scholarly journals Patterns and Predictors of Off-Label Drug Prescribing in Psychiatric Practice: A Qualitative Study

Pharmacy ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 203
Author(s):  
Sadia Shakeel ◽  
Shagufta Nesar ◽  
Hina Rehman ◽  
Khizra Jamil ◽  
Imran Ahsan Mallick ◽  
...  
Keyword(s):  
Scientific Evidence ◽  
Qualitative Interviews ◽  
Structured Interview ◽  
Further Education ◽  
Drug Prescribing ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Off Label ◽  
Data Saturation ◽  
Almost All

Off-label drug prescribing (OLDP) must be based on strong scientific evidence to make sure that patients get the optimum therapeutic outcomes. Adherence to the prerequisites is determined by the physicians’ attitude and knowledge. In this context, the present study was conducted with the goal of investigating psychiatrists’ perceptions of the use of OLDP in their clinical practice. A total of 14 psychiatrists were interviewed using a semi-structured interview guide. Thematic content analysis was performed. Data saturation was achieved at the 12th interview. Six major themes and fifteen subthemes emerged from qualitative interviews. Among the major themes were knowledge and concepts about the off-label drugs, attitude and current practice of prescribing off-label drugs, and rationale of prescribing and suggestions for reducing the use of off-label drugs. Almost all of the respondents interviewed provided detailed comments concerning the OLDP concept, depicted an optimistic approach and deemed that OLDP is quite common in psychiatry. Off-label usage of benzodiazepines such as clonazepam, diazepam and lorazepam in mania, depression, and obsessive–compulsive disorder were commonly reported. It was observed that the majority of the respondents did not inform the patients before prescribing off-label drugs. The present findings revealed that respondents had awareness; however, they depicted diverse attitudes towards prescribing off-label drugs. Further education and sensitization in regions with impoverished knowledge would certainly assist in preventing the risks associated with the use of OLDP.

Structured Interview for Hoarding Disorder (SIHD)

2019 ◽  
Vol 35 (4) ◽  
pp. 512-520
Author(s):  
Caterina Novara ◽  
Paolo Cavedini ◽  
Stella Dorz ◽  
Susanna Pardini ◽  
Claudio Sica
Keyword(s):  
Convergent Validity ◽  
Structured Interview ◽  
Diagnostic Process ◽  
Schizophrenia Spectrum Disorders ◽  
Clinical Environment ◽  
Obsessive Compulsive ◽  
Rater Reliability ◽  
Hoarding Disorder ◽  
Compulsive Disorder ◽  
Schizophrenia Spectrum

Abstract. The Structured Interview for Hoarding Disorder (SIHD) is a semi-structured interview designed to assist clinicians in diagnosing a hoarding disorder (HD). This study aimed to validate the Italian version of the SIHD. For this purpose, its inter-rater reliability has been analyzed as well as its ability to differentiate HD from other disorders often comorbid. The sample was composed of 74 inpatients who had been diagnosed within their clinical environment: 9 with HD, 11 with obsessive-compulsive disorder (OCD) and HD, 22 with OCD, 19 with major depressive disorder (MDD), and 13 with schizophrenia spectrum disorders (SSD). The results obtained indicated “substantial” or “perfect” inter-rater reliability for all the core HD criteria, HD diagnosis, and specifiers. The SIHD differentiated between subjects suffering from and not suffering from a HD. Finally, the results indicated “good” convergent validity and high scores were shown in terms of both sensitivity and specificity for HD diagnosis. Altogether, the SIHD represents a useful instrument for evaluating the presence of HD and is a helpful tool for the clinician during the diagnostic process.

Which biopsychosocial view of mental illness?

2020 ◽  
pp. 82-96
Author(s):  
Walter Sinnott-Armstrong ◽  
Jesse S. Summers
Keyword(s):  
Mental Illness ◽  
Social Engagement ◽  
Psychological Symptoms ◽  
Mental Illnesses ◽  
Post Traumatic Stress ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Disinhibited Social Engagement Disorder ◽  
Post Traumatic ◽  
Almost All

Biopsychosocial theories of mental illness claim that biological, psychological, and social factors are all central to every mental illness. This general approach cannot be assessed or employed properly without specifying the precise relation between mental illnesses and these three levels of understanding. This chapter distinguishes disjunctive, causal, explanatory, therapeutic (or treatment), and constitutive (or definitional) versions of biopsychosocial theories. However, all of these claims are uncontroversial and not distinctive of the biopsychosocial approach, except the constitutive claim. That constitutive claim is inaccurate, because almost all mental illnesses are and should be defined by their psychological symptoms instead of their biological or social causes. These lessons are applied to case studies of post-traumatic stress disorder, disinhibited social engagement disorder, obsessive–compulsive disorder, and scrupulosity.

scholarly journals Comorbidity in Juvenile Obsessive—Compulsive Disorder: A Report from India

2000 ◽  
Vol 45 (3) ◽  
pp. 274-278 ◽  
Author(s):  
YC Janardhan Reddy ◽  
P Srinivas Reddy ◽  
S Srinath ◽  
S Khanna ◽  
SP Sheshadri ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Children And Adolescents ◽  
Obsessive Compulsive Disorder ◽  
Structured Interview ◽  
Child And Adolescent Psychiatry ◽  
Tic Disorders ◽  
Obsessive Compulsive ◽  
Interview Schedule ◽  
Compulsive Disorder ◽  
Disruptive Disorders

Objective: Using minimal exclusion criteria, to assess systematically the psychiatric comorbidity in children and adolescents with obsessive–compulsive disorder (OCD) and compare the findings with those of previous studies. Method: Fifty-four children and adolescents who satisfied DSM-III-R criteria for OCD were assessed using a structured interview schedule, the Children's version of the Yale-Brown Obsessive Compulsive Scale (CY-BOCS), and the questionnaire for tic disorders. All 54 subjects were recruited from the Child and Adolescent Psychiatry (CAP) services of the National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, South India. Diagnoses were determined consensually after a review of all the available data. Results: Comorbidity was found in 69% of the sample: 22% were diagnosed with disruptive disorders; 20% met criteria for mood disorders; 19% had anxiety disorders; and 17% had tic disorders. Only 1 subject had bipolar disorder, and none had psychosis. The rates for individual diagnoses—in particular, the rates for disruptive disorders, bipolar disorder, and psychosis—were considerably lower than those reported in previous studies. Conclusions: Patterns of comorbidity in this study differed from those previously reported. Novel patterns of comorbidity with disruptive disorders, bipolar disorder, and psychosis reported in a few recent studies were not replicated in this study. These differences are probably due to different ascertainment methods. Comorbidity needs to be assessed in large epidemiological samples before definite associations can be made between certain comorbid disorders and juvenile OCD.

Understanding the Genetic Basis of Obsessive-Compulsive Disorder

CNS Spectrums ◽  
1999 ◽  
Vol 4 (5) ◽  
pp. 32-34,47-48 ◽  
Author(s):  
Humberto Nicolini ◽  
Carlos Cruz ◽  
Beatriz Camarena ◽  
Francisco Páez ◽  
Juan Ramón De La Fuente
Keyword(s):  
Psychiatric Disorders ◽  
Obsessive Compulsive Disorder ◽  
Genetic Study ◽  
Genetic Basis ◽  
Scientific Evidence ◽  
Genetic Component ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Different Types

AbstractGenetic study holds potential for understanding the etiology of a number of serious psychiatric disorders. In the case of obsessive-compulsive disorder (OCD), many investigators agree that there is a strong genetic component to its development. In this article, we review the scientific evidence gleaned from different types of studies that has led to a better understanding of the nature of the inherited factors 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.

scholarly journals Prader–Willi syndrome, compulsive and ritualistic behaviours: the first population-based survey

2002 ◽  
Vol 180 (4) ◽  
pp. 358-362 ◽  
Author(s):  
D. J. Clarke ◽  
H. Boer ◽  
J. Whittington ◽  
A. Holland ◽  
J. Butler ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
Rating Scales ◽  
Structured Interview ◽  
Population Based ◽  
Control Group ◽  
Prader Willi Syndrome ◽  
Obsessive Compulsive ◽  
Obsessive Compulsive Symptoms ◽  
Compulsive Disorder ◽  
Population Based Survey

BackgroundObsessive–compulsive disorder has been reported in association with Prader–Willi syndrome.AimsTo report the nature and prevalence of compulsive and similar symptoms associated with Prader–Willi syndrome in a population ascertained as completely as possible.MethodAttempted complete ascertainment of people with Prader– Willi syndrome in eight English counties. Administration of standardised rating scales and a structured interview. Comparison with people with learning disability and high body mass indices.ResultsPrader–Willi syndrome was associated with high rates of ritualistic behaviours, such as the need to ask or to tell something, insistence on routines, hoarding and ordering objects and repetitive actions and speech, compared with the control group, and was negatively correlated with IQ and socialisation age. Typical obsessive–compulsive symptoms, such as checking, counting and cleaning compulsions or obsessional thoughts, were not found.ConclusionsRitualistic and compulsive behaviours occur more frequently in association with Prader–Willi syndrome than among people with intellectual disability and significant obesity.

scholarly journals Severe obsessive-compulsive disorder (OCD): socio-demographic and clinical features

2013 ◽  
Vol 7 (2) ◽  
pp. 53-61 ◽  
Author(s):  
Sylvia Rigardetto ◽  
Andrea Aguglia ◽  
Gabriele Di Salvo ◽  
Umberto Albert ◽  
Filippo Bogetto ◽  
...  
Keyword(s):  
Mood Disorders ◽  
Clinical Features ◽  
Rating Scales ◽  
Age Of Onset ◽  
Total Sample ◽  
Structured Interview ◽  
Main Diagnosis ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Cluster A

Aim: the aim of the study is to evaluate the socio-demographic and clinical features with prognostic value in predicting evolution in severe OCD.Materials and methods: patients with a main diagnosis of OCD were recruited according to DSM-IV criteria. Socio-demographic and clinical features were assessed by mean of a semi-structured interview and clinical rating scales (Y-BOCS, HAM-A, HAM-D and SCID-II). Two subgroups were compared according to the severity of symptoms (severe vs mild-moderate).Results: the total sample was made up of 450 OCD subjects aged 34.5±12.1, with a mean age of onset 22.3±9.1; 215 subjects (47.8%) were females. Patients with severe OCD (Y-BOCS ≥ 32) showed a more insidious onset and a more chronic course compared to patients with mild-moderate symptoms. Other predictors of increased OCD severity were washing and hoarding compulsions. Lastly, the severity of the obsessive-compulsive condition was higher when it was associated either with mood disorders or with Axis II disorders (particularly Cluster A).Discussion: our study shows a correlation between severe OCD and severity predictors such as functional impairment and mood disorders. Furthermore washing and hoarding symptoms, lifetime comorbity with mood disorders and Cluster A personality disorders seem to predict OCD severity.

OCD and Intolerance of Uncertainty: Treatment Issues

2010 ◽  
Vol 24 (1) ◽  
pp. 3-15 ◽  
Author(s):  
Jonathan B. Grayson
Keyword(s):  
Intolerance Of Uncertainty ◽  
Cognitive Distortion ◽  
Obsessive Compulsive ◽  
Patient Factors ◽  
Compulsive Disorder ◽  
Clinical Challenge ◽  
Unsuccessful Treatment ◽  
Almost All ◽  
The Ideal

Recognition of the importance of intolerance of uncertainty (IU) as a critical cognitive distortion in anxiety disorders has been growing. The clinical challenge for researchers and clinicians is to understand the nature of IU and what it means to help clients to cope with it. Obsessive compulsive disorder (OCD) is the ideal diagnosis to examine the challenges IU can present, since, in the author’s opinion, it is the core of almost all manifestations of OCD. The article then focuses upon three factors in which IU factors play a role in successful/unsuccessful treatment: (a) the role of the therapist in helping the sufferer to understand IU and the goals of treatment; (b) techniques for helping the sufferer to accept and carry out the goals of treatment; and (c) patient factors/problems leading to “resistance” in coping with IU.

scholarly journals Obsessive-compulsive disorder and Tourette Syndrome: is there a relationship?

1997 ◽  
Vol 115 (2) ◽  
pp. 1410-1411 ◽  
Author(s):  
Maria Conceição do Rosário ◽  
Eurípedes Constantino Miguel Filho
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Tourette Syndrome ◽  
Biological Markers ◽  
Scientific Evidence ◽  
Psychiatric Disease ◽  
Obsessive Compulsive ◽  
Clinical Genetic ◽  
Compulsive Disorder ◽  
Neuroimaging Data ◽  
Definition Of

The authors describe the main characteristics of Obsessive-Compulsive Disorder, the fourth most frequent psychiatric disease, and Tourette Syndrome. Considered completely separate disorders, there is growing scientific evidence that there is a connection between them. The authors present clinical, genetic and neuroimaging data reinforcing this idea, and call attention to the importance of research in this area, as they believe that the definition of more homogenous subgroups will facilitate the identification of biological markers and predictors of treatment response.

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