Specialty knowledge and competency standards for pharmacotherapy for adult obsessive-compulsive disorder

PSYCHIATRY RESEARCH

卷:300

Article

Pittenger, Christopher^1,2  Brennan, Brian P.^3,4,5  Koran, Lorrin⁶  Mathews, Carol A.⁷  Nestadt, Gerald⁸  Pato, Michele^9,10  Phillips, Katharine A.^11,12  Rodriguez, Carolyn I.^6,19  Simpson, H. Blair^13,14  Skapinakis, Petros¹⁵  Stein, Dan J.^16,17  Storch, Eric A.¹⁸ 

[1] Yale Univ, Sch Med, Dept Psychiat, New Haven, CT USA

[2] Yale Univ, Sch Med, Yale Child Study Ctr, New Haven, CT USA

[3] McLean Hosp, Biol Psychiat Lab, 115 Mill St, Belmont, MA 02178 USA

[4] McLean Hosp, Obsess Compuls Disorder Inst, 115 Mill St, Belmont, MA 02178 USA

[5] Harvard Med Sch, Dept Psychiat, Boston, MA 02115 USA

[6] Stanford Univ, Dept Psychiat & Behav Sci, Sch Med, Stanford, CA 94305 USA

[7] Univ Florida, Dept Psychiat, Gainesville, FL 32611 USA

[8] Johns Hopkins Univ, Sch Med, Dept Psychiat & Behav Sci, Baltimore, MD 21205 USA

[9] SUNY Downstate Coll Med, Inst Genom Hlth, Brooklyn, NY USA

[10] SUNY Downstate Coll Med, Dept Psychiat, Brooklyn, NY USA

[11] Brown Univ, Dept Psychiat & Human Behav, Warren Alpert Med Sch, Providence, RI 02912 USA

[12] Weill Cornell Med Coll, Dept Psychiat, New York, NY USA

[13] Columbia Univ Vagelos Coll Phys & Surg, Dept Psychiat, New York, NY USA

[14] New York Psychiat Inst, Off Mental Hlth, Res Fdn Mental Hyg, New York, NY USA

[15] Univ Ioannina, Dept Psychiat, Sch Hlth Sci, Ioannina, Greece

[16] Univ Cape Town, Dept Psychiat, Cape Town, South Africa

[17] Univ Cape Town, Inst Neurosci, Cape Town, South Africa

[18] Baylor Coll Med, Menninger Dept Psychiat & Behav Sci, Houston, TX 77030 USA

[19] Vet Affairs Palo Alto Hlth Care Syst, Palo Alto, CA USA

关键词: Obsessive-compulsive disorder (OCD);    selective serotonin reuptake inhibitors (SSRIs);    pharmacotherapy;    treatment;    comorbidity;    augmentation;   

DOI  :  10.1016/j.psychres.2021.113853

来源: Elsevier

【 摘 要 】

Obsessive-compulsive disorder (OCD) affects approximately one person in 40 and causes substantial suffering. Evidence-based treatments can benefit many; however, optimal treatment can be difficult to access. Diagnosis is frequently delayed, and pharmacological and psychotherapeutic interventions often fail to follow evidence-based guidelines. To ameliorate this distressing situation, the International OCD Accreditation Task Force of the Canadian Institute for Obsessive-Compulsive Disorders has developed knowledge and competency standards for specialized treatments for OCD through the lifespan. These are foundational to evidence-based practice and will form the basis for upcoming ATF development of certification/accreditation programs. Here, we present specialty standards for the pharmacological treatment of adult OCD. We emphasize the importance of integrating pharmacotherapy with clear diagnosis, appreciation of complicating factors, and evidence-based cognitive behavioral therapy. Clear evidence exists to inform first- and second-line pharmacological treatments. In disease refractory to these initial efforts, multiple strategies have been investigated, but the evidence is more equivocal. These standards summarize this limited evidence to give the specialist practitioner a solid basis on which to make difficult decisions in complex cases. It is hoped that further research will lead to development of a clear, multistep treatment algorithm to support each step in clinical decision-making.

【 授权许可】

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