title: Dimensional predictors of response to SRI pharmacotherapy in obsessive-compulsive disorder.
abstract: BACKGROUND
  Obsessive-compulsive disorder (OCD) is clinically heterogeneous. Previous studies have reported different patterns of treatment response to serotonin reuptake inhibitors (SRI) based on symptom dimension. Our objective was to replicate these results in OCD patients who participated in one of four randomized, placebo-controlled, clinical trials (RCT).
  
  
  METHODS
  A total of 165 adult OCD subjects participated in one or more eight-week RCT with clomipramine, fluvoxamine, or fluoxetine. All subjects were classified as having major or minor symptoms in four specific OC symptom dimensions that were derived in a previous factor analytic study involving many of these same patients. Ordinal logistic regression was used to test the association between OC symptom dimensions and SRI response.
  
  
  RESULTS
  We found a significant association between the symptom dimension involving sexual, religious and harm-related obsessions as well as checking compulsions (AGG/SR) and improved SRI response. This increased rate of SRI response was experienced primarily by individuals with harm-related obsessions. Over 60% of patients with AGG/SR OCD symptoms were rated as very much improved after SRI treatment.
  
  
  CONCLUSIONS
  As some of the RCTs included were conducted prior to the development of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), improvement in OCD severity was assessed using the Clinical Global Improvement (CGI) Scale. Data from the double-blind and open-label continuation phases of these trials was collapsed together to increase statistical power.
  
  
  CONCLUSIONS
  Patients with OCD vary in their response to SRIs. The presence of AGG/SR symptoms is associated with an initial positive response to SRIs. These data add to the growing body of work linking central serotonin systems with aggressive behavior.
authors: Yale Child Study Center, Yale University School of Medicine, New Haven, CT 06520, USA. angeli_landeros@yahoo.com
authors: Angeli
authors: A
authors: Landeros-Weisenberger
authors: Michael H
authors: MH
authors: Bloch
authors: Ben
authors: B
authors: Kelmendi
authors: Ryan
authors: R
authors: Wegner
authors: Jake
authors: J
authors: Nudel
authors: Philip
authors: P
authors: Dombrowski
authors: Christopher
authors: C
authors: Pittenger
authors: John H
authors: JH
authors: Krystal
authors: Wayne K
authors: WK
authors: Goodman
authors: James F
authors: JF
authors: Leckman
authors: Vladimir
authors: V
authors: Coric
mesh_terms: D000328:Adult; D002997:Clomipramine / Q000009:adverse effects / Q000627:therapeutic use; D003237:Connecticut; D005260:Female; D005473:Fluoxetine / Q000009:adverse effects / Q000627:therapeutic use; D016666:Fluvoxamine / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D010555:Personality Inventory / Q000706:statistics & numerical data; D011379:Prognosis; D011594:Psychometrics; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D002997:Clomipramine; D005473:Fluoxetine; D016666:Fluvoxamine; D017367:Selective Serotonin Reuptake Inhibitors