V Brakoulias1, V Starcevic2, A Belloch3, C Brown4, Y A Ferrao5, L F Fontenelle6, C Lochner7, D Marazziti8, H Matsunaga9, E C Miguel10, Y C J Reddy11, M C do Rosario12, R G Shavitt10, A Shyam Sundar11, D J Stein7, A R Torres13, K Viswasam2. 1. Department of Psychiatry, The University of Sydney and Nepean Hospital, Sydney Medical School-Nepean, Discipline of Psychiatry, Sydney/Penrith, NSW, Australia. Electronic address: vbrakoulias@bigpond.com. 2. Department of Psychiatry, The University of Sydney and Nepean Hospital, Sydney Medical School-Nepean, Discipline of Psychiatry, Sydney/Penrith, NSW, Australia. 3. Department of Personality Psychology, Research Unit for Obsessive-Compulsive and Related Disorders, I'TOC, Faculty of Psychology, Universidad de Valencia, Spain. 4. NHMRC Clinical Trials Centre, the University of Sydney, Sydney, NSW, Australia. 5. Department of Psychiatry, Federal University of Health Sciences of Porto Alegre, Brazil. 6. Department of Psychiatry and Legal Medicine, Federal University of Rio de Janeiro, D'Or Institute for Research and Education, Brazil; Monash Institute of Cognitive and Clinical Neurosciences, Monash University. 7. MRC Unit on Anxiety Disorders, Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa. 8. Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, Dipartmento di Farmacia, Univeristy of Pisa, Italy. 9. Department of Neuropsychiatry, Hyogo College of Medicine, Hyogo, Japan. 10. Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, Brazil. 11. Department of Psychiatry National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India. 12. Child and Adolescent Psychiatry Unit (UPIA) at the Department of Psychiatry, Federal University of São Paulo (UNIFESP), Brazil. 13. Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, Univ Estadual Paulista (UNESP), Brazil.
Abstract
OBJECTIVES: To collate data from multiple obsessive-compulsive disorder (OCD) treatment centers across seven countries and five continents, and to report findings in relation to OCD comorbidity, age of onset of OCD and comorbid disorders, and suicidality, in a large clinical and ethnically diverse sample, with the aim of investigating cultural variation and the utility of the psychiatric diagnostic classification of obsessive-compulsive and related disorders. METHODS: Researchers in the field of OCD were invited to contribute summary statistics on current and lifetime psychiatric comorbidity, age of onset of OCD and comorbid disorders and suicidality in their patients with OCD. RESULTS: Data from 3711 adult patients with primary OCD came from Brazil (n=955), India (n=802), Italy (n=750), South Africa (n=565), Japan (n=322), Australia (n=219), and Spain (n=98). The most common current comorbid disorders were major depressive disorder (28.4%; n=1055), obsessive-compulsive personality disorder (24.5%, n=478), generalized anxiety disorder (19.3%, n=716), specific phobia (19.2%, n=714) and social phobia (18.5%, n=686). Major depression was also the most commonly co-occurring lifetime diagnosis, with a rate of 50.5% (n=1874). OCD generally had an age of onset in late adolescence (mean=17.9years, SD=1.9). Social phobia, specific phobia and body dysmorphic disorder also had an early age of onset. Co-occurring major depressive disorder, generalized anxiety disorder and psychotic disorders tended to have a later age of onset than OCD. Suicidal ideation within the last month was reported by 6.4% (n=200) of patients with OCD and 9.0% (n=314) reported a lifetime history of suicide attempt. CONCLUSIONS: In this large cross-continental study, comorbidity in OCD was common. The high rates of comorbid major depression and anxiety disorders emphasize the need for clinicians to assess and monitor for these disorders. Earlier ages of onset of OCD, specific phobia and social phobia may indicate some relatedness between these disorders, but this requires further study. Although there do not appear to be significant cultural variations in rates or patterns of comorbidity and suicidality, further research using similar recruitment strategies and controlling for demographic and clinical variables may help to determine whether any sociocultural factors protect against suicidal ideation or psychiatric comorbidity in patients with OCD.
OBJECTIVES: To collate data from multiple obsessive-compulsive disorder (OCD) treatment centers across seven countries and five continents, and to report findings in relation to OCD comorbidity, age of onset of OCD and comorbid disorders, and suicidality, in a large clinical and ethnically diverse sample, with the aim of investigating cultural variation and the utility of the psychiatric diagnostic classification of obsessive-compulsive and related disorders. METHODS: Researchers in the field of OCD were invited to contribute summary statistics on current and lifetime psychiatric comorbidity, age of onset of OCD and comorbid disorders and suicidality in their patients with OCD. RESULTS: Data from 3711 adult patients with primary OCD came from Brazil (n=955), India (n=802), Italy (n=750), South Africa (n=565), Japan (n=322), Australia (n=219), and Spain (n=98). The most common current comorbid disorders were major depressive disorder (28.4%; n=1055), obsessive-compulsive personality disorder (24.5%, n=478), generalized anxiety disorder (19.3%, n=716), specific phobia (19.2%, n=714) and social phobia (18.5%, n=686). Major depression was also the most commonly co-occurring lifetime diagnosis, with a rate of 50.5% (n=1874). OCD generally had an age of onset in late adolescence (mean=17.9years, SD=1.9). Social phobia, specific phobia and body dysmorphic disorder also had an early age of onset. Co-occurring major depressive disorder, generalized anxiety disorder and psychotic disorders tended to have a later age of onset than OCD. Suicidal ideation within the last month was reported by 6.4% (n=200) of patients with OCD and 9.0% (n=314) reported a lifetime history of suicide attempt. CONCLUSIONS: In this large cross-continental study, comorbidity in OCD was common. The high rates of comorbid major depression and anxiety disorders emphasize the need for clinicians to assess and monitor for these disorders. Earlier ages of onset of OCD, specific phobia and social phobia may indicate some relatedness between these disorders, but this requires further study. Although there do not appear to be significant cultural variations in rates or patterns of comorbidity and suicidality, further research using similar recruitment strategies and controlling for demographic and clinical variables may help to determine whether any sociocultural factors protect against suicidal ideation or psychiatric comorbidity in patients with OCD.
Authors: Lily A Brown; Emily Wakschal; Stefanie Russman-Block; Christina L Boisseau; Maria C Mancebo; Jane L Eisen; Steven A Rasmussen Journal: J Affect Disord Date: 2018-11-13 Impact factor: 4.839
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Authors: Nicole C R McLaughlin; Darin D Dougherty; Emad Eskandar; Herbert Ward; Kelly D Foote; Donald A Malone; Andre Machado; William Wong; Mark Sedrak; Wayne Goodman; Brian H Kopell; Fuad Issa; Donald C Shields; Osama A Abulseoud; Kendall Lee; Mark A Frye; Alik S Widge; Thilo Deckersbach; Michael S Okun; Dawn Bowers; Russell M Bauer; Dana Mason; Cynthia S Kubu; Ivan Bernstein; Kyle Lapidus; David L Rosenthal; Robert L Jenkins; Cynthia Read; Paul F Malloy; Stephen Salloway; David R Strong; Richard N Jones; Steven A Rasmussen; Benjamin D Greenberg Journal: Contemp Clin Trials Commun Date: 2021-06-05