Department of Mental Health, Department of Biomedical and Clinical Sciences, Luigi Sacco, University of Milan, Milan, Italy.
Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, UK.
Int J Psychiatry Clin Pract. 2022 Mar;26(1):92-107. doi: 10.1080/13651501.2021.1872646. Epub 2021 Jan 27.
Patients with obsessive-compulsive disorder (OCD) commonly exhibit a range of functional difficulties, presumed linked to neurocognitive changes. Evidence-based first-line treatments have limited effect on improving these cognitive-functional problems. Candidate interventions could be used to augment evidence-based treatments by the multi-professional mental health team.
A scoping review was performed to identify any intervention with at least one peer-reviewed report of clinical improvement in any of the 13 functional domains of the Cognitive Assessment Instrument of Obsessions and Compulsions (CAIOC-13). Next, an online survey of experts of the International College of Obsessive-Compulsive Spectrum Disorders was conducted.
Forty-four studies were identified reporting a positive outcome for 27 different kinds of intervention. Twenty-six experts from 12 different countries, including at least one expert from each continent, completed the opinion survey. Five interventions were identified as 'highly promising', none of which was moderated by rater-related factors, suggesting global applicability.
Patients with OCD may benefit from a detailed functional assessment, to identify areas of unmet need. A variety of interventions show theoretical promise for treating the complex functional difficulties in OCD as adjuncts to first-line treatments, but the published evidence is weak. Randomised controlled trials are needed to determine the clinical effectiveness of these interventions.HighlightsFunctional-cognitive problems are common in patients with OCD.First-line evidence-based treatments have limited effect on these functionalcognitive difficulties.In our scoping review we found 44 studies reporting of improved clinical outcomes in any of the 13 functional domains of the Cognitive Assessment Instrument of Obsessions and Compulsions (CAIOC-13).An online survey of experts of the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) was conducted and identified five interventions as "highly promising" candidate treatments for functional-cognitive problems in OCD.Randomised controlled trials are needed to determine the clinical effectiveness of these interventions.
强迫症（OCD）患者通常表现出一系列功能障碍，这些障碍被认为与神经认知变化有关。基于证据的一线治疗方法对改善这些认知-功能问题的效果有限。候选干预措施可以被多专业精神卫生团队用来增强基于证据的治疗方法。
进行了范围界定审查，以确定任何干预措施，这些干预措施至少有一份同行评议的报告表明在强迫症认知评估工具（CAIOC-13）的 13 个功能领域中的任何一个领域的临床改善。然后，对国际强迫症谱系障碍学院的专家进行了在线调查。
确定了 44 项研究，这些研究报告了 27 种不同干预措施的积极结果。来自 12 个不同国家的 26 名专家，包括每个大陆至少有一名专家，完成了意见调查。确定了 5 种干预措施具有“高度前景”，这些干预措施均不受评估者相关因素的影响，表明具有全球适用性。
强迫症患者可能受益于详细的功能评估，以确定未满足的需求领域。各种干预措施作为一线治疗的辅助手段，在治疗 OCD 的复杂功能障碍方面具有理论上的潜力，但发表的证据很薄弱。需要进行随机对照试验来确定这些干预措施的临床疗效。
功能认知问题在强迫症患者中很常见。
基于证据的一线治疗方法对这些功能认知困难的效果有限。
在我们的范围界定审查中，我们发现 44 项研究报告了强迫症认知评估工具（CAIOC-13）的 13 个功能领域中的任何一个领域的临床改善。
对国际强迫症谱系障碍学院（ICOCS）的专家进行了在线调查，确定了 5 种干预措施作为 OCD 功能认知问题的“高度有前景”的候选治疗方法。
需要进行随机对照试验来确定这些干预措施的临床疗效。
