Specialty knowledge and competency standards for pharmacotherapy for adult obsessive-compulsive disorder.

Journal: Psychiatry research

Volume: 300

Issue: 

Year of Publication: 2021

Affiliated Institutions:  Department of Psychiatry and Yale Child Study Center, Yale University School of Medicine, New Haven, CT, United States. Electronic address: christopher.pittenger@yale.edu. Biological Psychiatry Laboratory and Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, MA, United States; Department of Psychiatry, Harvard Medical School, Boston, MA, United States. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States. Department of Psychiatry, University of Florida, Gainesville, FL, United States. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States. Institute for Genomic Health and Department of Psychiatry, SUNY Downstate College of Medicine, Brooklyn, NY, United States. Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, and Department of Psychiatry, Weill Cornell Medical College, New York, NY, United States. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States. Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States; Office of Mental Health, Research Foundation for Mental Hygiene, New York Psychiatric Institute, New York, NY, United States. Department of Psychiatry, School of Health Sciences, University of Ioannina, Ioannina, Greece. Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa. Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States.

Abstract summary 

Obsessive-compulsive disorder (OCD) affects approximately one person in 40 and causes substantial suffering. Evidence-based treatments can benefit many; however, optimal treatment can be difficult to access. Diagnosis is frequently delayed, and pharmacological and psychotherapeutic interventions often fail to follow evidence-based guidelines. To ameliorate this distressing situation, the International OCD Accreditation Task Force of the Canadian Institute for Obsessive-Compulsive Disorders has developed knowledge and competency standards for specialized treatments for OCD through the lifespan. These are foundational to evidence-based practice and will form the basis for upcoming ATF development of certification/accreditation programs. Here, we present specialty standards for the pharmacological treatment of adult OCD. We emphasize the importance of integrating pharmacotherapy with clear diagnosis, appreciation of complicating factors, and evidence-based cognitive behavioral therapy. Clear evidence exists to inform first- and second-line pharmacological treatments. In disease refractory to these initial efforts, multiple strategies have been investigated, but the evidence is more equivocal. These standards summarize this limited evidence to give the specialist practitioner a solid basis on which to make difficult decisions in complex cases. It is hoped that further research will lead to development of a clear, multi-step treatment algorithm to support each step in clinical decision-making.

Authors & Co-authors:  Pittenger Christopher C Brennan Brian P BP Koran Lorrin L Mathews Carol A CA Nestadt Gerald G Pato Michele M Phillips Katharine A KA Rodriguez Carolyn I CI Simpson H Blair HB Skapinakis Petros P Stein Dan J DJ Storch Eric A EA

Study Outcome 

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Statistics
Citations :  Aboujaoude E, Barry JJ, Gamel N, 2009. Memantine augmentation in treatment-resistant obsessive-compulsive disorder: An open-label trial. J. Clin. Psychopharmacol 29, 51–55.
Authors :  12
Identifiers
Doi : 10.1016/j.psychres.2021.113853
SSN : 1872-7123
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
Obsessive-compulsive disorder (OCD);augmentation;comorbidity;pharmacotherapy;selective serotonin reuptake inhibitors (SSRIs);treatment
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
Ireland