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In this systematic review, a literature search is
performed for original papers published in English using the electronic
database Pubmed. The intention of the search was to find prospective or
retrospective studies that assessed on sociodemographic, clinical or genetic
predictors of chronic OCD. To get insight in the development of chronic
obsessive-compulsive disorder, studies about the long-term course of OCD were
also included. To include all relevant studies for this review a systematic
search strategy was used. The search terms were derived from three major
categories: 1) obsessive compulsive disorder, 2) chronicity, 3) risk factors or
predictors and one subcategory: course of illness. Based on these categories
the following Mesh-terms were used: (“Obsessive-Compulsive disorder”Mesh OR
Obsessive-Compulsive disordertiab OR OCDtiab) AND (“Chronic Disease”Mesh
OR Chronic Diseasetiab OR Chronicitytiab) AND (“Risk Factors”Mesh OR Risk
Factorstiab OR Predictorstiab) AND (“Disease progression”Mesh OR Disease
Progressiontiab OR Course of Illnesstiab OR Long-term coursetiab).
Different combinations of these Mesh-terms were used to search for all
published studies on this subject. Besides, searching through reference lists
(snowball-search) for relevant papers was applied. The exact search strategies
are provided in Appendix 1.

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In- and exclusion criteria were used to screen for
relevant studies out of the number of hits. Studies were included if they
performed research on the main diagnosis of obsessive-compulsive disorder, if
the patients were diagnosed with OCD or OCD
symptomatology, if the patient population was between 6
and 65 years old and if the follow-up lasted for at least 2 years (because
chronicity is usually defined as having OCD for more than 2 years). Preferably
studies were included if they were prospective or retrospective studies that assessed
sociodemographic, clinical or genetic predictors of OCD at baseline. On the
other hand, systematic reviews, studies published before 2007, studies that
were not written in English, studies that did not have obsessive-compulsive
disorder in its title and studies that did not fit the research question were




Several stages of screening were used to bring the
number of hits down to at least ten relevant studies as a reference for this
systematic review. In the first stage, screening for duplicated articles was
done. In the second stage, screening on the title and abstract was done using
the in- and exclusion criteria. Based on these screenings, useful articles were
selected for full-text assessment. Figure 1
illustrates the filtering process used in this review. In total 68 hits were
found based on the combinations of Mesh-terms used. In the first
screening-stage reviews and duplicated articles were excluded, resulting in 54
articles. These 54 hits were screened in the second stage on the title and
abstract using the in- and exclusion criteria. This resulted in ten potentially
relevant studies found by using the search strategy on Pubmed. Additional
records were identified through the snowball search method. Screening of the
reference list of the study by Van Oudheusden et
al. (2018) was done, bringing it down from fourty-eight references to eight
potentially relevant articles. Adding these eight articles to the ten articles
found in Pubmed, eighteen articles were selected for full-text assessment.
After reading the full content of these articles, eleven relevant articles were
included as a reference for this systemic review. The selected eleven articles
were all published between 2009 and 2018.








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