Missed diagnoses in African Americans with obsessive-compulsive disorder: the structured clinical interview for DSM-IV Axis I disorders (SCID-I)

Duration of untreated illness (DUI) is a predictor of outcome in psychotic and affective disorders. Data available on DUI and its relationship with outcome in obsessive-compulsive disorder (OCD) suggest an association between longer DUI and poorer treatment response. The present study investigated socio-demographic and clinical predictors of DUI and its association with long-term outcome in OCD patients. Eighty-three OCD outpatients were treated with serotonin reuptake inhibitors (SRIs) and prospectively followed-up for 3 years. Baseline information was collected on demographic and clinical characteristics using standard assessments. Each patient was assessed through the structured clinical interview for DSM-IV axis I disorders (SCID-I), the structured clinical interview for DSM-IV axis II personality disorders (SCID-II), the Yale-Brown obsessive–compulsive scale (Y-BOCS) and the 17-item Hamilton rating scale for depression (HDRS). The DUI was explored by interviewing patients, family caregivers and clinicians. OCD subjects had a mean DUI of 7.3 (5.8) years. A younger age at onset and a greater severity of OCD symptoms at baseline were associated with a longer DUI. The DUI of patients with a “good outcome” was shorter than that of patients with a “poor outcome”. Logistic regression analysis revealed indeed a possible association between longer DUI and “poor outcome”. In the logistic multivariable model, the association of DUI with treatment outcome held true whilst controlling for socio-demographic and clinical variables.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Gender-related clinical differences in obsessive-compulsive disorder

European Psychiatry ◽

10.1016/s0924-9338(99)00224-2 ◽

1999 ◽

Vol 14 (8) ◽

pp. 434-441 ◽

Cited By ~ 127

Author(s):

F. Bogetto ◽

S. Venturello ◽

U. Albert ◽

G. Maina ◽

L. Ravizza

Keyword(s):

Obsessive Compulsive Disorder ◽

Clinical Features ◽

Age At Onset ◽

Obsessive Compulsive ◽

Course Of Illness ◽

Compulsive Disorder ◽

History Of ◽

Axis I ◽

Dsm Iv ◽

Chronic Course

SummaryThe purpose of the present study was to investigate the gender-related differences of clinical features in a sample of obsessive-compulsive (OCD) patients. One hundred and sixty outpatients with a principal diagnosis of obsessive-compulsive disorder (DSM-IV, Y-BOCS = 16) were admitted. Patients were evaluated with a semi-structured interview covering the following areas: socio-demographic data, Axis I diagnoses (DSM-IV), OCD clinical features (age at onset of OC symptoms and disorder, type of onset, life events and type of course). For statistical analysis the sample was subdivided in two groups according to gender. We found an earlier age at onset of OC symptoms and disorder in males; an insidious onset and a chronic course of illness were also observed in that group of patients. Females more frequently showed an acute onset of OCD and an episodic course of illness; they also reported more frequently a stressful event in the year preceding OCD onset. A history of anxiety disorders with onset preceding OCD and hypomanic episodes occurring after OCD onset was significantly more common among males, while females showed more frequently a history of eating disorders. We found three gender-related features of OCD: males show an earlier age at onset with a lower impact of precipitant events in triggering the disorder; OCD seems to occur in a relative high proportion of males who already have phobias and/or tic disorders; and a surfeit of chronic course of the illness in males in comparison with females.

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Nosological Insertion of Axis I Disorders in the Etiology of Obsessive-Compulsive Disorder

Journal of Anxiety Disorders ◽

10.1016/s0887-6185(99)00027-4 ◽

2000 ◽

Vol 14 (1) ◽

pp. 19-30 ◽

Cited By ~ 34

Author(s):

Jose A. Yaryura-Tobias ◽

Michael S. Grunes ◽

John Todaro ◽

Dean McKay ◽

Fugen A. Neziroglu ◽

...

Keyword(s):

Obsessive Compulsive Disorder ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Axis I Disorders ◽

Axis I

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Effect of Clozapine on Psychiatric Comorbidities in Patients with Schizophrenia

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.2140 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S197-S197 ◽

Cited By ~ 1

Author(s):

G. Gürcan ◽

Ş. Hun Şenol ◽

A.E. Anıl Yağcıoğlu ◽

A. Ertuğrul

Keyword(s):

Substance Use ◽

Suicide Attempts ◽

De Novo ◽

Clinical Interview ◽

Obsessive Compulsive ◽

Psychiatric Comorbidities ◽

Compulsive Disorder ◽

Laboratory Test Results ◽

Axis I ◽

Dsm Iv

IntroductionClozapine has superior efficacy in treatment-resistant schizophrenia, and has various effects on psychiatric comorbidities, which may affect the illness course.AimsWe aimed to assess the past and current psychiatric comorbidities in schizophrenia patients treated with clozapine, and study their relationship with clinical variables.MethodsConsecutive 122 outpatients who met DSM-IV criteria for schizophrenia receiving clozapine were included. Information about past and current clinical status were gathered through a clinical interview and review of the medical records, along with laboratory test results. Patients were assessed with structured clinical interview for Axis-I Disorders for DSM-IV, Clinical Global Impression Scale, Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale, Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Panic and Agoraphobia Scale (PAS), WHO-Disability Assessment Schedule-II.ResultsThere was a significant decrease in the diagnosis of depression, alcohol and substance use disorder, number of suicide attempts, and an increase in the diagnosis of obsessive compulsive disorder (OCD) after clozapine initiation. Clozapine related de novo OCD appeared in 48.4% of the patients, and there was a positive correlation between Y-BOCS total scores and clozapine dose and plasma levels. In the de novo OCD group, compulsion scores were higher than obsession scores with checking most prevalent among compulsions. Total PANSS, Y-BOCS, PASscores were positively correlated withtotal disability score.ConclusionsClozapine seems to decrease comorbid depression, alcohol and substance use and number of suicide attempts and increase OCD. Assessment and treatment of psychiatric comorbidities in clozapine using schizophrenia patients is vital to decrease disability.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Symmetry Dimension in Obsessive–Compulsive Disorder: Prevalence, Severity and Clinical Correlates

Journal of Clinical Medicine ◽

10.3390/jcm10020274 ◽

2021 ◽

Vol 10 (2) ◽

pp. 274

Author(s):

Aline P. Vellozo ◽

Leonardo F. Fontenelle ◽

Ricardo C. Torresan ◽

Roseli G. Shavitt ◽

Ygor A. Ferrão ◽

...

Keyword(s):

Logistic Regression ◽

Obsessive Compulsive Disorder ◽

Clinical Sample ◽

Cross Sectional Study ◽

Obsessive Compulsive ◽

Chi Square ◽

Cross Sectional ◽

Compulsive Disorder ◽

Clinical Correlates ◽

Axis I

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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Demography and symptom severity of obsessive compulsive disorder in Bangladesh: a cross-sectional observation

Bangladesh Journal of Psychiatry ◽

10.3329/bjpsy.v30i2.45360 ◽

2020 ◽

Vol 30 (2) ◽

pp. 23-26

Author(s):

Sultana Algin ◽

Mohammad Waliul Hasnat Sajib ◽

SM Yasir Arafat

Keyword(s):

Obsessive Compulsive Disorder ◽

Symptom Severity ◽

Large Scale ◽

Depressive Disorders ◽

Obsessive Compulsive ◽

Cross Sectional ◽

Compulsive Disorder ◽

Co Morbidity ◽

Study Results ◽

Axis I

Obsessive Compulsive Disorder (OCD) is a common disorder and usually runs a chronic course with waxing and waning course. It leads to pervasive impairments in multiple domains of life. The aim of the study was to assess the demographic characteristics of the OCD patients and symptom severity of this disorder. This was a cross-sectional study done in OCD clinic of outpatient department (OPD) of BSMMU, during the period from May, 2015 to April, 2017. Four hundred patients fulfilling the inclusion and exclusion criteria were selected consecutively. After taking written consent a predetermined questionnaire was filled for each patient through face-to-face interview. Then patients were evaluated covering the following areas: Axis I diagnoses (DSM-IV) and Y-BOCS severity scale. The results showed that, the mean age of the respondents was 26.6 (SD±9.9) years, ranging from 8 to 63 years. According to Y-BOCS symptoms severity used for adult patients found that majority (70%) of the patients had moderate to severe sufferings. Male had co-morbid anxiety disorders (panic disorder, agoraphobia, social phobia) more but female patients were found more depressive disorders. Female had more hypothyroidism, diabetes, skin disorders and hypertension than male. These demographic status, co-morbidity profile and symptoms severity can serve as the baseline data for a country like Bangladesh and further large scale, multi-centered study would better generalize the study results. Bang J Psychiatry December 2016; 30(2): 23-26

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