TY - JOUR
T1 - Early intervention for obsessive compulsive disorder
T2 - An expert consensus statement
AU - Fineberg, Naomi A.
AU - Dell'Osso, Bernardo
AU - Albert, Umberto
AU - Maina, Giuseppe
AU - Geller, Daniel
AU - Carmi, Lior
AU - Sireau, Nick
AU - Walitza, Susanne
AU - Grassi, Giacomo
AU - Pallanti, Stefano
AU - Hollander, Eric
AU - Brakoulias, Vlasios
AU - Menchon, Jose M.
AU - Marazziti, Donatella
AU - Ioannidis, Konstantinos
AU - Apergis-Schoute, Annemieke
AU - Stein, Dan J.
AU - Cath, Danielle C.
AU - Veltman, Dick J.
AU - Van Ameringen, Michael
AU - Fontenelle, Leonardo F.
AU - Shavitt, Roseli G.
AU - Costa, Daniel
AU - Diniz, Juliana B.
AU - Zohar, Joseph
N1 - Publisher Copyright:
© 2019
PY - 2019/4
Y1 - 2019/4
N2 - Obsessive-compulsive disorder (OCD) is common, emerges early in life and tends to run a chronic, impairing course. Despite the availability of effective treatments, the duration of untreated illness (DUI) is high (up to around 10 years in adults) and is associated with considerable suffering for the individual and their families. This consensus statement represents the views of an international group of expert clinicians, including child and adult psychiatrists, psychologists and neuroscientists, working both in high and low and middle income countries, as well as those with the experience of living with OCD. The statement draws together evidence from epidemiological, clinical, health economic and brain imaging studies documenting the negative impact associated with treatment delay on clinical outcomes, and supporting the importance of early clinical intervention. It draws parallels between OCD and other disorders for which early intervention is recognized as beneficial, such as psychotic disorders and impulsive-compulsive disorders associated with problematic usage of the Internet, for which early intervention may prevent the development of later addictive disorders. It also generates new heuristics for exploring the brain-based mechanisms moderating the ‘toxic’ effect of an extended DUI in OCD. The statement concludes that there is a global unmet need for early intervention services for OC related disorders to reduce the unnecessary suffering and costly disability associated with under-treatment. New clinical staging models for OCD that may be used to facilitate primary, secondary and tertiary prevention within this context are proposed.
AB - Obsessive-compulsive disorder (OCD) is common, emerges early in life and tends to run a chronic, impairing course. Despite the availability of effective treatments, the duration of untreated illness (DUI) is high (up to around 10 years in adults) and is associated with considerable suffering for the individual and their families. This consensus statement represents the views of an international group of expert clinicians, including child and adult psychiatrists, psychologists and neuroscientists, working both in high and low and middle income countries, as well as those with the experience of living with OCD. The statement draws together evidence from epidemiological, clinical, health economic and brain imaging studies documenting the negative impact associated with treatment delay on clinical outcomes, and supporting the importance of early clinical intervention. It draws parallels between OCD and other disorders for which early intervention is recognized as beneficial, such as psychotic disorders and impulsive-compulsive disorders associated with problematic usage of the Internet, for which early intervention may prevent the development of later addictive disorders. It also generates new heuristics for exploring the brain-based mechanisms moderating the ‘toxic’ effect of an extended DUI in OCD. The statement concludes that there is a global unmet need for early intervention services for OC related disorders to reduce the unnecessary suffering and costly disability associated with under-treatment. New clinical staging models for OCD that may be used to facilitate primary, secondary and tertiary prevention within this context are proposed.
KW - Compulsive
KW - Duration of untreated illness
KW - Early intervention
KW - OCD
KW - Obsessive
KW - Staging
UR - http://www.scopus.com/inward/record.url?scp=85061443166&partnerID=8YFLogxK
U2 - 10.1016/j.euroneuro.2019.02.002
DO - 10.1016/j.euroneuro.2019.02.002
M3 - Article
C2 - 30773387
AN - SCOPUS:85061443166
SN - 0924-977X
VL - 29
SP - 549
EP - 565
JO - European Neuropsychopharmacology
JF - European Neuropsychopharmacology
IS - 4
ER -