Systematic review of environmental risk factors for Obsessive-Compulsive Disorder: A proposed roadmap from association to causation

IntroductionCognitive–behavioural therapy (CBT) with exposure and response prevention is the recommended standard for the treatment of obsessive–compulsive disorder (OCD). However, a high proportion of patients refuse this treatment, do not respond or relapse shortly after treatment. Growing evidence suggests that mindfulness-based and acceptance-based programmes (MABPs) are an effective option for the treatment of OCD. This systematic review and meta-analysis will examine the effectiveness of MABPs in treating OCD. We also aimed to explore potential moderators of the programmes’ effectiveness.Methods and analysisWe will systematically search MEDLINE, Embase, PsycINFO, PSYINDEX, Web of Science, CINAHL and Cochrane Register of Controlled Trials (no language restrictions) for studies that evaluate the effect of MABPs on patients with OCD. We will conduct backward and forward citation searches of included studies and relevant reviews and contact corresponding authors. The primary outcome will be pre-post intervention change in symptom severity. A secondary outcome will be change in depressive symptoms. Two reviewers will independently screen the records, extract the data and rate the methodological quality of the studies. We will include both controlled and uncontrolled trials. Randomised controlled trials will be meta-analysed, separately assessing between-group effects. A second meta-analysis will assess the within-group effect of all eligible studies. We will explore moderators and sources of heterogeneity such as the specific programme, study design, changes in depressive symptoms, hours of guided treatment, control condition and prior therapy (eg, CBT) using metaregression and subgroup analyses. We will perform sensitivity analyses using follow-up data. A narrative synthesis will also be pursued. We will use the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to assess the quality of the evidence.Ethics and disseminationEthical approval is not required. Results will be published in peer-reviewed journals and presented at international conferences.

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Obsessive-Compulsive Personality Disorder Co-occurring in Individuals with Obsessive-Compulsive Disorder: A Systematic Review and Meta-analysis

Harvard Review of Psychiatry ◽

10.1097/hrp.0000000000000287 ◽

2021 ◽

Vol 29 (2) ◽

pp. 95-107

Author(s):

Andrea Pozza ◽

Vladan Starcevic ◽

Fabio Ferretti ◽

Carolina Pedani ◽

Roberta Crispino ◽

...

Keyword(s):

Systematic Review ◽

Personality Disorder ◽

Obsessive Compulsive Disorder ◽

Meta Analysis ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Obsessive Compulsive Personality Disorder

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Cognitive confidence in obsessive-compulsive disorder: A systematic review and meta-analysis

Journal of Obsessive-Compulsive and Related Disorders ◽

10.1016/j.jocrd.2018.08.003 ◽

2018 ◽

Vol 19 ◽

pp. 77-86 ◽

Cited By ~ 1

Author(s):

Catherine Ouellet-Courtois ◽

Samantha Wilson ◽

Kieron O'Connor

Keyword(s):

Systematic Review ◽

Obsessive Compulsive Disorder ◽

Meta Analysis ◽

Obsessive Compulsive ◽

Compulsive Disorder

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Electrophysiology of obsessive compulsive disorder: A systematic review of the electroencephalographic literature

Journal of Anxiety Disorders ◽

10.1016/j.janxdis.2018.11.001 ◽

2019 ◽

Vol 62 ◽

pp. 1-14 ◽

Cited By ~ 11

Author(s):

M. Prabhavi N. Perera ◽

Neil W. Bailey ◽

Sally E. Herring ◽

Paul B. Fitzgerald

Keyword(s):

Systematic Review ◽

Obsessive Compulsive Disorder ◽

Obsessive Compulsive ◽

Compulsive Disorder

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Adult obsessive–compulsive disorder and quality of life outcomes: A systematic review and meta-analysis

Asian Journal of Psychiatry ◽

10.1016/j.ajp.2016.02.001 ◽

2016 ◽

Vol 22 ◽

pp. 41-52 ◽

Cited By ~ 28

Author(s):

Anna Coluccia ◽

Andrea Fagiolini ◽

Fabio Ferretti ◽

Andrea Pozza ◽

Giulia Costoloni ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Obsessive Compulsive Disorder ◽

Meta Analysis ◽

Life Outcomes ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Quality Of Life Outcomes

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Neurocircuitry of Deep Brain Stimulation for Obsessive-Compulsive Disorder as Revealed by Tractography: A Systematic Review

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.680484 ◽

2021 ◽

Vol 12 ◽

Author(s):

Eduardo Varjão Vieira ◽

Paula Ricci Arantes ◽

Clement Hamani ◽

Ricardo Iglesio ◽

Kleber Paiva Duarte ◽

...

Keyword(s):

Systematic Review ◽

Deep Brain Stimulation ◽

White Matter ◽

Data Processing ◽

Obsessive Compulsive Disorder ◽

Brain Stimulation ◽

Diffusion Tensor ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Deep Brain

Objective: Deep brain stimulation (DBS) was proposed in 1999 to treat refractory obsessive-compulsive disorder (OCD). Despite the accumulated experience over more than two decades, 30–40% of patients fail to respond to this procedure. One potential reason to explain why some patients do not improve in the postoperative period is that DBS might not have engaged structural therapeutic networks that are crucial to a favorable outcome in non-responders. This article reviews magnetic resonance imaging diffusion studies (DTI-MRI), analyzing neural networks likely modulated by DBS in OCD patients and their corresponding clinical outcome.Methods: We used a systematic review process to search for studies published from 2005 to 2020 in six electronic databases. Search terms included obsessive-compulsive disorder, deep brain stimulation, diffusion-weighted imaging, diffusion tensor imaging, diffusion tractography, tractography, connectome, diffusion analyses, and white matter. No restriction was made concerning the surgical target, DTI-MRI technique and the method of data processing.Results: Eight studies published in the last 15 years were fully assessed. Most of them used 3 Tesla DTI-MRI, and different methods of data acquisition and processing. There was no consensus on potential structures and networks underlying DBS effects. Most studies stimulated the ventral anterior limb of the internal capsule (ALIC)/nucleus accumbens. However, the contribution of different white matter pathways that run through the ALIC for the effects of DBS remains elusive. Moreover, the improvement of cognitive and affective symptoms in OCD patients probably relies on electric modulation of distinct networks.Conclusion: Though, tractography is a valuable tool to understand neural circuits, the effects of modulating different fiber tracts in OCD are still unclear. Future advances on image acquisition and data processing and a larger number of studies are still required for the understanding of the role of tractography-based targeting and to clarify the importance of different tracts for the mechanisms of DBS.

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The prevalence of autism spectrum traits and autism spectrum disorders in children and adolescents with obsessive compulsive disorder: a systematic review

BJPsych Open ◽

10.1192/bjo.2021.194 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S56-S56

Author(s):

Claire Tiley ◽

Marinos Kyriakopoulos

Keyword(s):

Systematic Review ◽

Children And Adolescents ◽

Obsessive Compulsive Disorder ◽

Functional Impairment ◽

Body Dysmorphic Disorder ◽

Autism Spectrum ◽

Control Group ◽

Obsessive Compulsive ◽

Global Functioning ◽

Compulsive Disorder

AimsAutism Spectrum Disorder (ASD) and Obsessive Compulsive Disorder (OCD) commonly co-occur in children and adolescents (C&A); evidence suggests functional impairment is increased in those diagnosed with both disorders. The aims of this systematic review were: 1) To review studies that report on the prevalence of ASD traits and/or diagnosis in C&A with OCD. 2) To review whether the severity of OCD symptoms is related to the severity of ASD traits in C&A with OCD. 3)To review whether the severity of comorbid ASD traits or diagnosis in C&A with OCD impact on their global functioning.MethodThis systematic review was registered in PROSPERO. Prisma guidelines were followed . Electronic searches were carried out on Pubmed, EMBASE and Psychinfo with the use of selected keywords. Inclusion criteria : 1) Participants up to the age of 18 who had an ICD or DSM diagnosis of OCD. 2) Journal articles published in the English, with no date specifications. 3) Papers evaluating ASD diagnosis or traits, or where data on this could be extracted. Exclusion criteria: 1) Papers looking at OCD related disorders such as body dysmorphic disorder, compulsive skin picking, trichotillomania and hoarding disorder. 2) Samples including adults where C&A data could not be extracted. 3) Posters, abstracts and dissertations.ResultA total of 15 studies were included in the systematic review. Seven of these studies directly compared the prevalence of ASD traits (measured by questionnaires) or diagnosis in OCD to a control group or normative data, with all studies reporting a significant elevation in ASD trait scores and diagnosis in OCD. Ten of the studies reported on the correlation between ASD trait severity and OCD severity. Four studies identified a significant correlation between ASD and OCD total scores or specified subscales. In contrast, one study found significantly elevated OCD scores in an OCD only group when compared to a comorbid OCD and ASD group. Three studies reported on the correlation between ASD scores and functional impairment or compared an OCD only group to a comorbid group. All three studies demonstrated that the presence ASD or ASD traits are associated with elevated scores in global functional impairment.ConclusionIn conclusion, this review suggests that there is an increased prevalence of ASD traits and diagnosis amongst C&A with OCD. Elevated ASD traits within this population are associated with a greater impact on global functioning.

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