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.
Journal: The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry
Volume: 24
Issue: 2
Year of Publication: 2023
Affiliated Institutions:
Department of Psychiatry and Psychotherapy, University Medical Center, Göttingen, Germany.
Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden.
Faculty of Medicine, University of Southampton, Southampton, United Kingdom.
Department and Institute of Psychiatry, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
Afdeling Psychiatrie, Universitair Medische Centra, Amsterdam, The Netherlands.
Psikiyatri Uzmanı, Üsküdar Üniversitesi Tıp Fakültesi Psikiyatri ABD İstanbul, Istanbul, Turkey.
Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Albert Einstein College of Medicine, New York, NY, USA.
Clinical Division of General Psychiatry Medical, University of Vienna, Vienna, Austria.
Department of Psychiatry and Psychotherapy, University of München, München, Germany.
Department of Pharmacology, University of Gothenburg, Gothenburg, Sweden.
School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire, United Kingdom.
Treatment Center for Anxiety and Depression, Zürich, Switzerland.
Department of Psychiatry, Kyoto Prefactual Medical College, Kyoto, Japan.
V.M. Bekhterev National Medical Research Center for Psychiatry and Neurology, Ministry of Health, Federal State Budgetary Institution of Higher Education, St. Petersburg State University, St. Petersburg, Russia.
S.T.A.R.T. CLINIC, Toronto, Ontario, Canada.
Department of Psychiatry, College of Medicine, Korea University, Seoul, Korea.
Department of Psychiatry, Tokyo Medical University, Tokyo, Japan.
Department of Psychiatry, Singapore General Hospital, Singapore, Singapore.
First Department of Psychiatry, Eginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.
Department of Psychiatry, Bellvitge University Hospital-IDIBELL, Cibersam, University of Barcelona, Barcelona, Spain.
Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
University of Florence, Florence, Italy.
Department of Biological Sciences, Humanitas University Pieve Emanuele, Milano, Italy.
Clinical Division of General Psychiatry Medical, University of Vienna, Austria.
Faculty of Medicine and Health, Sydney Medical School, Nepean Clinical School, University of Sydney, Sydney, Australia.
SA MRC Unit on Risk & Resilience in Mental Disorders, Department Psychiatry and Neuroscience Institute, University of Cape Town, South Africa.
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
V. M. Bekhterev National Medical Research Center for Psychiatry and Neurology, Ministry of Health, I.I. Mechnikov North-Western State Medical University, St. Petersburg, Russia.
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Chaim Sheba Medical Center, Tel Aviv, Israel.
Abstract summary
This is the third version of the guideline of the World Federation of Societies of Biological Psychiatry (WFSBP) Task Force for the Pharmacological Treatment of Anxiety, Obsessive-Compulsive and Posttraumatic Stress Disorders which was published in 2002 and revised in 2008.A consensus panel of 34 international experts representing 22 countries developed recommendations based on efficacy and acceptability of the treatments. In this version, not only medications but also psychotherapies and other non-pharmacological interventions were evaluated, applying the same rigorous methods that are standard for the assessment of medication treatments.The present paper (Part II) contains recommendations based on published randomised controlled trials (RCTs) for the treatment of OCD ( = 291) and PTSD ( = 234) in children, adolescents, and adults. The accompanying paper (Part I) contains the recommendations for the treatment of anxiety disorders.For OCD, first-line treatments are selective serotonin reuptake inhibitors (SSRIs) and cognitive behavioural therapy (CBT). Internet-CBT was also superior to active controls. Several second-line medications are available, including clomipramine. For treatment-resistant cases, several options are available, including augmentation of SSRI treatment with antipsychotics and other drugs.Other non-pharmacological treatments, including repetitive transcranial magnetic stimulation (rTMS), deep brain stimulation (DBS) and others were also evaluated.For PTSD, SSRIs and the SNRI venlafaxine are first-line treatments. CBT is the psychotherapy modality with the best body of evidence. For treatment-unresponsive patients, augmentation of SSRI treatment with antipsychotics may be an option.OCD and PTSD can be effectively treated with CBT and medications.
Authors & Co-authors:
Bandelow Borwin B
Allgulander Christer C
Baldwin David S DS
Costa Daniel Lucas da Conceição DLDC
Denys Damiaan D
Dilbaz Nesrin N
Domschke Katharina K
Hollander Eric E
Kasper Siegfried S
Möller Hans-Jürgen HJ
Eriksson Elias E
Fineberg Naomi A NA
Hättenschwiler Josef J
Kaiya Hisanobu H
Karavaeva Tatiana T
Katzman Martin A MA
Kim Yong-Ku YK
Inoue Takeshi T
Lim Leslie L
Masdrakis Vasilios V
Menchón José M JM
Miguel Euripedes C EC
Nardi Antônio E AE
Pallanti Stefano S
Perna Giampaolo G
Rujescu Dan D
Starcevic Vladan V
Stein Dan J DJ
Tsai Shih-Jen SJ
Van Ameringen Michael M
Vasileva Anna A
Wang Zhen Z
Zohar Joseph J
Study Outcome
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