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Application of a staging model in patients with obsessive–compulsive disorder: cross-sectional and follow-up results

Published online by Cambridge University Press:  30 October 2020

Beatrice Benatti Open the ORCID record for Beatrice Benatti [Opens in a new window] ,
Giulia Lucca ,
Riccardo Zanello ,
Fabio Fesce ,
Alberto Priori ,
Nicola Poloni ,
Camilla Callegari ,
Leonardo F. Fontenelle  and
Bernardo Dell’Osso Open the ORCID record for Bernardo Dell’Osso [Opens in a new window]
Beatrice Benatti*
Affiliation:
Luigi Sacco University Hospital, Department of Neuroscience, Psychiatry 2 Unit, University of Milan, Milan, Italy “Aldo Ravelli” Center for Nanotechnology and Neurostimulation, University of Milan, Milan, Italy
Giulia Lucca
Affiliation:
Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Varese, Italy
Riccardo Zanello
Affiliation:
Luigi Sacco University Hospital, Department of Neuroscience, Psychiatry 2 Unit, University of Milan, Milan, Italy
Fabio Fesce
Affiliation:
Luigi Sacco University Hospital, Department of Neuroscience, Psychiatry 2 Unit, University of Milan, Milan, Italy
Alberto Priori
Affiliation:
“Aldo Ravelli” Center for Nanotechnology and Neurostimulation, University of Milan, Milan, Italy
Nicola Poloni
Affiliation:
Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Varese, Italy
Camilla Callegari
Affiliation:
Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Varese, Italy
Leonardo F. Fontenelle
Affiliation:
Turner Institute for Brain and Mental Health, Monash University, VIC, Australia; Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (UFRJ) and D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
Bernardo Dell’Osso
Affiliation:
Luigi Sacco University Hospital, Department of Neuroscience, Psychiatry 2 Unit, University of Milan, Milan, Italy “Aldo Ravelli” Center for Nanotechnology and Neurostimulation, University of Milan, Milan, Italy Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA Centro per lo studio dei meccanismi molecolari alla base delle patologie neuro-psico-geriatriche”, University of Milan, Milan, Italy
*
*Author for correspondence: Beatrice Benatti, MD, Email: beatricebenatti@gmail.com
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Abstract

Introduction

Obsessive-compulsive disorder (OCD) is a prevalent and disabling condition with frequent chronic course. Staging models applied to psychiatric disorders seek to define their extent of progression at a particular time-point and differentiate early, milder clinical phenomena from those characterizing illness progression and chronicity. In OCD patients, a staging model has been recently proposed but not tested yet. This was the aim of the present study.

Methods

From an overall sample of 198 OCD patients, recruited across two psychiatric clinics in Northern Italy, 70 patients on stable treatment completed a follow-up assessment ranging from 12 to 24 months. At follow-up initiation, patients had been divided into four staging groups, according to the model proposed by Fontenelle and Yucel. At the end of the follow-up, patients were subdivided into three groups (no stage change, improved stage, or worsened stage) compared with statistical analyses.

Results

At the end of the follow-up, 67.1% patients showed no stage changes, 24.3% a stage improvement, and 8.6% a stage progression. Worsened patients showed higher rates of comorbid disorders and higher rates of unfavorable employment characteristics compared to the other subgroups (P < .05). Patients with worsened stage showed higher prevalence of somatic obsessions (P < .05), while patients with improved stage showed higher rates of magical thinking and violence/harm obsessions compared to other groups (P < .05).

Discussion

The present results provide epidemiologic and clinical correlates of the first application of a staging model in a sample of OCD patients, encouraging further studies to assess the utility of this approach in the field.

Keywords

Follow-upobsessive–compulsive disorderstaging
Type
Original Research
Information
CNS Spectrums , Volume 27 , Issue 2 , April 2022 , pp. 218 - 224
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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