Browsing by Subject "Obsessive compulsive disorder"

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    Severity and changes in OCD dimensions during COVID-19: a two-year longitudinal study
    (MDPI, 2023-07-31) Rosa Alcázar, Ángel; Parada Navas, José Luis; García Hernández, María Dolores; Pozza, Andrea; Tondi, Paolo; Rosa Alcázar, Ana Isabel; Personalidad, Evaluación y Tratamiento Psicológicos
    Background: The COVID-19 pandemic appears to be associated with a worsening of obsessive-compulsive symptoms in both young people and adults with OCD and it is necessary to analyze the variables involved in this worsening over time. The main aim of this study was to examine long-term changes in total severity and obsessive-compulsive dimensions in obsessive–compulsive patients during the COVID-19 pandemic. Method: A total 250 OCD patients were selected from various associations, clinical centers and hospitals. We discarded 75 as they did not meet the inclusion criteria. A total of 175 obsessive-compulsive participants aged between 16 and 58 years old (M = 33.33, SD = 9.42) were evaluated in obsessive–compulsive symptom severity and dimensions OCD assessed using the Y-BOCS and D-YBOCS scales in T1 (April–June 2020) and in T2 (March–April 2022). The evaluation was carried out through an online survey and face-to-face with a professional clinician at both time points. Results: Intragroup differences in severity were observed, reaching higher scores for patients with contamination, somatic, aggressive and religious. Some patients changed their main dimension, increasing the percentage of patients with contamination and somatic obsessions. Conclusions: COVID-19 was associated with both changes in severity and also affected some dimensions more than others, particularly those related to the virus itself (contamination and somatic).
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    Systematic review and meta-analysis: an empirical approach to defining treatment response and remission in pediatric obsessive-compulsive disorder
    (Elsevier, 2022-04) Farath, Luis C.; Rosa Alcázar, Ana Isabel; Rosa Alcázar, Ángel; Rozenman, Michelle et al.; Personalidad, Evaluación y Tratamiento Psicológicos
    Objective: A lack of universal definitions for response and remission in pediatric obsessive-compulsive disorder (OCD) has hampered the comparability of results across trials. To address this problem, we conducted an individual participant data diagnostic test accuracy meta-analysis to evaluate the discriminative ability of the Children’s Yale Brown Obsessive-Compulsive Scale (CY-BOCS) in determining response and remission. We also aimed to generate empirically derived cutoffs on the CY-BOCS for these outcomes. Method: A systematic review of PubMed, PsycINFO, Embase and CENTRAL identified 5,401 references; 42 randomized controlled clinical trials were considered eligible, and 21 provided data for inclusion (N 1,234). Scores of 2 in the Clinical Global Impressions Improvement and Severity scales were chosen to define response and remission, respectively. A 2-stage, random-effects meta-analysis model was established. The area under the curve (AUC) and the Youden Index were computed to indicate the discriminative ability of the CY-BOCS and to guide for the optimal cutoff, respectively. Results: The CY-BOCS had sufficient discriminative ability to determine response (AUC ¼ 0.89) and remission (AUC ¼ 0.92). The optimal cutoff for response was a 35% reduction from baseline to posttreatment (sensitivity ¼ 83.9, 95% CI ¼ 83.7 84.1; specificity ¼ 81.7, 95% CI ¼ 81.5 81.9). The optimal cutoff for remission was a posttreatment raw score of 12 (sensitivity ¼ 82.0, 95% CI ¼ 81.8 82.2; specificity ¼ 84.6, 95% CI ¼ 84.4 84.8). Conclusion: Meta-analysis identified empirically optimal cutoffs on the CY-BOCS to determine response and remission in pediatric OCD randomized controlled clinical trials. Systematic adoption of standardized operational definitions for response and remission will improve comparability across trials for pediatric OCD.