Vlasios Brakoulias1, Vladan Starcevic1, Umberto Albert2,3, Shyam Sundar Arumugham4, Brenda E Bailey5, Amparo Belloch6, Tania Borda7,8, Liliana Dell'Osso9, Jason A Elias10, Martha J Falkenstein10, Ygor A Ferrao11, Leonardo F Fontenelle12,13,14, Lena Jelinek15, Leto Kalogeraki16, Brian Kay5, Luana D Laurito12,13,14, Christine Lochner17, Giuseppe Maina3, Donatella Marazziti9, Andrew Martin18, Hisato Matsunaga19, Euripedes C Miguel20, Pedro Morgado21,22,23, Irakis Mourikis16, Massimo Pasquini24, Rodrigo Perez Rivera7, Sriramya Potluri10, Janardhan Y C Reddy4, Brian C Riemann5, Maria Conceição do Rosario25, Roseli G Shavitt11, Dan J Stein17, Kirupumani Viswasam1, Zhen Wang26,27, Naomi A Fineberg28. 1. Department of Psychiatry, Nepean Hospital, Sydney Medical School, The University of Sydney, Penrith, NSW, Australia. 2. Rita Levi Montalcini Department of Neuroscience, University of Turin, Turin, Italy. 3. Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy. 4. Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India. 5. Department of Psychiatry, Rogers Memorial Hospital, Oconomowoc, Wisconsin. 6. Department of Personality Psychology, Research Unit for Obsessive-Compulsive and Related Disorders, I'TOC, Faculty of Psychology, Universidad de Valencia, Valencia, Spain. 7. Department of Psychiatry, Bio-Behavioral Institute BA, Buenos Aires, Argentina. 8. Department of Psychology, Argentinian Catholic University (UCA), Buenos Aires, Argentina. 9. Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, Dipartmento di Farmacia, University of Pisa, Pisa, Italy. 10. Department of Psychiatry, McLean Hospital/Harvard Medical School, Belmont, Massachusetts. 11. Department of Psychiatry, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil. 12. Department of Psychiatry and Legal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. 13. Department of Psychiatry, D'Or Institute for Research and Education, Rio de Janeiro, Brazil. 14. Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Victoria. 15. Department of Psychology, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany. 16. Behavioral Therapy Department/Outpatient Clinic for OCD and Related Disorders, Division of Psychiatry I, National and Kapodistrian University of Athens, Athens, Greece. 17. MRC Unit on Anxiety Disorders, Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa. 18. NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia. 19. Department of Neuropsychiatry, Hyogo College of Medicine, Nishinomiya, Japan. 20. Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil. 21. Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal. 22. Department of Psychiatry, ICVS-3Bs-PT Government Associate Laboratory, Braga/Guimarães, Portugal. 23. Department of Psychiatry, Hospital de Braga, Braga, Portugal. 24. Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy. 25. Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil. 26. Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 27. Department of Psychiatry, Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China. 28. Department of Psychiatry, Hertfordshire Partnership University NHS Foundation Trust and University of Hertfordshire, Hatfield, UK.
Abstract
OBJECTIVE: The objective of this study was to characterise international trends in the use of psychotropic medication, psychological therapies, and novel therapies used to treat obsessive-compulsive disorder (OCD). METHODS: Researchers in the field of OCD were invited to contribute summary statistics on the characteristics of their samples. Consistency of summary statistics across countries was evaluated. RESULTS: The study surveyed 19 expert centres from 15 countries (Argentina, Australia, Brazil, China, Germany, Greece, India, Italy, Japan, Mexico, Portugal, South Africa, Spain, the United Kingdom, and the United States) providing a total sample of 7,340 participants. Fluoxetine (n = 972; 13.2%) and fluvoxamine (n = 913; 12.4%) were the most commonly used selective serotonin reuptake inhibitor medications. Risperidone (n = 428; 7.3%) and aripiprazole (n = 415; 7.1%) were the most commonly used antipsychotic agents. Neurostimulation techniques such as transcranial magnetic stimulation, deep brain stimulation, gamma knife surgery, and psychosurgery were used in less than 1% of the sample. There was significant variation in the use and accessibility of exposure and response prevention for OCD. CONCLUSIONS: The variation between countries in treatments used for OCD needs further evaluation. Exposure and response prevention is not used as frequently as guidelines suggest and appears difficult to access in most countries. Updated treatment guidelines are recommended.
OBJECTIVE: The objective of this study was to characterise international trends in the use of psychotropic medication, psychological therapies, and novel therapies used to treat obsessive-compulsive disorder (OCD). METHODS: Researchers in the field of OCD were invited to contribute summary statistics on the characteristics of their samples. Consistency of summary statistics across countries was evaluated. RESULTS: The study surveyed 19 expert centres from 15 countries (Argentina, Australia, Brazil, China, Germany, Greece, India, Italy, Japan, Mexico, Portugal, South Africa, Spain, the United Kingdom, and the United States) providing a total sample of 7,340 participants. Fluoxetine (n = 972; 13.2%) and fluvoxamine (n = 913; 12.4%) were the most commonly used selective serotonin reuptake inhibitor medications. Risperidone (n = 428; 7.3%) and aripiprazole (n = 415; 7.1%) were the most commonly used antipsychotic agents. Neurostimulation techniques such as transcranial magnetic stimulation, deep brain stimulation, gamma knife surgery, and psychosurgery were used in less than 1% of the sample. There was significant variation in the use and accessibility of exposure and response prevention for OCD. CONCLUSIONS: The variation between countries in treatments used for OCD needs further evaluation. Exposure and response prevention is not used as frequently as guidelines suggest and appears difficult to access in most countries. Updated treatment guidelines are recommended.
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