A Clinical Staging Model for Obsessive–Compulsive Disorder

Is It Ready for Prime Time?

Research output: Contribution to journalReview ArticleOtherpeer-review

Abstract

Recent changes to the diagnostic classification of obsessive–compulsive disorder (OCD), including its removal from the anxiety/neurotic, stress-related and somatoform disorders chapters of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and International Classification of Diseases 11th Revision (ICD-11), are based on growing evidence of unique pathogenic signatures and linked diagnostic and treatment approaches. In this review, we build on these recent developments and propose a ‘clinical staging model’ of OCD that integrates the severity of symptoms and phase of illness for personalised case management. A clinical staging model is especially relevant for the early identification and management of subthreshold OCD - a substantial and largely neglected portion of the population who, despite having milder symptoms, experience harms that may impact personal relationships, work-related functioning and productivity. Research on the pathogenesis, classification and management of such cases is needed, including the development of new outcomes measures that prove sensitive to changes in future clinical trials. Early intervention strategies in OCD are likely to yield better long-term outcomes.

Original languageEnglish
Pages (from-to)65-72
Number of pages8
JournalEClinicalMedicine
Volume7
DOIs
Publication statusPublished - 1 Jan 2019

Keywords

  • Biological markers
  • Clinical staging
  • Cognitive functioning
  • Early intervention
  • Neuroprogression
  • Obsessive–compulsive disorder
  • Transdiagnostic framework
  • Treatment outcome

Cite this

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title = "A Clinical Staging Model for Obsessive–Compulsive Disorder: Is It Ready for Prime Time?",
abstract = "Recent changes to the diagnostic classification of obsessive–compulsive disorder (OCD), including its removal from the anxiety/neurotic, stress-related and somatoform disorders chapters of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and International Classification of Diseases 11th Revision (ICD-11), are based on growing evidence of unique pathogenic signatures and linked diagnostic and treatment approaches. In this review, we build on these recent developments and propose a ‘clinical staging model’ of OCD that integrates the severity of symptoms and phase of illness for personalised case management. A clinical staging model is especially relevant for the early identification and management of subthreshold OCD - a substantial and largely neglected portion of the population who, despite having milder symptoms, experience harms that may impact personal relationships, work-related functioning and productivity. Research on the pathogenesis, classification and management of such cases is needed, including the development of new outcomes measures that prove sensitive to changes in future clinical trials. Early intervention strategies in OCD are likely to yield better long-term outcomes.",
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A Clinical Staging Model for Obsessive–Compulsive Disorder : Is It Ready for Prime Time? / Fontenelle, Leonardo F.; Yücel, Murat.

In: EClinicalMedicine, Vol. 7, 01.01.2019, p. 65-72.

Research output: Contribution to journalReview ArticleOtherpeer-review

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