Clinical features associated with treatment response in obsessive-compulsive disorder.
OBJECTIVE
This study aims to investigate the effect of sociodemographic and clinical features on the short-term response to pharmacological treatment in obsessive-compulsive disorder (OCD). We focused especially on investigating factors previously associated with poorer prognosis, such as comorbidity with tic disorders, early onset of symptoms, and sensory phenomena preceding compulsions, which have been described as common in both tic-related and early-onset OCD.


METHODS
The study involved 41 consecutive adult patients with OCD diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria and was conducted at the OCD Spectrum Disorders Clinic of the University of Sao Paulo School of Medicine in São Paulo, Brazil, between January of 2000 and December of 2001. All patients were treated exclusively with oral clomipramine for 14 weeks. Treatment response, measured for Yale-Brown Obsessive-Compulsive Scale score decrease from baseline, was assessed by an investigator blinded as to the variables of interest present.


RESULTS
Linear regression analysis showed that having a partner and sensory phenomena preceding compulsions were associated with better response to clomipramine treatment (P = .04 and P = .002, respectively). Tic comorbidity and early onset of symptoms were not associated with poorer response.


CONCLUSIONS
In OCD, having a partner and sensory phenomena preceding compulsions seem to be associated with a favorable response to pharmacological treatment.
Shavitt
Roseli G
RG
Department of Psychiatry, University of São Paulo School of Medicine, Caixa Postal 8091, São Paulo, Brazil. roseli@protoc.com.br
Belotto
Cristina
C
Curi
Mariana
M
Hounie
Ana G
AG
Rosário-Campos
Maria C
MC
Diniz
Juliana B
JB
Ferrão
Ygor A
YA
Pato
Michele T
MT
Miguel
Eurípedes C
EC
D000328:Adult; D017668:Age of Onset; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D001938:Brazil / Q000453:epidemiology; D002997:Clomipramine / Q000627:therapeutic use*; D015897:Comorbidity; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D017533:Marital Status; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology*; D010865:Pilot Projects; D012959:Socioeconomic Factors; D016896:Treatment Outcome
D000929:Antidepressive Agents, Tricyclic; D002997:Clomipramine