One explanation because of this obvious association may be that sufferers presenting an increased hereditary risk for OCD could possibly be more susceptible to developing the disorder whenever a SLE occurs. capability for treatment response was discovered. The very best predictor for treatment response was age group, agreeing with prior literature particular for SRI treatment. Recommendations are made around the possible role of neuroplasticity as a mediator on this association. PRS significantly predicted OCD severity impartial on pharmacological treatment. SLE at onset modulation role was not evidenced. Further research is needed to elucidate the genetic and environmental bases of treatment response in OCD. Background Obsessive-Compulsive Disorder (OCD) is usually a complex neuropsychiatric condition that may interfere severely in the patients life and lead to maladaptive behavior1,2. Lifetime prevalence of the disorder is usually 2C3%3. Treatment usually consists of medication and cognitive-behavioral therapy, as recommended in OCD clinical guidelines4. Selective serotonin reuptake inhibitors (SSRIs) comprise the first-line pharmacological treatment for OCD. However, treatment response is usually variable, with the proportion of OCD patients that improve with pharmacological treatment oscillating between 40 and 70%, and in some cases only a partial response is usually obtained5. Non-responders may be treated with another SSRI6, with antipsychotics as adjunctive treatment7, or clomipramine either as monotherapy or as a coadjuvant8. Several studies have examined the genetic and environmental factors associated with treatment response in OCD. Genetic variants in catecholaminergic (and (a gene involved in neuroproliferation and neuroplasticity) genes36. In addition, a gene associated with the catecholamine system (and SLEs at onset of the disorder12. However, none of these studies has made use of a PRS. Given the above, the objective of this study Modafinil was to analyze how genes influence treatment response in OCD, and how this influence may be modulated by certain environmental conditions. We hypothesized that a PRS built for OCD would predict treatment response to SRIs and that this association would be modulated by SLEs at onset of the disorder. Methods Subjects Our study sample comprised 103 Spanish Caucasian patients (46 females; mean age 33.23??9.66) recruited from the OCD clinic at Bellvitge Hospital (Barcelona, Spain). All participants met the DSM-IV criteria for OCD diagnosis38, with a duration of at least one year. Diagnoses were independently assigned by two psychiatrists with extensive clinical experience in OCD, each of whom interviewed the patients separately using the Structured Clinical Interview for DSM-IV Axis I Disorders-Clinician Version (SCIDCV)39. Patients were offered treatment at our clinic with a SRI (SSRI or clomipramine), considering their history of previous medication and preference. Maximum recommended doses were administered to the patients for a minimum period of 12 weeks. Exclusion criteria consisted of presenting psychoactive substance abuse/dependence (either current or in the past six months), psychotic disorders, intellectual disability, severe organic or neurological pathology except tic disorder, and autism spectrum disorder. Other affective and stress disorders were not considered criteria for exclusion if OCD was the main diagnosis. After receiving a full Rabbit Polyclonal to PDCD4 (phospho-Ser457) description of the study, patients were required to give their written Modafinil informed consent. This study was performed in accordance with the Helsinki Declaration of the World Medical Association, and approved by the Ethical Committees of Bellvitge Hospital. Clinical assessment Participants sociodemographic and clinical characteristics and medical data were collected in structured interviews during their first visit to our unit. Age at onset was defined as the moment when obsessive symptoms reached a clinically significant level. Baseline severity of the obsessive and compulsive symptoms was assessed through the clinician-administered version of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS)40. The presence of obsessive/compulsive dimensions in the worst-ever period of the disorder was evaluated using the DY-BOCS scale41. Family psychiatric history was coded in percentages for each category, considering solely family members who had received a formal diagnosis. Treatment response Treatment response was assessed by means of a Modafinil clinician-administered version of the Y-BOCS40. Patients were assessed twice: at baseline and after 12 weeks at maximum tolerated SRI doses, in both cases analyzing the severity of obsessive and compulsive symptoms. Stressful life event assessment Life stress at onset of the disorder was analyzed using the methodology described in Real et al.12. In face-to-face interviews, patients were asked whether they could identify a SLE in the year prior to the onset of the disorder. Patients reporting a SLE at onset were assigned to the SLE-preceded OCD.