The cross national epidemiology of obsessive compulsive disorder. The Cross National Collaborative Group.
ABSTRACT Data on the epidemiology of psychiatric disorders from different parts of the world using similar methods and diagnostic criteria have previously not been available. This article presents data on lifetime and annual prevalence rates, age at onset, symptom profiles, and comorbidity of obsessive compulsive disorder (OCD), using DSM-III criteria, from community surveys in seven countries: the United States, Canada, Puerto Rico, Germany, Taiwan, Korea, and New Zealand. The OCD annual prevalence rates are remarkably consistent among these countries, ranging from 1.1/100 in Korea and New Zealand to 1.8/100 in Puerto Rico. The only exception is Taiwan (0.4/100), which has the lowest prevalence rates for all psychiatric disorders. The data for age at onset and comorbidity with major depression and the other anxiety disorders are also consistent among countries, but the predominance of obsessions or compulsions varies. These findings suggest the robustness of OCD as a disorder in diverse parts of the world.
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ABSTRACT: Cognitive-behavioural models have linked unacceptable or repugnant thoughts in obsessive-compulsive disorder (OCD) with vulnerable self-themes and fear-of-self concerns. To investigate this notion, Aardema and coworkers recently developed and validated the Fear of Self-Questionnaire (FSQ) in non-clinical samples, finding it had strong internal inconsistency, and good divergent and convergent validity, including strong relationships to obsessional symptoms and with other processes implicated in cognitive models of OCD (e.g., obsessive beliefs and inferential confusion). The current article describes two studies that aim to replicate and extend these findings in clinical OCD and non-clinical samples. Study 1 investigated the psychometric properties of an Italian translation of the FSQ in a non-clinical sample (n = 405). Results of confirmatory factor analysis supported the unidimensionality of the scale; the FSQ also showed very good internal consistency and temporal stability. Study 2 investigated the role of fear of self in OCD symptoms, and unacceptable thoughts and repugnant obsessions in particular, using a clinical OCD sample (n = 76). As expected, fear of self was a unique, major predictor of unacceptable thoughts independent of negative mood states and obsessive beliefs. Moreover, even when considered with obsessive beliefs, anxiety and depression, the feared self was the only unique predictor of obsessionality, providing support for the notion that self-themes could explain why some intrusions convert into obsessions, whereas others do not. Implications for current cognitive-behavioural models are discussed.Clinical Psychology & Psychotherapy 02/2015; DOI:10.1002/cpp.1950 · 2.59 Impact Factor
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ABSTRACT: Patients suffering from obsessive compulsive disorder (OCD), despite heightened levels of functional impairment and disability, often wait several years before starting pharmacological treatment. The interval between the onset of a specific psychiatric disorder and administration of the first pharmacological treatment has been conceptualized as the duration of untreated illness (DUI). The DUI has been increasingly investigated as a predictor of long-term outcomes for OCD and other anxiety disorders. The present study investigated DUI, and demographic-clinical factors associated with DUI, among a sample of patients with OCD. The relationships between DUI, insight, and treatment outcomes were also assessed.Comprehensive Psychiatry 04/2015; 58:88-93. DOI:10.1016/j.comppsych.2014.12.019 · 2.26 Impact Factor
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ABSTRACT: Randomized controlled trials (RCTs) on repetitive transcranial magnetic stimulation (rTMS) as augmentation of selective serotonin reuptake inhibitors (SSRIs) for SSRI-resistant obsessive-compulsive disorder (OCD) have yielded conflicting results. Therefore, this meta-analysis was conducted to assess the efficacy of this strategy for SSRI-resistant OCD. Scientific and medical databases, including international databases (PubMed, MEDLINE, EMBASE, CCTR, Web of Science, PsycINFO), two Chinese databases (CBM-disc, CNKI), and relevant websites dated up to July 2014, were searched for RCTs on this strategy for treating OCD. Mantel-Haenszel random-effects model was used. Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score, response rates and drop-out rates were evaluated. Data were obtained from nine RCTs consisting of 290 subjects. Active rTMS was an effective augmentation strategy in treating SSRI-resistant OCD with a pooled WMD of 3.89 (95% CI = [1.27, 6.50]) for reducing Y-BOCS score and a pooled odds ratio (OR) of 2.65 (95% CI = [1.36, 5.17] for response rates. No significant differences in drop-out rates were found. No publication bias was detected. The pooled examination demonstrated that this strategy seems to be efficacious and acceptable for treating SSRI-resistant OCD. As the number of RCTs included here was limited, further large-scale multi-center RCTs are required to validate our conclusions.International Journal of Clinical and Experimental Medicine 01/2014; 7(12):4897-905. · 1.42 Impact Factor