Biomarkers of Clinical Subtype and Treatment Response in Obsessive-Compulsive Disorder

The purpose of this study is to explore whether non-invasive measures of neural structure, chemistry and physiology in obessive compulsive disorder predict clinical response to pharmacological treatment with serotonin reuptake inhibitors and glutamate modulating agents and to explore whether non-invasive measures of neural structure, chemistry, and physiology distinguish between clinically differentiable subtypes of obsessive-compulsive disorder.

All subjects - Exclusion criteria:

a.Any contraindications to undergoing an MRI scan, including having mental implants or metal fragments in the body (contraindication to MRI, fMRI, and MRS only; subjects may still participate in ERP studies)

b.Any significant neurological or medical problem that may substantially affect CNS function, including epilepsy, stroke, thyroid disease, and poorly controlled hypertension.

c.Any unstable medical condition that may render study procedures unsafe (although all study procedures are sufficiently benign and non-invasive that this is not expected to exclude a substantial number of patients

d.Any history of significant hearing loss

e.Any history of head injury with loss of consciousness for more than 30 minutes

f.Positive urine pregnancy test

g.Active use of illicit substances

h.Active alcohol abuse

i.Primary diagnosis of a psychotic disorder

j.Primary diagnosis of pervasive developmental disorder

k.Active suicidality

Subjects with OCD or OCD symptoms

Inclusion criteria

2.DSM-IV diagnosis of OCD, established by a trained clinician interview and confirmed by SCID-IV administered by trained personnel

3.Y-BOCS score of at least 16 at evaluation or at some point during treatment

Exclusion criteria

1.Past psychosurgery

2.General exclusion criteria, as summarized above

Subjects with other mood and anxiety disorders

Inclusion criteria

1. DSM-IV diagnosis of a mood or anxiety disorder other than OCD, established by a trained clinician interview and confirmed by a SCID-IV administered by trained personnel

Exclusion criteria

1.General exclusion criteria, as summarized above

2.Psychotic depression

3.Manic state

Normal control subjects

Inclusion criteria

1.No significant history of major psychiatric disorder, based on clinician interview and confirmed by SCID-IV, adapted for normal controls, administered by trained personnel

2.No history of significant or prolonged psychotropic medication

Exclusion criteria

1.Significant family history of OCD, major depression, psychotic disorder, bipolar disorder, or suicide

2. General exclusion criteria, as summarized above