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In this integrative review, we discuss findings supporting the use neuroimaging biomarkers in the diagnosis and treatment of obsessive-compulsive disorder (OCD). To do so, we have selected the most recent studies that attempted to identify the underlying pathogenic process associated with OCD and whether they provide useful information to predict clinical features, natural history or treatment responses. Studies using functional magnetic resonance (fMRI), voxel-based morphometry (VBM), diffusion tensor imaging (DTI) and proton magnetic resonance spectroscopy (1H MRS) in OCD patients are generally supportive of an expanded version of the earlier cortico-striatal-thalamus-cortical (CSTC) model of OCD. Although it is still unclear whether this information will be incorporated into the daily clinical practice (due to current conceptual approaches to mental illness), statistical techniques, such as pattern recognition methods, appear promising in identifying OCD patients and predicting their outcomes.
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Encéfalo/diagnóstico por imagem , Neuroimagem/métodos , Transtorno Obsessivo-Compulsivo/diagnóstico , Biomarcadores , Imagem de Tensor de Difusão/métodos , Humanos , Imageamento por Ressonância Magnética/métodos , Espectroscopia de Ressonância Magnética/métodosRESUMO
The COVID-19 pandemic has emerged as a worldwide public health crisis, leading to significant disruptions in societal behaviors and norms. Within the affected population, individuals with mental health disorders are considered a vulnerable group, experiencing higher infection rates and poorer outcomes. These adverse outcomes can be attributed to various factors, including inadequate adherence to vaccination and other preventive measures. To address this issue, this study aims to present the research protocol for a scoping review that will comprehensively examine the literature on the adherence of individuals with mental disorders to preventive behaviors during the COVID-19 pandemic. The scoping review will adhere to the methodological guidelines outlined by the Joanna Briggs Institute and will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. A comprehensive search for published literature containing original data will be conducted in the Embase, MEDLINE, PsycINFO, and Web of Science databases. The search strategy will be developed based on the Population, Concept, and Context inclusion criteria. Two authors will independently screen titles, abstracts, and full texts for inclusion and extract relevant data. The findings of the review will be presented using descriptive statistics, including tables, charts, and flow diagrams, to elucidate the key concepts of interest.
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INTRODUCTION: Obsessive-compulsive and related disorders (OCRDs) and disorders due to addictive behaviours (DABs) are prevalent conditions that share behavioural and neurobiological characteristics. The Research Domain Criteria lists a series of constructs whose dysfunctions may be present in both groups of disorders. The present study will describe the research protocol of a scoping review of the literature on self-report scales and questionnaires that tap dysfunctional constructs that underlie OCRDs and DABs. METHODS AND ANALYSIS: This protocol outlines a scoping review on self-report tools and questionnaires that assess OCRDs and DABs-related constructs. The scoping review will select sources in MEDLINE, EMBASE, PsychINFO and Web of Science databases. Inclusion and exclusion criteria will be designed according to the Population, Concept, Context, Types of source framework. Two reviewers will screen independently titles, abstracts and full texts to determine the eligibility of articles. A methodological framework including six stages steps ((1) identifying a research question; (2) identifying relevant studies; (3) study selection; (4) charting the data; (5) collating, summarising and reporting the result) will be used, and the findings will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Information extracted will be collated, and quantitative results will be presented using descriptive statistics such as percentages, tables, charts and flow diagrams as appropriate. ETHICS AND DISSEMINATION: Ethical approval for conducting this scoping review is not required, as this study will involve secondary analysis of existing literature. The researchers will disseminate the study results via conference presentations and publication in a peer-reviewed journal. SCOPING REVIEW PROTOCOL REGISTRATION: DOI 10.17605/OSF.IO/UJ7G5.
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Comportamento Aditivo , Projetos de Pesquisa , Transtorno da Personalidade Compulsiva , Humanos , Revisão por Pares , Revisões Sistemáticas como AssuntoRESUMO
The etiology of obsessive-compulsive disorder (OCD) is largely unknown, but family, twin, neuroimaging, and pharmacological studies suggest that glutamatergic system plays a significant role on its underlying pathophysiology. We performed an association analysis of six Single Nucleotide Polymorphisms (SNPs) within SLC1A1 gene (rs12682807, rs2075627, rs3780412, rs301443, rs301430, rs301434) in a group of 199 patients and 200 healthy controls. Symptom profiles were evaluated using the Florida Obsessive-Compulsive Inventory (FOCI) and the Obsessive-Compulsive Inventory-Revised (OCI-R). SNPs were analyzed by Taqman® methodology (Thermo Fisher, Brazil). The genotype distributions were in Hardy-Weinberg equilibrium. The A-A-G (rs301434-rs3780412-rs301443) haplotype was twice as common in OCD as in controls (Pâ¯=â¯0.02). We also found significant differences between male patients and controls for rs301443 in a dominant model (Pâ¯=â¯0.04) and a protective effect of GG genotype of rs2072657 in women (Pâ¯=â¯0.02). Regarding clinical characteristics, the G-A (rs301434-rs3780412) haplotype was almost twice more common in patients with vs. without hoarding (Pâ¯=â¯0.04). Further analyses showed significant associations between hoarding and rs301434 (Pâ¯=â¯0.04) and rs3780412 (Pâ¯=â¯0.04) in women, both in a dominant model. A dominant effect was also observed on ordering dimension for rs301434 (Pâ¯=â¯0.01, in women) and rs301443 (Pâ¯=â¯0.04). Finally, the rs2072657 showed a recessive effect on neutralization (Pâ¯=â¯0.04) and checking (Pâ¯=â¯0.03, in men). These preliminary results demonstrated that the SLC1A1 may contribute to some extent the susceptibility to OCD and its symptoms. However, additional studies are still needed.
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Transportador 3 de Aminoácido Excitatório/genética , Predisposição Genética para Doença/genética , Transtorno Obsessivo-Compulsivo/genética , Adulto , Brasil , Estudos de Casos e Controles , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo ÚnicoRESUMO
Obsessive-compulsive disorder (OCD) is a neuropsychiatric illness characterized by obsessions and/or compulsions. Its pathophysiology is still not well understood but it is known that the cortico-striatal-thalamic-cortical (CSTC) circuitry plays an important role. Here, we used a multi-method MRI approach combining proton magnetic resonance spectroscopy (H1-MRS) and diffusion tensor imaging (DTI) techniques to investigate both the metabolic and the microstructural white matter (WM) changes of the anterior cingulate cortex (ACC) in OCD patients as compared to healthy controls. Twenty-three OCD patients and 21 age-, sex-, and education-matched healthy volunteers participated in the study. Our 1H-MRS findings show increased levels of Glx in ACC in OCD. Further, significantly lower fractional anisotropy (FA) values were observed in OCD patients' left cingulate bundle (CB) as compared to healthy controls. Finally, there was a negative correlation between FA in the left CB and level of obsessions, as well as the duration of the illness. Our findings reinforce the involvement of CSTC bundles in pathophysiology of OCD, pointing to a specific role of glutamate (glutamine) and WM integrity.
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OBJECTIVE: To assess the efficacy of electroconvulsive therapy (ECT) in DSM-5 obsessive-compulsive-related disorders (OCRDs) and conditions subsumed under an "extended" OCD spectrum, including tic disorders and self-injurious behaviors. DATA SOURCES: A systematic search of the MEDLINE, Web of Science, Scopus, and LILACS databases and other sources was performed between June 6 and July 2, 2017. Search terms included (Autis*) AND (ECT OR electroconvulsive), (Self-injur*) AND (ECT OR electroconvulsive), (Tic* OR Tourette) AND (ECT OR electroconvulsive), (Body Dysmorphic Disorder OR Dysmorphophobi*) AND (ECT OR electroconvulsive), (Hoard*) AND (ECT OR electroconvulsive), (Trichotillomani*) AND (ECT OR electroconvulsive), (Skin Picking OR Excoriation) AND (ECT OR electroconvulsive), (Grooming) AND (ECT OR electroconvulsive), (Kleptomani*) AND (ECT OR electroconvulsive), and (Pyromani*) AND (ECT OR electroconvulsive). No search restrictions (ie, date, language, or document type) were used. STUDY SELECTION: Fifty-two records that described the individual responses of OCRDs to ECT (involving 69 patients) were selected. DATA EXTRACTION: Clinical data and responses of individual cases were recorded. Data from responders were compared to nonresponders. RESULTS: All records were case reports or case series; there were no randomized controlled trials. Of the 69 OCRD participants who had undergone ECT, a positive response was reported in 73.4% of the cases (including 44.0% of the BDD, 74.1% of the tic disorder, and 85.7% of the self-injurious behavior patients). At follow-up, the majority of responders who had abstained from further ECT had experienced relapse. However, a positive response was obtained in all participants who received a new course of ECT. Patients who responded positively to ECT were likely to report previous unsuccessful treatment with antipsychotics (P < .001) and antidepressants (P = .007). CONCLUSIONS: The finding that more than 70% of the reviewed cases showed some response to ECT should not be considered unequivocal evidence of its efficacy in OCRDs. The available evidence suggests that a randomized controlled trial of ECT in OCRDs may be warranted, particularly in severe tic disorders and self-injurious behaviors.