Several studies have examined the predictors of treatment response in obsessive-compulsive disorder (OCD). Only limited information is available on the predictors of response to antipsychotic augmentation of serotonin reuptake inhibitors (SRIs). Data from placebo-controlled studies of augmentation with quetiapine were combined in a best subsets logistic regression to derive a predictive model for Yale-Brown obsessive-compulsive scale (YBOCS) change and the YBOCS endpoint. Data from the YBOCS checklist and a variety of clinical and demographic variables previously shown to predict treatment outcome in OCD were analysed. In univariate analyses, the failure of fewer previous SRI trials was associated with the YBOCS response. In the multivariate model, for YBOCS change, 45% of the variance was attributed to the fact that patients had failed fewer previous SRI treatments, had higher baseline obsession scores, and ordering and arranging compulsions. For the YBOCS endpoint scores, 50% of the variance was attributed to the fact that patients had fewer failed SRI trials, higher baseline compulsion scores, and counting/ordering and arranging compulsions. These data indicate a number of predictors of response to augmentation of SRIs in treatment-refractory OCD. These include fewer previously failed SRI trials and generally higher overall baseline scores for obsessions and compulsions as well as counting/ordering and arranging compulsions. Other factors are, however, also likely to play an important role in predicting outcome.
These findings are the first to show that SPD and BFRBs other than HPD frequently co-occur. Furthermore, they extend previous work showing that SPD has a family component and suggest that SPD and HPD may run in the same families. Given the recruitment method and the self-report nature of the comorbidity data, replication in clinical samples is needed.
In two racialized societies, perceived discrimination acts independent of demographic factors, general stressors, social desirability bias, racial identity, and SES, to negatively affect the psychological resources of self-esteem and mastery.
Read moreOur findings suggest that anxiety disorder patients may differ across countries in terms of childhood trauma. Certain forms of childhood abuse may contribute specific vulnerability to different types of psychopathology. Longitudinal studies should focus on the potential sequential development of SAD/PD among individuals with childhood emotional abuse.
Read moreBackground and purpose: Development of minimal invasive operation techniques has given unicompartemental knee arthroplasty (UKA) renewed interest. Indications for use of UKA are however debated, and short-term advantages of UKA over total knee arthroplasty (TKA) should be weighed against the higher risk of reoperation. More knowledge on long term results of pain and function after knee arthroplasties is therefore needed and was the purpose of this study.Methods: Patient-reported pain and function were collected at least two years after the operations in postal questionnaires from 1643 osteoarthritis patients reported to the Norwegian Arthroplasty Register with intact primary TKA (n=1271) or UKA (n=372). The questionnaire contained instruments for calculation of the knee specific Knee Osteoarthritis Outcome Score (KOOS), and for quality of life (EQ-5D, post- and pre-operative). 5 subscales from KOOS were used as outcome. To incorporate an outcome for anterior knee pain an additional subscale based on 7 que...
Read moreThese results indicate that psychological treatments of depression and anxiety disorders are also effective in LAMI countries, and may encourage global dissemination of these interventions.
Read morePost-traumatic stress disorder (PTSD) is a prevalent and disabling disorder. Recognition of neurobiological abnormalities associated with this condition suggests the potential efficacy of medication in its treatment. Nevertheless, questions regarding the efficacy of medications remain, despite general endorsement by clinical practice guidelines of selective serotonin reuptake inhibitors (SSRIs) as first-line agents in treating PTSD. This paper reviews evidence from randomized controlled trials (RCTs) for the efficacy of acute and long-term pharmacotherapy for PTSD, including the treatment of refractory PTSD. In addition, we conducted a systematic meta-analysis to compare the efficacy of different medications in treating PTSD. The effects of methodological study features (including year of publication, duration, number of centres) and sample characteristics (proportion of combat veterans, gender composition) were also tested. The largest body of evidence for short- and long-term efficacy of medication currently exists for SSRIs, with promising initial findings for the selective noradrenergic reuptake inhibitor venlafaxine and the atypical antipsychotic risperidone. Treatment effect was predicted by number of centres and recency of the study, with little evidence that sample characteristics predicted response. Evidence for the effectiveness of benzodiazepines is lacking, despite their continued use in clinical practice. Finally, the α1 antagonist prazosin and the atypical antipsychotics show some efficacy in treatment-resistant PTSD. Adequately powered trials that are designed in accordance with best-practice guidelines are required to provide conclusive evidence of clinically relevant differences in efficacy between agents in treating PTSD, and to help estimate clinical and methodological predictors of treatment response.
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