The comorbidity of cluster C personality disorders in obsessive compulsive disorder as a marker of anxiety and depression severity

2016 ◽  
Vol 33 (S1) ◽  
pp. S202-S203
Author(s):  
A. Pozza ◽  
S. Domenichetti ◽  
G.P. Mazzoni ◽  
D. Dèttore
Keyword(s):  
Personality Disorders ◽  
Obsessive Compulsive Disorder ◽  
Treatment Strategies ◽  
Severe Depression ◽  
Anxiety And Depression ◽  
Obsessive Compulsive ◽  
Axis Ii ◽  
Compulsive Disorder ◽  
Tailored Treatment ◽  
Competing Interest

IntroductionComorbid Cluster C Personality Disorders (PDs) are the most prevalent PDs in Obsessive-Compulsive Disorder (OCD). Investigating clinical correlates associated to OCD with Cluster C PDs may allow identifying tailored treatment strategies.ObjectivesThe current study examined whether OCD with comorbid cluster C PDs is associated to more severe OCD symptoms, anxiety and depression relative to OCD with comorbid cluster B PDs or OCD alone.MethodsTwo hundred thirty-nine patients with OCD were included (mean age = 35.64, SD = 11.08, 51% females). Seventeen percent had a comorbid Cluster C PD, 8% had a comorbid Cluster B PD, and 75% had OCD alone. The Structured Clinical Interview for Axis II Disorders, Yale-Brown Obsessive Compulsive Scale, Beck Anxiety Inventory, Beck Depression Inventory-II were administered.ResultsPatients with comorbid Cluster C PDs reported more severe depression and anxiety than those with comorbid Cluster B PDs (F = 10.48, P < 0.001) or with OCD alone (F = 9.10, P < 0.001). Patients with comorbid Cluster C PDs had more severe OCD symptoms than those with OCD alone but not than those with comorbid Cluster B PDs (F = 3.12, P < 0.05).ConclusionsOCD with Cluster C PDs could be a subtype with more severe anxiety and depression. These findings could be explained with the fact that Cluster C PDs are characterized by behaviours, which can be seen as maladaptive attempts to cope with anxiety and depression. Tailored treatment strategies for OCD with comorbid Cluster C PDs are discussed to target co-occurring anxiety and depression.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Duloxetine augmentation in resistant obsessive compulsive disorder: Surveying a new medication for challenges in treatment of OCD

2017 ◽  
Vol 41 (S1) ◽  
pp. S415-S415
Author(s):  
A. Mowla
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Primary Outcome Measure ◽  
Controlled Clinical Trial ◽  
Double Blind Study ◽  
Obsessive Compulsive ◽  
Double Blind ◽  
Compulsive Disorder ◽  
Significant Difference ◽  
Competing Interest ◽  
To Receive

IntroductionUp to 50% of patients with OCD have failed to respond in SSRI trials, so looking for pharmacological alternatives in treatment of obsessive compulsive disorder (OCD) seems necessary.ObjectivesSurveying duloxetine augmentation in treatment of resistant OCD.AimsStudy the effects of serotonin-norepinephrine enhancers for treatment of OCD.MethodsThis augmentation trial was designed as an 8-week randomized controlled, double blind study. Forty-six patients suffering from OCD who had failed to respond to at least 12 weeks of treatment with a selective serotonin reuptake inhibitor (fluoxetine, citalopram or fluvoxamine) were randomly allocated to receive duloxetine or sertraline plus their current anti OCD treatment. Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was the primary outcome measure.ResultsForty-six patients (24 of 30 in duloxetine group and 22 of 27 in sertraline group) completed the trial. Both groups showed improvement over the 8-week study period (mean Y-BOCS total score at week 8 as compared with baseline: P < 0.001 and P < 0.001) without significant difference (P = 0.861). Those receiving duloxetine plus their initial medications experienced a mean decrease of 33.0% in Y-BOCS score and the patients with sertraline added to their initial medication experienced a mean decrease of 34.5% in Y-BOCS.ConclusionsOur double blind controlled clinical trial showed duloxetine to be as effective as sertraline in reducing obsessive and compulsive symptoms in resistant OCD patients. However, it needs to be noted that our study is preliminary and larger double blind placebo controlled studies are necessary to confirm the results.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Four-year course of quality of life and obsessive–compulsive disorder

2019 ◽  
Vol 55 (8) ◽  
pp. 989-1000 ◽  
Author(s):  
Karin C. P. Remmerswaal ◽  
Neeltje M. Batelaan ◽  
Adriaan W. Hoogendoorn ◽  
Nic J. A. van der Wee ◽  
Patricia van Oppen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Obsessive Compulsive Disorder ◽  
Patient Characteristics ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Data Sets ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Comorbid Anxiety

Abstract Objective Patients with obsessive compulsive disorder (OCD) have high disease burden. It is important to restore quality of life (QoL) in treatment, so that patients become able to live a fulfilling life. Little is known about the longitudinal course of QoL in patients with OCD, its association with remission from OCD, and about factors that contribute to an unfavourable course of QoL in remitting patients. Methods Study on the 4-year course of QoL of patients with chronic (n = 144), intermittent (n = 22), and remitting OCD (n = 73) using longitudinal data of the Netherlands Obsessive Compulsive Disorder Association (NOCDA; complete data: n = 239; imputed data n = 382). The EuroQol five-dimensional questionnaire (EQ-5D) utility score was used to assess QoL. In patients with remitting OCD, we examined patient characteristics that contributed to an unfavourable course of QoL, including sociodemographics, OCD characteristics, psychiatric comorbidity, and personality traits. Results Course of QoL was associated with course of OCD. QoL improved in those who remitted from OCD; however, even in these patients, QoL remained significantly below the population norms. The correlation between QoL and severity of OCD was only moderate: r = − 0.40 indicating that other factors besides OCD severity contribute to QoL. In remitters, more severe anxiety and depression symptoms were related to a lower QoL. Results were similar in complete and imputed data sets. Conclusions Remission from OCD is associated with improvement of QoL, but comorbid anxiety and depression symptoms hamper the improvement of QoL. QoL could be improved by reducing OCD symptoms in patients with OCD and by treating comorbid anxiety and depression symptoms in remitting patients.

The epidemiology of obsessive-compulsive disorder in an Italian population

1992 ◽  
Vol 7 (2) ◽  
pp. 53-59 ◽  
Author(s):  
P Ronchi ◽  
M Abbruzzese ◽  
S Erzegovesi ◽  
G Diaferia ◽  
G Sciuto ◽  
...  
Keyword(s):  
Family History ◽  
Obsessive Compulsive Disorder ◽  
Age At Onset ◽  
Epidemiological Data ◽  
Italian Population ◽  
Obsessive Compulsive ◽  
Axis Ii ◽  
Compulsive Disorder ◽  
Axis I ◽  
The Relationship

SummaryThis study presents the clinical and demographic characteristics of a sample of 131 patients, who met DSM III-R criteria for obsessive-compulsive disorder (OCD). Our aim was to compare our epidemiological data with non-European research, and to investigate the relationship between OCD symptoms and other clinical features, ie other Axis I concomitant disturbances, personality disorders (Axis II) and family history. Furthermore, we evaluated the age at onset distribution according to sex, family history and presence/absence of a comorbid diagnosis of mood disorder, by means of survival analysis.

Application of Cognitive-behavioral Therapy in a Case of Obsessive-compulsive Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S644-S644
Author(s):  
L. Rodríguez Andrés ◽  
A. Rodriguez Campos ◽  
I. Sevillano Benito ◽  
H. De la Red Gallego ◽  
C. Noval Canga ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Cognitive Behavioral Therapy ◽  
Obsessive Compulsive Disorder ◽  
Behavioral Therapy ◽  
Psychiatric Inpatient ◽  
Normal Function ◽  
Cognitive Behavioral ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Competing Interest

We present the case report of a 46-year-old woman who experienced obsessive-compulsive symptoms for over twenty years, with multiple relapses, severe depressive symptoms and many hospitalizations in the psychiatric Inpatient Unit. Treatment with different SSRIs, tricyclic antidepressants, atypical antipsychotics and even electroconvulsive therapy were administered with poor results.After her last hospitalization a Cognitive-Behavioral Therapy, including exposure and response prevention and cognitive therapy, is initiated combined with medication, improving depressive symptoms, the ritual behaviors and levels of anxiety.Modern treatments for Obsessive-Compulsive Disorder (OCD) have radically changed how the disorder is viewed. While in the past OCD was regarded as chronic and untreatable, a diagnosis of OCD may now be regarded with hope. Cognitive and behavior therapy and antidepressant medications are currently used to treat the disorder. They can be used to control the symptoms and enable people with OCD to restore normal function in their lives.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A mixed approach: Posttraumatic obsessive compulsive disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. S411-S411
Author(s):  
R. Landera Rodríguez ◽  
M. Gómez Revuelta ◽  
M. Juncal Ruíz ◽  
O. Porta Olivares ◽  
R. Martín Gutiérrez ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Traumatic Event ◽  
Case Reports ◽  
Poor Response ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Psychotherapeutic Approach ◽  
Limited Experience ◽  
Competing Interest ◽  
Mixed Approach

IntroductionSeveral studies along the last two decades provide information indicating the relationship between posttraumatic stress disorder (PTSD) and obsessive compulsive disorder (OCD). The particular features described in patients who developed OCD symptoms closely after the onset of PTSD, may suggest the existence of a specific subtype of OCD more likely to be suffered after a traumatic event. The few studies focused on evaluating treatment efficacy for the association between OCD and PTSD seem to predict poor response to pharmacologic or behavioral cognitive (BCT) monotherapy.ObjectivesDespite the evidence, most widely used guidelines propose the employment of either a psychotherapeutic or psychopharmacologic approach. We propose to combine intensive BCT and serotonin profile antidepressants in order to optimize PTSD-OCD subtype.Material and methodsWe present two detailed case reports offering the results of combining intensive BCT and serotonin profile antidepressants as soon as the comorbid diagnosis for both disorders was established. These two patients were recruited from outpatient care centers.ResultsOur limited experience supplied promising outcome results. Significant improvement regarding to functional impairment appeared from early stages of the treatment in both patients.DiscussionDespite logistic difficulties, an intensive and coordinated psychopharmacologic and psychotherapeutic approach might constitute another treatment choice which may be taken into account in those cases monotherapy fails to reduce PTSD-OCD subtype patients’ impairment.ConclusionsA mixed treatment approach might be taken into account as a first line treatment in PTSD-OCD disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Antipsychotic Adjuvant Treatment in OCD

2017 ◽  
Vol 41 (S1) ◽  
pp. S642-S642
Author(s):  
L. Monte. Reula ◽  
H. Saiz García ◽  
A. Portilla Fernández
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Serotonin Reuptake ◽  
Partial Agonist ◽  
Antidepressant Drugs ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Low Mood ◽  
Component Traits ◽  
Potential Risks ◽  
Competing Interest

Antidepressant drugs selective inhibitors of serotonin reuptake (IRS) are the drugs effective in obsessive compulsive disorder. It has not been proven more effective none of them except clomipramine. Around 40–60% of the Patients with obsessive-compulsive disorder (OCD) remain unimproved by serotonin reuptake inhibitors (SRIs).Two cases are presented in relation to this disorder and its treatment.Twenty-three year old woman begins to present anhedonia, apathy, isolation and low mood. Treatment was initiated with escitalopram with partial improvement.Obsessive component traitsThirty year old man with obsessive clinic of years of evolution, with worsening in recent months treatment with 200 mg sertraline.In both cases treatment with oral aripiprazole it was associated with a dose of 5 mg daily with improvement in obsessive symptoms.ResultsThe efficacy of aripiprazole as adjunctive drug treatment and obsessive anxiety is observed. However, we must take into account the potential risks posed as neuroleptic malignant syndrome and QTc prolongation.ConclusionAripiprazole is an antipsychotic which has a novel mechanism of action to be a partial agonist of dopamine D2 receptors. This fact has led to its inclusion in the group of antipsychotics called third generation, also called partial dopamine agonists, dopamine stabilizers or “dopamine-serotonin modulators system.” Its most common side effects such as nausea, headaches, agitation and akathisia were observed in studies on schizophrenia, schizoaffective disorder and bipolar disorder. Unlike other atypical antipsychotics, is considered a relatively neutral drug to weight gain, hyperprolactinemia, changes in metabolic parameters and sedation.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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