OBJECTIVE: Data were analyzed from 2 prospective, double-blind, placebo-controlled trials of escitalopram in obsessive-compulsive disorder (OCD) to characterize the baseline levels of functional disability and impairment in health-related quality of life (HRQoL) and to assess the relationship between treatment outcomes (response or relapse) and disability or HRQoL. METHOD: Data from a 24-week, placebo-controlled, fixed-dose trial (N = 466) of escitalopram (10-20 mg/d) or paroxetine (40 mg/d) and from a 40-week, flexible-dose (escitalopram 10-20 mg/d), placebo-controlled relapse-prevention trial (N = 468) were analyzed. Obsessive-compulsive disorder symptoms (DSM-IV criteria) were assessed using the Yale-Brown Obsessive Compulsive Scale (YBOCS), functioning was assessed using the Sheehan Disability Scale (SDS), and HRQoL was assessed using the Medical Outcomes Study Short Form (SF-36). Baseline data were pooled for patients across both studies. For patients in the fixed-dose study, SDS and SF-36 scores were compared across treatment groups and for responders versus nonresponders. In the relapse-prevention trial, SDS and SF-36 scores were compared for relapsed versus nonrelapsed patients. RESULTS: Patients with more severe baseline symptoms (YBOCS > or = 27) reported significantly greater impairment on the SDS (P < .001) and SF-36 (except for bodily pain). Patients receiving escitalopram or paroxetine reported significant improvements on most SF-36 dimensions and on the SDS compared to placebo; however, improvements in work-related functioning were seen earlier for patients receiving escitalopram (20 mg/d). At the study endpoints, SDS and SF-36 scores were significantly better for patients who were responders (versus nonresponders) and for patients who did not relapse (versus relapsers). CONCLUSIONS:Obsessive-compulsive disorder is associated with significant impairment in functioning and HRQoL. Significant differences in disability and HRQoL between responders and nonresponders or relapsers and nonrelapsers suggest a relationship between symptomatic and functional outcomes. TRIAL REGISTRATION: lundbecktrials.com Identifiers: 10205 and 10193. 2010 Physicians Postgraduate Press, Inc.
RCT Entities:
OBJECTIVE: Data were analyzed from 2 prospective, double-blind, placebo-controlled trials of escitalopram in obsessive-compulsive disorder (OCD) to characterize the baseline levels of functional disability and impairment in health-related quality of life (HRQoL) and to assess the relationship between treatment outcomes (response or relapse) and disability or HRQoL. METHOD: Data from a 24-week, placebo-controlled, fixed-dose trial (N = 466) of escitalopram (10-20 mg/d) or paroxetine (40 mg/d) and from a 40-week, flexible-dose (escitalopram 10-20 mg/d), placebo-controlled relapse-prevention trial (N = 468) were analyzed. Obsessive-compulsive disorder symptoms (DSM-IV criteria) were assessed using the Yale-Brown Obsessive Compulsive Scale (YBOCS), functioning was assessed using the Sheehan Disability Scale (SDS), and HRQoL was assessed using the Medical Outcomes Study Short Form (SF-36). Baseline data were pooled for patients across both studies. For patients in the fixed-dose study, SDS and SF-36 scores were compared across treatment groups and for responders versus nonresponders. In the relapse-prevention trial, SDS and SF-36 scores were compared for relapsed versus nonrelapsed patients. RESULTS:Patients with more severe baseline symptoms (YBOCS > or = 27) reported significantly greater impairment on the SDS (P < .001) and SF-36 (except for bodily pain). Patients receiving escitalopram or paroxetine reported significant improvements on most SF-36 dimensions and on the SDS compared to placebo; however, improvements in work-related functioning were seen earlier for patients receiving escitalopram (20 mg/d). At the study endpoints, SDS and SF-36 scores were significantly better for patients who were responders (versus nonresponders) and for patients who did not relapse (versus relapsers). CONCLUSIONS:Obsessive-compulsive disorder is associated with significant impairment in functioning and HRQoL. Significant differences in disability and HRQoL between responders and nonresponders or relapsers and nonrelapsers suggest a relationship between symptomatic and functional outcomes. TRIAL REGISTRATION: lundbecktrials.com Identifiers: 10205 and 10193. 2010 Physicians Postgraduate Press, Inc.
Authors: Josien Schuurmans; Anton J L M van Balkom; Harold J G M van Megen; Johannes H Smit; Merijn Eikelenboom; Danielle C Cath; Maarten Kaarsemaker; Desiree Oosterbaan; Gert-Jan Hendriks; Koen R J Schruers; Nic J A van der Wee; Gerrit Glas; Patricia van Oppen Journal: Int J Methods Psychiatr Res Date: 2012-11-12 Impact factor: 4.035
Authors: Anu Asnaani; Antonia N Kaczkurkin; Elizabeth Alpert; Carmen P McLean; H Blair Simpson; Edna B Foa Journal: Compr Psychiatry Date: 2016-10-11 Impact factor: 3.735
Authors: Dan J Stein; Daniel L C Costa; Christine Lochner; Euripedes C Miguel; Y C Janardhan Reddy; Roseli G Shavitt; Odile A van den Heuvel; H Blair Simpson Journal: Nat Rev Dis Primers Date: 2019-08-01 Impact factor: 52.329