TY - JOUR
T1 - Treatment non-response in OCD
T2 - Methodological issues and operational definitions
AU - Pallanti, Stefano
AU - Hollander, Eric
AU - Bienstock, Carol
AU - Koran, Lorrin
AU - Leckman, James
AU - Marazziti, Donatella
AU - Pato, Michele
AU - Stein, Dan
AU - Zohar, Joseph
PY - 2002
Y1 - 2002
N2 - While controlled trials with SRIs have demonstrated a selective efficacy in obsessive-compulsive disorder (OCD), up to 40-60% of patients do not have a satisfactory outcome. Non-response to treatment in OCD is associated with serious social disability. There are a large number of non-responsive patients, and they are difficult to cluster due to ambiguities in the diagnostic criteria, possibility of subtypes, and a high rate of comorbidity. Moreover, the findings of current studies of so-called 'non-responsive' cases are currently nongeneralizable because of the lack of an operational definition of non-response. The result has been that a cumulative body of data on a reasonably homogeneous sample of non-responders has not been developed. The aims of this paper are to clarify some of the obstacles in defining stages of response and levels of non-response and, through a comprehensive analysis, to propose a systematic nosology for this rather common condition. Better characterization of which patients respond and do not respond to various treatments will enable more accurate clustering of patients, and help facilitate multi-site data collection for future research trials.
AB - While controlled trials with SRIs have demonstrated a selective efficacy in obsessive-compulsive disorder (OCD), up to 40-60% of patients do not have a satisfactory outcome. Non-response to treatment in OCD is associated with serious social disability. There are a large number of non-responsive patients, and they are difficult to cluster due to ambiguities in the diagnostic criteria, possibility of subtypes, and a high rate of comorbidity. Moreover, the findings of current studies of so-called 'non-responsive' cases are currently nongeneralizable because of the lack of an operational definition of non-response. The result has been that a cumulative body of data on a reasonably homogeneous sample of non-responders has not been developed. The aims of this paper are to clarify some of the obstacles in defining stages of response and levels of non-response and, through a comprehensive analysis, to propose a systematic nosology for this rather common condition. Better characterization of which patients respond and do not respond to various treatments will enable more accurate clustering of patients, and help facilitate multi-site data collection for future research trials.
KW - OCD
KW - Refractory OCD
KW - Resistant OCD
KW - Treatment non-response
KW - Treatment response
UR - http://www.scopus.com/inward/record.url?scp=0036087695&partnerID=8YFLogxK
U2 - 10.1017/S1461145702002900
DO - 10.1017/S1461145702002900
M3 - Review article
C2 - 12135542
AN - SCOPUS:0036087695
SN - 1461-1457
VL - 5
SP - 181
EP - 191
JO - International Journal of Neuropsychopharmacology
JF - International Journal of Neuropsychopharmacology
IS - 2
ER -