Longitudinal Follow-up Study of Obsessive Compulsive Disorder

描述(由申请人提供)：我们建议继续进行布朗纵向强迫症研究(BLOGS)，这是一项独特的、自然的、前瞻性的研究，对400名寻求治疗的主要原因是强迫症的受试者进行为期5年的f/u研究。这将使我们能够在所有科目上获得至少7年的f/u，并纳入新的评估和数据分析方法，以解决重要的未回答问题，同时全面了解强迫症的纵向过程和结果。它将提供有关预后、缓解率和复发率、缓解和复发的预测因素以及接受的治疗等重要的新的临床相关信息，这些信息反过来将对公共卫生政策产生重大影响。我们的具体目标是(1)确定选定的强迫症表型的病程、稳定性和结局(2)收集有关SRIs、增强药物和认知行为疗法长期效果的综合治疗数据(3)确定强迫症儿童和青少年临床样本的病程和结果模式，并将其与成人强迫症临床样本进行比较。受试者将每隔一年接受一次评估，评估工具将获得有关症状状态和严重程度、诊断状态、接受的治疗、心理社会功能和其他领域的详细信息。自上次提交以来，我们增加了新的评估，衡量应激性生活事件、潜在的情绪和焦虑相关特征，以及独立于诊断和功能的症状严重程度；我们还纳入了新的数据分析方法，以回答有关强迫症的重要问题。为了有足够的统计能力来检验我们的假设，还需要5年以上的前瞻性观察。BLOGS数据集的独特之处在于其大量的受试者、评估的全面性和预期的F/U长度。这项建议将使我们能够更全面地调查先前资助的赠款的目标和假设，并添加过去4年来自BLOGS和其他调查人员的发现产生的新的、以前未探索的目标和假设。持续的分组有望为临床和理论上重要的、关于未被充分研究的重大精神障碍的创新问题提供新的线索，这些问题在以前的研究中没有得到充分的解决。

DESCRIPTION (provided by applicant): We propose to continue the Brown Longitudinal Obsessive Compulsive Study (BLOCS), a unique, naturalistic, prospective study of 400 subjects whose primary reason for seeking treatment was OCD, for an additional 5 years of f/u. This will enable us to obtain a minimum of 7 years of f/u on all subjects and to incorporate new assessments and data analysis methods in order to address important unanswered questions while developing a comprehensive picture of the longitudinal course and outcome of OCD. It will provide important new and clinically relevant information about prognosis, rates of remission and relapse, predictors of remission and relapse and treatment received that will in turn have significant implications for public health policy. Our specific aims are to (1) determine the course, stability and outcome of selected OCD phenotypes (2) collect comprehensive treatment data on the long term effects of SRIs, augmenting medications, and cognitive behavior therapy (3) to determine the patterns of course and outcome of a clinical sample of child and adolescents with OCD and compare them to a clinical sample of adults with OCD. Subjects will be evaluated at 1 year intervals with instruments that obtain detailed information on symptom status and severity, diagnostic status, treatment received, psychosocial functioning, and other domains. Since the last submission we have added new assessments that measure stressful life events, underlying mood- and anxiety-related traits, and symptom severity independent of diagnosis and functioning; we have also incorporated new data analysis methods in order to answer important questions about OCD. To have sufficient statistical power to test our hypotheses, 5 more years of prospective observation are needed. The BLOCS data set is unique in its large number of subjects, comprehensiveness of assessment, and length of prospective f/u. This proposal will allow us to more completely investigate the aims and hypotheses of the previously funded grant and to add new, previously unexplored aims and hypotheses generated by findings from BLOCS and other investigators during the past 4 years. Continuation of BLOCS is expected to shed new light on clinically and theoretically important, innovative questions about an understudied major psychiatric disorder, which have not been adequately addressed by previous research.