Hostname: page-component-7b7567c8c-7pwfn Total loading time: 0 Render date: 2026-11-14T08:31:39.502Z Has data issue: false hasContentIssue false
  • English
  • Français

Obsessive-Compulsive Spectrum Disorders: Cross-national and Ethnic Issues

Published online by Cambridge University Press:  07 November 2014

Hisato Matsunaga and
Soraya Seedat
Get accessRights & Permissions [Opens in a new window]

Abstract

Epidemiological and clinical data from a variety of cultural and geographic settings on obsessive-compulsive disorder (OCD), and many of the obsessive-compulsive spectrum disorders, suggest that this is a group of disorders with a good degree of transcultural homogeneity. However, the content and themes that predominate in patients with these disorders, and the course of illness, can be shaped by cultural, ethnic, and religious experiences. Across cultures, OCD is commonly comorbid with mood, anxiety, and impulse-control disorders. However, little is known about the mechanisms by which culture and ethnicity may affect the expression of OCD and related disorders. Cross-national comparative studies exploring culturally influenced differences in clinical course, treatment outcome, including ethnogenetic differences in drug response, and prognosis are needed.

Information

Type
Review Articles
Information
CNS Spectrums , Volume 12 , Issue 5 , May 2007, pp. 392 - 400
Copyright
Copyright © Cambridge University Press 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

REFERENCES

1.Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
2.Sasson, Y, Zohar, J, Chopra, M, Lustig, M, lancu, I, Hendler, T. Epidemiology of obsessive-compulsive disorder: a world view. J Clin Psychiatry. 1997;58(suppl 12):7–10.Google ScholarPubMed
3.Eisen, JL, Rasmussen, SA. Phenomenology of obsessive-compulsive disorder. In: Stein, DJ, Hollander, E, eds. Pathogenesis of Obsessive-Compulsive Disorder. Textbook of Anxiety Disorders. Washington, DC: American Psychiatric Association; 2002:173–189.Google Scholar
4.de Silva, P. Culture and obsessive-compulsive disorder. Psychiatry. 2006;5:402–404.CrossRefGoogle Scholar
5.Shama, BP. Obsessive-compulsive neurosis in Nepal. Transcult Psychiatr Res Rev. 1968;5:38–41.Google Scholar
6.Khanna, S, Channabasavanna, SM. Phenomenology of obsessions in obsessive-compulsive neurosis. Psychopathology. 1988;21:12–18.CrossRefGoogle ScholarPubMed
7.Honjo, S, Hirano, C, Murase, S, et al.Obsessive-compulsive symptoms in childhood and adolescence. Acta Psychiatr Scand. 1989;80:83–91.CrossRefGoogle ScholarPubMed
8.Mahgoub, OM, Abdel-Hafeiz, HB. Pattern of obsessive-compulsive disorder in Eastern Saudi Arabia. Br J Psychiatry. 1991;158:840–842.CrossRefGoogle ScholarPubMed
9.Okasha, A, Saad, A, Khalil, AH, el Dawla, AS, Yehia, N. Phenomenology of obsessive compulsive disorder: A transcultural study. Compr Psychiatry. 1994;35:191–197.CrossRefGoogle ScholarPubMed
10.Tukel, R, Polat, A, Ozdemir, O, Aksut, D, Turksoy, N. Comorbid conditions in obsessive-compulsive disorder. Compr Psychiatry. 2002;43:204–209.CrossRefGoogle ScholarPubMed
11.Fontenelle, LFMendlowicz, MVMarques, C, Versiani, M. Trans-cultural aspects of obsessive-compulsive disorder; a description of a Brazilian sample and a systematic review of international clinical studies. J Psychiatr Res. 2004;38:403–411.CrossRefGoogle Scholar
12.Hollander, E, Wong, CM. Obsessive-compulsive spectrum disorders. J Clin Psychiatry. 1995;56(suppl 4):3–6.Google ScholarPubMed
13.Weissman, MM, Bland, RC, Canino, GJ, et al.The cross national epidemiology of obsessive-compulsive disorder. The Cross National Collaborative Group. J Clin Psychiatry. 1994;55(suppl):5–10.Google ScholarPubMed
14.Matsunaga, H, Matsui, T, Ohya, K, et al.An examination of homogeneity in patients with contamination obsessions and washing compulsions using a manifest symptom- based typology [Japanese]. Seishin Igaku (Clin Psychiatry). 2002;44:885–892.Google Scholar
15.Pigott, TA, L'Heureux, F, Dubbert, BBernstein, S, Murphy, DL. Obsessive compulsive disorder: comorbid conditions. J Clin Psychiatry. 1994;55(suppl):15–27.Google ScholarPubMed
16.Hollander, E, Wong, CM. Spectrum, boundary, and subtyping issues: implications for treatment refractory obsessive-compulsive disorder. In: Goodman, WK, Rudorfer, MV, Maser, JD, eds. Obsessive-Compulsive Disorder: Contemporary Issues in Treatment. Mahwah, NJ: Lawrence Erlbaum Associates; 2000:3–22.Google Scholar
17.Baer, L, Jenike, MA, Black, DWTreece, C, Rosenfeld, R, Greist, J. Effect of axis II disorders on treatment outcome with clomipramine in 55 patients with obsessive-compulsive disorder. Arch Gen Psychiatry. 1992;49:862–866.CrossRefGoogle ScholarPubMed
18.McDougle, CJGoodman, WK, Leckman, JFBarr, LCHeninger, GR, Price, LH. The efficacy of fluvoxamine in obsessive compulsive disorder; effects of comorbid chronictic disorder. J Clin Psychopharmacol. 1993;13:354–358.CrossRefGoogle Scholar
19.Derkesen, J. Sociocultural and economic backgrounds of personality disorders. In: Derkesen, J, ed. Personality Disorders: Clinical and Social Perspectives. Chichester, UK: John Willy & Sons, 1995:279–305.Google Scholar
20.Stoll, AL, Tohen, M, Baldessarini, RJ. Increasing frequency of the diagnosis of obsessive-compulsive disorder. Am J Psychiatry. 1992;149:638–640.Google ScholarPubMed
21.Fontenelle, LF, Mendlowicz, MV, Versiani, M. The descriptive epidemiology of obsessive-compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2006;30:327–337.CrossRefGoogle ScholarPubMed
22.Robins, LN, Helzer, JE, Orvaschel, Het al.The diagnostic interview schedule. In: Eaton, WW, Kessler, LG, eds. Epidemiologic Field Methods in Psychiatry: The NIMH Epidemiologic Catchment Area Program. Orlando, FL: Academic Press; 1985:143–168.CrossRefGoogle Scholar
23.Myers, JK, Weissman, MM, Tischler, GL, et al.Six-month prevalence of psychiatric disorders in three communities 1980 to 1982. Arch Gen Psychiatry. 1984;41:959–967.CrossRefGoogle ScholarPubMed
24.Robins, LN, Helzer, JE, Weissman, MM, et al.Lifetime prevalence of specific psychiatric disorders in three sites. Arch Gen Psychiatry. 1984;41:949–958.CrossRefGoogle ScholarPubMed
25.Stefansson, JG, Lindal, E, Bjornsson, JK, Guomundsdottir, A. Lifetime prevalence of specific mental disorders among people born in Island in 1931. Acta Psychiatr Scand. 1991;84:142–149.CrossRefGoogle ScholarPubMed
26.Chen, CN, Wong, J, Lee, N, Chan-Ho, MWLau, JT, Fung, M. The Shatin community montal health survey in Hong Kong II major findings. Arch Gen Psychiatry. 1993;50:125–133.CrossRefGoogle Scholar
27.Nemeth, A, Szadoczky, E, Teuer, T, et al.Epidemiology of OCD in Hungary. Eur Neuropsychopharmacol. 1997;7(suppl 2):S234.CrossRefGoogle Scholar
28.Robins, LN, Wing, J, Wittchen, HU, et al.The Composite International Diagnostic Interview. An epidemiologic Instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Arch Gen Psychiatry. 1988;45:1069–1077.CrossRefGoogle ScholarPubMed
29.Stein, MB, Forde, DR, Anderson, G, Walker, JR. Obsessive-compulsive disorder in the community; An epidemiologic survey with clinical reappraisal. Am J Psychiatry. 1997;154:1120–1126.Google ScholarPubMed
30.Bijl, RV, Ravelli, A, van Zessen, G. Prevalence of psychiatric disorder in the general population: results of The Netherlands Mental Health Survey and Incidence Study (NEMESIS). Soc Psychiatry Psychiatr Epidemiol. 1998;33:587–595.CrossRefGoogle ScholarPubMed
31.Grabe, HJ, Meyer, C, Hapke, U, et al.Prevalence, quality of life and psychosocial function in obsessive-compulsive disorder and subclinical obsessive-compulsive disorder in northern Germany. Eur Arch Psychiatry Clin Neurosci. 2000;250:262–268.CrossRefGoogle ScholarPubMed
32.Henderson, S, Andrews, G, Hall, W. Australia's mental health: an overview of the general population survey. Aust N Z J Psychiatry. 2000;34:197–205.CrossRefGoogle ScholarPubMed
33.Andrade, L, Walters, EE, Gentil, V, Laurenti, R. Prevalence of ICD-10 mental disorders in a catchment area in the city of Sao Paulo, Brazil. Soc Psychiatry Psychiatr Epidemiol. 2002;37:316–325.CrossRefGoogle Scholar
34.Cillicilli, AS, Telcioglu, M, Askin, R, Kaya, N, Bodur, S, Kucur, R. Twelve-month prevalence of obsessive-compulsive disorder in Konya, Turkey. Compr Psychiatry. 2004;45:367–374.CrossRefGoogle ScholarPubMed
35.Endicott, J, Spitzer, RL. A diagnostic interview: the schedule for affective disorders and schizophrenia. Arch Gen Psychiatry. 1978;35:837–844.CrossRefGoogle ScholarPubMed
36.Mohammadi, MR, Ghanizadeh, A, Rahgozar, M, et al.Prevalence of obsessive-compulsive disorder in Iran. BMC Psychiatry. 2004;4:2.CrossRefGoogle ScholarPubMed
37.Nestadt, G, Bienvenu, OJ, Cai, G, Samuels, J, Eaton, WW. Incidence of obsessive-compulsive disorder in adults. J Nerv Ment Dis. 1998;186:401–406.CrossRefGoogle ScholarPubMed
38.Matsunaga, H, Kirrike, N, Matsui, T, et al.Gender difference in social and interpersonal features and personality disorders among Japanese patients with obsessive-compulsive disorder. Compr Psychiatry. 2000;41:266–272.CrossRefGoogle Scholar
39.Mataix-Cols, D, Rauch, SL, Manzo, PA, Jenike, MA, Baer, L. Use of factor-analyzed symptom dimensions to predict outcome with serotonin reuptake inhibitors and placebo in the treatment of obsessive-compulsive disorder. Am J Psychiatry. 1999;156:1409–1416.CrossRefGoogle ScholarPubMed
40.Shooka, A, Al-haddad, MK, Raees, A. OCD in Bahrain: a phenomenological profile. Int J Soc Psychiatry. 1998;44:147–154.CrossRefGoogle ScholarPubMed
41.Karadag, F, Oguzhanoglu, NK, Ozdel, O, Atesci, FC, Amuk, T. OCD symptoms in a sample of Turkish patients: a phenomenological picture. Depress Anxiety. 2006;23:145–152.CrossRefGoogle Scholar
42.Juang, YY, Liu, CY. Phenomenology of obsessive-compulsive disorder in Taiwan. Psychiatry Clin Neurosci. 2001;55:623–627.CrossRefGoogle ScholarPubMed
43.Tukel, R, Polat, A, Ozdemir, O, Aksut, D, Turksoy, N. Comorbid conditions in obsessive compulsive disorder. Compr Psychiatry. 2002;43:204–209.CrossRefGoogle ScholarPubMed
44.Horwath, E, Weissman, MM. The epidemiology and cross-national presentation of obsessive-compulsive disorder. Psychiatr Clin North Am. 2000;23:493–507.CrossRefGoogle ScholarPubMed
45.Denys, D, de Geus, F, van Megen, HJ, Westenberg, HG. Use of factor analysis to detect potential phenotypes in obsessive-compulsive disorder. Psychiatry Res. 2004;128:273–280.CrossRefGoogle ScholarPubMed
46.Lochner, C, Kinnear, CJ, Hemmings, SM, et al.Hoarding in obsessive-compulsive disorder: clinical and genetic correlates. J Clin Psychiatry. 2005;66:1155–1160.CrossRefGoogle ScholarPubMed
47.Fiske, AP, Haslam, N. Is obsessive-compulsive disorder a pathology of the human disposition to perform socially meaningful rituals? Evidence of similar content. J Nerv Ment Dis. 1997;185:211–222.CrossRefGoogle ScholarPubMed
48.Ghassemzadeh, H, Mojtabai, R, Khamseh, A, Ebrahimkhani, N, Issazadegan, AA, Saif-Nobakht, Z. Symptoms of obsessive-compulsive disorder in a sample of Iranian patients. Int J Soc Psychiatry. 2002;48:20–28.CrossRefGoogle Scholar
49.Okasha, A, Omar, AM, Lotaief, F, Ghanem, M, Seif el Dawla, A, Okasha, T. Comorbidity of axis I and axis II diagnoses in a sample of Egyptian patients with neurotic disorders. Compr Psychiatry. 1996;37:95–101.CrossRefGoogle Scholar
50.Cansever, A, Uzun, O, Donmez, E, Ozsahin, A. The prevalence and clinical features of body dysmorphic disorder in college students: a study in a Turkish sample. Compr Psychiatry. 2003;44:60–64.CrossRefGoogle Scholar
51.Bohne, A, Keuthen, NJ, Wilhelm, S, Deckersbach, T, Jenike, MA. Prevalence of symptoms of body dysmorphic disorder and its correlates: a cross-cultural comparison. Psychosomatics. 2002;43:486–490.CrossRefGoogle ScholarPubMed
52.Gibbon, M, Spitzer, RL, Williams, J, First, MB, eds. Structured Clinical Interview for DSM-IV Axis I Disorders. clinician version. Washington, DC: American Psychiatric Press; 1996.Google Scholar
53.Brown, TA, Campbell, LA, Lehman, CL, Grisham, JR, Mancill, RB. Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample. J Abnorm Psychol. 2001;110:585–599.CrossRefGoogle Scholar
54.Fireman, B, Koran, LM, Leventhal, JL, Jacobson, A. The prevalence of clinically recognized obsessive-compulsive disorder in a large health maintenance organization. Am J Psychiatry. 2001;158:1904–1910.CrossRefGoogle Scholar
55.Nestadt, G, Samuels, J, Riddle, MA, et al.The relationship between obsessive-compulsive disorder and anxiety and affective disorders; results from the Johns Hopkins OCD family study. Psychol Med. 2001;31:481–487.CrossRefGoogle ScholarPubMed
56.Denys, D, Tenney, N, van Megen, HJ, de Geus, F, Westenberg, HG. Axis I and II comorbidity in a large sample of patients with obsessive-compulsive disorder. J Affect Disord. 2004;80:155–162.CrossRefGoogle Scholar
57.LaSalle, VH, Cromer, KR, Nelson, KN, Kazuba, D, Justement, L, Murphy, DL. Diagnostic interview assessed neuropsychiatric disorder comorbidity in 334 individuals with obsessive-compulsive disorder. Depress Anxiety. 2004;19:163–173.CrossRefGoogle ScholarPubMed
58.du Toit, PL, van Kradenburg, J, Niehaus, D, Stein, DJ. Comparison of obsessive-compulsive disorder patients with and without comorbid putative obsessive-compulsive spectrum disorders using a structured clinical interview. Compr Psychiatry. 2001;42:291–300.CrossRefGoogle ScholarPubMed
59.Eichstedt, JA, Arnold, SL. Childhood-onset obsessive-compulsive disorder: a ticrelated subtype of OCD? Clin Psychol Rev. 2001;21:137–157.CrossRefGoogle ScholarPubMed
60.Grant, JE, Mancebo, MC, Pinto, A, Eisen, JL, Rasmussen, SA. Impulsive control disorders in adult with obsessive-compulsive disorder. J Psychiatr Res. 2006;40:494–501.CrossRefGoogle ScholarPubMed
61.Richter, MA, Summerfeldt, LJ, Antony, MM, Swinson, RP. Obsessive-compulsive spectrum conditions in obsessive-compulsive disorder and other anxiety disorders. Depress Anxiety. 2003;18:118–127.CrossRefGoogle ScholarPubMed
62.Bartz, JA, Hollander, E. Is obsessive-compulsive disorder an anxiety disorder? Prog Neuropsychopharmacol Biol Psychiatry. 2006;30:338–352.CrossRefGoogle ScholarPubMed
63.Nestadt, G, Addington, A, Samuels, J, et al.The identification of OCD-related subgroups based on comorbidity. Biol Psychiatry. 2003;53:914–920.CrossRefGoogle ScholarPubMed
64.Lochner, C, Hemmings, SMJ, Kinnear, CJ, et al.Cluster analysis of obsessive-compulsive spectrum disorders in patients with obsessive-compulsive disorder; clinical and genetic correlates. Compr Psychiatry. 2005;46:14–19.CrossRefGoogle ScholarPubMed
65.Hasler, G, LaSalle-Ricci, VH, Ronquillo, JG, et al.Obsessive-compulsive disorder symptom dimensions show specific relationships to psychiatric comorbidity. Psychiatr Res. 2005;135:121–132.CrossRefGoogle ScholarPubMed
66.Leckman, JF, Walker, DE, Cohen, DJ. Premonitory urges in Tourette's syndrome. Am J Psychiatry. 1993;150:98–102.Google ScholarPubMed
67.Thiel, A, Broocks, A, Ohlmeier, M, Jacoby, GE, Schussler, G. Obsessive-compulsive disorder among patients with anorexia nervosa and bulimia nervosa. Am J Psychiatry. 1995;152:72–75.Google ScholarPubMed
68.Kaye, WH. Neurobiology and genetics-anorexia nervosa, obsessional behavior, and serotonin. Psychopharmacol Bull. 1997;33:335–344.Google Scholar
69.Lilenfeld, LR, Kaye, WH, Greeno, CG, et al.A controlled family study of anorexia nervosa and bulimia anervosa; psychiatric disorders in first-degree relatives and effects of proband comorbidity. Arch Gen Psychiatry. 1998;55:603–610.CrossRefGoogle ScholarPubMed
70.Matsui, T, Matsunaga, H, Iwasaki, Y, et al.Comorbid major Depression in Japanese patients with obsessive-compulsive disorder. Seishin Igaku (Clin Psychiatry). 2001;43:957–962.Google Scholar
71.Jaisoorya, TS, Reddy, YC, Srinath, S. The relationship of obsessive-compulsive disorder to putative spectrum disorders: results from an Indian study. Compr Psychiatry. 2003;44:317–323.CrossRefGoogle ScholarPubMed
72.Matsunaga, H, Kiriike, N, Matsui, T, Oya, K, Okino, K, Stein, DJ. Impulsive-control disorders in japanese adult patients with obsessive-compulsive disorder. Compr Psychiatry. 2005;46:43–49.CrossRefGoogle Scholar
73.Fontenelle, LF, Mendlowicz, MV, Versiani, M. Impulse control disorders in patients with obsessive-compulsive disorder. Psychiatry Clin Neurosci. 2005;59:30–37.CrossRefGoogle ScholarPubMed
74.Lochner, C, Stein, DJ. Does work on obsessive-compulsive spectrum disorders contribute to understanding the heterogeneity of obsessive-compulsive disorder? Prog Neuropsychopharmacol Biol Psychiatry. 2006;30:353–361.CrossRefGoogle ScholarPubMed
75.Matsunaga, H, Kiriike, N, Iwasaki, Y, Miyata, A, Yamagami, S, Kaye, WH. Clinical characteristics in patients with anorexia nervosa and obsessive-compulsive disorder. Psychol Med. 1999;29:407–414.CrossRefGoogle ScholarPubMed
76.Matsunaga, H, Kiriike, N, Miyata, A, et al.Prevalence and symptomatology of comorbid obsessive-compulsive disorder among bulimic patients. Psychiatr Clin Neurosci. 1999;53:661–666.CrossRefGoogle ScholarPubMed
77.Black, DW, Noyes, R. Obsessive-compulsive disorder and axis II. Int Rev Psychiatry. 1997;9:111–118.CrossRefGoogle Scholar
78.Ricciardi, JN, Baer, L, Jenike, MA, Fischer, SC, Sholtz, D, Buttolph, ML. Changes in DSM-III-R axis II diagnoses following treatment of obsessive-compulsive disorder. Am J Psychiatry. 1992;149:829–831.Google ScholarPubMed
79.Matsunaga, H, Kiriike, N, Miyata, A, et al.Personality disorders in patients with obsessive compulsive disorder in Japan. Acta Psychiatr Scand. 1998;98:128–134.CrossRefGoogle ScholarPubMed
80.Matsunaga, H, Kiriike, N, Matsui, T, et al.Obsessive-compulsive disorder patients with poor Insight. Compr Psychiatry. 2002;43:150–157.CrossRefGoogle ScholarPubMed
81.Mataix-Cols, D, van den Heuvel, OA. Common and distinct neural correlates of obsessive-compulsive and related disorders. Psychiatr Clin N Am. 2006;29:391–410.CrossRefGoogle ScholarPubMed
82.Ho Pian, KL, van Megen, HJ, Ramsey, NF, et al.Decreased thalamic blood flow in obsessive-compulsive disorder patients responding to fluvoxamine. Psychiatry Res. 2005;138:89–97.CrossRefGoogle ScholarPubMed
83.Nakao, T, Nakagawa, A, Yoshiura, T, et al.Brain activation of patients with obsessive-compulsive disorder during neuropsychological and symptom provocation tasks before and after symptom improvement: a functional magnetic resonance imaging study. Biol Psychiatry. 2005;57:901–910.CrossRefGoogle ScholarPubMed
84.Cavallini, MC, Di Bella, D, Catalano, M, Bellodi, L. An association between 5-HTTLPR polymorphism, COMT polymorphism, and Tourette's syndrome. Psychiatry Res. 2000;97:93–100.CrossRefGoogle ScholarPubMed
85.Kim, SJ, Lee, HS, Kim, CH. Obsessive-compulsive disorder, factor-analyzed symptom dimensions and serotonin transporter polymorphism. Neuropsychobiology. 2005;52:176–182.CrossRefGoogle ScholarPubMed
86.Hasler, G, Kazuba, D, Murphy, DL. Factor analysis of obsessive-compulsive disorder Y-BOCS-SC symptoms and association with 5-HTTLPR SERT polymorphism. Am J Med Genet B Neuropsychiatr Genet. 2006;141:403–408.CrossRefGoogle Scholar
87.Karayiorgou, M, Sobin, C, Blundell, ML, et al.Family-based association studies support a sexually dimorphic effect of COMT and MAOA on genetic susceptibility to obsessive-compulsive disorder. Biol Psychiatry. 1999;45:1178–1189.CrossRefGoogle ScholarPubMed
88.Kinnear, C, Niehaus, DJ, Seedat, S, et al.Obsessive-compulsive disorder and a novel polymorphism adjacent to the oestrogen responseelement (ERE 6) upstream to the COMT gene. Psychiatr Genet. 2001;11:85–87.CrossRefGoogle Scholar
89.Fisher, PL, Wells, A. How effective are cognitive and behavioral treatments for obsessive-compulsive disorder? A clinical significance analysis. Behav Res Ther. 2005;43:1543–1558.CrossRefGoogle ScholarPubMed
90.Braga, DT, Cordioli, AV, Niederauer, K, Manfro, GG. Cognitive-behavioral group therapy for obsessive-compulsive disorder: a 1-year follow-up. Acta Psychiatr Scand. 2005;112:180–186.CrossRefGoogle ScholarPubMed
91.Huppert, JD, Franklin, ME. Cognitive behavioral therapy for obsessive-compulsive disorder: an update. Curr Psychiatry Rep. 2005;7:268–273.CrossRefGoogle ScholarPubMed
92.van Oppen, P, van Balkom, AJ, de Haan, E, van Dyck, R. Cognitive therapy and exposure in vivo alone and in combination with fluvoxamine in obsessive-compulsive disorder: a 5-year follow-up. J Clin Psychiatry. 2005;66:1415–1422.CrossRefGoogle ScholarPubMed
93.Kampman, M, Keijsers, GP, Hoogduin, CA, Verbraak, MJ. Addition of cognitive-behaviour therapy for obsessive-compulsive disorder patients non-responding to fluoxetine. Acta Psychiatr Scand. 2002;106:314–319.CrossRefGoogle ScholarPubMed
94.Marazziti, D, Pfanner, C, Del'Osso, B, et al.Augmentation strategy with olanzapine in resistant obsessive compulsive disorder: an Italian long-term open-label study. J Psychopharmacol. 2005;19:392–394.CrossRefGoogle ScholarPubMed
95.Fineberg, NA, Sivakumaran, T, Roberts, A, Gale, T. Adding quetiapine to SRI in treatment-resistant obsessive-compulsive disorder: a randomized controlled treatment study. Int Clin Psychopharmacol. 2005;20:223–226.CrossRefGoogle Scholar
96.Schruers, K, Koning, K, Luermans, J, Haack, MJ, Griez, E. Obsessive-compulsive disorder: a critical review of therapeutic perspectives. Acta Psychiatr Scand. 2005;111:261–271.CrossRefGoogle ScholarPubMed
97.Bloch, MH, Landeros-Weisenberger, A, Kelmendi, B, Coric, V, Bracken, MB, Leckman, JF. A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder. Mol Psychiatry. 2006;11:622–632.CrossRefGoogle ScholarPubMed
98.Di Bella, D, Cavallini, MC, Bellodi L., No association between obsessive-compulsive disorder and the 5-HT(1 Dbeta) receptor gene. Am J Psychiatry. 2002;159:1783–1785.CrossRefGoogle Scholar
99.Billett, EA, Richter, MA, King, N, Heils, A, Lesch, KP, Kennedy, JL. Obsessive compulsive disorder, response to serotonin reuptake inhibitors and the serotonin transporter gene. Mol Psychiatry. 1997;2:403–406.CrossRefGoogle ScholarPubMed