International prescribing practices in obsessive-compulsive disorder (OCD).
To assess rates of psychotropic medication use in patients with obsessive-compulsive disorder (OCD) in seven different countries on five continents and to compare these with international treatment guidelines.



Researchers in the field of OCD were invited to contribute summary statistics on the characteristics of their patients with OCD and on their incidence of psychotropic use. Consistency of summary statistics across countries was evaluated.



The data came from Brazil (n = 955), Italy (n = 750), South Africa (n = 555), Japan (n = 382), Australia (n = 213), India (n = 202) and Spain (n = 82). The majority (77.9%; n = 2445) of the total sample of 3139 participants received a psychotropic medication. Consistent with international guidelines, selective serotonin reuptake inhibitors (SSRIs) were most commonly used (73.5%, n = 1796), but their use ranged from 59% in Australia to 96% in Japan. Clomipramine use varied from 5% in Japan and South Africa to 26% in India and Italy. Atypical antipsychotic use ranged from 12% in South Africa to 50% in Japan.



Pharmacotherapy for OCD varied significantly across sites. Prospective studies are required to determine the cultural, pharmacoeconomic and pharmacogenomic factors that may play a role in the variation in prescribing practices internationally and whether these variations influence treatment outcomes. Copyright © 2016 John Wiley & Sons, Ltd.
Department of Psychiatry, The University of Sydney and Nepean Hospital, Sydney Medical School-Nepean, Discipline of Psychiatry, Sydney/Penrith, NSW, Australia.
Vlasios
V
Brakoulias
Department of Psychiatry, The University of Sydney and Nepean Hospital, Sydney Medical School-Nepean, Discipline of Psychiatry, Sydney/Penrith, NSW, Australia.
Vladan
V
Starcevic
Department of Personality Psychology, Research Unit for Obsessive-Compulsive and Related Disorders, I'TOC, Faculty of Psychology, Universidad de Valencia, Spain.
Amparo
A
Belloch
Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, Dipartmento di Farmacia, University of Pisa, Italy.
Liliana
L
Dell'Osso
Department of Psychiatry, Federal University of Health Sciences of Porto Alegre, Brazil.
Ygor A
YA
Ferrão
Department of Psychiatry and Legal Medicine, Federal University of Rio de Janeiro, Brazil.|D'Or Institute for Research and Education; Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Australia.
Leonardo F
LF
Fontenelle
MRC Unit on Anxiety Disorders, Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa.
Christine
C
Lochner
Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, Dipartmento di Farmacia, University of Pisa, Italy.
Donatella
D
Marazziti
NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia.
Andrew
A
Martin
Department of Neuropsychiatry, Hyogo College of Medicine, Hyogo, Japan.
Hisato
H
Matsunaga
Department and Institute of Psychiatry, University of São Paulo School of Medicine, Brazil.
Euripedes C
EC
Miguel
Department of Psychiatry National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.
Y C Janardhan
YC
Reddy
Child and Adolescent Psychiatry Unit (UPIA) at the Department of Psychiatry, Federal University of São Paulo, Brazil.
Maria C
MC
do Rosário
Department and Institute of Psychiatry, University of São Paulo School of Medicine, Brazil.
Roseli G
RG
Shavitt
Department of Psychiatry National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.
Arumugham Shyam
AS
Sundar
MRC Unit on Anxiety Disorders, Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa.
Dan Joseph
DJ
Stein
Department of Psychiatry, The University of Sydney and Nepean Hospital, Sydney Medical School-Nepean, Discipline of Psychiatry, Sydney/Penrith, NSW, Australia.
Kirupamani
K
Viswasam
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001315:Australia / Q000453:epidemiology; D001938:Brazil / Q000453:epidemiology; D003431:Cross-Cultural Comparison; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D038622:Internationality; D007558:Italy / Q000453:epidemiology; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy* / Q000453:epidemiology*; D011446:Prospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D013019:South Africa / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
D014150:Antipsychotic Agents; D017367:Selective Serotonin Reuptake Inhibitors
antipsychotics; benzodiazepines; cross-cultural study; medication; obsessive-compulsive disorder; pharmacotherapy; selective serotonin re-uptake inhibitors