Evidence map›Paper›PMID 38113781›Full record

Trial reportJournal of anxiety disorders2024

Predictors of clinical worsening during a discontinuation trial of serotonin reuptake inhibitors for obsessive compulsive disorder.

Jeremy Tyler, Thea Gallagher, Michael G Wheaton, Gabriella E Hamlett, Ben Rosenfield, David Rosenfield, Helen B Simpson, Edna B Foa

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of anxiety disorders, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Jeremy TylerCenter for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA. Electronic address: Jeremyty@pennmedicine.upenn.edu.
Thea GallagherNew York University, Department of Psychiatry, New York, NY 10016, USA.
Michael G WheatonBarnard College, Columbia University, New York, NY 10027, USA; New York State Psychiatric Institute, New York, NY 10032, USA.
Gabriella E HamlettHarvard University, Department of Psychology, Cambridge, MA 02138, USA.
Ben RosenfieldRosenfield Analytics, Denver, CO 80126, USA.
David RosenfieldSouthern Methodist University, Dallas, TX 75275, USA.
Helen B SimpsonNew York State Psychiatric Institute, New York, NY 10032, USA; Department of Psychiatry, Columbia University, New York, NY 10032, USA.
Edna B FoaCenter for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA.

Funding

Maximizing Treatment Outcome in OCDR01MH045404 · NIMH · UNIVERSITY OF PENNSYLVANIA · PI FOA, EDNA B · 1990 to 2016
$5.3M
Maximizing Treatment Outcome in OCDR01MH045436 · NIMH · NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC · PI SIMPSON, HELEN BLAIR · 1990 to 2015
$5.0M
NIMH NIH HHS R01 MH045404NIMH NIH HHS R01 MH045436
6 · The paper itself

Abstract

objectiveTo explore predictors and moderators of clinical worsening during a double-blind trial in which patients with obsessive-compulsive disorder (OCD) were randomized to either continue or discontinue their Serotonin Reuptake Inhibitor (SRI) medication after achieving wellness from the addition of exposure and response prevention (EX/RP) therapy.

methodThe data came from a double-blind discontinuation trial that included N = 101 participants, 35 of whom were removed from the study due to clinical worsening. We first used LASSO logistic regression to identify which of the 34 potential baseline variables of interest (including demographics, diagnoses, other relevant clinical constructs, and specific genotypes), might moderate or predict this clinical worsening. Then logistic regression was used to examine which of these identified variables were significantly related to later clinical worsening. We verified the validity of our final prediction model using k-fold cross-validation.

resultsThere was one significant predictor of clinical worsening: In both groups, those with more past diagnoses had a greater likelihood of clinical worsening (p = .015). There were several moderators. Rates of clinical worsening were higher in the Discontinuation group compared to the Continuation group for participants who were taking a shorter half-life SRI (p = .044), were female (p = .022), had higher baseline levels of maladaptive metacognitions (p < .001), had fewer sleep problems at baseline (p = .001), and/or had more years of education (p < .001).

conclusionsOur results identified several factors that may predict the development of clinical worsening in OCD patients discontinuing SRI medication following successful EX/RP treatment.

Indexed as

Implosive TherapyObsessive-Compulsive DisorderFemaleHumansMaleSelective Serotonin Reuptake InhibitorsTreatment OutcomeSelective Serotonin Reuptake InhibitorsClinical worseningMachine learning, EX/RPModeratorsOCDPredictors

Identifiers

PMID38113781
PMCPMC11056869

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.