Michael Jenike, M.D. Obsessive-Compulsive Disorders The staff of the Obsessive-Compulsive Disorders (OCD) Clinical and Research Unit are engaged in a number of ongoing projects including an NIMH funded study to evaluate treatment outcome and predictors of response in OCD patients blindly treated with Fluoxetine, phenelzine (a monoamine oxidase inhibitor), or placebo. They are also gathering data to evaluate the longitudinal course of symptoms in OCD patients. Other ongoing trials include: separate placebo-controlled double-blind studies involving clomipramine, fluoxetine, fluvoxamine, paroxetine, sertraline, and stimulants (eg, dextroamphetamine and methylphenidate); a controlled trial of group behavior therapy in preventing relapse upon drug withdrawal; comparative neuropsychological testing of patients with OCD, Tourette's syndrome, trichotillomania, and body dysmorphic disorder (BDD). Other studies are looking at predictors of treatment outcome, personality disorders and traits in OCD patients and the impact of these concomitant diagnoses on treatment outcome, studies of computerized behavior therapy and record keeping, signal-detection studies in collaboration with Professor Stephen Kosslyn from the Department of Psychology at Harvard, and the use of augmenting pharmacologic agents in treating refractory OCD patients. Since some OCD patients are refractory to state-of-the-art treatments and remain almost totally disabled, the research group has focused on the use of neurosurgical treatments for severe and treatment-refractory patients. Studies with both cingulotomy (in collaboration with the Department of Neurosurgery at MGH) and gamma capsulotomy (in collaboration with the Department of Neurosurgery at Brown Universty and the Karolinska Institute in Sweden) are ongoing. The first double-blind controlled (ie, sham) study of a neurosurgical procedure to treat OCD has been proposed by investigators in the OCD unit, and a NIMH RO1 application has been submitted. Human subjects approval has been obtained at MGH, Brown University, and Rhode Island Hospital, and this study is now underway. | |
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