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Real E.,Hospital Universitari Of Bellvitge | Real E.,Idibell Institute Dinvestigacio Biomedica Of Bellvitge | Labad J.,Hospital Universitari Of Bellvitge | Labad J.,Rovira i Virgili University | And 17 more authors.
Depression and Anxiety | Year: 2011

Background: Environmental stressors are considered to play an important role in the triggering of mental disorders such as obsessive-compulsive disorder (OCD). Although there is extensive literature on traumatic life events, little is known about the role of nontraumatic but nonetheless stressful life events (SLEs) in OCD. The aim of this study was to establish whether OCD preceded by an SLE presents a different clinical pattern compared to non-SLE-preceded OCD. Methods: We interviewed 412 OCD patients to assess both SLEs at onset of OCD and other clinical variables, including OCD symptom dimensions. Logistic regression was then applied to explore the relationship between clinical variables and OCD preceded by an SLE. Results: The SLE-preceded OCD group showed a later onset of the disorder (OR = 1.04, P =.015), a history of complicated birth (OR = 5.54, P<.001), less family history of OCD (OR = 0.42, P =.014), and the presence of contamination/cleaning symptoms (OR = 1.99, P =.01). Conclusions: Patients with OCD onset close to an SLE and those without an SLE close to OCD onset show a distinct clinical pattern. Depression and Anxiety, 2011. © 2011 Wiley-Liss, Inc. © 2011 Wiley-Liss, Inc.


Real E.,Neuroscience Group Idibell Institute Dinvestigacio Biomedica Of Bellvitge | Real E.,OCD Clinical and Research Unit | Real E.,Obsessive Compulsive Disorder Clinical and Research Unit | Gratacos M.,CIBER ISCIII | And 14 more authors.
Pharmacogenomics Journal | Year: 2013

Genetic and environmental factors seem to interact and influence both the onset and the course of obsessive-compulsive disorder (OCD), but the role of glutamate transporter variants (SLC1A1) in pharmacological resistance is not known. We aimed to assess whether genetic variants in SLC1A1 and life stress at onset of the disorder interact and modulate pharmacological resistance in OCD. A single-marker association study of several single-nucleotide polymorphisms in the SLC1A1 genomic region was performed in a sample of 238 OCD patients. For the most strongly associated SNP (rs3087879), one copy of the risk allele increased the probability of higher treatment resistance (odds ratio=2.42; 95% confidence interval=1.39-4.21; P=0.0018), but only in OCD patients without life stress at onset of the disorder. These results suggest a gene-by-environment interaction effect on treatment resistance in OCD and strengthen the existing evidence of the role of the glutamatergic system in the phenomenology of OCD. © 2013 Macmillan Publishers Limited All rights reserved.


Pertusa A.,Kings College London | Pertusa A.,Obsessive Compulsive Disorder Clinical and Research Unit | Fernandez de la Cruz L.,Kings College London | Alonso P.,Obsessive Compulsive Disorder Clinical and Research Unit | And 6 more authors.
European Psychiatry | Year: 2012

Introduction: Obsessive-compulsive disorder (OCD) is a clinically heterogeneous condition characterized by a few consistent, temporally stable symptom dimensions. The Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS) is a recently developed instrument that allows patient and clinician ratings of dimension-specific symptom severity, as well as estimates of global symptom severity in patients with OCD. Methods: We examined the psychometric properties of the DY-BOCS in a sample of 128 European adult patients with OCD. Results: The results of the psychometric analyses were overall excellent. The internal consistency across the domains of time, distress and interference for each dimension was high. The subscales of the DY-BOCS were largely independent from one another. The convergent and discriminant validity of the DY-BOCS subscales were adequate. The Global Severity and Interference scales were largely intercorrelated, suggesting that they may be redundant. The level of agreement between self-report and expert ratings was adequate although somewhat lower than in the original validation study. Conclusion: The results of the present study confirm the excellent psychometric properties of the DY-BOCS reported in the original validation study. © 2011 Elsevier Masson SAS.


Pertusa A.,Obsessive Compulsive Disorder Clinical and Research Unit | Pertusa A.,Kings College London | Jaurrieta N.,Obsessive Compulsive Disorder Clinical and Research Unit | Real E.,Obsessive Compulsive Disorder Clinical and Research Unit | And 10 more authors.
Comprehensive Psychiatry | Year: 2010

Background: The Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS) is a promising new instrument that allows patient and clinician ratings of dimension-specific symptom severity, as well as estimates of global symptom severity in patients with obsessive-compulsive disorder (OCD). The goal of this study was to further explore the psychometric properties of the DY-BOCS in a Spanish sample. Methods: The internal consistency, reliability, and convergent and divergent validity of the Spanish adaptation of the DY-BOCS were assessed in a sample of 51 Spanish adult patients with OCD. Results: All the subscales of the Spanish DY-BOCS showed high internal consistency. The interrater reliability was excellent for all component scores, and the level of agreement between self-report and expert ratings was high for most symptom dimensions. The subscales of the DY-BOCS were largely independent from one another and from global OCD severity. The convergent and divergent validities of the DY-BOCS subscales were adequate. Conclusions: The Spanish version of the DY-BOCS is a reliable and valid clinical tool for the assessment of obsessive-compulsive symptom dimensions. © 2010 Elsevier Inc. All rights reserved.


Labad J.,Obsessive Compulsive Disorder Clinical and Research Unit | Alonso P.,Obsessive Compulsive Disorder Clinical and Research Unit | Segalas C.,Obsessive Compulsive Disorder Clinical and Research Unit | Real E.,Obsessive Compulsive Disorder Clinical and Research Unit | And 4 more authors.
Archives of Women's Mental Health | Year: 2010

Ninety female outpatients with obsessive-compulsive disorder (OCD) completed a semistructured interview to assess the relationship between different OCD symptom dimensions and the onset of OCD at menarche or during the perinatal period. Patients with hoarding symptoms had an earlier age at menarche than non-hoarders (12.1 ± 1.3 vs 13.0 ± 1.5 years, p = 0.019) and were more likely to report OCD onset at menarche (OR = 4.1, p = 0.034). Patients with symptoms of the contamination/cleaning dimension were more likely to report the onset of their disorder during pregnancy or postpartum (OR = 9.3, p = 0.048). © 2009 Springer-Verlag.

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