In this letter to the editor, Dr Kellner and colleagues comment on the article "A Systematic Review of the Utility of Electroconvulsive Therapy in Broadly Defined Obsessive-Compulsive-Related Disorders" by dos Santos-Ribeiro et al.
Developmental vulnerability for mental disorders exists in childhood and adolescence. Read this article to learn the incidences and risk factors of mental disorders across childhood and adolescence in a nationwide birth cohort.
Here, read about a 44-year-old woman with diagnoses of OCD and body dysmorphic disorder who presented for evaluation of depression with suicidal thinking. The case illustrates a multipronged approach that included addressing the patient's depressive symptoms, cotreating with a psychologist, and prescribing medication.Â
Psychogenic movement disorders (PMDs) are common and frequently comorbid with other physical and psychiatric conditions. However, treatment of PMDs has been largely unsuccessful. This report describes a patient initially diagnosed with a PMD, who later received a diagnosis of comorbid OCD.Â Treatment with exposure and response prevention, an evidence-based psychotherapy for OCD, was successful in treating both conditions. Read on to find out more.
Clinicians often have little direction regarding optimal treatment options for obsessive-compulsive disorder (OCD). Read this article to learn the relative effectiveness of 7 strategies for treating OCD.
Alcohol dependence and pathological gambling are known to frequently co-occur. So how does problem gambling affect the treatment for alcohol dependence? This study looks at the influence of gambling on response to naltrexone and disulfiram in 254 patients with both disorders and discusses the implications for future development of treatments.
Trichotillomania, or pulling out of one's hair, can be both debilitating and difficult to treat. This letter reports 2 cases in which a brief, 4-component approach to exposure and ritual prevention therapy was used successfully.
Reports have indicated that a single intravenous ketamine dose rapidly decreases OCD symptoms. These researchers planned a study of nasal ketamine administration for this purpose, but they quickly encountered unexpected problems. Read the case report to find out more.
In contrast to depression or anxiety disorders where response is defined as a 50% reduction in symptom severity, a 35% reduction in symptoms is considered to be a response in OCD. Yet, up to 60% of patients fail to attain even this low threshold. CBT and SRIs are first-line agents, but obviously, they are not doing enough. This meta-analysis reviews the current evidence to see if augmenting with glutamatergic agents will provide a better response for patients with OCD.
Baclofen, a French Exception, Seriously Harms Alcohol Use Disorder Patients Without Benefit
To the Editor: Dr Andrade’s analysis of the Bacloville trial in a recent Clinical and Practical Psychopharmacology column, in which he concluded that “individualized treatment with high-dose baclofen (30-300 mg/d) may be a useful second-line approach in heavy drinkers” and that “baclofen may be particularly useful in patients with liver disease,” deserves comment.1
First, Andrade failed to recall that the first pivotal trial of baclofen, ALPADIR (NCT01738282; 320 patients, as with Bacloville), was negative (see Braillon et al2).
Second, Dr Andrade should have warned readers that Bacloville’s results are most questionable, lacking robustness. Although he cited us,3 he overlooked the evidence we provided indicating that the Bacloville article4 was published without acknowledging major changes to the initial protocol, affecting the primary outcome. Coincidentally (although as skeptics, we do not believe in coincidence), the initial statistical team was changed when data were sold to the French pharmaceutical company applying for the marketing authorization in France. As Ronald H. Coase warned, “If you torture the data long enough, it will confess.”