Meta-analysis of age at help-seeking and duration of untreated illness (DUI) in obsessive-compulsive disorder (OCD): The need for early interventions

Journal of Affective Disorders, Год журнала: 2025, Номер unknown

Опубликована: Март 1, 2025

Obsessive-compulsive disorder (OCD) is a chronic neuropsychiatric that often begins early in childhood. Patients with OCD are known to seek help late after onset, and therefore have long duration of untreated illness (DUI), which found correlate negative clinical outcomes. No meta-analysis has previously investigated this issue. Our protocol was pre-registered PROSPERO (CRD42020165226). We followed PRISMA-guidelines searched for relevant articles four electronic databases. Meta-analyses means based on random-effects (Der-Simonian-and-Laird-method) were used derive the pooled estimates. Subgroup-analyses meta-regressions conducted explore possible factors affecting help-seeking DUI. included N = 31 studies quantitative synthesis, 16 proving data age at providing illness. The mean 28.66 years (95 % CI: 27.34-29.98), while interval between onset 6.97 5.69-8.24), 80.23 months (68.72-91.75), around 6.69 years, all p < 0.001. Specific OCD-related affected course illness, associated more prognosis. This confirms proposes length process

Язык: Английский

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Feasibility, acceptability and practicality of transcranial stimulation in obsessive compulsive symptoms (FEATSOCS): A randomised controlled crossover trial

Comprehensive Psychiatry, Год журнала: 2023, Номер 122, С. 152371 - 152371

Опубликована: Янв. 26, 2023

Transcranial direct current stimulation (tDCS) is a non-invasive form of neurostimulation with potential for development as self-administered intervention. It has shown promise safe and effective treatment obsessive compulsive disorder (OCD) in small number studies. The two most favourable targets appear to be the left orbitofrontal cortex (L-OFC) supplementary motor area (SMA). We report first study test these head-to-head within randomised sham-controlled trial. Our aim was inform design future clinical research studies, by focussing on acceptability safety intervention, feasibility recruitment, adherence tolerability tDCS, size any treatment-effect. FEATSOCS randomised, double-blind, sham-controlled, cross-over, multicentre study. Twenty adults DSM-5-defined OCD were treatment, comprising three courses clinic-based tDCS (SMA, L-OFC, Sham), randomly allocated delivered counterbalanced order. Each course comprised four 20-min 2 mA stimulations, over consecutive days, separated 'washout' period at least weeks. Assessments carried out raters who blind stimulation-type. Clinical outcomes assessed before, during, up weeks after stimulation. Patient representatives lived experience actively involved all stages. Clinicians showed willingness recruit participants recruitment target achieved. Adherence interventions generally good, only dropouts. There no serious adverse events, effects which did occur transient mostly mild intensity. Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) scores numerically improved from baseline 24 h final across intervention groups but tended worsen thereafter. greatest effect seen L-OFC arm, (Cohen's d = −0.5 [95% CI −1.2 0.2] versus suggesting this site should pursued further Additional significant sham referenced improvements secondary occurred lesser extent SMA acceptable, practicable apply, well-tolerated appears promising OCD. represents based changes, though symptoms not statistically compared sham. signs promise. Further investigation warranted, determine optimal protocol (current, frequency, duration), longer-term effectiveness brain-based mechanisms effect. If efficacy substantiated, consideration home-based approaches rational next step. Trial registration: ISRCTN17937049. https://doi.org/10.1186/ISRCTN17937049

Язык: Английский

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Transcranial Magnetic Stimulation to Treat Neuropathic Pain: A Bibliometric Analysis

Healthcare, Год журнала: 2024, Номер 12(5), С. 555 - 555

Опубликована: Фев. 28, 2024

Neuropathic pain is caused by a lesion or disease of the somatosensory system and one most incapacitating types, representing significant non-met medical need. Due to increase in research field since innovative therapeutic strategies are required, namely intractable neuropathic pain, neurostimulation has been used. Within this approach, transcranial magnetic stimulation (TMS) that uses transient produce electrical currents over cortex emerges as popular method literature. Since an area expansion due putative role TMS, we performed bibliometric analysis Scopus with primary objective identifying scientific production related use TMS manage pain. The had no restrictions, focused on characteristics literature retrieved, collaboration main topics from inception 6 July 2023. A total 474 articles were collected. biggest co-occurrence between terms "neuropathic pain" "transcranial stimulation" was obtained. journal "Clinical Neurophysiology" leads Top 5 productive sources. United States country, 50% US documents being "review articles", followed France, 56% French "original articles". Lefaucheur, JP Saitoh, Y two influential authors. frequent type document article". Most studies (34%) identified traumatic although large proportion (38%) did not report type. This study allows us provide general overview application for useful establishing future directions field.

Язык: Английский

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Treating refractory obsessive compulsive disorder with cathodal transcranial direct current stimulation over the supplementary motor area: a large multisite randomized sham-controlled double-blind study

Frontiers in Psychiatry, Год журнала: 2024, Номер 15

Опубликована: Май 17, 2024

Background The present study evaluated the therapeutic efficacy and tolerability of 10 transcranial direct current stimulation (tDCS) sessions in treatment-resistance obsessive-compulsive disorder (OCD) patients using a multisite double-blind sham-controlled design. Methods Eighty outpatients suffering from were randomized to receive either active or sham stimulation. cathode was positioned over supplementary motor area anode right supraorbital area. Patients at baseline, end treatment (day 14), one-month follow-up 45), three-month 105) on Yale-Brown Obsessive Compulsive Scale. Results Although significant interaction between time observed, primary endpoint—measuring change obsessive compulsive scale scores after two weeks—was not achieved. Conversely, secondary endpoint, which concerned three months, successfully met. It is important note, however, that there no differences percentage responders remitters any post-treatment assessments. This suggests may have had clinically relevant impact. well received treatment, indicating its good tolerability. Conclusion largest controlled trial patients. Our results indicate importance studying placebo effect necessity consider long best evaluate effects intervention. Clinical registration ClinicalTrials.gov , identifier NCT03304600.

Язык: Английский

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Consensus review and considerations on TMS to treat depression: A comprehensive Update Endorsed by the National Network of depression Centers, the clinical TMS Society, and the International Federation of clinical Neurophysiology

Clinical Neurophysiology, Год журнала: 2024, Номер 170, С. 206 - 233

Опубликована: Дек. 20, 2024

Язык: Английский

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MAGNITUDE: Transcranial Magnetic Stimulation for Treatment-Resistant Obsessive–Compulsive Disorder: A Randomized Sham-Controlled Phase II Trial Protocol

Brain Sciences, Год журнала: 2025, Номер 15(2), С. 106 - 106

Опубликована: Янв. 23, 2025

Obsessive–Compulsive Disorder (OCD) is a chronic psychiatric condition with lifetime prevalence of 2–3%. It significantly burdens quality life and associated substantial economic disease burdens. Cognitive-behavioral therapy high-dose selective serotonin reuptake inhibitors are considered the first-line treatments for OCD. Approximately two-thirds patients exhibit inadequate responses to current standard therapies, thus lacking adequate therapy, resulting in loss huge Repetitive transcranial stimulation (rTMS) non-invasive, safe, well-tolerated intervention that modulates prefrontal cortical circuits involved A previous systematic review explored therapeutic effects rTMS applied dorsolateral cortex (dlPFC) area treatment-resistant showed application high-frequency low-frequency (LF) dlPFC region yielded controversial post-treatment Y-BOCS (Yale-Brown Scale) findings due factors such as small sample sizes, short-term study durations, variations protocols. Objectives: Thus, we propose theoretical protocol based on assess better effect LF OCD patients. Methods: We will recruit moderate severe limited response from in- outpatient clinics. use fMRI precious localization right 1 Hz total 2000 pulses three times 40 s inter-train intervals 5 days week, 6 consecutive weeks. The primary outcome be mean reduction at end this study. Conclusions: This highlights rTMS’s potential reform treatment, accentuate safety, accessibility, clinical integration, future research foundations.

Язык: Английский

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Augmentative transcranial magnetic stimulation over the left orbitofrontal cortex in patients with treatment-resistant obsessive-compulsive disorder: an acute and follow-up study

Neuroscience Applied, Год журнала: 2025, Номер unknown, С. 105511 - 105511

Опубликована: Фев. 1, 2025

Язык: Английский

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Effects of transcranial direct current stimulation (tDCS) at different cortical targets on cognition in obsessive-compulsive disorder (OCD): an exploratory analysis

International Clinical Psychopharmacology, Год журнала: 2025, Номер unknown

Опубликована: Апрель 4, 2025

Transcranial direct current stimulation (tDCS) holds promise as a treatment for obsessive-compulsive disorder (OCD). Patients with OCD show impairment in specific domains of cognitive flexibility and response inhibition. We previously reported that tDCS produced positive clinical effect on symptoms. Here, we report secondary analysis neurocognitive data. In this randomized, double-blind, sham-controlled, crossover, multicenter feasibility study, adults diagnosis according to the diagnostic statistical manual mental disorders, fifth edition (DSM-5) received three courses clinic-based tDCS, targeting left orbitofrontal cortex (L-OFC), bilateral supplementary motor area (SMA), sham, randomly allocated delivered counterbalanced order. Cognitive assessments were conducted before 2-h after first each arm. Nineteen recruited. both L-OFC SMA significantly improved inflexibility, while sham did not (paired-sample t test, baseline vs. stimulation). No significant was found impulsivity (stop-signal reaction time) any arms. small sample patients OCD, single administration rapid improvement inflexibility but impulsivity. A definitive controlled trial OFC SMA, including markers, is indicated.

Язык: Английский

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Obsessive-compulsive symptoms and traits in patients with burning mouth syndrome: a cross-sectional multicentric analysis

Clinical Oral Investigations, Год журнала: 2025, Номер 29(4)

Опубликована: Апрель 5, 2025

Abstract Objective This study investigates the frequency and characteristics of obsessive-compulsive (OC) symptoms Obsessive-Compulsive Personality Disorder (OCPD) in patients with Burning Mouth Syndrome (BMS). Background (OCD) is a chronic condition involving intrusive thoughts (obsessions) repetitive behaviors (compulsions), while personality disorder characterized by specific traits such as perfectionism, rigidity need for control. Both conditions frequently overlap, but their prevalence BMS has never been explored. Materials methods A total 151 were assessed using Inventory-Revised (OCI-R), Compulsive Assessment Scale (CPAS), Visual Analog (VAS), Short-Form McGill Pain Questionnaire (SF-MPQ), Hamilton Anxiety Depression scales (HAM-A, HAM-D), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness (ESS). Patients grouped based on OCI CPAS scores. Results n = 123 (81.6%) our sample females, mean age 63.19 ± 12.2 years. Clinically significant OC (OCI- R > 21) observed 41.7% sample, 37% met OCPD criteria; both present 24.5% patients. Conclusions show high traits, which should be taken into account clinicians considered therapeutic approach, given that they could complicate symptom management. Clinical relevance : By identifying these through OCI-R CPAS, may improve treatment strategies, perspective multidisciplinary tailored personalized approach.

Язык: Английский

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Efficacy of Adjunctive Deep Transcranial Magnetic Stimulation in Obsessive-Compulsive Disorder

Journal of Ect, Год журнала: 2025, Номер unknown

Опубликована: Апрель 22, 2025

Obsessive-compulsive disorder is one of the most common neuropsychiatric disorders with a higher lifetime prevalence than schizophrenia, often showing inadequate response to pharmacological and psychotherapeutic treatments. This study aimed examine efficacy adjunctive deep transcranial magnetic stimulation (dTMS) in randomized, sham-controlled set-up, addressing standard Forty-nine obsessive-compulsive patients were randomly allocated receive either high-frequency dTMS (20 Hz) or sham received 10 sessions treatment using H7 coil target dorsal anterior cingulate cortex medial prefrontal over period 2 weeks. Change Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) scores was primary outcome measure. Secondary measures changes Hamilton Anxiety Rating Depression rates as measured by Y-BOCS. The active group demonstrated significant reduction Y-BOCS compared (-10.4 vs -2.6 points; P < 0.001), an effect size 1.39. Full 75% versus 5% (P 0.001). depressive symptoms also improved significantly (Hamilton Scale: -9.1 -2.4 points, 0.001; -5.9 -1.8 Our that targeting obsessive-compulsive, anxiety, symptoms, faster fewer previous trials, suggesting may serve effective early intervention for wider range patients.

Язык: Английский

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