Please use this identifier to cite or link to this item: http://repositorio.unifesp.br/handle/11600/32318
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dc.contributor.authorShavitt, Roseli Gedanke
dc.contributor.authorValerio, Carolina
dc.contributor.authorFossaluza, Victor
dc.contributor.authorSilva, Elizabeth Meyer da
dc.contributor.authorCordeiro, Quirino
dc.contributor.authorDiniz, Juliana Belo
dc.contributor.authorBelotto-Silva, Cristina
dc.contributor.authorCordioli, Aristides Volpato
dc.contributor.authorMari, Jair [UNIFESP]
dc.contributor.authorMiguel, Euripedes Constantino
dc.date.accessioned2016-01-24T13:59:23Z-
dc.date.available2016-01-24T13:59:23Z-
dc.date.issued2010-03-01
dc.identifierhttp://dx.doi.org/10.1007/s00406-009-0015-3
dc.identifier.citationEuropean Archives of Psychiatry and Clinical Neuroscience. Heidelberg: Dr Dietrich Steinkopff Verlag, v. 260, n. 2, p. 91-99, 2010.
dc.identifier.issn0940-1334
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/32318-
dc.description.abstractFew case series studies have addressed the issue of treatment response in patients with obsessive-compulsive disorder (OCD) and comorbid post-traumatic stress disorder (PTSD), and there are no prospective studies addressing response to conventional treatment in OCD patients with a history of trauma (HT). the present study aimed to investigate, prospectively, the impact of HT or PTSD on two systematic, first-line treatments for OCD. Two hundred and nineteen non-treatment-resistant OCD outpatients were treated with either group cognitive-behavioral therapy (GCBT n = 147) or monotherapy with a selective serotonin reuptake inhibitor (SSRI n = 72). Presence of HT and PTSD were assessed at intake, as part of a broader clinical and demographical baseline characterization of the sample. Severity and types of OCD symptoms were assessed with the Yale-Brown Obsessive-Compulsive Scale (YBOCS) and the Dimensional YBOCS (DYBOCS), respectively. Depression and anxiety symptoms were measured with the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). Both treatments had 12-week duration. Treatment response was considered as a categorical [35% or greater reduction in baseline YBOCS scores plus a Clinical Global Impression-Improvement rating of better (2) or much better (1)] and continuous variable (absolute number reduction in baseline YBOCS scores). Treatment response was compared between the OCD + HT group versus the OCD without HT group and between the OCD + PTSD group versus the OCD without PTSD group. Parametric and non-parametric tests were used when indicated. Data on HT and PTSD were available for 215 subjects. Thirty-eight subjects (17.67% of the whole sample) had a positive HT (OCD + HT group) and 22 subjects (57.89% of the OCD + HT group and 10.23% of the whole sample) met full DSM-IV criteria for PTSD. the OCD + HT and OCD without HT groups presented similar response to GCBT (60% of responders in the first group and 63% of responders in the second group, p = 1.00). Regarding SSRI treatment, the difference between the response of the OCD + HT (47.4%) and OCD without HT (22.2%) groups was marginally significant (p = 0.07). in addition, the OCD + PTSD group presented a greater treatment response than the OCD without PTSD group when treatment response was considered as a continuous variable (p = 0.01). the age when the first trauma occurred had no impact on treatment response. in terms of specific OCD symptom dimensions, as measured by the DYBOCS, OCD treatment fostered greater reductions for the OCD + PTSD group than for the OCD without PTSD group in the scores of contamination obsessions and cleaning compulsions, collecting and hoarding and miscellaneous obsessions and related compulsions (including illness concerns and mental rituals, among others). the OCD + PTSD group also presented a greater reduction in anxiety scores than the OCD without PTSD group (p = 0.003). the presence of HT or PTSD was not related to a poorer treatment response in this sample of non-treatment-resistant OCD patients. Unexpectedly, OCD patients with PTSD presented a greater magnitude of response when compared with OCD without PTSD patients in specific OCD symptom dimensions. Future studies are needed to clarify if trauma and PTSD have a more significant impact on the onset and clinical expression of OCD than on the conventional treatment for this condition, and whether OCD stemming from trauma would constitute a subtype of OCD with a distinct response to conventional treatment.en
dc.description.sponsorshipFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
dc.description.sponsorshipConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
dc.format.extent91-99
dc.language.isoeng
dc.publisherDr Dietrich Steinkopff Verlag
dc.relation.ispartofEuropean Archives of Psychiatry and Clinical Neuroscience
dc.rightsAcesso restrito
dc.subjectTraumaen
dc.subjectPost-traumatic stress disorderen
dc.subjectObsessive-compulsive disorderen
dc.subjectTreatmenten
dc.titleThe impact of trauma and post-traumatic stress disorder on the treatment response of patients with obsessive-compulsive disorderen
dc.typeArtigo
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionUniv Fed Rio Grande do Sul
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.description.affiliationUniv São Paulo, Dept & Inst Psychiat, Sch Med, BR-05403010 São Paulo, Brazil
dc.description.affiliationUniv São Paulo, Inst Math & Stat, BR-05403010 São Paulo, Brazil
dc.description.affiliationUniv Fed Rio Grande do Sul, Dept Psychiat & Forens Med, BR-90035903 Porto Alegre, RS, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, Dept Psychiat, BR-04026001 São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Dept Psychiat, BR-04026001 São Paulo, Brazil
dc.description.sponsorshipIDFAPESP: 06/61459-7
dc.description.sponsorshipIDFAPESP: 06/50273-0
dc.description.sponsorshipIDFAPESP: 06/50829-8
dc.description.sponsorshipIDFAPESP: 2005-55628-8
dc.description.sponsorshipIDCNPq: 420.122/2005-2
dc.identifier.doi10.1007/s00406-009-0015-3
dc.description.sourceWeb of Science
dc.identifier.wosWOS:000275085300002
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