Research on OCD and related disorders, precision psychiatry, psychiatric genetics, suicide prevention, stress and PTSD
Jesper Enander held a most interesting lecture on Internet-based CBT – what it is, how it works and why you should do it. After the lecture, the research group representatives from Rücklab and Professor Sabine Wilhelm, Harvard Medical School and Chief of Psychology and Director of OCD and Related Disorders ProgramMassachusetts General Hospital had most engaging discussions on possible collaboration projects on ICBT for OCD-RD and other research questions
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A study using Swedish register and twin data just came out in World Psychiatry (click link of the reference bwlow for full text).
The study aimed to examine patterns of comorbidity, longitudinal risks, shared familial risks and shared genetic factors between OCD and Anorexia Nervosa (AN) at the population level. Participants were individuals with a diagnosis of OCD (N=19,814) or AN (N=8,462) in the Swedish National Patient Register ; their first-, second- and third-degree relatives; and population-matched (1:10 ratio) controls and their relatives. Female twins from the population-based Swedish Twin Register (N=8,550) were also included. Females with OCD had a 16-fold increased risk of having a comorbid diagnosis of AN, whereas males with OCD had a 37-fold increased risk. Longitudinal analyses showed that individuals first diagnosed with OCD had an increased risk for a later diagnosis of AN (risk ratio, RR=3.6), whereas individuals first diagnosed with AN had an even greater risk for a later diagnosis of OCD (RR=9.6). These longitudinal risks were about twice as high for males than for females. First- and second-degree relatives of probands with OCD had an increased risk for AN, and the magnitude of this risk tended to increase with the degree of genetic relatedness. Bivariate twin models revealed a moderate but significant degree of genetic overlap between self-reported OCD and AN diagnoses (ra =0.52, 95% CI: 0.26-0.81), but most of the genetic variance was disorder-specific. The moderately high genetic correlation supports the idea that this frequently observed comorbid pattern is at least in part due to shared genetic factors, though disorder-specific factors are more important.
The leading scientific journal Nature writes about our work on internet-based CBT for BDD today. Read it all here: http://www.nature.com/nature/journal/v526/n7572_supp/full/526S14a.html#close
Den behandling som visat sig effektivast mot tvångssyndrom är kognitiv beteendeterapi (KBT). Kognitiv beteendeterapi går ut på att förändra tankar och beteenden för att kunna må bättre och nå mål man värderar som viktiga.
Att behandlingen sker inom ramen för en studie innebär för dig som behandlingsdeltagare att den är helt gratis.
I studien kommer det att bli aktuellt med ett bedömningsbesök på Karolinska universitetssjukhuset Huddinge. Kommer du med i studien kommer du att lottas till antingen internetbehandling eller behandling där du träffar en psykolog. Det går inte att påverka vilken typ av behandling som du kommer att lottas till.
För att kunna bli aktuell för studien behöver du bland annat:
Intresseanmälan gör du här.
Vi söker studenter som vill arbeta i två olika projekt med OCD och relaterade sjukdomar. Vi söker dig som studerar till psykolog eller läkare och kan arbeta på tim-basis av och till. Intresserad? Hör av dig till christian.ruck@ki.se
Our newest addition is Ingrid Pettersson, medical student from Umeå University, who for her master thesis will study the neurocognition of OCD. This is an extention of our previous work in this area done in collaboration with Valerie Voon, Trevor Robbins and others at Cambridge University that has resulted in the following papers:
We are setting Karolinska Institutet’s Instagram on fire: https://instagram.com/karolinskainstitutet
Christopher LaLima, student at Hofstra in New York, who has worked in our pilot study of iCBT for OCD at Columbia University is now joining us here in Sweden for a year. He will work in our BDD project. Today was his first day at work and it started with some drama: he lost his passport on his way to work and our search and rescue efforts yielded nothing. But there is a happy ending: a very nice person replied to our SOS on Instagram and had heard that the passport had been found in the bus and now Chris has his passport back. Anyway, Chris you are very welcome in our group! (And hold on to you passport).
In a collaboration between Karolinska Institutet and Stockholm University led by Johanna Linde, a pilot study on an acceptance-based approach to BDD has just been published in Behavior Therapy. Highlights included:
These findings need to be confirmed by a controlled study before clinically inplemented.
The usefulness of cases diagnosed in registers for research purposes is dependent on diagnostic validity. This new study aimed to investigate the validity of recorded diagnoses of tic disorders and obsessive-compulsive disorder (OCD) in the Swedish National Patient Register (NPR). 100 tic disorder cases and 100 OCD cases were randomly selected from the NPR based on codes from the International Classification of Diseases (ICD) 8th, 9th and 10th editions, together with 50 epilepsy and 50 depression control cases. The obtained psychiatric records were blindly assessed by 2 senior psychiatrists according to the criteria of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) and ICD-10.
Results Between 1969 and 2009, the NPR included 7286 tic disorder and 24 757 OCD cases. The vast majority (91.3% of tic cases and 80.1% of OCD cases) are coded with the most recent ICD version (ICD-10). For tic disorders, the PPV was high across all ICD versions (PPV=89% in ICD-8, 86% in ICD-9 and 97% in ICD-10). For OCD, only ICD-10 codes had high validity (PPV=91–96%). None of the epilepsy or depression control cases were wrongly diagnosed as having tic disorders or OCD, respectively. Inter-rater reliability was outstanding for both tic disorders (κ=1) and OCD (κ=0.98).
Conclusions The validity and reliability of ICD codes for tic disorders and OCD in the Swedish NPR is generally high. We propose simple algorithms to further increase the confidence in the validity of these codes for epidemiological research.
Read the full text here
Rück C., Larsson K.J., Lind K., Perez-Virgil A., Isomura K., Sariaslan A., Lichtenstein P., Mataix-Cols D. Validity and reliability of chronic tic disorder and obsessive-compulsive disorder diagnoses in the Swedish National Patient Register. BMJ Open. 2015 Jun 22;5(6):e007520. doi: 10.1136/bmjopen-2014-007520
Rücklab - Psychiatry research at Karolinska Institutet 