{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T09:27:35Z","timestamp":1792315655949,"version":"4.4.0"},"reference-count":52,"publisher":"Royal College of Psychiatrists","issue":"4","license":[{"start":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T00:00:00Z","timestamp":1747267200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec id=\"S000712502500087X_as1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Selective serotonin reuptake inhibitors (SSRIs) are the preferred pharmacological treatment for obsessive\u2013compulsive disorder (OCD). However, insufficient response is common and it remains unclear whether specific patient-level factors influence the likelihood of treatment response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S000712502500087X_as2\">\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To determine the efficacy and acceptability of SSRIs in adult OCD, and to identify patient-level modifiers of efficacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S000712502500087X_as3\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an individual patient data meta-analysis (IPDMA) of industry-sponsored short-term, randomised, placebo-controlled SSRI trials submitted for approval to the Dutch regulatory agency to obtain marketing approval for treating OCD in adults. We performed a two-stage meta-analysis, using crude data of available trials. The primary outcome was the difference in Yale\u2013Brown Obsessive\u2013Compulsive Scale (YBOCS) change between active treatment and placebo. Secondary outcomes were differences in response (defined as the odds ratio of \u226535% YBOCS point reduction) and acceptability (defined as the odds ratio for all-cause discontinuation). We examined the modifying effect of baseline characteristics: age, gender, illness severity, depressive symptoms, weight, illness duration and history of antidepressant use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S000712502500087X_as4\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After excluding three trials because of missing data, we analysed results from 11 trials (79% of all submitted trials,\n                      <jats:italic>n<\/jats:italic>\n                      = 2372). The trial duration ranged from 10 to 13 weeks. Mean difference of SSRIs relative to placebo was 2.65 YBOCS points (95% CI 1.85\u20133.46,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.0001), equalling a small effect size (0.33 Hedges\u2019\n                      <jats:italic>g<\/jats:italic>\n                      ). The odds ratio for response was 2.21 in favour of active treatment (95% CI 1.72\u20132.83,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.0001), with a number needed to treat of seven. Patient characteristics did not modify symptom change or response. Acceptability was comparable for SSRIs and placebo.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S000712502500087X_as5\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our IPDMA showed that SSRIs are well accepted and superior to placebo for treating OCD. The effects are modest and independent of baseline patient characteristics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1192\/bjp.2025.87","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T02:03:44Z","timestamp":1747274624000},"page":"680-687","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":10,"title":["Individual patient data meta-analysis of placebo-controlled trials of selective serotonin reuptake inhibitors submitted for regulatory approval in adult obsessive\u2013compulsive disorder"],"prefix":"10.1192","volume":"227","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9733-6146","authenticated-orcid":false,"given":"Sem E.","family":"Cohen","sequence":"first","affiliation":[{"name":"Amsterdam UMC"},{"name":"Amsterdam Neuroscience Research 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2025. Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial licence (https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original article is properly cited. The written permission of Cambridge University Press must be obtained prior to any commercial use.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}