Obsessive-compulsive disorder, serotonin and oxytocin: treatment response and side effects

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Obsessive-compulsive disorder, serotonin and oxytocin : treatment response and side effects

Humble, Mats B., 1952- (författare): Örebro universitet,Institutionen för medicinska vetenskaper

Engström, Ingemar, Adjungerad professor (preses): Örebro universitet,Institutionen för medicinska vetenskaper

von Knorring, Lars, Professor (preses): Uppsala universitet

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Kjellin, Lars, Docent (preses): Örebro universitet,Institutionen för hälsovetenskaper

Träskman-Bendz, Lil, Professor (opponent): Institutionen för kliniska vetenskaper, Lunds universitet

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ISBN 9789175291536
Örebro : Örebro university, 2016
Engelska 133 s.
Serie: Örebro Studies in Medicine, 1652-4063 ; 148

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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)

Abstract Ämnesord

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Obsessive-compulsive disorder (OCD), with a prevalence of 1-2 %, frequently leads a chronic course. Persons with OCD are often reluctant to seek help and, if they do, their OCD is often missed. This is unfortunate, since active treatment may substantially improve social function and quality of life. Serotonin reuptake inhibitors (SRIs) have welldocumented efficacy in OCD, but delayed response may be problematic. Methods to predict response have been lacking. Because SRIs are effective, pathophysiological research on OCD has focussed on serotonin. However, no clear aberrations of serotonin have been found, thus other mechanisms ought to be involved.Our aims were to facilitate clinical detection and assessment of OCD, to search for biochemical correlates of response and side-effects in SRI treatment of OCD and to identify any possible involvement of oxytocin in the pathophysiology of OCD.In study I, we tested in 402 psychiatric out-patients the psychometric properties of a concise rating scale, “Brief Obsessive Compulsive Scale” (BOCS). BOCS was shown to be easy to use and have excellent discriminant validity in relation to other common psychiatric diagnoses.Studies II-V were based on 36 OCD patients from a randomised controlled trial of paroxetine, clomipramine or placebo. In study II, contrary to expectation, we found that the change (decrease) of serotonin in whole blood was most pronounced in non-responders to SRI. This is likely to reflect inflammatory influence on platelet turnover rather than serotonergic processes within the central nervous system.In studies IV-V, we found relations between changes of oxytocin in plasma and the anti-obsessive response, and between oxytocin and the SRI related delay of orgasm, respectively. In both cases, the relation to central oxytocinergic mechanisms is unclear. In males, delayed orgasm predicted anti-obsessive response.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Psykiatri (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Psychiatry (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Allmänmedicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- General Practice (hsv//eng)

Nyckelord

Adverse effects
Obsessive-compulsive disorder
Orgasm
Oxytocin
Randomised controlled trial
Rating scale
Response prediction
Serotonin
Serotonin uptake inhibitors
Sexual function
Psychiatry
Psykiatri

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Av författaren/redakt...: Humble, Mats B., ...; Engström, Ingema ...; von Knorring, La ...; Kjellin, Lars, D ...; Träskman-Bendz, ...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Psykiatri

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Allmänmedicin

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Av lärosätet: Örebro universitet

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