Treatment non-response in OCD: methodological issues and operational definitions
Treatment non-response in OCD: methodological issues and operational definitions
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DOI：
10.1017/s1461145702002900
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发表时间：
2002-06-01
影响因子：
4.8
通讯作者：
Zohar, J
中科院分区：
文献类型：
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作者：
Pallanti, S;Hollander, E;Zohar, J
虽然SRI的对照试验已经证明了对强迫症（OCD）的选择性疗效，但高达40-60%的患者没有令人满意的结果。对强迫症治疗无反应与严重的社会残疾有关。有大量的无应答患者，由于诊断标准的模糊性、亚型的可能性和高合并症率，很难对他们进行聚类。此外，目前对所谓的“无反应”案例的研究结果目前还不能普遍化，因为缺乏对无反应的操作定义。其结果是，尚未建立关于无应答者合理同质样本的累积数据。本文的目的是澄清一些障碍，在界定阶段的反应和水平的无反应，并通过全面的分析，提出一个系统的疾病分类，这是相当常见的条件。更好地描述哪些患者对各种治疗有反应，哪些患者对各种治疗无反应，将使患者的聚类更加准确，并有助于促进未来研究试验的多中心数据收集。
While controlled trials with SRIs have demonstrated a selective efficacy in obsessive-compulsive disorder (OCD), up to 40-60% of patients do not have a satisfactory outcome. Non-response to treatment in OCD is associated with serious social disability. There are a large number of non-responsive patients, and they are difficult to cluster due to ambiguities in the diagnostic criteria, possibility of subtypes, and a high rate of comorbidity. Moreover, the findings of current studies of so-called 'non-responsive' cases are currently non-generalizable because of the lack of an operational definition of non-response. The result has been that a cumulative body of data on a reasonably homogeneous sample of non-responders has not been developed. The aims of this paper are to clarify some of the obstacles in defining stages of response and levels of non-response and, through a comprehensive analysis, to propose a systematic nosology for this rather common condition. Better characterization of which patients respond and do not respond to various treatments will enable more accurate clustering of patients, and help facilitate multi-site data collection for future research trials.