AN EXAMINATION OF THE RELATIONSHIP BETWEEN WEIGHT CHANGES AND DRUG TREATMENT IN PATIENTS WITH PROFOUND, REFRACTORY OBSESSIVE COMPULSIVE DISORDER (OCD) TREATED IN A SPECIALISED INPATIENT SERVICE

• Published in: European neuropsychopharmacology Vol. 28; no. 6; p. 782
• Main Authors: Okanlawon, Agnes, White, Sarah Jane, Drummond, Lynne M
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01-06-2018
• ISSN: 0924-977X; 1873-7862
• DOI: 10.1016/j.euroneuro.2017.10.031

The National Inpatient Unit based at South West London and St George’s Mental Health NHS Trust treats people with the most refractory and profoundly severe OCD Symptoms. Previous studies from this Unit noted a high number of individuals had raised blood lipids. In light of this finding, the weight of all patients was regularly monitored throughout their admission. We decided to look at any changes in weight and other factors which may influence this including medication and severity of OCD.
Concern about the health and high lipids discovered amongst patients admitted to our service led to a number of preventative measures. Booklets about healthy living were written and distributed, and both exercise and healthy-eating is promoted by staff. There are regular interventions by a dietician and an exercise therapist. Despite these interventions, a pattern of excess weight gain was still observed in patients, we decided to explore the extent of this weight gain and whether any pattern could be established between this and specific medication regimes.
The electronic records of 217 successive patients admitted in to the National Inpatient Unit for OCD between 2009 and 2016 were examined. BMI, Yale-Brown Obsessive Compulsive scale (Y-BOCs) on admission and discharge, age, sex, use of SSRI’s, dopamine blockers and other augmentation to medication (including drug type and dosage) were recorded into SPSS. Univariate Analysis of variance was used.
Of the 217 patients admitted over the 7 year period 127 of them were males and 90 females. Their ages ranged from 19-71 years with the average age being 40. Mean YBOCS score on admission was 35.21 and on discharge was 23.22 (34% reduction). The mean BMI on admission was 26.25 and on discharge was 26.89. The weight changes were not related to any specific drug. No relationship was found between severity of OCD as measured by YBOCS and the tendency to gain or lose weight. Similarly age and sex did not appear to be predictive factors.
Overall, despite considerable attempts to prevent this, most patients gained weight following admission. Possible causes of this weight gain include the social effect of communal living, the availability of many food outlets in the vicinity and a lack of impulse control in some of these patients. Patients on medication had greater improvements shown in reduction in YBOCS scores, that those not on medication.