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research
Early intervention for obsessive compulsive disorder : An expert consensus statement
Authors
Umberto Albert
Annemieke Apergis-Schoute
+23 more
Vlasios Brakoulias
Lior Carmi
Danielle C. Cath
Daniel Costa
Bernardo Dell'Osso
Juliana B. Diniz
Naomi Fineberg
Leonardo F. Fontenelle
Daniel Geller
Giacomo Grassi
Eric Hollander
Konstantinos Ioannidis
Giuseppe Maina
Donatella Marazziti
Jose M. Menchon
Stefano Pallanti
Roseli G. Shavitt
Nick Sireau
Dan J. Stein
Michael Van Ameringen
Dick J. Veltman
Susanne Walitza
Joseph Zohar
Publication date
1 January 2019
Publisher
'Elsevier BV'
Doi
Cite
Abstract
© 2019 Elsevier B.V.and ECNP. All rights reserved.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.Peer reviewe
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