2024
An evaluation of treatment response and remission definitions in adult obsessive-compulsive disorder: A systematic review and individual-patient data meta-analysis
Ramakrishnan D, Farhat L, Vattimo E, Levine J, Johnson J, Artukoglu B, Landeros-Weisenberger A, Zangen A, Pelissolo A, de B Pereira C, Rück C, Costa D, Mataix-Cols D, Shannahoff-Khalsa D, Tolin D, Zarean E, Meyer E, Hawken E, Storch E, Andersson E, Miguel E, Maina G, Leckman J, Sarris J, March J, Diniz J, Kobak K, Mallet L, Vulink N, Amiaz R, Fernandes R, Shavitt R, Wilhelm S, Golshan S, Tezenas du Montcel S, Erzegovesi S, Baruah U, Greenberg W, Kobayashi Y, Bloch M. An evaluation of treatment response and remission definitions in adult obsessive-compulsive disorder: A systematic review and individual-patient data meta-analysis. Journal Of Psychiatric Research 2024, 173: 387-397. PMID: 38598877, DOI: 10.1016/j.jpsychires.2024.03.044.Peer-Reviewed Original ResearchMeSH KeywordsAdultHumansObsessive-Compulsive DisorderPsychiatric Status Rating ScalesTreatment OutcomeConceptsYale-Brown Obsessive-Compulsive ScaleObsessive-compulsive disorderCGI-IRandomized-controlled trialsAdult obsessive-compulsive disorderClinical Global Impression ImprovementObsessive-Compulsive ScaleTreatment responseIndividual-patient data meta-analysisPosttreatment scoresEvaluation of treatment responseMeta-analysis of randomized-controlled trialsFirst-line therapyCGIIndividual participant dataMeta-analysisNovel treatment modalitiesExpert consensusIndividual participant data meta-analysisSystematic reviewDisordersData meta-analysisPosttreatmentRemission definitionsImpressive improvement
2023
Gamma knife capsulotomy for intractable OCD: Neuroimage analysis of lesion size, location, and clinical response
McLaughlin N, Magnotti J, Banks G, Nanda P, Hoexter M, Lopes A, Batistuzzo M, Asaad W, Stewart C, Paulo D, Noren G, Greenberg B, Malloy P, Salloway S, Correia S, Pathak Y, Sheehan J, Marsland R, Gorgulho A, De Salles A, Miguel E, Rasmussen S, Sheth S. Gamma knife capsulotomy for intractable OCD: Neuroimage analysis of lesion size, location, and clinical response. Translational Psychiatry 2023, 13: 134. PMID: 37185805, PMCID: PMC10130137, DOI: 10.1038/s41398-023-02425-2.Peer-Reviewed Original ResearchConceptsY-BOCS reductionObsessive-compulsive disorderGamma knife capsulotomyLesion sizeRefractory obsessive-compulsive disorderOverall lesion volumeIntractable obsessive-compulsive disorderLesion-symptom mappingVoxel-wise lesion-symptom mappingClinical improvementClinical responseWhite matter pathwaysClinical outcomesFull respondersConventional therapyInternal capsuleLesion characteristicsLesion volumeAnterior limbEffective treatmentLesion locationLesion occurrenceCoronal planeSize/locationPatientsBrazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders guidelines for the treatment of adult obsessive-compulsive disorder. Part I: pharmacological treatment
de Oliveira M, de Barros P, de Mathis M, Boavista R, Chacon P, Echevarria M, Ferrão Y, de Queiroz Vattimo E, Lopes A, Torres A, Diniz J, Fontenelle L, do Rosário M, Shavitt R, Miguel E, da Silva R, da Conceição Costa D. Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders guidelines for the treatment of adult obsessive-compulsive disorder. Part I: pharmacological treatment. Brazilian Journal Of Psychiatry 2023, 45: 146-161. PMID: 36749887, PMCID: PMC10154009, DOI: 10.47626/1516-4446-2022-2891.Peer-Reviewed Original ResearchConceptsSelective serotonin reuptake inhibitorsAdult obsessive-compulsive disorderObsessive-compulsive disorderPharmacological treatmentReuptake inhibitorsEvidence-based pharmacological interventionsFirst-line pharmacological treatmentAmerican Psychiatric Association guidelinesEvidence-based pharmacological treatmentFirst-line treatmentNorepinephrine reuptake inhibitorsPrimary outcome measureSerotonin reuptake inhibitorsGlutamate-modulating agentsHigh-quality evidenceAmerican Heart AssociationLevel of evidenceTreatment of OCDBrazilian Research ConsortiumAdult patientsHeart AssociationTolerable dosesAssociation guidelinesTreatment recommendationsPharmacological interventions
2022
World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders – Version 3. Part II: OCD and PTSD
Bandelow B, Allgulander C, Baldwin D, da Conceição Costa D, Denys D, Dilbaz N, Domschke K, Hollander E, Kasper S, Möller H, Eriksson E, Fineberg N, Hättenschwiler J, Kaiya H, Karavaeva T, Katzman M, Kim Y, Inoue T, Lim L, Masdrakis V, Menchón J, Miguel E, Nardi A, Pallanti S, Perna G, Rujescu D, Starcevic V, Stein D, Tsai S, Van Ameringen M, Vasileva A, Wang Z, Zohar J. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders – Version 3. Part II: OCD and PTSD. The World Journal Of Biological Psychiatry 2022, 24: 118-134. PMID: 35900217, DOI: 10.1080/15622975.2022.2086296.Peer-Reviewed Original ResearchConceptsSelective serotonin reuptake inhibitorsRepetitive transcranial magnetic stimulationCognitive behavioral therapyFirst-line treatmentDeep brain stimulationSSRI treatmentBiological Psychiatry (WFSBP) GuidelinesSecond-line medicationsNon-pharmacological treatmentSerotonin reuptake inhibitorsNon-pharmacological interventionsTreatment-resistant casesTranscranial magnetic stimulationWorld FederationTreatment of anxietyPosttraumatic stress disorderTreatment of OCDReuptake inhibitorsMedication treatmentPharmacological treatmentSNRI venlafaxineInternet-CBTConsensus panelMagnetic stimulationBrain stimulationKetamine in the Treatment of Obsessive-Compulsive Disorder: A Systematic Review
Bandeira ID, Lins-Silva DH, Cavenaghi VB, Dorea-Bandeira I, Faria-Guimarães D, Barouh JL, Jesus-Nunes AP, Beanes G, Souza LS, Leal GC, Sanacora G, Miguel EC, Sampaio AS, Quarantini LC. Ketamine in the Treatment of Obsessive-Compulsive Disorder: A Systematic Review. Harvard Review Of Psychiatry 2022, 30: 135-145. PMID: 35267254, DOI: 10.1097/hrp.0000000000000330.Peer-Reviewed Original ResearchMeSH KeywordsHumansKetamineObsessive-Compulsive DisorderRetrospective StudiesSelective Serotonin Reuptake InhibitorsTreatment OutcomeConceptsObsessive-compulsive disorderSystematic reviewN-methyl-D-aspartate receptor antagonistAppropriate washout periodOpen-label trialPlacebo-controlled trialFirst-line treatmentRetrospective chart reviewUse of ketamineEffects of ketamineMeta-analysis protocolCombination of ketaminePubMed/MEDLINEPreferred Reporting ItemsMore effective treatmentsPotent N-methyl-d-aspartate receptor antagonistKetamine treatmentChart reviewGlutamate modulatorsGood tolerabilityReuptake inhibitorsWashout periodCase reportGlutamatergic neurotransmissionReceptor antagonist
2021
Efficacy and safety of transcranial direct current stimulation as an add-on treatment for obsessive-compulsive disorder: a randomized, sham-controlled trial
Silva R, Brunoni A, Goerigk S, Batistuzzo M, Costa D, Diniz J, Padberg F, D’Urso G, Miguel E, Shavitt R. Efficacy and safety of transcranial direct current stimulation as an add-on treatment for obsessive-compulsive disorder: a randomized, sham-controlled trial. Neuropsychopharmacology 2021, 46: 1028-1034. PMID: 33452434, PMCID: PMC8115679, DOI: 10.1038/s41386-020-00928-w.Peer-Reviewed Original ResearchMeSH KeywordsDouble-Blind MethodHumansMotor CortexObsessive-Compulsive DisorderTranscranial Direct Current StimulationTreatment OutcomeConceptsTreatment-resistant obsessive-compulsive disorderTranscranial direct current stimulationSupplementary motor areaBaseline Y-BOCS scoresActive transcranial direct current stimulationObsessive-compulsive disorderY-BOCS scoresDirect current stimulationAdverse eventsWeek 12Efficacy of tDCSCurrent stimulationCathodal transcranial direct current stimulationSham-controlled trialMild adverse eventsClinical Global ImpressionSham-controlled studyBetween-group differencesSymptoms of depressionSecondary outcomesPrimary outcomeImprovement subscaleGlobal ImpressionNeuromodulation therapiesTreatment resistance
2020
Delayed Brain Cyst Formation After Gamma Knife Anterior Capsulotomy
Kasabkojian S, Dwan A, Maziero M, de Salles A, Gorgulho A, Miguel E, Fillipo de Queiroz Vattimo E, Lopes A. Delayed Brain Cyst Formation After Gamma Knife Anterior Capsulotomy. World Neurosurgery 2020, 145: 298-300. PMID: 33022431, DOI: 10.1016/j.wneu.2020.07.199.Peer-Reviewed Original ResearchConceptsRefractory obsessive-compulsive disorderAnterior capsulotomyObsessive-compulsive disorderBrain cyst formationFrontal lobe symptomsMagnetic resonance imagingAnterior frontal regionsPostoperative monthBrain cystsBrain edemaManic episodesVisual hallucinationsRadiosurgical proceduresAbnormal complicationsHigh dosesCapsulotomyResonance imagingObsessive-compulsive symptomsCyst formationEffective optionLeft hemisphereRight hemisphereFrontal regionsComplicationsSymptoms
2018
Adaptive treatment strategies for children and adolescents with Obsessive-Compulsive Disorder: A sequential multiple assignment randomized trial
Fatori D, de Bragança Pereira CA, Asbahr FR, Requena G, Alvarenga PG, de Mathis MA, Rohde LA, Leckman JF, March JS, Polanczyk GV, Miguel EC, Shavitt RG. Adaptive treatment strategies for children and adolescents with Obsessive-Compulsive Disorder: A sequential multiple assignment randomized trial. Journal Of Anxiety Disorders 2018, 58: 42-50. PMID: 30025255, DOI: 10.1016/j.janxdis.2018.07.002.Peer-Reviewed Original ResearchConceptsGroup cognitive behavioral therapySequential multiple assignmentTreatment failureInitial treatmentBaseline Yale-Brown ObsessiveChildhood OCDEffective initial treatmentProvision of treatmentCompulsive Scale scoresCognitive behavioral therapyAdaptive treatment strategiesYale-Brown ObsessiveSame regimenObsessive-compulsive disorderTreatment strategiesSymptom reductionPrimary analysisScale scoreFluoxetineTime pointsWeeksTreatmentChildrenEffect sizeTrials
2017
Personality measures after gamma ventral capsulotomy in intractable OCD
Paiva R, Batistuzzo M, McLaughlin N, Canteras M, de Mathis M, Requena G, Shavitt R, Greenberg B, Norén G, Rasmussen S, Tavares H, Miguel E, Lopes A, Hoexter M. Personality measures after gamma ventral capsulotomy in intractable OCD. Progress In Neuro-Psychopharmacology And Biological Psychiatry 2017, 81: 161-168. PMID: 29100975, DOI: 10.1016/j.pnpbp.2017.10.023.Peer-Reviewed Original Research
2016
Transcranial direct current stimulation for treatment-resistant obsessive-compulsive disorder: report on two cases and proposal for a randomized, sham-controlled trial
da Silva R, Brunoni A, Miguel E, Shavitt R. Transcranial direct current stimulation for treatment-resistant obsessive-compulsive disorder: report on two cases and proposal for a randomized, sham-controlled trial. Sao Paulo Medical Journal 2016, 134: 446-450. PMID: 27901245, PMCID: PMC10871858, DOI: 10.1590/1516-3180.2016.0155010716.Peer-Reviewed Original ResearchConceptsTreatment-resistant obsessive-compulsive disorderTranscranial direct current stimulationObsessive-compulsive disorderDirect current stimulationClinical trialsCurrent stimulationSham-controlled trialSerotonin reuptake inhibitorsSupplementary motor cortexPrimary obsessive-compulsive disorderCognitive behavioral therapySecondary outcomesPrimary outcomeReuptake inhibitorsSham interventionFirst patientCortical excitabilityMotor cortexUniversity HospitalWeek 4YBOCS scoresNeuromodulation techniquesNon-invasive techniqueBrain circuitsPatientsNEUROPSYCHOLOGICAL PREDICTORS OF TREATMENT RESPONSE TO COGNITIVE BEHAVIORAL GROUP THERAPY IN OBSESSIVE–COMPULSIVE DISORDER
Braga D, Abramovitch A, Fontenelle L, Ferrão Y, Gomes J, Vivan A, Ecker K, Bortoncello C, Mittelman A, Miguel E, Trentini C, Cordioli A. NEUROPSYCHOLOGICAL PREDICTORS OF TREATMENT RESPONSE TO COGNITIVE BEHAVIORAL GROUP THERAPY IN OBSESSIVE–COMPULSIVE DISORDER. Depression And Anxiety 2016, 33: 848-861. PMID: 27100799, DOI: 10.1002/da.22509.Peer-Reviewed Original ResearchConceptsCognitive-behavioral group therapyObsessive-compulsive disorderBehavioral group therapyNeuropsychological test performanceTest performanceNeuropsychological domainsCBGT groupGroup therapyOCD patientsNeuropsychological outcome measuresNeuropsychological predictorsNeuropsychological functioningNeuropsychological measuresOCD symptomsNeurocognitive functionDepression symptomsTreatment respondersTreatment responseParticipantsAvailable researchInconsistent resultsDisordersPredictorsAnxietyMeasures
2015
Defining clinical severity in adults with obsessive–compulsive disorder
Storch E, De Nadai A, do Rosário M, Shavitt R, Torres A, Ferrão Y, Miguel E, Lewin A, Fontenelle L. Defining clinical severity in adults with obsessive–compulsive disorder. Comprehensive Psychiatry 2015, 63: 30-35. PMID: 26555489, PMCID: PMC4643407, DOI: 10.1016/j.comppsych.2015.08.007.Peer-Reviewed Original ResearchORBITOFRONTAL THICKNESS AS A MEASURE FOR TREATMENT RESPONSE PREDICTION IN OBSESSIVE–COMPULSIVE DISORDER
Hoexter M, Diniz J, Lopes A, Batistuzzo M, Shavitt R, Dougherty D, Duran F, Bressan R, Busatto G, Miguel E, Sato J. ORBITOFRONTAL THICKNESS AS A MEASURE FOR TREATMENT RESPONSE PREDICTION IN OBSESSIVE–COMPULSIVE DISORDER. Depression And Anxiety 2015, 32: 900-908. PMID: 26032588, DOI: 10.1002/da.22380.Peer-Reviewed Original ResearchConceptsTreatment-naïve OCD patientsObsessive-compulsive disorderTreatment responseIndependent cohortOCD patientsOFC thicknessRefractory OCD patientsTreatment-naïve patientsOrbitofrontal cortex thicknessSecond independent cohortLogistic regression modelsBaseline thicknessClinical trialsTreatment outcomesInitial cohortClinical utilityOrbitofrontal thicknessIneffective treatmentPatientsCohortMedial OFCNeuroimaging techniquesMorphometric biomarkersBiomarkersCortex thicknessVisuospatial Memory Improvement after Gamma Ventral Capsulotomy in Treatment Refractory Obsessive–Compulsive Disorder Patients
Batistuzzo M, Hoexter M, Taub A, Gentil A, Cesar R, Joaquim M, D'Alcante C, McLaughlin N, Canteras M, Shavitt R, Savage C, Greenberg B, Norén G, Miguel E, Lopes A. Visuospatial Memory Improvement after Gamma Ventral Capsulotomy in Treatment Refractory Obsessive–Compulsive Disorder Patients. Neuropsychopharmacology 2015, 40: 1837-1845. PMID: 25645373, PMCID: PMC4839507, DOI: 10.1038/npp.2015.33.Peer-Reviewed Original ResearchConceptsObsessive-compulsive disorderRefractory OCD patientsOCD patientsVisuospatial memory performanceComprehensive neuropsychological evaluationObsessive-compulsive disorder patientsTreatment-refractory obsessive-compulsive disorder patientsCognitive flexibilityNeuropsychological domainsMemory performanceVisuospatial learningNeuropsychological functioningVisuospatial perceptionIntellectual functioningInhibitory controlRefractory obsessive-compulsive disorderTreatment-refractory OCD patientsMemory improvementGamma ventral capsulotomyMotor functioningNeuropsychological evaluationNeuropsychological outcomesEffects of GVCMotor performanceFunctioning
2014
Gamma Ventral Capsulotomy for Obsessive-Compulsive Disorder: A Randomized Clinical Trial
Lopes A, Greenberg B, Canteras M, Batistuzzo M, Hoexter M, Gentil A, Pereira C, Joaquim M, de Mathis M, D’Alcante C, Taub A, de Castro D, Tokeshi L, Sampaio L, Leite C, Shavitt R, Diniz J, Busatto G, Norén G, Rasmussen S, Miguel E. Gamma Ventral Capsulotomy for Obsessive-Compulsive Disorder: A Randomized Clinical Trial. JAMA Psychiatry 2014, 71: 1066-1076. PMID: 25054836, DOI: 10.1001/jamapsychiatry.2014.1193.Peer-Reviewed Original ResearchConceptsIntractable obsessive-compulsive disorderObsessive-compulsive disorderClinical trialsGamma ventral capsulotomyClinical Global Impressions-Improvement scaleSerious adverse eventsRandomized clinical trialsCGI-I ratingsDeep brain stimulationYale-Brown ObsessiveAdverse eventsMonth 12Additional patientsActive treatmentSham groupSymptom improvementInternal capsuleSpecialized centersNeurosurgical ablationAnterior limbMAIN OUTCOMEPsychiatric disordersPatientsOCD symptom improvementSelect casesHoarding symptoms and prediction of poor response to limbic system surgery for treatment-refractory obsessive-compulsive disorder.
Gentil AF, Lopes AC, Dougherty DD, Rück C, Mataix-Cols D, Lukacs TL, Canteras MM, Eskandar EN, Larsson KJ, Hoexter MQ, Batistuzzo MC, Greenberg BD, Miguel EC. Hoarding symptoms and prediction of poor response to limbic system surgery for treatment-refractory obsessive-compulsive disorder. Journal Of Neurosurgery 2014, 121: 123-30. PMID: 24702323, DOI: 10.3171/2014.2.jns131423.Peer-Reviewed Original ResearchConceptsLimbic system surgeryClinical outcomesWorse responseMean Y-BOCS scoreTreatment-refractory obsessive-compulsive disorderSymptom dimensionsPreoperative symptom severityWorse clinical outcomesTreatment-refractory patientsY-BOCS scoresYale-Brown Obsessive Compulsive ScaleSymptom Checklist scoresHoarding dimensionObsessive Compulsive ScaleSurgery needObsessive-compulsive disorderSurgical modalitiesAblative surgeryPoor responseWorse outcomesTreatment outcomesDimensional Yale-Brown Obsessive Compulsive ScaleYBOCS scoresPatientsSurgery
2013
The impact of comorbid body dysmorphic disorder on the response to sequential pharmacological trials for obsessive-compulsive disorder
Diniz J, Costa D, Cassab R, Pereira C, Miguel E, Shavitt R. The impact of comorbid body dysmorphic disorder on the response to sequential pharmacological trials for obsessive-compulsive disorder. Journal Of Psychopharmacology 2013, 28: 603-611. PMID: 24288238, DOI: 10.1177/0269881113512042.Peer-Reviewed Original ResearchMeSH KeywordsAdultAntidepressive Agents, Second-GenerationAntidepressive Agents, TricyclicAntipsychotic AgentsBody Dysmorphic DisordersBrazilClomipramineComorbidityDrug Therapy, CombinationFemaleFluoxetineHumansMaleObsessive-Compulsive DisorderProspective StudiesQuetiapine FumarateRisk FactorsTreatment OutcomeConceptsBody dysmorphic disorderComorbid body dysmorphic disorderPharmacological trialsDysmorphic disorderAdult obsessive-compulsive disorder (OCD) patientsSequential treatment strategyObsessive-compulsive disorder patientsSequential treatmentFluoxetine monotherapyClinical characteristicsObsessive-compulsive disorderInitial severityTreatment strategiesDisorder patientsTreatment groupsPatientsWorse responseBDD patientsEffects of sexGEE modelTrialsDisordersSequential trialsWeeksType of augmentationCan early improvement be an indicator of treatment response in obsessive-compulsive disorder? Implications for early-treatment decision-making
da Conceição Costa D, Shavitt R, Cesar R, Joaquim M, Borcato S, Valério C, Miguel E, Diniz J. Can early improvement be an indicator of treatment response in obsessive-compulsive disorder? Implications for early-treatment decision-making. Journal Of Psychiatric Research 2013, 47: 1700-1707. PMID: 23948637, DOI: 10.1016/j.jpsychires.2013.07.006.Peer-Reviewed Original ResearchConceptsBaseline Y-BOCS scoresSerotonin reuptake inhibitorsEarly improvementTreatment responseY-BOCS scoresBaseline Yale-Brown ObsessiveLogistic regressionAdequate pharmacological treatmentPotential predictive factorsWeeks of treatmentGreater reductionObsessive-compulsive disorder patientsStepwise logistic regressionWarrants further investigationYale-Brown ObsessiveClinical featuresReuptake inhibitorsObsessive-compulsive disorderPharmacological treatmentPredictive factorsMajor depressionDisorder patientsOCD treatment responseCompulsive ScaleWeeks
2012
CLINICAL PREDICTORS OF LONG‐TERM OUTCOME IN OBSESSIVE‐COMPULSIVE DISORDER
Jakubovski E, Diniz J, Valerio C, Fossaluza V, Belotto‐Silva C, Gorenstein C, Miguel E, Shavitt R. CLINICAL PREDICTORS OF LONG‐TERM OUTCOME IN OBSESSIVE‐COMPULSIVE DISORDER. Depression And Anxiety 2012, 30: 763-772. PMID: 23109056, DOI: 10.1002/da.22013.Peer-Reviewed Original ResearchConceptsLong-term outcomesObsessive-compulsive disorderPositive family historyGroup cognitive behavioral therapyDepressive disorderFamily historyOCD patientsOnset of OCDInitial treatment modalityComorbid psychiatric disordersPercent of subjectsBeck depression scoresDuration of OCDCognitive behavioral therapyYale-Brown ObsessiveUntreated patientsClinical factorsClinical predictorsInitial treatmentOpen trialWorse prognosisClinical variablesPharmacological treatmentPsychiatric comorbidityTreatment modalitiesDifferential prefrontal gray matter correlates of treatment response to fluoxetine or cognitive-behavioral therapy in obsessive–compulsive disorder
Hoexter M, Dougherty D, Shavitt R, D'Alcante C, Duran F, Lopes A, Diniz J, Batistuzzo M, Evans K, Bressan R, Busatto G, Miguel E. Differential prefrontal gray matter correlates of treatment response to fluoxetine or cognitive-behavioral therapy in obsessive–compulsive disorder. European Neuropsychopharmacology 2012, 23: 569-580. PMID: 22841131, DOI: 10.1016/j.euroneuro.2012.06.014.Peer-Reviewed Original ResearchConceptsGray matter volumeMedial prefrontal cortexCognitive behavioral therapyObsessive-compulsive disorderTreatment responseTreatment-naïve OCD patientsTreatment groupsMagnetic resonance imagingMatter volumeOrbitofrontal cortexLateral orbitofrontal cortexSymptom improvementOCD patientsFluoxetine treatment groupTrial of fluoxetineSerotonin reuptake inhibitorsAdequate therapeutic approachStructural magnetic resonance imagingCBT treatment groupRight medial prefrontal cortexGroup-based cognitive behavioral therapyRegional gray matter volumeStructural MRI scansDistinct brain regionsYale-Brown Obsessive