7 results
Assessing response, remission, and treatment resistance in patients with obsessive–compulsive disorder with and without tic disorders: results from a multicenter study
- Beatrice Benatti, Nicolaja Girone, Dario Conti, Rita Cafaro, Caterina Viganò, Matteo Briguglio, Donatella Marazziti, Federico Mucci, Orsola Gambini, Benedetta Demartini, Antonio Tundo, Roberta Necci, Domenico De Berardis, Roberta Galentino, Sara De Michele, Roberta Balestrino, Umberto Albert, Sylvia Rigardetto, Giuseppe Maina, Giacomo Grassi, Stefano Pallanti, Andrea Amerio, Andrea Aguglia, Davide Prestia, Mario Amore, Alberto Priori, Domenico Servello, Mauro Porta, Bernardo Dell’Osso
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- Journal:
- CNS Spectrums / Volume 27 / Issue 6 / December 2022
- Published online by Cambridge University Press:
- 16 September 2021, pp. 747-753
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Background
Highlighting the relationship between obsessive–compulsive disorder (OCD) and tic disorder (TD), two highly disabling, comorbid, and difficult-to-treat conditions, Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) acknowledged a new “tic-related” specifier for OCD, ie, obsessive–compulsive tic-related disorder (OCTD). As patients with OCTD may frequently show poor treatment response, the aim of this multicenter study was to investigate rates and clinical correlates of response, remission, and treatment resistance in a large multicenter sample of OCD patients with versus without tics.
MethodsA sample of 398 patients with a DSM-5 diagnosis of OCD with and without comorbid TD was assessed from 10 different psychiatric departments across Italy. For the purpose of the study, treatment response profiles in the whole sample were analyzed comparing the rates of response, remission, and treatment-resistance as well as related clinical features. Multivariate logistic regressions were performed to identify possible factors associated with treatment response.
ResultsThe remission group was associated with later ages of onset of TD and OCD. Moreover, significantly higher rates of psychiatric comorbidities, TD, and lifetime suicidal ideation and attempts emerged in the treatment-resistant group, with larger degrees of perceived worsened quality of life and family involvement.
ConclusionsAlthough remission was associated with later ages of OCD and TD onset, specific clinical factors, such as early onset and presence of psychiatric comorbidities and concomitant TD, predicted a worse treatment response with a significant impairment in quality of life for both patients and their caregivers, suggesting a worse profile of treatment response for patients with OCTD.
Suicidal ideation and suicidal attempts in patients with obsessive-compulsive tic-related disorder vs obsessive-compulsive disorder: results of a multicenter Italian study
- Beatrice Benatti, Silvia Ferrari, Benedetta Grancini, Nicolaja Girone, Matteo Briguglio, Donatella Marazziti, Federico Mucci, Liliana Dell’Osso, Orsola Gambini, Benedetta Demartini, Antonio Tundo, Roberta Necci, Domenico De Berardis, Roberta Galentino, Sara De Michele, Umberto Albert, Sylvia Rigardetto, Giuseppe Maina, Giacomo Grassi, Stefano Pallanti, Andrea Amerio, Mario Amore, Alberto Priori, Domenico Servello, Caterina Viganò, Monica Bosi, Anna Colombo, Mauro Porta, Bernardo Dell’Osso
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- Journal:
- CNS Spectrums / Volume 26 / Issue 4 / August 2021
- Published online by Cambridge University Press:
- 06 May 2020, pp. 354-361
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Background
Obsessive-compulsive disorder (OCD) and tic disorder (TD) represent highly disabling, chronic and often comorbid psychiatric conditions. While recent studies showed a high risk of suicide for patients with OCD, little is known about those patients with comorbid TD (OCTD). Aim of this study was to characterize suicidal behaviors among patients with OCD and OCTD.
MethodsThree hundred and thirteen outpatients with OCD (n = 157) and OCTD (n = 156) were recruited from nine different psychiatric Italian departments and assessed using an ad-hoc developed questionnaire investigating, among other domains, suicide attempt (SA) and ideation (SI). The sample was divided into four subgroups: OCD with SA (OCD-SA), OCD without SA (OCD-noSA), OCTD with SA (OCTD-SA), and OCTD without SA (OCTD-noSA).
ResultsNo differences between groups were found in terms of SI, while SA rates were significantly higher in patients with OCTD compared to patients with OCD. OCTD-SA group showed a significant male prevalence and higher unemployment rates compared to OCD-SA and OCD-noSA sample. Both OCTD-groups showed an earlier age of psychiatric comorbidity onset (other than TD) compared to the OCD-SA sample. Moreover, patients with OCTD-SA showed higher rates of other psychiatric comorbidities and positive psychiatric family history compared to the OCD-SA group and to the OCD-noSA groups. OCTD-SA and OCD-SA samples showed higher rates of antipsychotics therapies and treatment resistance compared to OCD-noSA groups.
ConclusionsPatients with OCTD vs with OCD showed a significantly higher rate of SA with no differences in SI. In particular, OCTD-SA group showed different unfavorable epidemiological and clinical features which need to be confirmed in future prospective studies.
PP108 Novel Approaches For Fair And Reasonable Value-Based Recommendations
- Geneviève Plamondon, Yannick Auclair, Michèle de Guise, Sara Beha, Sylvie Arbour, Mireille Goetghebeur, Nathalie Jobin, Julie Nieminen
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- International Journal of Technology Assessment in Health Care / Volume 34 / Issue S1 / 2018
- Published online by Cambridge University Press:
- 03 January 2019, p. 106
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Introduction:
Stakeholders from the innovation field in Québec (Canada) have collectively stressed the need to formalize the process for evaluating innovative technologies in the province. In the context of innovation, and more so for non-pharmaceutical technologies where the pace of development is rapid and the lifecycle short, evidence supporting the added value can be limited and uncertainties are common. Therefore, pragmatic approaches are needed to guide recommendations and to assure that the process is rigorous, transparent and fair.
Methods:Inspired by international experiences, the Institut national d'excellence en santé et services sociaux (INESSS) has developed a novel framework, where four types of recommendations are possible (introduction, refusal, limited or conditional introduction). The starting point is an evaluation of the technology's added value, for the patient, the population and the healthcare system, and the identification of uncertainties. The value of addressing uncertainty with further research is assessed, based on the value-of-information theory, and the distinct characteristics of medical devices are taken into account (e.g. learning curve effect, irrecoverable costs and incremental innovation). Those elements interact to support the formulation of recommendations by INESSS’ advisory committee.
Results:The development of the framework was an iterative process supported by the use of the preliminary framework for the assessment of several innovative technologies. Challenges with its use were identified, and led to methodological and operational improvements. So far, the experience with the framework is positive and stakeholders confirm its relevance to support fair and reasonable recommendations for innovations.
Conclusions:In the rapidly changing landscape of innovation, HTA has to adapt to the challenges of assessing technologies in a context of promise and uncertainties. The framework developed by INESSS is a tool for supporting timely and fair value-based decision-making, which will benefit the healthcare system, and the patients and population it serves.
Contributors
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- By Masoud Azodi, Patricia Baetens, Steven Bayer, Joel Bernstein, Jonathan D. Black, Christophe Blockeel, Carolien M. Boomsma, Birgit Borgström, Mark Bowman, Nicholas Brook, Elisabeth Carlsen, Peter Carne, Ying Cheong, Jen-Ruei Chen, Erin Clark, S. Alberto Dávila Garza, Sunita De Sousa, Michel De Vos, Leo Doherty, Patricio Donoso, Cindy M. P. Duke, Human M. Fatemi, Alison Fernbach, Juan A. Garcia-Velasco, Elizabeth S. Ginsburg, Dorothy A. Greenfeld, William M. Hague, Daniel Hajioff, Tristan Hardy, Catherine Henry, Outi Hovatta, John Hutton, Gordana Ivanovic, Sameer Jatkar, Shilpa Jesudason, Theo Joseph, Amanda Kallen, Sonal Karia, Bala Karunakaran, Jenneke C. Kasius, Ben Kroon, Dimitra Kyrou, Robert Lahoud, Jennifer M Levine, Inge Liebaers, Shane T. Lipskind, Derek Lok, Nick S. Macklon, Manveen (Manny) Mangat, Tom P. Manolitsas, S. McDowell, Cherise Mooy, Mark R. Morton, Andrew Murray, Robert J. Norman, Sara Ornaghi, Israel Ortega, Michael J. Paidas, Evaggelos Papanikolaou, Pasquale Patrizio, Sofie Piessens, Biljana Popovic Todorovic, Luk Rombauts, Katrina Rowan, Denny Sakkas, P. Sanhueza, Kirsten Tryde Schmidt, Mark Teoh, Hammed A. Tijani, Jelena Todorovic, Saioa Torrealday, Herman Tournaye, Geoffrey Trew, W. Verpoest, Veerle Vloeberghs, A. Yazdani
- Edited by Nick S. Macklon, University of Southampton, Human M. Fatemi, Robert J. Norman, University of Adelaide, Pasquale Patrizio
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- Book:
- Case Studies in Assisted Reproduction
- Published online:
- 05 February 2015
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- 22 January 2015, pp ix-xiv
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Predictors of Survival in a Huntington's Disease Population from Southern Italy
- Carlo Rinaldi, Elena Salvatore, Ilaria Giordano, Sara De Matteis, Tecla Tucci, Valeria Russo Cinzia, Fabiana Rossi, Imma Castaldo, Vincenzo Brescia Morra, Luigi Di Maio, Alessandro Filla, Giuseppe De Michele
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 39 / Issue 1 / January 2012
- Published online by Cambridge University Press:
- 02 December 2014, pp. 48-51
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Background:
The primary aim of the present study was to determine the survival rates and identify predictors of disease duration in a cohort of Huntington's disease (HD) patients from Southern Italy.
Methods:All medical records of HD patients followed between 1977 and 2008 at the Department of Neurological Sciences of Federico II University in Naples were retrospectively reviewed and 135 patients were enrolled in the analysis. At the time of data collection, 41 patients were deceased (19 males and 22 females) with a mean ± SD age at death of 56.6 ± 14.9 years (range 18-83).
Results:The median survival time was 20 years (95% CI: 18.3-21.7). Cox regression analysis showed that the number of CAG in the expanded allele (HR 1.09 for 1 point triplet increase, p=0.002) and age of onset (HR 1.05 for 1 point year increase, p=0.022) were independent and significant predictors of lower survival rates.
Conclusions:We believe that these findings are important for a better understanding of the natural history of the disease and may be relevant in designing future therapeutic trials.
Notes on Contributors
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- By Thomas M. Achenbach, Marc H. Bornstein, W. Thomas Boyce, Robert H. Bradley, Kelly Bridges, Jeanne Brooks-Gunn, Brenda K. Bryant, Sandra L. Calvert, Scott Coltrane, E. Mark Cummings, Stacey B. Daughters, Cindy DeCoste, Marc de Rosnay, Jacquelynne S. Eccles, Hadas Eidelman, Ruth Feldman, Peter Fonagy, Walter S. Gilliam, Andrea L. Gold, Elena L. Grigorenko, Sara Harkness, Sybil L. Hart, Jessica S. Henry, Erika Hoff, Tom Hollenstein, Stephanie M. Jones, Julia Kim-Cohen, Pamela K. Klebanov, Brett Laursen, Mary J. Levitt, Alicia F. Lieberman, Shoon Lio, Jessica F. Magidson, Ann S. Masten, David L. Molfese, Peter J. Molfese, Lynne Murray, Jelena Obradović, Lauren M. Papp, Ross D. Parke, Yaacov Petscher, Aelesia Pisciella, Aliza W. Pressman, Sarah Rabbitt, Craig T. Ramey, Sharon Landesman Ramey, Jessica M. Richards, Robert W. Roeser, Thomas J. Schofield, Ronald Seifer, Anne Shaffer, Michelle Sleed, Laura Stout Sosinsky, Nancy E. Suchman, Charles M. Super, Louis Tuthill, Patricia Van Horn, Eric Vega, Sarah Ward, Monica Yudron
- Edited by Linda Mayes, Yale University, Connecticut, Michael Lewis
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- Book:
- The Cambridge Handbook of Environment in Human Development
- Published online:
- 05 October 2012
- Print publication:
- 27 August 2012, pp ix-xvi
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Looking Backward, Looking Forward: MLA Members Speak
- April Alliston, Elizabeth Ammons, Jean Arnold, Nina Baym, Sandra L. Beckett, Peter G. Beidler, Roger A. Berger, Sandra Bermann, J.J. Wilson, Troy Boone, Alison Booth, Wayne C. Booth, James Phelan, Marie Borroff, Ihab Hassan, Ulrich Weisstein, Zack Bowen, Jill Campbell, Dan Campion, Jay Caplan, Maurice Charney, Beverly Lyon Clark, Robert A. Colby, Thomas C. Coleman III, Nicole Cooley, Richard Dellamora, Morris Dickstein, Terrell Dixon, Emory Elliott, Caryl Emerson, Ann W. Engar, Lars Engle, Kai Hammermeister, N. N. Feltes, Mary Anne Ferguson, Annie Finch, Shelley Fisher Fishkin, Jerry Aline Flieger, Norman Friedman, Rosemarie Garland-Thomson, Sandra M. Gilbert, Laurie Grobman, George Guida, Liselotte Gumpel, R. K. Gupta, Florence Howe, Cathy L. Jrade, Richard A. Kaye, Calhoun Winton, Murray Krieger, Robert Langbaum, Richard A. Lanham, Marilee Lindemann, Paul Michael Lützeler, Thomas J. Lynn, Juliet Flower MacCannell, Michelle A. Massé, Irving Massey, Georges May, Christian W. Hallstein, Gita May, Lucy McDiarmid, Ellen Messer-Davidow, Koritha Mitchell, Robin Smiles, Kenyatta Albeny, George Monteiro, Joel Myerson, Alan Nadel, Ashton Nichols, Jeffrey Nishimura, Neal Oxenhandler, David Palumbo-Liu, Vincent P. Pecora, David Porter, Nancy Potter, Ronald C. Rosbottom, Elias L. Rivers, Gerhard F. Strasser, J. L. Styan, Marianna De Marco Torgovnick, Gary Totten, David van Leer, Asha Varadharajan, Orrin N. C. Wang, Sharon Willis, Louise E. Wright, Donald A. Yates, Takayuki Yokota-Murakami, Richard E. Zeikowitz, Angelika Bammer, Dale Bauer, Karl Beckson, Betsy A. Bowen, Stacey Donohue, Sheila Emerson, Gwendolyn Audrey Foster, Jay L. Halio, Karl Kroeber, Terence Hawkes, William B. Hunter, Mary Jambus, Willard F. King, Nancy K. Miller, Jody Norton, Ann Pellegrini, S. P. Rosenbaum, Lorie Roth, Robert Scholes, Joanne Shattock, Rosemary T. VanArsdel, Alfred Bendixen, Alarma Kathleen Brown, Michael J. Kiskis, Debra A. Castillo, Rey Chow, John F. Crossen, Robert F. Fleissner, Regenia Gagnier, Nicholas Howe, M. Thomas Inge, Frank Mehring, Hyungji Park, Jahan Ramazani, Kenneth M. Roemer, Deborah D. Rogers, A. LaVonne Brown Ruoff, Regina M. Schwartz, John T. Shawcross, Brenda R. Silver, Andrew von Hendy, Virginia Wright Wexman, Britta Zangen, A. Owen Aldridge, Paula R. Backscheider, Roland Bartel, E. M. Forster, Milton Birnbaum, Jonathan Bishop, Crystal Downing, Frank H. Ellis, Roberto Forns-Broggi, James R. Giles, Mary E. Giles, Susan Blair Green, Madelyn Gutwirth, Constance B. Hieatt, Titi Adepitan, Edgar C. Knowlton, Jr., Emanuel Mussman, Sally Todd Nelson, Robert O. Preyer, David Diego Rodriguez, Guy Stern, James Thorpe, Robert J. Wilson, Rebecca S. Beal, Joyce Simutis, Betsy Bowden, Sara Cooper, Wheeler Winston Dixon, Tarek el Ariss, Richard Jewell, John W. Kronik, Wendy Martin, Stuart Y. McDougal, Hugo Méndez-Ramírez, Ivy Schweitzer, Armand E. Singer, G. Thomas Tanselle, Tom Bishop, Mary Ann Caws, Marcel Gutwirth, Christophe Ippolito, Lawrence D. Kritzman, James Longenbach, Tim McCracken, Wolfe S. Molitor, Diane Quantic, Gregory Rabassa, Ellen M. Tsagaris, Anthony C. Yu, Betty Jean Craige, Wendell V. Harris, J. Hillis Miller, Jesse G. Swan, Helene Zimmer-Loew, Peter Berek, James Chandler, Hanna K. Charney, Philip Cohen, Judith Fetterley, Herbert Lindenberger, Julia Reinhard Lupton, Maximillian E. Novak, Richard Ohmann, Marjorie Perloff, Mark Reynolds, James Sledd, Harriet Turner, Marie Umeh, Flavia Aloya, Regina Barreca, Konrad Bieber, Ellis Hanson, William J. Hyde, Holly A. Laird, David Leverenz, Allen Michie, J. Wesley Miller, Marvin Rosenberg, Daniel R. Schwarz, Elizabeth Welt Trahan, Jean Fagan Yellin
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- Journal:
- PMLA / Publications of the Modern Language Association of America / Volume 115 / Issue 7 / December 2000
- Published online by Cambridge University Press:
- 23 October 2020, pp. 1986-2078
- Print publication:
- December 2000
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