Cortical and subcortical structural alterations in obsessive-compulsive disorder: relationships between morphology and clinical profiles in the Global OCD study.

Background: The Global OCD consortium investigated cortical and subcortical alterations in obsessive-compulsive disorder (OCD) using T1-weighted MRI, focusing on the relationship between brain morphology and clinical phenotypes, illness duration, comorbidity and medication history.

Methods: This preregistered study included 266 medication-free adults with OCD and 254 healthy controls. We analyzed cortical thickness, surface area, and (sub)cortical and cerebellar volumes using FreeSurfer ROI metrics and voxel-based morphometry (VBM).

The bidirectional relationship between severity of obsessive-compulsive symptoms and lifestyle factors in patients with obsessive-compulsive disorder: a contemporaneous and prospective analysis.

Objective: In psychiatric disorders, lifestyle factors are known to influence both the development and course of the illness. However, little is known about the longitudinal relationship between lifestyle factors and OCD symptom severity, including the potential bidirectional, prospective association between them. This study examines both the contemporaneous and two-year prospective relationships between lifestyle factors and OCD symptom severity, as well as the reverse relationship-namely, the influence of OCD severity on lifestyle factors.

Inference-Based Cognitive Behavioral Therapy versus Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder: A Multisite Randomized Controlled Non-Inferiority Trial.

Introduction: Although cognitive behavioral therapy (CBT) effectively treats obsessive-compulsive disorder (OCD), many patients refuse CBT or drop out prematurely, partly because of anxiety regarding exposure and response prevention (ERP) exercises. Inference-based cognitive behavioral therapy (I-CBT) focuses on correcting distorted inferential thinking patterns, enhancing reality-based reasoning, and addressing obsessional doubt by targeting underlying dysfunctional reasoning, without incorporating an ERP component. We hypothesized that I-CBT would be non-inferior to CBT.

Glutamate dynamics and BOLD response during OCD symptom provocation in the lateral occipital cortex: A 7 Tesla fMRI-fMRS study.

Obsessive-compulsive disorder (OCD) is linked with dysfunction in frontal-striatal, fronto-limbic, and visual brain regions. Research using proton magnetic resonance spectroscopy (H-MRS) suggests that altered neurometabolite levels, like glutamate, may contribute to this dysfunction. However, static neurometabolite levels in OCD patients have shown inconsistent results, likely due to previous studies' limited focus on neurometabolite dynamics.

Multifaceted, Brief Intensive Home-Based Exposure Treatment in Patients with Obsessive-Compulsive Disorder Who are Nonresponsive to Regular Cognitive Behavior Therapy: An Uncontrolled Pilot Study.

Objective: To test a multifaceted treatment program for patients with obsessive-compulsive disorder (OCD) who did not respond to regular cognitive behavior therapy (CBT). The treatment addresses several factors that may play a role in maintaining OCD.

Methods: We designed a treatment consisting of a 6-day intensive, individual exposure in vivo with response prevention (ERP) format, with 24 therapist-assisted treatment hours at the patient's home and 12 self-controlled ERP hours, including behavioral activation and family interventions.

Patient Perceptions of Illness Causes and Treatment Preferences for Obsessive-Compulsive Disorder: A Mixed-Methods Study.

Obsessive-compulsive disorder (OCD) is a condition with high patient morbidity and mortality. Research shows that eliciting patient explanations about illness causes and treatment preferences promotes cross-cultural work and engagement in health services. These topics are in the Cultural Formulation Interview (CFI), a semi-structured interview first published in DSM-5 that applies anthropological approaches within mental health services to promote person-centered care.

Does a lack of emotions make chatbots unfit to be psychotherapists?

Mental health chatbots (MHCBs) designed to support individuals in coping with mental health issues are rapidly advancing. Currently, these MHCBs are predominantly used in commercial rather than clinical contexts, but this might change soon. The question is whether this use is ethically desirable.

[Anxiety].

In this article, we will address 10 questions about anxiety that are relevant to doctors who encounter this in their practice. This often occurs in the primary care setting, where individuals with anxiety frequently present with somatic complaints. A focused medical history, including questions about the use and withdrawal of psychoactive substances, can assist in the diagnostic process.

The definition of treatment resistance in anxiety disorders: a Delphi method-based consensus guideline.

Anxiety disorders are very prevalent and often persistent mental disorders, with a considerable rate of treatment resistance which requires regulatory clinical trials of innovative therapeutic interventions. However, an explicit definition of treatment-resistant anxiety disorders (TR-AD) informing such trials is currently lacking. We used a Delphi method-based consensus approach to provide internationally agreed, consistent and clinically useful operational criteria for TR-AD in adults.

Treatment Preferences of Adolescents and Young Adults with Depressive Symptoms: A Discrete Choice Experiment.

Background: Depression in adolescents and young adults is common and causes considerable disease burden while hampering their development, leading to adverse consequences in later life. Although treatment is available, young people are a vulnerable group regarding uptake and completion of treatment. To improve this, insight into youth's preferences for treatment is essential.

Understanding and preventing nonadherence and treatment dropout in adolescents and young adults with anxiety and depressive disorders.

Dropout from psychological or pharmacological treatment for anxiety and depressive disorders is common. It is especially problematic in adolescents and young adults because of the adverse consequences for their development. Reasons for treatment dropout can be divided into therapy-process related factors, attitudinal aspects, and practical issues.

Risk factors of chronic course of anxiety and depressive disorders: a 3-year longitudinal study in the general population.

Background: Risk factors of a chronic course of anxiety and depressive disorders were previously studied using a limited definition of recovery, i.e. remission of the index disorder.

Changes in insight throughout the natural four-year course of obsessive-compulsive disorder and its association with OCD severity and quality of life.

Objective: Patients with obsessive-compulsive disorder (OCD) and poor insight show higher symptom severity, lower quality of life (QoL), and a reduced treatment response compared to patients with good insight. Little is known about changes in insight. This study explored the course of insight and its association with OCD severity and QoL among 253 patients with OCD participating in the prospective naturalistic Netherlands Obsessive Compulsive Disorder Association (NOCDA) Study.

Poor Insight in Obsessive-Compulsive Disorder as a Multifaceted Phenomenon: Evidence From Brain Activation During Symptom Provocation.

Background: Poor insight in obsessive-compulsive disorder (OCD) is associated with higher symptom severity, more comorbidities, and worse response to treatment. This study aimed to elucidate underlying mechanisms of poor insight in OCD by exploring its neurobiological correlates.

Methods: Using a symptom provocation task during functional magnetic resonance imaging, we compared brain activation of patients with poor insight (n = 19; 14 female, 5 male), good/fair insight (n = 63; 31 female, 32 male), and healthy control participants (n = 42; 22 female, 20 male) using a Bayesian region-of-interest and a general linear model whole-brain approach.

Schema therapy with cognitive behaviour day-treatment in patients with treatment-resistant anxiety disorders and obsessive-compulsive disorder: an uncontrolled pilot study.

Background: Treatment resistance in patients with anxiety disorders and obsessive-compulsive disorder (OCD) might be caused by dysfunctional personality traits or, more specifically, early maladaptive schemas (EMSs) and schema modes, that can be treated with schema therapy (ST).

Aim: To explore possible effectiveness of ST-CBT day-treatment in patients with treatment-resistant anxiety disorders and OCD in an uncontrolled pilot study.

Method: Treatment-resistant patients with anxiety disorders or OCD ( = 27) were treated with ST-CBT day-treatment for 37 weeks on average including 11.

Measurement fidelity of clinical assessment methods in a global study on identifying reproducible brain signatures of obsessive-compulsive disorder.

Objective: To describe the steps of ensuring measurement fidelity of core clinical measures in a five-country study on brain signatures of obsessive-compulsive disorder (OCD).

Method: We collected data using standardized instruments, which included the Yale-Brown Obsessive-Compulsive Scale (YBOCS), the Dimensional YBOCS (DYBOCS), the Brown Assessment of Beliefs Scale (BABS), the 17-item Hamilton Depression Scale (HAM-D), the Hamilton Anxiety Scale (HAM-A), and the Structured Clinical Interview for DSM-5 (SCID). Steps to ensure measurement fidelity included translating instruments, developing a clinical decision manual, and continuing reliability training with 11-13 transcripts of each instrument by 13 independent evaluators across sites over 4 years.

Global multi-center and multi-modal magnetic resonance imaging study of obsessive-compulsive disorder: Harmonization and monitoring of protocols in healthy volunteers and phantoms.

Objectives: We describe the harmonized MRI acquisition and quality assessment of an ongoing global OCD study, with the aim to translate representative, well-powered neuroimaging findings in neuropsychiatric research to worldwide populations.

Methods: We report on T1-weighted structural MRI, resting-state functional MRI, and multi-shell diffusion-weighted imaging of 140 healthy participants (28 per site), two traveling controls, and regular phantom scans.

Results: Human image quality measures (IQMs) and outcome measures showed smaller within-site variation than between-site variation.

The prescriber's guide to classic MAO inhibitors (phenelzine, tranylcypromine, isocarboxazid) for treatment-resistant depression.

This article is a clinical guide which discusses the "state-of-the-art" usage of the classic monoamine oxidase inhibitor (MAOI) antidepressants (phenelzine, tranylcypromine, and isocarboxazid) in modern psychiatric practice. The guide is for all clinicians, including those who may not be experienced MAOI prescribers. It discusses indications, drug-drug interactions, side-effect management, and the safety of various augmentation strategies.

Therapeutic Alliance and Treatment Outcome in Cognitive Behavior Therapy for Obsessive-Compulsive Disorder.

Objective: Therapeutic alliance has consistently been found to predict treatment outcomes across various psychotherapies and patient diagnosis. However, the relationship between therapeutic alliance and outcome in Cognitive Behavioral Therapy (CBT) has shown mixed results. This study investigated the impact of different aspects of therapeutic alliance in CBT for Obsessive-Compulsive Disorder (OCD).

Barriers and facilitators for treatment-seeking in adults with a depressive or anxiety disorder in a Western-European health care setting: a qualitative study.

Background: Previous research on barriers and facilitators regarding treatment-seeking of adults with depressive and anxiety disorders has been primarily conducted in the Anglosphere. This study aims to gain insight into treatment-seeking behaviour of adults with depressive and anxiety disorders in a European healthcare system.

Methods: In-depth semi-structured interviews were conducted with 24 participants, aged ≥18 years and diagnosed with an anxiety disorder and/or depressive disorder according to DSM-IV.