Are there neuropsychological predictors for response and nonresponse in first-episode drug naïve patients with OCD? A 12 weeks interventional study

Abstract

Background: Obsessive–compulsive disorder (OCD) is a common, chronic debilitating disorder. A detailed neuropsychological assessment at baseline might help us to identify the various neuropsychological predictors for response and nonresponse. Aim: The identification of neuropsychological predictors for response and nonresponse in patients with OCD. Materials and Methods: Patients with a diagnosis of OCD (Diagnostic and Statistical Manual 5th edition), first episode, and treatment naïve were evaluated for neuropsychological functioning with the National Institute of Mental Health and Neurosciences Neuropsychological Battery-2004, and the severity of OCD on the Yale-Brown Obsessive–Compulsive Scale (YBOCS). After baseline assessment, patients received either sertraline or fluvoxamine at a maximum tolerable therapeutic dose and were reassessed after 12 weeks for a response. Results: A total of 50 patients (25 in sertraline and 25 in the fluvoxamine group) were included in the 12 weeks study. The majority of the patients had adequate baseline neuropsychological functioning except for inadequacy in the category and verbal fluency, and the mean baseline total Y-BOCS score was 23.48 (standard deviation = 6.29). Out of 50 patients, 36 (72%) patients showed a response to the treatment. The correlation analysis showed that except for the N-1 hits variable, in the Verbal N Back test for working memory, which correlated significantly with a reduction in YBOCS score across 12 weeks, none of the other neuropsychological domain scores were correlated with the outcome. Conclusion: The index study concludes that working memory is significantly correlated with the response at 12 weeks. However, there are no other neuropsychological predictors for response and nonresponse in patients with OCD.