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Although the pathophysiology of\n                      <jats:styled-content style=\"fixed-case\">OCD<\/jats:styled-content>\n                      remains unknown, pathways involved in oxidative and nitrosative stress (O&amp;\n                      <jats:styled-content style=\"fixed-case\">NS<\/jats:styled-content>\n                      ) have been implicated. The present study aims to systematically review the literature for quantitative evidence that patients with\n                      <jats:styled-content style=\"fixed-case\">OCD<\/jats:styled-content>\n                      have altered measures of blood O&amp;\n                      <jats:styled-content style=\"fixed-case\">NS<\/jats:styled-content>\n                      markers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Independent random\u2010effects meta\u2010analyses using standardized mean differences were conducted to assess each marker separately. Additionally, data from multiple markers were pooled together in a meta\u2010analysis for measures of oxidant activity and another for measures of antioxidant activity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirteen studies met inclusion criteria, involving 433\n                      <jats:styled-content style=\"fixed-case\">OCD<\/jats:styled-content>\n                      patients and 459 controls. Eleven blood O&amp;\n                      <jats:styled-content style=\"fixed-case\">NS<\/jats:styled-content>\n                      markers were eligible for independent quantitative analyses. We found that, in\n                      <jats:styled-content style=\"fixed-case\">OCD<\/jats:styled-content>\n                      patients, the oxidant markers 8\u2010hydroxydeoxyguanosine and malondialdehyde, and the antioxidants glutathione peroxidase and superoxide dismutase, were significantly increased while total antioxidant status, vitamin C, and vitamin E were significantly decreased, when comparing with controls. Regarding pooled meta\u2010analyses, we found a statistically significant increase in oxidant markers, but non\u2010significant results regarding antioxidant markers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Our meta\u2010analysis suggests that\n                      <jats:styled-content style=\"fixed-case\">OCD<\/jats:styled-content>\n                      patients have a systemic oxidative imbalance that is not adequately buffered by the antioxidant system. Additional studies are needed in order to support this association.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acps.13026","type":"journal-article","created":{"date-parts":[[2019,3,15]],"date-time":"2019-03-15T04:22:41Z","timestamp":1552623761000},"page":"420-433","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":66,"title":["Oxidative and nitrosative stress markers in obsessive\u2013compulsive disorder: a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"139","author":[{"given":"A.","family":"Maia","sequence":"first","affiliation":[{"name":"Champalimaud Research and Clinical Centre Champalimaud Centre for the Unknown Lisboa Portugal"},{"name":"Department of Psychiatry and Mental Health Centro Hospitalar de Lisboa Ocidental Lisboa Portugal"},{"name":"NOVA Medical School|Faculdade de Ci\u00eancias M\u00e9dicas Universidade Nova de Lisboa Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3475-4794","authenticated-orcid":false,"given":"J.","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Champalimaud Research and Clinical Centre Champalimaud Centre for the Unknown Lisboa Portugal"},{"name":"NOVA Medical School|Faculdade de Ci\u00eancias M\u00e9dicas Universidade Nova de Lisboa Lisboa Portugal"},{"name":"Centro Hospitalar Psiqui\u00e1trico de Lisboa Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Lajnef","sequence":"additional","affiliation":[{"name":"INSERM U955 Translational Psychiatry Universit\u00e9 Paris\u2010Est\u2010Cr\u00e9teil Cr\u00e9teil France"},{"name":"Fondation Fondamental Cr\u00e9teil France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Mallet","sequence":"additional","affiliation":[{"name":"Fondation Fondamental Cr\u00e9teil France"},{"name":"CNRS INSERM Institut du cerveau et de la moelle \u00e9pini\u00e8re Sorbonne Universit\u00e9s UPMC Univ Paris 06 Paris France"},{"name":"Assistance Publique\u2010H\u00f4pitaux de Paris P\u00f4le de psychiatrie H\u00f4pitaux Universitaires Henri Mondor \u2013 Albert Chenevier Universit\u00e9 Paris\u2010Est Cr\u00e9teil Cr\u00e9teil France"},{"name":"Department of Mental Health and Psychiatry Global Health Institute University of Geneva Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3992-9565","authenticated-orcid":false,"given":"R.","family":"Tamouza","sequence":"additional","affiliation":[{"name":"Fondation Fondamental Cr\u00e9teil France"},{"name":"Assistance Publique\u2010H\u00f4pitaux de Paris P\u00f4le de psychiatrie H\u00f4pitaux Universitaires Henri Mondor \u2013 Albert Chenevier Universit\u00e9 Paris\u2010Est Cr\u00e9teil Cr\u00e9teil France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Leboyer","sequence":"additional","affiliation":[{"name":"INSERM U955 Translational Psychiatry Universit\u00e9 Paris\u2010Est\u2010Cr\u00e9teil Cr\u00e9teil France"},{"name":"Fondation Fondamental Cr\u00e9teil France"},{"name":"Assistance Publique\u2010H\u00f4pitaux de Paris P\u00f4le de psychiatrie H\u00f4pitaux Universitaires Henri Mondor \u2013 Albert Chenevier Universit\u00e9 Paris\u2010Est Cr\u00e9teil Cr\u00e9teil France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5071-3007","authenticated-orcid":false,"given":"A. 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