Clinical features associated to refractory obsessive-compulsive disorder

Some patients with obsessive-compulsive disorder (OCD) exhibit an unsatisfactory reduction in symptom severity despite being treated with all the available therapeutic alternatives. The clinical variables associated with treatment-refractoriness in OCD are inconsistently described in the literature. METHODS: To investigate factors associated with treatment-refractoriness of patients with OCD, we conducted a case-control study, comparing 23 patients with treatment-refractory OCD to 26 patients with treatment-responding OCD. RESULTS: The factors associated with refractoriness of OCD were higher severity of symptoms since the onset of OCD (p<0.001), chronic course (p=0.003), lack of a partner (p=0.037), unemployment (p=0.025), low economic status (p=0.015), presence of obsessive-compulsive symptoms of sexual/religious content (p=0.043), and higher scores on family accommodation (p<0.001). Only the three latter variables remained significantly associated with treatment-refractoriness after regression analyses. LIMITATIONS: small sample size, the biases and drawbacks inherent to a case-control study, and the inclusion criteria used to define the study groups may have limited the generalisation of the results. CONCLUSION: A major strength of this study is the systematic and structured evaluation of a vast array of variables related to the clinical expression of OCD, including epigenetic factors and ratings derived from instruments evaluating family accommodation. The presence of sexual/religious symptoms, low economic status and high modification on family function due to OCD were independently associated with treatment-refractoriness. Future longitudinal studies are warranted to verify if these variables represent predictive factors of treatment non-response.

Ferr„o, Ygor A.
Shavitt, Roseli G.
Bedin, N·dia R.
de Mathis, Maria EugÍnia
Carlos Lopes, AntÙnio
Fontenelle, Leonardo F.
Torres, Albina R.
Miguel, EurÌpedes C.
Item Type: 
Journal Article
Publication Title: 
Journal of Affective Disorders
Journal Abbreviation: 
J Affect Disord
Publication Date: 
Publication Year: 
Library Catalog: 
PMID: 16764938

Turabian/Chicago Citation

Ygor A. Ferr„o, Roseli G. Shavitt, N·dia R. Bedin, Maria EugÍnia de Mathis, AntÙnio Carlos Lopes, Leonardo F. Fontenelle, Albina R. Torres and EurÌpedes C. Miguel. 2006-08. "Clinical features associated to refractory obsessive-compulsive disorder." Journal of Affective Disorders 94: 3-Jan: 199-209. 10.1016/j.jad.2006.04.019.

Wikipedia Citation

<ref> {{Cite journal | doi = 10.1016/j.jad.2006.04.019 | issn = 0165-0327 | volume = 94 | pages = 199-209 | last = Ferr„o | first = Ygor A. | coauthors = Shavitt, Roseli G., Bedin, N·dia R., de Mathis, Maria EugÍnia, Carlos Lopes, AntÙnio, Fontenelle, Leonardo F., Torres, Albina R., Miguel, EurÌpedes C. | title = Clinical features associated to refractory obsessive-compulsive disorder | journal = Journal of Affective Disorders | date = 2006-08 | pmid = | pmc = }} </ref>