MHM Magazine

16 | MENTAL HEALTH MATTERS | 2023 | Issue 1 MHM This international study on obsessive- compulsive disorder (OCD) is funded by the National Institutes of Mental Health (NIMH) and is a collaboration between five sites in different countries (U.S.A., Brazil, India, Netherlands and South Africa). In South Africa, this study is conducted at the universities of Cape Town and Stellenbosch respectively, and it has been approved by the respective research ethics committees. The goal of this global study is to identify reproducible brain signatures of adults with OCD. Once identified, we will examine how these brain signatures are linked to behavioural performance on neurocognitive tasks and to a range of clinical profiles that are common to OCD. We also aim to explore how specific environmental features (e.g., childhood trauma, socioeconomic status, and religiosity) may moderate this brain-behaviour relationship. We have now reached our target of 250 participants with OCD and 250 age and sex-matched healthy volunteers. CURRENT RECRUITMENT EFFORTS ARE FOCUSED ON 1) SIBLINGS OF PATIENTS WITH OCD, AND 2) PARTICIPANTS IN THE OPTIONAL TREATMENT COMPONENT: 1. We are now recruiting siblings (brothers and sisters) of individuals with OCD. Several studies have examined the familiarity of OCD, and twin and family studies indicate that OCD aggregates in families, and both genetic and environmental factors are relevant to the etiology of the disorder. It has been suggested that obsessive-compulsive symptoms are common in first- degree relatives of individuals with OCD. The rationale for the addition is that unaffected siblings can be seen as an intermediate group between patients with OCD and HCs, and addition of data from this additional cohort to analysis will likely assist in identifying brain signatures of OCD. Recent MRI work in adult and adolescent patients with OCD and their unaffected siblings have for example, shown that there are similar morphological abnormalities in cortical and subcortical regions of the caudate nucleus, thalamus and the right orbitofrontal cortex in these groups. In addition, both patients with OCD and unaffected siblings, as compared with healthy controls, have shown increased thickness of the right precuneus. The current urgency is to recruit an additional 5 siblings of people that have been diagnosed with OCD before end of April 2023. 2. There also is an optional treatment component to this project; we hope to identify those variables that are associated with response to sertraline in adults with OCD. Treatment entails taking flexible-dose sertraline, a selective serotonin reuptake inhibitor, for 12 weeks. This is not an experimental medicine: it is FDA approved for use in OCD. Sertraline is taken to the maximum recommended or tolerated dose (e.g., increasing the dose gradually, and under supervision of a psychiatrist and psychologist for 12 weeks.) MRIs are done at baseline and at week 12. After that treatment proceeds under naturalistic conditions, i.e., as the patients would ordinarily receive from a typical mental health clinician for weeks 12-52. There are assessments at weeks 2, 4, 8 and 12, as well as 3-monthly follow-ups after these, until month 12. 3. There is scope for the addition of 13 additional patients from Cape Town over the next year. All study procedures including MRI and medication (up to 12 weeks) are cost-free to participants. For more information or to make a referral to this project, please contact Prof Christine Lochner: cl2@sun.ac.za Research Assistants: OCDRSA@sun.ac.za Landline: 021 938 9654 WhatsApp: 076 233 6270 Website: global-ocd.org Facebook: @OCDRSA RECRUITMENT OF PATIENTS AND THEIR SIBLINGS FOR A STUDY ON OCD AND THE BRAIN, TITLED: Identifying Reproducible Brain Signatures of Obsessive-Compulsive Profiles OCD? We are recruiting participants for a study on Obsessive- Compulsive Disorder (OCD) & the brain global-ocd.org 1. People with OCD 2. Brothers & sisters of people with OCD Researchers from Stellenbosch University are inviting: Contact: WhatsApp: 076 233 6270 Landline: 021 938 9179 Email: CL2@sun.ac.za or OCDRSA@sun.ac.za @OCDRSA 2023 Professor Christine Lochner SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University