Characteristics of Included Studies

MethodsParticipantsOutcomesInterventionsNotes
ALONSO2001
Study Type: RCT

Study Description: Allocation: random (no details), patients & clinician blind to treatment
Duration of study: 10 weeks
Number of sessions: 18 (3 per week for 6 weeks)

Blindness: Double blind

Duration (days):

Setting: Outpatient

Notes: Country of study: Spain; Analysis: ITT

Info on Screening Process: Not reported		N= 18

Age: Mean 35 Range 20-59

Sex: 6 males 12 females

Diagnosis:
  • OCD by DSM-IV
Exclusions: Not right-handed, any other DSM-IV axis I disorder, history of seizure or head trauma

Notes: Brain target right dorsolateral prefrontal cortex; patients received 18 sessions at 1 Hz; duration of each session 20 minutes		Data Used
  • Responder (OCD/BDD)
  • Hamilton Rating Scale for Depression
  • Yale-Brown Obsessive-Compulsive Scale: total
  • Adverse events
Group 1 N= 10
  • Transcranial Magnetic Stimulation - The intensity was 110% of the motor threshold as determined by the miniumum intensity in the right motor cortex that produced a visible motor response in the left thumb
Group 2 N= 8
  • Placebo - The intensity was 20% of the motor threshold
FODSTAD1982
Study Type: RCT

Study Description: Allocation: random (sealed envelope technique)

Blindness: No mention

Duration (days):

Followup: 12 months

Setting: Not reported

Notes: Country of study: Sweden, Analysis:

Info on Screening Process: Not reported		N= 4

Age: Mean 47 Range 37-60

Sex: all females

Diagnosis:
  • OCD
Exclusions: Inclusion criteria: poor response to extensive psychiatric treatment, experienced severe suffering and social disability
Notes: No formal diagnosis performed, patients had chronic obsessive compulsive neurosis as manifested by obsessional thoughts and compulsive behaviour		Data Used
  • Hamilton Rating Scale for Depression
  • Comprehensive Psychopathological Rating
  • Scale: OC
Group 1 N= 2
  • Anterior capsulotomy - Bilateral steriotactic capsulotomy; lesion points were on and 4 mm below the intercommissural line at distance of half the intercommissural distance in front of the anterior commissure
Group 2 N= 2
  • Cingulotomy - 4 lesions each on the left and right were made 7 and 11 mm above the roof of the frontal horn, 13 and 17 mm lateral to the midsagittal plane
Hamilton Scale as modified by Vilkki, 1977
GREENBERG1997
Study Type: Cross-over

Study Description: Allocation: random (no details)

Blindness: Single blind

Duration (days):

Setting: Not reported

Notes: Country of study: US; Analysis: ITT

Info on Screening Process: Not reported		N= 12

Age: Mean 37

Sex: 6 males 6 females

Diagnosis:
  • OCD by DSM-III-R
Exclusions: History of seizure or head traum, were reciving medications that lower the seizure threshold

Notes: Mean baseline Y-BOCS 19.8 +-9.7 Stimulation used 80% motor threshold, 20 Hz/2 seconds per minute for 20 minutes. Motor threshold was set at 2% below the value at which 5 successive pulses produced no visible abductor pollicis brevis contraction		Data Used
  • NIMH self-rating scale
Group 1 N= 12
  • Right lateral prefrontal cortex stimulation - Repetitive Transcranial Magnetic Stimulation, 30 min per session, stimulation site was right lateral prefrontal cortex, motor threshold set at 2% below value at which 5 successive pulses produced no visible abductor pollicis brevis contraction
Group 2 N= 12
  • Left lateral prefrontal cortex stimulation - Repetitive Transcranial Magnetic Stimulation, 30 min per session, stimulation site was left lateral prefrontal cortex, motor threshold set at 2% below value at which 5 successive pulses produced no visible abductor pollicis brevis contraction
Other measures: Mood scale: 100-point visual analog scale administered by blind researcher
NUTTIN2003
Study Type: Cross-over

Study Description: Allocation: random (coin-toss); patients, evaluating psychiatrist & psychologist were blinded
Study duration: 6 months (3 months in each condition)

Blindness: Double blind

Duration (days):

Setting: Not reported

Notes: Country of study: Belgium

Info on Screening Process: Not reported		N= 4

Age:

Sex: no information

Diagnosis:
  • OCD by DSM-IV
  • 50% MDD by DSM-I
Exclusions: Aged <18 or >60 years; Y-BOCS<30 + GAF>45 persisting over 5 years, despite adequte trials or intolerance to 2 SSRIs & clomipramine, augmentation startegies, and CBT; current or past psychotic disorder, clinically significant disorder or medical illness affecting brain function or structure, current or unstably remitted substance abuse

Notes: Two patients had comorbid major depression, one patient had comorbid somatoform disorder nos		Data Not Used
  • Beck Depression Inventory - no data
  • Clinical Global Severity Scale - no pre-cross-over data
  • Clinical Global Improvement - no pre-cross-over data
  • Yale-Brown Obsessive-Compulsive Scale: total - no pre-cross-over data
Group 1 N= 4
  • Capsular stimulation off - Stimulator off for 3 months
Group 2 N= 4
  • Capsular stimulation on - Stimulation electrodes placed in and dorsal to internal capsule, stimulator kept on for 3 months, stimulation performed at threshold level to achieve obvious acute reduction of obsessive thoughts, depression and anxiety
PERLMUTTER1999
Study Type: RCT

Study Description: Children with severe, infection-triggered exacerbations of OCD/tic disorders were randomly assigned treatment with plasma exchange, IVIG or placebo.

Blindness: Double blind
Duration (days):
Followup: 1 month and 1 year
Setting: National Institute of Mental Health outpatient clinic.
Notes: IVIG and placebo: double-blind. Plasma exchange: open. First assessment at 1 month. Follow-up at one year for plasma exchange and IVIG only.
Info on Screening Process: 200 children were screened by telephone; 58 underwent face-to-face screening at the clinic. 28 did not meet eligibility criteria or were unwilling to participate in the trial. 30 enrolled in the trial.		N= 30
Age:
Sex: 19 males 11 females
Diagnosis:
  • OCD by DSM-III
Exclusions: History of Sydenham's chorea or rheumatic fever, autism, schizophrenia or other psychotic disorder, a neurological disorder other than a tic disorder, an autoimmune disorder, or other medical illness.
Notes: Eligibility criteria were a tic disorder, OCD, or both. Mean age (SD): plasma exchange 10.3 years (2.8), IVIG 9.1 years (2.4), placebo 9.4 (2.3).		Data Used
  • Emotional lability
  • Global severity
  • Depression
  • Anxiety
  • Psychosocial functioning
  • Global impairment
  • Obsessions and compulsions
  • Leaving study early due to adverse events
  • Adverse events
  • Leaving study early
Group 1 N= 10
  • Plasma exchange - One plasma volume (45mL/kg bodyweight) was exchanged in each procedure, and 5 or 6 procedures were done, once a day or on alternate days, to complete a course in 10-12 days.
Group 2 N= 10
  • IV immunoglobulin - Children received 1g/kg IVIG daily for 2 consecutive days.
Group 3 N= 10
  • IV placebo - Children received 1g/kg saline solution daily for 2 consecutive days.
SACHDEV2001
Study Type: RCT

Study Description: Allocation: random (no details); patient and assessor was blind to side (left v right) of stimulation
Duration of study: 2 weeks

Blindness: Double blind

Duration (days):

Followup: 1 month

Setting: Not reported

Notes: Country of study: Australia; Analysis: ITT

Info on Screening Process: Not reported		N= 12

Age: Mean 40

Sex: 9 males 3 females

Diagnosis:
  • OCD by DSM-IV
Exclusions: History of psychosis, substance abuse or tic disorders

Notes: Duration of illness: 17.3 years, 9 patients had a history of comorbid major depression; baseline Y-BOCS 24.15+-7.81		Data Used
  • State-Anxiety Inventory
  • Montgomery-Asberg Depression Rating Scale
  • Beck Depression Inventory
  • Yale-Brown Obsessive-Compulsive Scale: total
Group 1 N= 6
  • Right rTMS - 5 rTMS sessions per week, stimulation parameters 10Hz, 30 trains of 5 seconds each, 25 seconds between trains, and 110% resting motor threshold. A 70-mm 8-shaped stimulating coil was centrered over the right dorsolateral prefrontal cortex
Group 2 N= 6
  • Left rTMS - 5 rTMS sessions per week, stimulation parameters 10Hz, 30 trains of 5 seconds each, 25 seconds between trains, and 110% resting motor threshold. A 70-mm 8-shaped stimulating coil was centrered over the left dorsolateral prefrontal cortex

From: Appendix 16, Characteristics of reviewed studies

Cover of Obsessive-Compulsive Disorder
Obsessive-Compulsive Disorder: Core Interventions in the Treatment of Obsessive-Compulsive Disorder and Body Dysmorphic Disorder.
NICE Clinical Guidelines, No. 31.
National Collaborating Centre for Mental Health (UK).
Leicester (UK): British Psychological Society (UK); 2006.
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