,Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jonathan S Abramowitz
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Martin M Antony
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Danielle Cath
- RGOc and Department of Psychiatry, Rijksuniversity Groningen, UMC Groningen, Groningen, The Netherlands.,Department of Specialized Trainings, Mental Health Services Drenthe, Assen, The Netherlands
| | - Adrian Carter
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Darin Dougherty
- Division of Neurotherapeutics, Massachusetts General Hospital, Boston, MA, USA.,Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, MA, USA.,Obsessive-Compulsive and Related Disorders Program, Massachusetts General Hospital, Boston, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Ygor A Ferrão
- Department of Psychiatry, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Martijn Figee
- Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Ben J Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| | - Marcelo Hoexter
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Jun Soo Kwon
- Department of Psychiatry, College of Medicine, Seoul National University, Seoul, Korea
| | - Anne Küelz
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Luísa Lazaro
- Department of Child and Adolescent Psychiatry and Psychology, Hospital Clinic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Christine Lochner
- SU/UCT MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Donatella Marazziti
- Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - David Mataix-Cols
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Dean McKay
- Department of Psychology, Fordham University, Bronx, NY, USA
| | - Euripedes C Miguel
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Sharon Morein-Zamir
- School of Psychology and Sports Science, Anglia Ruskin University, Cambridge, UK
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Kieron O'Connor
- Research Center of the Montreal University Institute of Mental Health, University of Montreal, Montreal, QC, Canada
| | - Stefano Pallanti
- Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Stanford, CA, USA.,Institute of Neuroscience, University of Florence, Florence, Italy
| | - Christine Purdon
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada
| | - Scott Rauch
- Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Peggy Richter
- Anxiety Disorders Centre, Sunnybrook Health Care Sciences, Toronto, Canada and Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Jean-Yves Rotge
- Inserm U 1127, CNRS UMR 7225, Department of Psychiatry, Institut du Cerveau et de la Moelle, ICM-A-IHU, Sorbonne Université, AP-HP, Paris, France
| | - Roseli G Shavitt
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Carles Soriano-Mas
- Department of Psychiatry and Department of Psychobiology and Methodology of Health Sciences, Bellvitge Biomedical Research Institute-IDIBELL, Mental Health Networking Biomedical Research Centre (CIBERSAM) and Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Vladan Starcevic
- Department of Psychiatry, Nepean Hospital, Faculty of Medicine and Health, Sydney Medical School, Nepean Clinical School, The University of Sydney, Sydney, NSW, Australia
| | - Dan J Stein
- Department of Psychiatry and MRC Unit on Risk & Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Gail Steketee
- School of Social Work, Boston University, Boston, USA
| | - Eric A Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TC, USA
| | - Steven Taylor
- Department of Psychiatry, The University of British Columbia, Vancouver, BC, Canada
| | - Odile A van den Heuvel
- Department of Psychiatry and Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.,Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway
| | - David Veale
- South London and Maudsley NHS Foundation Trust, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Douglas W Woods
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA.,Department of Psychology, Marquette University, Milwaukee, WI, USA
| | - Antonio Verdejo-Garcia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Murat Yücel
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
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Fineberg NA, Hollander E, Pallanti S, Walitza S, Grünblatt E, Dell’Osso BM, Albert U, Geller DA, Brakoulias V, Janardhan Reddy Y, Arumugham SS, Shavitt RG, Drummond L, Grancini B, De Carlo V, Cinosi E, Chamberlain SR, Ioannidis K, Rodriguez CI, Garg K, Castle D, Van Ameringen M, Stein DJ, Carmi L, Zohar J, Menchon JM. Clinical advances in obsessive-compulsive disorder: a position statement by the International College of Obsessive-Compulsive Spectrum Disorders. Int Clin Psychopharmacol 2020; 35:173-193. [PMID: 32433254 PMCID: PMC7255490 DOI: 10.1097/yic.0000000000000314] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 03/16/2020] [Indexed: 11/25/2022]
Abstract
In this position statement, developed by The International College of Obsessive-Compulsive Spectrum Disorders, a group of international experts responds to recent developments in the evidence-based management of obsessive-compulsive disorder (OCD). The article presents those selected therapeutic advances judged to be of utmost relevance to the treatment of OCD, based on new and emerging evidence from clinical and translational science. Areas covered include refinement in the methods of clinical assessment, the importance of early intervention based on new staging models and the need to provide sustained well-being involving effective relapse prevention. The relative benefits of psychological, pharmacological and somatic treatments are reviewed and novel treatment strategies for difficult to treat OCD, including neurostimulation, as well as new areas for research such as problematic internet use, novel digital interventions, immunological therapies, pharmacogenetics and novel forms of psychotherapy are discussed.
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Affiliation(s)
- Naomi A. Fineberg
- University of Hertfordshire, Hatfield
- Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, Hertfordshire
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Eric Hollander
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, USA
| | - Stefano Pallanti
- Istituto di Neuroscienze, University of Florence, Firenze, Italy
- Albert Einstein College of Medicine, Bronx, New York, USA
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich
- Neuroscience Center Zurich, University of Zurich and ETH Zurich
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Edna Grünblatt
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich
- Neuroscience Center Zurich, University of Zurich and ETH Zurich
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Bernardo Maria Dell’Osso
- University of Milan, Department of Biomedical and Clinical Sciences Luigi Sacco, Ospedale Sacco-Polo Universitario, ASST Fatebenefratelli-Sacco, Milan, Italy
- Department of Psychiatry and Behavioural Sciences, Stanford University, California, USA
- CRC ‘Aldo Ravelli’ for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Milan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, UCO Clinica Psichiatrica, University of Trieste, Trieste, Italy
| | - Daniel A. Geller
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Vlasios Brakoulias
- Western Sydney Obsessive-Compulsive and Related Disorders Service, Western Sydney Local Health District, Blacktown Hospital, Blacktown, New South Wales
- Translational Research Health Institute (THRI), Clinical and Health Psychology Research Initiative (CaHPRI) and School of Medicine, Western Sydney University, Sydney, Australia
| | - Y.C. Janardhan Reddy
- OCD Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Shyam Sundar Arumugham
- OCD Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Roseli G. Shavitt
- OCD Spectrum Disorders Program, Institute and Department of Psychiatry, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo-SP, Brazil
| | - Lynne Drummond
- Consultant Psychiatrist, SW London and St George’s NHS Trust and St George’s, University of London, London
| | - Benedetta Grancini
- Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, Hertfordshire
- University of Milan, Department of Biomedical and Clinical Sciences Luigi Sacco, Ospedale Sacco-Polo Universitario, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Vera De Carlo
- Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, Hertfordshire
- University of Milan, Department of Biomedical and Clinical Sciences Luigi Sacco, Ospedale Sacco-Polo Universitario, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Eduardo Cinosi
- University of Hertfordshire, Hatfield
- Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, Hertfordshire
| | - Samuel R. Chamberlain
- Department of Psychiatry, University of Cambridge, Cambridge
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Konstantinos Ioannidis
- Department of Psychiatry, University of Cambridge, Cambridge
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Carolyn I. Rodriguez
- Department of Psychiatry and Behavioural Sciences, Stanford University, California, USA
- Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Kabir Garg
- Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, Hertfordshire
| | - David Castle
- St. Vincent’s Hospital Melbourne and The University of Melbourne, Melbourne, Australia
| | - Michael Van Ameringen
- Department of Psychiatry and Behavioural Neurosciences, McMaster University
- Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Dan J. Stein
- SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Lior Carmi
- The Post Trauma Center, Chaim Sheba Medical Center, Ramat Gan
- The Data Science Institution, The Interdisciplinary Center, Herzliya
| | - Joseph Zohar
- The Post Trauma Center, Chaim Sheba Medical Center, Ramat Gan
- Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Jose M. Menchon
- Department of Psychiatry, Bellvitge University Hospital-IDIBELL, University of Barcelona, Cibersam, Barcelona, Spain
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Brakoulias V, Starcevic V, Albert U, Arumugham SS, Bailey BE, Belloch A, Borda T, Dell'Osso L, Elias JA, Falkenstein MJ, Ferrao YA, Fontenelle LF, Jelinek L, Kay B, Lochner C, Maina G, Marazziti D, Matsunaga H, Miguel EC, Morgado P, Pasquini M, Perez-Rivera R, Potluri S, Reddy JYC, Riemann BC, do Rosario MC, Shavitt RG, Stein DJ, Viswasam K, Fineberg NA. The rates of co-occurring behavioural addictions in treatment-seeking individuals with obsessive-compulsive disorder: a preliminary report. Int J Psychiatry Clin Pract 2020; 24:173-175. [PMID: 31916881 DOI: 10.1080/13651501.2019.1711424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: To assess the rates of co-occurring putative 'behavioural addictions' in patients with obsessive-compulsive disorder (OCD).Methods: Twenty-three international centres specialising in the treatment of OCD were invited to participate in a survey of the rates of behavioural addictions and other relevant comorbidity within their samples.Results: Sixteen of 23 (69.6%) invited centres from 13 countries had sufficient data to participate in the survey. The use of validated diagnostic tools was discrepant, with most centres relying on a 'clinical diagnosis' to diagnose behavioural addictions. The final sample comprised of 6916 patients with a primary diagnosis of OCD. The reported rates of behavioural addictions were as follows: 8.7% for problematic internet use, 6.8% for compulsive sexual behaviour disorder, 6.4% for compulsive buying, 4.1% for gambling disorder and 3.4% for internet gaming disorder.Conclusions: Behavioural addictions should be better assessed for patients with OCD. The absence of diagnostic scales developed specifically for behavioural addictions and overlapping obsessive-compulsive phenomena such as compulsive checking of information on the internet may explain the relatively high rate of problematic internet use in this sample. The study encourages better efforts to assess and to conceptualise the relatedness of behavioural addictions to obsessive-compulsive 'spectrum' disorders.
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Affiliation(s)
- Vlasios Brakoulias
- Department of Psychiatry, Sydney Medical School - Nepean, The University of Sydney and Nepean Hospital, Sydney/Penrith, Australia.,School of Medicine, Blacktown Hospital, Western Sydney University, Sydney/Blacktown, Australia
| | - Vladan Starcevic
- Department of Psychiatry, Sydney Medical School - Nepean, The University of Sydney and Nepean Hospital, Sydney/Penrith, Australia
| | - Umberto Albert
- Department of Neuroscience, Rita Levi Montalcini, University of Turin, Torino, Italy.,Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Shyam S Arumugham
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | | | - Amparo Belloch
- Department of Personality Psychology, Research Unit for Obsessive-Compulsive and Related Disorders, I'TOC, Universidad de Valencia, Spain
| | - Tania Borda
- Bio-Behavioral Institute, Buenos Aires, Argentina.,Department of Psychology, Argentinian Catholic University (UCA), Buenos Aires, Argentina
| | - Liliana Dell'Osso
- Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, Univeristy of Pisa, Pisa, Italy.,Dipartmento di Farmacia, Univeristy of Pisa, Pisa, Italy
| | - Jason A Elias
- McLean Hospital/Harvard Medical School, Belmont, MA, USA
| | | | - Ygor A Ferrao
- Department of Psychiatry, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Leonardo F Fontenelle
- Department of Psychiatry and Legal Medicine, D'Or Institute for Research and Education, Federal University of Rio de Janeiro.,Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Australia
| | - Lena Jelinek
- Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Brian Kay
- Rogers Memorial Hospital, Oconomowoc, WI, USA
| | - Christine Lochner
- Department of Psychiatry, MRC Unit on Anxiety Disorders, University of Stellenbosch, Cape Town, South Africa
| | - Giuseppe Maina
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Donatella Marazziti
- Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, Univeristy of Pisa, Pisa, Italy
| | - Hisato Matsunaga
- Department of Neuropsychiatry, Hyogo College of Medicine, Hyogo, Japan
| | - Euripedes C Miguel
- Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal.,ICVS-3Bs PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Hospital de Braga, Braga, Portugal
| | - Massimo Pasquini
- Department of Human Neurosciences, University of Rome, Sapienza, Italy
| | | | | | - Janardhan Y C Reddy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | | | - Maria C do Rosario
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Roseli G Shavitt
- Department of Neuropsychiatry, Hyogo College of Medicine, Hyogo, Japan
| | - Dan J Stein
- Department of Psychiatry, MRC Unit on Anxiety Disorders, University of Stellenbosch, Cape Town, South Africa
| | - Kirupamani Viswasam
- Department of Psychiatry, Sydney Medical School - Nepean, The University of Sydney and Nepean Hospital, Sydney/Penrith, Australia
| | - Naomi A Fineberg
- Hertfordshire Partnership University NHS Foundation Trust, University of Hertfordshire, Hatfield, UK
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28
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Domingues-Castro MS, Torresan RC, Shavitt RG, Fontenelle LF, Ferrão YA, Rosário MC, Torres AR. Bipolar disorder comorbidity in patients with obsessive-compulsive disorder: Prevalence and predictors. J Affect Disord 2019; 256:324-330. [PMID: 31201983 DOI: 10.1016/j.jad.2019.06.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/25/2019] [Accepted: 06/07/2019] [Indexed: 01/23/2023]
Abstract
BACKGROUND Patients with obsessive-compulsive disorder (OCD) often present with comorbidities, mainly anxiety and affective disorders, which may influence OCD course, help-seeking and treatment response. Some authors have studied bipolar disorder (BD) comorbidity in patients with OCD, but usually in small samples. The objective was to estimate the lifetime prevalence of BD in a large clinical sample of OCD patients, and to compare demographic and clinical features of patients with and without BD comorbidity. METHOD This cross-sectional study with 955 adult OCD patients from the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders (C-TOC) used several assessment instruments, including the Yale-Brown Obsessive-Compulsive Scale, the Dimensional Yale-Brown Obsessive-Compulsive Scale, the Beck Depression and Anxiety Inventories, and the Structured Clinical Interview for DSM-IV Axis I Disorders. Descriptive and bivariate analyses were followed by logistic regression. RESULTS The lifetime prevalence of BD was 7.75% (N = 74). The variables that were independently associated with BD comorbidity were: panic disorder with agoraphobia, impulse control disorders, and suicide attempts. LIMITATIONS The cross-sectional design does not permit causal inferences; the external validity may be limited, as the participants were from tertiary services. Despite the large sample size, some analyses may have been underpowered due to the relatively low prevalence of the outcome and of some explanatory variables. CONCLUSIONS Patients with OCD comorbid with BD have some clinical features indicative of greater severity, including higher suicide risk, and require a careful therapeutic approach for the appropriate treatment of both disorders.
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Affiliation(s)
- Mariana S Domingues-Castro
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, Univ Estadual Paulista (UNESP), Brazil
| | - Ricardo C Torresan
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, Univ Estadual Paulista (UNESP), Brazil
| | - Roseli G Shavitt
- Department and Institute of Psychiatry, University of São Paulo (USP), Brazil
| | - Leonardo F Fontenelle
- Department of Psychiatry and Legal Medicine, Federal University of Rio de Janeiro, D'Or Institute for Research and Education, Brazil; Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Australia
| | - Ygor A Ferrão
- Department of Psychiatry, Federal University of Health Sciences of Porto Alegre, Brazil
| | - Maria C Rosário
- Department of Psychiatry, Federal University of São Paulo (UNIFESP), Brazil
| | - Albina R Torres
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, Univ Estadual Paulista (UNESP), Brazil.
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29
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Abstract
Obsessive-compulsive disorder (OCD) is a highly prevalent and chronic condition that is associated with substantial global disability. OCD is the key example of the 'obsessive-compulsive and related disorders', a group of conditions which are now classified together in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and the International Classification of Diseases, 11th Revision, and which are often underdiagnosed and undertreated. In addition, OCD is an important example of a neuropsychiatric disorder in which rigorous research on phenomenology, psychobiology, pharmacotherapy and psychotherapy has contributed to better recognition, assessment and outcomes. Although OCD is a relatively homogenous disorder with similar symptom dimensions globally, individualized assessment of symptoms, the degree of insight, and the extent of comorbidity is needed. Several neurobiological mechanisms underlying OCD have been identified, including specific brain circuits that underpin OCD. In addition, laboratory models have demonstrated how cellular and molecular dysfunction underpins repetitive stereotyped behaviours, and the genetic architecture of OCD is increasingly understood. Effective treatments for OCD include serotonin reuptake inhibitors and cognitive-behavioural therapy, and neurosurgery for those with intractable symptoms. Integration of global mental health and translational neuroscience approaches could further advance knowledge on OCD and improve clinical outcomes.
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Affiliation(s)
- Dan J. Stein
- Department of Psychiatry, University of Cape Town and SA MRC Unit on Risk & Resilience in Mental Disorders, Cape Town, South Africa
| | - Daniel L. C. Costa
- OCD Research Program, Instituto de Psiquiatria, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Christine Lochner
- Department of Psychiatry, Stellenbosch University and SA MRC Unit on Risk & Resilience in Mental Disorders, Stellenbosch, South Africa
| | - Euripedes C. Miguel
- OCD Research Program, Instituto de Psiquiatria, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Y. C. Janardhan Reddy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Roseli G. Shavitt
- OCD Research Program, Instituto de Psiquiatria, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Odile A. van den Heuvel
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, Netherlands.,Department of Anatomy & Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - H. Blair Simpson
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY, USA
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30
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Miguel EC, Lopes AC, McLaughlin NCR, Norén G, Gentil AF, Hamani C, Shavitt RG, Batistuzzo MC, Vattimo EFQ, Canteras M, De Salles A, Gorgulho A, Salvajoli JV, Fonoff ET, Paddick I, Hoexter MQ, Lindquist C, Haber SN, Greenberg BD, Sheth SA. Evolution of gamma knife capsulotomy for intractable obsessive-compulsive disorder. Mol Psychiatry 2019; 24:218-240. [PMID: 29743581 PMCID: PMC6698394 DOI: 10.1038/s41380-018-0054-0] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 02/26/2018] [Accepted: 03/06/2018] [Indexed: 11/08/2022]
Abstract
For more than half a century, stereotactic neurosurgical procedures have been available to treat patients with severe, debilitating symptoms of obsessive-compulsive disorder (OCD) that have proven refractory to extensive, appropriate pharmacological, and psychological treatment. Although reliable predictors of outcome remain elusive, the establishment of narrower selection criteria for neurosurgical candidacy, together with a better understanding of the functional neuroanatomy implicated in OCD, has resulted in improved clinical efficacy for an array of ablative and non-ablative intervention techniques targeting the cingulum, internal capsule, and other limbic regions. It was against this backdrop that gamma knife capsulotomy (GKC) for OCD was developed. In this paper, we review the history of this stereotactic radiosurgical procedure, from its inception to recent advances. We perform a systematic review of the existing literature and also provide a narrative account of the evolution of the procedure, detailing how the procedure has changed over time, and has been shaped by forces of evidence and innovation. As the procedure has evolved and adverse events have decreased considerably, favorable response rates have remained attainable for approximately one-half to two-thirds of individuals treated at experienced centers. A reduction in obsessive-compulsive symptom severity may result not only from direct modulation of OCD neural pathways but also from enhanced efficacy of pharmacological and psychological therapies working in a synergistic fashion with GKC. Possible complications include frontal lobe edema and even the rare formation of delayed radionecrotic cysts. These adverse events have become much less common with new radiation dose and targeting strategies. Detailed neuropsychological assessments from recent studies suggest that cognitive function is not impaired, and in some domains may even improve following treatment. We conclude this review with discussions covering topics essential for further progress of this therapy, including suggestions for future trial design given the unique features of GKC therapy, considerations for optimizing stereotactic targeting and dose planning using biophysical models, and the use of advanced imaging techniques to understand circuitry and predict response. GKC, and in particular its modern variant, gamma ventral capsulotomy, continues to be a reliable treatment option for selected cases of otherwise highly refractory OCD.
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Affiliation(s)
- Euripedes C Miguel
- Department and Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil.
| | - Antonio C Lopes
- Department and Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Nicole C R McLaughlin
- Departments of Psychiatry and Human Behavior and Neurosurgery, Warren Alpert Medical School of Brown University and Veterans Affairs Medical Center of Providence, Providence, RI, USA
| | - Georg Norén
- Departments of Psychiatry and Human Behavior and Neurosurgery, Warren Alpert Medical School of Brown University and Veterans Affairs Medical Center of Providence, Providence, RI, USA
| | - André F Gentil
- Department and Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Clement Hamani
- Division of Neurosurgery, Sunnybrook Health Sciences Centre, Harquail Centre for Neuromodulation, University of Toronto, Toronto, Ontario, Canada
| | - Roseli G Shavitt
- Department and Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Marcelo C Batistuzzo
- Department and Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Edoardo F Q Vattimo
- Department and Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Miguel Canteras
- Discipline of Neurosurgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | | | | | | | - Erich Talamoni Fonoff
- Department of Neurology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Ian Paddick
- National Hospital for Neurology and Neurosurgery, London, UK
| | - Marcelo Q Hoexter
- Department and Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | | | - Suzanne N Haber
- University of Rochester School of Medicine, Rochester, New York, USA
- McLean Hospital, Harvard University, Boston, USA
| | - Benjamin D Greenberg
- Departments of Psychiatry and Human Behavior and Neurosurgery, Warren Alpert Medical School of Brown University and Veterans Affairs Medical Center of Providence, Providence, RI, USA
| | - Sameer A Sheth
- Discipline of Neurosurgery, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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31
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Copetti ME, Lopes AC, Requena G, Johnson INS, Greenberg BD, Noren G, McLaughlin NCR, Shavitt RG, Miguel EC, Batistuzzo MC, Hoexter MQ. Obsessive-Compulsive Personality Symptoms Predict Poorer Response to Gamma Ventral Capsulotomy for Intractable OCD. Front Psychiatry 2019; 10:936. [PMID: 31998155 PMCID: PMC6962231 DOI: 10.3389/fpsyt.2019.00936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 11/25/2019] [Indexed: 11/13/2022] Open
Abstract
Gamma ventral capsulotomy (GVC) is a radiosurgical procedure which aims to create lesions in the ventral part of the anterior limb of the internal capsule (ALIC). It has been used as a treatment option for patients with intractable obsessive-compulsive disorder (OCD) who do not respond to several first-line treatments attempts. However, changes in personality disorder symptoms after GVC have not been investigated. The aims of this study are to investigate changes in personality disorder symptoms after GVC and to search for baseline personality disorder symptoms that may predict clinical response to GVC. Fourteen treatment-intractable OCD patients who underwent GVC completed the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) at baseline and one year after the procedure. Wilcoxon signed-rank test was performed to investigate personality disorder symptom changes before and after surgery. Linear regression models were utilized to predict treatment response, using baseline personality disorder symptoms as independent variables. We did not observe any quantitative changes in personality disorder symptoms after GVC, compared with baseline. Higher severity of obsessive-compulsive personality disorder symptoms at baseline was correlated with worse treatment response after GVC for OCD (β = -0.085, t-value = -2.52, p-value = 0.027). These findings advocate for the safety of the GVC procedure in this specific population of intractable OCD patients, in terms of personality disorder symptom changes. They also highlight the importance of taking into account the severity of obsessive-compulsive personality disorder symptoms when GVC is indicated for intractable OCD patients.
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Affiliation(s)
- Maria Eugênia Copetti
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Antonio C Lopes
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Guaraci Requena
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Isaac N S Johnson
- Yale School of Medicine, New Haven, CT, United States.,Child Study Center, Yale University, New Haven, CT, United States
| | - Benjamin D Greenberg
- Department of Psychiatry and Human Behavior, Butler Hospital, Warren Alpert Medical School of Brown University, Providence, RI, United States.,Center of Neurorestoration and Neurology, Providence VA Medical Center, Providence, RI, United States
| | - Georg Noren
- Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Nicole C R McLaughlin
- Department of Psychiatry and Human Behavior, Butler Hospital, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Roseli G Shavitt
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Eurípedes C Miguel
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marcelo C Batistuzzo
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marcelo Q Hoexter
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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32
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Brakoulias V, Starcevic V, Albert U, Arumugham SS, Bailey BE, Belloch A, Borda T, Dell'Osso L, Elias JA, Falkenstein MJ, Ferrao YA, Fontenelle LF, Jelinek L, Kalogeraki L, Kay B, Laurito LD, Lochner C, Maina G, Marazziti D, Martin A, Matsunaga H, Miguel EC, Morgado P, Mourikis I, Pasquini M, Perez Rivera R, Potluri S, Reddy JYC, Riemann BC, do Rosario MC, Shavitt RG, Stein DJ, Viswasam K, Wang Z, Fineberg NA. Treatments used for obsessive-compulsive disorder-An international perspective. Hum Psychopharmacol 2019; 34:e2686. [PMID: 30628745 DOI: 10.1002/hup.2686] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/05/2018] [Accepted: 12/11/2018] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The objective of this study was to characterise international trends in the use of psychotropic medication, psychological therapies, and novel therapies used to treat obsessive-compulsive disorder (OCD). METHODS Researchers in the field of OCD were invited to contribute summary statistics on the characteristics of their samples. Consistency of summary statistics across countries was evaluated. RESULTS The study surveyed 19 expert centres from 15 countries (Argentina, Australia, Brazil, China, Germany, Greece, India, Italy, Japan, Mexico, Portugal, South Africa, Spain, the United Kingdom, and the United States) providing a total sample of 7,340 participants. Fluoxetine (n = 972; 13.2%) and fluvoxamine (n = 913; 12.4%) were the most commonly used selective serotonin reuptake inhibitor medications. Risperidone (n = 428; 7.3%) and aripiprazole (n = 415; 7.1%) were the most commonly used antipsychotic agents. Neurostimulation techniques such as transcranial magnetic stimulation, deep brain stimulation, gamma knife surgery, and psychosurgery were used in less than 1% of the sample. There was significant variation in the use and accessibility of exposure and response prevention for OCD. CONCLUSIONS The variation between countries in treatments used for OCD needs further evaluation. Exposure and response prevention is not used as frequently as guidelines suggest and appears difficult to access in most countries. Updated treatment guidelines are recommended.
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Affiliation(s)
- Vlasios Brakoulias
- Department of Psychiatry, Nepean Hospital, Sydney Medical School, The University of Sydney, Penrith, NSW, Australia
| | - Vladan Starcevic
- Department of Psychiatry, Nepean Hospital, Sydney Medical School, The University of Sydney, Penrith, NSW, Australia
| | - Umberto Albert
- Rita Levi Montalcini Department of Neuroscience, University of Turin, Turin, Italy.,Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Shyam Sundar Arumugham
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Brenda E Bailey
- Department of Psychiatry, Rogers Memorial Hospital, Oconomowoc, Wisconsin
| | - Amparo Belloch
- Department of Personality Psychology, Research Unit for Obsessive-Compulsive and Related Disorders, I'TOC, Faculty of Psychology, Universidad de Valencia, Valencia, Spain
| | - Tania Borda
- Department of Psychiatry, Bio-Behavioral Institute BA, Buenos Aires, Argentina.,Department of Psychology, Argentinian Catholic University (UCA), Buenos Aires, Argentina
| | - Liliana Dell'Osso
- Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, Dipartmento di Farmacia, University of Pisa, Pisa, Italy
| | - Jason A Elias
- Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, Massachusetts
| | - Martha J Falkenstein
- Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, Massachusetts
| | - Ygor A Ferrao
- Department of Psychiatry, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Leonardo F Fontenelle
- Department of Psychiatry and Legal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,Department of Psychiatry, D'Or Institute for Research and Education, Rio de Janeiro, Brazil.,Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Victoria
| | - Lena Jelinek
- Department of Psychology, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Leto Kalogeraki
- Behavioral Therapy Department/Outpatient Clinic for OCD and Related Disorders, Division of Psychiatry I, National and Kapodistrian University of Athens, Athens, Greece
| | - Brian Kay
- Department of Psychiatry, Rogers Memorial Hospital, Oconomowoc, Wisconsin
| | - Luana D Laurito
- Department of Psychiatry and Legal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,Department of Psychiatry, D'Or Institute for Research and Education, Rio de Janeiro, Brazil.,Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Victoria
| | - Christine Lochner
- MRC Unit on Anxiety Disorders, Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa
| | - Giuseppe Maina
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Donatella Marazziti
- Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, Dipartmento di Farmacia, University of Pisa, Pisa, Italy
| | - Andrew Martin
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia
| | - Hisato Matsunaga
- Department of Neuropsychiatry, Hyogo College of Medicine, Nishinomiya, Japan
| | - Euripedes C Miguel
- Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal.,Department of Psychiatry, ICVS-3Bs-PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Department of Psychiatry, Hospital de Braga, Braga, Portugal
| | - Irakis Mourikis
- Behavioral Therapy Department/Outpatient Clinic for OCD and Related Disorders, Division of Psychiatry I, National and Kapodistrian University of Athens, Athens, Greece
| | - Massimo Pasquini
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | | | - Sriramya Potluri
- Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, Massachusetts
| | - Janardhan Y C Reddy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Brian C Riemann
- Department of Psychiatry, Rogers Memorial Hospital, Oconomowoc, Wisconsin
| | | | - Roseli G Shavitt
- Department of Psychiatry, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Dan J Stein
- MRC Unit on Anxiety Disorders, Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa
| | - Kirupumani Viswasam
- Department of Psychiatry, Nepean Hospital, Sydney Medical School, The University of Sydney, Penrith, NSW, Australia
| | - Zhen Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Psychiatry, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
| | - Naomi A Fineberg
- Department of Psychiatry, Hertfordshire Partnership University NHS Foundation Trust and University of Hertfordshire, Hatfield, UK
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Shannahoff-Khalsa D, Fernandes RY, Pereira CADB, March JS, Leckman JF, Golshan S, Vieira MSR, Polanczyk GV, Miguel EC, Shavitt RG. Kundalini Yoga Meditation Versus the Relaxation Response Meditation for Treating Adults With Obsessive-Compulsive Disorder: A Randomized Clinical Trial. Front Psychiatry 2019; 10:793. [PMID: 31780963 PMCID: PMC6859828 DOI: 10.3389/fpsyt.2019.00793] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 10/04/2019] [Indexed: 12/17/2022] Open
Abstract
Background: Obsessive-compulsive disorder (OCD) is often a life-long disorder with high psychosocial impairment. Serotonin reuptake inhibitors (SRIs) are the only FDA approved drugs, and approximately 50% of patients are non-responders when using a criterion of 25% to 35% improvement with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). About 30% are non-responders to combined first-line therapies (SRIs and exposure and response prevention). Previous research (one open, one randomized clinical trial) has demonstrated that Kundalini Yoga (KY) meditation can lead to an improvement in symptoms of obsessive-compulsive severity. We expand here with a larger trial. Design: This trial compared two parallel run groups [KY vs. Relaxation Response meditation (RR)]. Patients were randomly allocated based on gender and Y-BOCS scores. They were told two different (unnamed) types of meditation would be compared, and informed if one showed greater benefits, the groups would merge for 12 months using the more effective intervention. Raters were blind in Phase One (0-4.5 months) to patient assignments, but not in Phase Two. Main Outcome Measures: Primary outcome variable, clinician-administered Y-BOCS. Secondary scales: Dimensional Yale-Brown Obsessive Compulsive Scale (clinician-administered), Profile of Mood Scales, Beck Anxiety Inventory, Beck Depression Inventory, Clinical Global Impression, Short Form 36 Health Survey. Results: Phase One: Baseline Y-BOCS scores: KY mean = 26.46 (SD 5.124; N = 24), RR mean = 26.79 (SD = 4.578; N = 24). An intent-to-treat analysis with the last observation carried forward for dropouts showed statistically greater improvement with KY compared to RR on the Y-BOCS, and statistically greater improvement on five of six secondary measures. For completers, the Y-BOCS showed 40.4% improvement for KY (N = 16), 17.9% for RR (N = 11); 31.3% in KY were judged to be in remission compared to 9.1% in RR. KY completers showed greater improvement on five of six secondary measures. At the end of Phase Two (12 months), patients, drawn from the initial groups, who elected to receive KY continued to show improvement in their Y-BOCS scores. Conclusion: KY shows promise as an add-on option for OCD patients unresponsive to first line therapies. Future studies will establish KY's relative efficacy compared to Exposure and Response Prevention and/or medications, and the most effective treatment schedule. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT01833442.
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Affiliation(s)
- David Shannahoff-Khalsa
- BioCircuits Institute, University of California, San Diego, La Jolla, CA, United States.,Center for Integrative Medicine, University of California, San Diego, La Jolla, CA, United States.,The Khalsa Foundation for Medical Science, Del Mar, CA, United States
| | - Rodrigo Yacubian Fernandes
- The National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Carlos A de B Pereira
- Mathematics and Statistics Institute, Statistics Department, University of São Paulo, São Paulo, Brazil
| | - John S March
- Department of Psychiatry and Behavioral Sciences, Duke School of Medicine, Durham, NC, United States
| | - James F Leckman
- Child Study Center, Department of Pediatrics and Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Shahrokh Golshan
- Center for Integrative Medicine, University of California, San Diego, La Jolla, CA, United States.,Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | | | - Guilherme V Polanczyk
- The National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Euripedes C Miguel
- The National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Roseli G Shavitt
- The National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
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Skinazi M, de Mathis MA, Cohab T, de Marco E Souza M, Shavitt RG, Miguel EC, Hoexter MQ, Batistuzzo MC. No evidence of attentional bias toward angry faces in patients with obsessive-compulsive disorder. ACTA ACUST UNITED AC 2018; 41:257-260. [PMID: 30540026 PMCID: PMC6794136 DOI: 10.1590/1516-4446-2018-0130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 09/12/2018] [Indexed: 11/21/2022]
Abstract
Objective: Although attentional bias (AB) toward angry faces is well established in patients with anxiety disorders, it is still poorly studied in obsessive-compulsive disorder (OCD). We investigated whether OCD patients present AB toward angry faces, whether AB is related to symptom severity and whether AB scores are associated with specific OCD symptom dimensions. Method: Forty-eight OCD patients were assessed in clinical evaluations, intelligence testing and a dot-probe AB paradigm that used neutral and angry faces as stimuli. Analyses were performed with a one-sample t-test, Pearson correlations and linear regression. Results: No evidence of AB was observed in OCD patients, nor was there any association between AB and symptom severity or dimension. Psychiatric comorbidity did not affect our results. Conclusion: In accordance with previous studies, we were unable to detect AB in OCD patients. To investigate whether OCD patients have different brain activation patterns from anxiety disorder patients, future studies using a transdiagnostic approach should evaluate AB in OCD and anxiety disorder patients as they perform AB tasks under functional neuroimaging protocols.
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Affiliation(s)
- Michele Skinazi
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.,Universidade Presbiteriana Mackenzie, São Paulo, SP, Brazil
| | - Maria A de Mathis
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Tatiana Cohab
- Universidade Presbiteriana Mackenzie, São Paulo, SP, Brazil
| | - Marina de Marco E Souza
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Roseli G Shavitt
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Euripedes C Miguel
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Marcelo Q Hoexter
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Marcelo C Batistuzzo
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
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35
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Franco RR, Fonoff ET, Alvarenga PG, Alho EJL, Lopes AC, Hoexter MQ, Batistuzzo MC, Paiva RR, Taub A, Shavitt RG, Miguel EC, Teixeira MJ, Damiani D, Hamani C. Assessment of Safety and Outcome of Lateral Hypothalamic Deep Brain Stimulation for Obesity in a Small Series of Patients With Prader-Willi Syndrome. JAMA Netw Open 2018; 1:e185275. [PMID: 30646396 PMCID: PMC6324383 DOI: 10.1001/jamanetworkopen.2018.5275] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
IMPORTANCE Deep brain stimulation (DBS) has been investigated for treatment of morbid obesity with variable results. Patients with Prader-Willi syndrome (PWS) present with obesity that is often difficult to treat. OBJECTIVE To test the safety and study the outcome of DBS in patients with PWS. DESIGN, SETTING, AND PARTICIPANTS This case series was conducted in the Hospital das Clínicas, University of São Paulo, Brazil. Four patients with genetically confirmed PWS presenting with severe obesity were included. EXPOSURE Deep brain stimulation electrodes were bilaterally implanted in the lateral hypothalamic area. After DBS implantation, the treatment included the following phases: titration (1-2 months), stimulation off (2 months), low-frequency DBS (40 Hz; 1 month), washout (15 days), high-frequency DBS (130 Hz; 1 month), and long-term follow-up (6 months). MAIN OUTCOMES AND MEASURES Primary outcome measures were adverse events recorded during stimulation and long-term DBS treatment. Secondary outcomes consisted of changes in anthropometric measures (weight, body mass index [calculated as weight in kilograms divided by height in meters squared], and abdominal and neck circumference), bioimpedanciometry, and calorimetry after 6 months of treatment compared with baseline. The following evaluations and measurements were conducted before and after DBS: clinical, neurological, psychiatric, neuropsychological, anthropometry, calorimetry, blood workup, hormonal levels, and sleep studies. Adverse effects were monitored during all follow-up visits. RESULTS Four patients with PWS were included (2 male and 2 female; ages 18-28 years). Baseline mean (SD) body mass index was 39.6 (11.1). Two patients had previous bariatric surgery, and all presented with psychiatric comorbidity, which was well controlled with the use of medications. At 6 months after long-term DBS, patients had a mean 9.6% increase in weight, 5.8% increase in body mass index, 8.4% increase in abdominal circumference, 4.2% increase in neck circumference, 5.3% increase in the percentage of body fat, and 0% change in calorimetry compared with baseline. Also unchanged were hormonal levels and results of blood workup, sleep studies, and neuropsychological evaluations. Two patients developed stimulation-induced manic symptoms. Discontinuation of DBS controlled this symptom in 1 patient. The other required adjustments in medication dosage. Two infections were documented, 1 associated with skin picking. CONCLUSIONS AND RELEVANCE Safety of lateral hypothalamic area stimulation was in the range of that demonstrated in patients with similar psychiatric conditions receiving DBS. In the small cohort of patients with PWS treated in our study, DBS was largely ineffective.
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Affiliation(s)
- Ruth R. Franco
- Children’s Institute, Division of Pediatric Endocrinology, University of São Paulo Medical School, São Paulo, Brazil
| | - Erich T. Fonoff
- Division of Functional Neurosurgery of Institute of Psychiatry, Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil
| | - Pedro G. Alvarenga
- Institute of Psychiatry, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Eduardo J. L. Alho
- Division of Functional Neurosurgery of Institute of Psychiatry, Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil
| | - Antonio Carlos Lopes
- Institute of Psychiatry, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Marcelo Q. Hoexter
- Institute of Psychiatry, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Marcelo C. Batistuzzo
- Institute of Psychiatry, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Raquel R. Paiva
- Institute of Psychiatry, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Anita Taub
- Institute of Psychiatry, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Roseli G. Shavitt
- Institute of Psychiatry, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Euripides C. Miguel
- Institute of Psychiatry, Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Manoel J. Teixeira
- Division of Functional Neurosurgery of Institute of Psychiatry, Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil
| | - Durval Damiani
- Children’s Institute, Division of Pediatric Endocrinology, University of São Paulo Medical School, São Paulo, Brazil
| | - Clement Hamani
- Division of Functional Neurosurgery of Institute of Psychiatry, Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil
- Harquail Centre for Neuromodulation, Division of Neurosurgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
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Fatori D, de Bragança Pereira CA, Asbahr FR, Requena G, Alvarenga PG, de Mathis MA, Rohde LA, Leckman JF, March JS, Polanczyk GV, Miguel EC, Shavitt RG. Adaptive treatment strategies for children and adolescents with Obsessive-Compulsive Disorder: A sequential multiple assignment randomized trial. J Anxiety Disord 2018; 58:42-50. [PMID: 30025255 DOI: 10.1016/j.janxdis.2018.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 06/19/2018] [Accepted: 07/09/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE This sequential multiple assignment randomized trial (SMART) tested the effect of beginning treatment of childhood OCD with fluoxetine (FLX) or group cognitive-behavioral therapy (GCBT) accounting for treatment failures over time. METHODS A two-stage, 28-week SMART was conducted with 83 children and adolescents with OCD. Participants were randomly allocated to GCBT or FLX for 14 weeks. Responders to the initial treatment remained in the same regimen for additional 14 weeks. Non-responders, defined by less than 50% reduction in baseline Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) scores, were re-randomized to either switch to or add the other treatment. Assessments were performed at baseline, 7, 14, 21, and 28 weeks. RESULTS Among the 43 children randomized to FLX who completed the first stage, 15 (41.7%) responded to treatment and 21 non-responders were randomized to switch to (N = 9) or add GCBT (N = 12). Among the 40 children randomized to GCBT who completed the first stage, 18 (51.4%) responded to treatment and 17 non-responders were randomized to switch to (N = 9) or add FLX (N = 8). Primary analysis showed that significant improvement occurred in children initially treated with either FLX or GCBT. Each time point was statistically significant, showing a linear trend of symptom reduction. Effect sizes were large within (0.76-0.78) and small between (-0.05) groups. CONCLUSIONS Fluoxetine and GCBT are similarly effective initial treatments for childhood OCD considering treatment failures over time. Consequently, provision of treatment for childhood OCD could be tailored according to the availability of local resources.
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Affiliation(s)
- Daniel Fatori
- Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil.
| | | | - Fernando R Asbahr
- Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Guaraci Requena
- Institute of Mathematics and Statistics, University of Sao Paulo, Sao Paulo, Brazil
| | - Pedro G Alvarenga
- Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | | | - Luis A Rohde
- Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil; Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - James F Leckman
- Child Study Center, School of Medicine, Yale University, New Haven, CT, USA
| | - John S March
- Division of Neurosciences Medicine, Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA
| | - Guilherme V Polanczyk
- Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
| | - Eurípedes C Miguel
- Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
| | - Roseli G Shavitt
- Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
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Paiva RR, Batistuzzo MC, McLaughlin NC, Canteras MM, de Mathis ME, Requena G, Shavitt RG, Greenberg BD, Norén G, Rasmussen SA, Tavares H, Miguel EC, Lopes AC, Hoexter MQ. Personality measures after gamma ventral capsulotomy in intractable OCD. Prog Neuropsychopharmacol Biol Psychiatry 2018; 81:161-168. [PMID: 29100975 DOI: 10.1016/j.pnpbp.2017.10.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 10/30/2017] [Accepted: 10/31/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Neurosurgeries such as gamma ventral capsulotomy (GVC) are an option for otherwise intractable obsessive-compulsive disorder (OCD) patients. In general, clinical and neuropsychological status both improve after GVC. However, its consequences on personality traits are not well-studied. The objective of this study was to investigate personality changes after one year of GVC in intractable OCD patients. METHODS The personality assessment was conducted using the Revised NEO Personality Inventory (NEO PI-R) and Cloninger's Temperament and Character Inventory (TCI) in 14 intractable OCD patients before and one year after GVC. Comparisons of personality features between treatment responders (n=5) and non-responders (n=9) were performed. Multiple linear regression was also used for predicting changes in clinical and global functioning variables. RESULTS Overall, no deleterious effect was found in personality after GVC. Responders had a reduction in neuroticism (p=0.043) and an increase in extraversion (p=0.043). No significant changes were observed in non-responders. Increases in novelty seeking and self-directedness, and decreases in persistence and cooperativiness predicted OCD symptom improvement. Similary, improvement in functioning was also predicted by hgher novelty seeking and self-directedness after GVC, whereas better functioning was also associated with lower reward dependence and cooperativeness after surgery. CONCLUSIONS The pattern of changes in personality traits after GVC was generally towards that observed in nonclinical population, and does not raise safety concerns.
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Affiliation(s)
- Raquel R Paiva
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
| | - Marcelo C Batistuzzo
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Nicole C McLaughlin
- Department of Psychiatry and Human Behavior, Butler Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Miguel M Canteras
- Institute of Neurological Radiosurgery, Hospital Santa Paula, São Paulo, Brazil
| | - Maria E de Mathis
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Guaraci Requena
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Roseli G Shavitt
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Benjamin D Greenberg
- Department of Psychiatry and Human Behavior, Butler Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA; Center of Neurorestoration and Neurology, Providence VA Medical Center, RI, USA
| | - Georg Norén
- Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Steven A Rasmussen
- Department of Psychiatry and Human Behavior, Butler Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Hermano Tavares
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Eurípedes C Miguel
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Antonio C Lopes
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Marcelo Q Hoexter
- Department & Institute of Psychiatry, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
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Shavitt RG, Requena G, Alonso P, Zai G, Costa DLC, de Bragança Pereira CA, do Rosário MC, Morais I, Fontenelle L, Cappi C, Kennedy J, Menchon JM, Miguel E, Richter PMA. Quantifying dimensional severity of obsessive-compulsive disorder for neurobiological research. Prog Neuropsychopharmacol Biol Psychiatry 2017; 79:206-212. [PMID: 28673486 DOI: 10.1016/j.pnpbp.2017.06.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 06/27/2017] [Accepted: 06/29/2017] [Indexed: 10/19/2022]
Abstract
Current research to explore genetic susceptibility factors in obsessive-compulsive disorder (OCD) has resulted in the tentative identification of a small number of genes. However, findings have not been readily replicated. It is now broadly accepted that a major limitation to this work is the heterogeneous nature of this disorder, and that an approach incorporating OCD symptom dimensions in a quantitative manner may be more successful in identifying both common as well as dimension-specific vulnerability genetic factors. As most existing genetic datasets did not collect specific dimensional severity ratings, a specific method to reliably extract dimensional ratings from the most widely used severity rating scale, the Yale-Brown Obsessive Compulsive Scale (YBOCS), for OCD is needed. This project aims to develop and validate a novel algorithm to extrapolate specific dimensional symptom severity ratings in OCD from the existing YBOCS for use in genetics and other neurobiological research. To accomplish this goal, we used a large data set comprising adult subjects from three independent sites: the Brazilian OCD Consortium, the Sunnybrook Health Sciences Centre in Toronto, Canada and the Hospital of Bellvitge, in Barcelona, Spain. A multinomial logistic regression was proposed to model and predict the quantitative phenotype [i.e., the severity of each of the five homogeneous symptom dimensions of the Dimensional YBOCS (DYBOCS)] in subjects who have only YBOCS (categorical) data. YBOCS and DYBOCS data obtained from 1183 subjects were used to build the model, which was tested with the leave-one-out cross-validation method. The model's goodness of fit, accepting a deviation of up to three points in the predicted DYBOCS score, varied from 78% (symmetry/order) to 84% (cleaning/contamination and hoarding dimensions). These results suggest that this algorithm may be a valuable tool for extracting dimensional phenotypic data for neurobiological studies in OCD.
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Affiliation(s)
- Roseli G Shavitt
- Department of Psychiatry, University of São Paulo, School of Medicine, Rua Dr. Ovídio Pires de Campo, 785/3(o). andar-sala 7. CEP 01060-970 São Paulo, Brazil.
| | - Guaraci Requena
- Institute of Mathematics and Statistics, University of Sao Paulo, R. do Matão, 1010 - Vila Universitaria, São Paulo, SP CEP 05508-090, Brazil
| | - Pino Alonso
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain; Bellvitge Biomedical Research Institute (IDIBELL), Centro de Investigación en Red de Salud Mental, Carlos III Health Institute, Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Feixa Llarga, s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Gwyneth Zai
- Sunnybrook Health Sciences Centre, Centre for Addiction and Mental Health, 2075 Bayview Avenue, Suite FG42, Toronto, ON M4N 3M5, Canada.
| | - Daniel L C Costa
- Department of Psychiatry, University of São Paulo, School of Medicine, Rua Dr. Ovídio Pires de Campo, 785/3(o). andar-sala 7. CEP 01060-970 São Paulo, Brazil
| | - Carlos Alberto de Bragança Pereira
- Institute of Mathematics and Statistics, University of Sao Paulo, R. do Matão, 1010 - Vila Universitaria, São Paulo, SP CEP 05508-090, Brazil
| | - Maria Conceição do Rosário
- Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), Rua Borges Lagoa 570, CEP04038-020 São Paulo, Brazil
| | - Ivanil Morais
- Department of Psychiatry, University of São Paulo, School of Medicine, Rua Dr. Ovídio Pires de Campo, 785/3(o). andar-sala 7. CEP 01060-970 São Paulo, Brazil
| | - Leonardo Fontenelle
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, Brazil. Av. Venceslau Braz, 71 fundos. Botafogo, Rio de Janeiro, RJ, 22290-140, Brazil
| | - Carolina Cappi
- Department of Psychiatry, University of São Paulo, School of Medicine, Rua Dr. Ovídio Pires de Campo, 785/3(o). andar-sala 7. CEP 01060-970 São Paulo, Brazil
| | - James Kennedy
- Sunnybrook Health Sciences Centre, Centre for Addiction and Mental Health, 2075 Bayview Avenue, Suite FG42, Toronto, ON M4N 3M5, Canada.
| | - Jose M Menchon
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain; Bellvitge Biomedical Research Institute (IDIBELL), Centro de Investigación en Red de Salud Mental, Carlos III Health Institute, Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Feixa Llarga, s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Euripedes Miguel
- Department of Psychiatry, University of São Paulo, School of Medicine, Rua Dr. Ovídio Pires de Campo, 785/3(o). andar-sala 7. CEP 01060-970 São Paulo, Brazil
| | - Peggy M A Richter
- Sunnybrook Health Sciences Centre, Centre for Addiction and Mental Health, 2075 Bayview Avenue, Suite FG42, Toronto, ON M4N 3M5, Canada.
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Costa DLDC, Barbosa VS, Requena G, Shavitt RG, Pereira CADB, Diniz JB. Dissecting the Yale-Brown Obsessive-Compulsive Scale severity scale to understand the routes for symptomatic improvement in obsessive-compulsive disorder. J Psychopharmacol 2017; 31:1312-1322. [PMID: 28441896 DOI: 10.1177/0269881117705087] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We aimed to investigate which items of the Yale-Brown Obsessive-Compulsive Severity Scale best discriminate the reduction in total scores in obsessive-compulsive disorder patients after 4 and 12 weeks of pharmacological treatment. Data from 112 obsessive-compulsive disorder patients who received fluoxetine (⩽80 mg/day) for 12 weeks were included. Improvement indices were built for each Yale-Brown Obsessive-Compulsive Severity Scale item at two timeframes: from baseline to week 4 and from baseline to week 12. Indices for each item were correlated with the total scores for obsessions and compulsions and then ranked by correlation coefficient. A correlation coefficient ⩾0.7 was used to identify items that contributed significantly to reducing obsessive-compulsive disorder severity. At week 4, the distress items reached the threshold of 0.7 for improvement on the obsession and compulsion subscales although, contrary to our expectations, there was greater improvement in the control items than in the distress items. At week 12, there was greater improvement in the time, interference, and control items than in the distress items. The use of fluoxetine led first to reductions in distress and increases in control over symptoms before affecting the time spent on, and interference from, obsessions and compulsions. Resistance did not correlate with overall improvement. Understanding the pathway of improvement with pharmacological treatment in obsessive-compulsive disorder may provide clues about how to optimize the effects of medication.
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Affiliation(s)
| | - Veronica S Barbosa
- 2 Institute of Mathematics and Statistics, University of São Paulo, São Paulo, Brazil
| | - Guaraci Requena
- 2 Institute of Mathematics and Statistics, University of São Paulo, São Paulo, Brazil
| | - Roseli G Shavitt
- 1 Department and Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
| | | | - Juliana B Diniz
- 1 Department and Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
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Brakoulias V, Starcevic V, Belloch A, Brown C, Ferrao YA, Fontenelle LF, Lochner C, Marazziti D, Matsunaga H, Miguel EC, Reddy YCJ, do Rosario MC, Shavitt RG, Shyam Sundar A, Stein DJ, Torres AR, Viswasam K. Comorbidity, age of onset and suicidality in obsessive-compulsive disorder (OCD): An international collaboration. Compr Psychiatry 2017; 76:79-86. [PMID: 28433854 DOI: 10.1016/j.comppsych.2017.04.002] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 02/16/2017] [Accepted: 04/08/2017] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES To collate data from multiple obsessive-compulsive disorder (OCD) treatment centers across seven countries and five continents, and to report findings in relation to OCD comorbidity, age of onset of OCD and comorbid disorders, and suicidality, in a large clinical and ethnically diverse sample, with the aim of investigating cultural variation and the utility of the psychiatric diagnostic classification of obsessive-compulsive and related disorders. METHODS Researchers in the field of OCD were invited to contribute summary statistics on current and lifetime psychiatric comorbidity, age of onset of OCD and comorbid disorders and suicidality in their patients with OCD. RESULTS Data from 3711 adult patients with primary OCD came from Brazil (n=955), India (n=802), Italy (n=750), South Africa (n=565), Japan (n=322), Australia (n=219), and Spain (n=98). The most common current comorbid disorders were major depressive disorder (28.4%; n=1055), obsessive-compulsive personality disorder (24.5%, n=478), generalized anxiety disorder (19.3%, n=716), specific phobia (19.2%, n=714) and social phobia (18.5%, n=686). Major depression was also the most commonly co-occurring lifetime diagnosis, with a rate of 50.5% (n=1874). OCD generally had an age of onset in late adolescence (mean=17.9years, SD=1.9). Social phobia, specific phobia and body dysmorphic disorder also had an early age of onset. Co-occurring major depressive disorder, generalized anxiety disorder and psychotic disorders tended to have a later age of onset than OCD. Suicidal ideation within the last month was reported by 6.4% (n=200) of patients with OCD and 9.0% (n=314) reported a lifetime history of suicide attempt. CONCLUSIONS In this large cross-continental study, comorbidity in OCD was common. The high rates of comorbid major depression and anxiety disorders emphasize the need for clinicians to assess and monitor for these disorders. Earlier ages of onset of OCD, specific phobia and social phobia may indicate some relatedness between these disorders, but this requires further study. Although there do not appear to be significant cultural variations in rates or patterns of comorbidity and suicidality, further research using similar recruitment strategies and controlling for demographic and clinical variables may help to determine whether any sociocultural factors protect against suicidal ideation or psychiatric comorbidity in patients with OCD.
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Affiliation(s)
- V Brakoulias
- Department of Psychiatry, The University of Sydney and Nepean Hospital, Sydney Medical School-Nepean, Discipline of Psychiatry, Sydney/Penrith, NSW, Australia.
| | - V Starcevic
- Department of Psychiatry, The University of Sydney and Nepean Hospital, Sydney Medical School-Nepean, Discipline of Psychiatry, Sydney/Penrith, NSW, Australia
| | - A Belloch
- Department of Personality Psychology, Research Unit for Obsessive-Compulsive and Related Disorders, I'TOC, Faculty of Psychology, Universidad de Valencia, Spain
| | - C Brown
- NHMRC Clinical Trials Centre, the University of Sydney, Sydney, NSW, Australia
| | - Y A Ferrao
- Department of Psychiatry, Federal University of Health Sciences of Porto Alegre, Brazil
| | - L F Fontenelle
- Department of Psychiatry and Legal Medicine, Federal University of Rio de Janeiro, D'Or Institute for Research and Education, Brazil; Monash Institute of Cognitive and Clinical Neurosciences, Monash University
| | - C Lochner
- MRC Unit on Anxiety Disorders, Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa
| | - D Marazziti
- Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, Dipartmento di Farmacia, Univeristy of Pisa, Italy
| | - H Matsunaga
- Department of Neuropsychiatry, Hyogo College of Medicine, Hyogo, Japan
| | - E C Miguel
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Brazil
| | - Y C J Reddy
- Department of Psychiatry National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - M C do Rosario
- Child and Adolescent Psychiatry Unit (UPIA) at the Department of Psychiatry, Federal University of São Paulo (UNIFESP), Brazil
| | - R G Shavitt
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Brazil
| | - A Shyam Sundar
- Department of Psychiatry National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - D J Stein
- MRC Unit on Anxiety Disorders, Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa
| | - A R Torres
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, Univ Estadual Paulista (UNESP), Brazil
| | - K Viswasam
- Department of Psychiatry, The University of Sydney and Nepean Hospital, Sydney Medical School-Nepean, Discipline of Psychiatry, Sydney/Penrith, NSW, Australia
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Costa DLC, Diniz JB, Requena G, Joaquim MA, Pittenger C, Bloch MH, Miguel EC, Shavitt RG. Randomized, Double-Blind, Placebo-Controlled Trial of N-Acetylcysteine Augmentation for Treatment-Resistant Obsessive-Compulsive Disorder. J Clin Psychiatry 2017; 78:e766-e773. [PMID: 28617566 DOI: 10.4088/jcp.16m11101] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 10/06/2016] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To evaluate the efficacy of serotonin reuptake inhibitor (SRI) augmentation with N-acetylcysteine (NAC), a glutamate modulator and antioxidant medication, for treatment-resistant obsessive-compulsive disorder (OCD). METHODS We conducted a randomized, double-blind, placebo-controlled, 16-week trial of NAC (3,000 mg daily) in adults (aged 18-65 years) with treatment-resistant OCD, established according to DSM-IV criteria. Forty subjects were recruited at an OCD-specialized outpatient clinic at a tertiary hospital (May 2012-October 2014). The primary outcome measure was the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores. To evaluate the variables group, time, and interaction effects for Y-BOCS scores at all time points, we used nonparametric analysis of variance with repeated measures. Secondary outcomes were the severity scores for anxiety, depression, specific OCD symptom dimensions, and insight. RESULTS Both groups showed a significant reduction of baseline Y-BOCS scores at week 16: the NAC group had a reduction of 4.3 points (25.6 to 21.3), compared with 3.0 points (24.8 to 21.8) for the placebo group. However, there were no significant differences between groups (P = .92). Adding NAC was superior to placebo in reducing anxiety symptoms (P = .02), but not depression severity or specific OCD symptom dimensions. In general, NAC was well tolerated, despite abdominal pain being more frequently reported in the NAC group (n [%]: NAC = 9 [60.0], placebo = 2 [13.3]; P < .01). CONCLUSIONS Our trial did not demonstrate a significant benefit of NAC in reducing OCD severity in treatment-resistant OCD adults. Secondary analysis suggested that NAC might have some benefit in reducing anxiety symptoms in treatment-resistant OCD patients. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01555970.
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Affiliation(s)
- Daniel L C Costa
- Department & Institute of Psychiatry, University of São Paulo Medical School, Rua Dr, Ovídio Pires de Campos, 485, 3° andar, CEAPESQ, sala 7, CEP 05403-010, São Paulo-SP, Brazil. .,Department & Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Juliana B Diniz
- Department & Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Guaraci Requena
- Department & Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.,Institute of Mathematics and Statistics, University of São Paulo, São Paulo, Brazil
| | - Marinês A Joaquim
- Department & Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | | | - Michael H Bloch
- Child Study Center, Yale University, New Haven, Connecticut, USA
| | - Euripedes C Miguel
- Department & Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Roseli G Shavitt
- Department & Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
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Saad LO, do Rosario MC, Cesar RC, Batistuzzo MC, Hoexter MQ, Manfro GG, Shavitt RG, Leckman JF, Miguel EC, Alvarenga PG. The Child Behavior Checklist-Obsessive-Compulsive Subscale Detects Severe Psychopathology and Behavioral Problems Among School-Aged Children. J Child Adolesc Psychopharmacol 2017; 27:342-348. [PMID: 28151703 PMCID: PMC5439443 DOI: 10.1089/cap.2016.0125] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The aims of this study were (1) to assess obsessive-compulsive symptoms (OCS) dimensionally in a school-aged community sample and to correlate them with clinical and demographical variables; (2) to determine a subgroup with significant OCS ("at-risk for OCD") using the Child Behavior Checklist (CBCL-OCS) and (3) to compare it with the rest of the sample; (4) To review the CBCL-OCS subscale properties as a screening tool for pediatric OCD. METHODS Data from the Brazilian High Risk Cohort were analyzed. The presence and severity of OCS were assessed through the CBCL-OCS subscale. DSM-IV psychiatric diagnoses were obtained by the Developmental and Well-Being Assessment. Behavioral problems were assessed using the Strengths and Difficulties Questionnaire, the Youth Strengths Inventory, and the CBCL internalizing and externalizing behavior subscales. RESULTS A total of 2512 (mean age: 8.86 ± 1.84 years; 55.0% male) children were included. Moderate correlations were found between OCS severity and functional impairment (r = 0.36, p < 0.001). Children with higher levels of OCS had higher rates of psychiatric comorbidity and behavioral problems (p < 0.001). A score of 5 or higher in the CBCL-OCS scale determined an "at-risk for OCD" subgroup, comprising 9.7% of the sample (n = 244), with behavioral patterns and psychiatric comorbidities (e.g., tics [odds ratios, OR = 6.41, p < 0.001]), anxiety disorders grouped [OR = 3.68, p < 0.001] and depressive disorders [OR = 3.0, p < 0.001] very similar to those described in OCD. Sensitivity, specificity, positive predictive value, and negative predictive value of the CBCL-OCS for OCD diagnosis were, respectively, 48%, 91.5%; 15.1%, and 98.2%. CONCLUSIONS The dimensional approach suggests that the presence of OCS in children is associated with higher rates of comorbidity, behavioral problems, and impairment. The "at-risk for OCD" group defined by the CBCL revealed a group of patients phenotypically similar to full blown OCD.
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Affiliation(s)
- Laura O. Saad
- Department of Psychiatry, University of São Paulo Medical School (USP), São Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
| | - Maria C. do Rosario
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil.,Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Raony C. Cesar
- Department of Psychiatry, University of São Paulo Medical School (USP), São Paulo, Brazil
| | - Marcelo C. Batistuzzo
- Department of Psychiatry, University of São Paulo Medical School (USP), São Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
| | - Marcelo Q. Hoexter
- Department of Psychiatry, University of São Paulo Medical School (USP), São Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
| | - Gisele G. Manfro
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil.,Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Roseli G. Shavitt
- Department of Psychiatry, University of São Paulo Medical School (USP), São Paulo, Brazil
| | - James F. Leckman
- Department of Psychiatry, University of São Paulo Medical School (USP), São Paulo, Brazil.,Child Study Center, Yale School of Medicine, New Haven, Connecticut
| | - Eurípedes C. Miguel
- Department of Psychiatry, University of São Paulo Medical School (USP), São Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
| | - Pedro G. Alvarenga
- Department of Psychiatry, University of São Paulo Medical School (USP), São Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
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Brakoulias V, Starcevic V, Belloch A, Dell'Osso L, Ferrão YA, Fontenelle LF, Lochner C, Marazziti D, Martin A, Matsunaga H, Miguel EC, Reddy YCJ, do Rosário MC, Shavitt RG, Sundar AS, Stein DJ, Viswasam K. International prescribing practices in obsessive-compulsive disorder (OCD). Hum Psychopharmacol 2016; 31:319-24. [PMID: 27271200 DOI: 10.1002/hup.2541] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 04/21/2016] [Accepted: 05/03/2016] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To assess rates of psychotropic medication use in patients with obsessive-compulsive disorder (OCD) in seven different countries on five continents and to compare these with international treatment guidelines. METHODS Researchers in the field of OCD were invited to contribute summary statistics on the characteristics of their patients with OCD and on their incidence of psychotropic use. Consistency of summary statistics across countries was evaluated. RESULTS The data came from Brazil (n = 955), Italy (n = 750), South Africa (n = 555), Japan (n = 382), Australia (n = 213), India (n = 202) and Spain (n = 82). The majority (77.9%; n = 2445) of the total sample of 3139 participants received a psychotropic medication. Consistent with international guidelines, selective serotonin reuptake inhibitors (SSRIs) were most commonly used (73.5%, n = 1796), but their use ranged from 59% in Australia to 96% in Japan. Clomipramine use varied from 5% in Japan and South Africa to 26% in India and Italy. Atypical antipsychotic use ranged from 12% in South Africa to 50% in Japan. CONCLUSIONS Pharmacotherapy for OCD varied significantly across sites. Prospective studies are required to determine the cultural, pharmacoeconomic and pharmacogenomic factors that may play a role in the variation in prescribing practices internationally and whether these variations influence treatment outcomes. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Vlasios Brakoulias
- Department of Psychiatry, The University of Sydney and Nepean Hospital, Sydney Medical School-Nepean, Discipline of Psychiatry, Sydney/Penrith, NSW, Australia
| | - Vladan Starcevic
- Department of Psychiatry, The University of Sydney and Nepean Hospital, Sydney Medical School-Nepean, Discipline of Psychiatry, Sydney/Penrith, NSW, Australia
| | - Amparo Belloch
- Department of Personality Psychology, Research Unit for Obsessive-Compulsive and Related Disorders, I'TOC, Faculty of Psychology, Universidad de Valencia, Spain
| | - Liliana Dell'Osso
- Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, Dipartmento di Farmacia, University of Pisa, Italy
| | - Ygor A Ferrão
- Department of Psychiatry, Federal University of Health Sciences of Porto Alegre, Brazil
| | - Leonardo F Fontenelle
- Department of Psychiatry and Legal Medicine, Federal University of Rio de Janeiro, Brazil.,D'Or Institute for Research and Education; Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Australia
| | - Christine Lochner
- MRC Unit on Anxiety Disorders, Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa
| | - Donatella Marazziti
- Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, Dipartmento di Farmacia, University of Pisa, Italy
| | - Andrew Martin
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia
| | - Hisato Matsunaga
- Department of Neuropsychiatry, Hyogo College of Medicine, Hyogo, Japan
| | - Euripedes C Miguel
- Department and Institute of Psychiatry, University of São Paulo School of Medicine, Brazil
| | - Y C Janardhan Reddy
- Department of Psychiatry National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Maria C do Rosário
- Child and Adolescent Psychiatry Unit (UPIA) at the Department of Psychiatry, Federal University of São Paulo, Brazil
| | - Roseli G Shavitt
- Department and Institute of Psychiatry, University of São Paulo School of Medicine, Brazil
| | - Arumugham Shyam Sundar
- Department of Psychiatry National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - Dan Joseph Stein
- MRC Unit on Anxiety Disorders, Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa
| | - Kirupamani Viswasam
- Department of Psychiatry, The University of Sydney and Nepean Hospital, Sydney Medical School-Nepean, Discipline of Psychiatry, Sydney/Penrith, NSW, Australia
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Dos Santos-Ribeiro S, Lins-Martins NM, Frydman I, Conceição do Rosário M, Ferrão YA, Shavitt RG, Yücel M, Miguel EC, Fontenelle LF. Prevalence and correlates of electroconvulsive therapy delivery in 1001 obsessive-compulsive disorder outpatients. Psychiatry Res 2016; 239:145-8. [PMID: 27137976 DOI: 10.1016/j.psychres.2016.03.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 03/03/2016] [Accepted: 03/07/2016] [Indexed: 11/17/2022]
Abstract
Individuals with obsessive-compulsive disorder (OCD) who sought treatment in seven different specialized centers (n=1001) were evaluated with a structured assessment battery. Thirteen OCD patients (1.3% of the sample) reported having been treated with electroconvulsive therapy (ECT) in the past. They were older and exhibited higher global severity of OCD symptoms, but were less likely to display symmetry/ordering and contamination/washing symptoms. They also had greater suicidality and increased rates of psychosis. Finally, OCD patients exposed to ECT were more frequently treated with antipsychotics, although they did not differ in terms of responses to adequate trials with serotonin reuptake inhibitors.
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Affiliation(s)
| | | | - Ilana Frydman
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Ygor A Ferrão
- Department of Psychiatry and Legal Medicine, Health Sciences Federal University of Porto Alegre, Rio Grande do Sul, Brazil
| | - Roseli G Shavitt
- Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Murat Yücel
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Victoria, Australia
| | - Euripedes C Miguel
- Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Leonardo F Fontenelle
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Victoria, Australia; Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro, Brazil.
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45
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Alvarenga PG, do Rosario MC, Cesar RC, Manfro GG, Moriyama TS, Bloch MH, Shavitt RG, Hoexter MQ, Coughlin CG, Leckman JF, Miguel EC. Obsessive-compulsive symptoms are associated with psychiatric comorbidities, behavioral and clinical problems: a population-based study of Brazilian school children. Eur Child Adolesc Psychiatry 2016; 25:175-82. [PMID: 26015374 DOI: 10.1007/s00787-015-0723-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Accepted: 05/07/2015] [Indexed: 11/28/2022]
Abstract
Pediatric-onset obsessive-compulsive disorder (OCD) is underdiagnosed, and many affected children are untreated. The present study seeks to evaluate the presence and the clinical impact of OCD and obsessive-compulsive symptoms (OCS) in a large sample of school-age children. In Phase I, we performed an initial screening using the Family History Screen (FHS). In Phase II, we identified an "at-risk" sample, as well as a randomly selected group of children. A total of 2,512 children (6-12 years old) were assessed using the FHS, the Development and Well-Being Assessment (DAWBA), the Strengths and Difficulties Questionnaire (SDQ), and the Child Behavior Checklist (CBCL). Data analyses included descriptive and multivariate analytical techniques. 2,512 children (mean age: 8.86 ± 1.84 years; 55.0% male) were categorized into one of the three diagnostic groups: OCD (n = 77), OCS (n = 488), and unaffected controls (n = 1,947). There were no significant socio-demographic differences (age, gender, socioeconomic status) across groups. The OCS group resembled the OCD on overall impairment, including school problems and delinquent behaviors. However, the OCD group did have significantly higher rates of several comorbid psychiatric disorders, including separation anxiety, generalized anxiety, and major depressive disorder, than OCS or unaffected controls. Moreover, the OCD group also scored higher than the SDQ, as well as on each of CBCL items rated by the parent. Our findings suggest that there is a psychopathological continuum between OCS and OCD in school-aged children. The presence of OCS is associated with functional impairment, which needs further investigation in longitudinal studies.
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Affiliation(s)
- Pedro G Alvarenga
- Department and Institute of Psychiatry, University of Sao Paulo Medical School (USP), Rua Dr. Ovídio Pires de Campos, 785, São Paulo, SP, 01060-970, Brazil. .,National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, Rua. Dr. Ovídio Pires de Campos, São Paulo, SP, 01060-970, Brazil.
| | - Maria C do Rosario
- National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, Rua. Dr. Ovídio Pires de Campos, São Paulo, SP, 01060-970, Brazil. .,Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), Rua Pedro de Toledo, 590, São Paulo, SP, 04038-020, Brazil.
| | - Raony C Cesar
- Department and Institute of Psychiatry, University of Sao Paulo Medical School (USP), Rua Dr. Ovídio Pires de Campos, 785, São Paulo, SP, 01060-970, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, Rua. Dr. Ovídio Pires de Campos, São Paulo, SP, 01060-970, Brazil
| | - Gisele G Manfro
- National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, Rua. Dr. Ovídio Pires de Campos, São Paulo, SP, 01060-970, Brazil. .,Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2350, Porto Alegre, RS, 90035-903, Brazil.
| | - Tais S Moriyama
- Department and Institute of Psychiatry, University of Sao Paulo Medical School (USP), Rua Dr. Ovídio Pires de Campos, 785, São Paulo, SP, 01060-970, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, Rua. Dr. Ovídio Pires de Campos, São Paulo, SP, 01060-970, Brazil
| | - Michael H Bloch
- Child Study Center, Yale School of Medicine, 230, South Frontage Rd, New Haven, CT, 06519, USA.
| | - Roseli G Shavitt
- Department and Institute of Psychiatry, University of Sao Paulo Medical School (USP), Rua Dr. Ovídio Pires de Campos, 785, São Paulo, SP, 01060-970, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, Rua. Dr. Ovídio Pires de Campos, São Paulo, SP, 01060-970, Brazil
| | - Marcelo Q Hoexter
- Department and Institute of Psychiatry, University of Sao Paulo Medical School (USP), Rua Dr. Ovídio Pires de Campos, 785, São Paulo, SP, 01060-970, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, Rua. Dr. Ovídio Pires de Campos, São Paulo, SP, 01060-970, Brazil
| | - Catherine G Coughlin
- Child Study Center, Yale School of Medicine, 230, South Frontage Rd, New Haven, CT, 06519, USA
| | - James F Leckman
- Department and Institute of Psychiatry, University of Sao Paulo Medical School (USP), Rua Dr. Ovídio Pires de Campos, 785, São Paulo, SP, 01060-970, Brazil.,Child Study Center, Yale School of Medicine, 230, South Frontage Rd, New Haven, CT, 06519, USA
| | - Euripedes C Miguel
- Department and Institute of Psychiatry, University of Sao Paulo Medical School (USP), Rua Dr. Ovídio Pires de Campos, 785, São Paulo, SP, 01060-970, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents, CNPq, Rua. Dr. Ovídio Pires de Campos, São Paulo, SP, 01060-970, Brazil
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Hoexter MQ, Diniz JB, Lopes AC, Batistuzzo MC, Shavitt RG, Dougherty DD, Duran FLS, Bressan RA, Busatto GF, Miguel EC, Sato JR. ORBITOFRONTAL THICKNESS AS A MEASURE FOR TREATMENT RESPONSE PREDICTION IN OBSESSIVE-COMPULSIVE DISORDER. Depress Anxiety 2015; 32:900-8. [PMID: 26032588 DOI: 10.1002/da.22380] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 04/15/2015] [Accepted: 04/21/2015] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Early prediction of treatment response could reduce exposure to ineffective treatments and optimize the use of medical resources. Neuroimaging techniques have been used to identify biomarkers that are predictive of outcomes. The aims of this study were to investigate orbitofrontal cortex (OFC) thickness as a potential morphometric biomarker to discriminate outcomes in obsessive-compulsive disorder (OCD) and then to reexamine this biomarker in an independent cohort METHODS Using a logistic regression model based on the mean baseline thickness of subregions of the OFC, we estimated the probability of treatment response in 29 treatment-naïve OCD patients who participated in a clinical trial. That algorithm was then tested in an independent cohort of 12 patients with a confirmed diagnosis of refractory OCD RESULTS: Among the treatment-naïve OCD patients, measures of OFC thickness statistically significantly differentiated responders (n = 13) and nonresponders (n = 16), with an overall classification accuracy of ≈80%, a sensitivity of 77% (10/13), and a specificity of 81% (13/16). Of the refractory OCD patients in the second independent cohort, 67% were correctly classified as nonresponders. The most discriminative measures in the initial cohort of treatment-naïve patients were the thicknesses of the left and right medial OFC (P = .009 and P = .028, respectively) CONCLUSIONS We found OFC thickness to be a strong predictor of treatment response in treatment-naïve OCD patients. Although there are not yet any brain imaging biomarkers with clinical utility, our results highlight the potential of these measures as tools for predicting treatment outcomes in OCD.
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Affiliation(s)
- Marcelo Q Hoexter
- Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil.,Department of Psychiatry, Interdisciplinary Laboratory for Clinical Neuroscience, Federal University of São Paulo, São Paulo, Brazil.,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Juliana B Diniz
- Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Antonio C Lopes
- Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Marcelo C Batistuzzo
- Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Roseli G Shavitt
- Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Darin D Dougherty
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Fabio L S Duran
- Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Rodrigo A Bressan
- Department of Psychiatry, Interdisciplinary Laboratory for Clinical Neuroscience, Federal University of São Paulo, São Paulo, Brazil
| | - Geraldo F Busatto
- Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Euripides C Miguel
- Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Joao R Sato
- Center of Mathematics, Computation, and Cognition, Federal University of the ABC, Santo André, Brazil
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47
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Storch EA, De Nadai AS, do Rosário MC, Shavitt RG, Torres AR, Ferrão YA, Miguel EC, Lewin AB, Fontenelle LF. Defining clinical severity in adults with obsessive-compulsive disorder. Compr Psychiatry 2015; 63:30-5. [PMID: 26555489 PMCID: PMC4643407 DOI: 10.1016/j.comppsych.2015.08.007] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 07/17/2015] [Accepted: 08/12/2015] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) is the most commonly used instrument to assess the clinical severity of obsessive-compulsive symptoms. Treatment determinations are often based on Y-BOCS score thresholds. However, these benchmarks are not empirically based, which may result in non-evidence based treatment decisions. Accordingly, the present study sought to derive empirically-based benchmarks for defining obsessive-compulsive symptom severity. METHOD Nine hundred fifty-four adult patients with obsessive-compulsive disorder (OCD), recruited through the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders, were evaluated by experienced clinicians using a structured clinical interview, the Y-BOCS, and the Clinical Global Impressions-Severity scale (CGI-Severity). RESULTS Similar to results in treatment-seeking children with OCD, our findings demonstrated convergence between the Y-BOCS and global OCD severity assessed by the CGI-Severity (Nagelkerke R(2)=.48). Y-BOCS scores of 0-13 corresponded with 'mild symptoms' (CGI-Severity=0-2), 14-25 with 'moderate symptoms' (CGI-Severity=3), 26-34 with 'moderate-severe symptoms' (CGI-Severity=4) and 35-40 with 'severe symptoms' (CGI-Severity=5-6). Neither age nor ethnicity was associated with Y-BOCS scores, but females demonstrated more severe obsessive-compulsive symptoms than males (d=.34). Time spent on obsessions/compulsions, interference, distress, resistance, and control were significantly related to global OCD severity although the symptom resistance item pairing demonstrated a less robust relationship relative to other components of the Y-BOCS. CONCLUSIONS These data provide empirically-based benchmarks on the Y-BOCS for defining the clinical severity of treatment seeking adults with OCD, which can be used for normative comparisons in the clinic and for future research.
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Affiliation(s)
- Eric A. Storch
- Department of Pediatrics, University of South Florida,Department of Health Policy & Management, University of South Florida,Rogers Behavioral Health – Tampa Bay,All Children’s Hospital - Johns Hopkins Medicine
| | | | | | - Roseli G. Shavitt
- Department of Psychiatry, University of São Paulo Medical School, Brazil
| | - Albina R. Torres
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, Univ Estadual Paulista, Brazil
| | - Ygor A. Ferrão
- Department of Psychiatry, Health Sciences Federal University of Porto Alegre, Brazil
| | | | - Adam B. Lewin
- Department of Pediatrics, University of South Florida,All Children’s Hospital - Johns Hopkins Medicine
| | - Leonardo F. Fontenelle
- Anxiety and Obsessive-Compulsive Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro & D’Or Institute for Research and Education, Brazil
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48
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Batistuzzo MC, Hoexter MQ, Taub A, Gentil AF, Cesar RCC, Joaquim MA, D'Alcante CC, McLaughlin NC, Canteras MM, Shavitt RG, Savage CR, Greenberg BD, Norén G, Miguel EC, Lopes AC. Visuospatial Memory Improvement after Gamma Ventral Capsulotomy in Treatment Refractory Obsessive-Compulsive Disorder Patients. Neuropsychopharmacology 2015; 40:1837-45. [PMID: 25645373 PMCID: PMC4839507 DOI: 10.1038/npp.2015.33] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 12/26/2014] [Accepted: 01/11/2015] [Indexed: 12/22/2022]
Abstract
Gamma ventral capsulotomy (GVC) radiosurgery is intended to minimize side effects while maintaining the efficacy of traditional thermocoagulation techniques for the treatment of refractory obsessive-compulsive disorder (OCD). Neuropsychological outcomes are not clear based on previous studies and, therefore, we investigated the effects of GVC on cognitive and motor performance. A double-blind, randomized controlled trial (RCT) was conducted with 16 refractory OCD patients allocated to active treatment (n=8) and sham (n=8) groups. A comprehensive neuropsychological evaluation including intellectual functioning, attention, verbal and visuospatial learning and memory, visuospatial perception, inhibitory control, cognitive flexibility, and motor functioning was applied at baseline and one year after the procedure. Secondary analysis included all operated patients: eight from the active group, four from the sham group who were submitted to surgery after blind was broken, and five patients from a previous open pilot study (n=5), totaling 17 patients. In the RCT, visuospatial memory (VSM) performance significantly improved in the active group after GVC (p=0.008), and remained stable in the sham group. Considering all patients operated, there was no decline in cognitive or motor functioning after one year of follow-up. Our initial results after 1 year of follow-up suggests that GVC not only is a safe procedure in terms of neuropsychological functioning but in fact may actually improve certain neuropsychological domains, particularly VSM performance, in treatment refractory OCD patients.
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Affiliation(s)
- Marcelo C Batistuzzo
- Department & Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Marcelo Q Hoexter
- Department & Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Anita Taub
- Department & Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - André F Gentil
- Department & Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Raony CC Cesar
- Department & Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Marinês A Joaquim
- Department & Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Carina Chaubet D'Alcante
- Department & Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Nicole C McLaughlin
- Department of Psychiatry and Behavioral Sciences, Butler Hospital and Brown Medical School, Providence, RI, USA
| | - Miguel M Canteras
- Institute of Neurological Radiosurgery-Hospital Santa Paula, São Paulo, Brazil
| | - Roseli G Shavitt
- Department & Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Cary R Savage
- Center for Health Behavior Neuroscience, University of Kansas Medical Center, Kansas City, KS, USA
| | - Benjamin D Greenberg
- Department of Psychiatry and Behavioral Sciences, Butler Hospital and Brown Medical School, Providence, RI, USA
| | - Georg Norén
- Department of Neurosurgery, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Eurípedes C Miguel
- Department & Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Antonio C Lopes
- Department & Institute of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
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Subirà M, Sato JR, Alonso P, do Rosário MC, Segalàs C, Batistuzzo MC, Real E, Lopes AC, Cerrillo E, Diniz JB, Pujol J, Assis RO, Menchón JM, Shavitt RG, Busatto GF, Cardoner N, Miguel EC, Hoexter MQ, Soriano-Mas C. Brain structural correlates of sensory phenomena in patients with obsessive-compulsive disorder. J Psychiatry Neurosci 2015; 40:232-40. [PMID: 25652753 PMCID: PMC4478056 DOI: 10.1503/jpn.140118] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Sensory phenomena (SP) are uncomfortable feelings, including bodily sensations, sense of inner tension, "just-right" perceptions, feelings of incompleteness, or "urge-only" phenomena, which have been described to precede, trigger or accompany repetitive behaviours in individuals with obsessive-compulsive disorder (OCD). Sensory phenomena are also observed in individuals with tic disorders, and previous research suggests that sensorimotor cortex abnormalities underpin the presence of SP in such patients. However, to our knowledge, no studies have assessed the neural correlates of SP in patients with OCD. METHODS We assessed the presence of SP using the University of São Paulo Sensory Phenomena Scale in patients with OCD and healthy controls from specialized units in São Paulo, Brazil, and Barcelona, Spain. All participants underwent a structural magnetic resonance examination, and brain images were examined using DARTEL voxel-based morphometry. We evaluated grey matter volume differences between patients with and without SP and healthy controls within the sensorimotor and premotor cortices. RESULTS We included 106 patients with OCD and 87 controls in our study. Patients with SP (67% of the sample) showed grey matter volume increases in the left sensorimotor cortex in comparison to patients without SP and bilateral sensorimotor cortex grey matter volume increases in comparison to controls. No differences were observed between patients without SP and controls. LIMITATIONS Most patients were medicated. Participant recruitment and image acquisition were performed in 2 different centres. CONCLUSION We have identified a structural correlate of SP in patients with OCD involving grey matter volume increases within the sensorimotor cortex; this finding is in agreement with those of tic disorder studies showing that abnormal activity and volume increases within this region are associated with the urges preceding tic onset.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marcelo Q. Hoexter
- Correspondence to: M. Hoexter, Department & Institute of Psychiatry, University of São Paulo Medical School, Rua Ovídio Pires de Campos, 785-3°andar Ala Norte-sala 9, São Paulo, Brazil, , or C. Soriano-Mas, Bellvitge Biomedical Research Institute-IDIBELL, Psychiatry Department, Bellvitge University Hospital, Feixa Llarga s/n 08907, Hospitalet de Llobregat, Barcelona, Spain;
| | - Carles Soriano-Mas
- Correspondence to: M. Hoexter, Department & Institute of Psychiatry, University of São Paulo Medical School, Rua Ovídio Pires de Campos, 785-3°andar Ala Norte-sala 9, São Paulo, Brazil, , or C. Soriano-Mas, Bellvitge Biomedical Research Institute-IDIBELL, Psychiatry Department, Bellvitge University Hospital, Feixa Llarga s/n 08907, Hospitalet de Llobregat, Barcelona, Spain;
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50
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Senço NM, Huang Y, D'Urso G, Parra LC, Bikson M, Mantovani A, Shavitt RG, Hoexter MQ, Miguel EC, Brunoni AR. Transcranial direct current stimulation in obsessive-compulsive disorder: emerging clinical evidence and considerations for optimal montage of electrodes. Expert Rev Med Devices 2015; 12:381-91. [PMID: 25982412 DOI: 10.1586/17434440.2015.1037832] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Neuromodulation techniques for obsessive-compulsive disorder (OCD) treatment have expanded with greater understanding of the brain circuits involved. Transcranial direct current stimulation (tDCS) might be a potential new treatment for OCD, although the optimal montage is unclear. OBJECTIVE To perform a systematic review on meta-analyses of repetitive transcranianal magnetic stimulation (rTMS) and deep brain stimulation (DBS) trials for OCD, aiming to identify brain stimulation targets for future tDCS trials and to support the empirical evidence with computer head modeling analysis. METHODS Systematic reviews of rTMS and DBS trials on OCD in Pubmed/MEDLINE were searched. For the tDCS computational analysis, we employed head models with the goal of optimally targeting current delivery to structures of interest. RESULTS Only three references matched our eligibility criteria. We simulated four different electrodes montages and analyzed current direction and intensity. CONCLUSION Although DBS, rTMS and tDCS are not directly comparable and our theoretical model, based on DBS and rTMS targets, needs empirical validation, we found that the tDCS montage with the cathode over the pre-supplementary motor area and extra-cephalic anode seems to activate most of the areas related to OCD.
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Affiliation(s)
- Natasha M Senço
- Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
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