2023
Brazilian 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 I: Anxiety disorders
Bandelow B, Allgulander C, Baldwin D, da Conceição Costa D, Denys D, Dilbaz N, Domschke K, Eriksson E, Fineberg N, Hättenschwiler J, Hollander E, Kaiya H, Karavaeva T, Kasper S, Katzman M, Kim Y, Inoue T, Lim L, Masdrakis V, Menchón J, Miguel E, Möller H, 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 I: Anxiety disorders. The World Journal Of Biological Psychiatry 2022, 24: 79-117. PMID: 35900161, DOI: 10.1080/15622975.2022.2086295.Peer-Reviewed Original ResearchConceptsSocial anxiety disorderCognitive behavioral therapyAnxiety disordersPanic disorder/agoraphobiaMixed anxiety disordersPosttraumatic stress disorderSerotonin-norepinephrine reuptake inhibitorsSelective serotonin reuptake inhibitorsTreatment of anxietyFirst-line psychotherapySelective mutismBehavioral therapySeparation anxietyStress disorderSpecific phobiaObsessive-CompulsiveReuptake inhibitorsAnxietyNon-pharmacological interventionsBiological Psychiatry (WFSBP) GuidelinesFirst-line medicationSerotonin reuptake inhibitorsAdolescentsAssessment of medicationsPsychotherapyWorld 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 stimulationManagement of Patients With Obsessive-Compulsive Disorder: Focus on Pharmacotherapy
Maziero M, Macaya D, Shavitt R, Diniz J, Miguel E, Silva R, Costa D. Management of Patients With Obsessive-Compulsive Disorder: Focus on Pharmacotherapy. Psychiatric Annals 2022, 52: 143-151. DOI: 10.3928/00485713-20220315-01.Peer-Reviewed Original ResearchSelective serotonin reuptake inhibitorsObsessive-compulsive disorderPharmacological treatmentFirst-line pharmacological therapySecond-line pharmacological treatmentPotential clinical situationsHalf of patientsManagement of patientsSerotonin reuptake inhibitorsKnowledge of cliniciansCommon clinical issueTreatment of patientsReports of RCTsTreatment of OCDAdverse eventsSSRI treatmentPharmacological therapyReuptake inhibitorsSignificant morbidityPharmacological strategiesLimited efficacyClinical practiceClinical situationsClinical issuesSocial disability
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 circuitsPatientsPrevalence and correlates of electroconvulsive therapy delivery in 1001 obsessive-compulsive disorder outpatients
dos Santos-Ribeiro S, Lins-Martins N, Frydman I, do Rosário M, Ferrão Y, Shavitt R, Yücel M, Miguel E, Fontenelle L. Prevalence and correlates of electroconvulsive therapy delivery in 1001 obsessive-compulsive disorder outpatients. Psychiatry Research 2016, 239: 145-148. PMID: 27137976, DOI: 10.1016/j.psychres.2016.03.020.Peer-Reviewed Original ResearchConceptsElectroconvulsive therapyObsessive-compulsive disorderOCD patientsHigher global severitySerotonin reuptake inhibitorsObsessive-compulsive disorder outpatientsContamination/washing symptomsRates of psychosisDifferent specialized centersAdequate trialReuptake inhibitorsSpecialized centersGlobal severityGreater suicidalityDisorder outpatientsTherapy deliveryTerms of responseAssessment BatteryPatientsOCD symptomsSymptomsWashing symptomsAntipsychoticsOutpatientsTherapy
2013
Can 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
Differential 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
2011
A Double-Blind, Randomized, Controlled Trial of Fluoxetine Plus Quetiapine or Clomipramine Versus Fluoxetine Plus Placebo for Obsessive-Compulsive Disorder
Diniz J, Shavitt R, Fossaluza V, Koran L, de Bragança Pereira C, Miguel E. A Double-Blind, Randomized, Controlled Trial of Fluoxetine Plus Quetiapine or Clomipramine Versus Fluoxetine Plus Placebo for Obsessive-Compulsive Disorder. Journal Of Clinical Psychopharmacology 2011, 31: 763-768. PMID: 22020357, DOI: 10.1097/jcp.0b013e3182367aee.Peer-Reviewed Original ResearchConceptsY-BOCS scoresFluoxetine groupTreatment regimenSelective serotonin reuptake inhibitorsPlacebo-controlled trialSevere adverse eventsSerotonin reuptake inhibitorsMain outcome measuresObsessive-compulsive disorder patientsCompulsive Scale scoresYale-Brown ObsessiveFluoxetine monotherapyAdverse eventsReuptake inhibitorsObsessive-compulsive disorderPrimary diagnosisOutcome measuresDisorder patientsScale scoreFluoxetineMental disordersQuetiapinePatientsStatistical ManualClomipramineGroup cognitive-behavioral therapy versus selective serotonin reuptake inhibitors for obsessive-compulsive disorder: A practical clinical trial
Belotto-Silva C, Diniz J, Malavazzi D, Valério C, Fossaluza V, Borcato S, Seixas A, Morelli D, Miguel E, Shavitt R. Group cognitive-behavioral therapy versus selective serotonin reuptake inhibitors for obsessive-compulsive disorder: A practical clinical trial. Journal Of Anxiety Disorders 2011, 26: 25-31. PMID: 21907540, DOI: 10.1016/j.janxdis.2011.08.008.Peer-Reviewed Original ResearchConceptsGroup cognitive behavioral therapyY-BOCS scoresPsychiatric comorbidityCognitive behavioral therapySSRI groupMean Y-BOCS scoreSelective serotonin reuptake inhibitorsBaseline Y-BOCS scoresY-BOCS reductionSerotonin reuptake inhibitorsMore psychiatric comorbiditiesPractical clinical trialsReal-world populationObsessive-compulsive disorder outpatientsBroad inclusion criteriaAdditional psychiatric comorbidityReuptake inhibitorsObsessive-compulsive disorderClinical effectivenessClinical trialsMajor depressionCGI ratingsInclusion criteriaComorbiditiesWorse responseRisk factors for early treatment discontinuation in patients with obsessive-compulsive disorder
Diniz J, Malavazzi D, Fossaluza V, Belotto-Silva C, Borcato S, Pimentel I, Miguel E, Shavitt R. Risk factors for early treatment discontinuation in patients with obsessive-compulsive disorder. Clinics 2011, 66: 387-393. PMID: 21552660, PMCID: PMC3071996, DOI: 10.1590/s1807-59322011000300004.Peer-Reviewed Original ResearchConceptsEarly treatment discontinuationSelective serotonin reuptake inhibitorsTreatment discontinuationObsessive-compulsive disorder patientsObsessive-compulsive disorderDisorder patientsFirst-line treatmentGroup of patientsSerotonin reuptake inhibitorsStructured Clinical InterviewLogistic regression analysisLogistic regression modelsGeneralized anxiety disorderCognitive behavioral therapyMann-Whitney testClinical characteristicsCompliant patientsDiscontinuation ratesReuptake inhibitorsPsychiatric comorbidityClinical correlatesTreatment modalitiesRisk factorsSomatization disorderDiscontinuation
2009
The drug-naïve OCD patients imaging genetics, cognitive and treatment response study: methods and sample description
Hoexter M, Shavitt R, D'Alcante C, Cecconi J, Diniz J, Belotto-Silva C, Hounie A, Borcato S, Moraes I, Joaquim M, Cappi C, Sampaio A, de Mathis M, Batistuzzo M, Lopes A, Rosa A, Muniz R, Marques A, Santos L, Taub A, de Souza Duran F, Dougherty D, Busatto G, Bressan R, Miguel E. The drug-naïve OCD patients imaging genetics, cognitive and treatment response study: methods and sample description. Brazilian Journal Of Psychiatry 2009, 31: 349-353. PMID: 20098825, DOI: 10.1590/s1516-44462009000400011.Peer-Reviewed Original ResearchConceptsObsessive-compulsive disorder patientsObsessive-compulsive disorderNeuropsychological evaluationClinical trialsGroup cognitive behavioral therapyDisorder patientsTRODAT-1 single photon emissionIntegrative neurobiological modelCognitive behavioral therapySelective serotonin reuptake inhibitorsAdult obsessive-compulsive disorder (OCD) patientsMagnetic resonance imagesDrug-naïve OCD patientsDrug-naïve patientsSerotonin reuptake inhibitorsSame research procedureNeurobiological modelsSingle photon emissionResonance imagesTreatment response studiesOCD patientsReuptake inhibitorsHealthy controlsBlood samplesPatientsThe impact of trauma and post-traumatic stress disorder on the treatment response of patients with obsessive-compulsive disorder
Shavitt R, Valério C, Fossaluza V, da Silva E, Cordeiro Q, Diniz J, Belotto-Silva C, Cordioli A, Mari J, Miguel E. The impact of trauma and post-traumatic stress disorder on the treatment response of patients with obsessive-compulsive disorder. European Archives Of Psychiatry And Clinical Neuroscience 2009, 260: 91-99. PMID: 20077119, DOI: 10.1007/s00406-009-0015-3.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge of OnsetAnxietyDepressionDiagnostic and Statistical Manual of Mental DisordersFemaleFollow-Up StudiesHumansMaleMiddle AgedObsessive-Compulsive DisorderPsychiatric Status Rating ScalesSelective Serotonin Reuptake InhibitorsStatistics, NonparametricStress Disorders, Post-TraumaticTreatment OutcomeConceptsHistory of traumaPost-traumatic stress disorderObsessive-compulsive disorderTreatment responseHT groupBeck Depression InventoryPTSD groupBeck Anxiety InventorySpecific OCD symptom dimensionsConventional treatmentOCD symptom dimensionsOCD patientsSelective serotonin reuptake inhibitorsStress disorderFull DSM-IV criteriaFirst-line treatmentSerotonin reuptake inhibitorsCase series studyPoor treatment responseResistant OCD patientsSymptom dimensionsGreater treatment responseDSM-IV criteriaGreater reductionGroup cognitive behavioral therapy
2008
World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision
Bandelow B, Zohar J, Hollander E, Kasper S, Möller H, Zohar J, Hollander E, Kasper S, Möller H, Bandelow B, Allgulander C, Ayuso-Gutierrez J, Baldwin D, Buenvicius R, Cassano G, Fineberg N, Gabriels L, Hindmarch I, Kaiya H, Klein D, Lader M, Lecrubier Y, Lépine J, Liebowitz M, Lopez-Ibor J, Marazziti D, Miguel E, Oh K, Preter M, Rupprecht R, Sato M, Starcevic V, Stein D, van Ameringen M, Vega J. World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Post-Traumatic Stress Disorders – First Revision. The World Journal Of Biological Psychiatry 2008, 9: 248-312. PMID: 18949648, DOI: 10.1080/15622970802465807.Peer-Reviewed Original ResearchConceptsSerotonin-noradrenaline reuptake inhibitorsPost-traumatic stress disorderSelective serotonin reuptake inhibitorsObsessive-compulsive disorderPharmacological treatmentCognitive behavioral therapyReuptake inhibitorsStress disorderTricyclic antidepressantsSSRI/SNRIAnxiety disordersBiological Psychiatry (WFSBP) GuidelinesFirst-line treatmentRelapse prevention studySerotonin reuptake inhibitorsTreatment-resistant casesPotential treatment optionSubstance abuse disordersWorld FederationObsessive-CompulsiveStudy of anxiolyticsOpen studySustained efficacyStandard treatmentTreatment options
2006
Tourette's Syndrome
Shavitt R, Hounie A, Campos M, Miguel E. Tourette's Syndrome. Psychiatric Clinics Of North America 2006, 29: 471-486. PMID: 16650718, DOI: 10.1016/j.psc.2006.02.005.Peer-Reviewed Original ResearchConceptsSerotonin reuptake inhibitorsReuptake inhibitorsLong-term side effect profileFirst-choice treatmentFirst-line optionSide effect profileCurrent treatment strategiesDorsolateral caudate nucleusPathophysiology of OCDExpression of TSTypical antipsychoticsAtypical antipsychoticsClinical manifestationsSomato-sensoryGenetic epidemiologic studiesGlobus pallidusTreatment strategiesEpidemiologic studiesCaudate nucleusTourette syndromePatient associationsRelated disordersBehavioral therapyPresence of TsSegregation analysis studies
2003
How to treat OCD in patients with Tourette syndrome
Miguel E, Shavitt RG, Ferrão YA, Brotto SA, Diniz JB. How to treat OCD in patients with Tourette syndrome. Journal Of Psychosomatic Research 2003, 55: 49-57. PMID: 12842231, DOI: 10.1016/s0022-3999(02)00583-4.Peer-Reviewed Original ResearchConceptsSelective serotonin reuptake inhibitorsSerotonin reuptake inhibitorsObsessive-compulsive disorderTourette syndromeCognitive behavior therapyOCD patientsCircuit-based therapiesGonadal hormone systemsWorse treatment responsePresence of ticsRefractory patientsAutoimmune processReuptake inhibitorsSuch patientsCombined therapyResistant casesTreatment responseDrug treatmentPharmacological approachesNew therapiesPatientsEffective psychological interventionsTherapyHormone systemPsychological interventions
2001
Adults With Early-Onset Obsessive-Compulsive Disorder
Rosario-Campos MC, Leckman JF, Mercadante MT, Shavitt RG, Prado HS, Sada P, Zamignani D, Miguel EC. Adults With Early-Onset Obsessive-Compulsive Disorder. American Journal Of Psychiatry 2001, 158: 1899-1903. PMID: 11691698, DOI: 10.1176/appi.ajp.158.11.1899.Peer-Reviewed Original ResearchConceptsSymptom onsetObsessive-compulsive disorderSelective serotonin reuptake inhibitorsOCD patientsSerotonin reuptake inhibitorsEarlier symptom onsetEarly-onset groupLater symptom onsetOnset obsessive-compulsive disorderYale-Brown Obsessive Compulsive ScaleComorbid tic disordersAdult OCD patientsObsessive Compulsive ScaleReuptake inhibitorsAdult outpatientsTic disordersTreatment outcomesOCD symptom onsetBimodal ageEarly onsetHeterogeneous disorderCompulsive ScaleDisordersAgePatients
1994
Tourette's Disorder and Related Problems: A Review and Update
Coffey B, Miguel E, Savage C, Rauch S. Tourette's Disorder and Related Problems: A Review and Update. Harvard Review Of Psychiatry 1994, 2: 121-132. PMID: 9384893, DOI: 10.3109/10673229409017128.Peer-Reviewed Original ResearchConceptsTourette's disorderSerotonin reuptake inhibitorsNonmedication approachesNeuroleptic treatmentObsessive-compulsive disorderPsychiatric comorbidityVariety of agentsBasal gangliaModerate symptomsTricyclic antidepressantsCorticothalamic circuitVocal ticsLongitudinal followSevere symptomsStudy of childrenPsychiatric symptomatologyNeurological originMultifaceted conditionClinical settingObsessive-compulsive symptomsSymptomsDisordersNeuropsychological studiesFurther investigationTreatment