A Clinical Staging Model for Obsessive–Compulsive Disorder: Is It Ready for Prime Time?
Recent changes to the diagnostic classification of obsessive–compulsive disorder (OCD), including its removal from the anxiety/neurotic, stress-related and somatoform disorders chapters of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and International Classificati...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Elsevier
2019-01-01
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| Series: | EClinicalMedicine |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589537019300203 |
| _version_ | 1811336835877568512 |
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| author | Leonardo F. Fontenelle Murat Yücel |
| author_facet | Leonardo F. Fontenelle Murat Yücel |
| author_sort | Leonardo F. Fontenelle |
| collection | DOAJ |
| description | Recent changes to the diagnostic classification of obsessive–compulsive disorder (OCD), including its removal from the anxiety/neurotic, stress-related and somatoform disorders chapters of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and International Classification of Diseases 11th Revision (ICD-11), are based on growing evidence of unique pathogenic signatures and linked diagnostic and treatment approaches. In this review, we build on these recent developments and propose a ‘clinical staging model’ of OCD that integrates the severity of symptoms and phase of illness for personalised case management. A clinical staging model is especially relevant for the early identification and management of subthreshold OCD - a substantial and largely neglected portion of the population who, despite having milder symptoms, experience harms that may impact personal relationships, work-related functioning and productivity. Research on the pathogenesis, classification and management of such cases is needed, including the development of new outcomes measures that prove sensitive to changes in future clinical trials. Early intervention strategies in OCD are likely to yield better long-term outcomes. Keywords: Obsessive–compulsive disorder, Clinical staging, Early intervention, Neuroprogression, Cognitive functioning, Biological markers, Treatment outcome, Transdiagnostic framework |
| first_indexed | 2024-04-13T17:46:22Z |
| format | Article |
| id | doaj.art-aa3f0a5fa540495c9128f9c88dff38fc |
| institution | Directory Open Access Journal |
| issn | 2589-5370 |
| language | English |
| last_indexed | 2024-04-13T17:46:22Z |
| publishDate | 2019-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | EClinicalMedicine |
| spelling | doaj.art-aa3f0a5fa540495c9128f9c88dff38fc2022-12-22T02:36:59ZengElsevierEClinicalMedicine2589-53702019-01-0176572A Clinical Staging Model for Obsessive–Compulsive Disorder: Is It Ready for Prime Time?Leonardo F. Fontenelle0Murat Yücel1Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil; D'Or Institute for Research and Education, Rio de Janeiro, Brazil; Brain & Mental Health Research Hub, Turner Institute for Brain and Mental Health, Monash University, Victoria, Australia; Corresponding author at: Rua Visconde de Pirajá, 547, 617, Ipanema, Rio de Janeiro-RJ, CEP: 22410-003, Brazil.Brain & Mental Health Research Hub, Turner Institute for Brain and Mental Health, Monash University, Victoria, AustraliaRecent changes to the diagnostic classification of obsessive–compulsive disorder (OCD), including its removal from the anxiety/neurotic, stress-related and somatoform disorders chapters of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and International Classification of Diseases 11th Revision (ICD-11), are based on growing evidence of unique pathogenic signatures and linked diagnostic and treatment approaches. In this review, we build on these recent developments and propose a ‘clinical staging model’ of OCD that integrates the severity of symptoms and phase of illness for personalised case management. A clinical staging model is especially relevant for the early identification and management of subthreshold OCD - a substantial and largely neglected portion of the population who, despite having milder symptoms, experience harms that may impact personal relationships, work-related functioning and productivity. Research on the pathogenesis, classification and management of such cases is needed, including the development of new outcomes measures that prove sensitive to changes in future clinical trials. Early intervention strategies in OCD are likely to yield better long-term outcomes. Keywords: Obsessive–compulsive disorder, Clinical staging, Early intervention, Neuroprogression, Cognitive functioning, Biological markers, Treatment outcome, Transdiagnostic frameworkhttp://www.sciencedirect.com/science/article/pii/S2589537019300203 |
| spellingShingle | Leonardo F. Fontenelle Murat Yücel A Clinical Staging Model for Obsessive–Compulsive Disorder: Is It Ready for Prime Time? EClinicalMedicine |
| title | A Clinical Staging Model for Obsessive–Compulsive Disorder: Is It Ready for Prime Time? |
| title_full | A Clinical Staging Model for Obsessive–Compulsive Disorder: Is It Ready for Prime Time? |
| title_fullStr | A Clinical Staging Model for Obsessive–Compulsive Disorder: Is It Ready for Prime Time? |
| title_full_unstemmed | A Clinical Staging Model for Obsessive–Compulsive Disorder: Is It Ready for Prime Time? |
| title_short | A Clinical Staging Model for Obsessive–Compulsive Disorder: Is It Ready for Prime Time? |
| title_sort | clinical staging model for obsessive compulsive disorder is it ready for prime time |
| url | http://www.sciencedirect.com/science/article/pii/S2589537019300203 |
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