The impact of comorbid body dysmorphic disorder on the response to sequential pharmacological trials for obsessive-compulsive disorder

Author(s)

Diniz, Juliana B. ^[1] ; Costa, Daniel L. C. ^[1] ; Cassab, Raony C. C. ^[2] ; Pereira, Carlos A. B. ^{[1, 2]} ; Miguel, Euripedes C. ^[1] ; Shavitt, Roseli G. ^[1]

Affiliation

^[1] Univ Sao Paulo, Sch Med, Clin Hosp, Inst Psychiat, Sao Paulo - Brazil

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

• Document type: Journal article
• Source: JOURNAL OF PSYCHOPHARMACOLOGY; v. 28, n. 6, p. 603-611, JUN 2014.
• Web of Science Citations: 3

Abstract

Our aim was to investigate the impact of comorbid body dysmorphic disorder (BDD) on the response to sequential pharmacological trials in adult obsessive-compulsive disorder (OCD) patients. The sequential trial initially involved fluoxetine monotherapy followed by one of three randomized, add-on strategies: placebo, clomipramine or quetiapine. We included 138 patients in the initial phase of fluoxetine, up to 80 mg or the maximum tolerated dosage, for 12 weeks. We invited 70 non-responders to participate in the add-on trial; as 54 accepted, we allocated 18 to each treatment group and followed them for an additional 12 weeks. To evaluate the combined effects of sex, age, age at onset, initial severity, type of augmentation and BDD on the response to sequential treatments, we constructed a model using generalized estimating equations (GEE). Of the 39 patients who completed the study (OCD-BDD, n = 13; OCD-non-BDD, n = 26), the OCD-BDD patients were less likely to be classified as responders than the OCD-non-BDD patients (Pearson Chi-Square = 4.4; p = 0.036). In the GEE model, BDD was not significantly associated with a worse response to sequential treatments (z-robust = 1.77; p = 0.07). The predictive potential of BDD regarding sequential treatment strategies for OCD did not survive when the analyses were controlled for other clinical characteristics. (AU)

• FAPESP's process: 11/00968-0 - Fear conditioning, extinction and recall in obsessive-compulsive disorder patients pre- and post-treatment with serotonin reuptake inhibitors.
• Grantee: Juliana Belo Diniz
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• FAPESP's process: 11/21357-9 - Research on neural circuits and biological markers involved in obsessive-compulsive disorder using behavioral paradigms of fear and anxiety
• Grantee: Eurípedes Constantino Miguel Filho
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 08/57896-8 - National Institute for Developmental Psychiatry
• Grantee: Eurípedes Constantino Miguel Filho
• Support Opportunities: Research Projects - Thematic Grants