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CHILDHOOD, ADOLESCENT AND ADULT AGE AT ONSET AND RELATED CLINICAL CORRELATES IN OBSESSIVE-COMPULSIVE DISORDER: A REPORT FROM THE INTERNATIONAL COLLEGE OF OBSESSIVE-COMPULSIVE DISORDERS (ICOCS)
European Neuropsychopharmacology (2017) 27, 610–623
www.elsevier.com/locate/euroneuro
Abstracts of the ICOCS 11th Scientific Meeting in conjunction with the ECNP OCRN meeting, Wednesday 2 September 2015, Amsterdam
CHILDHOOD, ADOLESCENT AND ADULT AGE AT ONSET AND RELATED CLINICAL CORRELATES IN OBSESSIVECOMPULSIVE DISORDER: A REPORT FROM THE INTERNATIONAL COLLEGE OF OBSESSIVE-COMPULSIVE DISORDERS (ICOCS)
Bernardo Dell'Osso1,16, Beatrice Benatti1, Humberto Nicolini2,3, Nuria Lanzagorta3, M. Carlotta Palazzo1, Donatella Marazziti4, Eric Hollander5, Naomi Fineberg6, Dan J. Stein7, Stefano Pallanti8, Michael Van Ameringen9, Christine Lochner10, Georgi Hranov11, Oguz Karamustafalioglu12,13, Luchezar Hranov11, Jose M Menchon12,13, Joseph Zohar14, Damiaan Denys15 1
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’Granda, Ospedale Maggiore Policlinico, Milano, Italy 2Servicios de Atención Psiquiátrica, Minister of Health, Mexico 3Carracci Medical Group, Mexico City, Mexico 4Dipartimento di Psichiatria, Neurobiologia, Farmacologia e Biotechnologie, Università di Pisa, Italy 5Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine and Montefiore Medical Center, New York, USA 6Mental Health Unit, Hertfordshire Partnership Foundation Trust, Queen Elizabeth II Hospital, Welwyn Garden City, UK 7MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa 8Department of Psychiatry, University of Florence, and Institute of Neuros-
http://dx.doi.org/10.1016/j.euroneuro.2016.07.013 0924-977X/& 2016 Published by Elsevier B.V.
ciences, Florence, Italy 9Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada 10MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, University of Stellenbosch, South Africa 11University Multiprofile Hospital for Active Treatment in Neurology and Psychiatry Sveti Naum, Sofia, Bulgaria 12Department of Psychiatry, Sisli Eftal Teaching and Research Hospital, Istanbul, Turkey 13Psychiatry Unit at Hospital Universitari de Bellvitge. Barcelona, Spain 14Department of Psychiatry, Chaim Sheba Medical Center, Tel Hashomer, Israel 15Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands 16Bipolar Disorders Clinic; Stanford University, CA, US Objective: Many studies suggest that age at onset of obsessive-compulsive disorder (OCD) is an important factor in subtyping OCD (1). In fact, significant differences in clinical profile and comorbidity patterns have been observed between "juvenile-onset" and "adult-onset" OCD (2). Aim of the present study was to compare the prevalence and the socio-demographic and clinical patterns of OCD patients with "childhood-onset" (≤12 years), "adolescent-onset" (1218 years), and "adult-onset" (≥18 years) in a large international sample. Methods: The sample included 431 OCD out-patients of eit her gender and any age attending to different psychiatric departments worldwide participating to the “international college of obsessive-compulsive spectrum disorders” (ICOCS) network. The records of patients diagnosed with OCD and followed in the Psychiatric departments of the
Abstracts of the ICOCS 11th Scientific Meeting ICOCS network were collected and included in a common web-database and their main demographic and clinical variables were analyzed and Chi-squared and ANOVA analysis were performed to compare the three subgroups. Results: Twenty-one percent (n=92) of the sample was represented by patients with childhood onset, while 36% (n=155) of the sample showed an adolescent onset and 43% (n=184) showed an adult onset. Patients with adult onset showed a significant female prevalence compared to the other two subgroups (χ2=10.92, po0.05; 28% of females in the adult onset subgroup vs 11% in childhood onset and 18% in adolescent onset subgroup) and showed a significantly lower prevalence of patients receiving cognitive behavioural therapy (CBT) compared to the other two subgroups (χ2=14.5, po0.01; 28% in adult onset subgroup were not under CBT vs 10% of the childhood onset and 19% of the adolescent onset subgroup). No significant differences among the three onset subgroups were found in terms of Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores nor in terms of psychopharmacological treatments and presence of comorbidity patterns. Conclusions: Present naturalistic study suggests that more than 50% of the sample showed an onset during childhood or adolescence. Furthermore, there was a female prevalence in the subgroup of OCD patients with adult onset, as previously shown in recent studies (2) and a less frequent use of CBT in the same subgroup. Further research is required to better understand the clinical features of OCD with different age at onset.
References [1] Taylor S. Early versus late onset obsessive-compulsive disorder: evidence for distinct subtypes. Clin Psychol Rev. 2011;31(7):1083-100. [2] Sharma E, Sundar AS, Thennarasu K, Reddy YC. Is lateonset OCD a distinct phenotype? Findings from a comparative analysis of "age at onset" groups. CNS Spectr. 2015; 20:1-7. The authors declare that all experiments on human subjects and animal experiments were conducted in accordance with the relevant ethical standards and have passed the appropriate ethics boards.
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Amsterdam, The Netherlands 3Department of Social and Behavioural Science, Utrecht University, Utrecht, The Netherlands 4Neuroscience Campus Amsterdam, VU/VUmc, Amsterdam, The Netherlands 5The OCD team, Haukeland University Hospital, Bergen, Norway 6 Academic Anxiety Center Altrecht, Utrecht, The Netherlands 7Netherlands Institute for Neuroscience, Amsterdam, The Netherlands 8Department of Physics & Medical Technology, VUmc, Amsterdam, The Netherlands Objective: Obsessive-compulsive disorder (OCD) is a common neuropsychiatric disorder with moderate genetic influences and white matter (WM) abnormalities in frontalstriatal and limbic regions. Inconsistencies in reported WM results from diffusion tensor imaging (DTI) studies can be explained, at least partly, by medication use and betweengroup differences in disease profile and stage. We used a family design aiming to establish whether WM abnormalities, if present in un-medicated OCD patients, also exist in their unaffected siblings. Method: Forty-four un-medicated OCD patients, 15 of their unaffected siblings and 37 healthy controls (HC) underwent DTI using a 3-Tesla MRI-scanner. Data analysis was done using tract-based spatial statistics (TBSS). Fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD) values were compared within seven skeletonised regions of interest (ROIs), i.e., corpus callosum (CC), bilateral cingulum bundle (CB), bilateral inferior longitudinal fasciculus/frontal-occipital fasciculus (ILF/ FOF) and bilateral superior longitudinal fasciculus (SLF). Results: Un-medicated OCD patients, compared with HC, had significantly lower FA in the left CB. FA was trendsignificantly lower in all other ROIs, except for the CC. Significant three-group differences in FA (and in RD at trendsignificant level) were observed in the left CB, with the unaffected siblings representing an intermediate group between OCD patients and HC. Conclusions: OCD patients showed lower FA in the left CB, partly driven by trend-significantly higher values in RD. Since the unaffected siblings were found to be an intermediate group between OCD patients and HC, this WM alteration may be considered an endophenotype for OCD.
http://dx.doi.org/10.1016/j.euroneuro.2016.07.013
Grant support MILD WHITE MATTER CHANGES IN UN-MEDICATED OBSESSIVE-COMPULSIVE DISORDER PATIENTS AND THEIR UNAFFECTED SIBLINGS
Siyan Fan1,2,3, Odile A. van den Heuvel1,2,4,5, Danielle C. Cath3,6, Ysbrand D. van der Werf1,4,7, Stella J. de Wit1,2,4,5, Froukje E. de Vries1,2,4, Dick J. Veltman2,4, Petra J.W. Pouwels4,8 1
Department of Anatomy and Neurosciences, VU university medical center (VUmc), Amsterdam, The Netherlands 2Department of Psychiatry, VUmc,
This study was supported by FP7-People-2012-ITN grant (316978, project: TS-Eurotrain), the Dutch Organization for Scientific Research (NWO) with a ZonMW VENI grant (916-86-038 to dr. van den Heuvel) and ZonMW AGIKO grant (920-03-542 to Ms. de Vries), a NARSAD young investigators award of the Brain & Behavior Research Foundation (to dr. van den Heuvel), the Amsterdam Brain Imaging Platform, the Netherlands Brain Foundation (2010(1)-50 to dr. van den Heuvel), the Stichting tot Steun VCVGZ (STO957 to dr. Cath). http://dx.doi.org/10.1016/j.euroneuro.2016.07.014
www.elsevier.com/locate/euroneuro
Abstracts of the ICOCS 11th Scientific Meeting in conjunction with the ECNP OCRN meeting, Wednesday 2 September 2015, Amsterdam
CHILDHOOD, ADOLESCENT AND ADULT AGE AT ONSET AND RELATED CLINICAL CORRELATES IN OBSESSIVECOMPULSIVE DISORDER: A REPORT FROM THE INTERNATIONAL COLLEGE OF OBSESSIVE-COMPULSIVE DISORDERS (ICOCS)
Bernardo Dell'Osso1,16, Beatrice Benatti1, Humberto Nicolini2,3, Nuria Lanzagorta3, M. Carlotta Palazzo1, Donatella Marazziti4, Eric Hollander5, Naomi Fineberg6, Dan J. Stein7, Stefano Pallanti8, Michael Van Ameringen9, Christine Lochner10, Georgi Hranov11, Oguz Karamustafalioglu12,13, Luchezar Hranov11, Jose M Menchon12,13, Joseph Zohar14, Damiaan Denys15 1
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’Granda, Ospedale Maggiore Policlinico, Milano, Italy 2Servicios de Atención Psiquiátrica, Minister of Health, Mexico 3Carracci Medical Group, Mexico City, Mexico 4Dipartimento di Psichiatria, Neurobiologia, Farmacologia e Biotechnologie, Università di Pisa, Italy 5Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine and Montefiore Medical Center, New York, USA 6Mental Health Unit, Hertfordshire Partnership Foundation Trust, Queen Elizabeth II Hospital, Welwyn Garden City, UK 7MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa 8Department of Psychiatry, University of Florence, and Institute of Neuros-
http://dx.doi.org/10.1016/j.euroneuro.2016.07.013 0924-977X/& 2016 Published by Elsevier B.V.
ciences, Florence, Italy 9Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada 10MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, University of Stellenbosch, South Africa 11University Multiprofile Hospital for Active Treatment in Neurology and Psychiatry Sveti Naum, Sofia, Bulgaria 12Department of Psychiatry, Sisli Eftal Teaching and Research Hospital, Istanbul, Turkey 13Psychiatry Unit at Hospital Universitari de Bellvitge. Barcelona, Spain 14Department of Psychiatry, Chaim Sheba Medical Center, Tel Hashomer, Israel 15Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands 16Bipolar Disorders Clinic; Stanford University, CA, US Objective: Many studies suggest that age at onset of obsessive-compulsive disorder (OCD) is an important factor in subtyping OCD (1). In fact, significant differences in clinical profile and comorbidity patterns have been observed between "juvenile-onset" and "adult-onset" OCD (2). Aim of the present study was to compare the prevalence and the socio-demographic and clinical patterns of OCD patients with "childhood-onset" (≤12 years), "adolescent-onset" (1218 years), and "adult-onset" (≥18 years) in a large international sample. Methods: The sample included 431 OCD out-patients of eit her gender and any age attending to different psychiatric departments worldwide participating to the “international college of obsessive-compulsive spectrum disorders” (ICOCS) network. The records of patients diagnosed with OCD and followed in the Psychiatric departments of the
Abstracts of the ICOCS 11th Scientific Meeting ICOCS network were collected and included in a common web-database and their main demographic and clinical variables were analyzed and Chi-squared and ANOVA analysis were performed to compare the three subgroups. Results: Twenty-one percent (n=92) of the sample was represented by patients with childhood onset, while 36% (n=155) of the sample showed an adolescent onset and 43% (n=184) showed an adult onset. Patients with adult onset showed a significant female prevalence compared to the other two subgroups (χ2=10.92, po0.05; 28% of females in the adult onset subgroup vs 11% in childhood onset and 18% in adolescent onset subgroup) and showed a significantly lower prevalence of patients receiving cognitive behavioural therapy (CBT) compared to the other two subgroups (χ2=14.5, po0.01; 28% in adult onset subgroup were not under CBT vs 10% of the childhood onset and 19% of the adolescent onset subgroup). No significant differences among the three onset subgroups were found in terms of Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores nor in terms of psychopharmacological treatments and presence of comorbidity patterns. Conclusions: Present naturalistic study suggests that more than 50% of the sample showed an onset during childhood or adolescence. Furthermore, there was a female prevalence in the subgroup of OCD patients with adult onset, as previously shown in recent studies (2) and a less frequent use of CBT in the same subgroup. Further research is required to better understand the clinical features of OCD with different age at onset.
References [1] Taylor S. Early versus late onset obsessive-compulsive disorder: evidence for distinct subtypes. Clin Psychol Rev. 2011;31(7):1083-100. [2] Sharma E, Sundar AS, Thennarasu K, Reddy YC. Is lateonset OCD a distinct phenotype? Findings from a comparative analysis of "age at onset" groups. CNS Spectr. 2015; 20:1-7. The authors declare that all experiments on human subjects and animal experiments were conducted in accordance with the relevant ethical standards and have passed the appropriate ethics boards.
611
Amsterdam, The Netherlands 3Department of Social and Behavioural Science, Utrecht University, Utrecht, The Netherlands 4Neuroscience Campus Amsterdam, VU/VUmc, Amsterdam, The Netherlands 5The OCD team, Haukeland University Hospital, Bergen, Norway 6 Academic Anxiety Center Altrecht, Utrecht, The Netherlands 7Netherlands Institute for Neuroscience, Amsterdam, The Netherlands 8Department of Physics & Medical Technology, VUmc, Amsterdam, The Netherlands Objective: Obsessive-compulsive disorder (OCD) is a common neuropsychiatric disorder with moderate genetic influences and white matter (WM) abnormalities in frontalstriatal and limbic regions. Inconsistencies in reported WM results from diffusion tensor imaging (DTI) studies can be explained, at least partly, by medication use and betweengroup differences in disease profile and stage. We used a family design aiming to establish whether WM abnormalities, if present in un-medicated OCD patients, also exist in their unaffected siblings. Method: Forty-four un-medicated OCD patients, 15 of their unaffected siblings and 37 healthy controls (HC) underwent DTI using a 3-Tesla MRI-scanner. Data analysis was done using tract-based spatial statistics (TBSS). Fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD) values were compared within seven skeletonised regions of interest (ROIs), i.e., corpus callosum (CC), bilateral cingulum bundle (CB), bilateral inferior longitudinal fasciculus/frontal-occipital fasciculus (ILF/ FOF) and bilateral superior longitudinal fasciculus (SLF). Results: Un-medicated OCD patients, compared with HC, had significantly lower FA in the left CB. FA was trendsignificantly lower in all other ROIs, except for the CC. Significant three-group differences in FA (and in RD at trendsignificant level) were observed in the left CB, with the unaffected siblings representing an intermediate group between OCD patients and HC. Conclusions: OCD patients showed lower FA in the left CB, partly driven by trend-significantly higher values in RD. Since the unaffected siblings were found to be an intermediate group between OCD patients and HC, this WM alteration may be considered an endophenotype for OCD.
http://dx.doi.org/10.1016/j.euroneuro.2016.07.013
Grant support MILD WHITE MATTER CHANGES IN UN-MEDICATED OBSESSIVE-COMPULSIVE DISORDER PATIENTS AND THEIR UNAFFECTED SIBLINGS
Siyan Fan1,2,3, Odile A. van den Heuvel1,2,4,5, Danielle C. Cath3,6, Ysbrand D. van der Werf1,4,7, Stella J. de Wit1,2,4,5, Froukje E. de Vries1,2,4, Dick J. Veltman2,4, Petra J.W. Pouwels4,8 1
Department of Anatomy and Neurosciences, VU university medical center (VUmc), Amsterdam, The Netherlands 2Department of Psychiatry, VUmc,
This study was supported by FP7-People-2012-ITN grant (316978, project: TS-Eurotrain), the Dutch Organization for Scientific Research (NWO) with a ZonMW VENI grant (916-86-038 to dr. van den Heuvel) and ZonMW AGIKO grant (920-03-542 to Ms. de Vries), a NARSAD young investigators award of the Brain & Behavior Research Foundation (to dr. van den Heuvel), the Amsterdam Brain Imaging Platform, the Netherlands Brain Foundation (2010(1)-50 to dr. van den Heuvel), the Stichting tot Steun VCVGZ (STO957 to dr. Cath). http://dx.doi.org/10.1016/j.euroneuro.2016.07.014