Table 1.

Examples of clinical factors potentially linked to obsessive-compulsive disorder (OCD) treatment-refractory responses

Eventual OCD clinical features contributing to OCD refractory response toward SRI antidepressants	Assessment	Sample references by first author and year
Poor-insight feature, global severity of OCD	Clinical interview/BABS/Y-BOCS	Ravi Kishore 2004 [28]; Goodman 1989 [20]
Age at onset, familial history, duration of untreated illness and other sociodemographic features	Clinical interview/SCID-I demographics	First 1997 [18]; Fornaro 2009 [7]
Axis-I comorbidities (for example, MDD/other anxiety disorders)	Clinical interview/SCID-I/HAM-D/HAM-A	First 1997 [18]; Fornaro 2009 [7]; Hamilton 1960 [21]; Hamilton 1959 [22]
Temperamental/personality traits	Clinical interview/TEMPS-A	Hantouche 2003 [29]; Akiskal 2005 [25]
Medical comorbidities, including those affecting the cognitive status	Clinical interview/specific assessment	Fornaro 2009 [7]
Impaired circadian rhythms?	BRIAN	Giglio 2009a [23]

^aFurther clinical features may predict treatment-refractory response to SRIs among OCD patients; while the chance of response tends to reduce with increase of total comorbidities and higher severity of illness, the eventual impact of some features as impairment of circadian rhythm still needs further assessment.

BABS = Brown Assessment of Beliefs Scale; BRIAN = Biological Rhythms Interview of Assessment in Neuropsychiatry; HAM-A/D = Hamilton Scale for Anxiety/Depression; MDD = major depressive disorder; SCID-I = Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) Axis-I; SRI = serotonin reuptake inhibitor; TEMPS-A = Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego lifetime Autoquestionnaire; Y-BOCS = Yale-Brown Obsessive Compulsive Scale.