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Escitalopram in obsessive-compulsive disorder: Response of symptom dimensions to pharmacotherapy

dc.contributor.authorStein D.J.
dc.contributor.authorCarey P.D.
dc.contributor.authorLochner C.
dc.contributor.authorSeedat S.
dc.contributor.authorFineberg N.
dc.contributor.authorAndersen E.W.
dc.date.accessioned2011-05-15T16:01:23Z
dc.date.available2011-05-15T16:01:23Z
dc.date.issued2008
dc.identifier.citationCNS Spectrums
dc.identifier.citation13
dc.identifier.citation6
dc.identifier.issn10928529
dc.identifier.urihttp://hdl.handle.net/10019.1/11955
dc.description.abstractIntroduction: There is a substantial body of evidence that obsessive-compulsive disorder (OCD) symptoms can be grouped into a series of discrete dimensions, and some evidence that not all OCD symptom dimensions respond equally well to pharmacologic or psychotherapeutic intervention. The response of OCD symptom dimensions to 12 weeks of treatment with escitalopram or placebo was investigated. Methods: Data from a randomized, double-blind, placebo-controlled study of escitalopram in 466 adults with OCD were analyzed. Exploratory factor analysis of individual items of the Yale-Brown Obsessive-Compulsive Scale checklist was performed and subscale scores based on the extracted factors were determined. Analyses of covariance were undertaken to determine whether inclusion of each subscale score in these models impacted on the efficacy of escitalopram versus placebo. Results: Exploratory factor analysis of individual Yale-Brown Obsessive-Compulsive Scale items yielded 5 factors (contamination/cleaning, harm/checking, hoarding/symmetry, religious/ sexual, and somatic/hypochondriacal). Analyses of covariance including all the subscales demonstrated that escitalopram was more effective than placebo. There was a significant interaction for the hoarding/symmetry factor, which was associated with a poor treatment response. Conclusion: Escitalopram shows good efficacy across the range of OCD symptom dimensions. Nevertheless, hoarding/symmetry was associated with a poorer treatment response. Hoarding/symmetry may be particularly characteristic of an early-onset group of OCD patients, with the involvement of neurotransmitters other than serotonin. Further work is needed to delineate fully the subtypes of OCD, and their correlates with underlying psychobiology and treatment responsivity.
dc.subjectescitalopram
dc.subjectparoxetine
dc.subjectplacebo
dc.subjectadult
dc.subjectaged
dc.subjectarticle
dc.subjectcontrolled study
dc.subjectdrug dose titration
dc.subjectdrug efficacy
dc.subjectfemale
dc.subjecthuman
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectobsessive compulsive disorder
dc.subjectpriority journal
dc.subjectrating scale
dc.subjectrecommended drug dose
dc.subjecttreatment response
dc.subjectAdult
dc.subjectAntidepressive Agents, Second-Generation
dc.subjectCitalopram
dc.subjectDose-Response Relationship, Drug
dc.subjectDouble-Blind Method
dc.subjectFemale
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectObsessive-Compulsive Disorder
dc.subjectParoxetine
dc.subjectPersonality Assessment
dc.subjectPersonality Inventory
dc.subjectPsychometrics
dc.subjectTreatment Outcome
dc.titleEscitalopram in obsessive-compulsive disorder: Response of symptom dimensions to pharmacotherapy
dc.typeArticle
dc.description.versionArticle


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