Early intervention for obsessive compulsive disorder: An expert consensus statement.
Journal: European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology
Volume: 29
Issue: 4
Year of Publication: 2020
Affiliated Institutions:
Hertfordshire Partnership University NHS Foundation Trust, Rosanne House, Welwyn Garden City, Hertfordshire AL HG, UK; Center for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; School of Clinical Medicine, University of Cambridge, Cambridge, UK. Electronic address: naomi.fineberg@nhs.net.
Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milan, Milan, Italy; Department of Psychiatry, ASST Fatebenefratelli-Sacco, Via GB Grassi , , Milan, Italy; Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA; Fondazione IRCCS Ca' Granda, CRC "Aldo Ravelli" for Neurotechnology and Experimental Brain Therapeutics, University of Milan, Italy.
Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.
Rita Levi Montalcini Department of Neuroscience, University of Turin, Italy; San Luigi Gonzaga University Hospital, Orbassano, Torino, Italy.
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, USA.
School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel.
Orchard, Devonshire Road, Cambridge, CB BL, UK.
Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Switzerland.
Department of Neuroscience, Psychology, Drug Research and Child Health - Neurofarba, University of Florence, Italy; INS, Institute of Neuroscience, Florence, Italy.
Department of Psychiatry, Stanford University, CA, USA; INS, Institute of Neuroscience, Florence, Italy.
Department of Psychiatry and Compulsive, Impulsive and Autism Spectrum Program, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.
Western Sydney Area Health Service, Obsessive-Compulsive and Related Disorders Service, Blacktown Hospital, Blacktown, Sydney, Australia.
Department of Psychiatry, Bellvitge University Hospital, IDIBELL, Cibersam, University of Barcelona, Barcelona, Spain.
Dipartimento di Medicina Clinica e Sperimentale, Section of Psychiatry, University of Pisa, Italy.
Department of Psychiatry, University of Cambridge, Cambridge, UK; Cambridge & Peterborough NHS Foundation Trust, Cambridge, UK.
Department of Neuroscience, Psychology and Behaviour, University of Leicester, UK.
Department of Psychiatry and Mental Health, South African MRC Unit on Risk & Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa.
RUG and UMC Groningen, Department of Psychiatry, GGZ Drenthe Mental Health Institute, The Netherlands.
Department of Psychiatry, VU University Medical Centre, Amsterdam, The Netherlands.
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Ontario, Canada.
Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, D'Or Institute for Research and Education Rio de Janeiro, Federal University of Rio de Janeiro, Brazil; Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia.
Department & Institute of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil.
Sackler Medical School, Tel Aviv University, Chaim Sheba Medical Center, Tel Hashomer, Tel Aviv, Israel.
Abstract summary
Obsessive-compulsive disorder (OCD) is common, emerges early in life and tends to run a chronic, impairing course. Despite the availability of effective treatments, the duration of untreated illness (DUI) is high (up to around 10 years in adults) and is associated with considerable suffering for the individual and their families. This consensus statement represents the views of an international group of expert clinicians, including child and adult psychiatrists, psychologists and neuroscientists, working both in high and low and middle income countries, as well as those with the experience of living with OCD. The statement draws together evidence from epidemiological, clinical, health economic and brain imaging studies documenting the negative impact associated with treatment delay on clinical outcomes, and supporting the importance of early clinical intervention. It draws parallels between OCD and other disorders for which early intervention is recognized as beneficial, such as psychotic disorders and impulsive-compulsive disorders associated with problematic usage of the Internet, for which early intervention may prevent the development of later addictive disorders. It also generates new heuristics for exploring the brain-based mechanisms moderating the 'toxic' effect of an extended DUI in OCD. The statement concludes that there is a global unmet need for early intervention services for OC related disorders to reduce the unnecessary suffering and costly disability associated with under-treatment. New clinical staging models for OCD that may be used to facilitate primary, secondary and tertiary prevention within this context are proposed.
Authors & Co-authors:
Fineberg Naomi A NA
Dell'Osso Bernardo B
Albert Umberto U
Maina Giuseppe G
Geller Daniel D
Carmi Lior L
Sireau Nick N
Walitza Susanne S
Grassi Giacomo G
Pallanti Stefano S
Hollander Eric E
Brakoulias Vlasios V
Menchon Jose M JM
Marazziti Donatella D
Ioannidis Konstantinos K
Apergis-Schoute Annemieke A
Stein Dan J DJ
Cath Danielle C DC
Veltman Dick J DJ
Van Ameringen Michael M
Fontenelle Leonardo F LF
Shavitt Roseli G RG
Costa Daniel D
Diniz Juliana B JB
Zohar Joseph J
Study Outcome
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