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C48H32N10O4Zn, monoclinic, P21/c (no. 14), a = 18.661(7) Å, b = 12.003(4) Å, c = 21.043(8) Å, β = 111.632(4)°, V = 4381(3) Å3, Z = 4, Rgt(F) = 0.0539, wRref(F2) = 0.1210, T = 293 K.

C48H32N10O4Zn, monoclinic, P21/ c (no. 14), a = 18.661(7) Å, b = 12.003(4) Å, c = 21.043(8) Å, β = 111.632(4)°, V = 4381(3) Å3, Z = 4, Rgt (F) = 0.0539, wRref (F2) = 0.1210, T = 293 K. [ABSTRACT FROM AUTHOR]

Objectives: Obsessive-compulsive disorder (OCD) is a chronic and refractory mental disorder with early onset, low response rate, and poor prognosis. Studies have shown that the age of onset, severity, course of disease, and untreated course of disease may affect its clinical efficacy. At present, there are few studies on the duration of untreated illness (DUI) of OCD patients. The current medical status and untreated course of OCD patients in China are still unclear. This study aims to investigate the current medical status of OCD patients in psychiatric outpatients of a general hospital, including the course of disease and DUI as well as its influencing factors., Methods: A total of 310 outpatients with OCD who visited the Department of Mental Health, Guangdong Provincial People's Hospital for the first time, were recruited and interviewed. The information including age, gender, years of education, marital status, work status, age of onset, comorbid mental disorders, age of first treatment, course of disease, and DUI were collected. We also calculated the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and Global Assessment Function (GAF) scores for total sample to analyze the demographic characteristics and clinical data of patients with OCT. The median DUI was used as the cut-off value, and the patients were divided into a short DUI group and a long DUI group. The differences in demographic characteristics and clinical data between the 2 groups were compared, and the factors affecting the DUI were analyzed., Results: There were 158 males (51%) and 152 females (49%). The age of onset was (19.48±7.97) years. The years of education were 13.49±3.13; 215 (69.4%) were single and 95 (30.6%) were married; 103 (33.2%) were employed and 207 (66.8%) were unemployed. The median course of OCD was 4 years and the median DUI was 3 years. There were 177 cases in the short DUI (≤3 years) group and 133 cases in the long DUI (>3 years) group. Compared with the long DUI group, the patients in the short DUI group were younger ( P <0.01); they had mild obsessive-compulsive symptoms ( P <0.05) and a shorter education period and course of disease ( P <0.01 and P <0.001, respectively); and they were more unemployed and single (both P <0.001). Correlation analysis showed that DUI was positively correlated with age, course of disease, years of education, and Y-BOCS score ( r =0.45, P <0.001; r =0.74, P <0.001; r =0.27, P <0.001; r =0.17, P <0.01). When the DUI of OCD patients was used as the dependent variable, Y-BOCS, age, course of disease, whether to work, marital status, and years of education were used as the independent variables for binary logistic regression analysis, which showed that the duration of illness could predict the short and long DUI of OCD [Wald χ 2 =49.78, Exp( B )=1.34, P <0.001]., Conclusions: Investigation for the medical status of OCD patients in the psychiatric outpatients of a general hospital in Guangdong, China shows that the duration of illness of OCD patients in the psychiatric outpatients and the DUI of OCD patients are generally shorter than previous foreign reports. The DUI of OCD patients is affected by the course of disease, age, severity of symptoms, and other factors. In the future, large sample, multi-center, and follow-up studies could be considered to further explore the influencing factors for the DUI of OCD and the impact on the prognosis of the disease, to help improve the status of delayed treatment for OCD and improve the effective rate of OCD treatment.

Objectives: To investigate the neurobiochemical characteristics of the anterior cingulate cortex (ACC) in patients with obsessive-compulsive disorder (OCD) comorbid skin-picking disorder (SPD), and to provide reference for the pathophysiological basis for OCD., Methods: We examined the levels of glutamate and other neurochemicals in ACC of 30 adult OCD patients (13 with comorbid SPD, 17 without SPD), using proton magnetic resonance spectroscopy ( 1 H-MRS) at 3T. The clinical evaluation and the quantitative analysis of metabolites were carried out in the two groups., Results: OCD patients with comorbid SPD showed significantly lower ACC glutamate than the patients without SPD ( P =0.001). In all OCD patients, glutamate was negatively correlated with scores of Hamilton Anxiety Rating Scale ( r =-0.55, P =0.002). Moreover, the ACC glutamate of female patients was correlated with the total score of Yale-Brown Obsessive Compulsive Scale ( r =0.69, P =0.041) in the OCD with comorbid SPD patients., Conclusions: Alterations of the glutamate content in the ACC are involved in the pathophysiological process of OCD with comorbid SPD, which provides evidence for the study on the pathogenesis of OCD and SPD.

Objective: To observe the clinical efficacy of dopamine modulator methylphenidate (MPH) of extended-release formulations (MPH-ER) augmentation of ongoing fluvoxamine treatment in refractory obsessive-compulsive disorder (OCD) and its effects on patient's anxiety and sleep quality.
 Methods: A pilot randomized, placebo-controlled, and double-blind trial was conducted at an outpatient, single-center academic setting. Participants included 44 adults with serotonin reuptake inhibitor treatment-refractory OCD and they received a stable fluvoxamine pharmacotherapy with Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores higher than 20. The 44 patients were randomly assigned into a study group and a control group, with 22 patiencs in each group. Fluvoxamine and MPH-ER were given to the study group, while fluvoxamine and placebo were given to the control group, with 8 weeks of the treatment course. Y-BOCS, Hamilton Anxiety Scale (HAMA) were used to assess the efficacy, Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality, and Treatment Emergent Symptom Scale (TESS) was used to evaluate the side effects. Data were analyzed in the intention-to-treat sample.
 Results: The improvement in the Y-BOCS total score, Y-BOCS obsession subscale score and HAMA score were more prominent in the study group than those in the control group (P<0.001). There was no significant difference in PSQI score and TESS score between the two groups. MPH-ER was well tolerated.
 Conclusion: Fluvoxamine combined with MPH-ER is effective in the treatment of refractory obsessive-compulsive disorder. It can improve anxiety and has no adverse effect on sleep quality.