Brakoulias Vlasios, Starcevic Vladan, Albert Umberto, Arumugham Shyam Sundar, Bailey Brenda E, Belloch Amparo, Borda Tania, Dell'Osso Liliana, Elias Jason A, Falkenstein Martha J, Ferrao Ygor A, Fontenelle Leonardo F, Jelinek Lena, Kalogeraki Leto, Kay Brian, Laurito Luana D, Lochner Christine, Maina Giuseppe, Marazziti Donatella, Martin Andrew, Matsunaga Hisato, Miguel Euripedes C, Morgado Pedro, Mourikis Irakis, Pasquini Massimo, Perez Rivera Rodrigo, Potluri Sriramya, Reddy Janardhan Y C, Riemann Brian C, do Rosario Maria Conceição, Shavitt Roseli G, Stein Dan J, Viswasam Kirupumani, Wang Zhen, Fineberg Naomi A
Department of Psychiatry, Nepean Hospital, Sydney Medical School, The University of Sydney, Penrith, NSW, Australia.
Rita Levi Montalcini Department of Neuroscience, University of Turin, Turin, Italy.
Hum Psychopharmacol. 2019 Jan;34(1):e2686. doi: 10.1002/hup.2686. Epub 2019 Jan 10.
The objective of this study was to characterise international trends in the use of psychotropic medication, psychological therapies, and novel therapies used to treat obsessive-compulsive disorder (OCD).
Researchers in the field of OCD were invited to contribute summary statistics on the characteristics of their samples. Consistency of summary statistics across countries was evaluated.
The study surveyed 19 expert centres from 15 countries (Argentina, Australia, Brazil, China, Germany, Greece, India, Italy, Japan, Mexico, Portugal, South Africa, Spain, the United Kingdom, and the United States) providing a total sample of 7,340 participants. Fluoxetine (n = 972; 13.2%) and fluvoxamine (n = 913; 12.4%) were the most commonly used selective serotonin reuptake inhibitor medications. Risperidone (n = 428; 7.3%) and aripiprazole (n = 415; 7.1%) were the most commonly used antipsychotic agents. Neurostimulation techniques such as transcranial magnetic stimulation, deep brain stimulation, gamma knife surgery, and psychosurgery were used in less than 1% of the sample. There was significant variation in the use and accessibility of exposure and response prevention for OCD.
The variation between countries in treatments used for OCD needs further evaluation. Exposure and response prevention is not used as frequently as guidelines suggest and appears difficult to access in most countries. Updated treatment guidelines are recommended.
本研究的目的是描述用于治疗强迫症（OCD）的精神药物、心理治疗和新型治疗方法的国际使用趋势。
邀请强迫症领域的研究人员提供其样本特征的汇总统计数据。评估各国汇总统计数据的一致性。
该研究调查了来自15个国家（阿根廷、澳大利亚、巴西、中国、德国、希腊、印度、意大利、日本、墨西哥、葡萄牙、南非、西班牙、英国和美国）的19个专家中心，共提供了7340名参与者的样本。氟西汀（n = 972；13.2%）和氟伏沙明（n = 913；12.4%）是最常用的选择性5-羟色胺再摄取抑制剂药物。利培酮（n = 428；7.3%）和阿立哌唑（n = 415；7.1%）是最常用的抗精神病药物。经颅磁刺激、深部脑刺激、伽玛刀手术和精神外科手术等神经刺激技术在样本中的使用比例不到1%。强迫症暴露与反应阻止法的使用和可及性存在显著差异。
各国用于治疗强迫症的方法差异需要进一步评估。暴露与反应阻止法的使用频率不如指南建议的那样高，且在大多数国家似乎难以获得。建议更新治疗指南。
