Predictors of course in obsessive?compulsive disorder: logistic regression versus Cox regression for recurrent events

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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The Structure, Validity, and Specificity of OCD Symptoms

Understanding the Emotional Disorders ◽

10.1093/med:psych/9780199301096.003.0009 ◽

2017 ◽

pp. 232-259

Author(s):

David Watson ◽

Michael W. O’Hara

Keyword(s):

Logistic Regression ◽

Scale Development ◽

Obsessive Compulsive Disorder ◽

Criterion Validity ◽

Incremental Validity ◽

Regression Analyses ◽

Diagnostic Specificity ◽

Obsessive Compulsive ◽

Symptom Dimensions ◽

Compulsive Disorder

This chapter reviews early attempts to assess obsessive-compulsive disorder (OCD) symptoms, as well as the structural evidence that eventually led to the identification of core, consensual dimensions within the disorder. It then reviews instruments (the Obsessive-Compulsive Inventory; the Schedule of Compulsions, Obsessions, and Pathological Impulses; and the Yale-Brown Obsessive-Compulsive Scale) that have been developed to assess these core symptom dimensions and discusses the validity (including convergent, discriminant, criterion, and incremental validity) and specificity of the scales included in these measures. Three sets of OCD-related items (representing Cleaning, Checking, and Ordering) marked clear, replicable factors in the IDAS-II scale development samples. Indicators of checking and ordering/rituals produced the most impressive results overall, exhibiting the strongest criterion validity, good diagnostic specificity, and significant incremental validity in logistic regression analyses. Washing/cleaning symptoms also showed good diagnostic specificity, but they displayed more moderate criterion validity.

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Characteristic and Early Discontinuation of Obsessive-Compulsive Disorder Trials Registered on ClinicalTrials.gov

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.650057 ◽

2021 ◽

Vol 12 ◽

Author(s):

Shanxia Luo ◽

Qiong Guo ◽

Liu Yang ◽

Yifan Cheng ◽

Youlin Long ◽

...

Keyword(s):

Risk Factors ◽

Regression Analysis ◽

Obsessive Compulsive Disorder ◽

Cox Regression ◽

Drug Trials ◽

Obsessive Compulsive ◽

Early Discontinuation ◽

Cox Regression Analysis ◽

Compulsive Disorder ◽

Independent Risk Factors

Objective: This study aimed to analyze the characteristics and reasons of early discontinuation of obsessive-compulsive disorder (OCD) trials registered on ClinicalTrials.gov.Methods: OCD trials and relevant publications were searched on ClinicalTrials.gov and PubMed, respectively. The characteristics and details regarding the timely publication of trials were recorded. Cox regression analysis was used to explore factors associated with the early discontinuation of OCD trials.Results: The analysis included 298 OCD therapy trials. Most investigations recruited <100 patients and were more likely to involve adults. Of all OCD studies identified, 67.8% were randomized and 61.4% were blind (single- or double-blind). Universities and hospitals were recorded as the two primary locations in the majority of trials. A total of 155 trials (52%) were completed; however, only 29% of those were published. Of the published trials, >70% were published at least 1 year after completion. Behavioral therapy trials were the most common type of major treatment-aimed OCD trials (39%), followed by drug trials (35.1%) and device/procedure trials (24.7%). The univariate Cox regression analysis indicated that drug trials [hazard ratio (HR) = 2.56, 95% confidence interval (CI): 1.21–5.43], absence of collaborators (HR = 3.87, 95% CI: 1.62–9.26), and sponsorship by industry (HR = 3.97, 95% CI: 1.49–10.53) were risk factors for early discontinuation of OCD trials. Further multivariate Cox regression showed that drug trials (HR = 3.93, 95% CI: 1.71–9.08) and absence of collaborators (HR = 5.17, 95% CI: 1.97–13.54) were independent risk factors for early trial discontinuation of OCD trials. The sensitivity analysis confirmed these results. Non-drug trials (OR = 3.32, 95% CI: 1.21–9.11), absence of collaborators (OR = 3.25, 95% CI: 1.10–9.60), and non-blinded trials (OR = 5.23, 95% CI: 1.05–26.2) were independent risk factors for unreported results in registry.Conclusion: The diagnosis and prevention of OCD are rarely investigated in trials. Underreporting and delayed reporting remain major problems. The type of intervention and participation of collaborators are associated with early discontinuation of OCD trials.

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Prevalence of suicide attempt and clinical characteristics of suicide attempters with obsessive-compulsive disorder: a report from the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS)

CNS Spectrums ◽

10.1017/s1092852917000177 ◽

2017 ◽

Vol 23 (1) ◽

pp. 59-66 ◽

Cited By ~ 12

Author(s):

Bernardo Dell’Osso ◽

Beatrice Benatti ◽

Chiara Arici ◽

Carlotta Palazzo ◽

A. Carlo Altamura ◽

...

Keyword(s):

Logistic Regression ◽

Suicide Attempt ◽

Obsessive Compulsive Disorder ◽

Clinical Features ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

International College ◽

History Of ◽

Spectrum Disorders ◽

The Impact

ObjectiveObsessive-compulsive disorder (OCD) is associated with variable risk of suicide and prevalence of suicide attempt (SA). The present study aimed to assess the prevalence of SA and associated sociodemographic and clinical features in a large international sample of OCD patients.MethodsA total of 425 OCD outpatients, recruited through the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) network, were assessed and categorized in groups with or without a history of SA, and their sociodemographic and clinical features compared through Pearson’s chi-squared and t tests. Logistic regression was performed to assess the impact of the collected data on the SA variable.Results14.6% of our sample reported at least one SA during their lifetime. Patients with an SA had significantly higher rates of comorbid psychiatric disorders (60 vs. 17%, p<0.001; particularly tic disorder), medical disorders (51 vs. 15%, p<0.001), and previous hospitalizations (62 vs. 11%, p<0.001) than patients with no history of SA. With respect to geographical differences, European and South African patients showed significantly higher rates of SA history (40 and 39%, respectively) compared to North American and Middle-Eastern individuals (13 and 8%, respectively) (χ2=11.4, p<0.001). The logistic regression did not show any statistically significant predictor of SA among selected independent variables.ConclusionsOur international study found a history of SA prevalence of ~15% in OCD patients, with higher rates of psychiatric and medical comorbidities and previous hospitalizations in patients with a previous SA. Along with potential geographical influences, the presence of the abovementioned features should recommend additional caution in the assessment of suicide risk in OCD patients.

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Response to Fluvoxamine in the Obsessive-Compulsive Disorder Patients: Bayesian Ordinal Quantile Regression

Clinical Practice and Epidemiology in Mental Health ◽

10.2174/1745017902117010151 ◽

2021 ◽

Vol 17 (1) ◽

pp. 146-151

Author(s):

Samad Safiloo ◽

Yadollah Mehrabi ◽

Sareh Asadi ◽

Soheila Khodakarim

Keyword(s):

Logistic Regression ◽

Quantile Regression ◽

Regression Model ◽

Marital Status ◽

Obsessive Compulsive Disorder ◽

Regression Models ◽

Obsessive Compulsive ◽

Logistic Regression Models ◽

Compulsive Disorder ◽

Quantile Regression Model

Background: Obsessive-Compulsive Disorder (OCD) is a chronic neuropsychiatric disorder associated with unpleasant thoughts or mental images, making the patient repeat physical or mental behaviors to relieve discomfort. 40-60% of patients do not respond to Serotonin Reuptake Inhibitors, including fluvoxamine therapy. Introduction: The aim of the study is to identify the predictors of fluvoxamine therapy in OCD patients by Bayesian Ordinal Quantile Regression Model. Methods: This study was performed on 109 patients with OCD. Three methods, including Bayesian ordinal quantile, probit, and logistic regression models, were applied to identify predictors of response to fluvoxamine. The accuracy and weighted kappa were used to evaluate these models. Results: Our result showed that rs3780413 (mean=-0.69, sd=0.39) and cleaning dimension (mean=-0.61, sd=0.20) had reverse effects on response to fluvoxamine therapy in Bayesian ordinal probit and logistic regression models. In the 75th quantile regression model, marital status (mean=1.62, sd=0.47) and family history (mean=1.33, sd=0.61) had a direct effect, and cleaning (mean=-1.10, sd=0.37) and somatic (mean=-0.58, sd=0.27) dimensions had reverse effects on response to fluvoxamine therapy. Conclusion: Response to fluvoxamine is a multifactorial problem and can be different in the levels of socio-demographic, genetic, and clinical predictors. Marital status, familial history, cleaning, and somatic dimensions are associated with response to fluvoxamine therapy.

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Labour market marginalisation in obsessive–compulsive disorder: a nationwide register-based sibling control study

Psychological Medicine ◽

10.1017/s0033291718001691 ◽

2018 ◽

Vol 49 (6) ◽

pp. 1015-1024 ◽

Cited By ~ 5

Author(s):

Ana Pérez-Vigil ◽

Ellenor Mittendorfer-Rutz ◽

Magnus Helgesson ◽

Lorena Fernández de la Cruz ◽

David Mataix-Cols

Keyword(s):

Labour Market ◽

Obsessive Compulsive Disorder ◽

Sickness Absence ◽

Disability Pension ◽

Cox Regression ◽

Specialist Care ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

The Impact

AbstractBackgroundThe impact of obsessive–compulsive disorder (OCD) on objective indicators of labour market marginalisation has not been quantified.MethodsLinking various Swedish national registers, we estimated the risk of three labour market marginalisation outcomes (receipt of newly granted disability pension, long-term sickness absence and long-term unemployment) in individuals diagnosed with OCD between 2001 and 2013 who were between 16 and 64 years old at the date of the first OCD diagnosis (n = 16 267), compared with matched general population controls (n = 157 176). Hazard ratios (HR) with 95% confidence intervals (CI) were calculated using Cox regression models, adjusting for a number of covariates (e.g. somatic disorders) and stratifying by sex. To adjust for potential familial confounders, we further analysed data from 7905 families that included full siblings discordant for OCD.ResultsPatients were more likely to receive at least one outcome of interest [adjusted HR = 3.63 (95% CI 3.53–3.74)], including disability pension [adjusted HR = 16.36 (95% CI 15.34–17.45)], being on long-term sickness absence [adjusted HR = 3.07 (95% CI 2.95–3.19)] and being on long-term unemployment [adjusted HR = 1.72 (95% CI 1.63–1.82)]. Results remained similar in the adjusted sibling comparison models. Exclusion of comorbid psychiatric disorders had a minimal impact on the results.ConclusionsHelp-seeking individuals with OCD diagnosed in specialist care experience marked difficulties to participate in the labour market. The findings emphasise the need for cooperation between policy-makers, vocational rehabilitation and mental health services in order to design and implement specific strategies aimed at improving the patients’ participation in the labour market.

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