INTRODUCTION: 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.
RCT Entities:
INTRODUCTION: 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 OCDpatients, 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.
Authors: Katharine A Phillips; Dan J Stein; Scott L Rauch; Eric Hollander; Brian A Fallon; Arthur Barsky; Naomi Fineberg; David Mataix-Cols; Ygor Arzeno Ferrão; Sanjaya Saxena; Sabine Wilhelm; Megan M Kelly; Lee Anna Clark; Anthony Pinto; O Joseph Bienvenu; Joanne Farrow; James Leckman Journal: Depress Anxiety Date: 2010-06 Impact factor: 6.505
Authors: James F Leckman; Damiaan Denys; H Blair Simpson; David Mataix-Cols; Eric Hollander; Sanjaya Saxena; Euripedes C Miguel; Scott L Rauch; Wayne K Goodman; Katharine A Phillips; Dan J Stein Journal: Depress Anxiety Date: 2010-06 Impact factor: 6.505
Authors: Christine Lochner; Samuel R Chamberlain; Martin Kidd; Lian Taljaard; Naomi A Fineberg; Trevor W Robbins; Dan J Stein Journal: Psychopharmacology (Berl) Date: 2020-07-08 Impact factor: 4.530
Authors: Hilga Katerberg; Kevin L Delucchi; S Evelyn Stewart; Christine Lochner; Damiaan A J P Denys; Denise E Stack; J Michael Andresen; J E Grant; Suck W Kim; Kyle A Williams; Johan A den Boer; Anton J L M van Balkom; Johannes H Smit; Patricia van Oppen; Annemiek Polman; Michael A Jenike; Dan J Stein; Carol A Mathews; Danielle C Cath Journal: Behav Genet Date: 2010-04-02 Impact factor: 2.805
Authors: Martin A Katzman; Pierre Bleau; Pierre Blier; Pratap Chokka; Kevin Kjernisted; Michael Van Ameringen; Martin M Antony; Stéphane Bouchard; Alain Brunet; Martine Flament; Sophie Grigoriadis; Sandra Mendlowitz; Kieron O'Connor; Kiran Rabheru; Peggy M A Richter; Melisa Robichaud; John R Walker Journal: BMC Psychiatry Date: 2014-07-02 Impact factor: 3.630
Authors: D R M A Højgaard; E L Mortensen; T Ivarsson; K Hybel; G Skarphedinsson; J B Nissen; R Valderhaug; K Dahl; B Weidle; N C Torp; M Grados; A B Lewin; K H Melin; E A Storch; L H Wolters; T K Murphy; E J S Sonuga-Barke; P H Thomsen Journal: Eur Child Adolesc Psychiatry Date: 2016-07-07 Impact factor: 4.785