Parents of patient with obsessive-compulsive disorder
Family histories obtained from 27 patients with obsessive-compulsive disorder failed to find a single parent with the disorder. To augment the family history data the Leyton Obsessional Inventory was completed by a subset of 10 patients and by their 20 parents. Although as a group parents showed lower Leyton Obsessional Inventory symptom scores than their obsessional offspring, 3 parents who had not been identified by family history were distinguished by high symptom scores in the absence of significant resistance or interference.
Available from: Paula M. Barrett
- "Note: CBFT = cognitive-behavioral family-based therapy; CDI = Children's Depression Inventory (Kovacs, 1992); MASC = Multidimensional Anxiety Scale for Children (March, 1997); NIMH GOCS = National Institute of Mental Health Global Obsessive-Compulsive Scale (Insel et al., 1983); Improvement = NIMH GOCS improvement ratings (i.e., not available at pretreatment; Insel et al., 1983); NA = not applicable. Main effect for time is denoted by asterisks beside the measure name. "
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ABSTRACT: To evaluate the relative efficacy of (1) individual cognitive-behavioral family-based therapy (CBFT); (2) group CBFT; and (3) a waitlist control group in the treatment of childhood obsessive-compulsive disorder (OCD).
This study, conducted at a university clinic in Brisbane, Australia, involved 77 children and adolescents with OCD who were randomized to individual CBFT, group CBFT, or a 4- to 6-week waitlist control condition. Children were assessed before and after treatment and at 3 months and 6 months following the completion of treatment using diagnostic interviews, symptom severity interviews, and self-report measures. Parental distress, family functioning, sibling distress, and levels of accommodation to OCD demands were also assessed. Active treatment involved a manualized 14-week cognitive-behavioral protocol, with parental and sibling components.
By an evaluable patient analysis, statistically and clinically significant pretreatment-to-posttreatment change occurred in OCD diagnostic status and severity across both individual and group CBFT, with no significant differences in improvement ratings between these conditions. There were no significant changes across measures for the waitlist condition. Treatment gains were maintained up to 6 months of follow-up.
Contrary to previous findings and expectations, group CBFT is as effective in reducing OCD symptoms for children and adolescents as individual treatment. Findings support the efficacy and durability of CBFT in treating childhood OCD.
Journal of the American Academy of Child & Adolescent Psychiatry 02/2004; 43(1):46-62. DOI:10.1097/00004583-200401000-00014 · 7.26 Impact Factor
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ABSTRACT: Although therapeutic responsiveness to tricyclic antidepressants has been primarily associated with the affective disorders, clinical investigations in the last decade have suggested that non-affective disorders such as panic disorder, obsessive-compulsive disorder, anxiety disorder, bulimia, enuresis, migraine, and the chronic pain syndrome may also respond to tricyclics and other antidepressants. This therapeutic responsiveness may sometimes be related to improvement in secondary depressive symptoms, but may also clearly occur in the absence of secondary depression; in particular, improvement in the core symptoms of at least some of these disorders may occur without a change in mood. Furthermore, many patients with these disorders display psychobiologic abnormalities that show many similarities, but also some differences, compared to those observed in patients with affective disorders, despite the frequent absence of affective symptoms. While an improvement in subclinical or "masked" depression remains one hypothesis linking tricyclic responsiveness and shared biological abnormalities in this diverse group of diagnostic entities, an alternative hypothesis (the "ven disorder" hypothesis) is presented, suggesting the possibility that tricyclic and other antidepressant-responding patients have a core disorder with common psychobiologic abnormalities but multiple clinical and diagnostic presentations. An alternative hypothesis (the "shotgun" hypothesis) suggests that the multiple actions of tricyclics (e.g. on adrenergic receptors vs. muscarinic receptors vs. serotonin system changes) may each be differentially important in the therapeutic outcome in patients with specific or predominant problems in one or another of these areas. An examination of both the similarities and differences among the non-affective, tricyclic-responsive disorders and the affective disorders may provide clues about the important psychobiologic elements in these disorders, and to the mode of action of tricyclic antidepressants and related drugs across the psychiatric disorder spectrum.
Progress in Neuro-Psychopharmacology and Biological Psychiatry 02/1985; 9(1):3-13. DOI:10.1016/0278-5846(85)90174-5 · 3.69 Impact Factor
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ABSTRACT: The nature of the relationship between obsessive-compulsive personality and obsessive-compulsive disorder has been the subject of considerable debate. The present article dealt with clinical opinion and reviewed empirical data bearing on this issue. It was concluded that, although the two clinical entities bear a surface similarity in terms of shared behavioral features and defenses, obsessive-compulsive personality is neither a necessary nor sufficient factor in the development of obsessive-compulsive disorder, though the latter appears to be more frequently associated with premorbid obsessive-compulsive personality patterns than with other personality patterns. Suggestions for future research study are made.
The Journal of Psychology Interdisciplinary and Applied 04/1987; 121(2):137-48. DOI:10.1080/00223980.1987.9712651 · 0.86 Impact Factor
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