CLINICAL PREDICTORS OF LONG-TERM OUTCOME IN OBSESSIVE-COMPULSIVE DISORDER

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Arquivos
art_DINIZ_CLINICAL_PREDICTORS_OF_LONG_TERM_OUTCOME_IN_OBSESSIVE_2013.PDF (312.58 KB)
Citações na Scopus
70
Tipo de produção
article
Data de publicação
2013
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
WILEY-BLACKWELL
Autores
JAKUBOVSKI, Ewgeni
FOSSALUZA, Victor
Citação
DEPRESSION AND ANXIETY, v.30, n.8, p.763-772, 2013
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background: The purpose of this study was to investigate demographic and clinical factors associated with the long-term outcome of obsessive-compulsive disorder (OCD). Methods: A hundred ninety-six previously untreated patients with DSM-IV criteria OCD completed a 12-week randomized open trial of group cognitive-behavioral therapy (GCBT) or fluoxetine, followed by 21 months of individualized, uncontrolled treatment, according to international guidelines for OCD treatment. OCD severity was assessed using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) at different times over the follow-up period. Demographics and several clinical variables were assessed at baseline. Results: Fifty percent of subjects improved at least 35% from baseline, and 21.3% responded fully (final Y-BOCS score < or = 8). Worse prognosis was associated with earlier age at onset of OCD (P = 0.045), longer duration of illness (P = 0.001) presence of at least one comorbid psychiatric disorder (P = 0.001), comorbidity with a mood disorder (P = 0.002), higher baseline Beck-Depression scores (P = 0.011), positive family history of tics (P = 0.008), and positive family history of anxiety disorders (P = 0.008). Type of initial treatment was not associated with long-term outcome. After correction for multiple testing, the presence of at least one comorbid disorder, the presence of a depressive disorder, and duration of OCD remained significant. Conclusions: Patients under cognitive-behavioral or pharmacological treatment improved continuously in the long run, regardless of initial treatment modality or degree of early response, suggesting that OCD patients benefit from continuous treatment. Psychiatric comorbidity, especially depressive disorders, may impair the long-term outcome of OCD patients. Depression and Anxiety 30:763-772, 2013. (C) 2012 Wiley Periodicals, Inc.
Palavras-chave
obsessive-compulsive disorder, follow-up studies, drug therapy, cognitive therapy, fluoxetine
URI
https://observatorio.fm.usp.br/handle/OPI/4218
Referências
  1. Abramowitz JS, 2000, BEHAV THER, V31, P517, DOI 10.1016/S0005-7894(00)80028-3
  2. Ackerman DL, 1998, J CLIN PSYCHOPHARM, V18, P185, DOI 10.1097/00004714-199806000-00002
  3. ALARCON RD, 1993, J CLIN PSYCHOPHARM, V13, P210
  4. ALLSOPP M, 1989, BRIT J PSYCHIAT, V154, P829, DOI 10.1192/bjp.154.6.829
  5. Alonso P, 2001, J CLIN PSYCHIAT, V62, P535
  6. Anderson RA, 2007, BEHAV RES THER, V45, P123, DOI 10.1016/j.brat.2006.01.016
  7. BECK AT, 1988, J CONSULT CLIN PSYCH, V56, P893, DOI 10.1037/0022-006X.56.6.893
  8. BECK AT, 1961, ARCH GEN PSYCHIAT, V4, P561
  9. Belotto-Silva C, 2011, CAN J PSYCHIAT, V56, P127
  10. Belotto-Silva C, 2012, J ANXIETY DISORD, V26, P25, DOI 10.1016/j.janxdis.2011.08.008
  11. Braga DT, 2005, ACTA PSYCHIAT SCAND, V112, P180, DOI 10.1111/j.1600-0447.2005.00559.x
  12. Catapano F, 2006, J PSYCHIAT RES, V40, P502, DOI 10.1016/j.jpsychires.2005.04.010
  13. Cordioli AV, 2003, PSYCHOTHER PSYCHOSOM, V72, P211, DOI 10.1159/000070785
  14. deHaan E, 1997, ACTA PSYCHIAT SCAND, V96, P354
  15. de Mathis MA, 2009, CNS SPECTRUMS, V14, P362
  16. de Mathis MA, 2008, EUR PSYCHIAT, V23, P187, DOI 10.1016/j.eurpsy.2008.01.002
  17. Diniz JB, 2011, CLINICS, V66, P387, DOI 10.1590/S1807-59322011000300004
  18. Diniz JB, 2011, J CLIN PSYCHOPHARM, V31, P763, DOI 10.1097/JCP.0b013e3182367aee
  19. Diniz JB, 2004, J CLIN PSYCHIAT, V65, P22
  20. Diniz JB, 2010, J PSYCHOPHARMACOL, V24, P297, DOI 10.1177/0269881108099423
  21. Eisen JL, 1999, J CLIN PSYCHIAT, V60, P346
  22. Eisen JL, 2010, J CLIN PSYCHIAT, V71, P1033, DOI 10.4088/JCP.08m04806blu
  23. Ferrao YA, 2006, J AFFECT DISORDERS, V94, P199, DOI 10.1016/j.jad.2006.04.019
  24. First MB, 1997, STRUCTURED CLIN INTE
  25. FLAMENT MF, 1990, J CHILD PSYCHOL PSYC, V31, P363, DOI 10.1111/j.1469-7610.1990.tb01575.x
  26. FOA EB, 1983, J CONSULT CLIN PSYCH, V51, P287
  27. Foa EB, 2005, AM J PSYCHIAT, V162, P151, DOI 10.1176/appi.ajp.162.1.151
  28. FOA EB, 1992, BRIT J CLIN PSYCHOL, V31, P279
  29. Fontenelle LF, 2004, J AFFECT DISORDERS, V83, P283, DOI 10.1016/j.jad.2004.07.007
  30. Fossaluza V, 2009, CLINICS, V64, P511, DOI 10.1590/S1807-59322009000600005
  31. GOODMAN WK, 1989, ARCH GEN PSYCHIAT, V46, P1006
  32. Lensi P, 1996, BRIT J PSYCHIAT, V169, P101, DOI 10.1192/bjp.169.1.101
  33. LEONARD HL, 1993, ARCH GEN PSYCHIAT, V50, P429
  34. MARKS IM, 1975, BRIT J PSYCHIAT, V127, P349, DOI 10.1192/bjp.127.4.349
  35. MCDOUGLE CJ, 1994, ARCH GEN PSYCHIAT, V51, P302
  36. McLean PD, 2001, J CONSULT CLIN PSYCH, V69, P205, DOI 10.1037//0022-006X.69.2.205
  37. Miguel EC, 2008, REV BRAS PSIQUIATR, V30, P185, DOI 10.1590/S1516-44462008000300003
  38. Miguel EC, 2005, MOL PSYCHIATR, V10, P258, DOI 10.1038/sj.mp.4001617
  39. ORLOFF LM, 1994, AM J PSYCHIAT, V151, P441
  40. OSULLIVAN G, 1991, J CLIN PSYCHIAT, V52, P150
  41. PAULS DL, 1995, AM J PSYCHIAT, V152, P76
  42. THOMSEN PH, 1995, EUR CHILD ADOLES PSY, V4, P112
  43. Pollitt J, 1957, BRIT MED J, P194
  44. PRICE LH, 1987, AM J PSYCHIAT, V144, P1059
  45. RASMUSSEN SA, 1994, J CLIN PSYCHIAT, V55, P5
  46. Rasmussen SA, 1994, J CLIN PSYCHIAT S, V55, P11
  47. RAVIZZA L, 1995, J CLIN PSYCHIAT, V56, P368
  48. Rosario-Campos MC, 2006, MOL PSYCHIATR, V11, P495, DOI 10.1038/sj.mp.4001798
  49. Shavitt Roseli G, 2006, Compr Psychiatry, V47, P276, DOI 10.1016/j.comppsych.2005.09.001
  50. Singer JM, 2004, BIOMETRICAL J, V46, P460, DOI 10.1002/bimj.200310045
  51. Skoog G, 1999, ARCH GEN PSYCHIAT, V56, P121, DOI 10.1001/archpsyc.56.2.121
  52. Sousa MB, 2006, J CLIN PSYCHIAT, V67, P1133
  53. SPPS Inc, 2009, PASW STAT 18 0
  54. Steketee G, 1999, PSYCHIAT RES, V89, P229, DOI 10.1016/S0165-1781(99)00104-3
  55. Tolin DF, 2004, J CLIN PSYCHIAT, V65, P922
  56. Valerio C, 2012, J AFFECT DISORDERS, V139, P187, DOI 10.1016/j.jad.2012.02.002
  57. WARREN W, 1960, J MENT SCI, V106, P815
  58. Zitterl W, 2000, PSYCHOPATHOLOGY, V33, P75, DOI 10.1159/000029124

Coleções
Artigos e Materiais de Revistas Científicas - FM/MPS
Artigos e Materiais de Revistas Científicas - HC/IPq
Artigos e Materiais de Revistas Científicas - LIM/21
Artigos e Materiais de Revistas Científicas - LIM/23