Week 2: Exploring Current OCD Research
Hello, everyone!
Welcome back to my second blog post! I spent the majority of the past week conducting independent research, thoroughly reading several scientific papers published within the last five years discussing the current understanding of OCD and its treatment options. The papers I read comprehensively review many aspects of OCD and the available treatments; however, they can be condensed down into three major topics: comprehensive assessment and diagnosis of OCD, improving CBT and SSRI treatments, and changing understanding of OCD mechanisms. As the information is very dense in these papers, I will summarize them as best as I can.
Currently, studies have found that OCD is commonly under-diagnosed, comorbid with other mental health disorders, and unnoticed in patients for several years (Pampaloni et al., 2022). These aspects of the disorder make it difficult to diagnose OCD in patients, and due to it being a fairly complex disorder, a general guideline was proposed to include any and all possible factors that may influence OCD and aid in providing treatment. Pampaloni et al. (2022) recommended that these factors should include the patient’s OCD subtype, the level of insight into symptoms, the age of onset, and potential comorbidities. Other interesting aspects the authors recommended for complete assessment were neurocognitive and immunological factors as well as family history for OCD and other mental health disorders.
The last few factors stood out to me as I did not expect that OCD may be hereditary and influenced significantly by the immune system. However, a newer view in OCD neurobiology began to emerge that reveals that there are even more factors at play than previously speculated. Goodman et al. (2021) detail that many genes, molecular compounds, and brain region networks are likely involved in OCD. The authors proposed that specifically glutamate and serotonin transporters may have a role in OCD as indicated in initial studies. The review also emphasized that OCD may be the result of dysfunction in large brain networks, mentioning the cortico-striato-thalamo-cortical loop (CSTC) to be the most influential. Due to these findings, treatments such as TMS and DBS could be more precise and target regions involved in the CSTC loop.
CBT and SSRIs still remain as the main first-line treatments for OCD, but these treatments face many issues when utilized. Multiple studies have reported that CBT and SSRIs are only semi-effective for patients and that many would experience a relapse in symptoms after treatment ended. According to Nezgovorova et al. (2022), despite these treatments being considered first-line, many errors and gaps were noted in studies researching CBT, SSRIs, and combination treatments. The authors highlighted that many CBT trials were improperly conducted where participants had been undergoing SSRI treatment before taking part in the research studies and that the trials were completed over only a short-term period. Van Roessel et al. (2022) explored alternative medications and molecular compounds which could augment current SSRI treatment to increase its effectiveness. Many of the medications described affected serotonin, dopamine, and glutamate release in the brain, with various research trials providing supporting evidence.
These papers delved into the intricacies of OCD, its influences, and its treatments. There is an additional article I unfortunately did not have a chance to discuss here, but it will be included in my next blog post.
See you all then!
Pampaloni, I., Marriott, S., Pessina, E., Fisher, C., Govender, A., Mohamed, H., Chandler, A., Tyagi, H., Morris, L., & Pallanti, S. (2022). The global assessment of OCD. Comprehensive Psychiatry, 118, 152342. https://doi.org/10.1016/j.comppsych.2022.152342
Goodman, W. K., Storch, E. A., & Sheth, S. A. (2021). Harmonizing the neurobiology and treatment of Obsessive-Compulsive Disorder. The American Journal of Psychiatry, 178(1), 17–29. https://doi.org/10.1176/appi.ajp.2020.20111601
Nezgovorova, V., Reid, J., Fineberg, N. A., & Hollander, E. (2022). Optimizing first line treatments for adults with OCD. Comprehensive Psychiatry, 115, 152305. https://doi.org/10.1016/j.comppsych.2022.152305
Van Roessel, P. J., Grassi, G., Aboujaoude, E. N., Menchón, J. M., Ameringen, M. V., & Rodríguez, C. I. (2022). Treatment-resistant OCD: Pharmacotherapies in adults. Comprehensive Psychiatry, 120, 152352. https://doi.org/10.1016/j.comppsych.2022.152352
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