Efficacy of pharmacological treatment in OCD comorbid with tic disorder: Systematic review and meta-analysis

IF 3.7 2区 医学 Q1 PSYCHIATRY Journal of psychiatric research Pub Date : 2024-09-30 DOI:10.1016/j.jpsychires.2024.09.048
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Abstract

Up to 30% of subjects with obsessive compulsive disorder (OCD) also have a lifetime tic disorder. Several meta-analyses of pharmaceutical or psychotherapeutic interventions for the management of OCD have been published, but none specifically on patients with OCD comorbid with tics. The literature regarding pharmacological treatments of patients with this condition is mainly focused on studies of OCD. After a search of the Cochrane, EMBASE, PubMed, PsychINFO and Science Direct databases, we performed a proportion meta-analysis of the percentage of patients whose condition improved and a paired meta-analysis of the change in the OCD score (Y-BOCS). Twelve case reports were retained for qualitative analysis and 14 articles for meta-analysis. Case reports showed better efficacy of combined antidepressant-antipsychotic treatment for OCD comorbid with tic disorder. The meta-analysis showed an improvement in 29% [18–42] of patients with antidepressants. Although there was no significant difference with placebo add-on, in antidepressant-resistant OCD patients, adding an antipsychotic to the antidepressant regimen led to an increase in the number of patients who improved (67% [45–86] vs 7% [0–35]) and seemed to show a decrease in the Y-BOCS score (−10.06 [-20.38; 0.26] vs (−3.61 [-9.08; 13.85]). Our study provides new evidence on the pharmacological treatment of OCD comorbid with tics. In some patients, the condition is improved by a first-line antidepressant. In case of non-response or insufficient efficacy of antidepressants, add-on treatment with certain antipsychotics can be implemented.
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药物治疗对强迫症合并抽搐症的疗效:系统回顾与荟萃分析。
多达 30% 的强迫症(OCD)患者在其一生中都患有抽搐症。关于治疗强迫症的药物或心理治疗干预措施的荟萃分析已发表过几篇,但没有一篇是专门针对合并抽搐的强迫症患者的。有关对此类患者进行药物治疗的文献主要集中在对强迫症的研究中。在对 Cochrane、EMBASE、PubMed、PsychINFO 和 Science Direct 数据库进行检索后,我们对病情得到改善的患者比例进行了荟萃分析,并对强迫症评分(Y-BOCS)的变化进行了配对荟萃分析。定性分析保留了 12 篇病例报告,荟萃分析保留了 14 篇文章。病例报告显示,对合并抽搐症的强迫症患者进行抗抑郁-抗精神病联合治疗有更好的疗效。荟萃分析显示,29%[18-42]的患者在使用抗抑郁药物后病情有所改善。虽然与添加安慰剂相比没有明显差异,但在抗抑郁药耐药的强迫症患者中,在抗抑郁药治疗方案中添加抗精神病药物可使病情改善的患者人数增加(67% [45-86] vs 7% [0-35]),Y-BOCS评分似乎也有所下降(-10.06 [-20.38; 0.26] vs (-3.61 [-9.08; 13.85])。我们的研究为强迫症合并抽搐的药物治疗提供了新的证据。在一些患者中,一线抗抑郁药物可改善病情。如果对抗抑郁药无反应或疗效不佳,可加用某些抗精神病药进行治疗。
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来源期刊
Journal of psychiatric research
Journal of psychiatric research 医学-精神病学
CiteScore
7.30
自引率
2.10%
发文量
622
审稿时长
130 days
期刊介绍: Founded in 1961 to report on the latest work in psychiatry and cognate disciplines, the Journal of Psychiatric Research is dedicated to innovative and timely studies of four important areas of research: (1) clinical studies of all disciplines relating to psychiatric illness, as well as normal human behaviour, including biochemical, physiological, genetic, environmental, social, psychological and epidemiological factors; (2) basic studies pertaining to psychiatry in such fields as neuropsychopharmacology, neuroendocrinology, electrophysiology, genetics, experimental psychology and epidemiology; (3) the growing application of clinical laboratory techniques in psychiatry, including imagery and spectroscopy of the brain, molecular biology and computer sciences;
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