TREATMENT OF OBSESSIVE-COMPULSIVE SPECTRUM DISORDERS WITH SSRIS

Background Obsessive-compulsive spectrum disorders (OCSDs) are now rec ognised as distinct diagnostic entities related to obsessive - compuls ive disorder (OCD). The features of OCSDs and OCD overlap in many resp ects including demographics, repetitive intrusive thoughts or behaviou rs, comorbidity, aetiology and preferential response to anti-obsession al drugs such as the selective serotonin reuptake inhibitors (SSRIs). Method Literature was reviewed and preliminary data from various studi es were re-examined to assess the relation ship between compulsivity a nd impulsivity, and between OCD and OCSDs. Results OCSDs include both compulsive and impulsive disorders and these can be viewed as lying at opposite ends of the dimension of risk avoidance. Compulsiveness is a ssociated with increased frontal lobe activity and increased serotoner gic activity, while impulsiveness is associated with reduced activity of these variables. Neural circuits affected by serotonergic pathways have been identified and pharmacological challenge of OCSD patients wi th serotonin receptor agonists have supported the involvement of serot onergic processes. Conclusions SSRIs such as fluvoxamine have establis hed efficacy in OCD and preliminary studies indicate that they are als o effective in OCSDs. The features of three specimen OCSDs body dysmor phic disorder, pathological gambling and autism - and their treatment with SSRIs are reviewed.