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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S303–S364



Duration of untreated illness and

outcome of obsessive-compulsive

disorder: A naturalistic follow-up


V. Prisco

, F. Perris , T. Iannaccone , M. Fabrazzo , F. Catapano

University of Naples SUN, department of psychiatry, Naples, Italy

Corresponding author.

Duration of untreated illness (DUI) is a predictor of outcome

in psychotic and affective disorders. Data available on DUI and

its relationship with outcome in obsessive-compulsive disorder

(OCD) suggest an association between longer DUI and poorer treat-

ment response. The present study investigated socio-demographic

and clinical predictors of DUI and its association with long-term

outcome in OCD patients. Eighty-three OCD outpatients were trea-

ted with serotonin reuptake inhibitors (SRIs) and prospectively

followed-up for 3 years. Baseline information was collected on

demographic and clinical characteristics using standard assess-

ments. Each patient was assessed through the structured clinical

interview for DSM-IV axis I disorders (SCID-I), the structured cli-

nical interview for DSM-IV axis II personality disorders (SCID-II),

the Yale-Brown obsessive–compulsive scale (Y-BOCS) and the 17-

item Hamilton rating scale for depression (HDRS). The DUI was

explored by interviewing patients, family caregivers and clinicians.

OCD subjects had a mean DUI of 7.3 (5.8) years. A younger age at

onset and a greater severity of OCD symptoms at baseline were

associated with a longer DUI. The DUI of patients with a “good out-

come” was shorter than that of patients with a “poor outcome”.

Logistic regression analysis revealed indeed a possible association

between longer DUI and “poor outcome”. In the logistic multi-

variable model, the association of DUI with treatment outcome

held true whilst controlling for socio-demographic and clinical


Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Prevalence and clinical correlates of

sensory phenomena in obsessive

compulsive disorder

S. Rayappa

, A. Hegde , J.C. Narayanaswamy , S.S. Arumugham ,

S. Bada Math , Y.C.J. Reddy

National institute of mental health and neurosciences NMHANS,

psychiartry, Bengaluru, India

Corresponding author.


A substantial number of patients suffering from

obsessive compulsive disorder (OCD) report a subjective distres-

sing experience prior to the repetitive behavior, known as sensory



Need to systematically evaluate SP and the clinical

correlates in OCD.


Assess prevalence of SP and clinical correlates in OCD.


Subjects (


= 71) fulfilling the criteria for DSM IV-TR

OCD were recruited consecutively from a specialty OCD clinic in

Southern India and were assessed using the Yale brown obsessive

and compulsive scale (YBOCS), dimensional Yale-Brown obsessive

compulsive scale (D-YBOCS) and the University of São Paulo Sen-

sory Phenomena Scale (USP-SPS).


The prevalence of the SP was found to be 50.7%. Pre-

valence of SP is significantly greater in the patients with early

age of onset (


= 0.47). In subtypes of SP, Tactile was 12.7%, “just

right” for look was 26.8%, “just right” for sound was 9.9%, “just

right” for feeling was 16.9%, feeling of incompleteness leading

to repetitive behavior was 22.5%, “energy release” sensation lea-

ding to repetitive behavior was 4.2% and “urge only” leading

to repetitive behavior was 11.3%. SP was found to have signi-

ficant correlation with symmetry/ordering/arranging/counting

dimension (


= 0.003). Significant positive correlation existed

between SP severity and the severity of the compulsions



= 0.02).


Considering its high prevalence in OCD, it might be

useful to incorporate SP assessment during the routine clinical

assessment of OCD. It might warrant a place in the phenome-

nological and nosological description of OCD. Additionally, the

neurobiological correlates of SP need to be explored.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Deep brain stimulation and anterior

capsulotomy: The question of


S. Raymaekers

1 ,

, Z. Van Duppen


, K. Demyttenaere


, L. Luyten



L. Gabriels


, B. Nuttin


, C. Bervoets



KU Leuven, psychiatry, Leuven, Belgium


UPC KU Leuven, psychiatry, Leuven, Belgium


KU Leuven, centre for psychology of learning and experimental

psychopathology, Leuven, Belgium


KU Leuven, neurosurgery, Leuven, Belgium

Corresponding author.


In carefully selected treatment-refractory patients

with obsessive compulsive disorder (OCD), deep brain stimulation

(DBS) or anterior capsulotomy (AC) might be considered as a pos-

sible treatment. However, the direct intervention in the brain can

raise questions about autonomy. Dopatients still feel like they are in

control of their actions when their behavior is changed by a surgical



To examine in both AC and DBS patients whether

these intervention influenced perception of autonomy. We aimed

to discover any differences in these perceptions when comparing

AC and DBS patients.


We conducted semi-structured interviews with AC and

DBS patients. Interviews were recorded digitally and transcribed

verbatim. We analyzed interviews in an iterative process based on

grounded theory principles.


We interviewed 10 DBS patients and 6 AC patients.

Sense of agency (the awareness that one is the author of his/her

own actions) did not seem to be diminished by AC or DBS.

However, especially DBS patients are aware of their depen-

dency on a device for their well-being. Another important theme

is authenticity (in how far patients perceive their actions and

thoughts as matching their self-concept). Feelings of authenti-

city can be disturbed especially in cases of induced hypomania

(for DBS) or apathy (for AC). OCD itself also has an impact on

autonomy as patients describe a lack of freedom due to their



Despite extensive changes in emotions, behavior and

even personal identity after DBS or AC surgery, perceived autonomy

was not greatly altered in these OCD patients.

Disclosure of interest

Medtronic provided grants for research,

education, and traveling to B. Nuttin and L. Gabriëls, who hold

the Medtronic Chair for Stereotactic Neurosurgery in Psychiatric

Disorders at KU Leuven. S. Raymaekers is supported by this Chair.

B. Nuttin co-owns a patent on DBS in OCD.