Ruscio AM, Stein DJ, Chiu WT, Kessler RC. The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Mol Psychiatry. 2010;15:53-63.

Fontenelle LF, Mendlowicz MV, Versiani M. The descriptive epidemiology of obsessive-compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry. 2006;30:327-37.

Frank E, Prien RF, Jarrett RB, Keller MB, Kupfer DJ, Lavori PW. Conceptualization and rationale for consensus definitions of terms in major depressive disorder: Remission, recovery, relapse, and recurrence. Arch Gen Psychiatry. 1991;48:851-5.

Ferrão YA, Fontenelle LF. Discussing resistant and refractory cases in psychiatry. Rev Bras Psiquiatr. 2007;29(^s2):S39-40.

de Haan E, van Oppen P, van Balkom AJ, Spinhoven P, Hoogduin KA, Van Dyck R. Prediction of outcome and early vs. late improvement in OCD patients treated with cognitive behaviour therapy and pharmacotherapy. Acta Psychiatr Scand. 1997;96:354-61.

Rasmussen SA, Eisen JL. Treatment strategies for chronic and refractory obsessive-compulsive disorder. J Clin Psychiatry. 1997;58(^s13):9-13.

Goodman WK, Price LH. Assessment of severity and change in obsessive compulsive disorder. Psychiatr Clin North Am. 1992;15:861-9.

Goodman WK, Price LH, Delgado PL, Palumbo J, Krystal JH, Nagy LM. Specificity of serotonin reuptake inhibitors in the treatment of obsessive-compulsive disorder: Comparison of fluvoxamine and desipramine. Arch Gen Psychiatry. 1990;47:577-85.

Simpson HB, Huppert JD, Petkova E, Foa EB, Liebowitz MR. Response versus remission in obsessive-compulsive disorder. J Clin Psychiatry. 2006;67:269-76.

Mavissakalian M, Turner SM, Michelson L, Jacob R. Tricyclic antidepressants in obsessive-compulsive disorder: antiobsessional or antidepressant agents?. II. Am J Psychiatry. 1985;142:572-6.

Tolin DF, Abramowitz JS, Diefenbach GJ. Defining response in clinical trials for obsessive-compulsive disorder: a signal detection analysis of the Yale-Brown Obsessive Compulsive Scale. J Clin Psychiatry. 2005;66:1549-57.

Pallanti S, Hollander E, Bienstock C, Koran L, Leckman J, Marazziti D. Treatment non-response in OCD: methodological issues and operational definitions. Int J Neuropsychopharmacol. 2002;5:181-91.

Jenike MA, Rauch SL. Managing the patient with treatment-resistant obsessive compulsive disorder: current strategies. J Clin Psychiatry. 1994;55:11-7.

Hounie AG, Brotto SA, Diniz J, Chacon PJ, Miguel EC. Transtorno obsessivo-compulsivo: possíveis subtipos. Rev Bras Psiquiatr. 2001;23(^sII):13-6.

Robins LN, Helzer JE, Weissman MM, Orvaschel H, Gruenberg E, Burke JD-Jr. Lifetime prevalence of specific psychiatric disorders in three sites. Arch Gen Psychiatry. 1984;41:959-67.

Boschen MJ, Drummond LM, Pillay A, Morton K. Predicting outcome of treatment for severe, treatment resistant OCD in inpatient and community settings. J Behav Ther Exp Psychiatry. 2010;41:90-5.

Ferrão YA, Shavitt RG, Bedin NR, de Mathis ME, Carlos Lopes A, Fontenelle LF. Clinical features of refractory obsessive compulsive patients. J Affective Disord. 2006;94:199-209.

Matsunaga H, Hayashida K, Kiriike N, Nagata T, Stein DJ. Clinical features and treatment characteristics of compulsive hoarding in Japanese patients with obsessive-compulsive disorder. CNS Spectr. 2010;15:231-6.

Philips KA, McElroy SL. Insight, overvalued ideas and delusional thinking in body dysmorphic disorder: theoretical and treatment implications. J Nerv Ment Dis. 1993;181:699-702.

Neziroglu FA, Yaryura-Tobias JA. Exposure, response prevention, and cognitive therapy in the treatment of body dysmorphic disorder. Behav Ther. 1993;24:431-8.

Foa EB. Failures in treating obsessive-compulsives. Behav Res Ther. 1979;17:169-76.

Abel JL. Exposure and response prevention and serotonergic antidepressants in the treatment of obsessive-compulsive disorder: a review and implications for interdisciplinary treatment. Behav Res Ther. 1993;31:463-78.

Neziroglu FA, Stevens KP, Yaryura Tobias JA. Overvalued ideas and their impact on treatment outcome. Rev Bras Psiquiatr. 1999;21:209-16.

Pace SM, Thwaites R, Freeston MH. Exploring the role of external criticism in obsessive compulsive disorder: a narrative review. Clin Psychol Rev. 2011;31:361-70.

Chambless DL, Blake KD, Simmons RA. Attributions for relatives' behavior and perceived criticism: studies with community participants and patients with anxiety disorders. Behav Ther. 2010;41:388-400.

Eisen JL, Phillips KA, Baer L, Beer DA, Atala KD, Rasmussen AS. The Brown Assessment of Beliefs Scale (BABS): reliability and validity. Am J Psychiatry. 1998;155:102-8.

Corchs F, Corregiari F, Ferrão YA, Takakura T, Mathis ME, Lopes AC. Personality traits and treatment outcome in obsessive-compulsive disorder. Rev Bras Psiquiatr. 2008;30:246-50.

Baer L, Jenike MA. Personality disorders in obsessive compulsive disorder. Psychiatr Clin North Am. 1992;15:803-12.

Moritz S, Fricke S, Jacobsen D, Kloss M, Wein C, Rufer M. Positive schizotypal symptoms predict treatment outcome in obsessive-compulsive disorder. Behav Res Ther. 2004;42:217-27.

McDougle CJ, Goodman WK, Leckman JF, Lee NC, Heninger GR, Price LH. Haloperidol addition in fluvoxamine-refractory obsessive-compulsive disorder: a double blind, placebo controlled study in patients with and without tics. Arch Gen Psychiatry. 1994;51:302-8.

Ackerman DL, Greenland S, Bystrystky A, Morgenstern H, Katz RJ. Predictors of treatment response in obsessive-compulsive disorder: multivariate analyses from a multicenter trial of clomipramine. J Clin Psychopharmacol. 1994;14:247-54.

Fontenelle L, Marques C, Versiani M. The effect of gender on the clinical features and therapeutic response in obsessive-compulsive disorder. Rev Bras Psiquiatr. 2002;24:7-11.

Ackerman DL, Greenland S, Bystritsky A. Side effects as predictors of drug response in obsessive-compulsive disorder. J Clin Psychopharmacol. 1999;19:459-65.

Alarcon RD, Libb JW, Spitler D. A predictive study of obsessive compulsive disorder response to clomipramine. J Clin Psychopharmacol. 1993;13:210-3.

Ravizza L, Barzega G, Bellino S, Bogetto F, Maina G. Predictors of drug treatment response in obsessive-compulsive disorder. J Clin Psychiatry. 1995;56:368-73.

Ferrão YA, Diniz JB, Lopes AC, Shavitt RG, Greenberg B, Miguel E. Resistance and refractoriness in obsessive-compulsive disorder. Rev Bras Psiquiatr. 2007;29(^s2):S66-76.

Calvocoressi L, Lewis B, Harris M, Trufan S, Goodman WK, McDougle CJ. Family accommodation in obsessive-compulsive disorder. Am J Psychiatry. 1995;152:441-3.

Calvocoressi L, Mazure C, Kasl S, Skolnick J, Fisk D, Vegso SJ. Family accommodation of obsessive-compulsive symptoms: instrument development and assessment of family behavior. J Nerv Mental Dis. 1999;187:636-642.

Steketee G, Van Noppen B. Family approaches to treatment for obsessive compulsive disorder. Rev Bras Psiquiatr. 2003;25:43-50.

Steketee G, Lam JN, Chambless DL, Rodebaugh TL, McCullouch CE. Effects of perceived criticism on anxiety and depression during behavioral treatment. Behav Res Ther. 2007;45:11-9.

Chambless DL, Steketee G. Expressed emotion and behavior therapy outcome: A prospective study with obsessive-compulsive and agoraphobic patients. J Consult Clin Psychol. 1999;67:658-65.

Emmelkamp PM, Hoekstra RJ, Visser A. The behavioral treatment of obsessive-compulsive disorder: prediction of outcome at 3,5 years follow-up. Psychiatry: the state of the art. 1985:265-70.

Greenberg BD, Pinto A, Mancebo M, Eisen J, Rasmussen SA. Obsessive-compulsive disorder: recognition across medical settings, and treatments from behavior therapy to neurosurgery. Med Health R I.. 2006;89:162-5.

Koran L. Quality of life in obsessive-compulsive disorder. Psychiatr Clin North Am. 2000;23:509-17.

Volpato Cordioli A, Heldt E, Braga Bochi D, Margis R, Basso de Sousa M, Fonseca Tonello J. Cognitive-behavioral group therapy in obsessive-compulsive disorder: a randomized clinical trial. Psychother Psychosom. 2003;72:211-6.

Baer L, Minichiello WE. Internet assessment of obsessive compulsive disorder. J Clin Psychiatry. 2006;67.

Marques L, LeBlanc NJ, Weingarden HM, Timpano KR, Jenike M, Wilhelm S. Barriers to treatment and service utilization in an internet sample of individuals with obsessive-compulsive symptoms. Depress Anxiety. 2010;27:470-5.

Torres AR, Prince MJ, Bebbington PE, Bhugra DK, Brugha TS, Farrell M. Treatment seeking by individuals with obsessive-compulsive disorder from the British Psychiatric Morbidity Survey of 2000 psychiatric services. Psychiatr Serv. 2007;58:977-82.

Ninan PT, Koran LM, Kiev A, Davidson JR, Rasmussen SA, Zajecka JM. High-dose sertraline strategy for nonresponders to acute treatment for obsessive-compulsive disorder: a multicenter double-blind trial. J Clin Psychiatry. 2006;67:15-22.

Pampaloni I, Sivakumaran T, Hawley CJ, Al Allaq A, Farrow J, Nelson S. High-dose selective serotonin reuptake inhibitors in OCD: a systematic retrospective case notes survey. J Psychopharmacol. 2010;24:1439-45.

Koran LM, Sallee FR, Pallanti S. Rapid benefit of intravenous pulse loading of clomipramine in obsessive-compulsive disorder. Am J Psychiatry. 1997;154:396-401.

Obsessive-compulsive disorder: core interventions in the treatment of obsessive-compulsive disorder and body dysmorphic disorder. National Collaborating Centre for Mental Health. 2006.

Kochan LD, Qureshi AI, Fallon BA. Therapeutic approaches to the treatment of refractory obsessive-compulsive disorder. Curr Psychiatry Rep. 2000;2:327-34.

Ravindran LN, Stein MB. The pharmacologic treatment of anxiety disorders: a review of progress. J Clin Psychiatry. 2010;71:839-54.

Pallanti S, Quercioli L, Koran LM. Citalopram intravenous infusion in resistant obsessive-compulsive disorder: an open trial. J Clin Psychiatry. 2002;63:796-801.

Dell'Osso B, Nestadt G, Allen A, Hollander E. Serotonin-norepinephrine reuptake inhibitors in the treatment of obsessive-compulsive disorder: a critical review. J Clin Psychiatry. 2006;67:600-10.

Dell'osso B, Mundo E, Marazziti D, Altamura AC. Switching from serotonin reuptake inhibitors to duloxetine in patients with resistant obsessive compulsive disorder: a case series. J Psychopharmacol. 2008;22:210-3.

Phelps NJ, Cates ME. The role of venlafaxine in the treatment of obsessive compulsive disorder. Ann Pharmacother. 2005;39:136-40.

Fontenelle LF, Mendlowicz MV, Miguel EC, Versiani M. Citalopram plus reboxetine in treatment-resistant obsessive-compulsive disorder. World J Biol Psychiatry. 2005;6:57-9.

Moreno FA, Wiegand CB, Taitano EK, Delgado PL. Safety, efficacy and tolerability of psilocybin in 9 patients with obsessive-compulsive disorder. J Clin Psychiatry. 2006;67:1735-40.

Rocha FF, Corrêa H, Lage NV. Addition of trazodone to sertraline: a probable synergistic action in a case of obsessive-compulsive disorder. Rev Bras Psiquiatr. 2007;29:381-2.

Pigott TA, L'Heureux F, Rubenstein CS, Bernstein SE, Hill JL, Murphy DL. A double-blind, placebo controlled study of trazodone in patients with obsessive-compulsive disorder. J Clin Psychopharmacol. 1992;12:156-62.

Bloch MH, Landeros-Weisenberger A, Kelmendi B, Coric V, Bracken MB, Leckman JF. A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder. Mol Psychiatry. 2006;11:622-32.

Schruers K, Koning K, Luermans J, Haack MJ, Griez E. Obsessive-compulsive disorder: a critical review of therapeutic perspectives. Acta Psychiatr Scand. 2005;111:261-71.

Hollander E, Bienstock CA, Koran LM, Pallanti S, Marazziti D, Rasmussen SA. Refractory obsessive-compulsive disorder: state-of-art treatment. J Clin Psychiatry. 2002;63(^s6):20-9.

Decloedt E, Stein DJ. Current trends in drug treatment of obsessive-compulsive disorder. Neuropsychiatr Dis Treat. 2010;6:233-42.

Gao K, Muzina D, Gajwani P, Calabrese JR. Typical and atypical antipsichotics for primary and comorbid anxiety disorders or symptoms: a review. J Clin Psychiatry. 2006;67:1327-40.

Komossa K, Depping AM, Meyer M, Kissling W, Leucht S. Second-generation antipsychotics for obsessive compulsive disorder. Cochrane Database Syst Rev. 2010;12.

Diniz JB, Shavitt RG, Pereira CA, Hounie AG, Pimentel I, Koran LM. Quetiapine versus clomipramine in the augmentation of selective serotonin reuptake inhibitors for the treatment of obsessive-compulsive disorder: a randomized, open-label trial. J Psychopharmacol. 2010;24:297-307.

Diniz JB, Shavitt RG, Fossaluza V, Koran L, Pereira CA, Miguel EC. A double-blind, randomized, controlled trial of fluoxetine plus quetiapine or clomipramine versus fluoxetine plus placebo for obsessive-compulsive disorder. J Clin Psychopharmacol. 2011;31:763-8.

Vulink NC, Denys D, Fluitman SB, Meinardi JC, Westenberg HG. Quetiapine augments the effect of citalopram in non-refractory obsessive-compulsive disorder: a randomized, double-blind, placebo-controlled study of 76 patients. J Clin Psychiatry. 2009;70:1001-8.

Choi Y-J. Efficacy of treatment for patients with obsessive compulsive disorder: a systematic review. J Am Acad Nurse Pract. 2009;21:207-13.

Savas HA, Yumru M, Ozen ME. Quetiapine and ziprasidone as adjuncts in treatment-resistant obsessive-compulsive disorder: a retrospective comparative study. Clin Drug Investig. 2008;28:439-42.

Math SB, Reddy J. Pharmacological issues in the treatment of obsessive compulsive disorder. Int J Clin Pract. 2007;61:1170-80.

Koran LM, Aboujaoude E, Bullock KD, Franz B, Gamel N, Elliott M. Double-blind treatment with oral morphine in treatment-resistant obsessive-compulsive disorder. J Clin Psychiatry. 2005;66:353-9.

Aboujaoude E, Barry JJ, Gamel N. Memantine augmentation in treatment-resistant obsessive-compulsive disorder: an open-label trial. J Clin Psychopharmacol. 2009;29:51-5.

Zdanys K, Tampi RR. A systematic review of off-label uses of memantine for psychiatric disorders. Prog Neuropsychopharmacol Biol Psychiatry. 2008;32:1362-74.

Mahgoub N, Asemota B, Alexopoulos GS. The effect of riluzole augmentation in a patient with treatment-resistant obsessive-compulsive disorder, taking two other glutaminergic agents. J Neuropsychiatry Clin Neurosci. 2011;23:E24-5.

Berlin HA, Koran LM, Jenike MA, Shapira NA, Chaplin W, Pallanti S. Double-blind, placebo-controlled trial of topiramate augmentation in treatment-resistant obsessive-compulsive disorder. J Clin Psychiatry. 2011;72:716-21.

Harvey BH, Scheepers A, Brand L, Stein DJ. Chronic inositol increases striatal D(2) receptors but does not modify dexamphetamine-induced motor behavior: Relevance to obsessive-compulsive disorder. Pharmacol Biochem Behav. 2001;68:245-53.

Soltani F, Sayyah M, Feizy F, Malayeri A, Siahpoosh A, Motlagh I. A double-blind, placebo-controlled pilot study of ondansetron for patients with obsessive-compulsive disorder. Hum Psychopharmacol. 2010;25:509-13.

Cordioli AV. Cognitive-behavioral therapy in obsessive-compulsive disorder. Rev Bras Psiquiatr. 2008;30(^s2):s65-72.

Prazeres AM, Souza WF, Fontenelle LF. Cognitive-behavior therapy for obsessive-compulsive disorder: a systematic review of the last decade. Rev Bras Psiquiatr. 2007;29:262-70.

Polman A, Bouman TK, van Hout WJ, de Jong PJ, den Boer JA. Processes of change in cognitive-behavioural treatment of obsessive-compulsive disorder: current status and some future directions. Clin Psychol Psychother. 2010;17:1-12.

Storch EA, Mariaskin A, Murphy TK. Psychotherapy for obsessive-compulsive disorder. Curr Psychiatry Rep. 2009;11:296-301.

Lotufo Neto F, Baltieri MA. Processos cognitivos e seu tratamento no transtorno obsessivo compulsivo. Rev Bras Psiquiatr. 2001;23:46-8.

Mancuso E, Faro A, Joshi G, Geller DA. Treatment of pediatric obsessive-compulsive disorder: a review. J Child Adolesc Psychopharmacol. 2010;20:299-308.

Marks IM, Hodgson R, Rachman S. Treatment of chronic obsessive-compulsive neurosis by in-vivo exposure: A two-year follow-up and issues in treatment. Br J Psychiatry. 1975;127:349-64.

Thornicroft G, Colson L, Marks I. An in-patient behavioural psychotherapy unit: Description and audit. Br J Psychiatry. 1991;158:362-7.

Piacentini J, Bergman RL, Jacobs C, McCracken JT, Kretchman J. Open trial of cognitive behavior therapy for childhood obsessive-compulsive disorder. J Anxiety Disord. 2002;16:207-19.

Calvocoressi L, McDougle CI, Wasylink S, Goodman WK, Trufan SJ, Price LH. Inpatient treatment of patients with severe obsessive-compulsive disorder. Hosp Community Psychiatry. 1993;44:1150-4.

Maina G, Rosso G, Rigardetto S, Chiadò Piat S, Bogetto F. No effect of adding brief dynamic therapy to pharmacotherapy in the treatment of obsessive-compulsive disorder with concurrent major depression. Psychother Psychosom. 2010;79:295-302.

Hofmann SG, Meuret AE, Smits JA, Simon NM, Pollack MH, Eisenmenger K. Augmentation of exposure therapy with D-cycloserine for social anxiety disorder. Arch Gen Psychiatry. 2006;63:298-304.

Storch EA, Merlo LJ, Bengtson M, Murphy TK, Lewis MH, Yang MC. D-cycloserine does not enhance exposure-response prevention therapy in obsessive-compulsive disorder. Int Clin Psychopharmacol. 2007;22:230-7.

Storch EA, Murphy TK, Goodman WK, Geffken GR, Lewin AB, Henin A. A preliminary study of D-cycloserine augmentation of cognitive-behavioral therapy in pediatric obsessive-compulsive disorder. Biol Psychiatry. 2010;68:1073-6.

Wilhelm S, Buhlmann U, Tolin DF, Meunier SA, Pearlson GD, Reese HE. Augmentation of behavior therapy with D-cycloserine for obsessive-compulsive disorder. Am J Psychiatry. 2008;165:335-41.

Chasson GS, Buhlmann U, Tolin DF, Rao SR, Reese HE, Rowley T. Need for speed: evaluating slopes of OCD recovery in behavior therapy enhanced with d-cycloserine. Behav Res Ther. 2010;48:675-9.

Lopes AC, de Mathis ME, Canteras MM, Salvajoli JV, Del Porto JA, Miguel EC. Atualização sobre o tratamento neurocirúrgico do transtorno obsessivo-compulsivo. Rev Bras Psiquiatr. 2004;26:62-6.

Miguel EC, Lopes AC, Guertzenstein EZ, Calazas ME, Teixeira MJ, Brasil MA. Diretrizes para a neurocirurgia dos transtornos psiquiátricos graves no Brasil: uma proposta preliminar. Rev Bras Psiquiatr. 2004;26:8-9.

Maletzky B, McFarland B, Burt A. Refractory obsessive compulsive disorder and ECT. Convuls Ther. 1994;10:34-42.

Blom RM, Figee M, Vulink N, Denys D. Update on repetitive transcranial magnetic stimulation in obsessive-compulsive disorder: different targets. Curr Psychiatry Rep. 2011;13:289-94.

Greenberg BD, George MS, Martin JD, Benjamin J, Schlaepfer TE, Altemus M. Effect of prefrontal repetitive transcranial magnetic stimulation in obsessive-compulsive disorder: a preliminary study. Am J Psychiatry. 1997;154:867-9.

Alonso P, Pujol J, Cardoner N, Benlloch L, Deus J, Menchón JM. Right prefrontal repetitive transcranial magnetic stimulation in obsessive-compulsive disorder: a double-blind, placebo-controlled study. Am J Psychiatry. 2001;158:1143-5.

Sachdev PS, McBride R, Loo CK, Mitchell PB, Malhi GS, Croker VM. Right versus left prefrontal transcranial magnetic stimulation for obsessive-compulsive disorder: a preliminary investigation. J Clin Psychiatry. 2001;62:981-4.

Prasko J, Pasková B, Zálesky R, Novák T, Kopecek M, Bares M. The effect of repetitive transcranial magnetic stimulation (rTMS) on symptoms in obsessive compulsive disorder: A randomized, double blind, sham controlled study. Neuro Endocrinol Lett. 2006;27:327-32.

Yücel M, Harrison BJ, Wood SJ, Fornito A, Wellard RM, Pujol J. Functional and biochemical alterations of the medial frontal cortex in obsessive-compulsive disorder. Arch Gen Psychiatry. 2007;64:946-55.

Mantovani A, Simpson HB, Fallon BA, Rossi S, Lisanby SH. Randomized sham-controlled trial of repetitive transcranial magnetic stimulation in treatment-resistant obsessive-compulsive disorder. Int J Neuropsychopharmacol. 2010;13:217-27.

Koning PP, Figee M, van den Munckhof P, Schuurman PR, Denys D. Current status of deep brain stimulation for obsessive-compulsive disorder: a clinical review of different targets. Curr Psychiatry Rep. 2011;13:274-82.

Lipsman N, Neimat JS, Lozano AM. Deep brain stimulation for treatment refractory obsessive-compulsive disorder: the search for a valid target. Neurosurgery. 2007;61:1-11.

Mindus P, Rasmussen SA, Lindquist C. Neurosurgical treatment for refractory obsessive-compulsive disorder: implications for understanding frontal lobe function. J Neuropsychiatry Clin Neurosci. 1994;1:26-36.

Lopes AC, Greenberg BD, Norén G, Canteras MM, Busatto GF, de Mathis ME. J Neuropsychiatry Clin Neurosci. 2009;21:381-92.

Greenberg BD, Price LH, Rauch SL. Neurosurgery for intractable obsessive-compulsive disorder and depression: critical issues. Neurosurg Clin N Am. 2003;14:199-212.

Abelson JL, Curtis GC, Sagher O, Albucher RC, Harrigan M, Taylor SF. Deep brain stimulation for refractory obsessive compulsive disorder. Biol Psychiatry. 2005;57:510-6.

George MS, Ward HE, Ninan PT, Pollack M, Nahas Z, Anderson B. A pilot study of vagus nerve stimulation (VNS) for treatment-resistant anxiety disorders. Brain Stimul. 2008;1:112-21.