Clinical Predictors of Drug Nonresponse in Obsessive-Compulsive Disorder

Chandrashekhar N. Shetti, DPM, MD; Y. C. Janardhan Reddy, DPM, MD; Thennarasu Kandavel, PhD; Kartik Kashyap, DPM; Srinivas Singisetti, MD; Avinash S. Hiremath, MD; Mulia Umar-Faruq Siddequehusen, MD; and Samar Raghunandanan, MD

Published: December 15, 2005

Article Abstract

Objective: Obsessive-compulsive disorder (OCD) is often a chronic and disabling illness with high comorbidity. Serotonin reuptake inhibitors (SRIs) are effective in treating OCD. However, 40% to 60% of patients with OCD do not respond adequately to SRIs. This study aims to identify the clinical predictors of nonresponse to SRIs in OCD by comparing SRI responders and nonresponders.

Method: 122 subjects with a diagnosis of DSM-IV OCD of at least 1 year’s duration and with treatment history of adequate trials with at least 2 SRIs were recruited from December 2002 to March 2004. Of these, 67 were SRI responders and 55 were SRI nonresponders; they were compared on various clinical parameters. Nonresponse was defined as a score of > = 3 on the Clinical Global Impressions-Improvement subscale (CGI-I) after at least 2 adequate trials with SRIs. Response was defined as a score of 1 or 2 on the CGI-I.

Results: In regression analysis, baseline severity of OCD (p = .049), comorbid major depressive disorder (p = .005), presence of sexual obsessions (p = .002), and washing (p = .008) and miscellaneous compulsions (p = .013) were identified as predictors of nonresponse to SRIs. Early age at onset showed a trend toward prediction of nonresponse (p = .056). In the univariate analysis, mixed OCD (p = .001) and poor insight (p = .023) were associated with nonresponse.

Conclusion: This study has identified clinical predictors of nonresponse to SRIs. These predictors may have to be taken into consideration and assessed carefully when SRIs are prescribed to treat OCD. Future studies should aim at identifying treatment modalities that are effective in SRI nonresponders.

Volume: 66

Quick Links: Obsessive-Compulsive and Related Disorders

Continue Reading…

Subscribe to read the entire article

$40.00

Buy this Article as a PDF

Sign-up to stay
up-to-date today!

SUBSCRIBE

Already registered? Sign In

Original Research

Prevalence and Correlates of Obsessive-Compulsive Symptoms in Individuals With Schizophrenia, Schizoaffective Disorder, or Bipolar Disorder

Prevalence and correlates of obsessive-compulsive symptoms and OCD were identified from the case records of over 22,500...

Read More...