Fri. Oct 11, 2019 8:40 AM - 10:20 AM Room 14 (Palace Room A)

Organizer / Chair: Hisato MATSUNAGA (Department of Neuropsychiatry, Hyogo College of Medicine, Japan), Co-chair: Tomohiro NAKAO (Department of Neuropsychiatry, Graduate School of Medicasl Sciences, Kyushu University, Japan), Discussants: ‌Takashi NAKAMAE (Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Japan), Eiji SHIMIZU (Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Japan)

Obsessive-compulsive disorder (OCD) is a relatively common and frequently debilitating neuropsychiatric disorder that affects approximately 2% of the general population. OCD is characterized by intrusive and unwanted obsessions and compulsions, and by a waxing and waning course of symptoms that rarely remit.
Standardized treatments for OCD, including drugs (e.g., selective serotonin reuptake inhibitors; (SSRIs)) and cognitive-behavioral therapy (CBT), are well established and used worldwide. However, the effectiveness of current OCD pharmacotherapy is limited. To optimize this type of therapy, cross-sectional or longitudinal evaluations of individuals with OCD are needed, which focus on comprehensive psychopathological features such as primary or secondary comorbid disorders (e.g., tic-related-OCD, major depression), antecedent traumatic events, and the brain mechanisms that mediate temporal transitions, according to the duration of untreated illness or the chronic course of OCD. These clinical factors should be taken into account in developing an adequate treatment regimen for OCD patients who show insufficient responses to the standardized pharmacotherapy for OCD.
DSM-5 categorizes OCD as an obsessive-compulsive and related disorder (OCRD), based on the concept of an obsessive-compulsive spectrum. Among OCRDs, hoarding disorder, which is frequently comorbid with OCD, has been characterized as a treatment refractory disorder; the neurobiological mechanism of the disorder still remains to be elucidated. Thus, comorbidity of hoarding disorder or hoarding symptoms may also be associated with treatment resistance in patients with OCD.
Therefore, it may be crucial to consider such cross-sectional heterogeneity of OCD or OCRDs to fully understand the biological mechanisms underlying these disorders, and to develop more effective treatment strategies (including novel treatment approaches such as adaptation to neuromodulation).
In our symposium, we will discuss tic-related and trauma-related OCD and hoarding disorder, focusing particularly on novel treatment strategies based on the advanced understanding of each condition’s neurobiological mechanisms. We will also discuss neuromodulation as a possible treatment option for treatment-refractory patients with OCD or OCRD.