Functional Interventions as Augmentation Strategies for Obsessive-Compulsive Disorder (OCD): Scoping Review and Expert Survey from the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS)

Alberto Varinelli, Valentina Caricasole, Luca Pellegrini, Natalie Hall, Kabir Garg, Davis Mpavaenda, Bernardo Dell'Osso, Umberto Albert, Naomi Fineberg

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Abstract

Background. Patients with obsessive-compulsive disorder (OCD) commonly exhibit a range of functional difficulties, presumed linked to neurocognitive changes. Evidence-based first-line treatments have limited effect on improving these cognitive-functional problems. Candidate interventions could be used to augment evidence-based treatments by the multi-professional mental health team. Methods. A scoping review was performed to identify any intervention with at least one peer-reviewed report of clinical improvement in any of the 13 functional domains of the Cognitive Assessment Instrument of Obsessions and Compulsions (CAIOC-13). Next, an online survey of experts of the International College of Obsessive-Compulsive Spectrum Disorders was conducted.Results. Forty-four studies were identified reporting a positive outcome for 27 different kinds of intervention. Twenty-six experts from 12 different countries, including at least one expert from each continent, completed the opinion survey. Five interventions were identified as ‘highly promising’, none of which was moderated by rater-related factors, suggesting global applicability. Conclusion. Patients with OCD may benefit from a detailed functional assessment, to identify areas of unmet need. A variety of interventions show theoretical promise for treating the complex functional difficulties in OCD as adjuncts to first-line treatments, but the published evidence is weak. Randomised controlled trials are needed to determine the clinical effectiveness of these interventions.
Original languageEnglish
JournalInternational Journal of Psychiatry in Clinical Practice
Early online date27 Jan 2021
DOIs
Publication statusE-pub ahead of print - 27 Jan 2021

Keywords

  • Obsessive-Compulsive Disorder
  • Functional-cognitive problems
  • Functional interventions
  • Augmentation strategies
  • International College of Obsessive-Compulsive Spectrum Disorders
  • ICOCS

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