Escitalopram in Obsessive-Compulsive Disorder: Response of Symptom Dimensions to Pharmacotherapy

CNS Spectrums ◽  
2008 ◽  
Vol 13 (6) ◽  
pp. 492-498 ◽  
Author(s):  
Dan J. Stein ◽  
Paul D. Carey ◽  
Christine Lochner ◽  
Soraya Seedat ◽  
Naomi Fineberg ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Treatment Response ◽  
Obsessive Compulsive Disorder ◽  
Exploratory Factor Analysis ◽  
Subscale Score ◽  
Controlled Study ◽  
Obsessive Compulsive ◽  
Double Blind ◽  
Symptom Dimensions ◽  
Compulsive Disorder

ABSTRACTIntroduction:There is a substantial body of evidence that obsessive-compulsive disorder (OCD) symptoms can be grouped into a series of discrete dimensions, and some evidence that not all OCD symptom dimensions respond equally well to pharmacologic or psychotherapeutic intervention. The response of OCD symptom dimensions to 12 weeks of treatment with escitalopram or placebo was investigated.Methods:Data from a randomized, double-blind, placebo-controlled study of escitalopram in 466 adults with OCD were analyzed. Exploratory factor analysis of individual items of the Yale-Brown Obsessive-Compulsive Scale checklist was performed and subscale scores based on the extracted factors were determined. Analyses of covariance were undertaken to determine whether inclusion of each subscale score in these models impacted on the efficacy of escitalopram versus placebo.Results:Exploratory factor analysis of individual Yale-Brown Obsessive-Compulsive Scale items yielded 5 factors (contamination/cleaning, harm/checking, hoarding/symmetry, religious/sexual, and somatic/hypochondriacal). Analyses of covariance including all the subscales demonstrated that escitalopram was more effective than placebo. There was a significant interaction for the hoarding/symmetry factor, which was associated with a poor treatment response.Conclusion:Escitalopram shows good efficacy across the range of OCD symptom dimensions. Nevertheless, hoarding/symmetry was associated with a poorer treatment response. Hoarding/symmetry may be particularly characteristic of an early-onset group of OCD patients, with the involvement of neurotransmitters other than serotonin. Further work is needed to delineate fully the subtypes of OCD, and their correlates with underlying psychobiology and treatment responsivity.

scholarly journals Response of symptom dimensions in obsessive-compulsive disorder to treatment with citalopram or placebo

2007 ◽  
Vol 29 (4) ◽  
pp. 303-307 ◽  
Author(s):  
Dan J Stein ◽  
Elisabeth W Andersen ◽  
Kerstin Fredricson Overo
Keyword(s):  
Factor Analysis ◽  
Obsessive Compulsive Disorder ◽  
Early Onset ◽  
Female Gender ◽  
Male Gender ◽  
Controlled Study ◽  
Obsessive Compulsive ◽  
Symptom Dimensions ◽  
Compulsive Disorder ◽  
The Impact

OBJECTIVE: There is increasing evidence that the symptoms of obsessive-compulsive disorder lie on discrete dimensions. Relatively little work has, however, explored the relationship between such factors and response to pharmacotherapy. METHOD: Data from a multi-site randomized placebo-controlled study of citalopram in obsessive-compulsive disorder were analyzed. Factor analysis of individual items and symptom categories of the Yale-Brown Obsessive-Compulsive Scale Checklist were undertaken, and the impact of symptom dimensions on treatment outcomes was analysed. RESULTS: Factor analysis of Yale-Brown Obsessive-Compulsive Scale Checklist individual items yielded 5 factors (contamination/cleaning, harm/checking, aggressive/sexual/religious, hoarding/symmetry, and somatic/hypochondriacal). Hoarding/symmetry was associated with male gender, longer duration of obsessive-compulsive disorder and early onset, whereas contamination/cleaning was associated with female gender. Citalopram was more effective than placebo, but high scores on the symmetry/hoarding and contamination/cleaning subscales predicted worse outcome at the end of study while high scores on the aggressive/religious/sexual subscale predicted better outcome. Factor analysis of Yale-Brown Obsessive-Compulsive Scale Checklist symptom clusters yielded a 4 factor solution, but confirmed that symmetry/ordering was associated with male gender, early onset, and long duration of obsessive-compulsive disorder while high scores on the hoarding subscale predicted worse response to pharmacotherapy. CONCLUSION: Citalopram shows good efficacy across the range of obsessive-compulsive disorder symptom dimensions. The relatively worse response of symmetry/hoarding to a selective serotonin reuptake inhibitor is consistent with other evidence that this symptom dimension is mediated by the dopamine system. There may be associations between symmetry/hoarding, male gender, early onset, tics, and particular genetic variants; further work is, however, needed to delineate fully obsessive-compulsive disorder subtypes and their underlying neurobiology.

Does GRIN2B gene influence obsessive-compulsive disorder risk, symptom dimensions and treatment response?

2018 ◽  
Vol 31 ◽  
pp. 150-151 ◽  
Author(s):  
Biju Viswanath ◽  
Reshma Jabeen Taj MJ ◽  
Ravi Kumar Nadella ◽  
Tulika Shukla ◽  
Madhuri H. Nanjundaswamy ◽  
...  
Keyword(s):  
Treatment Response ◽  
Obsessive Compulsive Disorder ◽  
Obsessive Compulsive ◽  
Symptom Dimensions ◽  
Compulsive Disorder ◽  
Risk Symptom ◽  
Disorder Risk

Patterns of Neural Response to Emotive Stimuli Distinguish the Different Symptom Dimensions of Obsessive-Compulsive Disorder

CNS Spectrums ◽  
2004 ◽  
Vol 9 (4) ◽  
pp. 275-283 ◽  
Author(s):  
Mary L. Phillips ◽  
David Mataix-Cols
Keyword(s):  
Treatment Response ◽  
Obsessive Compulsive Disorder ◽  
Emotion Perception ◽  
Anterior Cingulate ◽  
Neural Systems ◽  
Obsessive Compulsive ◽  
Specific Symptom ◽  
Symptom Dimensions ◽  
Related Material ◽  
Compulsive Disorder

ABSTRACTDespite its heterogeneous symptomatology, obsessive-compulsive disorder (OCD) is currently conceptualized as a unitary diagnostic entity. Recent factor-analytic studies have identified several OCD symptom dimensions that are associated with different demographic variables, comorbidity, patterns of genetic transmission, and treatment response. Functional abnormalities in neural systems important for emotion perception, including the orbitofrontal cortex, lateral prefrontal cortex, anterior cingulate gyrus, and limbic regions, have been reported in OCD. In this review, we discuss the extent to which neurobiological markers may distinguish these different symptom dimensions and whether specific symptom dimensions, such as contamination/washing, are associated with abnormalities in emotion and, in particular, disgust, perception in OCD. Also discussed are findings that indicate that anxiety can be induced in healthy volunteers in response to OCD symptom-related material, and that associated increases in activity within neural systems important for emotion perception occur to washing- and hoarding-related material in particular in these subjects. Further examination of neural responses during provocation of different symptom dimensions in OCD patients will help determine the extent to which specific abnormalities in neural systems underlying emotion perception are associated with different symptom dimensions and predict treatment response in OCD.

Anorgasmia from Clomipramine in Obsessive-Compulsive Disorder

1987 ◽  
Vol 151 (1) ◽  
pp. 107-112 ◽  
Author(s):  
W. O. Monteiro ◽  
H. F. Noshirvani ◽  
I. M. Marks ◽  
P.T. Lelliott
Keyword(s):  
Side Effects ◽  
Sexual Function ◽  
Obsessive Compulsive Disorder ◽  
Structured Interview ◽  
Controlled Study ◽  
Obsessive Compulsive ◽  
Double Blind ◽  
Men And Women ◽  
Compulsive Disorder ◽  
Sexual Side Effects

Forty-six patients with obsessive-compulsive disorder undergoing a double-blind controlled study of clomipramine and placebo were interviewed to assess changes in sexual function. Of 33 patients with previously normal orgasm, nearly all of the 24 on clomipramine developed total or partial anorgasmia; none of the 9 on placebo did so. Anorgasmia persisted with minimal tolerance over the five months that clomipramine was taken. Men and women were equally affected. Sexual side-effects are easily missed without a structured interview, and can detract from the value of drug treatment.

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