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        Early intervention for obsessive compulsive disorder : An expert consensus statement

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        NF_AAM_1.pdf (PDF, 552Kb)(embargoed until 14/02/2020)
        Author
        Fineberg, Naomi
        Dell'Osso, Bernardo
        Albert, Umberto
        Maina, Giuseppe
        Geller, Daniel
        Carmi, Lior
        Sireau, Nick
        Walitza, Susanne
        Grassi, Giacomo
        Pallanti, Stefano
        Hollander, Eric
        Brakoulias, Vlasios
        Menchon, Jose M.
        Marazziti, Donatella
        Ioannidis, Konstantinos
        Apergis-Schoute, Annemieke
        Stein, Dan J.
        Cath, Danielle C.
        Veltman, Dick J.
        Van Ameringen, Michael
        Fontenelle, Leonardo F.
        Shavitt, Roseli G.
        Costa, Daniel
        Diniz, Juliana B.
        Zohar, Joseph
        Attention
        2299/21315
        Abstract
        Obsessive-compulsive disorder (OCD) is common, emerges early in life and tends to run a chronic, impairing course. Despite the availability of effective treatments, the duration of untreated illness (DUI) is high (up to around 10 years in adults) and is associated with considerable suffering for the individual and their families. This consensus statement represents the views of an international group of expert clinicians, including child and adult psychiatrists, psychologists and neuroscientists, working both in high and low and middle income countries, as well as those with the experience of living with OCD. The statement draws together evidence from epidemiological, clinical, health economic and brain imaging studies documenting the negative impact associated with treatment delay on clinical outcomes, and supporting the importance of early clinical intervention. It draws parallels between OCD and other disorders for which early intervention is recognized as beneficial, such as psychotic disorders and impulsive-compulsive disorders associated with problematic usage of the Internet, for which early intervention may prevent the development of later addictive disorders. It also generates new heuristics for exploring the brain-based mechanisms moderating the ‘toxic’ effect of an extended DUI in OCD. The statement concludes that there is a global unmet need for early intervention services for OC related disorders to reduce the unnecessary suffering and costly disability associated with under-treatment. New clinical staging models for OCD that may be used to facilitate primary, secondary and tertiary prevention within this context are proposed.
        Publication date
        2019-04-01
        Published in
        European Neuropsychopharmacology
        Published version
        https://doi.org/10.1016/j.euroneuro.2019.02.002
        Other links
        http://hdl.handle.net/2299/21315
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