Neuropsychological predictors of response to randomized treatment in obsessive-compulsive disorder

Author(s)

D'Alcante, Carina C. ^[1] ; Diniz, Juliana B. ^[1] ; Fossaluza, Victor ^{[1, 2]} ; Batistuzzo, Marcelo C. ^[1] ; Lopes, Antonio C. ^[1] ; Shavitt, Roseli G. ^[1] ; Deckersbach, Thilo ^[3] ; Malloy-Diniz, Leandro ^[4] ; Miguel, Euripedes C. ^[1] ; Hoexter, Marcelo Q. ^{[1, 5]}

Affiliation

^[1] Univ Sao Paulo, Sch Med, Dept Psychiat, Obsess Compuls Disorder Spectrum Project Clin, BR-78505453 Sao Paulo - Brazil

^[2] Univ Sao Paulo, Inst Math & Stat, BR-78505453 Sao Paulo - Brazil

^[3] Harvard Univ, Sch Med, Dept Psychiat, Massachusetts Gen Hosp, Boston, MA 02115 - USA

^[4] Univ Fed Minas Gerais, Inst Biol Sci, Grad Program Neurosci, Belo Horizonte, MG - Brazil

^[5] Fed Univ Sao Paulo UNIFESP, Dept Psychiat, Interdisciplinary Lab Clin Neurosci LiNC, Sao Paulo - Brazil

• Document type: Journal article
• Source: PROGRESS IN NEURO-PSYCHOPHARMACOLOGY & BIOLOGICAL PSYCHIATRY; v. 39, n. 2, p. 310-317, DEC 3 2012.
• Web of Science Citations: 34

Abstract

Objective: To identify neuropsychological predictors of treatment response to cognitive-behavioral therapy (CBT) and fluoxetine in treatment-naive adults with obsessive-compulsive disorder (OCD). Method: Thirty-eight adult outpatients with OCD underwent neuropsychological assessment, including tasks of intellectual function, executive functioning and visual and verbal memory, before randomization to a 12-week clinical trial of either CBT or fluoxetine. Neuropsychological measures were used to identify predictors of treatment response in OCD. Results: Neuropsychological measures that predicted a better treatment response to either CBT or fluoxetine were higher verbal IQ (Wechsler Abbreviated Scale of Intelligence) (p = 0.008); higher verbal memory on the California Verbal Learning Test (p = 0.710); shorter time to complete part D (Dots) (p<0.001), longer time to complete part W (Words) (p = 0.025) and less errors on part C (Colors) (p<0.001) in the Victoria Stroop Test (VST). Fewer perseverations on the California Verbal Learning Test, a measure of mental flexibility, predicted better response to CBT, but worse response to fluoxetine (p = 0.002). Conclusion: In general, OCD patients with better cognitive and executive abilities at baseline were more prone to respond to either CBT or fluoxetine. Our finding that neuropsychological measures of mental flexibility predicted response to treatment in opposite directions for CBT and fluoxetine suggests that OCD patients with different neuropsychological profiles may respond preferentially to one type of treatment versus the other. Further studies with larger samples of OCD patients are necessary to investigate the heuristic value of such findings in a clinical context. (C) 2012 Elsevier Inc. All rights reserved. (AU)

• FAPESP's process: 06/50273-0 - Pharmacological augmentation strategies in treatment of resistant obsessive-compulsive disorder: a double-blind placebo-controlled trial
• Grantee: Juliana Belo Diniz
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)