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2002 Fiscal Year Final Research Report Summary

AN INVESTIGATION ON HETEROGENEITY IN PATIENTS WITH OBSESSIVE-COMPULSIVE DISORDER

Research Project

Project/Area Number 13671025
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field Psychiatric science
Research InstitutionOsaka City Univ.

Principal Investigator

MATSUNAGA Hisato  Dept' of Neuropsychiatry, Osaka City University Med. School, Lecturer, 大学院・医学研究科, 講師 (20254394)

Co-Investigator(Kenkyū-buntansha) MATSUI Tokuzo  Dept' of Neuropsychiatry, Osaka City University Med. School, Research Associate, 大学院・医学研究科, 助手 (90305623)
Project Period (FY) 2001 – 2002
KeywordsObsessive-Compulsive Disorder / Heterogeneity / Combined treatment / Selective Serotonin Reuptake Inhibitors / Poor insight / Symptomatology
Research Abstract

To investigate the heterogeneity of Obsessive-Compulsive Disorder (OCD), some possible indicators were examined from phenomenological, psychopathological or biological point of view. For instance, OCD subjects with poorer level of insight exhibit more severe psychopathological features such as personality pathology and poorer treatment response compared to those with good or fair insight. In addition, OCD subjects with both washing and checking compulsions were significantly more likely than pure washers or checkers to have poor insight, severe psychopathological features such as perfectionism, and poor responses to both pharmacological and behavioral treatments. These findings support the possibility of that OCD may be heterogeneous, and some distinct subtypes may exist. In addition, the typical treatment strategy for OCD should be modified for each subtype. Indeed, our prospective study revealed that poor level of insight especially that with comorbid cluster A personality disorders … More may be an important indicator of poor treatment outcome.
Taken together, we proposed additional treatment strategies for OCD patients who exhibit poorer responses to the standardized combination treatment of pharmacotherapy such as SSRIs and cognitive behavioral treatment (CBT). As for pharmacotherapy, augmentation of antidepressants especially inhibitors of norepinephrine reuptake appear to be effective for patients with severe depressive status equivalent to a diagnosis of major depression. In addition, augmentation of antipsychotic drugs may also be useful especially for patients with poor insight into their OCD symptoms. As for CBT, the significance of cognitive restructuring should be emphasized especially in patients with persistent belief about the rationality of their OCD symptoms.
Thus there may be subtypes of OCD and the treatment strategies for typical OCD patients should be modified for patients with clinical or psychopathological features indicative of treatment-resistant OCD. Further studies focusing on biological abnormalities such as neuroimaging should be needed to verify the possible subtypes of OCD. Less

  • Research Products

    (20 results)

All Other

All Publications (20 results)

  • [Publications] Hisato Matsunaga et al.: "A form of social anxiety disorder that responds to serotonin reuptake inhibitors?"Int. J. Neuropsychopharmacol. 4. 231-237 (2001)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] Hisato Matsunaga et al.: "A compulsive study of clinical and psychopathological characters between pure checkers and pure washers"Phychiatr. Res.. 105. 221-229 (2001)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] Hisato Matsunaga et al.: "Obsessive-Compulsive Disorder Patients with Poor Insight"Compr. Psychiatry. 43. 150-157 (2002)

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      「研究成果報告書概要(和文)」より
  • [Publications] 松永寿人など: "選択的セロトニン再取り込み阻害薬と抗精神病薬の併用が奏功した強迫性障害の一症例"臨床精神医学. 16. 913-919 (2001)

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      「研究成果報告書概要(和文)」より
  • [Publications] 松永寿人など: "汚染に関する強迫観念の内容を分類基準とした汚染/洗浄強迫の均質性に関する検討"精神医学. 44. 885-892 (2002)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] 松永寿人: "強迫性障害とうつ病"日本臨床別冊精神医学症候群(1). (印刷中).

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      「研究成果報告書概要(和文)」より
  • [Publications] 松永寿人: "キーワード精神第3版(共著)"先端医学社. 251 (2003)

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      「研究成果報告書概要(和文)」より
  • [Publications] H. Matsunaga, N. Kiriike, T. Matsui, Y. Iwasaki, T. Nagata, DJ. Stein.: "Taijin kyohusho: A form of social anxiety disorder that responds to serotonin reuptake inhibitors"International Journal of Neuropsychopharmacology. 4(3). 231-237 (2001)

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      「研究成果報告書概要(欧文)」より
  • [Publications] H. Matsunaga, Nobuo Kiriike, Tokuzo Matsui, Yoko Iwasaki, Kayo Koshimune, Kenzo Ohya, Dan J. Stein: "A Comparative Study of Clinical and Psychopathological Characteristics between Pure Checkers and Pure Washers Categorized Using A Lifetime Symptom Rating Method."Psychiatric Research. 105. 221-229 (2001)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] D.J. Stein & H. Matsunaga: "Cross-cultural aspects of social anxiety disorder"Psychiatric Clinics of North America. 24(4). 773-782 (2001)

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      「研究成果報告書概要(欧文)」より
  • [Publications] H. Matsunaga, N. Kiriike, Y. Iwasaki, K. Koshimune, A. Miyata, S. Kasai, Oya & A. Shidao: "Obsessive-compulsive disorder patients"Comprehensive Psychiatry. 43(2). 150-157 (2002)

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      「研究成果報告書概要(欧文)」より
  • [Publications] H. Matsunaga, T. Matsui, K. Ohya, K. Koshimune, N. Kiriike: "An examination of homogeneity in patients with contamination obsessions and washing compulsions using a manifest symptom-based typology"SeishinIgaku (Clin Psychiatry). 44(8). 885-892 (2002)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] H. Matsunaga, M. Tani, T. Matsui, K. Ohya, N. Kiriike: "A case of OCD patients who reponds to an augmentation of antipsychotic drugs to SSRIs"Japanese Journal of Clinical Psychiatry. 16(9). 913-919 (2001)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] T. Matsui, H. Matsunaga, K. Koshimune, H. Kanda, N. Kiriie: "A case of body dysmorphic disorder improved by the administration of paroxetine"Japanese Journal of Clinical Psychiatry. 31(2). 199-204 (2002)

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      「研究成果報告書概要(欧文)」より
  • [Publications] H. Matsunaga, N. Kiriike, T. Matsui, Y. Iwasaki, A. Miyata & K. Fujimoto: "Gender differences of social and interpersonal features and personality disorders among Japanese patients with obsessive-compulsive disorder."Comprehensive Psychiatry. 41. 266-272 (2000)

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      「研究成果報告書概要(欧文)」より
  • [Publications] Y. Iwasaki, H. Matsunaga, N. Kiriike, H. Tanaka, T. Matsui: "Comorbidity of Axis I disorders among Eating Disordered Subjects in Japan"Comprehensive Psychiatry. 41(6). 454-460 (2000)

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  • [Publications] H. Matsunaga: "Pharmacotherapy of social phobia"Japanese Journal of Psychiatric Treatment. 18(3). 305-310 (2003)

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      「研究成果報告書概要(欧文)」より
  • [Publications] H. Matsunaga, N. Kiriike: "A combined treatment of behavioral therapy and medication with TKS ; A perspective of social phobia."Japanese Journal of Psychiatric Treatment. 17(6). 777-782 (2002)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] H. Matsunaga, N. Kiriike: "An inpatient treatment program for patients with severe obsessive-compulsive disorder"Japanese Journal of Psychiatric Treatment. 15(7). 779-782 (2000)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] H. Matsunaga, N. Kiriike: "Do sociocultural factors influence the comorbidrty of eating disorders?, (Maj M, Halmi K, Lopez-Ibor JJ & Sartorius N eds.) WPA series; Evidence and Experience in vol. 6; Eating Disorders."70-72 (2003)

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      「研究成果報告書概要(欧文)」より

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Published: 2004-04-14  

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