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Assessing response, remission and treatment resistance in patients with Obsessive-Compulsive Disorder with and without Tic Disorders: results from a multicenter study

Published online by Cambridge University Press:  01 September 2022

D. Conti ,
N. Girone ,
B. Benatti ,
O. Gambini ,
U. Albert ,
G. Maina ,
M. Amore ,
M. Porta  and
B. Dell’Osso
D. Conti*
Affiliation:
University of Milan, Luigi Sacco University Hospital, Psychiatry 2 Unit, Milan, Italy
N. Girone
Affiliation:
University of Milan, Luigi Sacco University Hospital, Psychiatry 2 Unit, Milan, Italy
B. Benatti
Affiliation:
University of Milan, Luigi Sacco University Hospital, Psychiatry 2 Unit, Milan, Italy University of Milan, Aldo Ravelli” Center For Nanotechnology And Neurostimulation, Milan, Italy
O. Gambini
Affiliation:
University of Milan, Aldo Ravelli” Center For Nanotechnology And Neurostimulation, Milan, Italy Università degli Studi di Milano, Health Science Department, Milano, Italy
U. Albert
Affiliation:
Università degli studi di Trieste, Dipartimento Universitario Clinico Di Scienze Mediche Chirurgiche E Della Salute, Trieste, Italy
G. Maina
Affiliation:
University of Turin, San Luigi Gonzaga Hospital, Turin, Italy
M. Amore
Affiliation:
IRCCS Ospedale Policlinico San Martino, Genoa, Italy, Department Of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal And Child Health, Section Of Psychiatry, University Of Genoa, Genoa, Italy, Genoa, Italy
M. Porta
Affiliation:
IRCCS Orthopedic Institute Galeazzi, Department Of Functional Neurosurgery, Tourette Center, Milan, Italy
B. Dell’Osso
Affiliation:
University of Milan, Luigi Sacco University Hospital, Psychiatry 2 Unit, Milan, Italy University of Milan, “aldo Ravelli” Center For Nanotechnology And Neurostimulation, Milan, Italy Stanford University, Department Of Psychiatry And Behavioral Sciences, Stanford, United States of America University of Milan, “centro Per Lo Studio Dei Meccanismi Molecolari Alla Base Delle Patologie Neuro-psico-geriatriche”, Milan, Italy
*
*Corresponding author.

Abstract

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Introduction

Obsessive Compulsive Disorder (OCD) and Tic Disorder (TD) are two highly disabling, comorbid and difficult-to-treat conditions. DSM-5 acknowledged a new “tic-related” specifier for OCD, i.e., Obsessive-Compulsive Tic-related Disorder (OCTD), which may show poor treatment response.

Objectives

The aim of the present study was to evaluate rates and clinical correlates of response, remission and resistance to treatment in a large multicentre sample of OCD patients with versus without tics.

Methods

398 patients with a DSM-5 diagnosis of OCD with and without comorbid TD was assessed from ten psychiatric departments across Italy. Treatment response profiles in the whole sample were analysed comparing the rates of response, remission and treatment-resistance as well as related clinical features. Multivariate logistic regressions were performed to highlight possible treatment response related factors.

Results

Later ages of onset of TD and OCD were found in the remission group. Moreover, significantly higher rates of psychiatric comorbidities, TD, and lifetime suicidal ideation and attempts were associated to the treatment-resistant group, with larger degrees of perceived worsened quality of life and family involvement.

Conclusions

While remission was related to later ages of OCD and TD onset, specific clinical factors, such as early onset and presence of psychiatric comorbidities and concomitant TD, predicted a worse treatment response, with a significant impairment in quality of life for both patients and their caregivers. These findings suggest a worse profile of treatment response for patients with OCTD.

Disclosure

No significant relationships.

Keywords

psychopharmacologyobsessive compulsive disordertic disorderTreatment Resistance
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S642 - S643
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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