Relationships between thought-action fusion, thought suppression and obsessive-compulsive symptoms: a structural equation modeling approach.

PubMed

Rassin, E; Muris, P; Schmidt, H; Merckelbach, H

2000-09-01

Research has shown that there are strong similarities in content between the obsessions and compulsions that characterize obsessive-compulsive disorder and nonclinical obsessions and compulsions. However, clinical and nonclinical obsessions and compulsions do differ with respect to characteristics like frequency, intensity, discomfort and elicited resistance. Two separate concepts have been invoked to explain how normal obsessions and compulsions may develop into clinical phenomena. First, it is suggested that thought-action fusion (TAF) contributes to obsessive-compulsive symptoms. Second, thought suppression may intensify obsessive-compulsive symptoms due to its paradoxical effect on intrusive thoughts. Although both phenomena have been found to contribute to obsessive-compulsive symptoms, possible interactions between these two have never been investigated. The current study explored how TAF and thought suppression interact in the development of obsessive-compulsive symptoms. Undergraduate psychology students (N = 173) completed questionnaires pertaining to TAF, thought suppression and obsessive-compulsive symptoms. Covariances between the scores on these questionnaires were analyzed by means of structural equation modeling. Results suggest that TAF triggers thought suppression, while thought suppression, in turn, promotes obsessive-compulsive symptoms.

Obsessive-compulsive personality disorder traits and personality dimensions in parents of children with obsessive-compulsive disorder.

PubMed

Calvo, Rosa; Lázaro, Luisa; Castro-Fornieles, Josefina; Font, Elena; Moreno, Elena; Toro, J

2009-04-01

To compare patterns of temperament and character and the prevalence of Obsessive-Compulsive Personality Disorder (OCPD) and OCPD traits in parents of children with OCD and parents of healthy controls. TCI and SCID-II were administered to 63 parents of 32 children with OCD and 63 parents of age- and sex-matched controls with no psychiatric diagnosis. Interviewers were not blind to proband status. Personality dimension scores and frequencies of OCPD criteria in both groups were compared after excluding parents with a diagnosis of OCD. Relationships between TCI dimensions and OCPD symptoms in parents and the clinical characteristics of OCD children were also studied. Parents of OCD children presented significantly higher scores in harm avoidance and lower scores in self-directedness, cooperativeness and reward dependence than parents of healthy children. A higher incidence of OCPD was found in parents of probands (p<0.02). Hoarding, perfectionism and preoccupation with details were significantly more frequent in parents of OCD children. Counting, ordering and cleaning compulsions in OCD children predicted elevated odds of perfectionism and rigidity in their parents. The existence of the dimensional personality profile associated with OCD in parents of children with OCD and the higher number of OCPD criteria in these parents in comparison to parents of healthy children highlight the importance of the role of personality factors in familial OCD.

Obsessionality & compulsivity: a phenomenology of obsessive-compulsive disorder.

PubMed

Denys, Damiaan

2011-02-01

Progress in psychiatry depends on accurate definitions of disorders. As long as there are no known biologic markers available that are highly specific for a particular psychiatric disorder, clinical practice as well as scientific research is forced to appeal to clinical symptoms. Currently, the nosology of obsessive-compulsive disorder is being reconsidered in view of the publication of DSM-V. Since our diagnostic entities are often simplifications of the complicated clinical profile of patients, definitions of psychiatric disorders are imprecise and always indeterminate. This urges researchers and clinicians to constantly think and rethink well-established definitions that in psychiatry are at risk of being fossilised. In this paper, we offer an alternative view to the current definition of obsessive-compulsive disorder from a phenomenological perspective. TRANSLATION: This article is translated from Dutch, originally published in [Handbook Obsessive-compulsive disorders, Damiaan Denys, Femke de Geus (Eds.), (2007). De Tijdstroom uitgeverij BV, Utrecht. ISBN13: 9789058980878.].

Influence of specific obsessive-compulsive symptom dimensions on strategic planning in patients with obsessive-compulsive disorder.

PubMed

Pinto, Paula Sanders Pereira; Iego, Sandro; Nunes, Samantha; Menezes, Hemanny; Mastrorosa, Rosana Sávio; Oliveira, Irismar Reis de; Rosário, Maria Conceição do

2011-03-01

This study investigates obsessive-compulsive disorder patients in terms of strategic planning and its association with specific obsessive-compulsive symptom dimensions. We evaluated 32 obsessive-compulsive disorder patients. Strategic planning was assessed by the Rey-Osterrieth Complex Figure Test, and the obsessive-compulsive dimensions were assessed by the Dimensional Yale-Brown Obsessive-Compulsive Scale. In the statistical analyses, the level of significance was set at 5%. We employed linear regression, including age, intelligence quotient, number of comorbidities, the Yale-Brown Obsessive-Compulsive Scale score, and the Dimensional Yale-Brown Obsessive-Compulsive Scale. The Dimensional Yale-Brown Obsessive-Compulsive Scale "worst-ever" score correlated significantly with the planning score on the copy portion of the Rey-Osterrieth Complex Figure Test (r = 0.4, p = 0.04) and was the only variable to show a significant association after linear regression (β = 0.55, t = 2.1, p = 0.04). Compulsive hoarding correlated positively with strategic planning (r = 0.44, p = 0.03). None of the remaining symptom dimensions presented any significant correlations with strategic planning. We found the severity of obsessive-compulsive symptoms to be associated with strategic planning. In addition, there was a significant positive association between the planning score on the copy portion of the Rey-Osterrieth Complex Figure Test copy score and the hoarding dimension score on the Dimensional Yale-Brown Obsessive-Compulsive Scale. Our results underscore the idea that obsessive-compulsive disorder is a heterogeneous disorder and suggest that the hoarding dimension has a specific neuropsychological profile. Therefore, it is important to assess the peculiarities of each obsessive-compulsive symptom dimension.

Effects of traumatic experiences on obsessive-compulsive and internalizing symptoms: The role of avoidance and mindfulness.

PubMed

Kroska, Emily B; Miller, Michelle L; Roche, Anne I; Kroska, Sydney K; O'Hara, Michael W

2018-01-01

Trauma exposure is associated with adverse psychological outcomes including anxiety, depression, and obsessive-compulsive (OC) symptoms. Adolescence is increasingly recognized as a period of vulnerability for the onset of these types of psychological symptoms. The current study explored the mediating roles of experiential avoidance and mindfulness processes in the association between retrospective reports of childhood trauma and current internalizing and OC symptoms in adolescents. A group of at-risk adolescents (N = 51) and a group of college students (N = 400) reported on childhood trauma, experiential avoidance, mindfulness, anxiety, depressive, and OC symptoms. Mediation analyses were performed to examine the mechanistic roles of avoidance and mindfulness in the association between trauma and internalizing and OC-specific symptoms. In the group of at-risk adolescents, experiential avoidance and mindfulness both significantly mediated the association between childhood trauma and OC symptoms. In the college student sample, experiential avoidance mediated the association between trauma and OC symptoms. Experiential avoidance, as well as the observe, act with awareness, and nonjudgmental facets of mindfulness all significantly mediated the association between trauma and internalizing symptoms. The group of at-risk adolescents was small, and the college student group was demographically homogeneous. All data was self-report and cross-sectional. The current study demonstrated that experiential avoidance and mindfulness processes may be the mechanisms through which the association between trauma and obsessive-compulsive and trauma and internalizing symptoms exist in adolescents. These findings provide potential targets for clinical intervention to improve outcomes for adolescents who have experienced trauma. Copyright © 2017 Elsevier B.V. All rights reserved.

Effects of Traumatic Experiences on Obsessive-Compulsive and Internalizing Symptoms: The Role of Avoidance and Mindfulness

PubMed Central

Kroska, Emily B.; Miller, Michelle L.; Roche, Anne I.; Kroska, Sydney K.; O’Hara, Michael W.

2017-01-01

Background Trauma exposure is associated with adverse psychological outcomes including anxiety, depression, and obsessive-compulsive (OC) symptoms. Adolescence is increasingly recognized as a period of vulnerability for the onset of these types of psychological symptoms. The current study explored the mediating roles of experiential avoidance and mindfulness processes in the association between retrospective reports of childhood trauma and current internalizing and OC symptoms in adolescents. Method A group of at-risk adolescents (N =51) and a group of college students (N =400) reported on childhood trauma, experiential avoidance, mindfulness, anxiety, depressive, and OC symptoms. Mediation analyses were performed to examine the mechanistic roles of avoidance and mindfulness in the association between trauma and internalizing and OC-specific symptoms. Results In the group of at-risk adolescents, experiential avoidance and mindfulness both significantly mediated the association between childhood trauma and OC symptoms. In the college student sample, experiential avoidance mediated the association between trauma and OC symptoms. Experiential avoidance, as well as the observe, act with awareness, and nonjudgmental facets of mindfulness all significantly mediated the association between trauma and internalizing symptoms. Limitations The group of at-risk adolescents was small, and the college student group was demographically homogeneous. All data was self-report and cross-sectional. Conclusion The current study demonstrated that experiential avoidance and mindfulness processes may be the mechanisms through which the association between trauma and obsessive-compulsive and trauma and internalizing symptoms exist in adolescents. These findings provide potential targets for clinical intervention to improve outcomes for adolescents who have experienced trauma. PMID:28843915

Suicidal ideation versus suicidal obsession: a case report.

PubMed

Wetzler, Alzbeta Juven; Elias, Rachela; Fostick, Leah; Zohar, Joseph

2007-07-01

This case report illustrates the relationship between stress and obsessive-compulsive disorder (OCD) by describing an unusual case of OCD sequelae following a suicide attempt. The patient is a 29-year-old married woman who suffered a major depressive episode without OCD and tried to commit suicide by drinking household cleaner. Following the attempt, violent obsessive thoughts of harming herself and others emerged along with avoidance behavior. After exposure therapy, there was a decrease in her obsessive thoughts, less anxiety, and no avoidance behavior. This report highlights not only the existence of "posttraumatic obsession" but also the importance of accurate interpretation of suicidal preoccupation, leading to the diagnosis of OCD rather then suicidal ideation secondary to depression.

Obsessive-compulsive symptoms among alcoholics in outpatient treatment: Prevalence, severity and correlates.

PubMed

Campos, Luana Moraes; Yoshimi, Nicoli Tamie; Simão, Maria Odete; Torresan, Ricardo Cezar; Torres, Albina Rodrigues

2015-09-30

The literature on symptoms of obsessive-compulsive disorder (OCD) in alcoholic patients is scarce and such symptoms can go unnoticed, worsening the prognosis of alcoholism. The objectives were to estimate the prevalence and severity of obsessive-compulsive symptoms in alcoholics undergoing outpatient treatment and to assess sociodemographic and clinical correlates, including suicidal behaviors. The instruments used in this cross-sectional study were the Obsessive-Compulsive Inventory - Revised (OCI-R), the Short Alcohol Dependence Data and the Beck Depression Inventory. After descriptive analyses, bivariate analyses between the categorical ("probable OCD": OCI-R≥27) and dimensional (OCI-R total and subscales scores) outcomes and all explanatory variables were conducted. Eleven (20.4%) of the 54 alcoholic patients (37 men and 17 women) presented "probable OCD", which was associated with lower income, more severe dependence, depression, lifetime suicidal thoughts and plans and suicide attempts. OCI-R severity (mean 16.0) was associated with the same predictors and with psychiatric hospitalization. Suicidal behaviors were mainly associated with the Obsession, Hoarding and Washing subscales. It is essential to investigate and treat OCD symptoms in alcoholics, as they are associated with greater severity of dependence, depression and suicidal behaviors. Longitudinal studies are required to assess the impact of OCD treatment on the clinical course of alcoholism. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Diagnostic Stability of Internet Addiction in Obsessive-compulsive Disorder: Data from a Naturalistic One-year Treatment Study

PubMed Central

Yerramilli, Srinivasa SRR; Karredla, Ashok Reddy; Gopinath, Srinath

2015-01-01

Whether internet addiction should be categorized as a primary psychiatric disorder or the result of an underlying psychiatric disorder still remains unclear. In addition, the relationship between internet addiction and obsessive-compulsive disorder remains to be explored. We hypothesized that internet addiction is a manifestation of underlying psychopathology, the treatment of which will improve internet addiction. We enrolled 34 control subjects (with or without internet addiction) and compared them to 38 patients with “pure” obsessive-compulsive disorder (with or without internet addiction). Internet addiction and obsessive-compulsive disorder were diagnosed based on Young’s Diagnostic Questionnaire and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), respectively. Age and Internet Addiction Test scores were comparable in both the control (years: 26.87±6.57; scores: 43.65±11.56) and obsessive-compulsive disorder groups (years: 27.00±6.13 years, p=0.69; scores: 43.47±15.21, p=0.76). Eleven patients with obsessive-compulsive disorder (28.95%) were diagnosed with internet addiction as compared to three control subjects (p=0.039). In the obsessive-compulsive disorder group, no difference in the Yale-Brown Obsessive Compulsive Scale (24.07±3.73 non-internet addiction, 23.64±4.65 internet addiction; p=0.76) score was seen between the internet addiction/obsessive-compulsive disorder and non-internet addiction/obsessive-compulsive disorder groups. As expected, the Internet Addiction Test scores were higher in the internet addiction/obsessive-compulsive disorder group (64.09±9.63) than in the non-internet addiction/obsessive-compulsive disorder group (35.07±6.37; p=0.00). All enrolled patients with obsessive-compulsive disorder were subsequently treated for a period of one year. Treatment of obsessive-compulsive disorder improved Yale-Brown Obsessive Compulsive Scale and Internet Addiction Test scores over time. At 12 months, only two of the 11 patients with obsessive-compulsive disorder (18.18%) fulfilled the Young’s Diagnostic Questionnaire criteria for internet addiction. In conclusion, treatment of the underlying disorder improved internet addiction. PMID:26000201

Impact of obsessive-compulsive personality disorder symptoms in Internet users.

PubMed

Chamberlain, Samuel R; Redden, Sarah A; Stein, Dan J; Lochner, Christine; Grant, Jon E

2017-08-01

Internet use is pervasive in many cultures. Little is known about the impact of obsessive-compulsive personality disorder (OCPD) symptoms on impulsive and compulsive psychopathologies in people who use the Internet. Adult Internet users (N = 1,323) completed an online questionnaire quantifying OCPD symptoms, likely occurrence of select mental disorders (obsessive-compulsive disorder, attention-deficit/hyperactivity disorder [ADHD], problematic Internet use, generalized anxiety disorder), and personality questionnaires of impulsivity and compulsivity. Predictors of the presence of OCPD symptoms (endorsement of at least 4 of 8 DSM-5 criteria) were identified using binary logistic regression. In regression (P < .001, area under the curve, 0.77), OCPD symptoms were significantly associated with (in order of decreasing effect size) lower non-planning impulsivity, higher ADHD symptoms, problematic Internet use, avoidant personality disorder, female sex, generalized anxiety disorder, and some types of compulsions (checking, dressing/washing). These data suggest that OCPD symptoms, defined in terms of at least 4 of 8 DSM criteria being met, are common in Internet users. OCPD symptoms were associated with considerably higher levels of psychopathology relating to both impulsive (ADHD) and compulsive (OCD-related and problematic Internet use) disorders. These data merit replication and extension using standard in-person clinical assessments, because the current study relied on self-report over the Internet.

Personality traits in subclinical and non-obsessive-compulsive volunteers and their parents.

PubMed

Frost, R O; Steketee, G; Cohn, L; Griess, K

1994-01-01

Theorists from a variety of perspectives have asserted that obsessive compulsives are more risk-aversive, perfectionistic and guilt-ridden than non-obsessive compulsives, and that these characteristics are central features of the disorder. Furthermore, several have hypothesized that the parents of obsessive compulsives are characterized by risk-aversion, perfectionism, and high levels of criticism. Little research exists which corroborates these hypotheses, however. The present investigation examined these hypotheses among subclinical obsessive compulsives. In two different samples, subclinical obsessive compulsives were found to be more risk-aversive, perfectionistic, and guilt-ridden. Subclinical obsessive compulsives also perceived their parents to be more overprotective. The findings regarding other parental traits were less clear. There was some support for the hypothesis that the parents of subclinical obsessive compulsives are more risk-aversive, and that fathers are more critical and perfectionistic.

Interpretation of Ambiguity in Individuals with Obsessive-Compulsive Symptoms

PubMed Central

Kuckertz, Jennie M.; Amir, Nader; Tobin, Anastacia C.; Najmi, Sadia

2013-01-01

In two experiments we examined the psychometric properties of a new measure of interpretation bias in individuals with obsessive-compulsive symptoms (OCs). In Experiment 1, 38 individuals high in OC symptoms, 34 individuals high in anxiety and dysphoric symptoms, and 31 asymptomatic individuals completed the measure. Results revealed that the Word Sentence Association Test for OCD (WSAO) can differentiate those with OC symptoms from both a matched anxious/dysphoric group and a non-anxious/non-dysphoric group. In a second experiment, we tested the predictive validity of the WSAO using a performance-based behavioral approach test of contamination fears, and found that the WSAO was a better predictor of avoidance than an established measure of OC washing symptoms (Obsessive Compulsive Inventory-Revised, washing subscale). Our results provide preliminary evidence for the reliability and validity of the WSAO as well as its usefulness in predicting response to behavioral challenge above and beyond OC symptoms, depression, and anxiety. PMID:24179287

The relation between depressive and obsessive-compulsive symptoms in obsessive-compulsive disorder: Results from a large, naturalistic follow-up study.

PubMed

Rickelt, Judith; Viechtbauer, Wolfgang; Lieverse, Ritsaert; Overbeek, Thea; van Balkom, Anton J; van Oppen, Patricia; van den Heuvel, Odile A; Marcelis, Machteld; Eikelenboom, Merijn; Tibi, Lee; Schruers, Koen Rj

2016-10-01

Despite the frequent occurrence of depressive symptoms in obsessive-compulsive disorder (OCD), little is known about the reciprocal influence between depressive and obsessive-compulsive symptoms during the course of the disease. The aim of the present study is to investigate the longitudinal relationship between obsessive-compulsive and depressive symptoms in OCD patients. We used the baseline and 1-year follow-up data of the Netherlands Obsessive Compulsive Disorder Association (NOCDA) study. In 276 patients with a lifetime diagnosis of obsessive-compulsive disorder, depressive and obsessive-compulsive symptoms were assessed at baseline and at one-year follow-up with the Beck Depression Inventory (BDI) and the Yale-Brown Obsessive Compulsive Symptom (Y-BOCS) scale. Relations were investigated using a cross-lagged panel design. The association between the severity of depressive symptoms at baseline and obsessive-compulsive symptoms at follow-up was significant (β=0.244, p<0.001), while the association between the severity of obsessive-compulsive symptoms at baseline and depressive symptoms at follow-up was not (β=0.097, p=0.060). Replication of the analyses in subgroups with and without current comorbid major depressive disorder (MDD) and subgroups with different sequence of onset (primary versus secondary MDD) revealed the same results. There may be other factors, which affect both depressive and obsessive-compulsive symptoms that were not assessed in the present study. The present study demonstrates a relation between depressive symptoms and the course of obsessive-compulsive symptoms in OCD patients, irrespective of a current diagnosis of MDD and the sequence of onset of OCD and MDD. Copyright © 2016 Elsevier B.V. All rights reserved.

Responsibility/Threat Overestimation Moderates the Relationship Between Contamination-Based Disgust and Obsessive-Compulsive Concerns About Sexual Orientation.

PubMed

Ching, Terence H W; Williams, Monnica T; Siev, Jedidiah; Olatunji, Bunmi O

2018-05-01

Disgust has been shown to perform a "disease-avoidance" function in contamination fears. However, no studies have examined the relevance of disgust to obsessive-compulsive (OC) concerns about sexual orientation (e.g., fear of one's sexual orientation transforming against one's will, and compulsive avoidance of same-sex and/or gay or lesbian individuals to prevent that from happening). Therefore, we investigated whether the specific domain of contamination-based disgust (i.e., evoked by the perceived threat of transmission of essences between individuals) predicted OC concerns about sexual orientation, and whether this effect was moderated/amplified by obsessive beliefs, in evaluation of a "sexual orientation transformation-avoidance" function. We recruited 283 self-identified heterosexual college students (152 females, 131 males; mean age = 20.88 years, SD = 3.19) who completed three measures assessing disgust, obsessive beliefs, and OC concerns about sexual orientation. Results showed that contamination-based disgust (β = .17), responsibility/threat overestimation beliefs (β = .15), and their interaction (β = .17) each uniquely predicted OC concerns about sexual orientation, ts = 2.22, 2.50, and 2.90, ps < .05. Post hoc probing indicated that high contamination-based disgust accompanied by strong responsibility/threat overestimation beliefs predicted more severe OC concerns about sexual orientation, β = .48, t = 3.24, p < .001. The present study, therefore, provided preliminary evidence for a "sexual orientation transformation-avoidance" process underlying OC concerns about sexual orientation in heterosexual college students, which is facilitated by contamination-based disgust, and exacerbated by responsibility/threat overestimation beliefs. Treatment for OC concerns about sexual orientation should target such beliefs.

The characteristics of unacceptable/taboo thoughts in obsessive-compulsive disorder.

PubMed

Brakoulias, Vlasios; Starcevic, Vladan; Berle, David; Milicevic, Denise; Moses, Karen; Hannan, Anthony; Sammut, Peter; Martin, Andrew

2013-10-01

In the quest to unravel the heterogeneity of obsessive-compulsive disorder (OCD), an increasing number of factor analytic studies are recognising unacceptable/taboo thoughts as one of the symptom dimensions of OCD. This study aims to examine the characteristics associated with unacceptable/taboo thoughts. Using the Yale-Brown Obsessive-Compulsive Scale Symptom Checklist (YBOCS-SC) with 154 individuals with OCD, obsessive-compulsive symptoms were subjected to principal components analysis. The characteristics associated with the resulting symptom dimensions were then assessed using logistic and linear regression techniques. Unacceptable/taboo thoughts comprised of sexual, religious and impulsive aggressive obsessions, and mental rituals. Higher scores on an unacceptable/taboo thoughts symptom dimension were predicted by higher Y-BOCS obsession subscores, Y-BOCS time preoccupied by obsessions scores, Y-BOCS distress due to obsessions scores, importance of control of thought ratings, male gender, and having had treatment prior to entering into the study. Unacceptable/taboo thoughts were also predicted by greater levels of hostility, and a past history of non-alcohol substance dependence. An unacceptable/taboo thought symptom dimension of OCD is supported by a unique set of associated characteristics that should be considered in the assessment and treatment of individuals with these symptoms. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

Does obsessive-compulsive personality disorder belong within the obsessive-compulsive spectrum?

PubMed

Fineberg, Naomi A; Sharma, Punita; Sivakumaran, Thanusha; Sahakian, Barbara; Chamberlain, Sam R; Chamberlain, Sam

2007-06-01

It has been proposed that certain Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I disorders share overlapping clinical features, genetic contributions, and treatment response and fall within an "obsessive-compulsive" spectrum. Obsessive-compulsive personality disorder (OCPD) resembles obsessive-compulsive disorder (OCD) and other spectrum disorders in terms of phenomenology, comorbidity, neurocognition, and treatment response. This article critically examines the nosological profile of OCPD with special reference to OCD and related disorders. By viewing OCPD as a candidate member of the obsessive-compulsive spectrum, we gain a fresh approach to understanding its neurobiology, etiology, and potential treatments.

A clinical profile of compulsive exercise in adolescent inpatients with anorexia nervosa.

PubMed

Noetel, Melissa; Miskovic-Wheatley, Jane; Crosby, Ross D; Hay, Phillipa; Madden, Sloane; Touyz, Stephen

2016-01-01

The aim of the current study was to contribute to the development of a clinical profile of compulsive exercise in adolescents with Anorexia Nervosa (AN), by examining associations between compulsive exercise and eating and general psychopathology. A sample of 60 female adolescent inpatients with AN completed a self-report measure of compulsive exercise and a series of standardized self-report questionnaires assessing eating and general psychopathology. Higher levels of compulsive exercise were associated with increased levels of eating disorder psychopathology and anxiety. Specifically, the avoidance aspect (negatively reinforced) of compulsive exercise was associated with elevated scores on measures of eating disorder, anxiety, depression, and obsessive compulsiveness psychopathology, as well as lower self-esteem scores. The mood improvement value (positively reinforced) of compulsive exercise, however, did not reflect such trends. Compulsive exercise driven by avoidance of negative affect is associated with more severe psychological features in adolescent inpatients with AN. The current findings emphasize the need for research and clinical efforts in the development of treatments addressing avoidance of negative affect and compulsive exercise in adolescents with AN.

Dissecting the Yale-Brown Obsessive-Compulsive Scale severity scale to understand the routes for symptomatic improvement in obsessive-compulsive disorder.

PubMed

Costa, Daniel L da Conceição; Barbosa, Veronica S; Requena, Guaraci; Shavitt, Roseli G; Pereira, Carlos A de Bragança; Diniz, Juliana B

2017-10-01

We aimed to investigate which items of the Yale-Brown Obsessive-Compulsive Severity Scale best discriminate the reduction in total scores in obsessive-compulsive disorder patients after 4 and 12 weeks of pharmacological treatment. Data from 112 obsessive-compulsive disorder patients who received fluoxetine (⩽80 mg/day) for 12 weeks were included. Improvement indices were built for each Yale-Brown Obsessive-Compulsive Severity Scale item at two timeframes: from baseline to week 4 and from baseline to week 12. Indices for each item were correlated with the total scores for obsessions and compulsions and then ranked by correlation coefficient. A correlation coefficient ⩾0.7 was used to identify items that contributed significantly to reducing obsessive-compulsive disorder severity. At week 4, the distress items reached the threshold of 0.7 for improvement on the obsession and compulsion subscales although, contrary to our expectations, there was greater improvement in the control items than in the distress items. At week 12, there was greater improvement in the time, interference, and control items than in the distress items. The use of fluoxetine led first to reductions in distress and increases in control over symptoms before affecting the time spent on, and interference from, obsessions and compulsions. Resistance did not correlate with overall improvement. Understanding the pathway of improvement with pharmacological treatment in obsessive-compulsive disorder may provide clues about how to optimize the effects of medication.

Assessment of Obsessive-Compulsive Symptom Dimensions: Development and Evaluation of the Dimensional Obsessive-Compulsive Scale

ERIC Educational Resources Information Center

Abramowitz, Jonathan S.; Deacon, Brett J.; Olatunji, Bunmi O.; Wheaton, Michael G.; Berman, Noah C.; Losardo, Diane; Timpano, Kiara R.; McGrath, Patrick B.; Riemann, Bradley C.; Adams, Thomas; Bjorgvinsson, Throstur; Storch, Eric A.; Hale, Lisa R.

2010-01-01

Although several measures of obsessive-compulsive (OC) symptoms exist, most are limited in that they are not consistent with the most recent empirical findings on the nature and dimensional structure of obsessions and compulsions. In the present research, the authors developed and evaluated a measure called the Dimensional Obsessive-Compulsive…

[The way to proceed in psychotherapy--focusing on the framework of phobias and obsessive-compulsive stories].

PubMed

Nishimura, Ryoji

2012-01-01

Compulsion becomes long-term when treatment is commenced with very severe resistance. Patients showing emotional changes are rare compared to those with conversion and phobic disorders. However, most people improve when careful treatment is carried out. Although there are those in whom drug treatment is effective, drug treatment and psychotherapy are concomitantly used in most cases. In this lecture, the characteristics of compulsion were psychodynamically investigated regarding: 1. Central conflict, 2. Defense mechanisms, 3. Condition of love life (including sex life), 4. Growth history, by comparing with phobias. When the life of the inner-self protrudes, obsessive-compulsive patients try to contradict and deny this. The symptoms sometimes directly represent the mental conflict of the person, and sometimes the symptom formation process may be understood to some extent. It is said that such cases are suitable for psychotherapy. Psychodynamic psychotherapy involves regaining the continuity of emotional life divided due to defenses such as negation, reaction formation, and isolation. Meanwhile, the real nature of phobias is avoidance and escape. Therefore, the trick in proceeding with interviews is to lead the phobia patient to areas which they avoid during interviews and areas which they avoid in daily life, and to have the patient enter these fields at times by encouraging them.

Obsessive Compulsive Disorder

PubMed Central

Goli, Veeraindar; Krishnan, Ranga; Ellinwood, Everett

1991-01-01

An estimated three to seven million Americans suffer from obsessive compulsive disorder at some time in their lives. Until recently, obsessive compulsive disorder was considered refractory to most treatments. However, recent studies indicate a better prognosis with behavioral therapy, antidepressant medications, or both. Behavioral treatment is generally more effective for compulsions than for obsessions. PMID:21229040

Are obsessive-compulsive symptoms impulsive, compulsive or both?

PubMed Central

Chamberlain, Samuel R; Leppink, Eric W.; Redden, Sarah A.; Grant, Jon E.

2017-01-01

Background The relationships between obsessive-compulsive symptoms and distinct forms of impulsivity and compulsivity are unclear. Such examination would be relevant in terms of how best to classify psychiatric disorders and in understanding candidate ‘latent traits’ that extend across a continuum between normalcy and clinical disorders. Method 515 young adults (aged 18-29 years) completed the Padua Inventory and undertook detailed clinical and neurocognitive assessments. Relationships between obsessive-compulsive symptoms and distinct types of impulsivity and compulsivity were evaluated using linear regression modelling. Results Obsessive-compulsive symptoms were significantly predicted by female gender, lower quality of life, psychiatric disorders in general (but not impulse control disorders), and worse extra-dimensional set-shifting. Obsessive-compulsive symptoms were not significantly predicted by alcohol/nicotine consumption, stop-signal reaction times, or decision-making abilities. Conclusion These data indicate that obsessive-compulsive symptoms are more related to certain forms of compulsivity than to impulsivity. These findings have important implications for diagnostic conceptualizations and neurobiological models. PMID:27234191

TREATMENT OF OBSESSIVE COMPULSIVE SYMPTOMS IN SCHIZOPHRENIA WITH FLUOXETINE

PubMed Central

Agarwal, Vivek; Agarwal, K.M.

2000-01-01

Obsessive compulsive symptoms have been reported to occur in high proportion in schizophrenia. Presence of obsessive compulsive symptoms in schizophrenia has poor prognostic significance. Because of the antiobsessional effect of the fluoxetine, present study was undertaken as preliminary investigation in cases of schizophrenia with obsessive compulsive symptoms. We conducted an open trial of 12 weeks duration in which fluoxetine was added up to 80 mg to the maintenance neuroleptic medication of outpatients of schizophrenia with obsessive compulsive symptoms diagnosed by DSM-IV criteria. Five patients showed a significant reduction in scores of Positive and Negative Syndrome Scale, Yale Brown Obsessive Compulsive Scale and Clinical Global Impression Scale. Two patients did not show any response. Fluoxetine was well tolerated by all the patients. The positive findings of this preliminary investigation supports the further investigations of fluoxetine as potential treatment in the obsessive compulsive symptoms in schizophrenia. PMID:21407959

Group behavioral therapy for adolescents with tic-related and non-tic-related obsessive-compulsive disorder.

PubMed

Himle, Joseph A; Fischer, Daniel J; Van Etten, Michelle L; Janeck, Amy S; Hanna, Gregory L

2003-01-01

Prior research supports the distinction between tic-related and non-tic-related obsessive-compulsive disorder (OCD) based on phenomenologic, etiologic, and neurobehavioral data. The present study examines whether response to psychosocial treatment differs in adolescents, depending on the presence of comorbid tics. Nineteen adolescents, 12-17 years of age, participated in 7-week, uncontrolled trial of group cognitive-behavioral treatment (CBT) for OCD. Eight of the patients had tic-related and eleven had non-tic-related OCD. The group CBT program included psycho-education, exposure and response prevention, cognitive strategies, and family involvement. Significant improvement was observed for all subjects on the Yale-Brown Obsessive Compulsive Scale ratings of obsessions, compulsions, and total OCD symptoms. Outcomes were similar for subjects with tic-related and non-tic-related OCD. These preliminary results suggest that the presence of comorbid tic disorders may not attenuate response to behavioral group treatment among adolescents. Copyright 2003 Wiley-Liss, Inc.

The role of depression and anxiety in impulsive and obsessive-compulsive behaviors among anorexic and bulimic patients.

PubMed

Finzi-Dottan, Ricky; Zubery, Eynat

2009-01-01

Eating disorders are believed to range across a spectrum of varying degrees of obsessive-compulsive and impulsive behavior. Sixty anorexic (mean age = 19.8; sd = 5.9) and 109 bulimic (mean age = 26.9; sd = 11.3) female patients completed self-report questionnaires assessing obsessive-compulsiveness, impulsivity, depression and anxiety, as well as two eating disorder scales. Results yielded significantly higher levels of impulsivity and negative body image in the bulimic compared to the anorexic group. Regression analysis predicting impulsivity showed that bulimia and negative body image were the main contributors. Regression analysis for predicting obsessive-compulsive behavior suggested that depression and anxiety obscure the link between anorexia and obsessive-compulsive behavior, and a high BMI intensifies the association between anxiety and obsessive-compulsive behavior. The high rates of both impulsivity and obsessive-compulsiveness found in both groups, and their association with the severity of the eating disorder, may suggest that impulsivity and obsessive-compulsiveness are not mutually exclusive and can both be found among anorexic and bulimic patients.

Obsessive-compulsive symptoms and related sex differences in brain structure: an MRI study in Dutch twins.

PubMed

den Braber, Anouk; de Geus, Eco J C; Boomsma, Dorret I; van 't Ent, Dennis

2013-04-01

Neuroimaging studies have indicated abnormalities in cortico-striato-thalamo-cortical circuits in obsessive-compulsive disorder patients, but results have not been consistent. Since there are significant sex differences in human brain anatomy and obsessive-compulsive symptomatology and its developmental trajectories tend to be distinct in males and females, we investigated whether sex is a potential source of heterogeneity in neuroimaging studies on obsessive-compulsive symptoms. We selected male and female twin pairs who were concordant for scoring either high or low for obsessive-compulsive symptoms and a group of discordant pairs where one twin scored high and the co-twin scored low. The design included 24 opposite-sex twin pairs. Magnetic resonance imaging scans of 31 males scoring high for obsessive-compulsive symptoms, 41 low-scoring males, 58 high-scoring females, and 73 low-scoring females were analyzed and the interaction of obsessive-compulsive symptoms by sex on gray matter volume was assessed using voxel-based morphometry. An obsessive-compulsive symptom by sex interaction was observed for the left middle temporal gyrus, the right middle temporal gyrus, and the right precuneus. These interactions acted to reduce or hide a main effect in our study and illustrate the importance of taking sex into account when investigating the neurobiology of obsessive-compulsive symptoms.

Obsessive-compulsive and posttraumatic stress symptoms among civilian survivors of war.

PubMed

Morina, Naser; Sulaj, Vita; Schnyder, Ulrich; Klaghofer, Richard; Müller, Julia; Martin-Sölch, Chantal; Rufer, Michael

2016-04-27

Several psychological sequelae have been identified in civilian war survivors. However, little is known about the prevalence of obsessive-compulsive symptoms and their relationship to trauma in this population. Fifty-one adult civilian survivors of the Kosovo War (28 males) who had immigrated to Switzerland completed the Revised Obsessive-Compulsive Inventory Scale, the Posttraumatic Stress Diagnostic Scale and the Hopkins Symptom Checklist. Data were analysed using multiple regression analyses. Overall, 35 and 39% of the sample scored above the cut-offs for likely obsessive-compulsive disorder and posttraumatic stress disorder, respectively. Participants with high levels of posttraumatic stress symptoms were significantly more likely to have obsessive-compulsive symptoms, and vice versa. In multiple regression analysis, gender and severity of posttraumatic stress symptoms were predictors of obsessive-compulsive symptoms, whereas number of traumatic life event types and depressive symptoms were not. Given the small sample size, the results of this study need to be interpreted cautiously. Nevertheless, a surprisingly high number of participants in our study suffered from both obsessive-compulsive and posttraumatic stress symptoms, with obsessive-compulsive symptoms tending to be more pronounced in women. It remains, therefore, critical to specifically assess both obsessive-compulsive and posttraumatic stress symptoms in civilian war survivors, and to provide persons afflicted with appropriate mental health care.

The Relative Contributions of Experiential Avoidance and Distress Tolerance to OC Symptoms.

PubMed

Blakey, Shannon M; Jacoby, Ryan J; Reuman, Lillian; Abramowitz, Jonathan S

2016-07-01

Obsessive beliefs account for substantial (but not all) obsessive-compulsive (OC) symptoms. Intolerance of internal experiences (IIE), which encompasses the constructs of experiential avoidance (EA) and distress tolerance (DT), refers to difficulty managing unwanted thoughts, emotions, and other internal states, and might add to current explanatory models. Although IIE appears to be conceptually relevant to obsessive-compulsive (OC) symptoms, scant research has examined this relationship empirically. The present study examined the relative contributions of EA and DT as predictors of OC symptom dimensions. A nonclinical sample (n = 496) completed self-report questionnaires measuring general distress, EA, DT and OC symptom dimensions. All variables of interest were significantly (all ps ≤ .001) correlated with one another, such that higher general distress, higher EA, and lower DT were associated with greater OC symptom severity for all symptom dimensions; however, only EA independently predicted obsessional symptoms, but not other OC symptom dimensions. One's willingness to endure (i.e. EA), rather than their ability to tolerate (i.e. DT) unpleasant internal experiences best predicts obsessional symptoms (i.e. obsessing) above and beyond general distress. Potential implications for understanding, assessing, and treating OC symptoms are discussed.

Repetitive behaviour in children with high functioning autism and obsessive compulsive disorder.

PubMed

Zandt, Fiona; Prior, Margot; Kyrios, Michael

2007-02-01

Children with Autism Spectrum Disorders (ASD) and children with Obsessive Compulsive Disorder (OCD) were compared on a range of repetitive behaviours. Parents reported similar levels of sameness behaviour and repetitive movements in the clinical groups, although children with OCD engaged in more repetitive behaviour focussed around routines and rituals. Children with OCD reported more compulsions and obsessions than children with ASD; both groups reported more compulsions and obsessions than a typically developing comparison group. Types of compulsions and obsessions tended to be less sophisticated in children with ASD than those with OCD. Sameness behaviour was more prevalent in younger children with OCD, but for children with ASD, age was not significantly related to sameness behaviour, repetitive movements, compulsions, or obsessions.

Dissociative Experiences are Associated with Obsessive-Compulsive Symptoms in a Non-clinical Sample: A Latent Profile Analysis

PubMed Central

BOYSAN, Murat

2014-01-01

Introduction There has been a burgeoning literature considering the significant associations between obsessive-compulsive symptoms and dissociative experiences. In this study, the relationsips between dissociative symtomotology and dimensions of obsessive-compulsive symptoms were examined in homogeneous sub-groups obtained with latent class algorithm in an undergraduate Turkish sample. Method Latent profile analysis, a recently developed classification method based on latent class analysis, was applied to the Dissociative Experiences Scale (DES) item-response data from 2976 undergraduates. Differences in severity of obsessive-compulsive symptoms, anxiety and depression across groups were evaluated by running multinomial logistic regression analyses. Associations between latent class probabilities and psychological variables in terms of obsessive-compulsive sub-types, anxiety, and depression were assessed by computing Pearson’s product-moment correlation coefficients. Results The findings of the latent profile analysis supported further evidence for discontinuity model of dissociative experiences. The analysis empirically justified the distinction among three sub-groups based on the DES items. A marked proportion of the sample (42%) was assigned to the high dissociative class. In the further analyses, all sub-types of obsessive-compulsive symptoms significantly differed across latent classes. Regarding the relationships between obsessive-compulsive symptoms and dissociative symptomatology, low dissociation appeared to be a buffering factor dealing with obsessive-compulsive symptoms; whereas high dissociation appeared to be significantly associated with high levels of obsessive-compulsive symptoms. Conclusion It is concluded that the concept of dissociation can be best understood in a typological approach that dissociative symptomatology not only exacerbates obsessive-compulsive symptoms but also serves as an adaptive coping mechanism. PMID:28360635

Dissociative Experiences are Associated with Obsessive-Compulsive Symptoms in a Non-clinical Sample: A Latent Profile Analysis.

PubMed

Boysan, Murat

2014-09-01

There has been a burgeoning literature considering the significant associations between obsessive-compulsive symptoms and dissociative experiences. In this study, the relationsips between dissociative symtomotology and dimensions of obsessive-compulsive symptoms were examined in homogeneous sub-groups obtained with latent class algorithm in an undergraduate Turkish sample. Latent profile analysis, a recently developed classification method based on latent class analysis, was applied to the Dissociative Experiences Scale (DES) item-response data from 2976 undergraduates. Differences in severity of obsessive-compulsive symptoms, anxiety and depression across groups were evaluated by running multinomial logistic regression analyses. Associations between latent class probabilities and psychological variables in terms of obsessive-compulsive sub-types, anxiety, and depression were assessed by computing Pearson's product-moment correlation coefficients. The findings of the latent profile analysis supported further evidence for discontinuity model of dissociative experiences. The analysis empirically justified the distinction among three sub-groups based on the DES items. A marked proportion of the sample (42%) was assigned to the high dissociative class. In the further analyses, all sub-types of obsessive-compulsive symptoms significantly differed across latent classes. Regarding the relationships between obsessive-compulsive symptoms and dissociative symptomatology, low dissociation appeared to be a buffering factor dealing with obsessive-compulsive symptoms; whereas high dissociation appeared to be significantly associated with high levels of obsessive-compulsive symptoms. It is concluded that the concept of dissociation can be best understood in a typological approach that dissociative symptomatology not only exacerbates obsessive-compulsive symptoms but also serves as an adaptive coping mechanism.

The Obsessive Compulsive Scale of the Child Behavior Checklist Predicts Obsessive-Compulsive Disorder: A Receiver Operating Characteristic Curve Analysis

ERIC Educational Resources Information Center

Hudziak, James J.; Althoff, Robert R.; Stanger, Catherine; van Beijsterveldt, C. E. M.; Nelson, Elliot C.; Hanna, Gregory L.; Boomsma, Dorret I.; Todd, Richard D.

2006-01-01

Background: The purpose of this study was to determine a score on the Obsessive Compulsive Scale (OCS) from the Child Behavior Checklist (CBCL) to screen for obsessive compulsive disorder (OCD) in children and to rigorously test the specificity and sensitivity of a single cutpoint. Methods: A receiver operating characteristic (ROC) curve analysis…

Predicting obsessions and compulsions according to superego and ego characteristics: A comparison between scrupulosity and non-religious obsessive-compulsive symptoms.

PubMed

Besharat, Mohammad Ali; Kamali, Zeynab Sadat

2016-02-01

Obsessive Compulsive Disorder (OCD) is characterized by intrusive images or impulses and/or ritualistic and rigid behaviors. Symptoms of OCD have different contents including contamination, harming and symmetry. Religion is one of the themes that has been observed in the context of OCD frequently. The aim of the present study was to examine the power of superego and ego characteristics in predicting scrupulosity and non-religious obsessions and compulsions, as well as comparing the two sets of obsessive-compulsive symptoms. Sixty six Iranian (19 men, 47 women) participated in the study. All participants were asked to complete Maudsley Obsessive-Compulsive Inventory, Penn Inventory of Scrupulosity, Perfectionism Cognitions Inventory, the Multidimensional Anger Inventory, and Ego Strength Scale. Results showed that perfectionism and anger were positively correlated with scrupulosity and non-religious obsessive-compulsive symptoms. Ego control was negatively correlated with scrupulosity, while ego resiliency was not correlated with any of these two sets of symptoms. Regression analysis indicated that among these variables, anger was the best predictor of non-religious obsessive-compulsive symptoms, while perfectionism and ego control were the best predictors of scrupulosity. Copyright © 2016. Published by Elsevier B.V.

Personality disorder functioning styles are associated with the effects of the cognitive-behavioral therapy for panic disorder: a preliminary study.

PubMed

Chen, Wanzhen; Hu, Jing; Xu, Shaofang; Shen, Mowei; Chai, Hao; Wang, Wei

2014-06-01

The effect of the cognitive behavioral therapy (CBT) for panic disorder varies, but how personality disorder functioning style influences it remains unclear. In 30 healthy volunteers and 44 patients with panic disorder (22 treated and 22 waiting list), we administered the Parker Personality Measure (PERM) and the Plutchik-van Praag Depression Inventory (PVP). Before and during the CBT or waiting period, patients were asked to record their panic attacks using the Panic Attack Record (PAR). Patients scored significantly higher on PERM Antisocial, Borderline, Histrionic, Avoident, Dependent, and Passive-aggressive styles and on depression. After CBT, all PAR parameters were significantly reduced in the treated group. The Obsessive-compulsive style was positively correlated with the panic attack duration and the total-thought before CBT or waiting period in all patients. In treated patients, the decreased panic attack duration was positively correlated with Histrionic, Obsessive-compulsive and Passive-aggressive; the decreased total symptom number was positively correlated with Antisocial and Histrionic; the decreased total-sensation was positively correlated with antisocial; and the total-thought was positively correlated with Narcissistic style. The length and duration of CBT was short and mainly with behavioral strategies, how personality influenced the related cognition per se remains unknown here. However, our preliminary results indicate that personality disorder functioning styles related to the externalized behaviors and the Obsessive-compulsive style have positive effects on CBT for panic disorder, implying that CBT practitioners should note their personality styles when treating these patients.

Test Review: C. R. Reynolds and B. Livingston "CMOCS--Children's Measure of Obsessive-Compulsive Symptoms." Los Angeles, CA: Western Psychological Services, 2010

ERIC Educational Resources Information Center

Lund, Emily M.; Dennison, Andrea; Ewing, Heidi K.; de Carvalho, Catharina F.

2011-01-01

This article presents a review of the Children's Measure of Obsessive-Compulsive Symptoms (CMOCS), a self-report screening measure of obsessive and compulsive thoughts and behaviors in children and adolescents aged 8 through 19 years. Obsessive-compulsive disorder (OCD) is estimated to affect 1% to 3% of the population over their lifetime. The…

Mapping Compulsivity in the DSM-5 Obsessive Compulsive and Related Disorders: Cognitive Domains, Neural Circuitry, and Treatment

PubMed Central

Apergis-Schoute, Annemieke M; Vaghi, Matilde M; Banca, Paula; Gillan, Claire M; Voon, Valerie; Chamberlain, Samuel R; Cinosi, Eduardo; Reid, Jemma; Shahper, Sonia; Bullmore, Edward T; Sahakian, Barbara J; Robbins, Trevor W

2018-01-01

Abstract Compulsions are repetitive, stereotyped thoughts and behaviors designed to reduce harm. Growing evidence suggests that the neurocognitive mechanisms mediating behavioral inhibition (motor inhibition, cognitive inflexibility) reversal learning and habit formation (shift from goal-directed to habitual responding) contribute toward compulsive activity in a broad range of disorders. In obsessive compulsive disorder, distributed network perturbation appears focused around the prefrontal cortex, caudate, putamen, and associated neuro-circuitry. Obsessive compulsive disorder-related attentional set-shifting deficits correlated with reduced resting state functional connectivity between the dorsal caudate and the ventrolateral prefrontal cortex on neuroimaging. In contrast, experimental provocation of obsessive compulsive disorder symptoms reduced neural activation in brain regions implicated in goal-directed behavioral control (ventromedial prefrontal cortex, caudate) with concordant increased activation in regions implicated in habit learning (presupplementary motor area, putamen). The ventromedial prefrontal cortex plays a multifaceted role, integrating affective evaluative processes, flexible behavior, and fear learning. Findings from a neuroimaging study of Pavlovian fear reversal, in which obsessive compulsive disorder patients failed to flexibly update fear responses despite normal initial fear conditioning, suggest there is an absence of ventromedial prefrontal cortex safety signaling in obsessive compulsive disorder, which potentially undermines explicit contingency knowledge and may help to explain the link between cognitive inflexibility, fear, and anxiety processing in compulsive disorders such as obsessive compulsive disorder. PMID:29036632

Intact coding region of the serotonin transporter gene in obsessive-compulsive disorder

DOE Office of Scientific and Technical Information (OSTI.GOV)

Altemus, M.; Murphy, D.L.; Greenberg, B.

1996-07-26

Epidemiologic studies indicate that obsessive-compulsive disorder is genetically transmitted in some families, although no genetic abnormalities have been identified in individuals with this disorder. The selective response of obsessive-compulsive disorder to treatment with agents which block serotonin reuptake suggests the gene coding for the serotonin transporter as a candidate gene. The primary structure of the serotonin-transporter coding region was sequenced in 22 patients with obsessive-compulsive disorder, using direct PCR sequencing of cDNA synthesized from platelet serotonin-transporter mRNA. No variations in amino acid sequence were found among the obsessive-compulsive disorder patients or healthy controls. These results do not support a rolemore » for alteration in the primary structure of the coding region of the serotonin-transporter gene in the pathogenesis of obsessive-compulsive disorder. 27 refs.« less

[The effect of 3-oxypyridine and succinic acid derivatives on obsessive-compulsive activity of mice in marble-burying test].

PubMed

Volchegorskiĭ, I A; Miroshnichenko, I Iu; Rassokhina, L M; Faĭzullin, R M; Priakhina, K E

2014-01-01

The effect of domestic derivatives of 3-oxypyridine and succinic acid (emoxipine, reamberin, and mexidol) on obsessive-compulsive behavior of mice was studied in the marble-burying test. Additionally the effect of these drugs on the behavior of animals was assessed in the open field test. Amitriptylin and alpha-lipoic acid were used as reference drugs. It was established that single administration of the investigated drugs in optimal doses, corresponding to therapeutic range in humans, inhibits obsessive-compulsive behavior of mice in the marble-burying test. Amitriptylin and alpha-lipoic acid produced similar effects. It is established that emoxipine stimulates the behavior of mice in the open field after single administration. An increase in the emoxipine dose led to decrease of stimulation and gradual development of sedative effect. Reamberin and mexidol, as well as alpha-lipoic acid and amitriptyline, caused sedation in mice tested in the open field. Inhibiting effect of emoxipine, reamberin, mexidol and alpha-lipoic acid on the obsessive-compulsive behavior in mice directly depended on sedative action of these drugs.

Relationships between magical thinking, obsessive-compulsiveness and other forms of anxiety in a sample of non-clinical children.

PubMed

Simonds, Laura M; Demetre, James D; Read, Cristina

2009-06-01

Despite the obvious phenomenological similarities between magical thinking and obsessive-compulsiveness, the relationship between them has been the subject of few empirical investigations in samples of children. The present study aimed to examine the relationship between a general epistemic stance towards magical causation and tendencies towards obsessive-compulsiveness in a non-clinical sample of schoolchildren. One-hundred and two children, aged between 5 and 10 years (48 boys and 54 girls), completed questionnaire measures designed to assess magical thinking, obsessive-compulsiveness, and other forms of anxiety. School teachers completed a measure of strengths and difficulties for each child. General belief in magical causation was correlated with all types of anxiety, not just obsessive-compulsiveness, with significant correlations shown for boys in the sample, but not girls. General belief in magical causation contributed little to the prediction of obsessive-compulsiveness beyond general anxiety. In this study, a general epistemic stance towards magical causation did not differentiate obsessive-compulsiveness from other anxiety dimensions. The findings are considered in the context of developmental theories of magical and scientific causal reasoning.

Temperament features in adolescents with ego-syntonic or ego-dystonic obsessive-compulsive symptoms.

PubMed

Marchesi, Carlo; Ampollini, Paolo; DePanfilis, Chiara; Maggini, Carlo

2008-09-01

The present study evaluated whether different patterns of temperament may predict a different threshold of acceptability of obsessive-compulsive (OC) symptoms in adolescents. OC symptomatology was detected with the Leyton Obsessional Inventory-Child Version (LOI-CV) and temperament was assessed using the tridimensional personality questionnaire in 2,775 high-school students. According to the LOI-CV scores, the adolescents were classified as high interference (interfering, ego-dystonic symptoms) (HI), supernormal (noninterfering, ego-syntonic symptoms) (Sn) and controls (C) HI were 119 (4.3%), Sn 85 (3.1%) and C 2,571 (92.6%). The best predictor of belonging to HI or Sn groups was the temperament configuration of high Harm Avoidance (HA) and high Persistence (P). The feature that mainly distinguishes the two symptomatic groups were Novelty Seeking (NS) levels. Our data suggest that people characterized by pessimistic worry in anticipation of future problems, passive avoidant behaviour, rapid fatigability (high HA) and irresoluteness, ambitiousness, perseverance, perfectionism, enduring feelings of frustration (high P) might develop OC symptoms. Whether OC symptoms become ego-syntonic or ego-dystonic seems to mainly depend on NS levels: low NS might protect people (with the prevention of "exploratory and active behaviours" that may elicit loss of control on symptoms) from the development of interfering OC symptoms.

Obsessive-Compulsive Personality Traits in Youth with Obsessive-Compulsive Disorder.

PubMed

Park, Jennifer M; Storch, Eric A; Pinto, Anthony; Lewin, Adam B

2016-04-01

While interest in the relationship between obsessive-compulsive disorder (OCD) and obsessive compulsive personality disorder has increased, there are currently no studies that have examined the presence of obsessive compulsive personality traits (OCPTs) in youth. The current study sought to determine the latent factors and psychometric properties of a modified version of the Childhood Retrospective Perfectionism Questionnaire (CHIRP) and examine the correlates of specific OCPTs (e.g., rigidity, perfectionism) in youth with OCD. Participants included 96 treatment-seeking youth diagnosed with primary OCD (and a parent). Parents and youth completed measures of OCPTs, OCD severity, depression, and disability. A confirmatory factor analysis of the modified CHIRP resulted in a two-factor model: perfectionism and preoccupation with details. The CHIRP and its subscales demonstrated acceptable internal consistency and preliminary evidence for convergent and divergent validity. Obsessive compulsive traits in youth were also found to be associated with the checking, symmetry and contamination symptom dimensions.

The Role of the Orbitofrontal Cortex in Normally Developing Compulsive-Like Behaviors and Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Evans, David W.; Lewis, Marc D.; Iobst, Emily

2004-01-01

Mounting evidence concerning obsessive-compulsive disorders points to abnormal functioning of the orbitofrontal cortices. First, patients with obsessive-compulsive disorder (OCD) perform poorly on tasks that rely on response suppression/motor inhibition functions mediated by the orbitofrontal cortex relative to both normal and clinical controls.…

Obsessive-compulsive disorder presenting with musical obsessions in otosclerosis: a case report.

PubMed

Islam, Lucrezia; Scarone, Silvio; Gambini, Orsola

2014-11-24

Musical obsessions consist of intrusive recollections of music fragments that are experienced as unwanted. Otosclerosis is caused by an abnormal bone homeostasis of the otic capsule and represents a frequent cause of hearing impairment. Many conditions causing hearing loss have been associated with musical hallucinations, but the association between musical obsessions and hearing loss is frequently overlooked. We present the case of a 51-year-old Caucasian woman with a history of obsessive-compulsive disorder who developed musical obsessions soon after being diagnosed with otosclerosis. She was referred to our obsessive-compulsive disorder outpatient unit by her general psychiatrist. At the time of our first evaluation, she had severe musical obsessions that interfered with her social functioning and made her unable to follow conversations. She was started on 40mg of paroxetine and 2.5mg of aripiprazole, which led to significant improvement of her symptoms and of her social and work functioning. To the best of our knowledge, this is the first report of musical obsessions in a patient with hearing loss due to otosclerosis and a history of obsessive-compulsive disorder. This case suggests that a differential diagnosis of obsessive-compulsive disorder should be carefully considered in patients with hearing impairment who complain of involuntary musical imagery, especially in those patients who have a previous history of obsessive-compulsive disorder.

The impact of attentional and emotional demands on memory performance in obsessive-compulsive disorder.

PubMed

Fink, Jakob; Hendrikx, Friederike; Stierle, Christian; Stengler, Katarina; Jahn, Ina; Exner, Cornelia

2017-08-01

Lower performance on memory tests in obsessive-compulsive disorder (OCD) has been repeatedly observed. However, the origins of these performance deficits are not sufficiently explained. In this study we tested if OCD-related extensive focus of attention on thoughts (heightened self-consciousness) could be an explanatory mechanism for lower memory performance. Heightened situational self-consciousness was manipulated by instructing participants to either monitor neutral thoughts or to monitor OCD-related thoughts. We included a Behavioral Avoidance Task based on individual obsessions and compulsions to induce OCD-related thoughts. Participants were asked to perform these monitoring tasks in parallel to a taxing verbal memory task, resulting in learning under divided attention. The two conditions of learning under divided attention were compared to a single-task condition. Twenty-four participants with OCD and 24 healthy controls took part in these three learning conditions. The results indicate that in both groups memory performance deteriorated in the two conditions with divided attention compared to the single task condition. In the OCD-related thought monitoring condition (OTM) self-consciousness and Behavioral Avoidance Task-induced stress and fear were particularly increased and memory performance further deteriorated in the OCD group. This finding highlights an important and underestimated mechanism (personal involvement) which might serve to better understand lower memory performance in OCD. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders: recruitment, assessment instruments, methods for the development of multicenter collaborative studies and preliminary results.

PubMed

Miguel, Euripedes Constantino; Ferrão, Ygor Arzeno; Rosário, Maria Conceição do; Mathis, Maria Alice de; Torres, Albina Rodrigues; Fontenelle, Leonardo Franklin; Hounie, Ana Gabriela; Shavitt, Roseli Gedanke; Cordioli, Aristides Volpato; Gonzalez, Christina Hojaij; Petribú, Kátia; Diniz, Juliana Belo; Malavazzi, Dante Marino; Torresan, Ricardo C; Raffin, Andréa Litvin; Meyer, Elisabeth; Braga, Daniela T; Borcato, Sonia; Valério, Carolina; Gropo, Luciana N; Prado, Helena da Silva; Perin, Eduardo Alliende; Santos, Sandro Iêgo; Copque, Helen; Borges, Manuela Corrêa; Lopes, Angélica Prazeres; Silva, Elenita D da

2008-09-01

To describe the recruitment of patients, assessment instruments, implementation, methods and preliminary results of The Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders, which includes seven university sites. This cross-sectional study included a comprehensive clinical assessment including semi-structured interviews (sociodemographic data, medical and psychiatric history, disease course and comorbid psychiatric diagnoses), and instruments to assess obsessive-compulsive (Yale-Brown Obsessive-Compulsive Scale and Dimensional Yale-Brown Obsessive-Compulsive Scale), depressive (Beck Depression Inventory) and anxious (Beck Anxiety Inventory) symptoms, sensory phenomena (Universidade de São Paulo Sensory Phenomena Scale), insight (Brown Assessment Beliefs Scale), tics (Yale Global Tics Severity Scale) and quality of life (Medical Outcome Quality of Life Scale Short-form-36 and Social Assessment Scale). The raters' training consisted of watching at least five videotaped interviews and interviewing five patients with an expert researcher before interviewing patients alone. The reliability between all leaders for the most important instruments (Structured Clinical Interview for DSM-IV, Dimensional Yale-Brown Obsessive-Compulsive Scale, Universidade de São Paulo Sensory Phenomena Scale) was measured after six complete interviews. Inter-rater reliability was 96%. By March 2008, 630 obsessive-compulsive disorder patients had been systematically evaluated. Mean age (+/-SE) was 34.7 (+/-0.51), 56.3% were female, and 84.6% Caucasian. The most prevalent obsessive compulsive symptom dimensions were symmetry and contamination. The most common comorbidities were major depression, generalized anxiety and social anxiety disorder. The most common DSM-IV impulsive control disorder was skin picking. The sample was composed mainly by Caucasian individuals, unmarried, with some kind of occupational activity, mean age of 35 years, onset of obsessive-compulsive symptoms at 13 years of age, mild to moderate severity, mostly of symmetry, contamination/cleaning and comorbidity with depressive disorders. The Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders has established an important network for standardized collaborative clinical research in obsessive-compulsive disorder and may pave the way to similar projects aimed at integrating other research groups in Brazil and throughout the world.

Validation study of the Japanese version of the Obsessive-Compulsive Drinking Scale.

PubMed

Tatsuzawa, Yasutaka; Yoshimasu, Haruo; Moriyama, Yasushi; Furusawa, Teruyuki; Yoshino, Aihide

2002-02-01

The Obsessive-Compulsive Drinking Scale (OCDS) is a self-rating questionnaire that measures cognitive and behavioral aspects of craving for alcohol. The OCDS consists of two subscales: the obsessive thoughts of drinking subscale (OS) and the compulsive drinking subscale (CS). This study aims to validate the Japanese version of the OCDS. First, internal consistency and discriminant validity were evaluated. Second, a prospective longitudinal 3-month outcome study of 67 patients with alcohol dependence who participated in a relapse prevention program was designed to assess the concurrent and predictive validity of the OCDS. The OCDS demonstrated high internal consistency. The OS had high discriminant validity, while the CS did not. Twenty-three patients (34.3%) dropped out of treatment. These patients had significantly higher OS scores than those who completed the program. At 3 months, the relapse group had significantly higher OCDS scores than the no relapse group. Also, the OCDS score was higher in subjects who had early-onset alcohol dependence than late-onset dependence. The OCDS is useful for evaluating cognitive aspect of craving and predicts dropout and relapse.

[Impact of eating psychopathology, obsessive-compulsion and depression on self-harm behavior in patients with eating disorders].

PubMed

Kong, Seong Sook

2009-08-01

The purpose of the study was to investigate psychological factors such as eating psychopathology, depression, and obsessive-compulsion that might influence self-harm behavior in patients with eating disorders. Patients with eating disorders (n=135) who visited "M" clinic for eating disorders participated in the study. Data were collected from March to August 2007 using the Eating Disorder Inventory-2, Beck Depression Inventory, Maudsley Obsessional-Compulsive Inventory, and Self-Harm Inventory (SHI). The participants scored high on self-harm as well as on depression and obsessive-compulsion. On the SHI, a high frequency of self harm behavior such as 'torturing self with self-defeating thoughts', 'abused alcohol', 'hit self', and 'suicide attempt' were found for the participants. There were significant correlations between most eating psychopathology variables, depression, obsessive-compulsion, and self-harm behavior. 'Interoceptive awareness' (eating psychopathology), depression, and 'checking' (obsessive-compulsion) were significant predictors of self-harm behavior. Future interventions for patients with eating disorders should focus on assessing the possibility of self-harm and suicidal attempts, especially in those patients with high levels of eating psychopathology, depression, or obsessive-compulsion. Early intervention for depression and obsessive-compulsion could contribute to preventing self-harm and suicide in patients with eating disorders.

Predictive value of obsessive compulsive symptoms involving the skin on quality of life in patients with acne vulgaris.

PubMed

Bez, Yasin; Yesilova, Yavuz; Arı, Mustafa; Kaya, Mehmet Cemal; Alpak, Gokay; Bulut, Mahmut

2013-11-01

Acne is one of the most common dermatological diseases, and obsessive compulsive disorder is among the most frequent psychiatric conditions seen in dermatology clinics. Comorbidity of these conditions may therefore be expected. The aim of this study was to measure obsessive compulsive symptoms and quality of life in patients with acne vulgaris, compare them with those of healthy control subjects, and determine whether there is any predictive value of obsessive compulsive symptoms for quality of life in patients with acne. Obsessive compulsive symptoms and quality of life measurements of 146 patients with acne vulgaris and 94 healthy control subjects were made using the Maudsley Obsessive Compulsive Questionnaire and Short Form-36 in a cross-sectional design. Patients with acne vulgaris had lower scores for physical functioning, physical role dysfunction, general health perception, vitality, and emotional role dysfunction. They also had higher scores for checking, slowness, and rumination. The only predictor of physical functioning and vitality dimensions of health-related quality of life in these patients was rumination score. Obsessive compulsive symptoms in patients with acne vulgaris are higher than in controls, and this may correlate with both disease severity and quality of life for patients.

Personality Disorders in Gay, Lesbian, Bisexual and Transgender Chemically Dependent Patients

PubMed Central

Grant, Jon E.; Flynn, Meredith; Odlaug, Brian L.; Schreiber, Liana R.N.

2011-01-01

This study sought to examine personality disorders and their related clinical variables in a sample of gay, lesbian, bisexual and transgender (GLBT) individuals with substance use disorders. Study participants were 145 GLBT patients who were admitted to a residential dual diagnosis chemical dependency treatment program. A total of 136 (93.8%) had at least one personality disorder. The most common personality disorders were borderline (n=93; 64.1%), obsessive-compulsive (n=82; 56.6%), and avoidant (n=71; 49.0%) personality disorders. Preliminary data suggests there is a high prevalence of personality disorders in the GLBT population undergoing chemical dependency treatment. PMID:21838838

Treatment for obsessive-compulsive disorder (OCD) and OCD-related disorders using GVG

DOEpatents

Dewey, Stephen L.; Brodie, Jonathan D.; Ashby, Jr., Charles R.

2002-01-01

The present invention relates to the use of gamma vinyl-GABA (GVG) to treat obsessive-compulsive disorder (OCD) and OCD-related disorders, and to reduce or eliminate behaviors associated with obsessive-compulsive disorder (OCD) and OCD-related disorders.

Obsessive-compulsive skin disorders: a novel classification based on degree of insight.

PubMed

Zhu, Tian Hao; Nakamura, Mio; Farahnik, Benjamin; Abrouk, Michael; Reichenberg, Jason; Bhutani, Tina; Koo, John

2017-06-01

Individuals with obsessive-compulsive features frequently visit dermatologists for complaints of the skin, hair or nails, and often progress towards a chronic relapsing course due to the challenge associated with accurate diagnosis and management of their psychiatric symptoms. The current DSM-5 formally recognizes body dysmorphic disorder, trichotillomania, neurotic excoriation and body focused repetitive behavior disorder as psychodermatological disorders belonging to the category of Obsessive-Compulsive and Related Disorders. However there is evidence that other relevant skin diseases such as delusions of parasitosis, dermatitis artefacta, contamination dermatitis, AIDS phobia, trichotemnomania and even lichen simplex chronicus possess prominent obsessive-compulsive characteristics that do not necessarily fit the full diagnostic criteria of the DSM-5. Therefore, to increase dermatologists' awareness of this unique group of skin disorders with OCD features, we propose a novel classification system called Obsessive-Compulsive Insight Continuum. Under this new classification system, obsessive-compulsive skin manifestations are categorized along a continuum based on degree of insight, from minimal insight with delusional obsessions to good insight with minimal obsessions. Understanding the level of insight is thus an important first step for clinicians who routinely interact with these patients.

Understanding the Association of Impulsivity, Obsessions, and Compulsions with Binge Eating and Purging Behaviors in Anorexia Nervosa

PubMed Central

Hoffman, Elizabeth R.; Gagne, Danielle A.; Thornton, Laura M.; Klump, Kelly L.; Brandt, Harry; Crawford, Steve; Fichter, Manfred M.; Halmi, Katherine A.; Johnson, Craig; Jones, Ian; Kaplan, Allan S.; Mitchell, James E.; Strober, Michael; Treasure, Janet; Woodside, D. Blake; Berrettini, Wade H.; Kaye, Walter H.; Bulik, Cynthia M.

2012-01-01

Objective To further refine our understanding of impulsivity, obsessions, and compulsions in anorexia nervosa (AN) by isolating which behaviors—binge eating, purging, or both—are associated with these features. Methods We conducted regression analyses with binge eating, purging, and the interaction of binge eating with purging as individual predictors of scores for impulsivity, obsessions, and compulsions in two samples of women with AN (n = 1373). Results Purging, but not binge eating, was associated with higher scores of impulsivity, obsessions and compulsions. Purging was also associated with worst eating rituals and with worst eating preoccupations. Conclusion Our results suggest that purging, compared with binge eating, may be a stronger correlate of impulsivity, obsessions, and compulsions in AN. PMID:22351620

Obsessive-Compulsive Disorder. [Revised.

ERIC Educational Resources Information Center

Strock, Margaret

This booklet provides an overview of the causes, symptoms, and incidence of obsessive-compulsive disorder (OCD) and addresses the key features of OCD, including obsessions, compulsions, realizations of senselessness, resistance, and shame and secrecy. Research findings into the causes of OCD are reviewed which indicate that the brains of…

The presence of magical thinking in obsessive compulsive disorder.

PubMed

Einstein, Danielle A; Menzies, Ross G

2004-05-01

Two research groups have raised the possibility that magical ideation may be a fundamental feature of obsessive-compulsive disorder. It has been proposed to underlie thought action fusion and superstitious beliefs. In this study, the Magical Ideation scale, the Lucky Behaviours and Lucky Beliefs scales, the Thought Action Fusion-Revised scale, the Padua Inventory, and the Obsessive Compulsive Inventory-Short Version were completed by 60 obsessive compulsive patients at a hospital clinic. Of all the measures, the Magical Ideation (MI) scale was found to be the most strongly related to obsessive compulsive symptoms. Large and significant relationships between MI scores and the measures of OCD were obtained even when alternative constructs (Lucky Behaviours, Lucky Beliefs, Thought Action Fusion-Revised scales) were held constant. No other variable remained significantly related to the Obsessive Compulsive Inventory-Short Version when magical ideation scores were held constant. The findings suggest that a general magical thinking tendency may underpin previous observed links between superstitiousness, thought action fusion and OCD severity.

Altered inhibition-related frontolimbic connectivity in obsessive-compulsive disorder.

PubMed

van Velzen, Laura S; de Wit, Stella J; Ćurĉić-Blake, Branislava; Cath, Daniëlle C; de Vries, Froukje E; Veltman, Dick J; van der Werf, Ysbrand D; van den Heuvel, Odile A

2015-10-01

Recent studies have shown that response inhibition is impaired in patients with obsessive-compulsive disorder and their unaffected siblings, suggesting that these deficits may be considered a cognitive endophenotype of obsessive-compulsive disorder. Structural and functional neural correlates of altered response inhibition have been identified in patients and siblings. This study aims to examine the functional integrity of the response inhibition network in patients with obsessive-compulsive disorder and their unaffected siblings. Forty-one unmedicated patients with obsessive-compulsive disorder, 17 of their unaffected siblings and 37 healthy controls performed a stop signal task during functional magnetic resonance imaging. Psycho-physiological interaction analysis was used to examine functional connectivity between the following regions of interest: the bilateral inferior frontal gyri, presupplementary motor area, subthalamic nuclei, inferior parietal lobes, anterior cingulate cortex, and amygdala. We then used dynamic causal modeling to investigate the directionality of the networks involved. Patients, and to a lesser extent also their unaffected siblings, show altered connectivity between the inferior frontal gyrus and the amygdala during response inhibition. The follow-up dynamic causal modeling suggests a bottom-up influence of the amygdala on the inferior frontal gyrus in healthy controls, whereas processing occurs top-down in patients with obsessive-compulsive, and in both directions in siblings. Our findings suggest that amygdala activation in obsessive-compulsive disorder interferes differently with the task-related recruitment of the inhibition network, underscoring the role of limbic disturbances in cognitive dysfunctions in obsessive-compulsive disorder. © 2015 Wiley Periodicals, Inc.

The relationship between Obsessive-Compulsive symptoms and PARKIN genotype: The CORE-PD study

PubMed Central

Sharp, ME; Caccappolo, E; Mejia-Santana, H; Tang, M–X; Rosado, L; Orbe Reilly, M; Ruiz, D; Louis, ED; Comella, C; Nance, M; Bressman, S; Scott, WK; Tanner, C; Waters, C; Fahn, S; Cote, L; Ford, B; Rezak, M; Novak, K; Friedman, JH; Pfeiffer, R; Payami, H; Molho, E; Factor, SA; Nutt, J; Serrano, C; Arroyo, M; Pauciulo, MW; Nichols, WC; Clark, LN; Alcalay, RN; Marder, KS

2014-01-01

Background Few studies have systematically investigated the association between PARKIN genotype and psychiatric co-morbidities of PD. PARKIN-associated PD is characterized by severe nigral dopaminergic neuronal loss, a finding that may have implications for behaviors rooted in dopaminergic circuits such as obsessive-compulsive symptoms (OCS). Methods The Schedule of Compulsions and Obsessions Patient Inventory (SCOPI) was administered to 104 patients with early-onset PD and 257 asymptomatic first-degree relatives. Carriers of one and two PARKIN mutations were compared to non-carriers. Results Among patients, carriers scored lower than non-carriers in adjusted models (one-mutation: 13.9 point difference, p=0.03; two-mutation: 24.1, p=0.001), where lower scores indicate less OCS. Among asymptomatic relatives, there was a trend towards the opposite: mutation carriers scored higher than non-carriers (one mutation p = 0.05; two mutations p = 0.13). Conclusions First, there was a significant association between PARKIN mutation status and obsessive-compulsive symptom level in both PD and asymptomatics, suggesting that OCS might represent an early non-motor dopamine-dependent feature. Second, irrespective of disease status, heterozygotes were significantly different that non-carriers suggesting that PARKIN heterozygosity may contribute to phenotype. PMID:25393808

[Neuroimaging the various symptom dimensions of obsessive-compulsive disorder].

PubMed

Dold, Markus; Aigner, Martin

2009-01-01

Following consensus on fronto-striato-thalamo-frontal dysfunction as the neuronal basis of obsessive-compulsive disorder, and increasing sub-classification of this clinical picture, neurobiological differentiation of the various obsessive symptoms is also attracting interest in neuroimaging research. Original papers studying the neurobiological correlates of the various dimensions of obsessive-compulsive disorder were listed by a systematic literature search. The "washing" factor seems to involve particular brain structures dealing with emotional control (mainly the orbito-frontal cortex (OFC), anterior cingulate cortex (ACC), amygdala and insula), but the predominant areas in the "forbidden thoughts" factor are cognitive control brain regions (mainly basal ganglia and ACC), and in hoarding obsessions and compulsions they are decision-making areas (mainly ventro-medial parts of the OFC and dorso-lateral prefrontal cortex (DLPFC)). The results underline the neurobiological heterogeneity of the obsessive-compulsive disorder clinical picture, pointing the way for future research approaches.

The continuity between DSM-5 obsessive-compulsive personality disorder traits and obsessive-compulsive symptoms in adolescence: an item response theory study.

PubMed

De Caluwé, Elien; Rettew, David C; De Clercq, Barbara

2014-11-01

Various studies have shown that obsessive-compulsive symptoms exist as part of not only obsessive-compulsive disorder (OCD) but also obsessive-compulsive personality disorder (OCPD). Despite these shared characteristics, there is an ongoing debate on the inclusion of OCPD into the recently developed DSM-5 obsessive-compulsive and related disorders (OCRDs) category. The current study aims to clarify whether this inclusion can be justified from an item response theory approach. The validity of the continuity model for understanding the association between OCD and OCPD was explored in 787 Dutch community and referred adolescents (70% female, 12-20 years old, mean = 16.16, SD = 1.40) studied between July 2011 and January 2013, relying on item response theory (IRT) analyses of self-reported OCD symptoms (Youth Obsessive-Compulsive Symptoms Scale [YOCSS]) and OCPD traits (Personality Inventory for DSM-5 [PID-5]). The results support the continuity hypothesis, indicating that both OCD and OCPD can be represented along a single underlying spectrum. OCD, and especially the obsessive symptom domain, can be considered as the extreme end of OCPD traits. The current study empirically supports the classification of OCD and OCPD along a single dimension. This integrative perspective in OC-related pathology addresses the dimensional nature of traits and psychopathology and may improve the transparency and validity of assessment procedures. © Copyright 2014 Physicians Postgraduate Press, Inc.

[Current and emerging features of obsessive-compulsive disorder--trends for the revision of DSM-5].

PubMed

Matsunaga, Hisato

2012-01-01

Obsessive-compulsive disorder (OCD) is characterized as significant impairment of cognitive-behavioral inhibition, which is causally associated with cognitive processes evoking anxiety, along with increased desire for perfect control over the possible harm, at least in typical OCD patients who have compulsions in response to obsessions. However, OCD has been well conceptualized as a multidimensional and heterogeneous disorder apparently comprising a number of potentially valid subtypes. For example, OCD can be diagnosed by either obsessions or compulsions, and a certain type of OCD patient has only compulsions in response to rules that must be applied rigidly. They often become stuck as a result of rigid rules in every step of their daily working and social life. This type of compulsive behavior is often triggered by specific sensory phenomena such as sight, touch, or personal expression (e. g. need to express himself precisely in written or spoken words). Thus, such OCD patients usually perform their compulsions in order to relieve sensory phenomena such as feelings of incompleteness and urges to reach a specific sensation of feeling "just right", and are less likely to have obsessions or cognitive processes preceding the repetitive behaviors. This type of OCD has also been characterized as "tic-related" and tends to have comorbid conditions such as tic disorders, ADHD or skin picking. Indeed, there are some crucial and significant differences in the psychopathology, phenomenology, and putative biological bases between OCD patients with obsession-related compulsions (cognitive type) and those with compulsions repeated according to rigid rules (motoric type). Because of the substantial heterogeneity of OCD, it seems to be beyond the traditional learning model in which anxiety-driven obsessions entrain neutralizing compulsions and also beyond the essential features of anxiety disorders commonly characterized by psychopathological characteristics such as marked and persistent fear, expectant anxiety, fear conditioning, avoidance, and cognitive process to evoke anxiety et al. Eventually, it has caused dramatic changes of view on the core psychopathology of OCD that is based on "preoccupation" and "repeated behaviors" as a failure of behavioral (cognitive and motor) inhibition, which also constitutes a key characteristic of obsessive-compulsive and related disorders (OCRDs) in process of the revision of DSM-5. The precise nature and compass of this spectrum remains to be fully elucidated, but a preliminary approach emphasizes that putative OCRDs have phenomenological (e.g. repetitive thoughts or behaviors), etiological, psychobiological or treatment overlap with OCD, differentiating OCD from other anxiety disorders. Therefore, OCRDs, including OCD, may be classified apart from other anxiety disorders in the revisions of DSM-5 or ICD-11. Nevertheless, recent neuroimaging evidence points to the critical involvement of the lateral and medial orbitofrontal cortices, the dorsal anterior cingulate cortex and amygdalo cortical circuitry, in addition to cortico-striatal circuitry, in the pathophysiology of OCD, suggesting the possibility that fear extinction, in addition to behavioral inhibition, might be impaired in OCD similarly to other anxiety disorders. Moreover, studies have investigated the relevant neurocircuitry, neurochemistry, and neuroendocrinology commonly underlying depression, anxiety disorders and OCRDs, and have explored the underlying genetic basis of and relevant intermediate phenotypes for developing these conditions. Thus more research is needed to elucidate the essential relationships among these disorders and to validate the future diagnostic classifications of anxiety disorders.

Obsessive-Compulsive Disorder in Late Life

ERIC Educational Resources Information Center

Calamari, John E.; Pontarelli, Noelle K.; Armstrong, Kerrie M.; Salstrom, Seoka A.

2012-01-01

Although obsessive-compulsive disorder (OCD) has received increasing attention, the study and treatment of OCD in late life has been neglected. The obsessions and compulsions seen with older adults do not appear to differ from the symptoms experienced by other age groups, although developmental issues might influence symptom focus (e.g., memory…

Dream content and intrusive thoughts in Obsessive-Compulsive Disorder.

PubMed

Cavallotti, Simone; Casetta, Cecilia; Fanti, Valentina; Gambini, Orsola; Ostinelli, Edoardo G; Ranieri, Rebecca; Vanelli, Irene; D'Agostino, Armando

2016-10-30

Although central to any exhaustive theory of human subjectivity, the relationship between dream and waking consciousness remains uncertain. Some findings suggest that dream consciousness can be influenced by severe disorders of thought content. The suppression of unwanted thoughts has been shown to influence dream content in healthy individuals. In order to better define this phenomenon, we evaluated the persistence of obsessive/compulsive themes across the dream and waking cognition of OCD patients and in a control group of healthy subjects. Participants were administered a shortened version of the Thematic Apperception Test to produce a waking fantasy narration, and were trained to keep a dream diary. Dream and waking narrative contents were analyzed in order to recognize obsessive/compulsive themes, and to calculate Mean Dream Obsession/Compulsion (MDO, MDC) and Mean TAT Obsession/Compulsion (MTO, MTC) parameters. No differences were found between the two populations in terms of MDO, MDC, MTO, nor MTC. Density of obsessive and compulsive themes were significantly higher in dream reports than in waking narratives for both groups. No correlation was observed between MDO/MDC scores and Y-BOCS obsession/compulsion scores in the OCD group. These findings strengthen the discontinuity hypothesis, suggesting that ruminative aspects of cognition are somehow interrupted during dream activity. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The Myth of the Pure Obsessional Type in Obsessive-Compulsive Disorder

PubMed Central

Williams, Monnica T.; Farris, Samantha G.; Turkheimer, Eric; Pinto, Anthony; Ozanick, Krystal; Franklin, Martin E.; Liebowitz, Michael; Simpson, H. Blair; Foa, Edna B.

2011-01-01

Background Several studies have identified discrete symptom dimensions in obsessive-compulsive disorder (OCD), derived from factor analyses of the individual items or symptom categories of the Yale-Brown Obsessive Compulsive Scale Symptom Checklist (YBOCS-SC). The current study aims to extend previous work on the relationship between obsessions and compulsions by specifically including mental compulsions and reassurance-seeking. Since these compulsions have traditionally been omitted from prior factor analytic studies, their association to what have been called “pure obsessions” may have been overlooked. Method Participants (N=201) were recruited from two multi-site randomized clinical treatment trials for OCD. The YBOCS-SC was used to assess OCD symptoms as it includes a comprehensive list of obsessions and compulsions, arranged by content category. Each category was given a score based on whether symptoms were present and if the symptom was a primary target of clinical concern, and a factor analysis was conducted. Mental compulsions and reassurance-seeking were considered separate categories for the analysis. Results Using an orthogonal geomin rotation of 16 YBOCS-SC categories/items, we found a five-factor solution that explained 67% of the total variance. Inspection of items that composed each factor suggests five familiar constructs, with mental compulsions and reassurance-seeking included with sexual, aggressive, and religious obsessions (unacceptable/taboo thoughts). Conclusions This study suggests that the concept of the “pure obsessional” (e.g., patients with unacceptable/taboo thoughts yet no compulsions) may be a misnomer, as these obsessions were factorially associated with mental compulsions and reassurance-seeking in these samples. These findings may have implications for DSM-5 diagnostic criteria. PMID:21509914

[Impact of psychological factors on marital satisfaction and divorce proneness in clinical couples].

PubMed

Kong, Seong Sook

2008-08-01

The purpose of the study was to investigate the psychological factors that affect marital satisfaction or divorce likelihood in clinical couples. Clinical couples (n=57) who visited "M" couple clinic participated in the study. Data was collected from September 2005 to June 2006 using a Marital Satisfaction Scale, a Marital Status Inventory, Beck Depression Inventory, Maudsley Obsessional-Compulsive Inventory, and Minnesota Multiphasic Personality Inventory. The couples showed high scores on depression, obsessive-compulsion, personality factors and divorce probability and a low score on marital satisfaction. The wife's obsessive-compulsion was a predictor of her marital satisfaction, and the wife's social introversion and depression, and husband's obsessive-compulsion were predictors of the wife's prospect of divorce. The husband's hypomania and depression were predictors of his marital satisfaction, and there were no predictors of the husband's prospect of divorce. Obsessive-compulsion is a significant factor in a couple's relationship, although previous studies have not been interested in obsessive-compulsion. Divorce likelihood should be evaluated for clinical couples as well as marital satisfaction, because it is more important for divorce prevention. Each spouse who has a psychological problem such as depression, obsessive-compulsion, and deviated personality needs individual therapy as well as couple therapy.

[Quality of life in individuals with obsessive-compulsive disorder: a review].

PubMed

Niederauer, Kátia Gomes; Braga, Daniela Tusi; Souza, Fernanda Pasquoto de; Meyer, Elizabeth; Cordioli, Aristides Volpato

2007-09-01

Obsessive-compulsive disorder affects between 1.6 and 3.1% of the population. Due to the distress caused by obsessive-compulsive disorder leading to disability as well as the prevalence of the disease, there has been an increase in the number of studies focusing on the general well-being of patients by assessing quality of life. A literature review of the studies that investigated the quality of life of patients with obsessive-compulsive disorder was performed. The search was carried out in the following database: Medline, SciELO and PsychoInfo, and the following key-words were used "quality of life" and "obsessive-compulsive disorder". Twenty-seven articles about the topic were selected. The results from this study describe the areas most severely affected by the disorder as well as the relationship between obsessive-compulsive disorder and quality of life. In addition, the effects of the treatment on the patients' quality of life are presented. The social and familial relationships and the occupational performance (capacity to work and study) were the areas most severely affected by the disorder, and, although there was an improvement with the treatment, these areas remain at a poor level of performance. The obsessions were associated with the most significant impairment of the quality of life if compared to the compulsions (rituals). Results from the selected studies suggest that obsessive-compulsive disorder patients have an impairment of quality of life. The level of impairment is similar to that of schizophrenic patients. Future studies with different designs are necessary so that more consistent results can be established.

Interpersonal problems across levels of the psychopathology hierarchy.

PubMed

Girard, Jeffrey M; Wright, Aidan G C; Beeney, Joseph E; Lazarus, Sophie A; Scott, Lori N; Stepp, Stephanie D; Pilkonis, Paul A

2017-11-01

We examined the relationship between psychopathology and interpersonal problems in a sample of 825 clinical and community participants. Sixteen psychiatric diagnoses and five transdiagnostic dimensions were examined in relation to self-reported interpersonal problems. The structural summary method was used with the Inventory of Interpersonal Problems Circumplex Scales to examine interpersonal problem profiles for each diagnosis and dimension. We built a structural model of mental disorders including factors corresponding to detachment (avoidant personality, social phobia, major depression), internalizing (dependent personality, borderline personality, panic disorder, posttraumatic stress, major depression), disinhibition (antisocial personality, drug dependence, alcohol dependence, borderline personality), dominance (histrionic personality, narcissistic personality, paranoid personality), and compulsivity (obsessive-compulsive personality). All dimensions showed good interpersonal prototypicality (e.g., detachment was defined by a socially avoidant/nonassertive interpersonal profile) except for internalizing, which was diffusely associated with elevated interpersonal distress. The findings for individual disorders were largely consistent with the dimension that each disorder loaded on, with the exception of the internalizing and dominance disorders, which were interpersonally heterogeneous. These results replicate previous findings and provide novel insights into social dysfunction in psychopathology by wedding the power of hierarchical (i.e., dimensional) modeling and interpersonal circumplex assessment. Copyright © 2017 Elsevier Inc. All rights reserved.

Thought-Action Fusion and Inflated Responsibility Beliefs in Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

O'Leary, Emily Marie; Rucklidge, Julia Jane; Blampied, Neville

2009-01-01

In obsessive-compulsive disorder (OCD), inflated responsibility (IR) beliefs and thought-action fusion (TAF) are two cognitive schema argued to contribute to obsessions and compulsions. We investigated whether IR and TAF are OCD-specific or whether they occur in other anxiety disorders. Adults diagnosed with OCD (n = 20) or other anxiety disorders…

Comparison of Knowledge of Obsessive-Compulsive Behavior between Counseling Students and School Administration Students.

ERIC Educational Resources Information Center

Foster, Sandy

Obsessive-compulsive adolescence behavior in the classroom environment can be disruptive, affecting the teacher and other students. Certain personality traits of the obsessive-compulsive are obvious, while other symptoms are frequently misdiagnosed. As school staff are often the first step in the primary diagnosis process, the purpose of this…

A Review of the Pharmacotherapy of Obsessive-Compulsive Disorder and Schizophrenia: The Case of Sam

ERIC Educational Resources Information Center

Randhawa, Ramandeep S.

2005-01-01

Obsessive-compulsive symptoms are a common feature of schizophrenia, and high rates of obsessive-compulsive disorder (OCD) have been reported in schizophrenic patients. Effective pharmacotherapeutic options are available for both OCD and schizophrenia, and for some patients combining medications targeted at both conditions may be a helpful…

The Development and Testing of an Obsessive-Compulsive Personality Instrument.

ERIC Educational Resources Information Center

Bailey, James R.; And Others

Compulsivity and obsessiveness are vaguely defined terms which include a broad range of behaviors and cognitions that have been elusive to quantify. To introduce the 22-item Obsessive-Compulsive Scale (OCS) and to perform preliminary validation studies, 114 (46 male, 68 female) college students and 57 counseling clients completed the OCS on two…

A Case Study of Cognitive and Biophysical Models of Education as Linked to Anxiety and Obsessive Compulsive Disorders

ERIC Educational Resources Information Center

Maye, Kelly M.

2012-01-01

Cognitive and biophysical factors have been considered contributors linked to identifiable markers of obsessive compulsive and anxiety disorders. Research demonstrates multiple causes and mixed results for the short-term success of educational programs designed to ameliorate problems that children with obsessive compulsive and anxiety disorders…

Practice Parameter for the Assessment and Treatment of Children and Adolescents with Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Journal of the American Academy of Child & Adolescent Psychiatry, 2012

2012-01-01

Research in etiology, neurobiology, genetics, clinical correlates, and evidence-based treatments in children and adolescents with obsessive-compulsive disorder indicate a need for the revision of the Practice Parameters for the Assessment and Treatment of Children and Adolescents with Obsessive-Compulsive Disorder first published a decade ago. The…

Efficacy of Danger Ideation Reduction Therapy in Obsessive-Compulsive Disorder Washer with Poor Insight: A Case Study and Literature Review

PubMed Central

Maqbool, Masood; Sengar, K. S.; Vikas; Kumar, Mohit; Uparikar, Premkant Damodhar

2017-01-01

Obsessive-compulsive disorder (OCD) is characterized by obsessions and compulsions. Treatment usually consists of serotonergic medications along with exposure therapies. Danger ideation reduction therapy (DIRT) is an alternative therapy predominantly for washing compulsions and focuses on reduction of danger ideations. DIRT was tried on Ms. S. with a history of OCD for 15 years and improvement was noticed on Yale–Brown Obsessive Compulsive Scale, Padua Inventory, Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale after 15 sessions of DIRT though she was not fully symptom-free. Thus, DIRT was found to improve OCD symptoms and improved her insight into illness. PMID:28852254

Familiality of factor analysis-derived YBOCS dimensions in OCD-affected sibling pairs from the OCD Collaborative Genetics Study.

PubMed

Hasler, Gregor; Pinto, Anthony; Greenberg, Benjamin D; Samuels, Jack; Fyer, Abby J; Pauls, David; Knowles, James A; McCracken, James T; Piacentini, John; Riddle, Mark A; Rauch, Scott L; Rasmussen, Steven A; Willour, Virginia L; Grados, Marco A; Cullen, Bernadette; Bienvenu, O Joseph; Shugart, Yin-Yao; Liang, Kung-Yee; Hoehn-Saric, Rudolf; Wang, Ying; Ronquillo, Jonne; Nestadt, Gerald; Murphy, Dennis L

2007-03-01

Identification of familial, more homogenous characteristics of obsessive-compulsive disorder (OCD) may help to define relevant subtypes and increase the power of genetic and neurobiological studies of OCD. While factor-analytic studies have found consistent, clinically meaningful OCD symptom dimensions, there have been only limited attempts to evaluate the familiality and potential genetic basis of such dimensions. Four hundred eighteen sibling pairs with OCD were evaluated using the Structured Clinical Interview for DSM-IV and the Yale-Brown Obsessive Compulsive Scale (YBOCS) Symptom Checklist and Severity scales. After controlling for sex, age, and age of onset, robust sib-sib intraclass correlations were found for two of the four YBOCS factors: Factor IV (hoarding obsessions and compulsions (p = .001) and Factor I (aggressive, sexual, and religious obsessions, and checking compulsions; p = .002). Smaller, but still significant, familiality was found for Factor III (contamination/cleaning; p = .02) and Factor II (symmetry/ordering/arranging; p = .04). Limiting the sample to female subjects more than doubled the familiality estimates for Factor II (p = .003). Among potentially relevant comorbid conditions for genetic studies, bipolar I/II and major depressive disorder were strongly associated with Factor I (p < .001), whereas ADHD, alcohol dependence, and bulimia were associated with Factor II (p < .01). Factor-analyzed OCD symptom dimensions in sibling pairs with OCD are familial with some gender-dependence, exhibit relatively specific relationships to comorbid psychiatric disorders and thus may be useful as refined phenotypes for molecular genetic studies of OCD.

Personality traits and smoking in patients with obsessive-compulsive disorder.

PubMed

Bejerot, S; von Knorring, L; Ekselius, L

2000-11-01

As opposed to other psychiatric populations, subjects with obsessive-compulsive disorder (OCD) smoke less than the general population. The present study aims at further investigating the relationship between smoking in OCD subjects and personality traits. Sixty-four subjects with OCD were interviewed concerning their smoking habits. Personality traits were evaluated using the Karolinska Scales of Personality, and specific obsessive-compulsive personality traits were elicited through self-report questionnaires. Non-smokers were more easily fatigued, more inclined to worry, more remorseful, less self-confident, less impulsive and became uneasy more frequently when urged to speed up, than smokers with OCD. Additionally, non-smokers fulfilled significantly more obsessive-compulsive personality disorder criteria as compared to the smokers (P < 0.001). We propose a clinical subtype of OCD related to non-smoking, psychasthenia, anxiety, and pronounced obsessive-compulsive personality disorder traits.

OCD with comorbid OCPD: a subtype of OCD?

PubMed

Coles, Meredith E; Pinto, Anthony; Mancebo, Maria C; Rasmussen, Steven A; Eisen, Jane L

2008-03-01

The current study examined the validity of using comorbid obsessive-compulsive personality disorder (OCPD) to identify a subtype of individuals with obsessive-compulsive disorder (OCD). Data for the current study were drawn from an ongoing, longitudinal study of the course of OCD and include intake assessments for 238 subjects with primary and current DSM-IV OCD who were treatment seeking. More than one fourth of the subjects (N=65, 27%) met criteria for comorbid OCPD. As compared to OCD-OCPD subjects, the OCD+OCPD subjects had a significantly younger age at onset of first OC symptoms (p=0.013), and a higher rate of symmetry and hoarding obsessions, and cleaning, ordering, repeating, and hoarding compulsions (all p's<0.01). Individuals with OCD+OCPD had higher rates of comorbid anxiety disorders (p=0.007) and avoidant personality disorder (p=0.006). The OCD+OCPD subjects also had significantly lower ratings of global functioning (p=0.001) and more impaired social functioning (p=0.004), despite a lack of significant differences on overall severity of OCD symptoms. Our findings indicate that individuals with both OCD and OCPD have distinct clinical characteristics in terms of age at onset of initial OC symptoms, the types of obsessions and compulsions they experience, and psychiatric comorbidity. Our findings, coupled with data from family studies showing a higher than expected frequency of OCPD in first degree relatives of OCD probands, suggest that OCD associated with OCPD may represent a specific subtype of OCD. Additional research is warranted to further establish the validity of this subtype.

Impact of obsessive-compulsive personality disorder (OCPD) symptoms in Internet users

PubMed Central

Chamberlain, Samuel R.; Leppink, Eric W.; Redden, Sarah A.; Stein, Dan J.; Lochner, Christine; Grant, Jon E.

2017-01-01

Background Internet use is pervasive in many cultures. Little is known about the impact of Obsessive-Compulsive Personality Disorder (OCPD) symptoms on impulsive and compulsive psychopathologies in people who use the Internet. Method 1323 adult Internet users completed an online questionnaire quantifying OCPD symptoms, likely occurrence of select mental disorders (OCD, ADHD, problematic Internet use, anxiety), and personality questionnaires of impulsivity (Barratt) and compulsivity (Padua). Predictors of presence of OCPD symptoms (endorsement of at least 4 of 8 DSM criteria) were identified using binary logistic regression. Results In regression (p<0.001, AUC 0.77), OCPD symptoms were significantly associated with (in order of decreasing effect size): lower non-planning impulsivity, higher ADHD symptoms, problematic Internet use, avoidant personality disorder, female gender, generalized anxiety disorder, and some types of compulsions (checking, dressing/washing). Conclusions These data suggest that OCPD symptoms, defined in terms of at least 4 of 8 DSM tick-list criteria being met, are common in Internet users. OCPD symptoms were associated with considerably higher levels of psychopathology relating to both impulsive (ADHD) and compulsive (OC-related and problematic Internet use) disorders. These data merit replication and extension using gold-standard in-person clinical assessments, as the current study relied on self-report over the Internet. PMID:28738097

Profile Analysis of Psychological Symptoms Associated With Misophonia: A Community Sample.

PubMed

McKay, Dean; Kim, Se-Kang; Mancusi, Lauren; Storch, Eric A; Spankovich, Christopher

2018-03-01

Misophonia is characterized by extreme aversive reactions to certain classes of sounds. It has recently been recognized as a condition associated with significant disability. Research has begun to evaluate psychopathological correlates of misophonia. This study sought to identify profiles of psychopathology that characterize misophonia in a large community sample. A total of N = 628 adult participants completed a battery of measures assessing anxiety and anxiety sensitivity, depression, stress responses, anger, dissociative experiences, obsessive-compulsive symptoms and beliefs, distress tolerance, bodily perceptions, as well as misophonia severity. Profile Analysis via Multidimensional Scaling (PAMS) was employed to evaluate profiles associated with elevated misophonia and those without symptoms. Three profiles were extracted. The first two accounted for 70% total variance and did not show distinctions between groups. The third profile accounted for 11% total variance, and showed that misophonia is associated with lower obsessive-compulsive symptoms for neutralizing, obsessions generally, and washing compared to those not endorsing misophonia, and higher levels of obsessive-compulsive symptoms associated with ordering and harm avoidance. This third profile extracted also showed significant differences between those with and without misophonia on the scale assessing physical concerns (that is, sensitivity to interoceptive sensations) as assessed with the ASI-3. Further research is called for involving diagnostic interviewing and experimental methods to clarify these putative mechanisms associated with misophonia. Copyright © 2017. Published by Elsevier Ltd.

Altered Cingulate Sub-Region Activation Accounts for Task-Related Dissociation in ERN Amplitude as a Function of Obsessive-Compulsive Symptoms

ERIC Educational Resources Information Center

Cavanagh, James F.; Grundler, Theo O. J.; Frank, Michael J.; Allen, John J. B.

2010-01-01

Larger error-related negativities (ERNs) have been consistently found in obsessive-compulsive disorder (OCD) patients, and are thought to reflect the activities of a hyperactive cortico-striatal circuit during action monitoring. We previously observed that obsessive-compulsive (OC) symptomatic students (non-patients) have larger ERNs during errors…

The Presentation of Childhood Obsessive--Compulsive Disorder across Home and School Settings: A Preliminary Report

ERIC Educational Resources Information Center

Sabuncuoglu, Osman; Berkem, Meral

2006-01-01

This study aimed to determine the exact pattern of obsessive--compulsive disorder (OCD) symptoms in children displayed across school and home settings. Twenty-six school children (aged 7 through 17) with OCD were tested using the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), the Clinical Global Impression (CGI)--severity subscale and…

Development and Psychometric Evaluation of the Yale-Brown Obsessive-Compulsive Scale--Second Edition

ERIC Educational Resources Information Center

Storch, Eric A.; Rasmussen, Steven A.; Price, Lawrence H.; Larson, Michael J.; Murphy, Tanya K.; Goodman, Wayne K.

2010-01-01

The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS; Goodman, Price, Rasmussen, Mazure, Delgado, et al., 1989) is acknowledged as the gold standard measure of obsessive-compulsive disorder (OCD) symptom severity. A number of areas where the Y-BOCS may benefit from revision have emerged in past psychometric studies of the Severity Scale and Symptom…

Vacation effects on behaviour, cognition and emotions of compulsive and non-compulsive workers: do obsessive workers go 'cold turkey'?

PubMed

de Bloom, Jessica; Radstaak, Mirjam; Geurts, Sabine

2014-08-01

Compulsive workers often face psychological and physical health disturbances because of working long hours and an obsessive preoccupation with work during off-job time. Prolonged respite episodes may either relief these employees from their daily stressors to recover or trigger withdrawal symptoms. Our research question was as follows: How do (1) work hours, (2) rumination and (3) affective well-being unfold for compulsive workers compared with non-compulsive workers across long vacations? In a longitudinal field study, work hours, rumination and affective well-being were assessed in 54 employees 2 weeks before, during and in the first, second and fourth week after a long summer vacation. Working compulsively was assessed 3 weeks before vacation. Work hours decreased during and increased after vacation. Levels of rumination dropped during vacation and remained below baseline until 2 weeks after vacation. Initial differences in rumination between obsessive and non-obsessive workers disappeared during and directly after vacation. Affective well-being rose during vacation and returned to baseline directly after vacation. Increases in affective well-being during vacation as well as decreases after vacation were greater in obsessive workers than in non-obsessive workers. Vacations seem to temporarily offset characteristic differences between obsessive and non-obsessive workers, decrease rumination and improve affective well-being. Copyright © 2014 John Wiley & Sons, Ltd.

Lamotrigine Augmentation Versus Placebo in Serotonin Reuptake Inhibitors-Resistant Obsessive-Compulsive Disorder: A Randomized Controlled Trial

PubMed Central

Khalkhali, Mohammadrasoul; Zarrabi, Homa; Kafie, Moosa; Heidarzadeh, Abtin

2016-01-01

Objective: Serotonin reuptake inhibitors are frequently used in first-line treatments for patients with obsessive-compulsive disorder. Nevertheless, many of these patients do not respond well to initial therapy. The hypothesis of glutamatergic dysfunction in specific brain regions has been proposed in the pathophysiology of obsessive-compulsive disorder. This study was designed to evaluate the possible efficacy of lamotrigine, a glutamatergic agent in Serotonin reuptake inhibitors-resistant patients with obsessive-compulsive disorder. Method: This study was a 12-week, double blind, randomized, placebo-controlled trial of adjunctive fixed-doses of lamotrigine (100 mg) to Serotonin reuptake inhibitors therapy in obsessive-compulsive disorder. Eligible subjects who had a total Y-BOCS of 21 or above were randomly assigned to receive adjunctive treatment with either lamotrigine (n = 26), or placebo (n = 27). Response to lamotrigine was defined as clinical improvement (>25% decrease in the total Y-BOCS score), which was administered at weeks 0, 8 and 12. Results: At the endpoint (week 12), significant differences were observed in obsession, compulsion, and total Y-BOCS scores comparing lamotrigine to placebo (P = 0.01, 0.005 and 0.007 respectively). The mean reduction in obsession, compulsion and total scores in lamotrigine group was about 4.15, 4.50 and 8.73, respectively. Similarly, the mean reductions in the placebo group were 2.52, 2.56 and 5.07. Effect sizes for efficacy measureswerecalculatedbyCohen’sd, and it was calculated as 0.54 for the total YBOCS. Conclusion: Our findings provide evidence that this augmentation is well tolerated and may be an effective strategy for patients with refractory obsessive-compulsive disorder. PMID:27437007

Hoarding in a compulsive buying sample.

PubMed

Mueller, Astrid; Mueller, Ulrike; Albert, Patricia; Mertens, Christian; Silbermann, Andrea; Mitchell, James E; de Zwaan, Martina

2007-11-01

Previous research has indicated that many compulsive buyers also suffer from compulsive hoarding. The present work specifically examined hoarding in a compulsive buying sample. Sixty-six treatment-seeking compulsive buyers were assessed prior to entering a group therapy for compulsive buying using the Compulsive Buying Scale (CBS), the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS)-Shopping Version, the Compulsive Acquisition Scale (CAS), the German-CBS, the Saving Inventory-Revised (SI-R), the Maudsley Obsessive Compulsive Inventory (MOCI), the Barratt Impulsiveness Scale (BIS-11), and the Structured Clinical Interview for DSM-IV Axis I (SCID). Inclusion criteria were current problems with compulsive buying according to the proposed diagnostic criteria for compulsive buying by McElroy, Keck, Pope, Smith, and Strakowski [(1994). Compulsive buying: A report of 20 cases. Journal of Clinical Psychiatry, 55, 242-248]. Our results support the assumption that many but not all compulsive buyers suffer from compulsive hoarding. A significant association between the SI-R and the compulsive buying measures CBS, Y-BOCS-SV, German-CBS, and the CAS-Buy subscale was found, which is mostly caused by the SI-R subscale acquisition. The SI-R subscales clutter and difficulty discarding were more closely associated with the CAS-Free subscale and with obsessive-compulsive symptoms. Hoarding compulsive buyers reported more severe buying symptoms and obsessive-compulsive symptoms and presented with a higher psychiatric co-morbidity, especially any current affective, anxiety and eating disorder. Specific therapeutic interventions for compulsive buyers who also report compulsive hoarding appear indicated.

Goal-directed learning and obsessive–compulsive disorder

PubMed Central

Gillan, Claire M.; Robbins, Trevor W.

2014-01-01

Obsessive–compulsive disorder (OCD) has become a paradigmatic case of goal-directed dysfunction in psychiatry. In this article, we review the neurobiological evidence, historical and recent, that originally led to this supposition and continues to support a habit hypothesis of OCD. We will then discuss a number of recent studies that have directly tested this hypothesis, using behavioural experiments in patient populations. Based on this research evidence, which suggests that rather than goal-directed avoidance behaviours, compulsions in OCD may derive from manifestations of excessive habit formation, we present the details of a novel account of the functional relationship between these habits and the full symptom profile of the disorder. Borrowing from a cognitive dissonance framework, we propose that the irrational threat beliefs (obsessions) characteristic of OCD may be a consequence, rather than an instigator, of compulsive behaviour in these patients. This lays the foundation for a potential shift in both clinical and neuropsychological conceptualization of OCD and related disorders. This model may also prove relevant to other putative disorders of compulsivity, such as substance dependence, where the experience of ‘wanting’ drugs may be better understood as post hoc rationalizations of otherwise goal-insensitive, stimulus-driven behaviour. PMID:25267818

Human compulsivity: A perspective from evolutionary medicine.

PubMed

Stein, Dan J; Hermesh, Haggai; Eilam, David; Segalas, Cosi; Zohar, Joseph; Menchon, Jose; Nesse, Randolph M

2016-05-01

Biological explanations address not only proximal mechanisms (for example, the underlying neurobiology of obsessive-compulsive disorder), but also distal mechanisms (that is, a consideration of how particular neurobiological mechanisms evolved). Evolutionary medicine has emphasized a series of explanations for vulnerability to disease, including constraints, mismatch, and tradeoffs. The current paper will consider compulsive symptoms in obsessive-compulsive and related disorders and behavioral addictions from this evolutionary perspective. It will argue that while obsessive-compulsive disorder (OCD) is typically best conceptualized as a dysfunction, it is theoretically and clinically valuable to understand some symptoms of obsessive-compulsive and related disorders in terms of useful defenses. The symptoms of behavioral addictions can also be conceptualized in evolutionary terms (for example, mismatch), which in turn provides a sound foundation for approaching assessment and intervention. Copyright © 2016. Published by Elsevier B.V.

A five-factor measure of obsessive-compulsive personality traits.

PubMed

Samuel, Douglas B; Riddell, Ashley D B; Lynam, Donald R; Miller, Joshua D; Widiger, Thomas A

2012-01-01

This study provides convergent, discriminant, and incremental validity data for the Five-Factor Obsessive-Compulsive Inventory (FFOCI), a newly developed measure of traits relevant to obsessive-compulsive personality disorder (OCPD) from the perspective of the Five-factor model (FFM). Twelve scales were constructed as maladaptive variants of specific FFM facets (e.g., Perfectionism as a maladaptive variant of FFM competence). On the basis of data from 407 undergraduates (oversampled for OCPD symptoms) these 12 scales demonstrated convergent correlations with established measures of OCPD and the FFM. Further, they obtained strong discriminant validity with respect to facets from other FFM domains. Most important, the individual scales and total score of the FFOCI obtained incremental validity beyond existing measures of the FFM and OCPD for predicting a composite measure of obsessive-compulsive symptomatology. The findings support the validity of the FFOCI as a measure of obsessive-compulsive personality traits, as well as of maladaptive variants of the FFM.

The relation among perfectionism, obsessive-compulsive personality disorder and obsessive-compulsive disorder in individuals with eating disorders.

PubMed

Halmi, Katherine A; Tozzi, Federica; Thornton, Laura M; Crow, Scott; Fichter, Manfred M; Kaplan, Allan S; Keel, Pamela; Klump, Kelly L; Lilenfeld, Lisa R; Mitchell, James E; Plotnicov, Katherine H; Pollice, Christine; Rotondo, Alessandro; Strober, Michael; Woodside, D Blake; Berrettini, Wade H; Kaye, Walter H; Bulik, Cynthia M

2005-12-01

Perfectionism and obsessionality are core features of eating disorders (ED), yet the nature of their relation remains unknown. Understanding the relation between these traits may enhance our ability to identify relevant behavioral endophenotypes for ED. Six-hundred seven individuals with anorexia and bulimia nervosa from the International Price Foundation Genetic Study were assessed for perfectionism, obsessive-compulsive personality disorder (OCPD), and obsessive-compulsive disorder (OCD). No differences were found across ED subtypes in the prevalence of OCPD and OCD, nor with the association between OCD and OCPD. Perfectionism scores were highest in individuals with OCPD whether alone or in combination with OCD. Perfectionism appears to be more closely associated with obsessive-compulsive personality symptoms rather than OCD. The pairing of perfectionism with OCPD may be a relevant core behavioral feature underlying vulnerability to ED. Copyright 2005 by Wiley Periodicals, Inc.

[Autistic dimension in obsessive-compulsive disorder in adolescence].

PubMed

Ardizzone, Ignazio; Soletti, Laura; Panunzi, Sara; Carratelli, Teresa I

2010-01-01

This study examines the obsessive-compulsive disorder (OCD) with normal and poor insight of illness and it detects the presence of autistic traits. The aim is to establish the relationship between OCD and Autistic Spectrum Disorder (ASD): comorbidity or subtype of OCD? The sample consists of 48 adolescents (aged 12-18) with a clinical diagnosis of OCD (according DSM-IV-TR). After administering the Children's Yale Brown Obsessive-Compulsive Scale (CYBOCS) and the Brown Assessement Beliefs Scale (BABS), the sample is divided into two groups according to insight of illness. Autism Diagnostic Observation Schedule (ADOS) and Social Communication Questionnaire (SCQ) were used to assist in the ASD diagnosis; Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) was administered to assess personality disorders. 47% of subjects presents poor insight and 27% are included within the diagnostic criteria for autistic spectrum disorder. Poor insight in obsessive-compulsive symptoms is significantly associated with the presence of autistic traits. There is also a significant association between cluster hoarding and poor insight. This study suggests the existence of an obsessive autistic atypical subtype, where the compulsive dimension of repetitive behaviours vanishes in an autistic dimension with stereotyped manifestations. Further research should be conducted to better understand this obsessive autistic atypical subtype and to put it in the obsessive-compulsive spectrum in adolescence.

Attachment insecurity and obsessive-compulsive personality disorder among inpatients with serious mental illness.

PubMed

Wiltgen, Anika; Adler, Herman; Smith, Ryan; Rufino, Katrina; Frazier, Christopher; Shepard, Christopher; Booker, Kirk; Simmons, Diedra; Richardson, Leah; Allen, Jon G; Fowler, J Christopher

2015-03-15

Obsessive-compulsive personality disorder (OCPD) is characterized by traits such as extreme rigidity, perfectionism, and controlling behavior, all of which have a negative impact on interpersonal functioning. Attachment theory provides a useful framework to elucidate the interpersonal dysfunction characteristic of OCPD; yet, there is a dearth of attachment research on OCPD in the context of severe mental illness. Attachment security and personality disorders were assessed in adult inpatients with severe mental illness. Propensity Score Matching (PSM) was used to match OCPD and control subjects on age, gender, number of psychiatric disorders, and number of criteria endorsed for borderline personality disorder. Consistent with hypotheses, the OCPD group (n=61) showed greater attachment avoidance than controls (n=61), and the avoidance was manifested in a predominance of the most insecure attachment style, fearful attachment. Correlations between attachment anxiety/avoidance with specific OCPD diagnostic criteria revealed that attachment avoidance was correlated with four of eight OCPD criteria across the full sample. Within the subset of OCPD patients, attachment avoidance was significantly correlated with OCPD criterion 3 (is excessively devoted to work and productivity to the exclusion of leisure activities and friendships). The use of self-report measure of attachment and the high burden of illness in the SMI population may not generalize to interview based assessment or outpatients, respectively. Findings attest to the severity of impairment in interpersonal functioning and attachment avoidance, in particular, is characteristic of OCPD patients. These results suggest that viable treatment targets include interpersonal functioning along with more classical features of OCPD such as perfectionism and obsessiveness in task performance. Copyright © 2014 Elsevier B.V. All rights reserved.

A study investigating the association between compulsive buying with measures of anxiety and obsessive-compulsive behavior among internet shoppers.

PubMed

Weinstein, A; Mezig, Hila; Mizrachi, S; Lejoyeux, M

2015-02-01

Compulsive buying is a chronic, repetitive behavior that becomes a primary response to negative events and feelings. Compulsive buyers are obsessed by buying and their behavior occurs in response to negative emotions and results in a decrease in the intensity of negative emotions. Euphoria or relief from negative emotions is the most common consequence of compulsive buying. A large number of studies have investigated the association between compulsive buying and anxiety, and some studies have used the Spielberger trait-state anxiety inventory. Compulsive buying, state and trait anxiety and general obsessive-compulsive measures were assessed among 120 habitual internet shoppers (2+ times a week, 70 men and 50 women). Results showed that Edwards Compulsive Buying scale measures were associated with Spielberger trait and not state anxiety measures. Spielberger Trait anxiety measures were also correlated with measures of Yale-Brown Obsessive-Compulsive scale (Y-Bocs). Finally, there were no sex differences in this sample. The results of this study support existing evidence for an association between compulsive buying and anxiety and they will be discussed in view of current research on comorbidity of behavioural addiction. Copyright © 2014 Elsevier Inc. All rights reserved.

Comparing two basic subtypes in OCD across three large community samples: a pure compulsive versus a mixed obsessive-compulsive subtype.

PubMed

Rodgers, Stephanie; Ajdacic-Gross, Vladeta; Kawohl, Wolfram; Müller, Mario; Rössler, Wulf; Hengartner, Michael P; Castelao, Enrique; Vandeleur, Caroline; Angst, Jules; Preisig, Martin

2015-12-01

Due to its heterogeneous phenomenology, obsessive-compulsive disorder (OCD) has been subtyped. However, these subtypes are not mutually exclusive. This study presents an alternative subtyping approach by deriving non-overlapping OCD subtypes. A pure compulsive and a mixed obsessive-compulsive subtype (including subjects manifesting obsessions with/without compulsions) were analyzed with respect to a broad pattern of psychosocial risk factors and comorbid syndromes/diagnoses in three representative Swiss community samples: the Zurich Study (n = 591), the ZInEP sample (n = 1500), and the PsyCoLaus sample (n = 3720). A selection of comorbidities was examined in a pooled database. Odds ratios were derived from logistic regressions and, in the analysis of pooled data, multilevel models. The pure compulsive subtype showed a lower age of onset and was characterized by few associations with psychosocial risk factors. The higher social popularity of the pure compulsive subjects and their families was remarkable. Comorbidities within the pure compulsive subtype were mainly restricted to phobias. In contrast, the mixed obsessive-compulsive subtype had a higher prevalence and was associated with various childhood adversities, more familial burden, and numerous comorbid disorders, including disorders characterized by high impulsivity. The current comparison study across three representative community surveys presented two basic, distinct OCD subtypes associated with differing psychosocial impairment. Such highly specific subtypes offer the opportunity to learn about pathophysiological mechanisms specifically involved in OCD.

Evidence for a genetic overlap between body dysmorphic concerns and obsessive-compulsive symptoms in an adult female community twin sample.

PubMed

Monzani, Benedetta; Rijsdijk, Fruhling; Iervolino, Alessandra C; Anson, Martin; Cherkas, Lynn; Mataix-Cols, David

2012-06-01

Body dysmorphic disorder (BDD) is thought to be etiologically related to obsessive-compulsive disorder (OCD) but the available evidence is incomplete. The current study examined the genetic and environmental sources of covariance between body dysmorphic and obsessive-compulsive symptoms in a community sample of adult twins. A total of 2,148 female twins (1,074 pairs) completed valid and reliable measures of body dysmorphic concerns and obsessive-compulsive symptoms. The data were analyzed using bivariate twin modeling methods and the statistical programme Mx. In the best-fitting model, the covariation between body dysmorphic and obsessive-compulsive traits was largely accounted for by genetic influences common to both phenotypes (64%; 95% CI: 0.50-0.80). This genetic overlap was even higher when specific obsessive-compulsive symptom dimensions were considered, with up to 82% of the phenotypic correlation between the obsessing and symmetry/ordering symptom dimensions and dysmorphic concerns being attributable to common genetic factors. Unique environmental factors, although influencing these traits individually, did not substantially contribute to their covariation. The results remained unchanged when excluding individuals reporting an objective medical condition/injury accounting for their concern in physical appearance. The association between body dysmorphic concerns and obsessive-compulsive symptoms is largely explained by shared genetic factors. Environmental risk factors were largely unique to each phenotype. These results support current recommendations to group BDD together with OCD in the same DSM-5 chapter, although comparison with other phenotypes such as somatoform disorders and social phobia is needed. Copyright © 2012 Wiley Periodicals, Inc.

Developmental Aspects of Error and High-Conflict-Related Brain Activity in Pediatric Obsessive-Compulsive Disorder: A FMRI Study with a Flanker Task before and after CBT

ERIC Educational Resources Information Center

Huyser, Chaim; Veltman, Dick J.; Wolters, Lidewij H.; de Haan, Else; Boer, Frits

2011-01-01

Background: Heightened error and conflict monitoring are considered central mechanisms in obsessive-compulsive disorder (OCD) and are associated with anterior cingulate cortex (ACC) function. Pediatric obsessive-compulsive patients provide an opportunity to investigate the development of this area and its associations with psychopathology.…

Open-label study of duloxetine for the treatment of obsessive-compulsive disorder.

PubMed

Dougherty, Darin D; Corse, Andrew K; Chou, Tina; Duffy, Amanda; Arulpragasam, Amanda R; Deckersbach, Thilo; Jenike, Michael A; Keuthen, Nancy J

2015-01-01

This study sought to investigate the efficacy of duloxetine for the treatment of obsessive-compulsive disorder (DSM-IV). Twenty individuals were enrolled in a 17-week, open-label trial of duloxetine at Massachusetts General Hospital. Data were collected between March 2007 and September 2012. Study measures assessing obsessive-compulsive disorder symptoms, quality of life, depression, and anxiety were administered at baseline and weeks 1, 5, 9, 13, and 17. The primary outcome measures were the Yale-Brown Obsessive Compulsive Scale and Clinical Global Improvement scale. For the 12 study completers, pre- and posttreatment analyses revealed significant improvements (P<.05) on clinician- and self-rated measures of obsessive-compulsive disorder symptoms and quality of life. Among the 12 completers, more than one-half (n=7) satisfied full medication response criteria. Intention-to-treat analyses (n=20) showed similar improvements (P<.05) on primary and secondary study outcome measures. The results of this study suggest that duloxetine may provide a significant reduction in symptoms for patients with obsessive-compulsive disorder. ClinicalTrials.gov NCT00464698; http://clinicaltrials.gov/ct2/show/NCT00464698?term=NCT00464698&rank=1. © The Author 2015. Published by Oxford University Press on behalf of CINP.

Frequency and correlates of suicidal ideation in pediatric obsessive-compulsive disorder.

PubMed

Storch, Eric A; Bussing, Regina; Jacob, Marni L; Nadeau, Joshua M; Crawford, Erika; Mutch, P Jane; Mason, Dana; Lewin, Adam B; Murphy, Tanya K

2015-02-01

This study examined the frequency and sociodemographic and clinical correlates of suicidal ideation in a sample of children and adolescents with obsessive-compulsive disorder (OCD). Fifty-four youth with OCD and their parent(s) were administered the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime, Children's Yale-Brown Obsessive Compulsive Scale, and Children's Depression Rating Scale-Revised. Children completed the Suicidal Ideation Questionnaire-Junior (SIQ-JR), Child Obsessive Compulsive Impact Scale-Child, and Multidimensional Anxiety Scale for Children; parents completed the Child Obsessive Compulsive Impact Scale-Parent, Swanson, Nolan, and Pelham-IV Parent Scale, and Young Mania Rating Scale-Parent Version. Seven youth endorsed clinically significant levels of suicidal ideation on the SIQ-JR. Suicidal ideation was significantly related to clinician-rated depressive symptoms, age, child-rated impairment and anxiety symptoms, and symmetry, sexuality/religiosity and miscellaneous symptom dimensions. There was no significant association between suicidal ideation and obsessive-compulsive symptom severity, comorbidity patterns, or several parent-rated indices (e.g., impairment, impulsivity). These results provide initial information regarding the frequency and correlates of suicidal ideation in treatment-seeking youth with OCD. Clinical implications are discussed, as well as directions for future research.

Frequency and Correlates of Suicidal Ideation in Pediatric Obsessive-Compulsive Disorder

PubMed Central

Storch, Eric A.; Bussing, Regina; Jacob, Marni L.; Nadeau, Joshua M.; Crawford, Erika; Mutch, P. Jane; Mason, Dana; Lewin, Adam B.; Murphy, Tanya K.

2014-01-01

This study examined the frequency and sociodemographic and clinical correlates of suicidal ideation in a sample of children and adolescents with obsessive-compulsive disorder (OCD). Fifty-four youth with OCD and their parent(s) were administered the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime, Children’s Yale-Brown Obsessive Compulsive Scale, and Children’s Depression Rating Scale-Revised. Children completed the Suicidal Ideation Questionnaire - Junior, Child Obsessive Compulsive Impact Scale–Child, and Multidimensional Anxiety Scale for Children; parents completed the Child Obsessive Compulsive Impact Scale–Parent, Swanson, Nolan, and Pelham–IV Parent Scale, and Young Mania Rating Scale–Parent Version. Seven youth endorsed clinically significant levels of suicidal ideation on the Suicidal Ideation Questionnaire - Junior. Suicidal ideation was significantly related to clinician-rated depressive symptoms, age, child-rated impairment and anxiety symptoms, and symmetry, sexuality/religiosity and miscellaneous symptom dimensions. There was no significant association between suicidal ideation and obsessive-compulsive symptom severity, comorbidity patterns, or several parent-rated indices (e.g., impairment, impulsivity). These results provide initial information regarding the frequency and correlates of suicidal ideation in treatment-seeking youth with OCD. Clinical implications are discussed, as well as directions for future research. PMID:24682580

Beliefs about excessive exercise in eating disorders: the role of obsessions and compulsions.

PubMed

Naylor, Heather; Mountford, Victoria; Brown, Gary

2011-01-01

This study aimed to develop an understanding of excessive exercise in eating disorders by exploring the role of exercise beliefs, obsessive beliefs and obsessive-compulsive behaviours. Sixty-four women were recruited from eating disorder services and 75 non-clinical women were recruited from a university. Exercise beliefs and behaviours, obsessive beliefs and behaviours and eating disorder psychopathology were assessed using self-report questionnaires. There was an association between exercise beliefs, obsessive beliefs and obsessive-compulsive behaviours in the eating-disordered group, but not in the non-eating-disordered group. In the eating-disordered group obsessive beliefs and obsessive-compulsive behaviours were associated with a significant proportion of variance in exercise beliefs after controlling for eating disorder psychopathology and BMI. In the non-eating-disordered group obsessive beliefs and behaviours were associated with beliefs about exercise as a method of affect regulation after controlling for BMI. The results are compatible with a model in which obsessive beliefs and exercise beliefs could maintain exercise in eating disorders. This has implications for the assessment and treatment of excessive exercise. Further research is necessary to determine the causality of these relationships. Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.

Tourette Syndrome (TS): Other Concerns and Conditions

MedlinePlus

... with friends. Learn more about ADHD » Obsessive-Compulsive Behaviors People with obsessive-compulsive behaviors have unwanted thoughts ( ... compulsive behaviors. Diagnosing OCD » Learn more about OCD » Behavior or Conduct Problems About 1 in 4 children ...

Suicidality in obsessive-compulsive disorder: prevalence and relation to symptom dimensions and comorbid conditions.

PubMed

Torres, Albina R; Ramos-Cerqueira, Ana Teresa A; Ferrão, Ygor A; Fontenelle, Leonardo F; do Rosário, Maria Conceição; Miguel, Euripedes C

2011-01-01

Suicidal thoughts and behaviors, also known as suicidality, are a fairly neglected area of study in patients with obsessive-compulsive disorder (OCD). To evaluate several aspects of suicidality in a large multicenter sample of OCD patients and to compare those with and without suicidal ideation, plans, and attempts according to demographic and clinical variables, including symptom dimensions and comorbid disorders. This cross-sectional study included 582 outpatients with primary OCD (DSM-IV) recruited between August 2003 and March 2008 from 7 centers of the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders. The following assessment instruments were used: the Yale-Brown Obsessive Compulsive Scale, the Dimensional Yale-Brown Obsessive Compulsive Scale, the Beck Depression and Anxiety Inventories, the Structured Clinical Interview for DSM-IV Axis I Disorders, and 6 specific questions to investigate suicidality. After univariate analyses, logistic regression analyses were performed to adjust the associations between the dependent and explanatory variables for possible confounders. Thirty-six percent of the patients reported lifetime suicidal thoughts, 20% had made suicidal plans, 11% had already attempted suicide, and 10% presented current suicidal thoughts. In the logistic regression, only lifetime major depressive disorder and posttraumatic stress disorder (PTSD) remained independently associated with all aspects of suicidal behaviors. The sexual/religious dimension and comorbid substance use disorders remained associated with suicidal thoughts and plans, while impulse-control disorders were associated with current suicidal thoughts and with suicide plans and attempts. The risk of suicidal behaviors must be carefully investigated in OCD patients, particularly those with symptoms of the sexual/religious dimension and comorbid major depressive disorder, PTSD, substance use disorders, and impulse-control disorders. © Copyright 2011 Physicians Postgraduate Press, Inc.

The correlates of obsessive-compulsive, schizotypal, and borderline personality disorders in obsessive-compulsive disorder.

PubMed

Melca, Isabela A; Yücel, Murat; Mendlowicz, Mauro V; de Oliveira-Souza, Ricardo; Fontenelle, Leonardo F

2015-06-01

We assessed correlates of obsessive-compulsive (OCPD), schizotypal (SPD) and borderline (BPD) personality disorders in 110 obsessive-compulsive disorder (OCD) patients. We found OCD patients with OCPD (20.9%) to exhibit higher rates of hoarding and bipolar disorders, increased severity of hoarding and symmetry, lower prevalence of unacceptable thoughts involving sex and religion and less non-planning impulsivity. Conversely, OCD patients with SPD (13.6%) displayed more frequently bipolar disorder, increased severity of depression and OCD neutralization, greater prevalence of "low-order" behaviors (i.e., touching), lower low-planning impulsivity and greater "behavioral" compulsivity. Finally, in exploratory analyses, OCD patients with BPD (21.8%) exhibited lower education, higher rates of several comorbid psychiatric disorders, greater frequency of compulsions involving interpersonal domains (e.g. reassurance seeking), increased severity of depression, anxiety and OCD dimensions other than symmetry and hoarding, more motor and non-planning impulsivity, and greater "cognitive" compulsivity. These findings highlight the importance of assessing personality disorders in OCD samples. Copyright © 2015 Elsevier Ltd. All rights reserved.

Anxiety disorders. Focus on obsessive-compulsive disorder.

PubMed Central

Warneke, L.

1993-01-01

Obsessive-compulsive disorder was once thought to be rare. Recent epidemiologic surveys reveal the lifetime prevalence rate to be as high as 3%. We now have greater understanding of the neurophysiologic and neurochemical basis of this very crippling disorder. Although obsessive-compulsive disorder often starts in adolescence or early adulthood and can last a lifetime, effective treatment enables most patients to lead relatively normal lives. PMID:8348022

Examination of the relations between obsessive-compulsive symptom dimensions and fear and distress disorder symptoms.

PubMed

Raines, Amanda M; Allan, Nicholas P; Oglesby, Mary E; Short, Nicole A; Schmidt, Norman B

2015-09-01

Whereas prior work has established fear and distress clusters underlying unipolar mood and anxiety disorders, the optimal placement of obsessive-compulsive disorder (OCD) within this model is unclear. One likely contributor to this ambiguity is the heterogeneous nature of OCD. There is increasing evidence for distinct symptom dimensions that are more homogenous than the broad OCD phenotype. Using structural equation modeling, the current study examined the relations between various OCD symptom dimensions and symptoms associated with fear/distress disorders. Participants included 526 individuals recruited from an online crowdsourcing marketplace. Results revealed that the symmetry obsessions/arranging compulsions, harm obsessions/checking compulsions, and unacceptable thoughts/neutralizing compulsions were related to both fear and distress disorder symptoms, whereas the contamination obsessions/washing compulsions dimension of OCD was specifically related to fear disorder symptoms. Limitations include the use of self-report questionnaires to measure all constructs of interest. These findings add to a growing body of literature attesting to the multidimensional nature of OCD and progress our understanding of the etiological underpinnings of this severe and debilitating condition. Copyright © 2015 Elsevier B.V. All rights reserved.

Emotional perception and theory of mind in first episode psychosis: the role of obsessive-compulsive symptomatology.

PubMed

Ntouros, Evangelos; Bozikas, Vasilios P; Andreou, Christina; Kourbetis, Dimitris; Lavrentiadis, Grigoris; Garyfallos, George

2014-12-15

The aim of the present study was to investigate the effects of comorbid obsessive-compulsive symptoms on emotional perception and theory of mind (ToM) in patients with first-episode psychosis. Participants were 65 patients with non-affective first episode psychosis (FEP) and 47 healthy controls. The patient group was divided into two subgroups, those with (FEP+; n=38) and those without obsessive-compulsive symptomatology (FEP-; n=27). Emotion perception and ToM were assessed with the Perception of Social Inference Test. Severity of psychotic and obsessive-compulsive symptoms was assessed with the Positive and Negative Syndrome Scale (PANSS) and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), respectively. Deficits in emotion recognition and theory of mind were confirmed in patients with non-affective first-episode psychosis compared to healthy controls. In patients, comorbidity with obsessive-compulsive symptoms was associated with worse performance on certain aspects of social cognition (ToM 2nd order) compared to FEP- patients. Our findings of impaired emotion perception and ToM in patients with first-episode psychosis support the hypothesis that deficits are already present at illness onset. Presence of OCS appears to have further deleterious effects on social cognition, suggesting that these patients may belong to a schizo-obsessive subtype of schizophrenia characterized by more extensive neurobiological impairment. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Deep brain stimulation for severe treatment-resistant obsessive-compulsive disorder: An open-label case series.

PubMed

Farrand, Sarah; Evans, Andrew H; Mangelsdorf, Simone; Loi, Samantha M; Mocellin, Ramon; Borham, Adam; Bevilacqua, JoAnne; Blair-West, Scott; Walterfang, Mark A; Bittar, Richard G; Velakoulis, Dennis

2017-09-01

Deep brain stimulation can be of benefit in carefully selected patients with severe intractable obsessive-compulsive disorder. The aim of this paper is to describe the outcomes of the first seven deep brain stimulation procedures for obsessive-compulsive disorder undertaken at the Neuropsychiatry Unit, Royal Melbourne Hospital. The primary objective was to assess the response to deep brain stimulation treatment utilising the Yale-Brown Obsessive Compulsive Scale as a measure of symptom severity. Secondary objectives include assessment of depression and anxiety, as well as socio-occupational functioning. Patients with severe obsessive-compulsive disorder were referred by their treating psychiatrist for assessment of their suitability for deep brain stimulation. Following successful application to the Psychosurgery Review Board, patients proceeded to have deep brain stimulation electrodes implanted in either bilateral nucleus accumbens or bed nucleus of stria terminalis. Clinical assessment and symptom rating scales were undertaken pre- and post-operatively at 6- to 8-week intervals. Rating scales used included the Yale-Brown Obsessive Compulsive Scale, Obsessive Compulsive Inventory, Depression Anxiety Stress Scale and Social and Occupational Functioning Assessment Scale. Seven patients referred from four states across Australia underwent deep brain stimulation surgery and were followed for a mean of 31 months (range, 8-54 months). The sample included four females and three males, with a mean age of 46 years (range, 37-59 years) and mean duration of obsessive-compulsive disorder of 25 years (range, 15-38 years) at the time of surgery. The time from first assessment to surgery was on average 18 months. All patients showed improvement on symptom severity rating scales. Three patients showed a full response, defined as greater than 35% improvement in Yale-Brown Obsessive Compulsive Scale score, with the remaining showing responses between 7% and 20%. Deep brain stimulation was an effective treatment for obsessive-compulsive disorder in these highly selected patients. The extent of the response to deep brain stimulation varied between patients, as well as during the course of treatment for each patient. The results of this series are comparable with the literature, as well as having similar efficacy to ablative psychosurgery techniques such as capsulotomy and cingulotomy. Deep brain stimulation provides advantages over lesional psychosurgery but is more expensive and requires significant multidisciplinary input at all stages, pre- and post-operatively, ideally within a specialised tertiary clinical and/or academic centre. Ongoing research is required to better understand the neurobiological basis for obsessive-compulsive disorder and how this can be manipulated with deep brain stimulation to further improve the efficacy of this emerging treatment.

Fusion or confusion in obsessive compulsive disorder.

PubMed

O'Connor, Kieron; Aardema, Frederick

2003-08-01

Inferential confusion occurs when a person mistakes an imagined possibility for a real probability and might account for some types of thought-action and other fusions reported in obsessive-compulsive disorder. Inferential confusion could account for the ego-dystonic nature of obsessions and their recurrent nature, since the person acts "as if" an imagined aversive inference is probable and tries unsuccessfully to modify this imaginary probability in reality. The clinical implications of the inferential confusion model focus primarily on the role of the imagination in obsessive-compulsive disorder rather than on cognitive beliefs.

The Relationship between Obsessive Compulsive Personality and Obsessive Compulsive Disorder Treatment Outcomes: Predictive Utility and Clinically Significant Change.

PubMed

Sadri, Shalane K; McEvoy, Peter M; Egan, Sarah J; Kane, Robert T; Rees, Clare S; Anderson, Rebecca A

2017-09-01

The evidence regarding whether co-morbid obsessive compulsive personality disorder (OCPD) is associated with treatment outcomes in obsessive compulsive disorder (OCD) is mixed, with some research indicating that OCPD is associated with poorer response, and some showing that it is associated with improved response. We sought to explore the role of OCPD diagnosis and the personality domain of conscientiousness on treatment outcomes for exposure and response prevention for OCD. The impact of co-morbid OCPD and conscientiousness on treatment outcomes was examined in a clinical sample of 46 participants with OCD. OCPD diagnosis and scores on conscientiousness were not associated with poorer post-treatment OCD severity, as indexed by Yale-Brown Obsessive Compulsive Scale (YBOCS) scores, although the relative sample size of OCPD was small and thus generalizability is limited. This study found no evidence that OCPD or conscientiousness were associated with treatment outcomes for OCD. Further research with larger clinical samples is required.

Change in obsessive-compulsive symptoms mediates subsequent change in depressive symptoms during exposure and response prevention.

PubMed

Zandberg, Laurie J; Zang, Yinyin; McLean, Carmen P; Yeh, Rebecca; Simpson, Helen Blair; Foa, Edna B

2015-05-01

The current study examines the temporal relationship between changes in obsessive-compulsive symptoms and changes in depressive symptoms during exposure and response prevention (EX/RP) therapy for obsessive-compulsive disorder (OCD). Participants were 40 adults (53% female) who received EX/RP in a randomized controlled trial comparing serotonin reuptake inhibitor (SRI) augmentation strategies. Participants completed clinician-administered assessments of OCD (Yale-Brown Obsessive Compulsive Scale) and depressive symptoms (Hamilton Depression Rating Scale) every four weeks from baseline to 32-week follow-up. Lagged multilevel mediational analyses indicated that change in OCD symptoms accounted for 65% of subsequent change in depressive symptoms. In contrast, change in depressive symptoms only partially mediated subsequent change in OCD symptoms, accounting for 20% of the variance in outcome. These data indicate that reductions in co-morbid depressive symptoms during EX/RP for OCD are largely driven by reductions in obsessive-compulsive symptoms. Copyright © 2015 Elsevier Ltd. All rights reserved.

Potential role of anticonvulsants in the treatment of obsessive-compulsive and related disorders.

PubMed

Wang, Hee Ryung; Woo, Young Sup; Bahk, Won-Myong

2014-10-01

We reviewed the extant literature to evaluate the current evidence regarding the efficacy and safety of anticonvulsants in the treatment of obsessive-compulsive and related disorders. Relevant literature was accessed using the Cochrane database, embase and PubMed on 29 October 2013. Prospective studies examining the efficacy of anticonvulsants in obsessive-compulsive and related disorders were included. Case reports, case series, and retrospective studies were excluded. A total of 10 studies were included in this review. The studies of obsessive-compulsive disorder, except for two negative studies, showed favorable efficacy results of anticonvulsants. In one study on body dysmorphic disorder, levetiracetam showed favorable efficacy. In two lamotrigine studies for pathologic skin-picking, the efficacy findings were inconsistent. In one trichotillomania study, topiramate had reduced hair-pulling symptoms. Despite limited evidence, our review suggests that anticonvulsants have a potential role in the treatment of obsessive-compulsive and related disorders. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

The relation of childhood trauma to suicide ideation in patients suffering from obsessive-compulsive disorder with lifetime suicide attempts.

PubMed

Khosravani, Vahid; Kamali, Zoleikha; Jamaati Ardakani, Razieh; Samimi Ardestani, Mehdi

2017-09-01

The aim of this study was to evaluate the relations of childhood trauma (CT) and obsessive-compulsive (OC) symptom dimensions to suicide ideation in patients with obsessive-compulsive disorder (OCD). Seventy OCD outpatients with lifetime suicide attempts and 60 controls were included. Participants completed the Scale for Suicide Ideation (SSI), the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Dimensional Obsessive-Compulsive Scale (DOCS) and the Depression Anxiety Stress Scales (DASS-21). Among OCD patients, 97.1% had current suicide ideation. OCD patients revealed higher scores on CT, suicide ideation, depression and anxiety than controls. The CT history of sexual abuse (SA) and OC symptom dimension of unacceptable thoughts explained suicide ideation. It was concluded that SA and unacceptable thoughts may contribute to high suicidality and have important implications for the assessment and treatment of suicide risk in OCD patients with lifetime suicide attempts. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

[Compulsive buying and psychiatric comorbidity].

PubMed

Mueller, Astrid; Mühlhans, Barbara; Silbermann, Andrea; Müller, Ulrike; Mertens, Christian; Horbach, Thomas; Mitchell, James E; de Zwaan, Martina

2009-08-01

Compulsive buying is an excessive behavior that has begun to receive attention from researchers in recent years. The current study provides an overview of research on compulsive buying and examines the psychiatric co-morbidity in a German female treatment seeking compulsive buying sample in comparison with age and gender-matched normal buying control groups. Thirty women suffering from compulsive buying disorder, 30 community controls, and 30 bariatric surgery candidates were assessed with the German versions of the Structured Clinical Interview for DSM-IV diagnoses (SCID). Women with compulsive buying disorder showed significantly higher prevalence rates of affective, anxiety, and eating disorders compared to community controls, and suffered significantly more often from affective and anxiety disorders compared to bariatric surgery candidates. The compulsive buying group presented with the highest rates of personality disorders, most commonly avoidant, depressive, obsessive-compulsive, and borderline personality disorder, and reported the highest prevalence rates of other impulse control disorders, especially for intermittent explosive disorder. The findings suggest an elevated psychiatric co-morbidity in patients with compulsive buying disorder.

Cognitive-behavioral high parental involvement treatments for pediatric obsessive-compulsive disorder: A meta-analysis.

PubMed

Iniesta-Sepúlveda, Marina; Rosa-Alcázar, Ana I; Sánchez-Meca, Julio; Parada-Navas, José L; Rosa-Alcázar, Ángel

2017-06-01

A meta-analysis on the efficacy of cognitive-behavior-family treatment (CBFT) on children and adolescents with obsessive-compulsive disorder (OCD) was accomplished. The purposes of the study were: (a) to estimate the effect magnitude of CBFT in ameliorating obsessive-compulsive symptoms and reducing family accommodation on pediatric OCD and (b) to identify potential moderator variables of the effect sizes. A literature search enabled us to identify 27 studies that fulfilled our selection criteria. The effect size index was the standardized pretest-postest mean change index. For obsessive-compulsive symptoms, the adjusted mean effect size for CBFT was clinically relevant and statistically significant in the posttest (d adj =1.464). For family accommodation the adjusted mean effect size was also positive and statistically significant, but in a lesser extent than for obsessive-compulsive symptoms (d adj =0.511). Publication bias was discarded as a threat against the validity of the meta-analytic results. Large heterogeneity among effect sizes was found. Better results were found when CBFT was individually applied than in group (d + =2.429 and 1.409, respectively). CBFT is effective to reduce obsessive-compulsive symptoms, but offers a limited effect for family accommodation. Additional modules must be included in CBFT to improve its effectiveness on family accommodation. Copyright © 2017 Elsevier Ltd. All rights reserved.

[The etiology of obsessive-compulsive disorder from the aspects of attachment theory, with special regard to perceived parental treatment, attachment patterns and emotion regulation difficulties].

PubMed

Rejtô, Nóra; Papp, Gábor; Molnár, Judit

The focus of our study was the etiology of obsessive-compulsive disorder from attachment aspects. Our aim was to examine the representations of perceived parental treatment, attachment patterns and the level of emotion regulation of people who suffer from obsessive-compulsive disorder. 223 people participated in our study. The clinical group consisted of 92 persons with obsessive-compulsive symptoms, while the control group involved 131 people without OC symptoms. In the study we used the Young Parenting Inventory, the Relationship Questionnaire, and the Difficulties in Emotion Regulation Scale. Besides we compiled a questionnaire based on the DSM-5 and a demographic questionnaire. Respondents could fill the questionnaires online. The clinical group is characterized by significantly higher toxic frustration of each five basic emotional needs than the control group. Specifically, in the case of people with OC smptoms the toxic parental treatments for Defectiveness/ Shame, Dependence/Incompetence, Enmeshment/Undeveloped self, Entitlement/Grandiosity, Approval-seeking/ Recognition-seeking, Negativity/Pessimism, Emotional inhibition, Unrelenting standards/Hypercriticalness and Punitiveness were significantly more frequent than in the control group. The OC group is also characterized by significantly lower rate of secure attachment style, while dismissive attachment style proved to be the most frequent attachment style among them. The OC group also struggle with significantly higher level of emotion regulation difficulties.

Cognitive and Clinical Characteristics of Sexual and Religious Obsessions

PubMed Central

Siev, Jedidiah; Steketee, Gail; Fama, Jeanne M.; Wilhelm, Sabine

2014-01-01

Sexual and religious obsessions are often grouped together as unacceptable thoughts, symptoms of obsessive-compulsive disorder hypothesized to be maintained by maladaptive beliefs about the importance and control of thoughts. Although there is empirical justification for this typology, there are several reasons to suspect that sexual and religious obsessions may differ with respect to associated obsessional beliefs and personality traits. In this study, we examined the associations between sexual and religious obsessions (separately) and (a) putatively obsessional cognitive styles, especially beliefs about the importance and control of thoughts, and responsibility, (b) obsessive-compulsive personality traits, and (c) schizotypal personality traits. Whereas sexual obsessions were predicted only by increased beliefs about the importance and control of thoughts, and contamination obsessions were predicted only by inflated responsibility appraisals and threat estimation, religious obsessions were independently predicted by both of these constructs. In addition, only religious obsessions were related to self-reported obsessive-compulsive personality traits. Researchers and clinicians should be cognizant of potentially important distinctions between sexual and religious obsessions, and the possibility that scrupulous OCD shares processes with both autogenous and reactive presentations. PMID:25045202

Nonverbal memory and organizational dysfunctions are related with distinct symptom dimensions in obsessive-compulsive disorder.

PubMed

Jang, Joon Hwan; Kim, Hee Sun; Ha, Tae Hyon; Shin, Na Young; Kang, Do-Hyung; Choi, Jung-Seok; Ha, Kyooseob; Kwon, Jun Soo

2010-12-30

Recent acceptance that obsessive-compulsive disorder (OCD) represents a heterogeneous phenomenon has underscored the need for dimensional approaches to this disorder. However little is known about the relation between neuropsychological functions and symptom dimensions. The purpose of this study was to identify the cognitive deficits correlated with specific symptom dimensions. Thirteen categories in the Yale-Brown Obsessive Compulsive Scale symptom checklist from 144 patients with OCD were analyzed by principal component analysis. Correlations between identified symptom dimensions and neuropsychological functioning, measured by the Boston Qualitative Scoring System, were analyzed. Five factors or dimensions were identified: contamination/cleaning, hoarding, symmetry/ordering, obsessions/checking, and repeating/counting. Dysfunctions in nonverbal memory and organizational strategies were related to the symmetry/ordering dimension and the obsessions/checking dimension, respectively. The results of the present study support a transculturally stable symptom structure for OCD. They also suggest the possibility that nonverbal memory dysfunction and organizational impairment are mediated by distinct obsessive-compulsive dimensions. Copyright © 2010 Elsevier Ltd. All rights reserved.

Obsessive-compulsive disorder and related disorders: a comprehensive survey

PubMed Central

Fornaro, Michele; Gabrielli, Filippo; Albano, Claudio; Fornaro, Stefania; Rizzato, Salvatore; Mattei, Chiara; Solano, Paola; Vinciguerra, Valentina; Fornaro, Pantaleo

2009-01-01

Our aim was to present a comprehensive, updated survey on obsessive-compulsive disorder (OCD) and obsessive-compulsive related disorders (OCRDs) and their clinical management via literature review, critical analysis and synthesis. Information on OCD and OCRD current nosography, clinical phenomenology and etiology, may lead to a better comprehension of their management. Clinicians should become familiar with the broad spectrum of OCD disorders, since it is a pivotal issue in current clinical psychiatry. PMID:19450269

Cognitive Control of a Simple Mental Image in Patients with Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Kocak, Orhan Murat; Ozpolat, Aysegul Yilmaz; Atbasoglu, Cem; Cicek, Metehan

2011-01-01

The nature of obsessions has led researchers to try to determine if the main problem in obsessive-compulsive disorder (OCD) is impaired inhibitory control. Previous studies report that the effort to suppress is one of the factors that increase the frequency of obsessive thoughts. Based on these results and those of the present study that suggest…

Quality of Life in Children with Obsessive-Compulsive Disorder.

PubMed

Vieira, Joana; Ramalho E Silva, Filipa

2016-09-01

Obsessive-compulsive disorder is a psychiatric disorder stated as one of the most debilitating diseases in the developedworld. However, not much is known about how this disease impairs patients' quality of life in children. We conducted a research in PubMed and Thomson Reuters Web Of Science using the following terms: 'Quality of life', 'Obsessive-compulsive disorder', 'Child', 'Pediatrics' and 'Adolescent'. Of the 138 papers retrieved with this search, five articles corresponded to the aim of this review. We analyzed quality of life in children with obsessive-compulsive disorder comparing with general population and searching the relation with other clinical variables such as sex, age, comorbidities, symptoms dimension, symptoms severity, family accommodation and quality of life. Albeit studies results not being concordant regarding the different dimensions analyzed, our findings pointed to an overall decrease of quality of life in children with obsessive-compulsive disorder. The presence of co-morbidities, symptoms severity and obsessions with harm/aggression content are the variables that have a higher influence in quality of life levels. The small number of articles found and the fact that their methodology was extremely heterogeneous made it difficult to state robust conclusions. Despite that, our findings agree with other studies in adults. Quality of life in children and adolescents with obsessive-compulsive disorder must be better explored in future researches. We suggest the introduction of quality of life as a routinely used instrument in patient's assessment and in treatment response evaluation.

Clinical Application of a Behavioral Model for the Treatment of Body Dysmorphic Disorder

ERIC Educational Resources Information Center

Rabinowitz, Dena; Neziroglu, Fugen; Roberts, Marty

2007-01-01

Body dysmorphic disorder (BDD) is characterized by an obsessive concern over a perceived flaw in bodily appearance. If a minor flaw does exist, the patient displays unwarranted distress. This preoccupation typically leads to compulsive behaviors, such as mirror checking or mirror avoiding, camouflaging, and seeking reassurance from others…

Hoarding in obsessive-compulsive disorder: a report of 20 cases.

PubMed

Winsberg, M E; Cassic, K S; Koran, L M

1999-09-01

We describe the demographic characteristics, hoarding phenomenology, comorbid disorders, family histories, and treatment response of 20 adult obsessive-compulsive disorder (OCD) patients exhibiting hoarding behavior. We utilized the Structured Clinical Interview for DSM-III-R, the Yale-Brown Obsessive Compulsive Scale, and a semistructured interview to gather data. We studied 9 women and 11 men. Their hoarding began from age 5 years to age 46 years (mean +/- SD age at onset = 20 +/- 11 years); hoarding was evident before the onset of other OCD symptoms in 9 patients. The most commonly hoarded items were newspapers and magazines, junk mail, old clothes, notes or lists, and old receipts. Hoarded material occupied from one room plus most or all closets to more than one room plus all closets, the garage, and yard. Seven patients rented additional storage space for hoarded items. Eighty-four percent of patients reported a family history of hoarding, and 80% grew up in a household where someone else hoarded. The most frequent primary motives for hoarding were fears of discarding something useful and discarding something that would be needed in the future. Lifetime prevalence of major depression and of impulse-control disorders, especially compulsive shopping, were high; only 3 patients met DSM-IV criteria for obsessive-compulsive personality disorder. Response of hoarding to selective serotonin reuptake inhibitors was less robust than is expected for obsessive-compulsive disorder. Whether hoarding behaviors mark a subset of obsessive-compulsive disorder patients with a different pathophysiology or functional anatomy deserves investigation.

Impact of depressive and anxiety disorder comorbidity on the clinical expression of obsessive-compulsive disorder.

PubMed

Viswanath, Biju; Narayanaswamy, Janardhanan C; Rajkumar, Ravi Philip; Cherian, Anish V; Kandavel, Thennarasu; Math, Suresh Bada; Reddy, Y C Janardhan

2012-08-01

The identification of distinct subtypes based on comorbidity offers potential utility in understanding variations in the clinical expression of obsessive-compulsive disorder (OCD). Hence, we examined the hypothesis whether patients with OCD with major depressive disorder (MDD) or anxiety disorder comorbidity would differ from those without in terms of phenomenology. A total of 545 consecutive patients who consulted a specialty OCD clinic during the period 2004 to 2009 at a psychiatric hospital in India formed the sample. They were evaluated with the Yale-Brown Obsessive-Compulsive Scale (YBOCS), the Mini International Neuropsychiatric Interview, and the Clinical Global Impression scale. Among 545 patients, 165 (30%) had current MDD, and 114 (21%) had current anxiety disorder comorbidity. Patients with OCD with MDD were mostly women who had a greater severity of OCD symptoms, more of obsessions (especially religious), greater occurrence of miscellaneous compulsions (need to confess or need to touch), higher suicidal risk, and past suicidal attempts. Patients with OCD with anxiety disorder had an earlier onset of illness that was associated with prior life events, less of compulsions, more of aggressive and hoarding obsessions, pathologic doubts, checking, and cognitive compulsions. Obsessive-compulsive disorder, when comorbid with MDD, is more severe and is associated with higher suicidal risk. On the other hand, anxiety disorder comorbidity seems to influence not so much the morbidity but the phenotypic expression of OCD. Copyright © 2012 Elsevier Inc. All rights reserved.

Validation of Self-Report Impairment Measures for Section III Obsessive-Compulsive and Avoidant Personality Disorders.

PubMed

Liggett, Jacqueline; Carmichael, Kieran L C; Smith, Alexander; Sellbom, Martin

2017-01-01

This study examined the validity of newly developed disorder-specific impairment scales (IS), modeled on the Level of Personality Functioning Scale, for obsessive-compulsive (OCPD) and avoidant (AvPD) personality disorders. The IS focused on content validity (items directly reflected the disorder-specific impairments listed in DSM-5 Section III) and severity of impairment. A community sample of 313 adults completed personality inventories indexing the DSM-5 Sections II and III diagnostic criteria for OCPD and AvPD, as well as measures of impairment in the domains of self- and interpersonal functioning. Results indicated that both impairment measures (for AvPD in particular) showed promise in their ability to measure disorder-specific impairment, demonstrating convergent validity with their respective Section II counterparts and discriminant validity with their noncorresponding Section II disorder and with each other. The pattern of relationships between scores on the IS and scores on external measures of personality functioning, however, did not indicate that it is useful to maintain a distinction between impairment in the self- and interpersonal domains, at least for AvPD and OCPD.

The role of experiential avoidance in obsessive-compulsive personality disorder traits.

PubMed

Wheaton, Michael G; Pinto, Anthony

2017-10-01

Obsessive-compulsive personality disorder (OCPD) is one of the most prevalent personality disorders, yet it remains an understudied phenomenon. Experiential avoidance (EA) has been investigated as a factor relevant in many forms of psychopathology, including borderline personality disorder. To date however, no study has yet investigated whether EA might also be relevant to OCPD. We administered a measure of EA and a multidimensional OCPD measure (assessing 5 OCPD trait dimensions and overall severity) to a large community sample (N = 571) as well as a group of individuals with self-identified OCPD features (N = 53). Results revealed that the OCPD group experienced heightened EA relative to the unscreened community sample, even controlling for group differences in distress symptoms. Correlational analyses showed significant relationships between EA and all 5 OCPD trait dimensions and overall severity. Moreover, EA accounted for OCPD traits and severity after controlling for symptoms of depression, anxiety, and stress. Implications for the role of EA in OCPD, including treatment implications, are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The Dynamics of Self-Esteem in Cognitive Therapy for Avoidant and Obsessive-Compulsive Personality Disorders: An Adaptive Role of Self-Esteem Variability?

PubMed Central

Cummings, Jorden A.; Hayes, Adele M.; Cardaciotto, LeeAnn; Newman, Cory F.

2011-01-01

Self-esteem variability is often associated with poor functioning. However, in disorders with entrenched negative views of self and in a context designed to challenge those views, variable self-esteem might represent a marker of change. We examined self-esteem variability in a sample of 27 patients with Avoidant and Obsessive-Compulsive Personality Disorders who received Cognitive Therapy (CT). A therapy coding system was used to rate patients’ positive and negative views of self expressed in the first ten sessions of a 52-week treatment. Ratings of negative (reverse scored) and positive view of self were summed to create a composite score for each session. Self-esteem variability was calculated as the standard deviation of self-esteem scores across sessions. More self-esteem variability predicted more improvement in personality disorder and depression symptoms at the end of treatment, beyond baseline and average self-esteem. Early variability in self-esteem, in this population and context, appeared to be a marker of therapeutic change. PMID:22923855

Phenomenology of obsessive-compulsive disorder in Taiwan.

PubMed

Juang, Y Y; Liu, C Y

2001-12-01

This study was designed to assess the phenomenology, comorbidities, correlation with depressive disorders, and gender differences in obsessive-compulsive disorder (OCD) in Taiwan. Two hundred outpatients who fulfilled the diagnostic criteria of OCD according to DSM-IV were included. Patient characteristics, age at onset, symptom profile, and Axis I comorbidity were recorded. Gender differences, age at onset, and comorbidity of depressive disorders among different subtypes of OCD were compared. The most common obsession was contamination, followed by pathological doubt, and need for symmetry. The most common compulsion was checking, followed by washing, and orderliness compulsions. More men than women presented with the obsession of need for symmetry. Eighty-three (41.5%) subjects had comorbid depressive disorders. Women had more major depressive disorder. Patients with somatic obsessions were more likely to have major depressive disorder. Most clinical characteristics of OCD in Taiwan were similar to that of previous studies in other countries.

Symptom-specific attentional bias to threatening stimuli in obsessive-compulsive disorder.

PubMed

Sizino da Victoria, Mara; Nascimento, Antonio Leandro; Fontenelle, Leonardo F

2012-08-01

There is mixed evidence as to whether patients with obsessive-compulsive disorder (OCD) have excessive attentional engagement and emotional response to OCD-related stimuli in the environment. Here we investigate the occurrence of an attentional bias toward specific OCD-related stimuli and its relationship with obsessive-compulsive symptom dimensions. Forty-eight patients with OCD participated in an attentional bias task containing OCD- and non-OCD-related stimuli and had their performance compared with that of 24 age-, sex-, and education-matched healthy control subjects. Severity of obsessive-compulsive and comorbid depressive symptoms was assessed using the Obsessive-Compulsive Inventory-Revised and the Beck Depression Inventory, respectively. Although there were significant and almost significant group effects on the reaction time (RT) toward OCD- and non-OCD-related figures, respectively, no difference between patients with OCD and controls was noted with regard to RT toward OCD-related figures minus RT toward non-OCD-related figures. Nevertheless, within the OCD group, partial correlational analysis controlled for age and severity of depression unveiled positive correlations between (1) obsessional symptoms and RT toward checking-related pictures and (2) ordering symptoms and RT toward ordering-related pictures. The positive correlations between RT to content-specific stimuli and the severity of corresponding obsessive-compulsive symptoms suggest that patients with OCD experience difficulty in disengaging attention from personally salient stimuli. Copyright © 2012 Elsevier Inc. All rights reserved.

[Orthorexia nervosa and adaptation of ORTO-11 into Turkish].

PubMed

Arusoğlu, Gülcan; Kabakçi, Elif; Köksal, Gülden; Merdol, Türkan Kutluay

2008-01-01

Orthorexia is a pathological fixation about the consumption of healthy food. The present study aimed to reveal the psychometric properties of the Turkish version of ORTO-15, which was developed to evaluate orthorexia, and to investigate the relationship betweenorthorexia, and eating attitude, obsessive-compulsive symptoms, and some demographic variables. The study included 994 participants aged between 19 and 66 years. ORTO-15, the Maudsley Obsessive-Compulsive Inventory, and the Eating Attitude Test-40 were administered to the participants. A 3-factor solution with varimax rotation explained 40.62% of the variance. When 4 items with factor loadings below+/- 0.50 were eliminated from ORTO-15, the Cronbach's alpha coefficient was 0.62. The remaining 11 items were thought to have statistically satisfactory properties for the Turkish version of ORTO and were collectively referred to as ORTO-11. This version was used to investigate the relationship between orthorexia, and eating attitude and obsessive-compulsive symptoms. Pathological eating attitude and obsessive-compulsive symptoms were related to orthorexia. Women exhibited more orthorexic symptoms then men. In the present study high a body mass index was an important variable for orthorexia, but only together with gender (female), pathological eating attitude, and increased obsessive-compulsive symptoms. The results, implications, and limitations of the study are discussed. ORTO-11 demonstrated statistically satisfactory properties. Orthorexia was related to pathological eating attitude and obsessive-compulsive symptoms; however, caution should be used when generalizing the reported results.

Neuropsychological profile of schizophrenia with and without obsessive compulsive disorder.

PubMed

Kazhungil, Firoz; Kumar, Keshav J; Viswanath, Biju; Shankar, Ravi Girikematha; Kandavel, Thennarasu; Math, Suresh Bada; Venkatasubramanian, Ganesan; Reddy, Y C J

2017-10-01

Neuropsychological profile of schizophrenia with obsessive compulsive disorder (OCD) in comparison with that of schizophrenia without OCD is understudied and the results are inconsistent. We hypothesize that patients having schizophrenia with OCD ('schizo-obsessive disorder') may have unique neuropsychological deficits in comparison with those with schizophrenia alone, particularly with respect to executive functions. Thirty patients with schizo-obsessive disorder and 30 individually matched patients with schizophrenia without any obsessive-compulsive symptoms formed the sample of the study. Neuropsychological assessment included tests for attention, executive functions and memory. Patients with schizo-obsessive disorder did not differ from those with schizophrenia alone with respect to measures of attention, executive functions and memory. Our findings do not support unique neuropsychological profile of schizo-obsessive disorder. Studying a larger sample of drug-naive patients in a longitudinal design may provide us more insights in to this. Copyright © 2017 Elsevier B.V. All rights reserved.

Repetitive Transcranial Magnetic Stimulation to Supplementary Motor Area in Refractory Obsessive-Compulsive Disorder Treatment: a Sham-Controlled Trial.

PubMed

Pelissolo, Antoine; Harika-Germaneau, Ghina; Rachid, Fady; Gaudeau-Bosma, Christian; Tanguy, Marie-Laure; BenAdhira, Rene; Bouaziz, Noomane; Popa, Traian; Wassouf, Issa; Saba, Ghassen; Januel, Dominique; Jaafari, Nematollah

2016-08-01

Repetitive transcranial magnetic stimulation has been explored in patients with obsessive-compulsive disorder, but with negative or conflicting results. This randomized double-blind study was designed to assess the efficacy of 1-Hz repetitive transcranial magnetic stimulation over the presupplementary area. Forty medication-resistant patients were assigned to 4 weeks of either active or sham repetitive transcranial magnetic stimulation targeting the presupplementary area with the help of a neuronavigation system. According to the Yale-Brown obsessive-compulsive scale, the baseline-week 4 evolution showed no significant differences between groups. Responder rates at week 4 were not different between groups (repetitive transcranial magnetic stimulation 10.5% vs sham 20%; P=.63). Low-frequency repetitive transcranial magnetic stimulation applied to the presupplementary area seems ineffective for the treatment of obsessive-compulsive disorder patients, at least in severe and drug-refractory cases such as those included in this study. Further research is required to determine profiles of responder patients and appropriate repetitive transcranial magnetic stimulation parameters for obsessive-compulsive disorder. © The Author 2016. Published by Oxford University Press on behalf of CINP.

Obsessive-Compulsive Tendencies, Self/Other Perception, Personality, and Suicidal Ideation in a Non-clinical Sample.

PubMed

Iliceto, Paolo; D'Antuono, Laura; Cassarà, Luisa; Giacolini, Teodosio; Sabatello, Ugo; Candilera, Gabriella

2017-06-01

Research on the risk factors for SI in adults with OC tendencies is limited, and it is still unclear whether the association between OC tendencies and SI in non-clinical individuals exists. The goal of the present study was to test the associations between OC tendencies, self/other perception, personality traits, depressive symptoms and SI among a non-clinical adult population. We investigated an Italian sample of 337 adults, who were administered a set of self-report questionnaires to assess obsessive-compulsive tendencies, depression, self/other perception, personality traits, and hopelessness. Confirmatory factor analyses (CFA) were performed. In the final model we found that personality, obsessive-compulsive factor and suicidal ideation were significantly correlated with each other: personality correlated negatively with obsessive-compulsive factor and suicidal ideation, while obsessive-compulsive factor and suicidal ideation resulted as strongly positively associated. Our results highlight the importance of assessing OC tendencies, negative self/other perception and SI. Understanding their role and interplay will allow for the development and implementation of more advanced prevention and treatment policies.

Should an Obsessive-Compulsive Spectrum Grouping of Disorders Be Included in DSM-V?

PubMed Central

Phillips, Katharine A.; Stein, Dan J.; Rauch, Scott; Hollander, Eric; Fallon, Brian A.; Barsky, Arthur; Fineberg, Naomi; Mataix-Cols, David; Ferrão, Ygor Arzeno; Saxena, Sanjaya; Wilhelm, Sabine; Kelly, Megan M.; Clark, Lee Anna; Pinto, Anthony; Bienvenu, O. Joseph; Farrow, Joanne; Leckman, James

2014-01-01

The obsessive-compulsive (OC) spectrum has been discussed in the literature for two decades. Proponents of this concept propose that certain disorders characterized by repetitive thoughts and/or behaviors are related to obsessive-compulsive disorder (OCD), and suggest that such disorders be grouped together in the same category (i.e., grouping, or “chapter”) in DSM. This paper addresses this topic and presents options and preliminary recommendations to be considered for DSM-V. The paper builds upon and extends prior reviews of this topic that were prepared for and discussed at a DSM-V Research Planning Conference on Obsessive-Compulsive Spectrum Disorders held in 2006. Our preliminary recommendation is that an OC-spectrum grouping of disorders be included in DSM-V. Furthermore, we preliminarily recommend that consideration be given to including this group of disorders within a larger supraordinate category of “Anxiety and Obsessive-Compulsive Spectrum Disorders.” These preliminary recommendations must be evaluated in light of recommendations for, and constraints upon, the overall structure of DSM-V. PMID:20533367

Orthorexia nervosa: relationship with obsessive-compulsive symptoms, disordered eating patterns and body uneasiness among Italian university students.

PubMed

Brytek-Matera, Anna; Fonte, Maria Luisa; Poggiogalle, Eleonora; Donini, Lorenzo Maria; Cena, Hellas

2017-12-01

The present study aimed to investigate the relationship between ORTO-15 score and obsessive-compulsive symptoms, disordered eating patterns and body uneasiness among female and male university students and to examine the predictive model of ORTO-15 in both groups. One hundred and twenty students participated in the present study (mean age 22.74 years, SD 7.31). The ORTO-15 test, the Maudsley Obsessive-Compulsive Questionnaire, the Eating Attitudes Test-26 and the Body Uneasiness Test were used for the present study. Our results revealed no gender differences in ORTO-15 score. Our results show, rather unexpectedly, that in female students lower scores, corresponding to greater severity, were related to less pathological body image discomfort and obsessive-compulsive signs, while in male students, lower ORTO-15 scores were related to less pathological eating patterns, as behaviors and symptoms. Further studies regarding the relationship between ON and anorexia nervosa, as well as obsessive-compulsive symptoms, are needed to better understand the causality. Level of Evidence Level V, descriptive study.

Should an obsessive-compulsive spectrum grouping of disorders be included in DSM-V?

PubMed

Phillips, Katharine A; Stein, Dan J; Rauch, Scott L; Hollander, Eric; Fallon, Brian A; Barsky, Arthur; Fineberg, Naomi; Mataix-Cols, David; Ferrão, Ygor Arzeno; Saxena, Sanjaya; Wilhelm, Sabine; Kelly, Megan M; Clark, Lee Anna; Pinto, Anthony; Bienvenu, O Joseph; Farrow, Joanne; Leckman, James

2010-06-01

The obsessive-compulsive (OC) spectrum has been discussed in the literature for two decades. Proponents of this concept propose that certain disorders characterized by repetitive thoughts and/or behaviors are related to obsessive-compulsive disorder (OCD), and suggest that such disorders be grouped together in the same category (i.e. grouping, or "chapter") in DSM. This article addresses this topic and presents options and preliminary recommendations to be considered for DSM-V. The article builds upon and extends prior reviews of this topic that were prepared for and discussed at a DSM-V Research Planning Conference on Obsessive-Compulsive Spectrum Disorders held in 2006. Our preliminary recommendation is that an OC-spectrum grouping of disorders be included in DSM-V. Furthermore, we preliminarily recommend that consideration be given to including this group of disorders within a larger supraordinate category of "Anxiety and Obsessive-Compulsive Spectrum Disorders." These preliminary recommendations must be evaluated in light of recommendations for, and constraints upon, the overall structure of DSM-V. (c) 2010 Wiley-Liss, Inc.

[Obsessive-compulsive disorder, a new model of basal ganglia dysfunction? Elements from deep brain stimulation studies].

PubMed

Haynes, W I A; Millet, B; Mallet, L

2012-01-01

Deep brain stimulation was first developed for movement disorders but is now being offered as a therapeutic alternative in severe psychiatric disorders after the failure of conventional therapies. One of such pathologies is obsessive-compulsive disorder. This disorder which associates intrusive thoughts (obsessions) and repetitive irrepressible rituals (compulsions) is characterized by a dysfunction of a cortico-subcortical loop. After having reviewed the pathophysiological evidence to show why deep brain stimulation was an interesting path to take for severe and resistant cases of obsessive-compulsive disorder, we will present the results of the different clinical trials. Finally, we will provide possible mechanisms for the effects of deep brain stimulation in this pathology. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Relationship between obsessive-compulsive personality disorder and obsessive-compulsive disorder.

PubMed

Diaferia, G; Bianchi, I; Bianchi, M L; Cavedini, P; Erzegovesi, S; Bellodi, L

1997-01-01

This study investigated the presence of obsessive-compulsive personality disorder (OCPD) in a group of 277 patients (88 with obsessive-compulsive disorder [OCD], 58 with major depressive disorder [MDD], and 131 with panic disorder [Panic]) to test the specificity of the relationship between OCPD and OCD. OCPD is statistically significantly more frequent in patients with OCD than in those with Panic and MDD. The distribution of single criteria of OCPD in the three groups does not differ significantly. Discriminant analysis selects a list of items that provide a correct classification rate of 66% based on OCPD criteria selected by canonical function. OCD patients with and without OCPD do not differ in sex, age of onset, duration of illness, positive family history for Tics disorder/Tourette syndrome (TS), or morbidity risk for OCD.

[Effect of religious culture on obsessive compulsive disorder symptomatology. A transcultural study in monotheistic religions].

PubMed

de Bilbao, Fabienne; Giannakopoulos, Pantéléimon

2005-11-30

Effect of religious culture on obsessive Cultural factors may influence the nature of obsessions and compulsions associated with the obsessive compulsive disorder (OCD). The aim of this review is to evaluate the effect of religious upbringing on OCD symptoms. In fact, a variety of symptoms related to religious thoughts are more prevalent in clinical populations from countries in which religion is at the central core of the society, particularly in Muslim and Jewish Middle Eastern cultures, as compared with clinical populations from the West. These findings suggest that clinicians should be sensitive to the fact that religious obsessions may be more prevalent in certain cultures with which they may not be well acquainted.

Standards of care for obsessive–compulsive disorder centres

PubMed Central

Menchón, José M.; van Ameringen, Michael; Dell’Osso, Bernardo; Denys, Damiaan; Figee, Martijn; Grant, Jon E.; Hollander, Eric; Marazziti, Donatella; Nicolini, Humberto; Pallanti, Stefano; Ruck, Christian; Shavitt, Roseli; Stein, Dan J.; Andersson, Erik; Bipeta, Rajshekhar; Cath, Danielle C.; Drummond, Lynne; Feusner, Jamie; Geller, Daniel A.; Hranov, Georgi; Lochner, Christine; Matsunaga, Hisato; McCabe, Randy E.; Mpavaenda, Davis; Nakamae, Takashi; O'Kearney, Richard; Pasquini, Massimo; Pérez Rivera, Ricardo; Poyurovsky, Michael; Real, Eva; do Rosário, Maria Conceição; Soreni, Noam; Swinson, Richard P.; Vulink, Nienke; Zohar, Joseph; Fineberg, Naomi

2016-01-01

Abstract In recent years, many assessment and care units for obsessive–compulsive disorder (OCD) have been set up in order to detect, diagnose and to properly manage this complex disorder, but there is no consensus regarding the key functions that these units should perform. The International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) together with the Obsessive Compulsive and Related Disorders Network (OCRN) of the European College of Neuropsychopharmacology (ECNP) and the Anxiety and Obsessive Compulsive Disorders Section of the World Psychiaric Association (WPA) has developed a standards of care programme for OCD centres. The goals of this collaborative initiative are promoting basic standards, improving the quality of clinical care and enhance the validity and reliability of research results provided by different facilities and countries. PMID:27359333

Initial validation of two opiate craving questionnaires the obsessive compulsive drug use scale and the desires for drug questionnaire.

PubMed

Franken, Ingmar H A; Hendriksa, Vincent M; van den Brink, Wim

2002-01-01

In the present study, the factor structure, internal consistency, and the concurrent validity of two heroin craving questionnaires are examined. The Desires for Drug Questionnaire (DDQ) measures three factors: desire and intention, negative reinforcement, and control. The Obsessive Compulsive Drug Use Scale (OCDUS) also measures three factors: thoughts about heroin and interference, desire and control, and resistance to thoughts and intention. Subjects were 102 Dutch patients who were currently in treatment for drug dependency. All proposed scales have good reliability and concurrent validity. Implementation of these instruments in both clinical and research field is advocated.

Examining the DSM-5 Section III Criteria for Obsessive-Compulsive Personality Disorder in a Community Sample.

PubMed

Liggett, Jacqueline; Sellbom, Martin; Carmichael, Kieran L C

2017-12-01

The current study examined the extent to which the trait-based operationalization of obsessive-compulsive personality disorder (OCPD) in Section III of the DSM-5 describes the same construct as the one described in Section II. A community sample of 313 adults completed a series of personality inventories indexing the DSM-5 Sections II and III diagnostic criteria for OCPD, in addition to a measure of functional impairment modelled after the criteria in Section III. Results indicated that latent constructs representing Section II and Section III OCPD overlapped substantially (r = .75, p < .001). Hierarchical latent regression models revealed that at least three of the four DSM-5 Section III facets (Rigid Perfectionism, Perseveration, and Intimacy Avoidance) uniquely accounted for a large proportion of variance (53%) in a latent Section II OCPD variable. Further, Anxiousness and (low) Impulsivity, as well as self and interpersonal impairment, augmented the prediction of latent OCPD scores.

Brain Imaging in Pediatric Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

MacMaster, Frank P.; O'Neill, Joseph; Rosenberg, David R.

2008-01-01

Neuroimaging findings support the frontal-striatal-thalamic model of pediatric obsessive-compulsive disorder. Glutamate is also implicated in the pathological finding of the disease. Implications for pediatric OCD treatments are discussed.

Effects of tryptophan depletion on selective serotonin reuptake inhibitor-remitted patients with obsessive compulsive disorder.

PubMed

Hood, Sean D; Broyd, Annabel; Robinson, Hayley; Lee, Jessica; Hudaib, Abdul-Rahman; Hince, Dana A

2017-12-01

Serotonergic antidepressants are first-line medication therapies for obsessive-compulsive disorder, however it is not known if synaptic serotonin availability is important for selective serotonin reuptake inhibitor efficacy. The present study tested the hypothesis that temporary reduction in central serotonin transmission, through acute tryptophan depletion, would result in an increase in anxiety in selective serotonin reuptake inhibitor-remitted obsessive-compulsive disorder patients. Eight patients (four males) with obsessive-compulsive disorder who showed sustained clinical improvement with selective serotonin reuptake inhibitor treatment underwent acute tryptophan depletion in a randomized, double-blind, placebo-controlled, within-subjects design, over two days one week apart. Five hours after consumption of the depleting/sham drink the participants performed a personalized obsessive-compulsive disorder symptom exposure task. Psychological responses were measured using the Spielberger State Anxiety Inventory, Yale-Brown Obsessive Compulsive Scale and Visual Analogue Scales. Free plasma tryptophan to large neutral amino acid ratio decreased by 93% on the depletion day and decreased by 1% on the sham day, as anticipated. Psychological rating scores as measured by Visual Analogue Scale showed a significant decrease in perceived control and increase in interfering thoughts at the time of provocation on the depletion day but not on the sham day. A measure of convergent validity, namely Visual Analogue Scale Similar to past, was significantly higher at the time of provocation on both the depletion and sham days. Both the depletion and time of provocation scores for Visual Analogue Scale Anxiety, Spielberger State Anxiety Inventory, Yale-Brown Obsessive Compulsive Scale and blood pressure were not significant. Acute tryptophan depletion caused a significant decrease in perceived control and increase in interfering thoughts at the time of provocation. Acute tryptophan depletion had no effect on the Spielberger State Anxiety Inventory or Visual Analogue Scale Anxiety measures, which suggests that the mechanism of action of selective serotonin reuptake inhibitors may be different to that seen in panic, social anxiety and post-traumatic stress disorder. Successful selective serotonin reuptake inhibitor treatment of obsessive-compulsive disorder may involve the ability of serotonin to switch habitual responding to goal-directed behaviour.

Psychometric Properties of the Obsessive-Compulsive Inventory-Child Version (OCI-CV) in Chilean Children and Adolescents

PubMed Central

Martínez-González, Agustín E.; Rodríguez-Jiménez, Tíscar; Piqueras, José A.; Vera-Villarroel, Pablo; Godoy, Antonio

2015-01-01

In recent years, there has been a considerable increase in the development of assessment tools for obsessive-compulsive symptomatology in children and adolescents. The Obsessive Compulsive Inventory-Child Version (OCI-CV) is a well-established assessment self-report, with special interest for the assessment of dimensions of Obsessive Compulsive Disorder (OCD). This instrument has shown to be useful for clinical and non-clinical populations in two languages (English and European Spanish). Thus, the aim of this study was to analyze the psychometric properties of the OCI-CV in a Chilean community sample. The sample consisted of 816 children and adolescents with a mean age of 14.54 years (SD = 2.21; range = 10–18 years). Factor structure, internal consistency, test-retest reliability, convergent/divergent validity, and gender/age differences were examined. Confirmatory factor analysis showed a 6-factor structure (Doubting/Checking, Obsessing, Hoarding, Washing, Ordering, and Neutralizing) with one second-order factor. Good estimates of reliability (including internal consistency and test-retest), evidence supporting the validity, and small age and gender differences (higher levels of OCD symptomatology among older participants and women, respectively) are found. The OCI-CV is also an adequate scale for the assessment of obsessions and compulsions in a general population of Chilean children and adolescents. PMID:26317404

The link between ADHD-like inattention and obsessions and compulsions during treatment of youth with OCD

PubMed Central

Guzick, Andrew G.; McNamara, Joseph P.H.; Reid, Adam M.; Balkhi, Amanda M.; Storch, Eric A.; Murphy, Tanya K.; Goodman, Wayne K.; Bussing, Regina; Geffken, Gary R.

2017-01-01

Attention-deficit/hyperactivity disorder (ADHD) has been found to be highly comorbid in children and adolescents with obsessive-compulsive disorder (OCD). Some have proposed, however, that obsessive anxiety may cause inattention and executive dysfunction, leading to inappropriate ADHD diagnoses in those with OCD. If this were the case, these symptoms would be expected to decrease following successful OCD treatment. The present study tested this hypothesis and evaluated whether ADHD symptoms at baseline predicted OCD treatment response. Obsessive-compulsive and ADHD symptoms were assessed in 50 youth enrolled in a randomized controlled trial investigating selective serotonin reuptake inhibitor and cognitive behavioral treatment. Repeated-measures analysis of variance (RMANOVA) revealed that ADHD symptoms at baseline do not significantly predict treatment outcome. A multivariate RMANOVA found that OCD treatment response moderated change in inattention; participants who showed greater reduction in OCD severity experienced greater reduction in ADHD-inattentive symptoms, while those with less substantial reduction in obsessions and compulsions showed less change. These findings suggest that children and adolescents with OCD and inattention may experience meaningful improvements in attention problems following OCD treatment. Thus, in many youth with OCD, inattention may be inherently tied to obsessions and compulsions. Clinicians may consider addressing OCD in treatment before targeting inattentive-type ADHD. PMID:28966908

[Obsessive-compulsive disorders in forensic-psychiatric opinions].

PubMed

Kocur, Józef; Trendak, Wiesława

2009-01-01

Obsessive-compulsive disorders and disorders within their spectrum pose a serious diagnostic and therapeutic problem, as the symptoms that appear along with the disorders result from dysfunction of the emotional, motivational and cognitive sphere. The dysfunction is determined by complex genetic, neurochemical and neurophysiological factors. Exacerbation of the symptoms may weaken the control over the disturbed impulses and compulsions, which in turn may lead to violation of law. Therefore, a forensic-psychiatric evaluation in cases related to patients suffering from obsessive-compulsive disorders has to include very complex relations between the type and the circumstances of the committed act or the undertaken actions and the type and intensity of these disorders.

Counterfactual Processing of Economic Action-Outcome Alternatives in Obsessive-Compulsive Disorder: Further Evidence of Impaired Goal-Directed Behavior

PubMed Central

Gillan, Claire M.; Morein-Zamir, Sharon; Kaser, Muzaffer; Fineberg, Naomi A.; Sule, Akeem; Sahakian, Barbara J.; Cardinal, Rudolf N.; Robbins, Trevor W.

2014-01-01

Background Obsessive-compulsive disorder (OCD) is a disorder of automatic, uncontrollable behaviors and obsessive rumination. There is evidence that OCD patients have difficulties performing goal-directed actions, instead exhibiting repetitive stimulus-response habit behaviors. This might result from the excessive formation of stimulus-response habit associations or from an impairment in the ability to use outcome value to guide behavior. We investigated the latter by examining counterfactual decision making, which is the ability to use comparisons of prospective action-outcome scenarios to guide economic choice. Methods We tested decision making (forward counterfactual) and affective responses (backward counterfactual) in 20 OCD patients and 20 matched healthy control subjects using an economic choice paradigm that previously revealed attenuation of both the experience and avoidance of counterfactual emotion in schizophrenia patients and patients with orbitofrontal cortex lesions. Results The use of counterfactual comparison to guide decision making was diminished in OCD patients, who relied primarily on expected value. Unlike the apathetic affective responses previously shown to accompany this decision style, OCD patients reported increased emotional responsivity to the outcomes of their choices and to the counterfactual comparisons that typify regret and relief. Conclusions Obsessive-compulsive disorder patients exhibit a pattern of decision making consistent with a disruption in goal-directed forward modeling, basing decisions instead on the temporally present (and more rational) calculation of expected value. In contrast to this style of decision making, emotional responses in OCD were more extreme and reactive than control subjects. These results are in line with an account of disrupted goal-directed cognitive control in OCD. PMID:23452663

Differential Impairment as an Indicator of Sex Bias in DSM-IV Criteria for Four Personality Disorders

ERIC Educational Resources Information Center

Boggs, Christina D.; Morey, Leslie C.; Skodol, Andrew E.; Shea, M. Tracie; Sanislow, Charles A.; Grilo, Carlos M.; McGlashan, Thomas H.; Zanarini, Mary C.; Gunderson, John G.

2005-01-01

The aim of the present study was to investigate the possibility of sex bias in the diagnostic criteria for borderline, schizotypal, avoidant, and obsessive-compulsive personality disorders. A clinical sample of 668 individuals was evaluated for personality disorder criteria using a semistructured interview, and areas of functional impairment were…

Obsessive Compulsive Disorder Treatment in Patients with Down Syndrome: A Case Series

ERIC Educational Resources Information Center

Sutor, Bruce; Hansen, Mark R.; Black, John L.

2006-01-01

In this case series we report four cases of patients with Down syndrome with symptoms consistent with obsessive compulsive disorder. Each patient experienced substantial reduction in compulsive behaviors with pharmacotherapy of an SSRI alone or with the addition of risperidone to SSRI therapy. None of the patients experienced significant side…

Polarity-dependent effects of transcranial direct current stimulation in obsessive-compulsive disorder.

PubMed

D'Urso, Giordano; Brunoni, Andre Russowsky; Anastasia, Annalisa; Micillo, Marco; de Bartolomeis, Andrea; Mantovani, Antonio

2016-01-01

About one third of patients with obsessive-compulsive disorder (OCD) fail to experience significant clinical benefit from currently available treatments. Hyperactivity of the presupplementary motor area (pre-SMA) has been detected in OCD patients, but it is not clear whether it is the primary cause or a secondary compensatory mechanism in OCD pathophysiology. Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique with polarity-dependent effects on motor cortical excitability. A 33-year-old woman with treatment-resistant OCD received 20 daily consecutive 2 mA/20 min tDCS sessions with the active electrode placed on the pre-SMA, according to the 10-20 EEG system, and the reference electrode on the right deltoid. The first 10 sessions were anodal, while the last 10 were cathodal. Symptoms severity was assessed using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) severity score. In the end of anodal stimulation, OCD symptoms had worsened. Subsequent cathodal stimulation induced a dramatic clinical improvement, which led to an overall 30% reduction in baseline symptoms severity score on the Y-BOCS. Our study supports the hypothesis that pre-SMA hyperfunction might be responsible for OCD symptoms and shows that cathodal inhibitory tDCS over this area might be an option when dealing with treatment-resistant OCD.

Doubt in the Insula: Risk Processing in Obsessive-Compulsive Disorder

PubMed Central

Luigjes, Judy; Figee, Martijn; Tobler, Philippe N.; van den Brink, Wim; de Kwaasteniet, Bart; van Wingen, Guido; Denys, Damiaan

2016-01-01

Extensive cleaning or checking of patients with obsessive-compulsive disorder (OCD) are often interpreted as strategies to avoid harm and as an expression of the widespread belief that OCD patients are more risk-averse. However, despite its clinical significance, the neural basis of risk attitude in OCD is unknown. Here, we investigated neural activity during risk processing using functional magnetic resonance imaging and simultaneously assessed risk attitude using a separate behavioral paradigm in OCD patients with different symptoms versus healthy controls (HCs). We found opposite insula responses to high versus low risk in OCD patients compared to HCs: a positive correlation between insula activity and risk-aversion in patients versus a negative correlation in controls. Although OCD patients overall were not more risk-averse than controls, there were differences between subgroups of OCD patients: patients with doubt/checking symptoms were more risk-averse than other patients. Taken together, OCD patients show a reversed pattern of risk processing by the insula compared to HCs. Moreover, the data suggest that increased activation of the insula signals an abnormal urge to avoid risks in the subpopulation of OCD patients with doubt and checking symptoms. These results indicate a role for the insula in excessive risk-avoidance relevant to OCD. PMID:27378883

Why did the white bear return? Obsessive-compulsive symptoms and attributions for unsuccessful thought suppression

PubMed Central

Magee, Joshua C.; Teachman, Bethany A.

2007-01-01

The current study examined the nature and consequences of attributions about unsuccessful thought suppression. Undergraduate students with either high (N=67) or low (N=59) levels of obsessive-compulsive symptoms rated attributions to explain their unsuccessful thought suppression attempts. We expected that self-blaming attributions and attributions ascribing importance to unwanted thoughts would predict more distress and greater recurrence of thoughts during time spent monitoring or suppressing unwanted thoughts. Further, we expected that these attributions would mediate the relationship between obsessive-compulsive symptom levels and the negative thought suppression outcomes (distress and thought recurrence). Structural equation models largely confirmed the hypotheses, suggesting that attributions may be an important factor in explaining the consequences of thought suppression. Implications are discussed for cognitive theories of obsessive-compulsive disorder and thought suppression. PMID:17825786

The Toronto Obsessive-Compulsive Scale: Psychometrics of a Dimensional Measure of Obsessive-Compulsive Traits.

PubMed

Park, Laura S; Burton, Christie L; Dupuis, Annie; Shan, Janet; Storch, Eric A; Crosbie, Jennifer; Schachar, Russell J; Arnold, Paul D

2016-04-01

To describe the Toronto Obsessive-Compulsive Scale (TOCS), a novel 21-item parent- or self-report questionnaire that covers wide variation in obsessive-compulsive (OC) traits, and to evaluate its psychometric properties in a community-based pediatric sample. The TOCS was completed for 16,718 children and adolescents between the ages of 6 and 17 years in a community setting. Internal consistency, convergent validity with the Obsessive-Compulsive Scale of the Child Behaviour Checklist (CBCL-OCS), divergent validity with the Strengths and Weaknesses of ADHD (Attention-Deficit/Hyperactivity Disorder) Symptoms and Normal Behaviour Rating Scale (SWAN), interrater reliability, as well as sensitivity and specificity of the TOCS were assessed. The internal consistency of the 21 TOCS items was excellent (Cronbach's α = 0.94). TOCS was moderately correlated with the CBCL-OCS (Spearman correlation = 0.51) and poorly correlated with the SWAN (Pearson correlation = 0.02). Sensitivity and specificity analyses indicated that a TOCS total score of greater than 0 successfully discriminated community-reported obsessive-compulsive disorder (OCD) cases from noncases. OC traits were continuously distributed both at the total score and dimensional level in our pediatric community sample. TOCS is a multidimensional measure of OC traits in children and adolescents with sound psychometric properties. TOCS reveals that OC traits are common and continuously distributed in a community sample. TOCS may be a useful measure for studies of the characteristics and etiology of OC traits. Copyright © 2016. Published by Elsevier Inc.

Capacity to Delay Reward Differentiates Obsessive Compulsive Disorder and Obsessive Compulsive Personality Disorder

PubMed Central

Pinto, Anthony; Steinglass, Joanna E.; Greene, Ashley L.; Weber, Elke U.; Simpson, H. Blair

2013-01-01

Background Although the relationship between obsessive compulsive disorder (OCD) and obsessive compulsive personality disorder (OCPD) has long been debated, clinical samples of OCD (without OCPD) and OCPD (without OCD) have never been systematically compared. We studied whether individuals with OCD, OCPD, or both conditions differ on symptomatology, functioning, and a measure of self-control: the capacity to delay reward. Methods 25 OCD, 25 OCPD, 25 comorbid OCD+OCPD, and 25 healthy controls (HC) completed clinical assessments and a validated intertemporal choice task that measures capacity to forego small immediate rewards for larger delayed rewards. Results OCD and OCPD subjects both showed impairment in psychosocial functioning and quality of life, as well as compulsive behavior, but only subjects with OCD reported obsessions. Individuals with OCPD, with or without comorbid OCD, discounted the value of delayed monetary rewards significantly less than OCD and HC. This excessive capacity to delay reward discriminates OCPD from OCD, and is associated with perfectionism and rigidity. Conclusions OCD and OCPD are both impairing disorders marked by compulsive behaviors, but they can be differentiated by the presence of obsessions in OCD and by excessive capacity to delay reward in OCPD. That individuals with OCPD show less temporal discounting (suggestive of excessive self-control) whereas prior studies have shown that individuals with substance use disorders show greater discounting (suggestive of impulsivity) supports the premise that this component of self-control lies on a continuum in which both extremes (impulsivity and overcontrol) contribute to psychopathology. PMID:24199665

Linking Career Counseling to Personality Disorders.

ERIC Educational Resources Information Center

Kjos, Diane

1995-01-01

Relates personality disorders to career development issues and counseling interventions. Case examples suggesting career-focused treatment interventions for dependent, borderline, obsessive-compulsive, and passive-aggressive personality disorders are presented. (Author/JBJ)

[Development of sexuality and motivational aspects of sexual behavior in men with obsessive-compulsive disorders].

PubMed

2014-09-01

Sexual behavior and formation of sexuality in men with obsessive-compulsive disorder is one of the pressing issues in contemporary medicine. Obsessive-compulsive disorder is characterized by the development of intrusive thoughts, memories, movements and actions, as well as a variety of pathological fears (phobias). Increase in the number of patients with this pathology in modern clinical practice of neurotic disorders, the young age of the patients and as a result violation of interpersonal, communicational and sexual nature is quite apparent. The study involved 35 men aged 23 to 47 years with clinical signs of OCD. We determined the severity of obsessive-compulsive symptoms using the Yale-Brown scale. We established the presence of a mild degree of disorder in 34,3% of cases; in 48,6% of cases disorder of moderate severity was diagnosed; remaining 17.1% were assessed subclinical condition of OCD at the applicable scale. The system of motivational maintenance of sexual behavior in men with obsessive-compulsive disorders is investigated. Motives of sexual behavior of the investigated men with the pathology are determined. The presented research in men with OCD have established multidimensionality and complexity of motivational ensuring of sexual behavior.

Association between cognitive impairments and obsessive-compulsive spectrum presentations following traumatic brain injury.

PubMed

Rydon-Grange, Michelle; Coetzer, Rudi

2017-01-02

This study examined the association between self-reported obsessive-compulsive spectrum symptomatology and cognitive performance in a sample of patients with traumatic brain injury (TBI). Twenty-four adults with a moderate-severe TBI accessing a community brain injury rehabilitation service were recruited. Age ranged between 19 and 69 years. Participants completed a battery of neuropsychological tasks assessing memory, executive functioning, and speed of information processing. Self-report questionnaires assessing obsessive-compulsive (OC) symptoms and obsessive-compulsive personality disorder (OCPD) traits were also completed. Correlational analyses revealed that deficits in cognitive flexibility were associated with greater self-reported OC symptomatology and severity. Greater OC symptom severity was significantly related to poorer performance on a visual memory task. Verbal memory and speed of information processing impairments were unrelated to OC symptoms. Performance on tasks of memory, executive functioning, and speed of information processing were not associated with OCPD traits. Overall, results indicate that greater OC symptomatology and severity were associated with specific neuropsychological functions (i.e., cognitive flexibility, visual memory). OCPD personality traits were unrelated to cognitive performance. Further research is needed to examine the potential causal relationship and longer-term interactions between cognitive sequelae and obsessive-compulsive spectrum presentations post-TBI.

Suicidality in clozapine-treated patients with schizophrenia: role of obsessive-compulsive symptoms.

PubMed

Szmulewicz, Alejandro G; Smith, José M; Valerio, Marina P

2015-11-30

Patients with schizophrenia have an increased lifetime risk of comorbid obsessive-compulsive symptoms. Up to 30% of these patients experience such symptoms and 12% may be diagnosed with obsessive-compulsive disorder. The presence of these symptoms in schizophrenia seems to be associated with poor outcomes including a greater suicidal risk. A subgroup of patients develops this symptomatology after the initiation with Second Generation Antipsychotics (SGA). Also, there is evidence of a causal relationship for this association, particularly for clozapine. The primary aim of this study was to investigate the association of this comorbidity with suicidality in a population of clozapine-medicated schizophrenic and schizoaffective patients (N=65). The prevalence of obsessive-compulsive symptoms in our sample was 29.2% (N=19) and the prevalence of obsessive-compulsive disorder was 13.8% (N=9). Significant positive correlations between suicidality and total Y-BOCS score and between Y- BOCS score and depressive symptoms were found. Further analysis indicated that a Y-BOCS score greater or equal than 8 was an independent predictor of suicide attempt during clozapine treatment. Routine screening for this adverse event should be warranted for this population. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Worry and Rumination in Generalized Anxiety Disorder and Obsessive Compulsive Disorder.

PubMed

Dar, Kaiser A; Iqbal, Naved

2015-01-01

Ample work has already been conducted on worry and rumination as negative thought processes involved in the etiology of most of the anxiety and mood related disorders. However, minimal effort has been exerted to investigate whether one type of negative thought process can make way for another type of negative thought process, and if so, how it subsequently results in experiencing a host of symptoms reflective of one or the other type of psychological distress. Therefore, the present study was taken up to investigate whether rumination mediates the relationship between worry and generalized anxiety disorder (GAD), and between worry and obsessive compulsive disorder (OCD) in two clinical groups. Self-report questionnaires tapping worry, rumination, generalized anxiety disorder (GAD), and obsessive compulsive disorder (OCD) were administered to a clinical sample of 60 patients aged 30-40. Worry, rumination, generalized anxiety disorder (GAD), and obsessive compulsive disorder (OCD) correlated substantially with each other, however, rumination did not mediate the relationship between worry and generalized anxiety disorder (GAD) and between worry and obsessive compulsive disorder (OCD). We also analyzed differences of outcome variables within two clinical groups. These results showed that worry and rumination were significantly different between GAD and OCD groups.

Predictors of Treatment Response in Pediatric Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Ginsburg, Golda S.; Kingery, Julie Newman; Drake, Kelly L.; Grados, Marco A.

2008-01-01

The study examines predictors of treatment response in pediatric obsessive-compulsive disorder, which is a severe mental illness causing distress and impaired functioning. Summarized findings of psychosocial factors and medication interventions are presented.

Treatment of Obsessive Compulsive Disorder in Young Children: An Intervention Model and Case Series

ERIC Educational Resources Information Center

Ginsburg, Golda S.; Burstein, Marcy; Becker, Kimberly D.; Drake, Kelly L.

2011-01-01

This article presents an intervention model for young children with obsessive-compulsive disorder (OCD). The intervention, designed to reduce compulsive behavior and improve parenting practices, was tested using a multiple baseline design with 7 children (M = 6 years old; 57% female) in which participants were randomly assigned to 1, 2, or 3 weeks…

Excessive nest building is a unique behavioural phenotype in the deer mouse model of obsessive-compulsive disorder.

PubMed

Wolmarans, De Wet; Stein, Dan J; Harvey, Brian H

2016-09-01

Obsessive-compulsive disorder (OCD) is a phenotypically heterogeneous condition characterised by time-consuming intrusive thoughts and/or compulsions. Irrespective of the symptom type diagnosed, the severity of OCD is characterised by heterogeneity in symptom presentation that complicates diagnosis and treatment. Heterogeneity of symptoms would be invaluable in an animal model. Nest building behaviour forms part of the normal behavioural repertoire of rodents and demonstrates profound between-species differences. However, it has been proposed that within-species differences in nest building behaviour (i.e. aberrant vs. normal nest building) may resemble obsessive-compulsive-like symptoms. In an attempt to investigate whether other obsessive-compulsive-like behaviours are present in an animal model of OCD, or if aberrant nest building behaviour may represent a unique obsessive-compulsive phenotype in such a model, the current study assessed nest building behaviour in high (H, viz obsessive-compulsive) and non (N, viz normal) stereotypical deer mice. Subsequently, 12 N and H animals, respectively, were provided with an excess of cotton wool daily for one week prior to and following four weeks of high-dose oral escitalopram treatment (50 mg/kg/day). Data from the current investigation demonstrate daily nesting activity to be highly variable in deer mice, with stereotypy and nest building being independent behaviours. However, we identified unique aberrant large nest building behaviour in 30% of animals from both cohorts that was attenuated by escitalopram to pre-treatment nesting scores of the larger group. In summary, behavioural and drug-treatment evidence confirms that deer mouse behaviour does indeed resemble symptom heterogeneity related to OCD, and as such expands its face and predictive validity for the disorder. © The Author(s) 2016.

OCD: obsessive-compulsive … disgust? The role of disgust in obsessive-compulsive disorder.

PubMed

Bhikram, Tracy; Abi-Jaoude, Elia; Sandor, Paul

2017-09-01

Recent research has identified the important role of disgust in the symptomatology of obsessive-compulsive disorder (OCD). Exaggerated and inappropriate disgust reactions may drive some of the symptoms of OCD, and in some cases, may even eclipse feelings of anxiety. This paper reviews behavioural and neuroimaging research that recognizes the prominent role of disgust in contributing to OCD symptoms, especially contamination-based symptoms. We discuss how elevated behavioural and biological markers of disgust reported in OCD populations support the need for alternative clinical treatment strategies and theoretical models of OCD.

Suicidality in schizophrenic patients with and without obsessive-compulsive disorder.

PubMed

Sevincok, Levent; Akoglu, Aybars; Kokcu, Filiz

2007-02-01

This report examines the suicidal behaviour in subjects with schizophrenia who have (N=24) and do not have comorbid Obsessive-Compulsive Disorder (OCD) (N=33). The patients with OCD-schizophrenia were more likely to have a previous history of suicidal attempts, and ideations. The number of previous suicidal attempts were significantly higher in patients with OCD-schizophrenia than in patients with non-OCD schizophrenia. The patients with a history of previous suicide attempts were more likely to have a comorbid diagnosis of OCD. Compulsive symptoms were significant predictors of suicide attempt among patients with schizophrenia. Our preliminary findings may suggest that obsessive-compulsive symptoms may account for the emergence of suicidality in patients with OCD-schizophrenia.

Obsessive-Compulsive Disorder: When Unwanted Thoughts or Irresistable Actions Take Over

MedlinePlus

... the obsessions and compulsions. Exposure and Response Prevention (EX/RP) is a specific form of CBT which ... shown to help many patients recover from OCD. EX/RP involves gradually exposing you to your fears ...

Obsessive compulsive personality disorder and obsessive compulsive disorder: clinical characteristics, diagnostic difficulties, and treatment.

PubMed

Mancebo, Maria C; Eisen, Jane L; Grant, Jon E; Rasmussen, Steven A

2005-01-01

The overlap between obsessive compulsive personality disorder (OCPD) and obsessive compulsive disorder (OCD) has received increasing recognition and continues to be a source of much debate. With the advent of new research methodologies, researchers have attempted to distinguish whether OCPD and OCD are two distinct phenomena that can co-occur or whether they are similar, overlapping constructs. MEDLINE was used to systematically review the OCPD and OCD literature published between 1991 and 2004. Using the more stringent DSM-IV criteria, results from OCD clinical samples suggest that the majority of individuals with OCD (75%) do not have OCPD. Similarly, results from personality disorder samples suggest that the majority of individuals with OCPD (80%) do not have OCD. While there is evidence that OCD and OCPD are linked, the literature does not support either one as a necessary or sufficient component of the other.

OBSESSIVE-COMPULSIVE SYMPTOMS IN CHRONIC SCHIZOPHRENIA: A NEW IDEA OR AN OLD BELIEF?

PubMed Central

Jaydeokar, Sujeet; Gore, Yogita; Diwan, Pradnya; Deshpande, Prasad; Desai, Neena

1997-01-01

Obsessive-compulsive (OC) symptoms during the course of schizophrenia have been reported, yet the incidence and significance of this finding is still unclear. This study was undertaken to determine the prevalence of OC symptoms among chronic schizophrenic patients and to systematically identify them. 101 patients satisfying DSM-IV diagnosis of chronic schizophrenia were assessed for OC symptoms. All patients were also rated on the Yale-Brown Obsessive Compulsive Scale for the severity of their symptoms. The study revealed that 26.7% of the chronic schizophrenic patients had significant OC symptoms with a high prevalence in the age group below 35 years. OC symptoms were more severe in patients with duration of illness more than 5 years. The OC symptoms were more prevalent among paranoid schizophrenics with the frequent obsessions being that of contamination, sexual and aggressive thoughts and frequent compulsion was need to ask or confess. PMID:21584101

[Are the current concepts of obsessive disorders a novelty? From Westphal (1877) and Thomsen (1895) to ICD-10 and DSM-5].

PubMed

Oberbeck, A; Steinberg, H

2015-09-01

In German-speaking countries it was Carl Westphal who in 1877 offered the first precise definition of obsessive ideas and distinguished obsessive compulsive disorder (OCD) as an independent disorder in its own right. The criteria mentioned by him for establishing OCD gave rise to a debate on the character and classification of OCD but were not fully acknowledged by his colleagues at the time. In 1895 Westphal's student Robert Thomsen tried to substantiate all points in his teacher's theory that had raised criticism. Thus the works by Westphal and Thomsen are most relevant for the current conceptualization and definition of OCD, for they laid the basis for the present phenomenology, definition and classification of OCD according to ICD-10 and DSM-5. Apart from phenomenologically differentiating between obsessions (i.e. obsessive thoughts and impulses) and compulsions (i.e. compulsive actions and inhibitions), Westphal and Thomsen also laid the basis for most of the current diagnostic criteria. Thomsen led the way to current classifications by subdifferentiating OCD as an illness on its own on the one hand and obsessions and compulsions as symptoms accompanying other conditions on the other.

Psychometric properties of revised Thought-Action Fusion questionnaire (TAF-R) in an Iranian population.

PubMed

Pourfaraj, Majid; Mohammadi, Nourallah; Taghavi, Mohammadreza

2008-12-01

The purpose of this study is to examine the psychometric properties of Thought-Action Fusion revised scale (TAF-R; Amir, N., freshman, M., Ramsey, B., Neary, E., & Brigidi, B. (2001). Thought-action fusion in individuals with OCD symptoms. Behaviour Research and Therapy, 39, 765-776) in a sample of 565 (321 female) students of Shiraz university. The results of factor analysis with using varimax rotation yielded eight factors that explained 80% variances of total scale. These factors are labeled: moral TAF, responsibility for positive thoughts, likelihood negative events, likelihood positive events, responsibility for negative thoughts, responsibility for harm avoidance, likelihood harm avoidance and likelihood self, respectively. The reliability coefficients of total scale are calculated by two methods: internal consistency and test-retest, which were 0.81 and 0.61, respectively. Concurrent validity showed that TAF-R scores positively and significantly correlate with responsibility, guilt and obsessive-compulsive symptoms. Confirming the expectations, there were people with high obsessive-compulsive symptoms having higher TAF-R scores than those with low symptoms. Moreover, subscales-total correlations showed that the correlations between subscales were low, but subscales correlating with total score of TAF-R were moderated.

Traumatic exposure and posttraumatic stress disorder in borderline, schizotypal, avoidant, and obsessive-compulsive personality disorders: findings from the collaborative longitudinal personality disorders study.

PubMed

Yen, Shirley; Shea, M Tracie; Battle, Cynthia L; Johnson, Dawn M; Zlotnick, Caron; Dolan-Sewell, Regina; Skodol, Andrew E; Grilo, Carlos M; Gunderson, John G; Sanislow, Charles A; Zanarini, Mary C; Bender, Donna S; Rettew, Jennifer Bame; McGlashan, Thomas H

2002-08-01

The association between trauma and personality disorders (PDs), while receiving much attention and debate, has not been comprehensively examined for multiple types of trauma and PDs. The authors examined data from a multisite study of four PD groups: schizotypal, borderline (BPD), avoidant, and obsessive-compulsive, and a major depression comparison group. Rates of traumatic exposure to specific types of trauma, age of first trauma onset, and rates of posttraumatic stress disorder are compared. Results indicate that BPD participants reported the highest rate of traumatic exposure (particularly to sexual traumas, including childhood sexual abuse), the highest rate of posttraumatic stress disorder, and youngest age of first traumatic event. Those with the more severe PDs (schizotypal, BPD) reported more types of traumatic exposure and higher rates of being physically attacked (childhood and adult) when compared to other groups. These results suggest a specific relationship between BPD and sexual trauma (childhood and adult) that does not exist among other PDs. In addition, they support an association between severity of PD and severity of traumatic exposure, as indicated by earlier trauma onset, trauma of an assaultive and personal nature, and more types of traumatic events.

Relationship between the prefrontal function and the severity of the emotional symptoms during a verbal fluency task in patients with major depressive disorder: a multi-channel NIRS study.

PubMed

Liu, Xiaomin; Sun, Gaoxiang; Zhang, Xiaoqian; Xu, Bo; Shen, Chenyu; Shi, Lujie; Ma, Xiangyun; Ren, Xiajin; Feng, Kun; Liu, Pozi

2014-10-03

Multi-channel near-infrared spectroscopy (NIRS) is a noninvasive and low-cost functional neuroimaging technique in psychiatric research, and it has been wildly used for detecting the spatiotemporal characteristics of brain activity. In order to evaluate the clinical value of NIRS data in the assistant diagnosis of major depressive disorder (MDD), prefrontal cortex (PFC) hemoglobin concentration exchange of 30 MDD patients combined with anxious and obsessive-compulsive symptom was detected by NIRS under voice fluency task (VFT), then the relationship between the severity of depressive, anxious and obsessive-compulsive symptom assessed by Hamilton Rating Scale for Depression (HAMD), Hamilton Anxiety Rating Scale (HAMA) and Yale-Brown Obsessive Compulsive Scale (Y-BOCS) with NIRS data in PFC was analyzed. Hypoactivation in lateral and lower PFC of MDD patients was confirmed in this study. Furthermore, Spearman correlation found that oxy-hemoglobin concentration ([oxy-Hb]) exchange in right-lateral PFC was associated with the severity of anxiety, while bilateral PFC and antero-medial PFC were associated with severity of depression. Meanwhile, no statistical correlation was observed on the severity of obsessive-compulsive symptom. The results prompted that MDD patients with anxiety and obsession-compulsion symptom showed a PFC hypoactivation state in NIRS. Furthermore, the function of right-lateral PFC was associated with anxiety symptom, while bilateral PFC and antero-medial PFC were associated with depression symptom. Different from depression and anxiety, obsession-compulsion may have a different biological character in PFC function. Copyright © 2014 Elsevier Inc. All rights reserved.

Understanding the covariation of tics, attention-deficit/hyperactivity, and obsessive-compulsive symptoms: A population-based adult twin study.

PubMed

Pinto, Rebecca; Monzani, Benedetta; Leckman, James F; Rück, Christian; Serlachius, Eva; Lichtenstein, Paul; Mataix-Cols, David

2016-10-01

Chronic tic disorders (TD), attention-deficit/hyperactivity-disorder (ADHD), and obsessive-compulsive disorder (OCD) frequently co-occur in clinical and epidemiological samples. Family studies have found evidence of shared familial transmission between TD and OCD, whereas the familial association between these disorders and ADHD is less clear. This study aimed to investigate to what extent liability of tics, attention-deficit/hyperactivity, and obsessive-compulsive symptoms is caused by shared or distinct genetic or environmental influences, in a large population-representative sample of Swedish adult twins (n = 21,911). Tics, attention-deficit/hyperactivity, and obsessive-compulsive symptoms showed modest, but significant covariation. Model fitting suggested a latent liability factor underlying the three phenotypes. This common factor was relatively heritable, and explained significantly less of the variance of attention-deficit/hyperactivity symptom liability. The majority of genetic variance was specific rather than shared. The greatest proportion of total variance in liability of tics, attention-deficit/hyperactivity, and obsessive-compulsive symptoms was attributed to specific non-shared environmental influences. Our findings suggest that the co-occurrence of tics and obsessive-compulsive symptoms, and to a lesser extent attention-deficit/hyperactivity symptoms, can be partly explained by shared etiological influences. However, these phenotypes do not appear to be alternative expressions of the same underlying genetic liability. Further research examining sub-dimensions of these phenotypes may serve to further clarify the association between these disorders and identify more genetically homogenous symptom subtypes. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Capacity to delay reward differentiates obsessive-compulsive disorder and obsessive-compulsive personality disorder.

PubMed

Pinto, Anthony; Steinglass, Joanna E; Greene, Ashley L; Weber, Elke U; Simpson, H Blair

2014-04-15

Although the relationship between obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) has long been debated, clinical samples of OCD (without OCPD) and OCPD (without OCD) have never been systematically compared. We studied whether individuals with OCD, OCPD, or both conditions differ on symptomatology, functioning, and a measure of self-control: the capacity to delay reward. Twenty-five OCD, 25 OCPD, 25 comorbid OCD + OCPD, and 25 healthy control subjects completed clinical assessments and a validated intertemporal choice task that measures capacity to forego small immediate rewards for larger delayed rewards. OCD and OCPD subjects both showed impairment in psychosocial functioning and quality of life, as well as compulsive behavior, but only subjects with OCD reported obsessions. Individuals with OCPD, with or without comorbid OCD, discounted the value of delayed monetary rewards significantly less than OCD and healthy control subjects. This excessive capacity to delay reward discriminates OCPD from OCD and is associated with perfectionism and rigidity. OCD and OCPD are both impairing disorders marked by compulsive behaviors, but they can be differentiated by the presence of obsessions in OCD and by excessive capacity to delay reward in OCPD. That individuals with OCPD show less temporal discounting (suggestive of excessive self-control), whereas prior studies have shown that individuals with substance use disorders show greater discounting (suggestive of impulsivity), supports the premise that this component of self-control lies on a continuum in which both extremes (impulsivity and overcontrol) contribute to psychopathology. © 2013 Society of Biological Psychiatry Published by Society of Biological Psychiatry All rights reserved.

Orbito-frontal cortex and thalamus volumes in the patients with obsessive-compulsive disorder before and after cognitive behavioral therapy.

PubMed

Atmaca, Murad; Yildirim, Hanefi; Yilmaz, Seda; Caglar, Neslihan; Mermi, Osman; Korkmaz, Sevda; Akaslan, Unsal; Gurok, M Gurkan; Kekilli, Yasemin; Turkcapar, Hakan

2018-07-01

Background The effect of a variety of treatment modalities including psychopharmacological and cognitive behavioral therapy on the brain volumes and neurochemicals have not been investigated enough in the patients with obsessive-compulsive disorder. Therefore, in the present study, we aimed to investigate the effect of cognitive behavioral therapy on the volumes of the orbito-frontal cortex and thalamus regions which seem to be abnormal in the patients with obsessive-compulsive disorder. We hypothesized that there would be change in the volumes of the orbito-frontal cortex and thalamus. Methods Twelve patients with obsessive-compulsive disorder and same number of healthy controls were included into the study. At the beginning of the study, the volumes of the orbito-frontal cortex and thalamus were compared by using magnetic resonance imaging. In addition, volumes of these regions were measured before and after the cognitive behavioral therapy treatment in the patient group. Results The patients with obsessive-compulsive disorder had greater left and right thalamus volumes and smaller left and right orbito-frontal cortex volumes compared to those of healthy control subjects at the beginning of the study. When we compared baseline volumes of the patients with posttreatment ones, we detected that thalamus volumes significantly decreased throughout the period for both sides and that the orbito-frontal cortex volumes significantly increased throughout the period for only left side. Conclusions In summary, we found that cognitive behavioral therapy might volumetrically affect the key brain regions involved in the neuroanatomy of obsessive-compulsive disorder. However, future studies with larger sample are required.

Obsessive-compulsive disorder. Diagnosis and management.

PubMed Central

Ladouceur, R.; Freeston, M.; Gagnon, F.

1996-01-01

We present three diagnostic tools to identify overt compulsive rituals, obsessional thinking, and neutralizing behaviours in obsessive-compulsive disorder (OCD) and describe the most effective cognitive-behavioural technique for treating obsessional thinking without overt rituals. Basic dysfunctional beliefs that lead to OCD are explained and integrated in the treatment model. We suggest how combined therapy can be used to tread OCD. PMID:8704492

PANS - A Detailed Study of the Patients, Their Symptoms, Biomarkers and Treatment Offered in a Scandinavian Cohort

ClinicalTrials.gov

2017-08-29

Obsessive-compulsive Disorder With Acute Onset; PANDAS; Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections; Pediatric Acute-onset Neuropsychiatric Syndrome (PANS); Childhood Acute Neuropsychiatric Symptoms (CANS); Obsessive-compulsive Disorder

Effects of selective serotonin reuptake inhibitors on thought-action fusion, metacognitions, and thought suppression in obsessive-compulsive disorder.

PubMed

Besiroglu, Lutfullah; Çetinkaya, Nuralay; Selvi, Yavuz; Atli, Abdullah

2011-01-01

We aimed to assess whether cognitive processes change over time in patients with obsessive-compulsive disorder (OCD) receiving selective serotonin reuptake inhibitors without cognitive behavioral therapy and to investigate the factors associated with probable cognitive changes. During the 16 weeks of the study, 55 patients who met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for OCD received open-label treatment with sertraline (100-200 mg/d) or fluoxetine (40-80 mg/d) and were assessed using the Yale-Brown Obsessive-Compulsive Scale, Beck Depression Inventory (BDI), Thought-Action Fusion Scale (TAFS), Metacognitions Questionnaire (MCQ-30), and White Bear Suppression Inventory (WBSI). The Yale-Brown Obsessive-Compulsive Scale (P < .001), BDI (P < .001), TAFS morality (P < .005), MCQ-30 (P < .01), and WBSI (P < .005) scores at follow-up were significantly lower than baseline scores. When we excluded OCD patients with depressive disorder (n = 12), statistical significance in paired comparisons for MCQ and WBSI disappeared. Similarly, when OCD patients with religious obsessions (n = 16) were excluded, paired comparisons for MCQ and TAF morality were not statistically significant. Changes in BDI, TAFS morality, MCQ-30, and WBSI (P < .005) were significantly correlated with changes in severity of obsessions, but not that of compulsions. After controlling for the change in depression severity, significant correlations between changes in obsessive and cognitive scales did not continue to have statistical significance. The BDI changes (P < .05) significantly explained the changes in symptom severity in a linear regression model. Our findings suggest that selective serotonin reuptake inhibitors can change appraisals of obsessive intrusions via their effects on negative emotions. Copyright © 2011 Elsevier Inc. All rights reserved.

Correlates and impact of obsessive-compulsive comorbidity in bipolar disorder.

PubMed

Magalhães, Pedro V S; Kapczinski, Natalia S; Kapczinski, Flávio

2010-01-01

Anxiety morbidity in general is frequent and harmful in bipolar disorder. Little is known, however, whether obsessive-compulsive comorbidity entails particular effects. This report aims to evaluate the prevalence and impact of obsessive-compulsive disorder (OCD) comorbidity in a relatively large clinical sample of bipolar disorder, with other lifetime anxiety comorbidities used as a more rigorous control group. A cross-sectional study in a consecutive clinical sample, with anxiety comorbidity derived from the intake Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, was conducted. Anxiety was assessed with the Hamilton Anxiety Rating Scale. The Young Mania Rating Scale and the Hamilton Depression Rating Scale were used to assess (hypo)manic and depressive symptoms. The domains of the WHOQOL BREF were used to evaluate quality of life. Lifetime prevalence of OCD comorbidity was 12.4%. No cases of OCD were detected during mania. Compared with subjects with no anxiety comorbidity, those with lifetime OCD were more likely to have a history of suicide attempts, rapid cycling, and alcohol dependence. Patients with OCD had a lower score on all domains of the WHOQOL. Compared with those with other lifetime anxiety disorders, those with OCD had more anxiety, which mediated a lower WHOQOL social domain. Bipolar disorder patients with obsessive-compulsive comorbidity have a number of indicators of an overall more severe illness. The presence of more anxiety symptoms and a lower social quality of life may be more specific features of the bipolar-OCD comorbidity. Copyright 2010 Elsevier Inc. All rights reserved.

Obsessive Compulsive Disorder: Beyond Segregated Cortico-striatal Pathways

PubMed Central

Milad, Mohammed R.; Rauch, Scott L.

2016-01-01

Obsessive-compulsive disorder (OCD) affects ∼2-3% of the population and is characterized by recurrent intrusive thoughts (obsessions) and repetitive behaviors or mental acts (compulsions), typically performed in response to obsessions or related anxiety. In the past few decades, the prevailing models of OCD pathophysiology have focused on cortico-striatal circuitry. More recent neuroimaging evidence, however, points to critical involvement of the lateral and medial orbitofrontal cortices, the dorsal anterior cingulate cortex and amygdalo-cortical circuitry, in addition to cortico-striatal circuitry, in the pathophysiology of the disorder. In this review, we elaborate proposed features of OCD pathophysiology beyond the classic parallel cortico-striatal pathways and argue that this evidence suggests that fear extinction, in addition to behavioral inhibition, may be impaired in OCD. PMID:22138231

Counterfactual processing of economic action-outcome alternatives in obsessive-compulsive disorder: further evidence of impaired goal-directed behavior.

PubMed

Gillan, Claire M; Morein-Zamir, Sharon; Kaser, Muzaffer; Fineberg, Naomi A; Sule, Akeem; Sahakian, Barbara J; Cardinal, Rudolf N; Robbins, Trevor W

2014-04-15

Obsessive-compulsive disorder (OCD) is a disorder of automatic, uncontrollable behaviors and obsessive rumination. There is evidence that OCD patients have difficulties performing goal-directed actions, instead exhibiting repetitive stimulus-response habit behaviors. This might result from the excessive formation of stimulus-response habit associations or from an impairment in the ability to use outcome value to guide behavior. We investigated the latter by examining counterfactual decision making, which is the ability to use comparisons of prospective action-outcome scenarios to guide economic choice. We tested decision making (forward counterfactual) and affective responses (backward counterfactual) in 20 OCD patients and 20 matched healthy control subjects using an economic choice paradigm that previously revealed attenuation of both the experience and avoidance of counterfactual emotion in schizophrenia patients and patients with orbitofrontal cortex lesions. The use of counterfactual comparison to guide decision making was diminished in OCD patients, who relied primarily on expected value. Unlike the apathetic affective responses previously shown to accompany this decision style, OCD patients reported increased emotional responsivity to the outcomes of their choices and to the counterfactual comparisons that typify regret and relief. Obsessive-compulsive disorder patients exhibit a pattern of decision making consistent with a disruption in goal-directed forward modeling, basing decisions instead on the temporally present (and more rational) calculation of expected value. In contrast to this style of decision making, emotional responses in OCD were more extreme and reactive than control subjects. These results are in line with an account of disrupted goal-directed cognitive control in OCD. Copyright © 2014 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Pediatric misophonia with comorbid obsessive-compulsive spectrum disorders.

PubMed

Webber, Troy A; Johnson, Patricia L; Storch, Eric A

2014-01-01

Misophonia is a potentially debilitating condition characterized by increased sensitivity to specific sounds, which cause subsequent behavioral and emotional responses. The nature, clinical phenomenology and etiology of misophonia remain unclear, and misophonic clinical presentations are not currently accounted for by existing psychiatric or audiological disorders. We present a case of pediatric misophonia in the context of comorbid obsessive-compulsive disorder and Tourette's syndrome. Given the interrelationships among obsessive-compulsive spectrum disorders and misophonia, these disorders may share underlying pathophysiology, particularly within the dopaminergic and serotonergic neural systems. Clinical (i.e., treatment) and theoretical implications are discussed. Published by Elsevier Inc.

Obsessive-compulsive disorder and romantic functioning.

PubMed

Abbey, Richard D; Clopton, James R; Humphreys, Joy D

2007-12-01

The current study examined the romantic relationships of individuals with obsessive-compulsive disorder (OCD). Participants were 64 individuals recruited from a national conference who completed measures of OCD symptoms, depressive symptoms, intimacy, self-disclosure, relationship satisfaction, and relationship worry. Severity of obsessions was negatively correlated with intimacy, relationship satisfaction, and self-disclosure. In contrast, two compulsive behaviors (washing and neutralizing) were positively correlated with several relationship variables. Fears of contamination from sexual activity were positively correlated with the severity of OCD symptoms. The clinical implications of the findings from this study and suggestions for future research are presented.

Obsessive-compulsive disorder for ICD-11: proposed changes to the diagnostic guidelines and specifiers

PubMed Central

Simpson, Helen Blair; Reddy, Y. C. Janardhan

2016-01-01

Since the approval of the ICD-10 by the World Health Organization (WHO) in 1990, global research on obsessive-compulsive disorder (OCD) has expanded dramatically. This article evaluates what changes may be needed to enhance the scientific validity, clinical utility, and global applicability of OCD diagnostic guidelines in preparation for ICD-11. Existing diagnostic guidelines for OCD were compared. Key issues pertaining to clinical description, differential diagnosis, and specifiers were identified and critically reviewed on the basis of the current literature. Specific modifications to ICD guidelines are recommended, including: clarifying the definition of obsessions (i.e., that obsessions can be thoughts, images, or impulses/urges) and compulsions (i.e., clarifying that these can be behaviors or mental acts and not calling these “stereotyped”); stating that compulsions are often associated with obsessions; and removing the ICD-10 duration requirement of at least 2 weeks. In addition, a diagnosis of OCD should no longer be excluded if comorbid with Tourette syndrome, schizophrenia, or depressive disorders. Moreover, the ICD-10 specifiers (i.e., predominantly obsessional thoughts, compulsive acts, or mixed) should be replaced with a specifier for insight. Based on new research, modifications to the ICD-10 diagnostic guidelines for OCD are recommended for ICD-11. PMID:25388607

Pathophysiology of obsessive-compulsive disorder: a necessary link between phenomenology, neuropsychology, imagery and physiology.

PubMed

Aouizerate, Bruno; Guehl, Dominique; Cuny, Emmanuel; Rougier, Alain; Bioulac, Bernard; Tignol, Jean; Burbaud, Pierre

2004-02-01

Obsessive-compulsive disorder (OCD) is characterized by repetitive intrusive thoughts and compulsive time-consuming behaviors classified into three to five distinct symptom dimensions including: (1) aggressive/somatic obsessions with checking compulsions; (2) contamination concerns with washing compulsions; (3) symmetry obsessions with counting/ordering compulsions; (4) hoarding obsessions with collecting compulsions; and (5) sexual/religious concerns. Phenomenologically, OCD could be thought of as the irruption of internal signals centered on the erroneous perception that "something is wrong" in a specific situation. This generates severe anxiety, leading to recurrent behaviors aimed at reducing the emotional tension. In this paper, we examine how the abnormalities in brain activity reported in OCD can be interpreted in the light of physiology after consideration of various approaches (phenomenology, neuropsychology, neuroimmunology and neuroimagery) that contribute to proposing the central role of several cortical and subcortical regions, especially the orbitofrontal cortex (OFC), the anterior cingulate cortex (ACC), the dorsolateral prefrontal cortex (DLPC), the head of the caudate nucleus and the thalamus. The OFC is involved in the significance attributed to the consequences of action, thereby subserving decision-making, whereas the ACC is particularly activated in situations in which there are conflicting options and a high likelihood of making an error. The DLPC plays a critical part in the cognitive processing of relevant information. This cortical information is then integrated by the caudate nucleus, which controls behavioral programs. A dysfunction of these networks at one or several stages will result in the emergence and maintenance of repetitive thoughts and characteristic OCD behavior. Copyright 2004 Elsevier Ltd.

The relationship between obsessive beliefs and symptom dimensions in obsessive-compulsive disorder.

PubMed

Wheaton, Michael G; Abramowitz, Jonathan S; Berman, Noah C; Riemann, Bradley C; Hale, Lisa R

2010-10-01

Research findings on the specific relationships between beliefs and OCD symptoms have been inconsistent, yet the existing studies vary in their approach to measuring the highly heterogeneous symptoms of this disorder. The Dimensional Obsessive-Compulsive Scale (DOCS) is a new measure that allows for the assessment of OCD symptom dimensions, rather than types of obsessions and compulsions per se. The present study examined the relationship between OCD symptom dimensions and dysfunctional (obsessive) beliefs believed to underlie these symptom dimensions using a large clinical sample of treatment-seeking adults with OCD. Results revealed that certain obsessive beliefs predicted certain OCD symptom dimensions in a manner consistent with cognitive-behavioral conceptual models. Specifically, contamination symptoms were predicted by responsibility/threat estimation beliefs, symmetry symptoms were predicted by perfectionism/certainty beliefs, unacceptable thoughts were predicted by importance/control of thoughts beliefs and symptoms related to being responsible for harm were predicted by responsibility/threat estimation beliefs. Implications for cognitive conceptualizations of OCD symptom dimensions are discussed. Copyright 2010 Elsevier Ltd. All rights reserved.

Awareness of illness and insight into obsessive-compulsive symptoms in schizophrenia patients with obsessive-compulsive disorder.

PubMed

Poyurovsky, Michael; Faragian, Sarit; Kleinman-Balush, Vered; Pashinian, Artashez; Kurs, Rena; Fuchs, Camil

2007-09-01

Obsessive-compulsive symptoms (OCS) have been revealed in a substantial proportion of schizophrenia patients. We sought to evaluate insight into OCS in schizo-obsessive patients. We evaluated insight into OCS and awareness of schizophrenia, using the Brown Assessment of Beliefs Scale (BABS) and the Scale to Assess Unawareness of Mental Disorder (SUMD), respectively. Fifty-seven inpatients that met DSM-IV criteria for both schizophrenia and OCD were recruited. To determine a possible modifying effect of OCS on the awareness of schizophrenia, we included a comparison group of non-OCD schizophrenia patients (N = 80). Nine (15.8%) schizo-obsessive patients revealed lack of insight into OCS, whereas a majority (48 patients, 84.2%) exhibited good or fair insight. In the schizo-obsessive group, insight into OCS positively correlated with awareness of schizophrenia but not with awareness of delusions. Roughly 40% of the schizo-obsessive and non-OCD schizophrenia patients revealed unawareness of schizophrenia. Our findings indicate that OCS in schizophrenia represent an identifiable dimension of psychopathology independent of core schizophrenia symptoms.

The Sense of Incompleteness as a Motivator of Obsessive-Compulsive Symptoms: An Empirical Analysis of Concepts and Correlates

PubMed Central

Taylor, Steven; McKay, Dean; Crowe, Katherine B.; Abramowitz, Jonathan S.; Conelea, Christine A.; Calamari, John E.; Sica, Claudio

2014-01-01

Contemporary models of obsessive-compulsive disorder emphasize the importance of harm avoidance (HA) and related dysfunctional beliefs as motivators of obsessive-compulsive (OC) symptoms. Recently, there has been a resurgence of interest in Janet’s (1908) concept of incompleteness (INC) as another potentially important motivator. Contemporary investigators define INC as the sense that one’s actions, intentions, or experiences have not been properly achieved. Janet defined INC more broadly to include alexithymia, depersonalization, derealization, and impaired psychological mindedness. We conducted two studies to address four issues: (a) the clinical correlates of INC; (b) whether INC and HA are distinguishable constructs; (c) whether INC predicts OC symptoms after controlling for HA; and (d) the relative merits of broad versus narrow conceptualizations of INC. Study 1 was a meta-analysis of the clinical correlates of narrowly defined INC (16 studies, N=5,940). INC was correlated with all types of OC symptoms, and was more strongly correlated with OC symptoms than with general distress. Study 2 (N=534 nonclinical participants) showed that: (a) INC and HA were strongly correlated but factor analytically distinguishable; (b) INC statistically predicted all types of OC symptoms even after controlling for HA; and (c) narrow INC was most strongly correlated with OC symptoms whereas broad INC was most strongly correlated with general distress. Although the findings are limited by being correlational in nature, they support the hypothesis that INC, especially in its narrow form, is a motivator of OC symptoms. PMID:24491200

Search for copy number variants in chromosomes 15q11-q13 and 22q11.2 in obsessive compulsive disorder

PubMed Central

2010-01-01

Background Obsessive-compulsive disorder (OCD) is a clinically and etiologically heterogeneous syndrome. The high frequency of obsessive-compulsive symptoms reported in subjects with the 22q11.2 deletion syndrome (DiGeorge/velocardiofacial syndrome) or Prader-Willi syndrome (15q11-13 deletion of the paternally derived chromosome), suggests that gene dosage effects in these chromosomal regions could increase risk for OCD. Therefore, the aim of this study was to search for microrearrangements in these two regions in OCD patients. Methods We screened the 15q11-13 and 22q11.2 chromosomal regions for genomic imbalances in 236 patients with OCD using multiplex ligation-dependent probe amplification (MLPA). Results No deletions or duplications involving 15q11-13 or 22q11.2 were identified in our patients. Conclusions Our results suggest that deletions/duplications of chromosomes 15q11-13 and 22q11.2 are rare in OCD. Despite the negative findings in these two regions, the search for copy number variants in OCD using genome-wide array-based methods is a highly promising approach to identify genes of etiologic importance in the development of OCD. PMID:20565924

Search for copy number variants in chromosomes 15q11-q13 and 22q11.2 in obsessive compulsive disorder.

PubMed

Delorme, Richard; Moreno-De-Luca, Daniel; Gennetier, Aurélie; Maier, Wolfgang; Chaste, Pauline; Mössner, Rainald; Grabe, Hans Jörgen; Ruhrmann, Stephan; Falkai, Peter; Mouren, Marie-Christine; Leboyer, Marion; Wagner, Michael; Betancur, Catalina

2010-06-21

Obsessive-compulsive disorder (OCD) is a clinically and etiologically heterogeneous syndrome. The high frequency of obsessive-compulsive symptoms reported in subjects with the 22q11.2 deletion syndrome (DiGeorge/velocardiofacial syndrome) or Prader-Willi syndrome (15q11-13 deletion of the paternally derived chromosome), suggests that gene dosage effects in these chromosomal regions could increase risk for OCD. Therefore, the aim of this study was to search for microrearrangements in these two regions in OCD patients. We screened the 15q11-13 and 22q11.2 chromosomal regions for genomic imbalances in 236 patients with OCD using multiplex ligation-dependent probe amplification (MLPA). No deletions or duplications involving 15q11-13 or 22q11.2 were identified in our patients. Our results suggest that deletions/duplications of chromosomes 15q11-13 and 22q11.2 are rare in OCD. Despite the negative findings in these two regions, the search for copy number variants in OCD using genome-wide array-based methods is a highly promising approach to identify genes of etiologic importance in the development of OCD.

Thought-action fusion as a mediator of religiosity and obsessive-compulsive symptoms.

PubMed

Williams, Alishia D; Lau, Gloria; Grisham, Jessica R

2013-06-01

Thought-action fusion (TAF), or maladaptive cognitions regarding the relationship between mental events and behaviours, has been implicated in the development and maintenance of obsessive-compulsive disorder (OCD). As some religions promote TAF-like appraisals, it has been proposed that religiosity may play a role in the transformation of normally occurring intrusive thoughts into clinically distressing obsessions. No research, however, has experimentally investigated the mediating role of TAF on the relationship between religiosity and OC symptoms. 85 Christian, Jewish, and Atheist/Agnostic participants were exposed to an experimental thought-induction protocol and reported on their associated levels of distress, guilt, feelings of responsibility, and urge to suppress target intrusions experienced during a 5-min monitoring period. Participants also completed measures of obsessive-compulsive symptomatology, TAF beliefs, and general psychopathology. Using PROCESS and bootstrapping analyses, a test of the conditional indirect effects of religiosity on obsessive-compulsive symptoms revealed that Christianity moderated the effects of religiosity on moral TAF beliefs, which in turn mediated the relationship between religiosity and obsessive-compulsive symptoms. Furthermore, in the Christian group, moral TAF beliefs mediated the relationship between religiosity and ratings of guilt and responsibility following the experimental protocol. The use of university students with moderate levels of religiosity. Collectively the results suggest that obsessional thinking is not attributable to religion per se, but that teachings underlying certain religious doctrines may fuel TAF beliefs that are implicated in the maintenance of OCD. Copyright © 2012 Elsevier Ltd. All rights reserved.

Topiramate as an adjuvant treatment for obsessive compulsive symptoms in patients with bipolar disorder: a randomized double blind placebo controlled clinical trial.

PubMed

Sahraian, Ali; Bigdeli, Mohammad; Ghanizadeh, Ahmad; Akhondzadeh, Shahin

2014-09-01

It has not been examined trialed whether obsessive compulsive symptoms in patients with bipolar disorder respond to topiramate as an adjuvant treatment. This 4-month double-blind placebo-controlled randomized clinical trial examined the efficacy and safety of augmentation with topiramat for treating the patients with bipolar disorder, manic phase type-I, and obsessive compulsive disorder symptoms. Both groups received lithium+olanzapine+clonazepam. However, one group received topiramate and the other group placebo as adjuvant medications. Yale Brown obsessive compulsive behavior scale was used to assess the outcome. Adverse effects were also recorded. A total of 32 patients completed this trial. The mean score decreased from 24.2(4.8) to 17.6(8.7) in the topiramate group (P<0.003) and from 20.9(2.9) to 9.6(3.5) in the placebo group during this trial (P<0.0001). Additionally, 9(52.9%) out of 17 patients in the topiramate group and 2(12.5%) out of 16 patients in the placebo group showed more than 34% decline in YBOC score (x2=6.0, df=1, P<0.01). No serious adverse effects were detected. The limitations of the present study were its small sample size and the fact that it was conducted in a single center. The combination of lithium+olanzapine+clonazepam decreased the symptoms of obsessive compulsive disorder in the patients with bipolar disorder type I. However, topiramate had a more significant effect than placebo on improvement of the patients with bipolar disorder and obsessive compulsive symptoms. This combination seems to be without serious adverse effects. Copyright © 2014 Elsevier B.V. All rights reserved.

Paternal overprotection in obsessive-compulsive disorder and depression with obsessive traits.

PubMed

Yoshida, Takafumi; Taga, Chiaki; Matsumoto, Yoshitake; Fukui, Kenji

2005-10-01

Previous studies have indicated that a parental rearing style showing a low level of care on the parental bonding instrument (PBI) is a risk factor for depression, and that there is a relationship between the overprotective rearing style on the PBI and obsessive-compulsive disorder (OCD). However, there is no study on the parental rearing attitudes in depressive patients divided into two groups based on their obsessive traits. In this study, we evaluated the parental rearing attitudes and examined the differences among four groups: depressive patients with severe obsessive traits, depressive patients with mild obsessive traits, OCD patients, and healthy volunteers. We divided the depressive patients into severe and mild groups based on their obsessive traits on the Mausdley Obsessional-Compulsive Inventory (MOCI). We compared PBI scores among four groups of 50 subjects matched for age and sex: depressive patients with severe obsessive traits, depressive patients with mild obsessive traits, OCD patients, and healthy volunteers. The paternal protection scores in the depressive patients with severely obsessive traits and the OCD patients were significantly higher than those in the depressive patients with mildly obsessive traits and healthy volunteers. This study indicated that the depressive patients with severe obsessive traits and the OCD patients have similar paternal controlling and interfering rearing attitudes. We conclude that the paternal controlling and interfering rearing attitudes are linked to the development of OCD and depression with obsessive traits, and are not linked to the development of depression itself.

Suicidal ideation in patients with obsessive-compulsive disorder.

PubMed

Balci, Volkan; Sevincok, Levent

2010-01-30

The risk factors for suicidal behaviour in obsessive-compulsive disorder (OCD) have been less studied compared than in other anxiety disorders. In the present study, we examined the demographic and clinical correlates of current suicidal ideation (SI) in patients with OCD. Forty-four patients were grouped into those with (n=23) and without current SI (n=21) as assessed by the Scale for Suicidal Ideation. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was used to assess the obsessive-compulsive (OC) symptomatology. Following Bonferroni correction, only the severity of depression differed significantly between the two groups. The presence of major depression and aggressive obsessions, the level of hopelessness, and the severity of OC symptomatology were significant predictors of current SI in patients with OCD. The relatively low frequency of some comorbid Axis I disorders is based on small sample size and therefore may be vulnerable to type II error. We did not examine the relationship between the recent suicidal attempts and OCD. Also, we did not assess the effect of impulsivity in the occurrence of SI in patients with OCD. Associated depression, hopelessness, and aggressive obsessions might play an important role in the occurrence of SI in patients with OCD. However, future studies with a psychological autopsy design are required to systematically determine the presence for OCD among those who have completed suicide.

Functional neuroimaging of avoidance habits in obsessive-compulsive disorder.

PubMed

Gillan, Claire M; Apergis-Schoute, Annemieke M; Morein-Zamir, Sharon; Urcelay, Gonzalo P; Sule, Akeem; Fineberg, Naomi A; Sahakian, Barbara J; Robbins, Trevor W

2015-03-01

The purpose of this study was to determine the neural correlates of excessive habit formation in obsessive-compulsive disorder (OCD). The authors aimed to test for neurobiological convergence with the known pathophysiology of OCD and to infer, based on abnormalities in brain activation, whether these habits arise from dysfunction in the goal-directed or habit system. Thirty-seven OCD patients and 33 healthy comparison subjects learned to avoid shocks while undergoing a functional MRI scan. Following four blocks of training, the authors tested whether the avoidance response had become a habit by removing the threat of shock and measuring continued avoidance. Task-related differences in brain activity in three regions of interest (the caudate, the putamen, and the medial orbitofrontal cortex) were tested at a statistical threshold set at <0.05 (family-wise-error corrected). Excessive habit formation in OCD patients, which was associated with hyperactivation in the caudate, was observed. Activation in this region was also associated with subjective ratings of increased urge to perform habits. The OCD group, as a whole, showed hyperactivation in the medial orbitofrontal cortex during the acquisition of avoidance; however, this did not relate directly to habit formation. OCD patients exhibited excessive habits that were associated with hyperactivation in a key region implicated in the pathophysiology of OCD, the caudate nucleus. Previous studies indicate that this region is important for goal-directed behavior, suggesting that habit-forming biases in OCD may be a result of impairments in this system, rather than differences in the buildup of stimulus-response habits themselves.

Obsessive-Compulsive Disorder - Multiple Languages

MedlinePlus

... sharing features on this page, please enable JavaScript. Russian (Русский) Somali (Af-Soomaali ) Spanish (español) HealthReach resources will open in a new window. Russian (Русский) Expand Section Obsessive Compulsive Disorder (OCD) (An ...

Hypochondriasis: considerations for ICD-11.

PubMed

van den Heuvel, Odile A; Veale, David; Stein, Dan J

2014-01-01

The World Health Organization (WHO) is currently revisiting the ICD. In the 10th version of the ICD, approved in 1990, hypochondriacal symptoms are described in the context of both the primary condition hypochondriacal disorder and as secondary symptoms within a range of other mental disorders. Expansion of the research base since 1990 makes a critical evaluation and revision of both the definition and classification of hypochondriacal disorder timely. This article addresses the considerations reviewed by members of the WHO ICD-11 Working Group on the Classification of Obsessive-Compulsive and Related Disorders in their proposal for the description and classification of hypochondriasis. The proposed revision emphasizes the phenomenological overlap with both anxiety disorders (e.g., fear, hypervigilance to bodily symptoms, and avoidance) and obsessive-compulsive and related disorders (e.g., preoccupation and repetitive behaviors) and the distinction from the somatoform disorders (presence of somatic symptom is not a critical characteristic). This revision aims to improve clinical utility by enabling better recognition and treatment of patients with hypochondriasis within the broad range of global health care settings.

Family accommodation in obsessive-compulsive and anxiety disorders: a five-year update

PubMed Central

Lebowitz, Eli R.; Panza, Kaitlyn E.; Bloch, Michael H.

2016-01-01

Family accommodation describes changes that individuals make to their behavior, to help their relative who is dealing with a psychiatric and/or psychological disorder(s), avoid or alleviate distress related to the disorder. Research on family accommodation has advanced rapidly. In this update we aim to provide a synthesis of findings from the past five years. A search of available, peer-reviewed, English language papers was conducted through PubMed and PsycINFO, cross referencing psychiatric disorders with accommodation and other family-related terms. The resulting 121 papers were individually reviewed and evaluated and the main findings were discussed. Family accommodation is common in obsessive-compulsive disorder (OCD) and in anxiety disorders, and manifests similarly across these disorders. Family accommodation is associated with more severe psychopathology and poorer clinical outcomes. Treatments have begun to focus on the reduction of family accommodation as a primary therapeutic goal and finally, neurobiological underpinnings of family accommodation are beginning to be investigated. PMID:26613396

Family accommodation in obsessive-compulsive and anxiety disorders: a five-year update.

PubMed

Lebowitz, Eli R; Panza, Kaitlyn E; Bloch, Michael H

2016-01-01

Family accommodation describes changes that individuals make to their behavior, to help their relative who is dealing with a psychiatric and/or psychological disorder(s), avoid or alleviate distress related to the disorder. Research on family accommodation has advanced rapidly. In this update we aim to provide a synthesis of findings from the past five years. A search of available, peer-reviewed, English language papers was conducted through PubMed and PsycINFO, cross referencing psychiatric disorders with accommodation and other family-related terms. The resulting 121 papers were individually reviewed and evaluated and the main findings were discussed. Family accommodation is common in obsessive-compulsive disorder (OCD) and in anxiety disorders, and manifests similarly across these disorders. Family accommodation is associated with more severe psychopathology and poorer clinical outcomes. Treatments have begun to focus on the reduction of family accommodation as a primary therapeutic goal and finally, neurobiological underpinnings of family accommodation are beginning to be investigated.

Dissociative absorption: An empirically unique, clinically relevant, dissociative factor.

PubMed

Soffer-Dudek, Nirit; Lassri, Dana; Soffer-Dudek, Nir; Shahar, Golan

2015-11-01

Research of dissociative absorption has raised two questions: (a) Is absorption a unique dissociative factor within a three-factor structure, or a part of one general dissociative factor? Even when three factors are found, the specificity of the absorption factor is questionable. (b) Is absorption implicated in psychopathology? Although commonly viewed as "non-clinical" dissociation, absorption was recently hypothesized to be specifically associated with obsessive-compulsive symptoms. To address these questions, we conducted exploratory and confirmatory factor analyses on 679 undergraduates. Analyses supported the three-factor model, and a "purified" absorption scale was extracted from the original inclusive absorption factor. The purified scale predicted several psychopathology scales. As hypothesized, absorption was a stronger predictor of obsessive-compulsive symptoms than of general psychopathology. In addition, absorption was the only dissociative scale that longitudinally predicted obsessive-compulsive symptoms. We conclude that absorption is a unique and clinically relevant dissociative tendency that is particularly meaningful to obsessive-compulsive symptoms. Copyright © 2015 Elsevier Inc. All rights reserved.

Cigarette smoking in patients with obsessive compulsive disorder: a report from the International College of Obsessive Compulsive Spectrum Disorders (ICOCS).

PubMed

Dell'Osso, Bernardo; Nicolini, Humberto; Lanzagorta, Nuria; Benatti, Beatrice; Spagnolin, Gregorio; Palazzo, M Carlotta; Marazziti, Donatella; Hollander, Eric; Fineberg, Naomi; Stein, Dan J; Pallanti, Stefano; Van Ameringen, Michael; Lochner, Christine; Hranov, Georgi; Karamustafalioglu, Oguz; Hranov, Luchezar; Zohar, Joseph; Denys, Damiaan; Altamura, A Carlo; Menchon, Jose M

2015-10-01

Obsessive compulsive disorder (OCD) showed a lower prevalence of cigarette smoking compared to other psychiatric disorders in previous and recent reports. We assessed the prevalence and clinical correlates of the phenomenon in an international sample of 504 OCD patients recruited through the International College of Obsessive Compulsive Spectrum Disorders (ICOCS) network. Cigarette smoking showed a cross-sectional prevalence of 24.4% in the sample, with significant differences across countries. Females were more represented among smoking patients (16% vs 7%; p<.001). Patients with comorbid Tourette's syndrome (p<.05) and tic disorder (p<.05) were also more represented among smoking subjects. Former smokers reported a higher number of suicide attempts (p<.05). We found a lower cross-sectional prevalence of smoking among OCD patients compared to findings from previous studies in patients with other psychiatric disorders but higher compared to previous and more recent OCD studies. Geographic differences were found and smoking was more common in females and comorbid Tourette's syndrome/tic disorder.

Schedule-induced polydipsia: a rat model of obsessive-compulsive disorder.

PubMed

Platt, Brian; Beyer, Chad E; Schechter, Lee E; Rosenzweig-Lipson, Sharon

2008-04-01

Obsessive-compulsive disorder (OCD) is difficult to model in animals due to the involvement of both mental (obsessions) and physical (compulsions) symptoms. Due to limitations of using animals to evaluate obsessions, OCD models are limited to evaluation of the compulsive and repetitive behaviors of animals. Of these, models of adjunctive behaviors offer the most value in regard to predicting efficacy of anti-OCD drugs in the clinic. Adjunctive behaviors are those that are maintained indirectly by the variables that control another behavior, rather than directly by their own typical controlling variables. Schedule-induced polydipsia (SIP) is an adjunctive model in which rats exhibit exaggerated drinking behavior (polydipsia) when presented with food pellets under a fixed-time schedule. The polydipsic response is an excessive manifestation of a normal behavior (drinking), providing face validity to the model. Furthermore, clinically effective drugs for the treatment of OCD decrease SIP. This protocol describes a rat SIP model of OCD and provides preclinical data for drugs that decrease polydipsia and are clinically effective in the treatment of OCD.

Memory and executive functions in patients with obsessive-compulsive disorder.

PubMed

Vandborg, Sanne Kjær; Hartmann, Tue Borst; Bennedsen, Birgit Egedal; Pedersen, Anders Degn; Thomsen, Per Hove

2014-03-01

We investigated whether patients with obsessive-compulsive disorder have poorer memory and executive functions than healthy controls. The relatively inconsistent previous findings on this question reflect a lack of well-matched control groups, the inclusion of patients with comorbidity, and the use of noncomparable neuropsychological tests to assess memory and executive functions. We used well-accepted neuropsychological tests of memory and executive functions to assess 42 patients who had obsessive-compulsive disorder without comorbidity, and 42 healthy controls. We matched the patients and controls pairwise by sex, age, and years of education. The patients performed significantly worse than the controls on the Rey Complex Figure Test, which assesses visuospatial memory and organizational skills. This group difference remained after we controlled for age, education, intelligence, and severity of depressive symptoms. The findings indicate that patients with obsessive-compulsive disorder may have impaired visuospatial memory and organizational skills, and these impairments should be considered in treatment. ClinicalTrials.gov NCT00792038.

Psychometric Properties of the Persian Version of the Padua Inventory: Washington State University Revision (PI-WSUR)

PubMed Central

Kaviani, Hosein; Esmaili, Yaghob; Ebrahimkhani, Narges; Manesh, Alireza Amin

2011-01-01

Objective The psychometric properties and factor structure of the Persian Padua Inventory Washington State University Revision (PI-WSUR), a measure of obsessive- compulsive phenomena, was examined in a non-clinical sample of 348 Iranian university students. Method The PI-WSUR was translated into Persian, and its back translation was controlled by the author inventory. A pilot study based on cultural differences was carried out on twenty students. The study subjects consisted of 348 university students, and they completed PPI, OCI-R, MOCI, BAI, STAI, BDI-II and the demographic inventory. Results The factor analysis of the PI-WSUR, exhibited eight factors similar but not identical with factor structure in previous studies. as the eight factors are as follows: contamination obsessions; washing compulsions; ordering compulsions; checking compulsions; obsessional thoughts to harm self/others; obsessional thoughts about violence; obsessional impulses to harm self/others; and obsessional impulses to steal. The result also indicated excellent internal consistency (Cronbach alpha= 0.92), Spearman split test (0.95) and test- retest (r= 0.77). We assessed the concurrent validity of the PPI in relation to the Obsessive Compulsive Inventory-Revised (OCI-R), and the Maudsley Obsessive- Compulsive Inventory (MOCI). Conclusion The Iranian version of the PI to some extend remains the sound psychometric properties of the original version. PMID:22952515

Obsessive-compulsive personality disorder co-occurring with obsessive-compulsive disorder: Conceptual and clinical implications.

PubMed

Starcevic, Vladan; Berle, David; Brakoulias, Vlasios; Sammut, Peter; Moses, Karen; Milicevic, Denise; Hannan, Anthony

2013-01-01

There are ongoing uncertainties in the relationship between obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD). This study aimed to test the proposition that OCPD may be a marker of severity of OCD by comparing groups of OCD individuals with and without OCPD on a number of variables. A total of 148 adults with a principal diagnosis of OCD were administered the Mini International Neuropsychiatric Interview, Yale-Brown Obsessive-Compulsive Scale, Sheehan Disability Scale, Vancouver Obsessional Compulsive Inventory and Symptom Checklist 90-Revised. Participants with a DSM-IV diagnosis of OCPD were compared with those without OCPD. Some 70 (47.3%) participants were diagnosed with OCPD. The groups of participants with and without OCPD did not differ significantly with respect to any of the demographic variables, clinician-rated severity of OCD, levels of disability and mean age of onset of OCD. All self-rated OCD symptom dimensions except for contamination and checking were significantly more prominent in participants with OCPD, as were all self-rated dimensions of psychopathology. Participants with OCPD had significantly more frequent hoarding compulsions and obsessions involving a need to collect and keep objects. Of Axis I disorders, only panic disorder was significantly more frequent in participants with OCPD than in those without OCPD. A high frequency of OCPD among individuals with OCD suggests a strong, although not necessarily a unique, relationship between the two conditions. This finding may also be a consequence of the blurring of the boundary between OCD and OCPD by postulating that hoarding and hoarding-like behaviours characterise both disorders. Results of this study do not support the notion that OCD with OCPD is a marker of clinician-rated severity of OCD. However, individuals with OCPD had more prominent OCD symptoms, they were more distressed and exhibited various other psychopathological phenomena more intensely, which is likely to complicate their treatment.

Incidence of obsessive-compulsive disorder in children with nonmonosymptomatic primary nocturnal enuresis.

PubMed

Yousefichaijan, Parsa; Khosrobeigi, Ali; Salehi, Bahman; Taherahmadi, Hassan; Shariatmadari, Fakhreddin; Ghandi, Yazdan; Alinejad, Saeed; Farhadiruzbahani, Fateme

2016-01-01

Enuresis is defined as the repeated voiding of urine into clothes or bed at least twice a week for at least 3 consecutive months in a child who is at least 5 years of age. The behavior is not due exclusively to the direct physiologic effect of a substance or a general medical condition. Diurnal enuresis defines wetting, whereas awake and nocturnal enuresis refers to voiding during sleep. Primary enuresis occurs in children who have never been consistently dry through the night, whereas secondary enuresis refers the resumption of wetting after at least 6 months of dryness. Monosymptomatic enuresis has no associated daytime symptoms, and nonmonosymptomatic enuresis, which is more common, often has at least one subtle daytime symptom. Monosymptomatic enuresis is rarely associated with significant organic underlying abnormalities. Obsessive-compulsive disorder (OCD) is a chronic disabling illness characterized by repetitive, ritualistic behaviors over which the patients have little or no control. The purpose of this study was to investigate the relationship between OCD and nonmonosymptomatic nocturnal enuresis (NMNE). In this case-control study, we evaluated 186 children aged 6-17 years old who were visited in the pediatric clinics of Amir Kabir Hospital, Arak, Iran. The control group included 93 healthy children, and the case group included 93 age- and sex-matched children with stage 1-3 chronic kidney disease (CKD). Then, the children's behavioral status was evaluated using the Children's Yale-Brown Obsessive-Compulsive Scale. The difference in compulsion was significant ( P = 0.021), whereas the difference in obsession was significant between the two groups ( P = 0.013). The most common symptom in CKD children with compulsion was silent repetition of words. Compulsive and obsessive are more common in NMNE versus healthy children. The observed correlation between compulsive-obsessive and NMNE makes psychological counseling mandatory in children with NMNE.

Reliability generalization study of the Yale-Brown Obsessive-Compulsive Scale for children and adolescents.

PubMed

López-Pina, José Antonio; Sánchez-Meca, Julio; López-López, José Antonio; Marín-Martínez, Fulgencio; Núñez-Núñez, Rosa Ma; Rosa-Alcázar, Ana I; Gómez-Conesa, Antonia; Ferrer-Requena, Josefa

2015-01-01

The Yale-Brown Obsessive-Compulsive Scale for children and adolescents (CY-BOCS) is a frequently applied test to assess obsessive-compulsive symptoms. We conducted a reliability generalization meta-analysis on the CY-BOCS to estimate the average reliability, search for reliability moderators, and propose a predictive model that researchers and clinicians can use to estimate the expected reliability of the CY-BOCS scores. A total of 47 studies reporting a reliability coefficient with the data at hand were included in the meta-analysis. The results showed good reliability and a large variability associated to the standard deviation of total scores and sample size.

Prevalence, sociodemographic factors, psychological distress, and coping strategies related to compulsive buying: a cross sectional study in Galicia, Spain.

PubMed

Otero-López, José Manuel; Villardefrancos, Estíbaliz

2014-04-05

Compulsive buying has become a serious problem affecting a growing number of people in contemporary consumer societies. Nevertheless, research examining its prevalence in representative samples from the general population is still scarce and mainly focused on the exploration of sociodemographic factors, neglecting other aspects like psychological distress and coping styles. Therefore, this study intends to contribute to the cumulative knowledge by assessing compulsive buying prevalence in a representative sample from the general population in the region of Galicia, in Spain. Sociodemographic determinants, psychological symptoms, and coping strategies are also analyzed to clarify their role in this phenomenon. A random routes procedure was employed in the recruitment of the sample which was comprised of 2159 participants who were classified as either compulsive buyers or non-compulsive buyers. Both groups were compared regarding sociodemographic determinants, symptoms, and coping strategies through chi-square tests or analyses of variance. A multivariate logistic regression analysis was conducted to determine which of these determinants might play a part in the make up of a risk profile for compulsive buying. Estimated prevalence of compulsive buying was 7.1%. Compulsive buyers and non-compulsive buyers differed significantly in sex and age, with women and younger people showing a higher propensity for this phenomenon. Individuals with compulsive buying presented significantly higher scores on all the psychological symptoms considered. They also employed passive-avoidance coping strategies much more frequently and active strategies of problem solving and cognitive restructuring much less frequently. The logistic regression analysis results confirmed that being female, experiencing symptoms of anxiety, depression, and obsession-compulsion, and employing the passive-avoidance coping strategies of problem avoidance, wishful thinking, and self-criticism, all constituted risk factors for compulsive buying, whilst the increased age and the use of the active coping strategies of problem solving and cognitive restructuring were protection factors. Our findings revealed a substantial prevalence of compulsive buying. Additionally, the relevance of sociodemographic determinants, psychological distress, and coping strategies in this problem was confirmed. The establishment of a risk profile for compulsive buying based on these different sets of determinants would likely contribute to the development of more effective intervention programs.

A Review of Metacognition in Psychological Models of Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Rees, Clare S.; Anderson, Rebecca A.

2013-01-01

Cognitive-behavioural models and interventions for obsessive-compulsive disorder (OCD) have always included some metacognitive elements but until recently these have been predominantly construed of as cognitive as opposed to metacognitive processes. Increasingly, psychological models of OCD are now recognising the importance of metacognitive…

Obsessive Compulsive Disorder: What an Educator Needs to Know

ERIC Educational Resources Information Center

Chaturvedi, Amrita; Murdick, Nikki L.; Gartin, Barbara C.

2014-01-01

The presence of obsessive compulsive disorder (OCD) impairs social, emotional and academic functioning. Individuals with OCD may have co-morbid disorders including attention deficit hyperactivity disorder, depression, oppositional defiant disorder, or Tourette syndrome. Challenges occur when students with OCD become a part of the general education…

Developmental Alterations of Frontal-Striatal-Thalamic Connectivity in Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Fitzgerald, Kate Dimond; Welsh, Robert C.; Stern, Emily R.; Angstadt, Mike; Hanna, Gregory L.; Abelson, James L.; Taylor, Stephan F.

2011-01-01

Objective: Pediatric obsessive-compulsive disorder is characterized by abnormalities of frontal-striatal-thalamic circuitry that appear near illness onset and persist over its course. Distinct frontal-striatal-thalamic loops through cortical centers for cognitive control (anterior cingulate cortex) and emotion processing (ventral medial frontal…

How does thought-action fusion relate to responsibility attitudes and thought suppression to aggravate the obsessive-compulsive symptoms?

PubMed

Altın, Müjgan; Gençöz, Tülin

2011-01-01

Comprehensive cognitive theories of obsessive compulsive disorder (OCD) propose that clinical obsessions and compulsions arise from specific sorts of dysfunctional beliefs and appraisals, such as inflated sense of responsibility, thought-action fusion (TAF), and thought suppression. The present study aimed to examine the mediator roles of responsibility and thought suppression between TAF and obsessive-compulsive symptoms. Specifically, it aimed to explore the relative effects of TAF factors (i.e. morality and likelihood) on inflated sense of responsibility and on thought suppression to increase the obsessive qualities of intrusions. Two hundred and eighty-three Turkish undergraduate students completed a battery of measures on responsibility, thought suppression, TAF, OC symptoms, and depression. A series of hierarchical regression analyses, where depressive symptoms were controlled for, indicated that TAF-morality and TAF-likelihood follow different paths toward OC symptoms. Although TAF-morality associated with inflated sense of responsibility, TAF-likelihood associated with thought suppression efforts, and in turn these factors increased OC symptoms. These findings provide support for the critical role of sense of responsibility and thought suppression between the relationship of TAF and OC symptoms. Findings were discussed in line with the literature.

Relationship between childhood trauma and suicide probability in obsessive-compulsive disorder.

PubMed

Ay, Rukiye; Erbay, Lale Gonenir

2018-03-01

The aim of this study is to assess the relationship between childhood trauma with the probability of suicide in obsessive compulsive disorders. Sixty-seven patients who were diagnosed with OCD were included in the study out of the patients who were admitted to Malatya Training and Research Hospital psychiatry outpatient clinic. The research data were collected using Yale Brawn Obsessive Compulsive Scale (YBOCS), Beck Depression (BDS) and Beck Anxiety Scales (BAS), Childhood Trauma Questionnaire-28 (CTQ-28), and Suicide Probability Scale (SPS). CTQ was detected as ≥ 35 in 36 of 67 patients who were included in the study. Aggression (p = 0.003), sexual (p = 0.007) and religious (p = 0.023) obsessions and rituelistic (p = 0.000) compulsions were significantly higher in the group with CTQ ≥ 35. Mild correlation was detected between the SPS score and the scores of CTQ. Correlation remained even when the effect of BAS and BDS scores were excluded. At the end of our study, childhood traumas were found to be associated with obsessive symptoms. In the group with childhood trauma, increased suicide probability was detected independently from depression and anxiety. Copyright © 2017. Published by Elsevier B.V.

The Downsides of Extreme Conscientiousness for Psychological Well-being: The Role of Obsessive Compulsive Tendencies.

PubMed

Carter, Nathan T; Guan, Li; Maples, Jessica L; Williamson, Rachel L; Miller, Joshua D

2016-08-01

Although conscientiousness exhibits positive relations with psychological well-being, theoretical and empirical work suggests individuals can be too conscientious, resulting in obsessive-compulsiveness, and therein less positive individual outcomes. However, the potential for curvilinearity between conscientiousness and well-being has been underexplored. We measured 912 subjects on facets of conscientiousness, obsessive-compulsive personality, and well-being variables (life satisfaction, job satisfaction, self-esteem, positive affect, negative affect, work stress). Methods of scoring included traditional sum-scoring, traditional item response theory (IRT), and a relatively new IRT approach. Structural models were estimated to evaluate curvilinearity. Results confirmed the curvilinear relationship between conscientiousness and well-being, and demonstrated that differential facet-level relationships underlie weaker curvilinearity at the general trait level. Consistency was found in the strength of relation between conscientiousness facets with their obsessive-compulsive variants and their contribution to decreased well-being. The most common association was that higher standing on conscientiousness facets was positively related to negative affect. Findings support the idea that extreme standing on facets of conscientiousness more strongly linked to their obsessive-compulsive variants contributed to lower well-being, highlighting the importance of considering alternative functional representations of the relationship between personality and other constructs. Future work should seek to further clarify the link between conscientiousness and negative affect. © 2015 Wiley Periodicals, Inc.

Obsessive-compulsive (anankastic) personality disorder: toward the ICD-11 classification.

PubMed

Fineberg, Naomi A; Reghunandanan, Samar; Kolli, Sangeetha; Atmaca, Murad

2014-01-01

Obsessive-compulsive personality disorder (OCPD) is an early-onset disorder characterized by perfectionism, need for control, and cognitive rigidity. Its nosological status is currently under review. Historically, OCPD has been conceptualized as bearing a close relationship with obsessive-compulsive disorder (OCD). In this article, we discuss the diagnosis of OCPD in anticipation of its review for the ICD-11, from the perspective of clinical utility, global applicability, and research planning. Considering the recent establishment of an obsessive-compulsive and related disorders (OCRD) category in DSM-5, we focus on the relationship between OCPD and the disorders that are currently thought to bear a close relationship with OCD, including DSM-5 OCRD, and other compulsive disorders such as eating disorder and autistic spectrum disorder (that were not included in the DSM-5 OCRD category), as well as with the personality disorders, focusing on nosological determinants such as phenomenology, course of illness, heritability, environmental risk factors, comorbidity, neurocognitive endophenotypes, and treatment response. Based on this analysis, we attempt to draw conclusions as to its optimal placement in diagnostic systems and draw attention to key research questions that could be explored in field trials.

Integrating evolutionary and regulatory information with a multispecies approach implicates genes and pathways in obsessive-compulsive disorder.

PubMed

Noh, Hyun Ji; Tang, Ruqi; Flannick, Jason; O'Dushlaine, Colm; Swofford, Ross; Howrigan, Daniel; Genereux, Diane P; Johnson, Jeremy; van Grootheest, Gerard; Grünblatt, Edna; Andersson, Erik; Djurfeldt, Diana R; Patel, Paresh D; Koltookian, Michele; M Hultman, Christina; Pato, Michele T; Pato, Carlos N; Rasmussen, Steven A; Jenike, Michael A; Hanna, Gregory L; Stewart, S Evelyn; Knowles, James A; Ruhrmann, Stephan; Grabe, Hans-Jörgen; Wagner, Michael; Rück, Christian; Mathews, Carol A; Walitza, Susanne; Cath, Daniëlle C; Feng, Guoping; Karlsson, Elinor K; Lindblad-Toh, Kerstin

2017-10-17

Obsessive-compulsive disorder is a severe psychiatric disorder linked to abnormalities in glutamate signaling and the cortico-striatal circuit. We sequenced coding and regulatory elements for 608 genes potentially involved in obsessive-compulsive disorder in human, dog, and mouse. Using a new method that prioritizes likely functional variants, we compared 592 cases to 560 controls and found four strongly associated genes, validated in a larger cohort. NRXN1 and HTR2A are enriched for coding variants altering postsynaptic protein-binding domains. CTTNBP2 (synapse maintenance) and REEP3 (vesicle trafficking) are enriched for regulatory variants, of which at least six (35%) alter transcription factor-DNA binding in neuroblastoma cells. NRXN1 achieves genome-wide significance (p = 6.37 × 10 -11 ) when we include 33,370 population-matched controls. Our findings suggest synaptic adhesion as a key component in compulsive behaviors, and show that targeted sequencing plus functional annotation can identify potentially causative variants, even when genomic data are limited.Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder with symptoms including intrusive thoughts and time-consuming repetitive behaviors. Here Noh and colleagues identify genes enriched for functional variants associated with increased risk of OCD.

Altered Brain Activity during Reward Anticipation in Pathological Gambling and Obsessive-Compulsive Disorder

PubMed Central

Choi, Jung-Seok; Shin, Young-Chul; Jung, Wi Hoon; Jang, Joon Hwan; Kang, Do-Hyung; Choi, Chi-Hoon; Choi, Sam-Wook; Lee, Jun-Young; Hwang, Jae Yeon; Kwon, Jun Soo

2012-01-01

Background Pathological gambling (PG) and obsessive-compulsive disorder (OCD) are conceptualized as a behavioral addiction, with a dependency on repetitive gambling behavior and rewarding effects following compulsive behavior, respectively. However, no neuroimaging studies to date have examined reward circuitry during the anticipation phase of reward in PG compared with in OCD while considering repetitive gambling and compulsion as addictive behaviors. Methods/Principal Findings To elucidate the neural activities specific to the anticipation phase of reward, we performed event-related functional magnetic resonance imaging (fMRI) in young adults with PG and compared them with those in patients with OCD and healthy controls. Fifteen male patients with PG, 13 patients with OCD, and 15 healthy controls, group-matched for age, gender, and IQ, participated in a monetary incentive delay task during fMRI scanning. Neural activation in the ventromedial caudate nucleus during anticipation of both gain and loss decreased in patients with PG compared with that in patients with OCD and healthy controls. Additionally, reduced activation in the anterior insula during anticipation of loss was observed in patients with PG compared with that in patients with OCD which was intermediate between that in OCD and healthy controls (healthy controls < PG < OCD), and a significant positive correlation between activity in the anterior insula and South Oaks Gambling Screen score was found in patients with PG. Conclusions Decreased neural activity in the ventromedial caudate nucleus during anticipation may be a specific neurobiological feature for the pathophysiology of PG, distinguishing it from OCD and healthy controls. Correlation of anterior insular activity during loss anticipation with PG symptoms suggests that patients with PG fit the features of OCD associated with harm avoidance as PG symptoms deteriorate. Our findings have identified functional disparities and similarities between patients with PG and OCD related to the neural responses associated with reward anticipation. PMID:23029329

Discovering what is hidden: The role of non-ritualized covert neutralizing strategies in Obsessive-Compulsive Disorder.

PubMed

Belloch, Amparo; Carrió, Carmen; Cabedo, Elena; García-Soriano, Gemma

2015-12-01

Neutralizing strategies are secondary to obsessions and an additional cause of distress and interference, but they have received little attention in theories and research, especially the non-ritualized covert strategies. This study focuses on the comparative impact of non-ritualized covert and compulsive-overt strategies in the course of OCD. Eighty-two OCD adult patients completed measures assessing distress, interference, appraisals and overt and covert neutralizing strategies to control obsessions. Thirty-eight patients who had completed cognitive therapy were assessed again after treatment. Only overt compulsions are associated with OCD severity. Nonetheless, considering the main symptom dimension, covert strategies are also associated with severity in patients with moral-based obsessions. Patients who used covert strategies more frequently, compared to those who use them less, reported more sadness, guilt, control importance, interference, and dysfunctional appraisals. Regarding the overt strategies, patients who used them more reported more anxiety and ascribed more personal meaning to their obsessions than the patients who used them less. After treatment, recovered patients decreased their use of both covert and overt strategies, while non-recovered patients did not. There was a higher rate of non-recovered patients among those who used more non-ritualized covert strategies before treatment. Emotions and appraisals were assessed with a single item. OCD symptom dimensions were only assessed by the Obsessive-Compulsive Inventory. In addition to studying overt compulsions, the impact of covert neutralizing strategies on the OCD course and severity warrants more in-depth study. Copyright © 2015 Elsevier Ltd. All rights reserved.

Perfectionism and Peer Relations among Children with Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Ye, Huan J.; Rice, Kenneth G.; Storch, Eric A.

2008-01-01

The study examined perfectionism, symptoms of obsessive-compulsive disorder (OCD) and depression, and peer relationships among a clinical sample of 31 youth (age range 7-18 years) diagnosed with OCD. Using a correlational design, perfectionistic beliefs accounted for significant variance in OCD symptoms, depressive symptoms, and difficulties in…

Evidence-Based Assessment of Child Obsessive Compulsive Disorder: Recommendations for Clinical Practice and Treatment Research

ERIC Educational Resources Information Center

Lewin, Adam B.; Piacentini, John

2010-01-01

Obsessive-compulsive disorder (OCD) presents heterogeneously and can be difficult to assess in youth. This review focuses on research-supported assessment approaches for OCD in childhood. Content areas include pre-visit screening, diagnostic establishment, differential diagnosis, assessment of comorbid psychiatric conditions, tracking symptom…

Pragmatic Competency and Obsessive-Compulsive Disorder: A Comparative Assessment with Normal Controls

ERIC Educational Resources Information Center

Ghahari, Shima; Hassani, Hamidreza; Purmofrad, Maryam

2017-01-01

Unlike such cognitive impairments as autism and schizophrenia, the speech pattern in obsessive-compulsive disorder (OCD) has largely remained underrepresented. We examined the pragmatic competence of OCD-affected individuals under two variant modes: pragmatic recognition and pragmatic production. In the recognition phase, the informants completed…

Family Therapy in Iran: A Case Study of Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Khodayarifard, Mohammad; McClenon, James

2011-01-01

Iranian clinical psychologists have devised family therapy methods that use cognitive behavior models that ft with their collectivist Islamic culture. The authors review Islamic-based strategies and describe family therapy with a culturally specific case of childhood obsessive-compulsive disorder. Family therapy, adapted to integrated,…

Neural Correlates of Symptom Dimensions in Pediatric Obsessive-Compulsive Disorder: A Functional Magnetic Resonance Imaging Study

ERIC Educational Resources Information Center

Gilbert, Andrew R.; Akkal, Dalila; Almeida, Jorge R. C.; Mataix-Cols, David; Kalas, Catherine; Devlin, Bernie; Birmaher, Boris; Phillips, Mary L.

2009-01-01

The use of functional magnetic resonance imaging on a group of pediatric subjects with obsessive compulsive disorder reveals that this group has reduced activity in neural regions underlying emotional processing, cognitive processing, and motor performance as compared to control subjects.

Recent Developments in the Assessment and Treatment of Pediatric Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Berman, Noah C.; Abramowitz, Jonathan S.

2010-01-01

Although tremendous strides have recently been made in the development of assessment and treatment methods for pediatric obsessive-compulsive disorder (OCD), more accurate methods for diagnosis, more effective treatments, and more refined instruments for monitoring progress during therapy are still needed. The present commentary highlights the…

Peer Victimization in Children with Obsessive-Compulsive Disorder: Relations with Symptoms of Psychopathology

ERIC Educational Resources Information Center

Storch, Eric A.; Ledley, Deborah Roth; Lewin, Adam B.; Murphy, Tanya K.; Johns, Natalie B.; Goodman, Wayne K.; Geffken, Gary R.

2006-01-01

This study examined the frequency of peer victimization and psychological symptom correlates among youth with obsessive-compulsive disorder (OCD). The Schwartz Peer Victimization Scale, Children's Depression Inventory, and Asher Loneliness Scale were administered to 52 children and adolescents diagnosed with OCD. The child's parent or guardian…

An Autistic Dimension: A Proposed Subtype of Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Bejerot, Susanne

2007-01-01

This article focuses on the possibility that autism spectrum disorder (ASD: Asperger syndrome, autism and atypical autism) in its milder forms may be clinically important among a substantial proportion of patients with obsessive-compulsive disorder (OCD), and discusses OCD subtypes based on this proposition. The hypothesis derives from extensive…

Cognitive Inflexibility and Frontal-Cortical Activation in Pediatric Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Britton, Jennifer C.; Rauch, Scott L.; Rosso, Isabelle M.; Killgore, William D. S.; Price, Lauren M.; Ragan, Jennifer; Chosak, Anne; Hezel, Dianne M.; Pine, Daniel S.; Leibenluft, Ellen; Pauls, David L.; Jenike, Michael A.; Stewart, S. Evelyn

2010-01-01

Objective: Deficits in cognitive flexibility and response inhibition have been linked to perturbations in cortico-striatal-thalamic circuitry in adult obsessive-compulsive disorder (OCD). Although similar cognitive deficits have been identified in pediatric OCD, few neuroimaging studies have been conducted to examine its neural correlates in the…

Impact of Comorbidity on Cognitive-Behavioral Therapy Response in Pediatric Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Storch, Eric A.; Merlo, Lisa J.; Larson, Michael J.; Geffken, Gary R.; Lehmkuh, Heather D.; Jacob, Marni L.; Murphy, Tanya K.; Goodman, Wayne K.

2008-01-01

A chronic psychiatric condition among children and adolescents of concern is obsessive-compulsive disorder, which involves comorbid conditions. The impact of a range of comorbid illnesses on cognitive-behavioral therapy response and remission rates was conducted, with results revealing a negative impact on treatment response.

Obsessive compulsive symptoms are associated with better functioning independently of cognition in schizophrenia.

PubMed

Kontis, Dimitrios; Theochari, Eirini; Nikolakopoulou, Mary; Andreopoulou, Angeliki; Vassos, Dimitrios; Grigoriou, Vasileios; Vassilouli, Spyridoula; Giannakopoulou, Dimitra; Kouloumbi, Maria; Tsaltas, Eleftheria

2016-10-01

Although the relationship of obsessive-compulsive symptoms (OCSs) with both cognition and social functioning (SF) has already been the focus of research in schizophrenia, the moderation of the relationship of OCSs with SF by cognition has not been explored to date. We investigated the association of OCSs with SF and its interaction with cognition in schizophrenia. We recruited 110 schizophrenia patients and assessed OCSs (Yale-Brown Scale), schizophrenia symptoms (Positive and Negative Syndrome Scale), SF (Strauss-Carpenter Scale) and cognition. 51 patients had one obsessive-compulsive symptom or more, whereas 59 patients had no obsessive compulsive-symptom, according to the Yale-Brown Scale. We mainly investigated: a) the predictive effect of OCSs on SF, controlling for cognition, illness duration and symptoms' severity and b) the moderating effect of cognition on the OCSs-SF relationship. The mean score of OCSs for patients having at least one symptom was 13.43 (SD=8.32). Higher OCSs predicted increased SF (B=0.98, t=2.41, df=88, p=0.018). This relationship was driven by the association of compulsions with job functioning (B=0.074, t=2.029, df=88, p=0.046). Patients without OCSs demonstrated worse functioning compared with those having at least one obsessive-compulsive symptom (mean difference=2.496, t=3.732, df=88, p<0.001). We failed to find evidence that cognition moderates the effect of OCSs on SF. There may be a beneficial effect of OCSs on SF in patients with schizophrenia which is independent of their cognitive performance. Copyright © 2016 Elsevier Inc. All rights reserved.

Beyond refractory obsessions and anxiety states: toward remission.

PubMed

Hollander, Eric; Zohar, Joseph

2004-01-01

At the Sixth International Obsessive-Compulsive Disorder Conference (IOCDC), held November 13-15, 2003, in Lanzarote, Spain, 2 issues were discussed that are of great importance to future research on obsessive-compulsive disorder (OCD). The first of these is the possible inclusion of obsessive-compulsive spectrum disorders (OCSD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. OCSD resemble OCD in their clinical symptoms, associated features, comorbidity, family/genetics, etiology, and neurocircuitry, as well as their selective response to treatment with serotonin reuptake inhibitors. The second issue is considering remission as the ultimate goal of treatment for OCD instead of just symptom reduction, as has been suggested in other disorders. These and other issues should be discussed at future meetings of the IOCDC and influence how we conceptualize the disorder and design future treatment trials.

Symptom Dimensions in Obsessive-Compulsive Disorder and Obsessive Beliefs.

PubMed

Cordeiro, Trinette; Sharma, Mahendra P; Thennarasu, Kandavel; Reddy, Y C Janardhan

2015-01-01

Obsessive-compulsive disorder (OCD) is a heterogeneous condition with a few major symptom dimensions. These symptom dimensions are thought to have unique clinical and neurobiological correlates. There seems to be a specific relation between OCD symptom dimensions and obsessive beliefs, but the findings are not consistent across studies. There is also a paucity of literature from culturally diverse settings. One of the reasons for the varied findings could be due to the method employed in measuring OCD symptoms. In this study, we examined the relation between symptom dimensions and obsessive beliefs using the Dimensional Yale-Brown Obsessive-Compulsive Scale and the Obsessive Beliefs Questionnaire respectively in 75 patients with Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition OCD. Perfectionism predicted both aggressive and symmetry dimensions whereas responsibility beliefs predicted sexual and religious dimensions. The findings suggest that certain obsessive beliefs predicted certain OCD symptom dimensions, but results are not entirely consistent with the published literature suggesting the possibility of cross-cultural variations. That the symptom dimensions have unique belief domains support the argument that symptom dimensions could be targeted to reduce the heterogeneity in etiological and treatment studies of OCD. Therapeutic interventions may have to aim at modifying unique belief domains underlying certain symptom dimensions rather than having generic cognitive-behavioral strategies.

Obsessive-Compulsive Disorder with Suicide Obsessions in a First Responder without Previous Diagnosis of OCD or History of Suicide Attempts.

PubMed

Rachamallu, Vivekananda; Song, Michael M; Liu, Haiying; Giles, Charles L; McMahon, Terry

2017-01-01

Obsessive-compulsive disorder (OCD) is a distressing and often debilitating disorder characterized by obsessions, compulsions, or both that are time-consuming and cause impairment in social, occupational, or other areas of functioning. There are many published studies reporting higher risk of suicidality in OCD patients, as well as studies describing increased risk of suicidality in OCD patients with other comorbid psychiatric conditions such as major depressive disorder (MDD) and posttraumatic stress disorder (PTSD). Existing case reports on OCD with suicide as the obsessive component describe patients with long standing diagnosis of OCD with suicidal ideations or previous suicide attempts. This report describes the case of a 28-year-old male, who works as a first responder, who presented with new onset symptoms characteristic of MDD and PTSD, with no past history of OCD or suicidality who developed OCD with suicidal obsessions. Differentiating between suicidal ideation in the context of other psychiatric illnesses and suicidal obsessions in OCD is critical to ensuring accurate diagnosis and timely provision of most appropriate treatment. The combination of exposure and response prevention therapy and pharmacotherapy with sertraline and olanzapine was effective in helping the patient manage the anxiety and distress stemming from the patient's OCD with suicidal obsession.

Obsessive-Compulsive Disorder with Suicide Obsessions in a First Responder without Previous Diagnosis of OCD or History of Suicide Attempts

PubMed Central

Song, Michael M.; Liu, Haiying; Giles, Charles L.; McMahon, Terry

2017-01-01

Obsessive-compulsive disorder (OCD) is a distressing and often debilitating disorder characterized by obsessions, compulsions, or both that are time-consuming and cause impairment in social, occupational, or other areas of functioning. There are many published studies reporting higher risk of suicidality in OCD patients, as well as studies describing increased risk of suicidality in OCD patients with other comorbid psychiatric conditions such as major depressive disorder (MDD) and posttraumatic stress disorder (PTSD). Existing case reports on OCD with suicide as the obsessive component describe patients with long standing diagnosis of OCD with suicidal ideations or previous suicide attempts. This report describes the case of a 28-year-old male, who works as a first responder, who presented with new onset symptoms characteristic of MDD and PTSD, with no past history of OCD or suicidality who developed OCD with suicidal obsessions. Differentiating between suicidal ideation in the context of other psychiatric illnesses and suicidal obsessions in OCD is critical to ensuring accurate diagnosis and timely provision of most appropriate treatment. The combination of exposure and response prevention therapy and pharmacotherapy with sertraline and olanzapine was effective in helping the patient manage the anxiety and distress stemming from the patient's OCD with suicidal obsession. PMID:29098105

Cognitive Therapy of Obsessive Compulsive Disorder with Chronic Tic Disorder

PubMed Central

Hebbar, Sudhir

2013-01-01

The gold standard of therapy for obsessive compulsive disorder, exposure with response prevention, may not be suitable to obsessional sub-type. Live exposure is not possible and response prevention is difficult. These obsessions (sexual, religious or aggressive) are repugnant and resisted. Negative attitude against obsessions leads to treatment refusal or dropout from therapy. In Cognitive therapy (CT) these attitudes can be corrected and exposure can be administered in the form of behavioral experiments (using behavioral tasks to change the dysfunctional attitudes). Such a case is treated with CT, weaned off medications and remains improved at 9 months. PMID:23833351

Association between Protestant religiosity and obsessive-compulsive symptoms and cognitions.

PubMed

Abramowitz, Jonathan S; Deacon, Brett J; Woods, Carol M; Tolin, David F

2004-01-01

There is evidence that religion and other cultural influences are associated with the presentation of obsessive-compulsive symptoms, as well as beliefs and assumptions presumed to underlie the development and maintenance of these symptoms. We sought to further examine the relationship between Protestant religiosity and (1) various symptoms of obsessive-compulsive disorder (OCD) (e.g., checking, washing) and (2) OCD-related cognitions. Using self-report questionnaires, we compared differences in these OCD-related phenomena between highly religious Protestants, moderately religious Protestants, and atheist/agnostic participants drawn from an undergraduate sample. Highly religious versus moderately religious Protestants reported greater obsessional symptoms, compulsive washing, and beliefs about the importance of thoughts. Additionally, the highly religious evinced more obsessional symptoms, compulsive washing, intolerance for uncertainty, need to control thoughts, beliefs about the importance of thoughts, and inflated responsibility, compared to atheists/agnostics. Results are discussed in terms of the relationship between religion and OCD symptoms in the context of the cognitive-behavioral conceptualization of OCD. Copyright 2004 Wiley-Liss, Inc.

Mediators of exposure therapy for youth obsessive-compulsive disorder: specificity and temporal sequence of client and treatment factors.

PubMed

Chu, Brian C; Colognori, Daniela B; Yang, Guang; Xie, Min-ge; Lindsey Bergman, R; Piacentini, John

2015-05-01

Behavioral engagement and cognitive coping have been hypothesized to mediate effectiveness of exposure-based therapies. Identifying which specific child factors mediate successful therapy and which therapist factors facilitate change can help make our evidence-based treatments more efficient and robust. The current study examines the specificity and temporal sequence of relations among hypothesized client and therapist mediators in exposure therapy for pediatric Obsessive Compulsive Disorder (OCD). Youth coping (cognitive, behavioral), youth safety behaviors (avoidance, escape, compulsive behaviors), therapist interventions (cognitive, exposure extensiveness), and youth anxiety were rated via observational ratings of therapy sessions of OCD youth (N=43; ages=8 - 17; 62.8% male) who had received Exposure and Response Prevention (ERP). Regression analysis using Generalized Estimation Equations and cross-lagged panel analysis (CLPA) were conducted to model anxiety change within and across sessions, to determine formal mediators of anxiety change, and to establish sequence of effects. Anxiety ratings decreased linearly across exposures within sessions. Youth coping and therapist interventions significantly mediated anxiety change across exposures, and youth-interfering behavior mediated anxiety change at the trend level. In CLPA, youth-interfering behaviors predicted, and were predicted by, changes in anxiety. Youth coping was predicted by prior anxiety change. The study provides a preliminary examination of specificity and temporal sequence among child and therapist behaviors in predicting youth anxiety. Results suggest that therapists should educate clients in the natural rebound effects of anxiety between sessions and should be aware of the negatively reinforcing properties of avoidance during exposure. Copyright © 2015. Published by Elsevier Ltd.

Emotional Processing in Obsessive-Compulsive Disorder: A Systematic Review and Meta-analysis of 25 Functional Neuroimaging Studies.

PubMed

Thorsen, Anders Lillevik; Hagland, Pernille; Radua, Joaquim; Mataix-Cols, David; Kvale, Gerd; Hansen, Bjarne; van den Heuvel, Odile A

2018-06-01

Patients with obsessive-compulsive disorder (OCD) experience aversive emotions in response to obsessions, motivating avoidance and compulsive behaviors. However, there is considerable ambiguity regarding the brain circuitry involved in emotional processing in OCD, especially whether activation is altered in the amygdala. We conducted a systematic literature review and performed a meta-analysis-seed-based d mapping-of 25 whole-brain neuroimaging studies (including 571 patients and 564 healthy control subjects) using functional magnetic resonance imaging or positron emission tomography, comparing brain activation of patients with OCD and healthy control subjects during presentation of emotionally valenced versus neutral stimuli. Meta-regressions were employed to investigate possible moderators. Patients with OCD, compared with healthy control subjects, showed increased activation in the bilateral amygdala, right putamen, orbitofrontal cortex extending into the anterior cingulate and ventromedial prefrontal cortex, and middle temporal and left inferior occipital cortices during emotional processing. Right amygdala hyperactivation was most pronounced in unmedicated patients. Symptom severity was related to increased activation in the orbitofrontal and anterior cingulate cortices and precuneus. Greater comorbidity with mood and anxiety disorders was associated with higher activation in the right amygdala, putamen, and insula as well as with lower activation in the left amygdala and right ventromedial prefrontal cortex. Patients with OCD show increased emotional processing-related activation in limbic, frontal, and temporal regions. Previous mixed evidence regarding the role of the amygdala in OCD has likely been influenced by patient characteristics (such as medication status) and low statistical power. Copyright © 2018 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

A Naturalistic Study of Referred Children and Adolescents with Obsessive-Compulsive Disorder.

ERIC Educational Resources Information Center

Masi, Gabriele; Millepiedi, Stefania; Mucci, Maria; Bertini, Nicoletta; Milantoni, Luca; Arcangeli, Francesca

2005-01-01

Objective: To report on clinical features, comorbidity, and response to pharmacotherapy in children and adolescents with obsessive-compulsive disorder (OCD) naturalistically followed and treated with serotonin reuptake inhibitors (SRIs). Method: A consecutive series of 94 patients (65 males, 29 females, age 13.6 [+ or -] 2.8 years), referred in…

Rage Attacks in Pediatric Obsessive-Compulsive Disorder: Phenomenology and Clinical Correlates

ERIC Educational Resources Information Center

Storch, Eric A.; Jones, Anna M.; Lack, Caleb W.; Ale, Chelsea M.; Sulkowski, Michael L.; Lewin, Adam B.; De Nadai, Alessandro S.; Murphy, Tanya K.

2012-01-01

Objective: Rage attacks have been documented in youth with varied psychiatric disorders, but few data have been reported on the clinical characteristics and correlates of rage attacks among children with obsessive-compulsive disorder (OCD). Method: Participants were 86 children (ages 6-16 years) with a primary diagnosis of OCD. Patients and their…

Subclinical Obsessive-Compulsive Symptoms, Cognitive Processes, School Achievement, and Intelligence-Achievement Relationship in Adolescents

ERIC Educational Resources Information Center

Malakar, Partha; Basu, Jayanti

2017-01-01

The aim of the study was to determine whether the general intelligence, cognitive processes, school achievement, and intelligence-achievement relationship of adolescents with subclinical levels of obsessive-compulsive symptoms differed from those of their normal counterparts. From an initial large pool of 14-year-old Bengali students in eighth…

Cognitive-Behavioral Therapy for PANDAS-Related Obsessive-Compulsive Disorder: Findings From A Preliminary Waitlist Controlled Open Trial

ERIC Educational Resources Information Center

Storch, Eric A.; Murphy, Tanya K.; Geffken, Gary R.; Mann, Giselle; Adkins, Jennifer; Merlo, Lisa J.; Duke, Danny; Munson, Melissa; Swaine, Zoe; Goodman, Wayne K.

2006-01-01

Objective: To provide preliminary estimates of the effectiveness of cognitive-behavioral therapy (CBT) in treating pediatric obsessive-compulsive disorder (OCD) of the pediatric autoimmune neuropsychiatric disorders associated with streptococcus (PANDAS) subtype. Method: Seven children with OCD of the PANDAS subtype (range 9-13 years) were treated…

Using Motivational Interviewing to Enhance Treatment Outcome in People with Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Simpson, Helen Blair; Zuckoff, Allan

2011-01-01

Obsessive-compulsive disorder (OCD) is a leading cause of health-related disability. There are two evidence-based treatments for OCD, pharmacotherapy and cognitive-behavioral therapy consisting of exposure and response prevention (EX/RP). Although effective, outcome from both treatments is often limited by patient lack of adherence to the…

Repetitive Behaviour and Obsessive-Compulsive Features in Asperger Syndrome: Parental and Self-Reports

ERIC Educational Resources Information Center

Dewrang, Petra; Sandberg, Annika Dahlgren

2011-01-01

Symptoms of repetitive, obsessive and compulsive behaviour were explored in a group of adolescents and young adults with Asperger syndrome and compared to a typically developing group. By means of self-evaluations and an interview regarding such symptoms with the adolescents and young adults and parental evaluations, the parents retrospectively…

Functional Magnetic Resonance Imaging during Planning before and after Cognitive-Behavioral Therapy in Pediatric Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Huyser, Chaim; Veltman, Dick J.; Wolters, Lidewij H.; de Haan, Else; Boer, Frits

2010-01-01

Objective: Pediatric obsessive compulsive disorder (OCD) has been associated with cognitive abnormalities, in particular executive impairments, and dysfunction of frontal-striatal-thalamic circuitry. The aim of this study was to investigate if planning as an executive function is compromised in pediatric OCD and is associated with…

Reduced Prefrontal Hemodynamic Response in Pediatric Obsessive-Compulsive Disorder as Measured by Near-Infrared Spectroscopy

ERIC Educational Resources Information Center

Ota, Toyosaku; Iida, Junzo; Sawada, Masayuki; Suehiro, Yuko; Yamamuro, Kazuhiko; Matsuura, Hiroki; Tanaka, Shohei; Kishimoto, Naoko; Negoro, Hideki; Kishimoto, Toshifumi

2013-01-01

Recent developments in near-infrared spectroscopy (NIRS) have enabled non-invasive clarification of brain functions in psychiatric disorders. Functional neuroimaging studies of patients with obsessive-compulsive disorder (OCD) have suggested that the frontal cortex and subcortical structures may play a role in the pathophysiology of the disorder.…

General and Maladaptive Personality Dimensions in Pediatric Obsessive-Compulsive Symptoms

ERIC Educational Resources Information Center

Aelterman, Nathalie; De Clercq, Barbara; De Bolle, Marleen; De Fruyt, Filip

2011-01-01

Obsessive-compulsive disorder (OCD) is a chronic and impairing clinical disorder in childhood, often characterized by a heterogeneous symptomatic profile and high co-occurrence with other disorders. The present study introduces a new perspective on the description of OCD symptoms in youth, and empirically examines the value of a personality…

Do the Traits of Autism-Spectrum Overlap with Those of Schizophrenia or Obsessive-Compulsive Disorder in the General Population?

ERIC Educational Resources Information Center

Wakabayashi, Akio; Baron-Cohen, Simon; Ashwin, Chris

2012-01-01

Social and communicative deficits, restricted interests and repetitive behaviors are diagnostic features of autism spectrum disorders (ASD). The present study examined the relationship between autistic characteristics and schizophrenia-spectrum traits as well as between autistic characteristics and obsessive-compulsive traits in typically…

Controlled Comparison of Family Cognitive Behavioral Therapy and Psychoeducation/Relaxation Training for Child Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Piacentini, John; Bergman, R. Lindsey; Chang, Susanna; Langley, Audra; Peris, Tara; Wood, Jeffrey J.; McCracken, James

2011-01-01

Objective: To examine the efficacy of exposure-based cognitive-behavioral therapy (CBT) plus a structured family intervention (FCBT) versus psychoeducation plus relaxation training (PRT) for reducing symptom severity, functional impairment, and family accommodation in youths with obsessive-compulsive disorder (OCD). Method: A total of 71…

Treating Obsessive-Compulsive Disorder and Schizophrenia: The Case of Sam

ERIC Educational Resources Information Center

Peasley-Miklus, Catherine; Massie, Elise; Baslett, Gaston; Carmin, Cheryl

2005-01-01

This article describes the case of Sam, a 22-year-old male with obsessive-compulsive disorder (OCD) and schizophrenia. The patient's background, the development and characteristics of his OCD and schizophrenia, and the history of what became a rather complicated treatment are described. In addition, four problem areas of therapy are identified.

Streptococcal Upper Respiratory Tract Infections and Exacerbations of Tic and Obsessive-Compulsive Symptoms: A Prospective Longitudinal Study

ERIC Educational Resources Information Center

Leckman, James F.; King, Robert A.; Gilbert, Donald L.; Coffey, Barbara J.; Singer, Harvey S.; Dure, Leon S., IV; Grantz, Heidi; Katsovich, Liliya; Lin, Haiqun; Lombroso, Paul J.; Kawikova, Ivana; Johnson, Dwight R.; Kurlan, Roger M.; Kaplan, Edward L.

2011-01-01

Objective: The objective of this blinded, prospective, longitudinal study was to determine whether new group A beta hemolytic streptococcal (GABHS) infections are temporally associated with exacerbations of tic or obsessive-compulsive (OC) symptoms in children who met published criteria for pediatric autoimmune neuropsychiatric disorders…

A Structural Equation Analysis of Family Accommodation in Pediatric Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Caporino, Nicole E.; Morgan, Jessica; Beckstead, Jason; Phares, Vicky; Murphy, Tanya K.; Storch, Eric A.

2012-01-01

Family accommodation of symptoms is counter to the primary goals of cognitive-behavioral therapy for pediatric obsessive-compulsive disorder (OCD) and can pose an obstacle to positive treatment outcomes. Although increased attention has been given to family accommodation in pediatric OCD, relatively little is known about associated child and…

Clinical Considerations when Tailoring Cognitive Behavioral Treatment for Young Children with Obsessive Compulsive Disorder

ERIC Educational Resources Information Center

Choate-Summers, Molly L.; Freeman, Jennifer B.; Garcia, Abbe M.; Coyne, Lisa; Przeworski, Amy; Leonard, Henrietta L.

2008-01-01

Research on the effectiveness of cognitive-behavioral therapy, and in particular, exposure with response prevention for Obsessive-Compulsive Disorder (OCD), has only been systematically evaluated in children and adolescents ages 7-17. These treatments do not address the unique characteristics of young children with OCD. This paper discusses…

Decreased Family Accommodation Associated with Improved Therapy Outcome in Pediatric Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Merlo, Lisa J.; Lehmkuhl, Heather D.; Geffken, Gary R.; Storch, Eric A.

2009-01-01

Pediatric obsessive-compulsive disorder (OCD) is a chronic, disabling condition that affects both patients and their families. Despite the identification of efficacious treatments (e.g., cognitive-behavioral therapy and selective serotonin reuptake inhibitor medications), not all patients respond fully. The purpose of the present study was to…

Development and Validation of a Child Version of the Obsessive Compulsive Inventory

ERIC Educational Resources Information Center

Foa, Edna B.; Coles, Meredith; Huppert, Jonathan D.; Pasupuleti, Radhika V.; Franklin, Martin E.; March, John

2010-01-01

Surprisingly, only 3 self-report measures that directly assess pediatric obsessive-compulsive disorder (OCD) have been developed. In addition, these scales have typically been developed in small samples and fail to provide a quick assessment of symptoms across multiple domains. Therefore, the current paper presents initial psychometric data for a…

Obsessive-Compulsive Disorder as a Disturbance of Security Motivation

ERIC Educational Resources Information Center

Szechtman, Henry; Woody, Erik

2004-01-01

The authors hypothesize that the symptoms of obsessive-compulsive disorder (OCD), despite their apparent nonrationality, have what might be termed an epistemic origin-that is, they stem from an inability to generate the normal "feeling of knowing" that would otherwise signal task completion and terminate the expression of a security motivational…

Cognitive Appraisals in Young People with Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Libby, Sarah; Reynolds, Shirley; Derisley, Jo; Clark, Sarah

2004-01-01

Background: A number of cognitive appraisals have been identified as important in the manifestation of obsessive-compulsive disorder (OCD) in adults. There have, however, been few attempts to explore these cognitive appraisals in clinical groups of young people. Method: This study compared young people aged between 11 and 18 years with OCD (N =…

Obsessive Compulsive Symptoms and Quality of Life in mothers of Children With Atopic Dermatitis.

PubMed

Gunduz, S; Usak, E; Ozen, S; Gorpelioglu, C

2017-06-01

Atopic dermatitis is one of the most common skin disorders in children and it can negatively affect both children and their families. The purpose of this study was to investigate the effect of atopic dermatitis on quality of life related to maternal health and maternal obsessive compulsive symptoms. A cross-sectional study was conducted in the pediatric and dermatology polyclinics. The SCORAD index was used for determining the severity of disease, and the Maudsley Obsessive Compulsive Inventory (MOCI) and SF-36 form were applied to the participants' mothers. A total of 120 children and their mothers participated the study. Comparing the atopic dermatitis group and the healthy control group, no statistically significant differences were seen in terms of MOCI and SF-36 scores, except for the physical functioning subscore. The results showed that having a child with atopic dermatitis and the severity of the disease do not influence their mothers in terms of obsessive-compulsive symptoms and health-related quality of life, except for physical functioning scores. Copyright © 2017 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

The association of anxiety disorders and obsessive compulsive personality disorder with anorexia nervosa: evidence from a family study with discussion of nosological and neurodevelopmental implications.

PubMed

Strober, Michael; Freeman, Roberta; Lampert, Carlyn; Diamond, Jane

2007-11-01

To investigate the association of anorexia nervosa with anxiety disorders through use of a case-control family study design. Lifetime prevalence of anxiety disorders and obsessive compulsive personality disorder was determined among 574 first-degree relatives of 152 probands with anorexia nervosa and compared to rates observed among 647 first-degree relatives of 181 never-ill control probands. Adjusting for comorbidity of the same illness in the proband, relatives of probands with anorexia nervosa, had a significantly higher prevalence of generalized anxiety, obsessive compulsive disorder, separation anxiety disorder, social phobia, panic disorder, and obsessive compulsive personality disorder compared to relatives of never-ill control probands. Anorexia nervosa may share familial liability factors in common with various anxiety phenotypes. In suggesting that a transmitted propensity for anxiety is a key aspect of vulnerability in anorexia nervosa, the findings point to research developments in the affective neurosciences, specifically the neurocircuitry of fear and anxiety, as a heuristic framework in which to interpret aspects of premorbid temperamental anxieties and clinical symptoms. (c) 2007 by Wiley Periodicals, Inc.

A randomized controlled trial comparing EMDR and CBT for obsessive-compulsive disorder.

PubMed

Marsden, Zoe; Lovell, Karina; Blore, David; Ali, Shehzad; Delgadillo, Jaime

2018-01-01

This study aimed to evaluate eye movement desensitization and reprocessing (EMDR) as a treatment for obsessive-compulsive disorder (OCD), by comparison to cognitive behavioural therapy (CBT) based on exposure and response prevention. This was a pragmatic, feasibility randomized controlled trial in which 55 participants with OCD were randomized to EMDR (n = 29) or CBT (n = 26). The Yale-Brown obsessive-compulsive scale was completed at baseline, after treatment and at 6 months follow-up. Treatment completion and response rates were compared using chi-square tests. Effect size was examined using Cohen's d and multilevel modelling. Overall, 61.8% completed treatment and 30.2% attained reliable and clinically significant improvement in OCD symptoms, with no significant differences between groups (p > .05). There were no significant differences between groups in Yale-Brown obsessive-compulsive scale severity post-treatment (d = -0.24, p = .38) or at 6 months follow-up (d = -0.03, p = .90). EMDR and CBT had comparable completion rates and clinical outcomes. Copyright © 2017 John Wiley & Sons, Ltd.

Compulsive buying. Demography, phenomenology, and comorbidity in 46 subjects.

PubMed

Schlosser, S; Black, D W; Repertinger, S; Freet, D

1994-05-01

Compulsive buying has been generally ignored in the psychiatric literature, although it is apparently frequent, underrecognized, and can lead to severe financial and legal consequences for its sufferers. The current investigation was designed to assess the overall life-style and problems of subjects identified as compulsive shoppers. Forty-six compulsive buyers were assessed for comorbid psychiatric disorders with the Diagnostic Interview Schedule, the Structured Interview for DSM-III-R Personality Disorders, and a semistructured interview to assess buying behavior. The typical shopper was a 31-year-old female who had developed compulsive buying at age 18 years. Subjects spent their money on clothing, shoes, and records/compact discs. The average debt load accrued was $5,422 out of an average yearly income of $23,443. More than two-thirds met lifetime criteria for a major (Axis I) mental disorder, most commonly anxiety, substance abuse, and mood disorders. Nearly 60% were found to meet criteria for a DSM-III-R personality disorder, most commonly the obsessive-compulsive, borderline, and avoidant types. The authors conclude that compulsive buying is a definable clinical syndrome which can cause its sufferers significant distress and is associated with significant psychiatric comorbidity.

Degree connectivity in body dysmorphic disorder and relationships with obsessive and compulsive symptoms.

PubMed

Beucke, Jan C; Sepulcre, Jorge; Buhlmann, Ulrike; Kathmann, Norbert; Moody, Teena; Feusner, Jamie D

2016-10-01

Individuals with body dysmorphic disorder (BDD) and obsessive-compulsive disorder (OCD) are categorized within the same major diagnostic group and both show regional brain hyperactivity in the orbitofrontal cortex (OFC) and the basal ganglia during symptom provocation. While recent studies revealed that degree connectivity of these areas is abnormally high in OCD and positively correlates with symptom severity, no study has investigated degree connectivity in BDD. We used functional magnetic resonance imaging (fMRI) to compare the local and distant degree of functional connectivity in all brain areas between 28 unmedicated BDD participants and 28 demographically matched healthy controls during a face-processing task. Correlational analyses tested for associations between degree connectivity and symptom severity assessed by the BDD version of the Yale-Brown obsessive-compulsive scale (BDD-Y-BOCS). Reduced local amygdalar connectivity was found in participants with BDD. No differences in distant connectivity were found. BDD-Y-BOCS scores significantly correlated with the local connectivity of the posterior-lateral OFC, and distant connectivity of the posterior-lateral and post-central OFC, respectively. These findings represent preliminary evidence that individuals with BDD exhibit brain-behavioral associations related to obsessive thoughts and compulsive behaviors that are highly similar to correlations previously found in OCD, further underscoring their related pathophysiology. This relationship could be further elucidated through investigation of resting-state functional connectivity in BDD, ideally in direct comparison with OCD and other obsessive-compulsive and related disorders. Copyright © 2016 Elsevier B.V. and ECNP. All rights reserved.

Repetitive transcranial magnetic stimulation of the supplementary motor area in treatment-resistant obsessive-compulsive disorder: An open-label pilot study.

PubMed

Lee, Young-Ji; Koo, Bon-Hoon; Seo, Wan-Seok; Kim, Hye-Geum; Kim, Ji-Yean; Cheon, Eun-Jin

2017-10-01

Obsessive-compulsive disorder (OCD) is a severely distressing disorder represented by obsessions and compulsions. A significant proportion of OCD patients fail to improve with conventional treatment methods. Repetitive transcranial magnetic stimulation (rTMS) has been proposed as an alternative for OCD treatment. Functional neuroimaging studies indicate that OCD is associated with increased activity in the supplementary motor area (SMA), a region that plays an important role in the pathophysiology of this disorder. In this study, we assessed the efficacy of augmentation with 1Hz rTMS over the SMA in treatment-resistant OCD patients. The participants received 1Hz rTMS over the SMA in 20 daily sessions for 4weeks. We observed significant reduction in Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score at the 4th week of the treatment. Reduction in compulsion contributed to the reduction of global Y-BOCS whereas there was no significant reduction in obsession. Clinical global impression-global improvement also showed significant change at the 2nd and 4th week of the treatment. No additional significant changes or significant adverse effects were seen. These findings suggest that 1Hz rTMS over the SMA can be an efficient and safe add-on therapeutic method in treatment-resistant patients with OCD. Further controlled studies in larger samples are required to confirm the effect of 1Hz rTMS over the SMA in OCD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Comparison of Saffron and Fluvoxamine in the Treatment of Mild to Moderate Obsessive-Compulsive Disorder: A Double Blind Randomized Clinical Trial

PubMed Central

Esalatmanesh, Sophia; Biuseh, Mojtaba; Noorbala, Ahmad Ali; Mostafavi, Seyed-Ali; Rezaei, Farzin; Mesgarpour, Bita; Mohammadinejad, Payam; Akhondzadeh, Shahin

2017-01-01

Objective: There are different pathophysiological mechanisms for obsessive- compulsive disorder (OCD) as suggested by the serotonergic, dopaminergic, and glutamatergic hypotheses. The present study aimed at comparing the efficacy and safety of saffron (stigma of Crocus sativus) and fluvoxamine in the treatment of mild to moderate obsessive- compulsive disorder. Method: In this study, 50 males and females, aged 18 to 60 years, with mild to moderate OCD, participated. The patients were randomly assigned to receive either saffron (30 mg/day, 15 mg twice a day) or fluvoxamine (100 mg/day) for 10 weeks. Using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Adverse Event Checklist, we assessed the patients at baseline, and at the second, fourth, sixth, eighth, and tenth week. Finally, the data were analyzed using general linear repeated measures. Results: In this study, 46 patients completed the trial. General linear repeated measures demonstrated no significant effect for time-treatment interaction on the Y-BOCS total scores [F (2.42, 106.87) = 0.70, P = 0.52], obsession Y-BOCS subscale scores [F (2.47, 108.87) = 0.77, p = 0.49], and compulsion Y-BOCS subscale scores [F (2.18, 96.06) = 0.25, P = 0.79]. Frequency of adverse events was not significantly different between the 2 groups. Conclusion: Our findings suggest that saffron is as effective as fluvoxamine in the treatment of patients with mild to moderate OCD. PMID:29062366

Obsessive compulsive personality disorder as a predictor of exposure and ritual prevention outcome for obsessive compulsive disorder.

PubMed

Pinto, Anthony; Liebowitz, Michael R; Foa, Edna B; Simpson, H Blair

2011-08-01

Despite elevated rates of obsessive compulsive personality disorder (OCPD) in patients with obsessive compulsive disorder (OCD), no study has specifically examined comorbid OCPD as a predictor of exposure and ritual prevention (EX/RP) outcome. Participants were adult outpatients (n = 49) with primary OCD and a Yale-Brown Obsessive Compulsive Scale (YBOCS) total score ≥ 16 despite a therapeutic serotonin reuptake inhibitor dose for at least 12 weeks prior to entry. Participants received 17 sessions of EX/RP over 8 weeks. OCD severity was assessed with the YBOCS pre- and post-treatment by independent evaluators. At baseline, 34.7% of the OCD sample met criteria for comorbid DSM-IV OCPD, assessed by structured interview. OCPD was tested as a predictor of outcome both as a diagnostic category and as a dimensional score (severity) based on the total number of OCPD symptoms coded as present and clinically significant at baseline. Both OCPD diagnosis and greater OCPD severity predicted worse EX/RP outcome, controlling for baseline OCD severity, Axis I and II comorbidity, prior treatment, quality of life, and gender. When the individual OCPD criteria were tested separately, only perfectionism predicted worse treatment outcome, over and above the previously mentioned covariates. These findings highlight the importance of assessing OCPD and suggest a need to directly address OCPD-related traits, especially perfectionism, in the context of EX/RP to minimize their interference in outcome. Copyright © 2011 Elsevier Ltd. All rights reserved.

Obsessive Compulsive Personality Disorder as a Predictor of Exposure and Ritual Prevention Outcome for Obsessive Compulsive Disorder

PubMed Central

Pinto, Anthony; Liebowitz, Michael R.; Foa, Edna B.; Simpson, H. Blair

2011-01-01

Despite elevated rates of obsessive compulsive personality disorder (OCPD) in patients with obsessive compulsive disorder (OCD), no study has specifically examined comorbid OCPD as a predictor of exposure and ritual prevention (EX/RP) outcome. Participants were adult outpatients (n = 49) with primary OCD and a Yale-Brown Obsessive Compulsive Scale (YBOCS) total score ≥ 16 despite a therapeutic serotonin reuptake inhibitor dose for at least 12 weeks prior to entry. Participants received 17 sessions of EX/RP over 8 weeks. OCD severity was assessed with the YBOCS pre- and post-treatment by independent evaluators. At baseline, 34.7% of the OCD sample met criteria for comorbid DSM-IV OCPD, assessed by structured interview. OCPD was tested as a predictor of outcome both as a diagnostic category and as a dimensional score (severity) based on the total number of OCPD symptoms coded as present and clinically significant at baseline. Both OCPD diagnosis and greater OCPD severity predicted worse EX/RP outcome, controlling for baseline OCD severity, Axis I and II comorbidity, prior treatment, quality of life, and gender. When the individual OCPD criteria were tested separately, only perfectionism predicted worse treatment outcome, over and above the previously mentioned covariates. These findings highlight the importance of assessing OCPD and suggest a need to directly address OCPD-related traits, especially perfectionism, in the context of EX/RP to minimize their interference in outcome. PMID:21600563

Differential diagnosis between obsessive compulsive disorder and restrictive and repetitive behavioural patterns, activities and interests in autism spectrum disorders.

PubMed

Paula-Pérez, Isabel

2013-01-01

The obsessive compulsive disorder (OCD) and the restricted and repetitive patterns of behavior, interests and activities inherent to autism spectrum disorders (ASD) share a number of features that can make the differential diagnosis between them extremely difficult and lead to erroneous overdiagnosis of OCD in people with autism. In both cases there may appear to have a fixation on routine, ritualized patterns of verbal and nonverbal behavior, resistance to change, and highly restrictive interests, which becomes a real challenge for differentiating rituals, stereotypes and adherence to routines in ASD from obsessions and compulsions in OCD. This article provides key points to clarify this differential diagnosis through the analysis of emotional valence, content, function and psychological theories that explain the obsessions and compulsions in OCD, and the desire for sameness, stereotyped movements and limited interest in autism. The terms "obsession" and "compulsion" should no longer be used when referring to patterns of behavior, interests or restricted and repetitive activities in autism due to syntonic characteristics, low perception of personal responsibility and low neutralizing efforts. Treatment focuses on changing the environment, the use of socio-communicative compensatory strategies and behavioral modification techniques to improve cognitive and behavioral flexibility. When there is comorbidity between, exposure behavioral and response prevention techniques are then used, followed by others of more cognitive orientation if necessary. Copyright © 2012 SEP y SEPB. Published by Elsevier Espana. All rights reserved.

Taboo thoughts and doubt/checking: a refinement of the factor structure for obsessive-compulsive disorder symptoms.

PubMed

Pinto, Anthony; Eisen, Jane L; Mancebo, Maria C; Greenberg, Benjamin D; Stout, Robert L; Rasmussen, Steven A

2007-06-30

The purpose of this report was to improve upon earlier factor analyses of obsessive-compulsive disorder (OCD) symptom categories by minimizing the heterogeneity in the aggressive obsessions category. An exploratory factor analysis was conducted on data from 293 adults with primary OCD. The resulting five factors (Symmetry/Ordering, Hoarding, Doubt/Checking, Contamination/Cleaning, and Taboo Thoughts) are phenomenologically more homogeneous than prior category-based factors and are consistent with those derived in previous item-level analyses.

Dissociative absorption, mind-wandering, and attention-deficit symptoms: Associations with obsessive-compulsive symptoms.

PubMed

Soffer-Dudek, Nirit

2018-06-05

Dissociative absorption is a tendency to become absorbed in imagination or in an external stimulus (movie, book) to the point of obliviousness to one's surroundings and reduced self-awareness. It has been hypothesized to play a role in the maintenance of obsessive-compulsive (OC) symptoms. However, because absorption is a trait of reduced attentional control, a possible confound may be attention-deficit/hyperactivity (ADHD) symptoms, which have been reported to be comorbid with obsessive-compulsive disorder (OCD). This study aimed to validate dissociative absorption as unique from ADHD symptoms as well as from mind-wandering and to show that it has incremental predictive value over these constructs in predicting OC symptoms. Cross-sectional. Three-hundred and three undergraduate students completed online questionnaires, which were analysed using exploratory and confirmatory factor analyses. As hypothesized, dissociative absorption emerged as a unique construct, separate from ADHD, and mind-wandering (whereas the latter two were not completely separate from each other). Additionally, absorption was uniquely associated with OC symptoms, with a moderate-to-strong effect size, demonstrating incremental predictive value over the other constructs. Attentional deficits and mind-wandering cannot account for the association between absorption and OC symptoms. Future research should explore whether reports of comorbidity between ADHD and OC symptoms may be inflated due to misdiagnosis of absorption tendencies as ADHD. Dissociative absorption is a personality tendency that may interact with obsessive-compulsive symptoms, and thus, it may deserve clinical attention when treating obsessive-compulsive disorder (OCD) Dissociative absorption might bring about an unnecessary diagnosis of attention-deficit hyperactivity disorder (ADHD) in individuals with obsessive-compulsive symptoms, and thus, it should be screened for. This study was based on a non-clinical sample; future studies should replicate the findings among samples with an OCD diagnosis. This study is based on self-report questionnaires; future studies should use clinician interviews. © 2018 The British Psychological Society.

Scrupulosity: a unique subtype of obsessive-compulsive disorder.

PubMed

Greenberg, David; Huppert, Jonathan D

2010-08-01

The earliest descriptions of obsessive-compulsive disorder (OCD) were religious, as was the understanding of their origins. With the emancipation, religion in OCD was relegated to its status today: a less common symptom of OCD in most Western societies known as scrupulosity. The frequency of scrupulosity in OCD varies in the literature from 0% to 93% of cases, and this variability seems predicated on the importance of religious belief and observance in the community examined. Despite the similarities between religious ritual and compulsions, the evidence to date that religion increases the risk of the development of OCD is scarce. Scrupulosity is presented as a classic version of OCD, with obsessions and compulsions, distress, and diminished functioning similar to those of other forms of OCD. The differentiation between normal religiosity and scrupulosity is presented, and the unique aspects of cognitive-behavioral therapy in treating scrupulosity, especially in religious populations, are reviewed.

Obsessive compulsive and related disorders: comparing DSM-5 and ICD-11.

PubMed

Marras, Anna; Fineberg, Naomi; Pallanti, Stefano

2016-08-01

Obsessive-compulsive disorder (OCD) has been recognized as mainly characterized by compulsivity rather than anxiety and, therefore, was removed from the anxiety disorders chapter and given its own in both the American Psychiatric Association (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the Beta Draft Version of the 11th revision of the World Health Organization (WHO) International Classification of Diseases (ICD-11). This revised clustering is based on increasing evidence of common affected neurocircuits between disorders, differently from previous classification systems based on interrater agreement. In this article, we focus on the classification of obsessive-compulsive and related disorders (OCRDs), examining the differences in approach adopted by these 2 nosological systems, with particular attention to the proposed changes in the forthcoming ICD-11. At this stage, notable differences in the ICD classification are emerging from the previous revision, apparently converging toward a reformulation of OCRDs that is closer to the DSM-5.

Five-Year Course of Obsessive-Compulsive Disorder: Predictors of Remission and Relapse

PubMed Central

Eisen, Jane L.; Sibrava, Nicholas J.; Boisseau, Christina L.; Mancebo, Maria C.; Stout, Robert L.; Pinto, Anthony; Rasmussen, Steven A.

2014-01-01

Background Obsessive-compulsive disorder (OCD) is a heterogeneous and disabling condition; however, no studies have examined symptom categories or subtypes as predictors of long-term clinical course in adults with primary OCD. Method A total of 213 adults with DSM-IV OCD were recruited from several mental health treatment sites between July 2001 and February 2006 as part of the Brown Longitudinal Obsessive Compulsive Study, a prospective, naturalistic study of treatment-seeking adults with primary OCD. OCD symptoms were assessed annually over the 5-year follow-up period using the Longitudinal Interval Follow-Up Evaluation. Results Thirty-nine percent of participants experienced either a partial (22.1%) or a full (16.9%) remission. Two OCD symptom dimensions impacted remission. Participants with primary obsessions regarding overresponsibility for harm were nearly twice as likely to experience a remission (P < .05), whereas only 2 of 21 participants (9.5%) with primary hoarding achieved remission. Other predictors of increased remission were lower OCD severity (P < .0001) and shorter duration of illness (P < .0001). Fifty-nine percent of participants who remitted subsequently relapsed. Participants with obsessive-compulsive personality disorder were more than twice as likely to relapse (P < .005). Participants were also particularly vulnerable to relapse if they experienced partial remission versus full remission (70% vs 45%; P < .05). Conclusions The contributions of OCD symptom categories and comorbid obsessive-compulsive personality disorder are critically important to advancing our understanding of the prognosis and ultimately the successful treatment of OCD. Longer duration of illness was also found to be a significant predictor of course, highlighting the critical importance of early detection and treatment of OCD. Furthermore, having full remission as a treatment target is an important consideration for the prevention of relapse in this disorder. PMID:23561228

Clinical features of pure obsessive-compulsive disorder.

PubMed

Torres, Albina R; Shavitt, Roseli G; Torresan, Ricardo C; Ferrão, Ygor A; Miguel, Euripedes C; Fontenelle, Leonardo F

2013-10-01

Psychiatric comorbidity is the rule in obsessive-compulsive disorder (OCD); however, very few studies have evaluated the clinical characteristics of patients with no co-occurring disorders (non-comorbid or "pure" OCD). The aim of this study was to estimate the prevalence of pure cases in a large multicenter sample of OCD patients and compare the sociodemographic and clinical characteristics of individuals with and without any lifetime axis I comorbidity. A cross-sectional study with 955 adult patients of the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders (C-TOC). Assessment instruments included the Yale-Brown Obsessive-Compulsive Scale, the Dimensional Yale-Brown Obsessive-Compulsive Scale, The USP-Sensory Phenomena Scale and the Brown Assessment of Beliefs Scale. Comorbidities were evaluated using the Structured Clinical Interview for DSM-IV Axis I Disorders. Bivariate analyses were followed by logistic regression. Only 74 patients (7.7%) presented pure OCD. Compared with those presenting at least one lifetime comorbidity (881, 92.3%), non-comorbid patients were more likely to be female and to be working, reported less traumatic experiences and presented lower scores in the Y-BOCS obsession subscale and in total DY-BOCS scores. All symptom dimensions except contamination-cleaning and hoarding were less severe in non-comorbid patients. They also presented less severe depression and anxiety, lower suicidality and less previous treatments. In the logistic regression, the following variables predicted pure OCD: sex, severity of depressive and anxious symptoms, previous suicidal thoughts and psychotherapy. Pure OCD patients were the minority in this large sample and were characterized by female sex, less severe depressive and anxious symptoms, less suicidal thoughts and less use of psychotherapy as a treatment modality. The implications of these findings for clinical practice are discussed. Copyright © 2013 Elsevier Inc. All rights reserved.

Family accommodation in obsessive-compulsive disorder: Relation to symptom dimensions, clinical and family characteristics.

PubMed

Albert, Umberto; Bogetto, Filippo; Maina, Giuseppe; Saracco, Paola; Brunatto, Cinthia; Mataix-Cols, David

2010-09-30

Family accommodation is the term used to indicate the process whereby family members of patients with obsessive-compulsive disorder (OCD) assist or participate in the patients' rituals. Family accommodation is a relatively under-researched phenomenon in OCD but an important one because it may be predictive of poor treatment outcome. This study systematically examined several socio-demographic and clinical variables that are associated with family accommodation in a well-characterized sample of adult patients and their healthy family members. Experienced clinicians administered the Family Accommodation Scale (FAS) to 141 psychopathology-free family members cohabiting with 97 patients with OCD. The items of the FAS were first subjected to principal component analysis (PCA) and the resulting domains of family accommodation (Participation, Modification, and Distress and Consequences) introduced as dependent variables in a series of multiple regression models assessing the relationship between family accommodation domains and a wide range of clinical variables, including Axis I and II psychopathology and symptom dimensions derived from the Yale-Brown Obsessive-Compulsive Scale (YBOCS) Symptom Checklist. The results showed that family accommodation was common, with the provision of reassurance, participation in rituals and assisting the patient in avoidance being the most frequent practices (occurring on a daily basis in 47%, 35%, and 43% of family members, respectively). The PCA of the YBOCS Symptom Checklist yielded four symptom dimensions, which were identical to those previously identified in the international literature. Multiple linear regression analyses showed that a higher score on the contamination/washing symptom dimension and a positive family history for an anxiety disorder other than OCD (referring to a family member other than the participant in this study) predicted greater scores on several domains of family accommodation. Our study confirms that family accommodation is frequent and distressing in psychopathology-free family members cohabiting with adult OCD patients. Family accommodation is particularly frequent and distressing when the patient has prominent contamination/washing symptoms and/or when another family member has a history of an anxiety disorder. Such families may be more likely to benefit from family-based interventions but this remains to be tested in controlled trials. Copyright © 2009 Elsevier Ltd. All rights reserved.

Obsessive-compulsive personality disorder and behavioral disinhibition.

PubMed

Villemarette-Pittman, Nicole R; Stanford, Matthew S; Greve, Kevin W; Houston, Rebecca J; Mathias, Charles W

2004-01-01

Although obsessive-compulsive personality disorder (OCPD) is an Axis II diagnosis that is not commonly associated with behavioral disinhibition, the literature contains reports of occasional explosive aggressive outbursts. Existing explanations of OCPD etiology do not address the coexistence of compulsive and impulsive features witnessed in some subpopulations of patients. In this study, the authors present a compensatory theory of OCPD in an effort to explain clinical observations of an unexpectedly large number of OCPD diagnoses among patients clinic referred and self-referred for aggression problems.

Perceived quality of life in obsessive-compulsive disorder: related factors

PubMed Central

Rodriguez-Salgado, Beatriz; Dolengevich-Segal, Helen; Arrojo-Romero, Manuel; Castelli-Candia, Paola; Navio-Acosta, Mercedes; Perez-Rodriguez, Maria M; Saiz-Ruiz, Jeronimo; Baca-Garcia, Enrique

2006-01-01

Background Obsessive-compulsive disorder (OCD) affects young adults and has great impact on the social, emotional and work spheres. Methods We measured perceived quality of life (QOL) in OCD patients, in order to analyse socio-demographic and clinical factors that may be associated with QOL perception. 64 OCD outpatients were assessed with the Mini International Neuropsychiatric Interview for DSM-IV, the Yale-Brown Obsessions and Compulsions scale (Y-BOCS), Hamilton's depression scale and the SF-36 self-administered global QOL perception scale. Results We found a correlation among Hamilton's scale scores and all SF-36 subscales. The severity of the obsessive-compulsive disorder was correlated with all SF-36 subscales and with the highest scores in Hamilton's scale. The obsessions subscale was correlated to all SF-36 subscales, while the compulsions subscale was correlated only to social functioning, emotional role, mental health and vitality. Compulsions were not related to general health perception. There were significant differences between OCD patients and the Spanish general population in all SF-36 subscales except those related to physical health and pain. Gender, age, age of onset of the disorder, years of evolution and marital status of the patients did not significantly affect quality of life perception. Being employed was related to better scores in the subscale of physical role. Patients with medical comorbidity scored lower in the subscales of general health, social functioning and mental health. Patients with comorbid psychiatric disorders had worse scores in the subscales of pain, general health, social functioning and mental health. Conclusion Quality of life perception was different in OCD patients and the general population. Quality of life perception was related to severity of the disorder, physical and psychiatric comorbidity and employment status. PMID:16684346

A model-based analysis of decision making under risk in obsessive-compulsive and hoarding disorders.

PubMed

Aranovich, Gabriel J; Cavagnaro, Daniel R; Pitt, Mark A; Myung, Jay I; Mathews, Carol A

2017-07-01

Attitudes towards risk are highly consequential in clinical disorders thought to be prone to "risky behavior", such as substance dependence, as well as those commonly associated with excessive risk aversion, such as obsessive-compulsive disorder (OCD) and hoarding disorder (HD). Moreover, it has recently been suggested that attitudes towards risk may serve as a behavioral biomarker for OCD. We investigated the risk preferences of participants with OCD and HD using a novel adaptive task and a quantitative model from behavioral economics that decomposes risk preferences into outcome sensitivity and probability sensitivity. Contrary to expectation, compared to healthy controls, participants with OCD and HD exhibited less outcome sensitivity, implying less risk aversion in the standard economic framework. In addition, risk attitudes were strongly correlated with depression, hoarding, and compulsion scores, while compulsion (hoarding) scores were associated with more (less) "rational" risk preferences. These results demonstrate how fundamental attitudes towards risk relate to specific psychopathology and thereby contribute to our understanding of the cognitive manifestations of mental disorders. In addition, our findings indicate that the conclusion made in recent work that decision making under risk is unaltered in OCD is premature. Copyright © 2017 Elsevier Ltd. All rights reserved.

Obsessive-compulsive disorder

MedlinePlus

... of the obsessive thoughts. But this only provides short-term relief. Not doing the obsessive rituals can cause ... resolve inner conflicts. Outlook (Prognosis) OCD is a long-term (chronic) illness with periods of severe symptoms followed ...

A Randomized Clinical Trial of Acceptance and Commitment Therapy versus Progressive Relaxation Training for Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Twohig, Michael P.; Hayes, Steven C.; Plumb, Jennifer C.; Pruitt, Larry D.; Collins, Angela B.; Hazlett-Stevens, Holly; Woidneck, Michelle R.

2010-01-01

Objective: Effective treatments for obsessive-compulsive disorder (OCD) exist, but additional treatment options are needed. The effectiveness of 8 sessions of acceptance and commitment therapy (ACT) for adult OCD was compared with progressive relaxation training (PRT). Method: Seventy-nine adults (61% female) diagnosed with OCD (mean age = 37…

D-Cycloserine for Treatment Nonresponders with Obsessive-Compulsive Disorder: A Case Report

ERIC Educational Resources Information Center

Norberg, Melissa M.; Gilliam, Christina M.; Villavicencio, Anna; Pearlson, Godfrey D.; Tolin, David F.

2012-01-01

Despite being the most effective treatment available, as many as one third of patients who receive exposure and response prevention (ERP) for obsessive-compulsive disorder (OCD) do not initially respond to treatment. Recent research suggests that the n-methyl d-aspartate (NMDA) receptor partial agonist D-Cycloserine (DCS) may speed up the course…

Intensive Family-Based Cognitive-Behavioral Therapy for Pediatric Obsessive-Compulsive Disorder: Applications for Treatment of Medication Partial- or Nonresponders

ERIC Educational Resources Information Center

Marien, Wendi E.; Storch, Eric A.; Geffken, Gary R.; Murphy, Tanya K.

2009-01-01

Serotonin reuptake inhibitor medications and cognitive-behavioral therapy (CBT) are both effective treatments for pediatric obsessive-compulsive disorder (OCD). Despite recommendations that youth with OCD be treated with CBT alone or together with serotonin reuptake inhibitor medication, many youth are treated with medication alone or with non-CBT…

Recent Advances in the Study of Sleep in the Anxiety Disorders, Obsessive-Compulsive Disorder, and Posttraumatic Stress Disorder.

PubMed

Boland, Elaine M; Ross, Richard J

2015-12-01

Sleep disturbance is frequently associated with generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, and posttraumatic stress disorder. This article reviews recent advances in understanding the mechanisms of the sleep disturbances in these disorders and discusses the implications for developing improved treatments. Published by Elsevier Inc.

Early-Onset Obsessive-Compulsive Disorder: A Subgroup with a Specific Clinical and Familial Pattern?

ERIC Educational Resources Information Center

Chabane, Nadia; Delorme, Richard; Millet, Bruno; Mouren, Marie-Christine; Leboyer, Marion; Pauls, David

2005-01-01

Background: The familial nature of obsessive-compulsive disorder (OCD) has been previously demonstrated. The identification of candidate symptoms such as age at onset may help to disentangle the clinical and genetic heterogeneity of the disorder. In this study, the specificity of early-onset OCD was investigated, focusing on the effect of gender,…

Streptococcal infections of skin and PANDAS.

PubMed

Carelli, Rosanna; Pallanti, Stefano

2014-01-01

Group A streptococcal infections are associated with a variety of infections and a subset of obsessive-compulsive disorder and/or tic disorders. Screening of obsessive-compulsive symptoms and tics in patient with streptococcal infection of skin must be effective in identifying subjects who met published criteria for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS). © 2013 Wiley Periodicals, Inc.

Patient Adherence Predicts Outcome from Cognitive Behavioral Therapy in Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Simpson, Helen Blair; Maher, Michael J.; Wang, Yuanjia; Bao, Yuanyuan; Foa, Edna B.; Franklin, Martin

2011-01-01

Objective: To examine the effects of patient adherence on outcome from exposure and response prevention (EX/RP) therapy in adults with obsessive-compulsive disorder (OCD). Method: Thirty adults with OCD were randomized to EX/RP (n = 15) or EX/RP augmented by motivational interviewing strategies (n = 15). Both treatments included 3 introductory…

Insight into Obsessive-Compulsive Symptoms and Awareness of Illness in Adolescent Schizophrenia Patients with and without OCD

ERIC Educational Resources Information Center

Faragian, Sarit; Kurs, Rena; Poyurovsky, Michael

2008-01-01

A substantial proportion of adolescent schizophrenia patients also has obsessive-compulsive disorder (OCD). As the reliability of OCD identification in schizophrenia has been challenged, we evaluated insight into OCD symptoms and awareness of schizophrenia, using the Brown Assessment of Beliefs Scale and the Scale to Assess Unawareness of Mental…

Treatment of Pediatric Obsessive Compulsive Disorder Utilizing Parent-Facilitated Acceptance and Commitment Therapy

ERIC Educational Resources Information Center

Barney, Jennifer Y.; Field, Clint E.; Morrison, Kate L.; Twohig, Michael P.

2017-01-01

Acceptance and commitment therapy (ACT) is a modern form of cognitive behavior therapy that uses acceptance and mindfulness-based procedures to address clinical issues. A brief protocol of ACT was used with 3 children ages 10 and 11 years who were diagnosed with obsessive compulsive disorder (OCD). Results showed notable and clinically significant…

Family-Based Cognitive-Behavioral Therapy for Pediatric Obsessive-Compulsive Disorder: Comparison of Intensive and Weekly Approaches

ERIC Educational Resources Information Center

Storch, Eric A.; Geffken, Gary R.; Merlo, Lisa J.; Mann, Giselle; Duke, Danny; Munson, Melissa; Adkins, Jennifer; Grabill, Kristen M.; Murphy, Tanya K.; Goodman, Wayne K.

2007-01-01

Objective: To examine the relative efficacy of intensive versus weekly cognitive-behavioral therapy (CBT) for children and adolescents with obsessive-compulsive disorder (OCD). Method: Forty children and adolescents with OCD (range 7-17 years) were randomized to receive 14 sessions of weekly or intensive (daily psychotherapy sessions) family-based…

Neither Saints nor Wolves in Disguise: Ambivalent Interpersonal Attitudes and Behaviors in Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Moritz, Steffen; Wahl, Karina; Ertle, Andrea; Jelinek, Lena; Hauschildt, Marit; Klinge, Ruth; Hand, Iver

2009-01-01

Inflated responsibility is ascribed a pivotal role in the pathogenesis of obsessive-compulsive disorder (OCD). The aim of the study was to assess interpersonal attitudes and behaviors contributing to enhanced responsibility in OCD. In particular, we tested the hypothesis that individuals diagnosed with OCD share stronger latent aggression toward…

Psychosocial Stress Predicts Future Symptom Severities in Children and Adolescents with Tourette Syndrome and/or Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Lin, Haiqun; Katsovich, Liliya; Ghebremichael, Musie; Findley, Diane B.; Grantz, Heidi; Lombroso, Paul J.; King, Robert A.; Zhang, Heping; Leckman, James F.

2007-01-01

Background: The goals of this prospective longitudinal study were to monitor levels of psychosocial stress in children and adolescents with Tourette syndrome (TS) and/or obsessive-compulsive disorder (OCD) compared to healthy control subjects and to examine the relationship between measures of psychosocial stress and fluctuations in tic,…

Error-Related Negativity and Tic History in Pediatric Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Hanna, Gregory L.; Carrasco, Melisa; Harbin, Shannon M.; Nienhuis, Jenna K.; LaRosa, Christina E.; Chen, Poyu; Fitzgerald, Kate D.; Gehring, William J.

2012-01-01

Objective: The error-related negativity (ERN) is a negative deflection in the event-related potential after an incorrect response, which is often increased in patients with obsessive-compulsive disorder (OCD). However, the relation of the ERN to comorbid tic disorders has not been examined in patients with OCD. This study compared ERN amplitudes…

Family Factors Predict Treatment Outcome for Pediatric Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Peris, Tara S.; Sugar, Catherine A.; Bergman, R. Lindsey; Chang, Susanna; Langley, Audra; Piacentini, John

2012-01-01

Objective: To examine family conflict, parental blame, and poor family cohesion as predictors of treatment outcome for youths receiving family-focused cognitive behavioral therapy (FCBT) for obsessive-compulsive disorder (OCD). Method: We analyzed data from a sample of youths who were randomized to FCBT (n = 49; 59% male; M age = 12.43 years) as…

Autism and ADHD Symptoms in Patients with OCD: Are They Associated with Specific OC Symptom Dimensions or OC Symptom Severity?

ERIC Educational Resources Information Center

Anholt, Gideon E.; Cath, Danielle C.; van Oppen, Patricia; Eikelenboom, Merijn; Smit, Johannes H.; van Megen, Harold; van Balkom, Anton J. L. M.

2010-01-01

In obsessive-compulsive disorder (OCD), the relationship between autism spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD) symptom, and obsessive-compulsive (OC) symptom dimensions and severity has scarcely been studied. Therefore, 109 adult outpatients with primary OCD were compared to 87 healthy controls on OC, ADHD and…

Obsessive-compulsive disorder with bipolar diathesis following isotretinoin therapy remitting upon treatment with olanzapine and fluvoxamine

PubMed Central

Fornaro, Michele

2010-01-01

Isotretinoin, a drug used for moderate to severe acne, has been repeatedly associated with various psychiatric complications, although a definitive causal relationship has not been established to date. This case report describes a 25-year-old male who developed obsessive-compulsive disorder at the age of 23 years following isotretinoin treatment for acne (10–20 mg/day) since the age of 16 years. Although standard treatment for obsessive-compulsive disorder caused mood swings, the combination of fluvoxamine 300 mg/day and olanzapine 15 mg/day significantly improves the clinical picture. Although rare, severe adulthood psychiatric complications may occur following isotretinoin treatment, requiring management which is individually tailored to the patient. PMID:21127690

On the nature of obsessions and compulsions.

PubMed

de Haan, Sanneke; Rietveld, Erik; Denys, Damiaan

2013-01-01

In this chapter, we give an overview of current and historical conceptions of the nature of obsessions and compulsions. We discuss some open questions pertaining to the primacy of the affective, volitional or affective nature of obsessive-compulsive disorder. Furthermore, we add some phenomenological suggestions of our own. In particular, we point to the patients' need for absolute certainty and the lack of trust underlying this need. Building on insights from Wittgenstein, we argue that the kind of certainty the patients strive for is unattainable in principle via the acquisition of factual knowledge. Moreover, we suggest that the patients' attempts to attain certainty are counter-productive as their excessive conscious control in fact undermines the trust they need. Copyright © 2013 S. Karger AG, Basel.

Differences in clinical intrusive thoughts between obsessive-compulsive disorder, generalized anxiety disorder, and hypochondria.

PubMed

Romero-Sanchiz, Pablo; Nogueira-Arjona, Raquel; Godoy-Ávila, Antonio; Gavino-Lázaro, Aurora; Freeston, Mark H

2017-11-01

Differences and similarities between intrusive thoughts typical of obsessive-compulsive disorder, generalized anxiety disorder, and hypochondriasis are relevant for their differential diagnosis, formulation, and psychological treatment. Previous research in non-clinical samples pointed out the relevance of some process variables, such as responsibility, guilt, or neutralization strategies. This research is aimed to investigate the differences and similarities between clinical obsessions, worries, and illness intrusions in some of these process variables. A second aim is to identify models based on these variables that could reliably differentiate between them. Three groups of patients with obsessive-compulsive disorder (n = 35; 60% women, mean age 38.57), generalized anxiety disorder (n = 36; 61.1% women, mean age 41.50), and hypochondriasis (n = 34; 70.6% women, mean age 31.59) were evaluated using the Cognitive Intrusions Questionnaire-Transdiagnostic Version (Romero-Sanchiz, Nogueira-Arjona, Godoy-Ávila, Gavino-Lázaro, & Freeston, ). The results showed that some appraisals (e.g., responsibility or egodystonicity), emotions (e.g., guilt or insecurity), neutralization strategies, and other variables (e.g., verbal content or trigger from body sensation) are relevant for the discrimination between obsessions, worries, and illness intrusions. The results also showed 3 stable models based on these variables for the discrimination between these thoughts. The implication of these results in the diagnosis, formulation, and psychological treatment of obsessive-compulsive disorder, generalized anxiety disorder, and hypochondriasis is discussed. Copyright © 2017 John Wiley & Sons, Ltd.

Anomalous basal ganglia connectivity and obsessive–compulsive behaviour in patients with Prader Willi syndrome

PubMed Central

Pujol, Jesus; Blanco-Hinojo, Laura; Esteba-Castillo, Susanna; Caixàs, Assumpta; Harrison, Ben J.; Bueno, Marta; Deus, Joan; Rigla, Mercedes; Macià, Dídac; Llorente-Onaindia, Jone; Novell-Alsina, Ramón

2016-01-01

Background Prader Willi syndrome is a genetic disorder with a behavioural expression characterized by the presence of obsessive–compulsive phenomena ranging from elaborate obsessive eating behaviour to repetitive skin picking. Obsessive–compulsive disorder (OCD) has been recently associated with abnormal functional coupling between the frontal cortex and basal ganglia. We have tested the potential association of functional connectivity anomalies in basal ganglia circuits with obsessive–compulsive behaviour in patients with Prader Willi syndrome. Methods We analyzed resting-state functional MRI in adult patients and healthy controls. Whole-brain functional connectivity maps were generated for the dorsal and ventral aspects of the caudate nucleus and putamen. A selected obsessive–compulsive behaviour assessment included typical OCD compulsions, self picking and obsessive eating behaviour. Results We included 24 adults with Prader Willi syndrome and 29 controls in our study. Patients with Prader Willi syndrome showed abnormal functional connectivity between the prefrontal cortex and basal ganglia and within subcortical structures that correlated with the presence and severity of obsessive–compulsive behaviours. In addition, abnormally heightened functional connectivity was identified in the primary sensorimotor cortex–putamen loop, which was strongly associated with self picking. Finally, obsessive eating behaviour correlated with abnormal functional connectivity both within the basal ganglia loops and between the striatum and the hypothalamus and the amygdala. Limitations Limitations of the study include the difficulty in evaluating the nature of content of obsessions in patients with Prader Willi Syndrome and the risk of excessive head motion artifact on brain imaging. Conclusion Patients with Prader Willi syndrome showed broad functional connectivity anomalies combining prefrontal loop alterations characteristic of OCD with 1) enhanced coupling in the primary sensorimotor loop that correlated with the most impulsive aspects of the behaviour and 2) reduced coupling of the ventral striatum with limbic structures for basic internal homeostasis that correlated with the obsession to eat. PMID:26645739

Autogenous and reactive obsessions: further evidence for a two-factor model of obsessions.

PubMed

Moulding, Richard; Kyrios, Michael; Doron, Guy; Nedeljkovic, Maja

2007-01-01

Obsessive-compulsive disorder is a highly disabling anxiety disorder, characterized by occurrence of intrusive and unwanted thoughts (obsessions), which lead to performance of repetitive compulsions and/or rituals in order to reduce distress. Recently, it has been proposed that obsessions may be divided into two categories, termed autogenous and reactive obsessions [Lee, H.-J., & Kwon, S.-M. (2003). Two different types of obsessions: autogenous obsessions and reactive obsessions. Behavior Research and Therapy, 41, 11-29]. In this study, we aimed to further validate this subtyping of obsessions, and to investigate the cognitive and emotional correlates of the subtypes. Evidence was found for the division, using a confirmatory factor analysis in an analogue sample (N=372). It was found that frequency of reactive obsessions related more strongly to distress caused by overt OC symptoms (e.g., washing, checking), whereas frequency of autogenous obsessions related to distress from impulses of harm. Compared to autogenous obsessions, frequency of reactive obsessions correlated more strongly with all OC-related beliefs. Few differences were found between autogenous and reactive obsessions with respect to depression, anxiety, and view about self (self-ambivalence, self-esteem). It is suggested that existing OC-belief measures are more relevant to reactive obsessions. Implications for theory and treatment are discussed.

Prevalence, sociodemographic factors, psychological distress, and coping strategies related to compulsive buying: a cross sectional study in Galicia, Spain

PubMed Central

2014-01-01

Background Compulsive buying has become a serious problem affecting a growing number of people in contemporary consumer societies. Nevertheless, research examining its prevalence in representative samples from the general population is still scarce and mainly focused on the exploration of sociodemographic factors, neglecting other aspects like psychological distress and coping styles. Therefore, this study intends to contribute to the cumulative knowledge by assessing compulsive buying prevalence in a representative sample from the general population in the region of Galicia, in Spain. Sociodemographic determinants, psychological symptoms, and coping strategies are also analyzed to clarify their role in this phenomenon. Methods A random routes procedure was employed in the recruitment of the sample which was comprised of 2159 participants who were classified as either compulsive buyers or non-compulsive buyers. Both groups were compared regarding sociodemographic determinants, symptoms, and coping strategies through chi-square tests or analyses of variance. A multivariate logistic regression analysis was conducted to determine which of these determinants might play a part in the make up of a risk profile for compulsive buying. Results Estimated prevalence of compulsive buying was 7.1%. Compulsive buyers and non-compulsive buyers differed significantly in sex and age, with women and younger people showing a higher propensity for this phenomenon. Individuals with compulsive buying presented significantly higher scores on all the psychological symptoms considered. They also employed passive-avoidance coping strategies much more frequently and active strategies of problem solving and cognitive restructuring much less frequently. The logistic regression analysis results confirmed that being female, experiencing symptoms of anxiety, depression, and obsession-compulsion, and employing the passive-avoidance coping strategies of problem avoidance, wishful thinking, and self-criticism, all constituted risk factors for compulsive buying, whilst the increased age and the use of the active coping strategies of problem solving and cognitive restructuring were protection factors. Conclusions Our findings revealed a substantial prevalence of compulsive buying. Additionally, the relevance of sociodemographic determinants, psychological distress, and coping strategies in this problem was confirmed. The establishment of a risk profile for compulsive buying based on these different sets of determinants would likely contribute to the development of more effective intervention programs. PMID:24708814

Pathological gambling and compulsive buying: do they fall within an obsessive-compulsive spectrum?

PubMed Central

Black, Donald W.; Shaw, Martha; Blum, Nancee

2010-01-01

Both compulsive buying (CB) and pathological gambling (PG) have been proposed as members of a spectrum of disorders related to obsessive-compulsive disorder (OCD). The spectrum hypothesis originated in the early 1990s and has gained considerable support, despite the lack of empirical evidence. Interest in this hypothesis has become critical because some investigators have recommended the creation of a new category that includes these disorders in DSM-5, now under development. In this article, the authors describe the origin of the obsessive-compulsive (OC) spectrum and its theoretical underpinnings, review both CB and PG, and discuss the data both in support of and against an OC spectrum. Both disorders are described in terms of their history, definition, classification, phenomenology, family history, pathophysiology, and clinical management. The authors conclude that: (i) CB and PG are probably not related to OCD, and there is insufficient evidence to place them within an OC spectrum in DSM-V; (ii) PG should stay with the impulse-control disorders (ICDs); and ( iii) a new diagnosis of CB should be created and be classified as an ICD. PMID:20623922

The appraisal of intrusive thoughts in relation to obsessional-compulsive symptoms.

PubMed

Barrera, Terri L; Norton, Peter J

2011-01-01

Research has shown that although intrusive thoughts occur universally, the majority of individuals do not view intrusive thoughts as being problematic (Freeston, Ladouceur, Thibodeau, & Gagnon, 1991; Rachman & de Silva, 1978; Salkovskis & Harrison, 1984). Thus, it is not the presence of intrusive thoughts that leads to obsessional problems but rather some other factor that plays a role in the development of abnormal obsessions. According to the cognitive model of obsessive-compulsive disorder (OCD) put forth by Salkovskis (1985), the crucial factor that differentiates between individuals with OCD and those without is the individual's appraisal of the naturally occurring intrusive thoughts. This study aimed to test Salkovskis's model by examining the role of cognitive biases (responsibility, thought-action fusion, and thought control) as well as distress in the relationship between intrusive thoughts and obsessive-compulsive symptoms in an undergraduate sample of 326 students. An existing measure of intrusive thoughts (the Revised Obsessional Intrusions Inventory) was modified for this study to include a scale of distress associated with each intrusive thought in addition to the current frequency scale. When the Yale-Brown Obsessive-Compulsive Scale was used as the measure of OCD symptoms, a significant interaction effect of frequency and distress of intrusive thoughts resulted. Additionally, a significant three-way interaction of Frequency × Distress × Responsibility was found when the Obsessive Compulsive Inventory-Revised was used as the measure of OCD symptoms. These results indicate that the appraisal of intrusive thoughts is important in predicting OCD symptoms, thus providing support for Salkovskis's model of OCD.

Early onset obsessive-compulsive disorder with and without tics.

PubMed

de Mathis, Maria Alice; Diniz, Juliana B; Shavitt, Roseli G; Torres, Albina R; Ferrão, Ygor A; Fossaluza, Victor; Pereira, Carlos; Miguel, Eurípedes; do Rosario, Maria Conceicão

2009-07-01

Research suggests that obsessive-compulsive disorder (OCD) is not a unitary entity, but rather a highly heterogeneous condition, with complex and variable clinical manifestations. The aims of this study were to compare clinical and demographic characteristics of OCD patients with early and late age of onset of obsessive-compulsive symptoms (OCS); and to compare the same features in early onset OCD with and without tics. The independent impact of age at onset and presence of tics on comorbidity patterns was investigated. Three hundred and thirty consecutive outpatients meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for OCD were evaluated: 160 patients belonged to the "early onset" group (EOG): before 11 years of age, 75 patients had an "intermediate onset" (IOG), and 95 patients were from the "late onset" group (LOG): after 18 years of age. From the 160 EOG, 60 had comorbidity with tic disorders. The diagnostic instruments used were: the Yale-Brown Obsessive Compulsive Scale and the Dimensional Yale-Brown Obsessive Compulsive Scale (DY-BOCS), Yale Global Tics Severity Scale, and Structured Clinical Interview for DSM-IV Axis I Disorders-patient edition. Statistical tests used were: Mann-Whitney, full Bayesian significance test, and logistic regression. The EOG had a predominance of males, higher frequency of family history of OCS, higher mean scores on the "aggression/violence" and "miscellaneous" dimensions, and higher mean global DY-BOCS scores. Patients with EOG without tic disorders presented higher mean global DY-BOCS scores and higher mean scores in the "contamination/cleaning" dimension. The current results disentangle some of the clinical overlap between early onset OCD with and without tics.

Neuropsychological Functioning in Obsessive-Compulsive Washers: Drug-Naive Without Depressive Symptoms.

PubMed

Saremi, Ali Akbar; Shariat, Seyed Vahid; Nazari, Mohammad Ali; Dolatshahi, Behrooz

2017-01-01

Obsessive-Compulsive Disorder (OCD) is a complex and heterogeneous neuropsychiatric syndrome. Contamination obsessions and washing/cleaning compulsions are the most frequent clinical OCD subtypes. The current study aimed at examining the neuropsychological impairments in drug-naive obsessive-compulsive (OC) washers without depressive symptoms and their association with the severity of symptoms. In the current causal-comparative study, 35 patients with diagnostic and statistical mental disorders class (DSM)-IV diagnosed with washing-subtype OCD and 35 healthy subjects were selected by the convenience sampling method and evaluated by computerized neuropsychology battery and clinical tests as Stroop Color-Word Test (SCWT), Wisconsin Card Sorting Test (WCST), Go/No-Go Test, Digits Forward (DF), Digits Backward (DB), Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and General Health Questionnaire (GHQ)-28. The patients were matched to the comparison group with regard to age, gender, intelligence quotient (IQ), education, and handedness. All the tests were standardized in Iran. SPSS version 20.00 was used for descriptive and analytical data analysis. There was no statistically significant different between the OCD washing and the control groups regarding socio-demographic variables or IQ. There were significant differences between the OC washer and the healthy control groups on the neuropsychological functioning. The obtained results suggested that OC washers performed significantly worse on neuropsychological measures than the controls. There was no significant association between the severity of OC symptoms and the neuropsychological functions in the OCD washing group. It was concluded that executive function impairment, which is a core feature in OC washers was trait-like in nature.

Relationship between symptom dimensions and brain morphology in obsessive-compulsive disorder.

PubMed

Hirose, Motohisa; Hirano, Yoshiyuki; Nemoto, Kiyotaka; Sutoh, Chihiro; Asano, Kenichi; Miyata, Haruko; Matsumoto, Junko; Nakazato, Michiko; Matsumoto, Koji; Masuda, Yoshitada; Iyo, Masaomi; Shimizu, Eiji; Nakagawa, Akiko

2017-10-01

Obsessive-compulsive disorder (OCD) is known as a clinically heterogeneous disorder characterized by symptom dimensions. Although substantial numbers of neuroimaging studies have demonstrated the presence of brain abnormalities in OCD, their results are controversial. The clinical heterogeneity of OCD could be one of the reasons for this. It has been hypothesized that certain brain regions contributed to the respective obsessive-compulsive dimensions. In this study, we investigated the relationship between symptom dimensions of OCD and brain morphology using voxel-based morphometry to discover the specific regions showing alterations in the respective dimensions of obsessive-compulsive symptoms. The severities of symptom dimensions in thirty-three patients with OCD were assessed using Obsessive-Compulsive Inventory-Revised (OCI-R). Along with numerous MRI studies pointing out brain abnormalities in autistic spectrum disorder (ASD) patients, a previous study reported a positive correlation between ASD traits and regional gray matter volume in the left dorsolateral prefrontal cortex and amygdala in OCD patients. We investigated the correlation between gray and white matter volumes at the whole brain level and each symptom dimension score, treating all remaining dimension scores, age, gender, and ASD traits as confounding covariates. Our results revealed a significant negative correlation between washing symptom dimension score and gray matter volume in the right thalamus and a significant negative correlation between hoarding symptom dimension score and white matter volume in the left angular gyrus. Although our result was preliminary, our findings indicated that there were specific brain regions in gray and white matter that contributed to symptom dimensions in OCD patients.

Compulsive buying in outline.

PubMed

Zadka, Łukasz; Olajossy, Marcin

2016-01-01

In spite of a hundred year long history of scientific research compulsive buying has been a hardly known phenomenon until today. Ambiguous scientific information makes it impossible to classify compulsive buying as a separate mental disorder. Recently many researchers have noticed phenomenological compatibility of compulsive buying with behavioural addictions. Nowadays, there is reasonable grounds that compulsive buying disorder can be defined as an addiction. There are many similarities occurring between a consumer type behaviours in compulsive buyers and a pathologic consumption of psychoactive substances which included the obsessive need to consumer or a compulsion to consume, personal dependence and loss of control over self-behaviour, as well as tendencies to the consumption increase. Compulsive buying disorder differs in its course from the compulsive behaviours. A strong compulsion to make a given activity, often impossible to restrain is associated with overwhelming but acceptable desire to purchase a specific item. Due to the latest information about the described phenomenon, it has been decided to present current knowledge of adequate classifications, epidemiology and therapy of compulsive buyers. In the article authors' own standpoint as regards pathogenesis and potential risk factors was described.

The Genetics of Obsessive-Compulsive Disorder and Tourette Syndrome: An Epidemiological and Pathway-Based Approach for Gene Discovery

ERIC Educational Resources Information Center

Grados, Marco A.

2010-01-01

Objective: To provide a contemporary perspective on genetic discovery methods applied to obsessive-compulsive disorder (OCD) and Tourette syndrome (TS). Method: A review of research trends in genetics research in OCD and TS is conducted, with emphasis on novel approaches. Results: Genome-wide association studies (GWAS) are now in progress in OCD…

Genetic and Environmental Contributions to Self-Report Obsessive-Compulsive Symptoms in Dutch Adolescents at Ages 12, 14, and 16

ERIC Educational Resources Information Center

Van Grootheest, Daniel S.; Bartels, Meike; Van Beijsterveldt, Catarina E. M.; Cath, Danielle C.; Beekman, Aartjan T.; Hudziak, James J.; Boomsma, Dorret I.

2008-01-01

The involvement of genetic and environmental factors to the development of obsessive compulsion symptoms during the adolescent period is examined. Study revealed that individual differences in OC symptoms are heritable during puberty and shared environmental influences played a role only in the beginning of adolescence but no sex differences in…

Randomized Controlled Trial of Full and Brief Cognitive-Behaviour Therapy and Wait-List for Paediatric Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Bolton, Derek; Williams, Tim; Perrin, Sean; Atkinson, Linda; Gallop, Catherine; Waite, Polly; Salkovskis, Paul

2011-01-01

Background: Reviews and practice guidelines for paediatric obsessive-compulsive disorder (OCD) recommend cognitive-behaviour therapy (CBT) as the psychological treatment of choice, but note that it has not been sufficiently evaluated for children and adolescents and that more randomized controlled trials are needed. The aim of this trial was to…

Familiality of Tourette Syndrome, Obsessive-Compulsive Disorder, and Attention-Deficit/Hyperactivity Disorder: Heritability Analysis in a Large Sib-Pair Sample

ERIC Educational Resources Information Center

Mathews, Carol A.; Grados, Marco A.

2011-01-01

Objective: Tourette syndrome (TS) is a neuropsychiatric disorder with a genetic component that is highly comorbid with obsessive-compulsive disorder (OCD) and attention deficit/hyperactivity disorder (ADHD). However, the genetic relations between these disorders have not been clearly elucidated. This study examined the familial relations among TS,…

Sensitivity of the Modified Children's Yale-Brown Obsessive Compulsive Scale to Detect Change: Results from Two Multi-Site Trials

ERIC Educational Resources Information Center

Scahill, Lawrence; Sukhodolsky, Denis G.; Anderberg, Emily; Dimitropoulos, Anastasia; Dziura, James; Aman, Michael G.; McCracken, James; Tierney, Elaine; Hallett, Victoria; Katz, Karol; Vitiello, Benedetto; McDougle, Christopher

2016-01-01

Repetitive behavior is a core feature of autism spectrum disorder. We used 8-week data from two federally funded, multi-site, randomized trials with risperidone conducted by the Research Units on Pediatric Psychopharmacology Autism Network to evaluate the sensitivity of the Children's Yale-Brown Obsessive Compulsive Scale modified for autism…

[Obsessive-compulsive symptoms, tics, stereotypic movements or need for absolute consistency? The occurrence of repetitive activities in patients with pervasive developmental disorders--case studies].

PubMed

Bryńska, Anita; Lipińska, Elzbieta; Matelska, Monika

2011-01-01

Repetitive and stereotyped behaviours in the form of stereotyped interests or specific routine activities are one ofthe diagnostic criteria in pervasive developmental disorders. The occurrence of repetitive behaviours in patients with pervasive developmental disorders is a starting point for questions about the type and classification criteria of such behaviours. The aim of the article is to present case studies of patients with pervasive developmental disorders and co-morbid symptoms in the form of routine activities, tics, obsessive-compulsive symptoms or stereotyped behaviours. The first case study describes a patient with Asperger's syndrome and obsessive compulsive symptoms. The diagnostic problems regarding complex motor tics are discussed in the second case study which describes a patient with Asperger's syndrome and Gilles de la Tourette syndrome. The third and fourth case study describes mono-zygotic twins with so called High Functioning Autism whose repetitive activities point to either obsessive compulsive symptoms, stereotypic movements, need for absolute consistency or echopraxia. The possible comorbidity of pervasive developmental disorders and symptoms in the form of repetitive behaviours, possible interactions as well as diagnostic challenges is discussed in the article.

Lisdexamfetamine Dimesylate Effects on Binge Eating Behaviour and Obsessive-Compulsive and Impulsive Features in Adults with Binge Eating Disorder.

PubMed

McElroy, Susan L; Mitchell, James E; Wilfley, Denise; Gasior, Maria; Ferreira-Cornwell, M Celeste; McKay, Michael; Wang, Jiannong; Whitaker, Timothy; Hudson, James I

2016-05-01

In a published 11-week, placebo-controlled trial, 50 and 70 mg/d lisdexamfetamine dimesylate (LDX), but not 30 mg/d LDX, significantly reduced binge eating days (primary endpoint) in adults with binge eating disorder (BED). This report provides descriptions of LDX effects on secondary endpoints (Binge Eating Scale [BES]; Three-Factor Eating Questionnaire [TFEQ]; Yale-Brown Obsessive Compulsive Scale modified for Binge Eating [Y-BOCS-BE]; and the Barratt Impulsiveness Scale, version 11 [BIS-11]) from that study. Week 11 least squares mean treatment differences favoured all LDX doses over placebo on the BES (p ≤ 0.03), TFEQ Disinhibition and Hunger subscales (all p < 0.05), and Y-BOCS-BE total, obsessive, and compulsive scales (all p ≤ 0.02) and on BIS-11 total score at 70 mg/d LDX (p = 0.015) and the TFEQ Cognitive Restraint subscale at 30 and 70 mg/d LDX (both p < 0.05). These findings indicate that LDX decreased global binge eating severity and obsessive-compulsive and impulsive features of BED in addition to binge eating days. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

Childhood obsessive-compulsive traits in anorexia nervosa patients, their unaffected sisters and healthy controls: a retrospective study.

PubMed

Degortes, Daniela; Zanetti, Tatiana; Tenconi, Elena; Santonastaso, Paolo; Favaro, Angela

2014-07-01

Although there is evidence that childhood perfectionistic traits predate the onset of eating disorders, few studies to date have examined the prevalence and clinical correlates of these traits in patients with anorexia nervosa (AN) and their unaffected sisters. The aim of this work was to study the prevalence of childhood obsessive-compulsive traits in patients with lifetime AN, their unaffected sisters and healthy women. A total of 116 AN patients, 32 healthy sisters and 119 controls were assessed by the EATATE Interview to assess traits such as perfectionism, inflexibility, rule-bound traits, drive for order and symmetry, and excessive doubt and cautiousness. Both self-report and maternal reports were collected. AN patients reported more childhood obsessive-compulsive traits than their healthy sisters and controls. In contrast, no differences between healthy controls and unaffected sisters emerged. In patients with AN, a dose-response relationship was found between the number of childhood obsessive-compulsive traits and psychopathology, including body image distortion, thus indicating that these traits are an important feature to be considered in assessing and treating eating disorders. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

Early maladaptive schemas and suicidal risk in an Iranian sample of patients with obsessive-compulsive disorder.

PubMed

Khosravani, Vahid; Sharifi Bastan, Farangis; Samimi Ardestani, Mehdi; Jamaati Ardakani, Razieh

2017-09-01

There are few studies on suicidal risk and its related factors in patients diagnosed with obsessive-compulsive disorder (OCD). This study investigated the associations of early maladaptive schemas, OC symptom dimensions, OCD severity, depression and anxiety with suicidality (i.e., suicidal ideation and suicide attempts) in OCD patients. Sixty OCD outpatients completed the Scale for Suicide Ideation (SSI), the Young Schema Questionnaire-Short Form (YSQ-SF), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Dimensional Obsessive-Compulsive Scale (DOCS) and the Depression Anxiety Stress Scales (DASS-21). 51.7% of patients had lifetime suicide attempts and 75% had suicidal ideation. OCD patients with lifetime suicide attempts exhibited significantly higher scores on early maladaptive schemas than those without such attempts. Logistic regression analysis revealed that the mistrust/abuse schema and the OC symptom dimension of unacceptable thoughts explained lifetime suicide attempts. The mistrust/abuse schema, unacceptable thoughts and depression significantly predicted suicidal ideation. These findings indicated that the mistrust/abuse schema may contribute to high suicidality in OCD patients. Also, patients suffering from unacceptable thoughts need to be assessed more carefully for warning signs of suicide. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Suicidal and death ideation among adults with obsessive-compulsive disorder presenting for intensive intervention.

PubMed

Storch, Eric A; Kay, Brian; Wu, Monica S; Nadeau, Joshua M; Riemann, Bradley

2017-02-01

This study examined the frequency and relation of death and/or suicidal ideation to treatment response in 101 adults with obsessive-compulsive disorder (OCD) presenting for intensive intervention. Within 2 days of admission to an intensive treatment program, 101 adults with OCD completed the Yale-Brown Obsessive Compulsive Scale-Self Report, Quick Inventory of Depressive Symptomatology-Self Report, Intolerance of Uncertainty Scale, Obsessive-Compulsive Inventory-Revised, Penn State Worry Questionnaire, and Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form, and were administered the Columbia Suicide Scale by a trained clinician. A majority of patients reported death ideation within their lifetime (62.4%) and within the past month (67%). Approximately 12% of patients reported recent suicidal ideation. Patients with recent suicidal ideation reported significantly more depressive symptoms, more OCD symptoms, and less life satisfaction compared with patients not reporting suicidal ideation. Although prevalent, the presence of suicidal ideation was not associated with treatment response in the current sample. Suicidal ideation and history are prevalent among patients being treated intensively and are associated with OCD severity and depression, but they do not predict intensive multimodal treatment response.

Suicidal behaviour of Indian patients with obsessive compulsive disorder.

PubMed

Dhyani, Mohan; Trivedi, Jitendra Kumar; Nischal, Anil; Sinha, Pramod Kumar; Verma, Subham

2013-04-01

The chronicity, distress, high rates of comorbidity and varying degree of non response to treatment in Obsessive Compulsive Disorder (OCD) may contribute to suicidal behavior. There is relatively little information on suicidal behavior in OCD subjects. Our study design is Single point non-invasive, cross sectional, clinical study of new and follow up cases. Assessment of Suicidal Behavior in patients of OCD attending the adult Psychiatry O.P.D. of Chatrapati Shahuji Maharaj Medical University (CSMMU) U.P. Lucknow using (DSM-IV) criteria for diagnosis of Obsessive Compulsive Disorder, Structured Clinical Interview for DSM-IV Axis-I disorders, Yale Brown Obsessive Compulsive Rating Scale, Scale for Suicidal Ideation (SSI), Beck's Hopelessness Scale (BHS). Mean standard deviation and t test for independent samples, Pearson's correlation coefficient. Statistically significant differences were seen in the SSI score between the "Clinical" and "Sub-Clinical" cases with Clinical group having higher scores. Value of correlation coefficient between YBOCS score and SSI and BHS score is positive and statistically significant (P<0.01). "Clinical" group of patients had significantly higher scores of suicidal ideation measured by Scale of Suicidal Ideation (SSI). There was a significantly positive correlation between disease severity (YBOCS Score) and degree of suicidal ideation (SIS Score).

Symptom Dimensions in Two Samples of Africans Americans with Obsessive-Compulsive Disorder

PubMed Central

Williams, M. T.; Elstein, J.; Buckner, E.; Abelson, J.; Himle, J.

2012-01-01

Obsessive-compulsive disorder (OCD) is a leading cause of disability worldwide, however, there is a lack of research that includes African Americans, thus it is unclear whether findings about symptom dimensions can be generalized to this population. A sample of adult African Americans with OCD (N=74) was recruited at the University of Pennsylvania (Penn) and administered the Yale Brown Obsessive-Compulsive checklist (YBOCS) to better understand the phenomenology of OCD in African Americans. Frequencies of symptoms are reported and compared to findings from the National Survey of American Life (NSAL; N=54). A principal components analysis of YBOCS categories and items was performed on the Penn sample. A six-component solution was found, that included Contamination & Washing, Hoarding, Sexual Obsessions & Reassurance, Aggression & Mental Compulsions, Symmetry & Perfectionism, and Doubt & Checking, explaining 59.1% of the variance. Factors identified were similar to those of previous studies in primarily white samples. African Americans with OCD reported more contamination symptoms and were twice as likely to report excessive concerns with animals as European Americans with OCD. The results indicate the presence of cultural differences, which is consistent with findings among non-clinical samples. Implications of these findings are discussed. PMID:22708117

Depression, anxiety, and obsessionality in long-term recovered patients with adolescent-onset anorexia nervosa.

PubMed

Holtkamp, K; Müller, B; Heussen, N; Remschmidt, H; Herpertz-Dahlmann, B

2005-03-01

Anorexia nervosa (AN) is frequently associated with symptoms of depression, anxiety, and obsessive-compulsive behavior which also develop secondary to semistarvation. It is less certain if these symptoms persist after recovery. A few studies have already reported on high prevalence rates of anxious, depressive, and obsessive features in long-term recovered patients with AN, but several of these so called "long-term" recovered patients had only maintained weight restoration for six to twelve months. The aim of this study was to determine whether depressive, anxious, and obsessive-compulsive symptoms persist in truly long-term recovered patients (BMI 20.3+/-2.5 kg/m(2)) who no longer had any eating disorder symptoms (including weight phobia) for at least 3 years. Seventeen subjects of an AN sample (n=39) previously described in a 10-year follow-up met our strict criteria of at least 3 years of complete recovery of AN. In comparison to 39 age-, sex-, and occupation-matched healthy subjects without a history of psychiatric or eating disorder, long-term recovered patients had higher levels of depressive (p=0.002), anxious (p=0.006), and obsessive-compulsive (p=0.015) features but did not differ with regard to psychiatric morbidity and psychosocial adaptation. In conclusion, depressive, anxious, and obsessive-compulsive symptoms may be personality traits in subjects with former adolescent anorexia nervosa.

Executive functioning in people with obsessive-compulsive personality traits: evidence of modest impairment.

PubMed

García-Villamisar, Domingo; Dattilo, John

2015-06-01

Investigations of executive dysfunctions among people with obsessive-compulsive personality disorders (OCPD) have yielded inconsistent results. The authors speculate that obsessive-compulsive personality traits (OCPT) from a nonclinical population may be associated with specific executive dysfunctions relative to working memory, attentional set-shifting, and planning. A sample consisting of 79 adults (39 females, 40 males) was divided into high and low scorers on the Personality Diagnostic Questionnaire-4 (PDQ-4; Hyler, 1994). In addition, these participants were interviewed using the SCID-II (First, Spitzer, Gibbon & Williams, 1997) to confirm the presence of symptoms of obsessive-compulsive personality. Participants completed a battery of executive tasks associated with the Cambridge Neuropsychological Test Automated Battery (CANTAB), including Spatial Working Memory, Intradimensional/Extradimensional (ID/ED), Attentional Set-Shifting, and Stockings of Cambridge. Also, self-report measures of executive functions as well as of anxiety and depressive symptoms were administered. The analysis of covariance revealed significant differences between participants with OCPT and controls on the Spatial Working Memory tasks, ID/ED tasks, Stockings of Cambridge, and the Dysexecutive Questionnaire (DEX). Nevertheless, there were no significant differences in the number of problems solved in minimum movements. These results suggest that executive dysfunctions are present in people with prominent OCPT and that there is a high convergence between clinical and ecological measures of executive functions in people with obsessive personality traits.

Exposure to emotionally arousing, contamination-relevant pictorial stimuli interferes with response inhibition: Implication for obsessive–compulsive disorder

PubMed Central

Adams, Thomas G.

2016-01-01

Multiple emotional processes are implicated in the pathogenesis of obsessions and compulsions and individuals diagnosed with obsessive-compulsive disorder (OCD) have reliably shown deficits in response inhibition. Little research has tested how emotional processes might interact with cognitive control in the context of OCD. High contamination obsessive-compulsive (OC) and low contamination-OC participants completed an emotional go/no-go task to measure the interfering effects contamination-threat images relative to neutral images on action restraint (errors of commission). Results revealed that high contamination-OC participants committed marginally more commission errors (11.04%) than low contamination-OC participants (10.30%) on neutral no-go trials, but this effect was not significant (p > .05). All participants committed significantly more errors of commission on contamination-threat trails relative to neutral no-go trials, p < .01, but the interfering effects of contamination-threat images was significantly larger (p = .05) for high-contamination-OC participants. Errors of commission almost doubled for high contamination-OC participants on contamination-threat no-go trials (20.78%), compared to a more modest increase for low contamination-OC participants (14.80%). These findings suggest that individuals with elevated symptoms of OCD may have significantly more difficulty inhibiting their actions when processing disorder relevant or emotionally arousing information. This observation has implications for the pathogenesis of obsessions and compulsions. PMID:28090434

Compulsion or chronobiology? A case of severe obsessive-compulsive disorder treated with cognitive-behavioral therapy augmented with chronotherapy.

PubMed

Coles, Meredith E; Sharkey, Katherine M

2011-06-15

Individuals with treatment-resistant obsessive compulsive disorder (OCD) have elevated rates of delayed sleep phase. This report describes a patient with severe OCD who had failed prior trials of pharmacotherapy and psychotherapy, and whose symptoms were associated with delayed bedtimes and delays in the time she initiated her nighttime compulsions. Case report. A 54 year-old woman with OCD kept sleep/symptom logs as an adjunct to traditional cognitive-behavioral therapy for OCD. At presentation, she reported habitual bedtime = 06:00, wake time = 13:00, sleep latency ' 5 min, and total sleep time = 6.5-7.5 h. Later time of initiating her compulsions was associated with longer time performing the compulsions (r = 0.86, p < 0.001). Cognitive-behavioral therapy with adjunctive chronotherapy was associated with substantial improvement. OCD patients with nighttime compulsions may receive light exposure that results in delayed sleep times/circadian phase. Chronotherapy may enhance outcomes for refractory OCD patients, particularly those who perform compulsions at night.

Personality disorders and normal personality dimensions in obsessive-compulsive disorder.

PubMed

Samuels, J; Nestadt, G; Bienvenu, O J; Costa, P T; Riddle, M A; Liang, K Y; Hoehn-Saric, R; Grados, M A; Cullen, B A

2000-11-01

Little is known about personality disorders and normal personality dimensions in relatives of patients with obsessive-compulsive disorder (OCD). To determine whether specific personality characteristics are part of a familial spectrum of OCD. Clinicians evaluated personality disorders in 72 OCD case and 72 control probands and 198 case and 207 control first-degree relatives. The selfcompleted Revised NEO Personality Inventory was used for assessment of normal personality dimensions. The prevalence of personality disorders and scores on normal personality dimensions were compared between case and control probands and between case and control relatives. Case probands and case relatives had a high prevalence of obsessive-compulsive personality disorder (OCPD) and high neuroticism scores. Neuroticism was associated with OCPD in case but not control relatives. Neuroticism and OCPD may share a common familial aetiology with OCD.

Self-esteem and obsessive compulsive disorder.

PubMed

Husain, Nusrat; Chaudhry, Imran; Raza-ur-Rehman; Ahmed, Ghazal Riaz

2014-01-01

To explore the association between self-esteem and obsessive compulsive disorder in a low-income country, and to conduct an in-depth analysis into the said relationship by identifying any confounding variables that might exist. The cross-sectional study was conducted at the psychiatry out-patient clinic of Civil Hospital, Karachi, from January to March 2008, and comprised 65 patients diagnosed with obsessive compulsive disorder and 30 healthy controls. The participatnts completed the Janis and Field Social Adequacy scale and the Rosenberg Self-esteem scale. SPSS 15 was used for statistical analysis. Significantly different scores were reported on both measures of self-esteem between the patients and the controls (p<0.001 each), indicating reduced levels of self-esteem in the patients compared to the controls. Data replicated earlier findings from populations in high-income countries.

Differences in obsessive-compulsive symptoms and obsessive beliefs: a comparison between African Americans, Asian Americans, Latino Americans, and European Americans.

PubMed

Wheaton, Michael G; Berman, Noah C; Fabricant, Laura E; Abramowitz, Jonathan S

2013-01-01

Clinical research has increasingly considered ethnic group differences in the expression of anxiety disorders, but to date few investigations have focused specifically on the symptoms of obsessive-compulsive disorder (OCD). We examined group differences in OC symptoms, related cognitions ("obsessive beliefs"), and their associations. The sample included European American (N = 1199), African American (N = 215), Asian American (N = 116), and Latino American (N = 72) participants. African American and Asian American participants reported more contamination-related OC symptoms than did European Americans. Asian Americans also reported elevated levels of obsessive beliefs. Moreover, group membership moderated the relationship between obsessive beliefs and certain dimensions of OC symptoms. These findings suggest group differences in the experience of OC symptoms and related cognitions, and that the cognitive-behavioral model of some OC symptoms could be refined and tailored for groups underrepresented in OCD research to date.

Causal role for inverse reasoning on obsessive-compulsive symptoms: Preliminary evidence from a cognitive bias modification for interpretation bias study.

PubMed

Wong, Shiu F; Grisham, Jessica R

2017-12-01

The inference-based approach (IBA) is a cognitive account of the genesis and maintenance of obsessive-compulsive disorder (OCD). According to the IBA, individuals with OCD are prone to using inverse reasoning, in which hypothetical causes form the basis of conclusions about reality. Several studies have provided preliminary support for an association between features of the IBA and OCD symptoms. However, there are currently no studies that have investigated the proposed causal relationship of inverse reasoning in OCD. In a non-clinical sample (N = 187), we used an interpretive cognitive bias procedure to train a bias towards using inverse reasoning (n = 64), healthy sensory-based reasoning (n = 65), or a control condition (n = 58). Participants were randomly allocated to these training conditions. This manipulation allowed us to assess whether, consistent with the IBA, inverse reasoning training increased compulsive-like behaviours and self-reported OCD symptoms. Results indicated that compared to a control condition, participants trained in inverse reasoning reported more OCD symptoms and were more avoidant of potentially contaminated objects. Moreover, change in inverse reasoning bias was a small but significant mediator of the relationship between training condition and behavioural avoidance. Conversely, training in a healthy (non-inverse) reasoning style did not have any effect on symptoms or behaviour relative to the control condition. As this study was conducted in a non-clinical sample, we were unable to generalise our findings to a clinical population. Findings generally support the IBA model by providing preliminary evidence of a causal role for inverse reasoning in OCD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Think twice: Impulsivity and decision making in obsessive-compulsive disorder.

PubMed

Grassi, Giacomo; Pallanti, Stefano; Righi, Lorenzo; Figee, Martijn; Mantione, Mariska; Denys, Damiaan; Piccagliani, Daniele; Rossi, Alessandro; Stratta, Paolo

2015-12-01

Recent studies have challenged the anxiety-avoidance model of obsessive-compulsive disorder (OCD), linking OCD to impulsivity, risky-decision-making and reward-system dysfunction, which can also be found in addiction and might support the conceptualization of OCD as a behavioral addiction. Here, we conducted an exploratory investigation of the behavioral addiction model of OCD by assessing whether OCD patients are more impulsive, have impaired decision-making, and biased probabilistic reasoning, three core dimensions of addiction, in a sample of OCD patients and healthy controls. We assessed these dimensions on 38 OCD patients and 39 healthy controls with the Barratt Impulsiveness Scale (BIS-11), the Iowa Gambling Task (IGT) and the Beads Task. OCD patients had significantly higher BIS-11 scores than controls, in particular on the cognitive subscales. They performed significantly worse than controls on the IGT preferring immediate reward despite negative future consequences, and did not learn from losses. Finally, OCD patients demonstrated biased probabilistic reasoning as reflected by significantly fewer draws to decision than controls on the Beads Task. OCD patients are more impulsive than controls and demonstrate risky decision-making and biased probabilistic reasoning. These results might suggest that other conceptualizations of OCD, such as the behavioral addiction model, may be more suitable than the anxiety-avoidance one. However, further studies directly comparing OCD and behavioral addiction patients are needed in order to scrutinize this model.

Do autistic traits play a role in the bullying of obsessive-compulsive disorder and social phobia sufferers?

PubMed

Bejerot, S; Mörtberg, E

2009-01-01

Social phobia and obsessive-compulsive disorder (OCD) share several similarities: both are categorized as anxiety disorders, avoidant personality disorder and depression are common in both, they have a similar age of onset and course, and both disorders respond to treatments with serotonin reuptake inhibitors and cognitive behavioural therapy. However, OCD and social phobia differ in respect to their relation to autism spectrum disorders (ASD; i.e. Asperger's syndrome, autism, pervasive disorder not otherwise specified). Findings that suggest a link between OCD and ASD have no parallel in social phobia. Moreover, obsessive-compulsive, paranoid and schizotypal personality disorders are prevalent in OCD and in ASD, but not in social phobia. Individuals with ASD are known to be frequent targets of bullying. We hypothesised that individuals with autistic traits would have been frequent targets for bullies during their childhood, as opposed to people without such traits. Adult patients with social phobia (n = 63) or OCD (n = 65) were assessed regarding autistic traits, and interviewed about being bullied at school. A reference group (n = 551) responded to questions about being bullied. There was a significant difference in the prevalence of being bullied between OCD (50%), social phobia patients (20%) and the reference group (27%). Autistic traits were more common in OCD than in social phobia. A history of being bullied was related to autistic traits among patients. Falling victim to bullying is not a random event. Autistic traits, i.e. low social skills, may be a predictor of being bullied in school. The high rate of bullying victims in persons who later develop OCD is suggested to be related to the overlap between OCD and ASD. Copyright 2009 S. Karger AG, Basel.

Emotional and Cognitive Variables Associated with Contamination-Related Obsessive-Compulsive Symptoms.

PubMed

García-Soriano, Gemma; Rosell-Clari, Vicent; Serrano, Miguel Ángel

2016-05-23

Different variables have been associated with the development/ maintenance of contamination-related obsessive-compulsive disorder (OCD), although the relevance of these factors has not been clearly established. The present study aimed to analyze the relevance and specificity of these variables. Forty-five women with high scores on obsessive-compulsive contamination symptoms (n = 16) or checking symptoms (n = 15), or non-clinical scores (n = 14) participated in a behavioral approach/avoidance task (BAT) with a contamination-OCD stimulus. Vulnerability variables and participants' emotional, cognitive, physiological and behavioral responses to the BAT were appraised. Results show that fear of illness was a relevant vulnerability variable specific to contamination participants (p = .001; η2 p = .291). Contamination participants responded with significantly higher subjective disgust (p =.001; η2 p = .269), anxiety (p = .001; η2 p = .297), urge to wash (p < .001; η2 p = 370), threat from emotion (p < .001; η2 p = .338) and contamination severity (p = .002; η2 p = .260) appraisals, and with lower behavioral approach (p = .008; η2 p = .208) than the other two groups. Moreover, contamination participants showed lower heart rate acceleration (p = .046; η2 p = .170) and higher contamination likelihood appraisals (p < .001; η2 p = .342) than the non-clinical group. Urge to wash was predicted by state disgust (R 2 change = .346) and threat from emotion (R 2 change = .088). These responses were predicted by general anxiety sensitivity (R 2 change = .161), disgust propensity (R 2 change = .255) and fear of illness (R 2 change = .116), but not by other vulnerability variables such as dysfunctional beliefs about thoughts (Responsibility and Overestimation of threat) or disgust sensitivity. State disgust, threat from disgust, anxiety sensitivity and fear of illness were found to be the most relevant variables in contamination symptoms.

Intravenous Clomipramine for Treatment-Resistant Obsessive-Compulsive Disorder

PubMed Central

Khani, Munir

2016-01-01

Background: This open trial was conducted to evaluate the effectiveness of intravenous clomipramine (CMI) in refractory obsessive-compulsive disorder (OCD). Methods: Thirty OCD poor responders to previous multiple trials of anti-obsessive medications were selected and admitted to the hospital. Severity of the illness and response to treatment were primarily assessed by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). CMI was gradually administered intravenously for one week. All patients were thereafter switched to oral CMI with a maximum dose of 225mg/day. Results: The Y-BOCS total score mean at admission was in the severe range (24–31), and dropped on discharge and follow-ups to the moderate range (16–23). At discharge, 23 patients (76.7%) had a decrease in Y-BOCS ≥25% and were considered responders, while only 18 (60%) were still responders at 24 weeks. No relevant persistent side effects were reported. Conclusion: Intravenous clomipramine could be of benefit for severe OCD cases that have not adequately responded to several therapies, including oral clomipramine. PMID:26221004

Obsessive versus delusional jealousy.

PubMed

Batinic, Borjanka; Duisin, Dragana; Barisic, Jasmina

2013-09-01

Although obsessive jealousy is a highly disturbing disorder, frequently it goes unrecognized, as most attention is paid to delusional jealousy, being the more prominent clinical phenomenon. In order to distinguish obsessive from delusional jealousy, the basic clinical characteristics of these two types of jealousy are presented, as well as the mechanism of their respective genesis, and the differences which we must be aware of in order to prevent misdiagnosis and consequent wrong treatment choices. The theoretical considerations are supported by case presentations providing a clear picture of the phenomena discussed. Unlike delusional jealousy, characterized by the presence of strong, false beliefs that the partner is unfaithful, individuals with obsessive jealousy suffer from unpleasant and irrational jealous ruminations that the partner could be unfaithful, accompanied by compulsive checking of partners' behaviour, which is recognised by the patient as ego-dystonic. This jealousy resembles obsessive-compulsive phenomenology more closely. Despite the differences, both forms of jealousy result in significant distress for patients and intimate relationships, and carry the risk of abuse, homicide and/or suicide. Delusional jealousy is a psychotic disorder and should be treated mainly with antipsychotics, while obsessive jealousy resembles obsessive-compulsive disorder and should be treated with SSRIs and cognitive-behavioural therapy. Regardless of the presence or absence of insight into the disorder, one of the key factors in the treatment of pathological jealousy is to motivate the sufferers for pharmacological and psychotherapeutic interventions.

Comorbidity and Suicidality in Patients Diagnosed with Panic Disorder/Agoraphobia and Major Depression.

PubMed

Batinic, Borjanka; Opacic, Goran; Ignjatov, Tijana; Baldwin, David S

2017-06-01

Comorbidity of anxiety and depression (both current and lifetime) is associated with greater chronicity and an increased risk of suicidality. We wished to ascertain which symptom clusters had the strongest association with suicidality. Our aims were (1) to examine the presence of current comorbidity and suicidality in patients diagnosed with panic disorder/agoraphobia (PD/A) and major depression (MD), and their relationship with duration of psychiatric treatment and frequency of hospital admission; and (2) to examine which coexisting symptoms were most strongly predictive of suicidality in sub-groups and the overall group. The study sample comprised 100 patients with PD/A and MD. The following assessment instruments were applied: the Panic and Agoraphobia Scale, the Beck Anxiety Inventory, the Beck Depression Inventory-II, the Beck Scale for Suicide Ideation, the Obsessive-Compulsive Inventory-Revised, the Liebowitz Social Anxiety Scale and the Whiteley Index of Hypochondriasis. High rates of current comorbidity were seen in both groups. Patients with MD had significantly higher suicidality scores, but were also older, with a longer duration of psychiatric treatment and more frequent hospitalizations. In the overall group, psychiatric comorbidity was correlated with duration of psychiatric treatment and frequency of hospitalizations (with the exception of hypochondriasis which was not correlated with frequency of hospitalization). In both sub-groups and the overall group, suicidality was correlated with scores for all examined comorbidity (with the exception of hypochondriasis in the PD/A group): however, after multiple regression only obsessive-compulsive symptomatology predicted suicidality in all sub-groups and the overall group, as well as depression in the overall group. Depression supposed as dependent variable and obsessive-compulsive symptomatology as a mediator explained around 37% of the variance in suicidal ideation. Patients with PD/A or MD show high rates of current comorbidity. The effect of depression on suicidality was significant, but a non-trivial impact was also mediated by obsessive-compulsive symptomatology.

The influence of age at onset and duration of illness on long-term outcome in patients with obsessive-compulsive disorder: a report from the International College of Obsessive Compulsive Spectrum Disorders (ICOCS).

PubMed

Dell'Osso, Bernardo; Benatti, Beatrice; Buoli, Massimiliano; Altamura, A Carlo; Marazziti, Donatella; Hollander, Eric; Fineberg, Naomi; Stein, Dan J; Pallanti, Stefano; Nicolini, Humberto; Van Ameringen, Michael; Lochner, Christine; Hranov, Georgi; Karamustafalioglu, Oguz; Hranov, Luchezar; Menchon, Jose M; Zohar, Joseph

2013-08-01

Several studies reported a negative effect of early onset and long duration of illness on long-term outcome in psychiatric disorders, including Obsessive-Compulsive Disorder (OCD). OCD is a prevalent, comorbid and disabling condition, associated with reduced quality of life and overall well-being for affected patients and related caregivers. The present multicenter naturalistic study sought to assess the influence of early onset and duration of illness on long-term outcome in a sample of 376 OCD out-patients worldwide, as part of the "International College of Obsessive-Compulsive Spectrum Disorders" (ICOCS) network. Binary logistic regressions were performed with age at the onset and duration of illness, as continuous independent variables, on a series of different outcome dependent variables, including lifetime number of hospitalizations and suicide attempts, poly-therapy and psychiatric comorbidity. Correlations in terms of disability (SDS) were analyzed as well. Results showed that a longer duration of illness (but not earlier age of onset) was associated with hospitalization (odds ratio=1.03, p=0.01), earlier age at onset with CBT (odds ratio=0.94, p<0.001) and both a later age at onset (odds ratio=1.05, p=0.02) and a shorter duration of illness (odds ratio=0.93, p=0.02) with panic disorder comorbidity. In addition, earlier age at onset inversely correlated with higher social disability (r=-0.12, p=0.048) and longer duration of illness directly correlated with higher disability in work, social and family life (r=0.14, p=0.017; r=0.13, p=0.035; r=0.14, p=0.02). The findings from the present large, multicenter study indicate early onset and long duration of illness as overall negative predictors of long-term outcome in OCD. Copyright © 2013 Elsevier B.V. and ECNP. All rights reserved.

Obsessive-compulsive severity spectrum in the community: prevalence, comorbidity, and course.

PubMed

Angst, Jules; Gamma, Alex; Endrass, Jerome; Goodwin, Renee; Ajdacic, Vladeta; Eich, Dominique; Rössler, Wulf

2004-06-01

To describe lifetime prevalence rates, course and comorbidity of obsessive-compulsive disorder (OCD), obsessive-compulsive syndromes (OCS) and OC-symptoms (OC-sx) up to age 41. In the Zurich community cohort study 591 subjects were selected after screening at the age of 19 and studied prospectively by 6 interviews from 20 to 40; they represent 1599 subjects of the normal population. The diagnoses of OCD met DSM-IV criteria. Course was assessed by graphic illustrations and prospective data. The lifetime prevalence rate was 3.5 % for OCD (males 1.7%, females 5.4 %) and 8.7 % for OCS (males 9.9%, females 7.5 %). The onset of OC-sx was 18 years (median); and in 70% before age 20. OCD was treated in one third of cases, OCS in 6.1%. The course of symptoms was chronic in 60%,but OCD and OCS showed in most cases considerable improvements over time. OCD reduced quality of life mostly in the subject's psychological wellbeing and at work but to a considerable extent also in other social roles. Comorbidity was prominent with bipolar disorder, panic disorder and social phobia and also significant with bulimia, binge eating, generalized anxiety disorder and suicide attempts; there was no association with substance abuse/dependence. OCD and OCD are manifestations of a wide spectrum of severity with high prevalence and strong clinical validity. The long-term course is better than generally assumed.

An exploratory dimensional approach to premenstrual manifestation of obsessive-compulsive disorder symptoms: a multicentre study.

PubMed

Moreira, Luciana; Bins, Helena; Toressan, Ricardo; Ferro, Cláudia; Harttmann, Thiago; Petribú, Kátia; Juruena, Mário Francisco; do Rosário, Maria Conceição; Ferrão, Ygor Arzeno

2013-04-01

In women with obsessive-compulsive disorder (OCD), symptom severity appears to fluctuate over the course of the menstrual cycle. The objective of this paper was to compare female OCD patients with and without premenstrual worsening of obsessive-compulsive symptoms (OCS), in terms of the clinical characteristics of OCD. This was a cross-sectional study involving 455 women with OCD, of whom 226 (49.7%) had experienced premenstrual OCS worsening and 229 (50.3%) had not (PMOCS-worse and PMOCS-same groups, respectively). Data were collected with the original and dimensional versions of the Yale-Brown obsessive-compulsive scale, as well as with the Beck Depression Inventory (BDI) and Beck anxiety inventory (BAI). We found significant differences between the PMOCS-same and PMOCS-worse groups, the latter showing a higher frequency of suicidal ideation (P<.001), suicide attempts (P=.027), current use of selective serotonin reuptake inhibitors (P=.022), lifetime use of mood stabilisers (P=.015), and sexual/religious obsessions (P<.001; OR=1.90), as well as higher scores on the BDI (P<.001) and BAI (P<.001). Underscoring the fact that OCD is a heterogeneous disorder, there appears to be a subgroup of female OCD patients in whom the premenstrual period is associated with a higher frequency of sexual/religious obsessions, depression, anxiety, and suicidality. This might be attributable to hormonal fluctuations. Further studies are warranted in order to investigate this hypothesis by evaluating such patients at different phases of the menstrual cycle, as well as measuring hormonal levels. Copyright © 2012 Elsevier Inc. All rights reserved.

Obsessive-compulsive disorder and its related disorders: a reappraisal of obsessive-compulsive spectrum concepts.

PubMed

Murphy, Dennis L; Timpano, Kiara R; Wheaton, Michael G; Greenberg, Benjamin D; Miguel, Euripedes C

2010-01-01

Obsessive-compulsive disorder (OCD) is a clinical syndrome whose hallmarks are excessive, anxiety-evoking thoughts and compulsive behaviors that are generally recognized as unreasonable, but which cause significant distress and impairment. When these are the exclusive symptoms, they constitute uncomplicated OCD. OCD may also occur in the context of other neuropsychiatric disorders, most commonly other anxiety and mood disorders. The question remains as to whether these combinations of disorders should be regarded as independent, cooccurring disorders or as different manifestations of an incompletely understood constellation of OCD spectrum disorders with a common etiology. Additional considerations are given here to two potential etiology-based subgroups: (i) an environmentally based group in which OCD occurs following apparent causal events such as streptococcal infections, brain injury, or atypical neuroleptic treatment; and (ii) a genomically based group in which OCD is related to chromosomal anomalies or specific genes. Considering the status of current research, the concept of OCD and OCD-related spectrum conditions seems fluid in 2010, and in need of ongoing reappraisal.

The obsessive compulsive drinking scale is a valid measure of alcohol craving in young adults.

PubMed

Connor, Jason P; Feeney, Gerald F X; Jack, Alyssa; Young, Ross McD

2010-12-01

Alcohol craving is associated with greater alcohol-related problems and less favorable treatment prognosis. The Obsessive Compulsive Drinking Scale (OCDS) is the most widely used alcohol craving instrument. The OCDS has been validated in adults with alcohol use disorders (AUDs), which typically emerge in early adulthood. This study examines the validity of the OCDS in a nonclinical sample of young adults. Three hundred and nine college students (mean age of 21.8 years, SD = 4.6 years) completed the OCDS, Alcohol Use Disorders Identification Test (AUDIT), and measures of alcohol consumption. Subjects were randomly allocated to 2 samples. Construct validity was examined via exploratory factor analysis (n = 155) and confirmatory factor analysis (n = 154). Concurrent validity was assessed using the AUDIT and measures of alcohol consumption. A second, alcohol-dependent sample (mean age 42 years, SD 12 years) from a previously published study (n = 370) was used to assess discriminant validity. A unique young adult OCDS factor structure was validated, consisting of Interference/Control, Frequency of Obsessions, Alcohol Consumption and Resisting Obsessions/Compulsions. The young adult 4-factor structure was significantly associated with the AUDIT and alcohol consumption. The 4 factor OCDS successfully classified nonclinical subjects in 96.9% of cases and the older alcohol-dependent patients in 83.7% of cases. Although the OCDS was able to classify college nonproblem drinkers (AUDIT <13, n = 224) with 83.2% accuracy, it was no better than chance (49.4%) in classifying potential college problem drinkers (AUDIT score ≥13, n = 85). Using the 4-factor structure, the OCDS is a valid measure of alcohol craving in young adult populations. In this nonclinical set of students, the OCDS classified nonproblem drinkers well but not problem drinkers. Studies need to further examine the utility of the OCDS in young people with alcohol misuse. Copyright © 2010 by the Research Society on Alcoholism.

Psychometric properties of the Chinese version of the Obsessive Beliefs Questionnaire-44 (OBQ-44).

PubMed

Wang, Jing; Wei, Zhen; Wang, He; Jiang, Zeyu; Peng, Ziwen

2015-08-04

The Obsessive Beliefs Questionnaire-44 (OBQ-44) is originally developed by the Obsessive Compulsive Cognitions Working Group and has been translated into several languages. This paper is aimed to investigate the psychometric properties of the Chinese version of the Obsessive Beliefs Questionnaire-44 (OBQ-44) in both clinical and non-clinical samples. Five hundred and sixty-nine undergraduate volunteers and sixty-six OCD patients were included in the study. All participants have completed Chinese version of OBQ-44, Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), and Beck Depression Inventory (BDI). Confirmatory factor analysis was conducted to examine the construct validity of Chinese version of OBQ-44. The internal consistency and test-retest reliabilities at 4-week interval were examined in both non-clinical and clinical groups. The confirmatory factor analysis of the non-clinical sample confirmed a 3-factor model which was suggested by the original authors of the instrument (χ (2)/d.f = 2.96, GFI = 0.83, NFI = 0.82, CFI = 0.88 and RMSEA = 0.06). The internal consistency and test-retest reliability were at an acceptable range for the two samples. The Chinese version of OBQ-44 is a valid and reliable instrument for assessing dysfunctional beliefs related to the etiology and maintenance of obsessions and compulsions.

Visual search for verbal material in patients with obsessive-compulsive disorder.

PubMed

Botta, Fabiano; Vibert, Nicolas; Harika-Germaneau, Ghina; Frasca, Mickaël; Rigalleau, François; Fakra, Eric; Ros, Christine; Rouet, Jean-François; Ferreri, Florian; Jaafari, Nematollah

2018-06-01

This study aimed at investigating attentional mechanisms in obsessive-compulsive disorder (OCD) by analysing how visual search processes are modulated by normal and obsession-related distracting information in OCD patients and whether these modulations differ from those observed in healthy people. OCD patients were asked to search for a target word within distractor words that could be orthographically similar to the target, semantically related to the target, semantically related to the most typical obsessions/compulsions observed in OCD patients, or unrelated to the target. Patients' performance and eye movements were compared with those of individually matched healthy controls. In controls, the distractors that were visually similar to the target mostly captured attention. Conversely, patients' attention was captured equally by all kinds of distractor words, whatever their similarity with the target, except obsession-related distractors that attracted patients' attention less than the other distractors. OCD had a major impact on the mostly subliminal mechanisms that guide attention within the search display, but had much less impact on the distractor rejection processes that take place when a distractor is fixated. Hence, visual search in OCD is characterized by abnormal subliminal, but not supraliminal, processing of obsession-related information and by an impaired ability to inhibit task-irrelevant inputs. Copyright © 2018 Elsevier B.V. All rights reserved.

An Open Trial of Intensive Family Based Cognitive-Behavioral Therapy in Youth with Obsessive-Compulsive Disorder Who Are Medication Partial Responders or Nonresponders

ERIC Educational Resources Information Center

Storch, Eric A.; Lehmkuhl, Heather D.; Ricketts, Emily; Geffken, Gary R.; Marien, Wendi; Murphy, Tanya K.

2010-01-01

This study reports an open-trial of family-based cognitive-behavioral therapy (CBT) in children and adolescents with obsessive-compulsive disorder (OCD). Thirty primarily Caucasian youth with OCD (range = 7-19 years; 15 girls) who were partial responders or nonresponders to two or more medication trials that were delivered either serially or…

Social, Family and Psychological Predictors of Obsessive-Compulsive Behaviour among Children and Adolescents

ERIC Educational Resources Information Center

Kirkcaldy, B. D.; Furnham, A. F.; Siefen, R. G.

2010-01-01

The incidence of "pure" obsessive-compulsive disorders in the clinical population was found to be around 1.2 percent for a clinical sample record--stretching over a 2.5-year period--of around 2500 adolescents in a German child and adolescent psychiatry clinic. Over a 3-month period (time-frame) a sample of 350 new entries to the clinic…

Association of Autism Spectrum Disorder with Obsessive-Compulsive and Attention-Deficit/ Hyperactivity Traits and Response Inhibition in a Community Sample

ERIC Educational Resources Information Center

van der Plas, Ellen; Dupuis, Annie; Arnold, Paul; Crosbie, Jennifer; Schachar, Russell

2016-01-01

We examined co-occurrence of autism spectrum disorder (ASD) with (traits of) attention-deficit/hyperactivity (ADHD), obsessive-compulsive (OCD) and inhibition deficits in a community sample (n = 16,676) and tested whether having a sibling with ASD manifested in increased features of ADHD, OCD or inhibition deficits. Individuals with ASD had…

Effects of Psilocybe argentipes on marble-burying behavior in mice.

PubMed

Matsushima, Yoshihiro; Shirota, Osamu; Kikura-Hanajiri, Ruri; Goda, Yukihiro; Eguchi, Fumio

2009-08-01

Psilocybe argentipes is a hallucinogenic mushroom. The present study examined the effects of P. argentipes on marble-burying behavior, which is considered an animal model of obsessive-compulsive disorder. P. argentipes significantly inhibited marble-burying behavior without affecting locomotor activity as compared with the same dose of authentic psilocybin. These findings suggest that P. argentipes would be efficient in clinical obsessive-compulsive disorder therapy.

Integrating play therapy in the treatment of children with obsessive-compulsive disorder.

PubMed

Gold-Steinberg, S; Logan, D

1999-10-01

While behavioral and psychopharmacological approaches are the most effective interventions for treating obsessive-compulsive disorder (OCD), psychodynamically oriented play therapy can enhance the treatment of children with this disorder. Play therapy techniques are useful in addressing treatment resistance, feelings of shame around OCD symptoms, negative self-concept, and issues of psychosocial adjustment. A case study illustrates this integrated approach to treatment.

Behavioral versus Cognitive Treatment of Obsessive-Compulsive Disorder: An Examination of Outcome and Mediators of Change

ERIC Educational Resources Information Center

Olatunji, Bunmi O.; Rosenfield, David; Tart, Candyce D.; Cottraux, Jean; Powers, Mark B.; Smits, Jasper A. J.

2013-01-01

Objective: To examine symptom change over time, the effect of attrition on treatment outcome, and the putative mediators of cognitive therapy (CT) versus behavior therapy (BT) for obsessive-compulsive disorder (OCD) using archival data. Method: Sixty-two adults with OCD were randomized to 20 sessions of CT (N = 30) or BT (N = 32) that consisted of…

Biased Processing of Threat-Related Information Rather than Knowledge Deficits Contributes to Overestimation of Threat in Obsessive-Compulsive Disorder

ERIC Educational Resources Information Center

Moritz, Steffen; Pohl, Rudiger F.

2009-01-01

Overestimation of threat (OET) has been implicated in the pathogenesis of obsessive-compulsive disorder (OCD). The present study deconstructed this complex concept and looked for specific deviances in OCD relative to controls. A total of 46 participants with OCD and 51 nonclinical controls were asked: (a) to estimate the incidence rate for 20…

Group and Individual Treatment of Obsessive-Compulsive Disorder Using Cognitive Therapy and Exposure Plus Response Prevention: A 2-Year Follow-Up of Two Randomized Trials

ERIC Educational Resources Information Center

Whittal, Maureen L.; Robichaud, Melisa; Thordarson, Dana S.; McLean, Peter D.

2008-01-01

Relatively little is known about the long-term durability of group treatments for obsessive-compulsive disorder (OCD) and contemporary cognitive treatments. The current study investigated the 2-year follow-up results for participants who completed randomized trials of group or individual treatment and received either cognitive therapy (CT) or…

Comparison of cognitive flexibility and planning ability in patients with obsessive compulsive disorder, patients with obsessive compulsive personality disorder, and healthy controls

PubMed Central

PAAST, Negin; KHOSRAVI, Zohreh; MEMARI, Amir Hossein; SHAYESTEHFAR, Monir; ARBABI, Mohammad

2016-01-01

Background Cognitive functioning in individuals with Obsessive Compulsive Disorder (OCD) and with Obsessive Compulsive Personality Disorder (OCPD) has not been adequately studied. Aim Examine the cognitive flexibility and planning ability of individuals with OCD and OCPD. Methods Twenty patients with OCD and 25 patients with OCPD who had not taken medication in the previous two weeks were identified in an outpatient psychology clinic in Tehran, and 25 healthy control subjects were identified from the university staff and local community residents. All participants were administered the 28-item version of the General Health Questionnaire (GHQ-28), the Wisconsin Card Sorting Test (WCST), and the Tower of London (TOL) test. Two measures of the WCTS (number of perseverative errors and number of categories completed) were used to assess cognitive flexibility and three measures of the TOL (total number of moves in 12 trials, total response time, and planning time) were used to assess planning ability. Results The level of current psychological distress in the two patient groups was significantly greater than that in the control group. After adjusting for demographic variables and the level of psychological distress, both OCD patients and OCPD patients made more perseverative errors on the WCST than control subjects, and the OCD patients (but not the OCPD patients) completed significantly fewer categories than the control subjects. Both the OCD patients and OCPD patients required significantly more moves than control subjects to complete the 12 TOL tasks and OCD patients took significantly longer than both OCPD patients and control subjects to complete the tasks. Conclusions Individuals with OCD and OCPD have impaired cognitive flexibility and planning ability compared to healthy controls, and there are some differences in these measures of cognitive functioning between OCD and OCPD. Long term follow-up studies of OCD and OCPD that assess changes in cognitive measures as the severity of obsessive compulsive symptoms wax and wane will be needed to determine whether or not such cognitive measures have diagnostic or clinical relevance for obsessive compulsive disorders. PMID:27688641

Comparison of cognitive flexibility and planning ability in patients with obsessive compulsive disorder, patients with obsessive compulsive personality disorder, and healthy controls.

PubMed

Paast, Negin; Khosravi, Zohreh; Memari, Amir Hossein; Shayestehfar, Monir; Arbabi, Mohammad

2016-02-25

Cognitive functioning in individuals with Obsessive Compulsive Disorder (OCD) and with Obsessive Compulsive Personality Disorder (OCPD) has not been adequately studied. Examine the cognitive flexibility and planning ability of individuals with OCD and OCPD. Twenty patients with OCD and 25 patients with OCPD who had not taken medication in the previous two weeks were identified in an outpatient psychology clinic in Tehran, and 25 healthy control subjects were identified from the university staff and local community residents. All participants were administered the 28-item version of the General Health Questionnaire (GHQ-28), the Wisconsin Card Sorting Test (WCST), and the Tower of London (TOL) test. Two measures of the WCTS (number of perseverative errors and number of categories completed) were used to assess cognitive flexibility and three measures of the TOL (total number of moves in 12 trials, total response time, and planning time) were used to assess planning ability. The level of current psychological distress in the two patient groups was significantly greater than that in the control group. After adjusting for demographic variables and the level of psychological distress, both OCD patients and OCPD patients made more perseverative errors on the WCST than control subjects, and the OCD patients (but not the OCPD patients) completed significantly fewer categories than the control subjects. Both the OCD patients and OCPD patients required significantly more moves than control subjects to complete the 12 TOL tasks and OCD patients took significantly longer than both OCPD patients and control subjects to complete the tasks. Individuals with OCD and OCPD have impaired cognitive flexibility and planning ability compared to healthy controls, and there are some differences in these measures of cognitive functioning between OCD and OCPD. Long term follow-up studies of OCD and OCPD that assess changes in cognitive measures as the severity of obsessive compulsive symptoms wax and wane will be needed to determine whether or not such cognitive measures have diagnostic or clinical relevance for obsessive compulsive disorders.

External Criticism by Parents and Obsessive Beliefs in Adolescents: Mediating Role of Beliefs associated with Inflated Responsibility.

PubMed

Halvaiepour, Zohreh; Nosratabadi, Mehdi

2015-09-18

Obsessive-compulsive disorder (OCD) is considered as a rare disorder in children. According to cognitive theories, criticism triggers responsibility behavior and thus causes obsessive behaviors. The purpose of the present study was to investigate the mediating role of beliefs associated with responsibility in the relationship between external criticism of parents and obsessive beliefs in adolescents. In this study, 547 high school students aged from 15 to18 years were selected using multi-stage cluster random sampling from four regions of the education office in Shiraz. Obsessive Beliefs Questionnaire-child version (OBQ-CV), Pathway to Inflated Responsibility beliefs Scale (PIRBS), and perceived criticism questionnaire were used to collect data. Pearson's correlation was used to investigate the relationship between the study variables. For analysis of mediation model, multiple mediators analysis using Macro Software was used. External criticism only indirectly and through beliefs associated with inflated responsibility accounts for 6% of the variance of responsibility, 14% of the variance of threat estimation and 10% of the variance of perfectionism of obsessive beliefs (P<0.05). However, external criticism, both directly and indirectly and through beliefs associated with inflated responsibility accounts for 7% of the variance of the importance of obsessive beliefs. This study showed that the beliefs associated with inflated responsibility can mediate the relationship between external criticism and obsessive beliefs. According to the cognitive model of Salkovskis, criticism by parents, as a violation to and an influence on children, by affecting the subscales of inflated responsibility, can increase the symptoms of obsessive-compulsive disorder. In order to identify potential affecting mechanisms of criticism on obsessive-compulsive disorder, further experimental research is required.

Attention bias in adults with anorexia nervosa, obsessive-compulsive disorder, and social anxiety disorder

PubMed Central

Schneier, Franklin R.; Kimeldorf, Marcia B.; Choo, Tse; Steinglass, Joanna E.; Wall, Melanie; Fyer, Abby J.; Simpson, H. Blair

2016-01-01

Background Attention bias to threat (selective attention toward threatening stimuli) has been frequently found in anxiety disorder samples, but its distribution both within and beyond this category is unclear. Attention bias has been studied extensively in social anxiety disorder (SAD) but relatively little in obsessive compulsive disorder (OCD), historically considered an anxiety disorder, or anorexia nervosa (AN), which is often characterized by interpersonal as well as body image/eating fears. Methods Medication-free adults with SAD (n=43), OCD (n=50), or AN (n=30), and healthy control volunteers (HC, n=74) were evaluated for attention bias with an established dot probe task presenting images of angry and neutral faces. Additional outcomes included attention bias variability (ABV), which summarizes fluctuation in attention between vigilance and avoidance, and has been reported to have superior reliability. We hypothesized that attention bias would be elevated in SAD and associated with SAD severity. Results Attention bias in each disorder did not differ from HC, but within the SAD group attention bias correlated significantly with severity of social avoidance. ABV was significantly lower in OCD versus HC, and it correlated positively with severity of OCD symptoms within the OCD group. Conclusions Findings do not support differences from HC in attention bias to threat faces for SAD, OCD, or AN. Within the SAD sample, the association of attention bias with severity of social avoidance is consistent with evidence that attention bias moderates development of social withdrawal. The association of ABV with OCD diagnosis and severity is novel and deserves further study. PMID:27174402

[The neurotic disorders].

PubMed

Honjo, Shuji; Nomura, Kenji; Kuriyama, Kikuko; Suzuki, Futoshi; Yoshikawa, Touru

2011-01-01

The clinical practice of child and adolescent psychiatry includes encounters with disorders not particular to childhood and adolescence, but seen in adulthood as well. For example, among the neurotic disorders, obsessive-compulsive disorder can be seen from around 3 years of age, with rapid rise in prevalence from around age 10. Increase is also seen in cases of anorexia nervosa from around age 11. This report examines the association between disorders in childhood and adolescence, in comparison to that in adulthood, with focus on obsessive-compulsive disorder. To start with, the characteristics of childhood onset cases with onset under age 7 were reviewed, revealing a relatively large proportion of subjects with experience of separation anxiety. Analyses revealed the possibility of anticipating obsessional tendencies in the parents of such subjects. Further clarification of the features of such early onset cases is hoped for in future. Next, we conducted a literature review comparing the characteristics of child and adolescent obsessive-compulsive disorder with that in adulthood. It has been determined that obsessive-compulsive symptoms in childhood and adolescence have a relatively unyielding 4-factor construct that persists through life, namely: 1) symmetry factor, 2) forbidden thoughts factor, 3) cleaning factor, and 4) hoarding factor. Of these, children with primary symptoms of hoarding are said to have poorer long-term diagnoses than children with other symptoms. Another point of note is the presence of large disparity regarding the prognosis of cases with concomitant tics. While the prognosis of childhood-obsessive compulsive disorder is generally favorable in many reports, the need for caution has also been noted regarding the possibility of transition on to schizophrenia in more than just a few cases.

The 5-Year Course of Obsessive-Compulsive Symptoms and Obsessive-Compulsive Disorder in First-Episode Schizophrenia and Related Disorders

PubMed Central

de Haan, Lieuwe; Sterk, Bouke; Wouters, Luuk; Linszen, Don H.

2013-01-01

Objective: To determine the course of obsessive-compulsive symptoms (OCS) and obsessive-compulsive disorder (OCD) in first-episode schizophrenia and related disorders and their relationship with clinical characteristics. Methods: Consecutively, admitted patients with a first-episode of schizophrenia, schizophreniform disorder, or schizoaffective disorder were screened for OCS, and these were measured with the Yale-Brown Obsessive-Compulsive Scale. Positive and Negative Syndrome Scale and Montgomery Åsberg Depression Rating Scale were used to assess severity of other symptoms. The course of 3- and 5-year symptoms, psychotic relapse, substance use, remission, full recovery, suicide, and social functioning were assessed. Results: One hundred and eighty-six consecutively admitted and consenting patients were included. Five years after admission, OCS could be assessed in 172 patients. Ninety-one patients (48.9%) reported no OCS symptoms on any of the assessments. OCS restricted to the first assessments occured in 15.1%, 13.4% had persistent OCS, 7.0% had no OCS at first assessment but developed OCS subsequently, and 15.6% had intermittent OCS. The proportion of patients with comorbid OCD varied between 7.3% and 11.8% during follow-up. OCD was associated with more severe depressive symptoms and poorer premorbid functioning and social functioning at follow-up. Conclusions: The 5-year course of OCS/OCD in patients with first-episode schizophrenia or related disorders is variable. OCS/OCD comorbidity was not associated with a more severe course of psychotic symptoms and relapse. Comorbid OCD was associated with more severe depressive symptoms, social dysfunction and worse premorbid functioning. Specific treatment options for schizophrenia patients with comorbid OCD are needed. PMID:21799212

Prevalence and correlates of obsessive-compulsive disorder and subthreshold obsessive-compulsive disorder among college students in Kerala, India

PubMed Central

Jaisoorya, T. S.; Janardhan Reddy, Y. C.; Nair, B. Sivasankaran; Rani, Anjana; Menon, Priya G.; Revamma, M.; Jeevan, C. R.; Radhakrishnan, K. S.; Jose, Vineetha; Thennarasu, K.

2017-01-01

Context: There are scarce data on the prevalence of adult obsessive-compulsive disorder (OCD) in India. Aims: The aim was to study the point prevalence of OCD and subthreshold OCD and its psychosocial correlates among college students in the district of Ernakulam, Kerala, India. Settings and Design: A cross-sectional survey of 5784 students of the age range of 18–25 years from 58 colleges was conducted. Materials and Methods: Students were self-administered the OCD subsection of the Clinical Interview Schedule-Revised, the Composite International Diagnostic Interview for obsessive-compulsive symptoms (OCSs), and other relevant instruments to identify OCD, subthreshold OCD, and related clinical measures. Statistical Analysis: The point prevalence of OCD and subthreshold OCD was determined. Categorical variables were compared using Chi-square/Fisher's exact tests as necessary. Differences between means were compared using the ANOVA. Results: The point prevalence of OCD was 3.3% (males = 3.5%; females = 3.2%). 8.5% students (males = 9.9%; females = 7.7%) fulfilled criteria of subthreshold OCD. Taboo thoughts (67.1%) and mental rituals (57.4%) were the most common symptoms in OCD subjects. Compared to those without obsessive-compulsive symptoms (OCSs), those with OCD and subthreshold OCD were more likely to have lifetime tobacco and alcohol use, psychological distress, suicidality, sexual abuse, and higher attention-deficit/hyperactivity disorder symptom scores. Subjects with subthreshold OCD were comparable to those with OCD except that OCD subjects had higher psychological distress scores and academic failures. Conclusions: OCD and subthreshold OCD are not uncommon in the community, both being associated with significant comorbidity. Hence, it is imperative that both are identified and treated in the community because of associated morbidity. PMID:28529361

The suicidality continuum in a large sample of obsessive-compulsive disorder (OCD) patients.

PubMed

Velloso, P; Piccinato, C; Ferrão, Y; Aliende Perin, E; Cesar, R; Fontenelle, L; Hounie, A G; do Rosário, M C

2016-10-01

Obsessive-compulsive disorder (OCD) has a chronic course leading to huge impact in the patient's functioning. Suicidal thoughts and attempts are much more frequent in OCD subjects than once thought before. To empirically investigate whether the suicidal phenomena could be analyzed as a suicidality severity continuum and its association with obsessive-compulsive (OC) symptom dimensions and quality of life (QoL), in a large OCD sample. Cross-sectional study with 548 patients diagnosed with OCD according to the DSM-IV criteria, interviewed in the Brazilian OCD Consortium (C-TOC) sites. Patients were evaluated by OCD experts using standardized instruments including: Yale-Brown Obsessive-Compulsive Scale (YBOCS); Dimensional Yale-Brown Obsessive-Compulsive Scale (DYBOCS); Beck Depression and Anxiety Inventories; Structured Clinical Interview for DSM-IV (SCID); and the SF-36 QoL Health Survey. There were extremely high correlations between all the suicidal phenomena. OCD patients with suicidality had significantly lower QoL, higher severity in the "sexual/religious", "aggression" and "symmetry/ordering" OC symptom dimensions, higher BDI and BA scores and a higher frequency of suicide attempts in a family member. In the regression analysis, the factors that most impacted suicidality were the sexual dimension severity, the SF-36 QoL Mental Health domain, the severity of depressive symptoms and a relative with an attempted suicide history. Suicidality could be analyzed as a severity continuum and patients should be carefully monitored since they present with suicidal ideation. Lower QoL scores, higher scores on the sexual dimension and a family history of suicide attempts should be considered as risk factors for suicidality among OCD patients. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

The 5-year course of obsessive-compulsive symptoms and obsessive-compulsive disorder in first-episode schizophrenia and related disorders.

PubMed

de Haan, Lieuwe; Sterk, Bouke; Wouters, Luuk; Linszen, Don H

2013-01-01

To determine the course of obsessive-compulsive symptoms (OCS) and obsessive-compulsive disorder (OCD) in first-episode schizophrenia and related disorders and their relationship with clinical characteristics. Consecutively, admitted patients with a first-episode of schizophrenia, schizophreniform disorder, or schizoaffective disorder were screened for OCS, and these were measured with the Yale-Brown Obsessive-Compulsive Scale. Positive and Negative Syndrome Scale and Montgomery Åsberg Depression Rating Scale were used to assess severity of other symptoms. The course of 3- and 5-year symptoms, psychotic relapse, substance use, remission, full recovery, suicide, and social functioning were assessed. One hundred and eighty-six consecutively admitted and consenting patients were included. Five years after admission, OCS could be assessed in 172 patients. Ninety-one patients (48.9%) reported no OCS symptoms on any of the assessments. OCS restricted to the first assessments occured in 15.1%, 13.4% had persistent OCS, 7.0% had no OCS at first assessment but developed OCS subsequently, and 15.6% had intermittent OCS. The proportion of patients with comorbid OCD varied between 7.3% and 11.8% during follow-up. OCD was associated with more severe depressive symptoms and poorer premorbid functioning and social functioning at follow-up. The 5-year course of OCS/OCD in patients with first-episode schizophrenia or related disorders is variable. OCS/OCD comorbidity was not associated with a more severe course of psychotic symptoms and relapse. Comorbid OCD was associated with more severe depressive symptoms, social dysfunction and worse premorbid functioning. Specific treatment options for schizophrenia patients with comorbid OCD are needed.

[Orthorexia or when a healthy diet becomes an obsession].

PubMed

Bartrina, Javier Aranceta

2007-12-01

Orthorexia is an obsessive-compulsive process characterized by extreme care for and selection of what is considered to be pure 'healthy' food. This ritual leads to a very restrictive diet and social isolation as a compensation. Orthorexics obsessively avoid foods which may contain artificial colours, flavours, preservant agents, pesticide residues or genetically modified ingredients, unhealthy fats, foods containing too much salt or too much sugar and other components. The way of preparation, kitchenware and other tools used are also part of the obsessive ritual. People with orthorexia often have a history or features in common with anorexic patients. They are very careful, detailed and tidy persons with an exagerated need for selfcare and protection. Women, adolescents and those who practice sports suchs as bodybuidling or ahthetics are the gruops at higher risk. A short test has been suggested as a screening tool and useful for early diagnosis of the disorder. Treatment of orthorexia require a multidisciplinary team involving physicians, psychoterapists and dietitians. In some cases, antiserotoninergic drugs may be required as part of the treatment.

A controlled study of Tourette syndrome. IV. Obsessions, compulsions, and schizoid behaviors.

PubMed Central

Comings, D E; Comings, B G

1987-01-01

To determine the frequency of obsessive, compulsive, and schizoid behaviors in Tourette syndrome (TS), we prospectively questioned 246 patients with TS, 17 with attention-deficit disorder (ADD), 15 with ADD due to a TS gene, and 47 random controls. The comparative frequency of obsessive, compulsive, and repetitive behaviors--such as obsessive unpleasant thoughts, obsessive silly thoughts, echolalia, palilalia, touching things excessively, touching things a specific number of times, touching others excessively, sexual touching, biting or hurting oneself, head banging, rocking, mimicking others, counting things, and occasional or frequent public exhibitionism--were significantly more common in TS patients than in controls. The frequency of each of these was much higher for grade 3 (severe) TS. Most of these behaviors also occurred significantly more often in individuals with ADD or in individuals with ADD secondary to TS (ADD 2(0) TS). When these features were combined into an obsessive-compulsive score, 45.4% of TS patients had a score of 4-15, whereas 8.5% of controls had a score of 4 or 5. These results indicate that obsessive-compulsive behaviors are an integral part of the expression of the TS gene and can be inherited as an autosomal dominant trait. Schizoid symptoms, such as thinking that people were watching them or plotting against them, were significantly more common in TS patients than in controls. Auditory hallucinations of hearing voices were present in 14.6% of TS patients, compared with 2.1% of controls (P = .02). These symptoms were absent in ADD patients but present in ADD 2(0) TS patients. These voices were often blamed for telling them to do bad things and were frequently identified with the devil. None of the controls had a total schizoid behavior score greater than 3, whereas 10.9% of the TS patients had scores of 4-10 (P = .02). This frequency increased to 20.6% in the grade 3 TS patients. These quantitative results confirm our clinical impression that some TS patients have paranoid ideations, often feel that people are out to get them, and hear voices. PMID:3479015

OCD Taboo Thoughts and Stigmatizing Attitudes in Clinicians.

PubMed

Steinberg, Daniel S; Wetterneck, Chad T

2017-04-01

Individuals who suffer from obsessive-compulsive disorder have persistent intrusive thoughts that cause severe distress that impairs daily functioning. These individuals often conceal their intrusive thoughts and delay help-seeking for fear of being stigmatized. Stigma can be problematic when it is present among mental health professionals because they may distance themselves from their clients and have a negative outlook on treatment outcome. To date there has not been any research that focuses on stigma that clinician's may hold towards obsessive-compulsive disorder or specific obsessions; however, there is evidence that mental health professionals may have prejudices towards individuals who suffer from other mental illnesses. The current study aimed to explore clinician and student clinician attitudes about obsessional content from varying symptom dimensions. Results indicated participants were more likely to socially reject or be concerned by individuals with obsessions related to contamination, harming, and sexual obsessions than those with scrupulous obsessions, and that they would be less likely to reveal sexual obsessions to others if they were experiencing them than the other three types of obsessions.

Obsessive-compulsive disorder: Insights from animal models☆

PubMed Central

Szechtman, Henry; Ahmari, Susanne E.; Beninger, Richard J.; Eilam, David; Harvey, Brian H.; Edemann-Callesen, Henriette; Winter, Christine

2017-01-01

Research with animal models of obsessive-compulsive disorder (OCD) shows the following: (1) Optogenetic studies in mice provide evidence for a plausible cause-effect relation between increased activity in cortico-basal ganglia-thalamo-cortical (CBGTC) circuits and OCD by demonstrating the induction of compulsive behavior with the experimental manipulation of the CBGTC circuit. (2) Parallel use of several animal models is a fruitful paradigm to examine the mechanisms of treatment effects of deep brain stimulation in distinct OCD endophenotypes. (3) Features of spontaneous behavior in deer mice constitute a rich platform to investigate the neurobiology of OCD, social ramifications of a compulsive phenotype, and test novel drugs. (4) Studies in animal models for psychiatric disorders comorbid with OCD suggest comorbidity may involve shared neural circuits controlling expression of compulsive behavior. (5) Analysis of compulsive behavior into its constitutive components provides evidence from an animal model for a motivational perspective on OCD. (6) Methods of behavioral analysis in an animal model translate to dissection of compulsive rituals in OCD patients, leading to diagnostic tests. PMID:27168347

The Future of D-Cycloserine and Other Cognitive Modifiers in Obsessive-Compulsive and Related Disorders

PubMed Central

Sulkowski, Michael L.; Geller, Daniel A.; Lewin, Adam B.; Murphy, Tanya K.; Mittelman, Andrew; Brown, Ashley; Storch, Eric A.

2014-01-01

Variants of exposure therapy are effective for treating obsessive-compulsive and related disorders (OCRDs). However, significant numbers of patients do not respond adequately to exposure therapy resulting in continued distress and functional impairment. Therefore, novel approaches to augmenting exposure therapy are needed to adequately treat non- and partial-responders. Emerging research suggests that interventions that augment learning and memory processes associated with exposure therapy (i.e., extinction training) may display promise in enhancing treatment response in OCRDs. As the most studied example, d-cycloserine (DCS) is a relatively safe cognitive enhancer that appears to accelerate treatment gains associated with exposure therapy. This article reviews research on the use of DCS and other putative cognitive modifiers as they relate to the treatment (or prospective treatment) of obsessive-compulsive disorder and other OCRDs. PMID:25383074

Using Family-Based Exposure With Response Prevention to Treat Obsessive-Compulsive Disorder in Young Children: A Case Study.

PubMed

Herren, Jenny; Freeman, Jennifer; Garcia, Abbe

2016-11-01

Cognitive-behavioral therapy (CBT) using exposure with response prevention (ERP) is the treatment of choice for obsessive-compulsive disorder (OCD); however, developmental modifications should be considered when treating young children. This article presents a case study illustrating family-based CBT using ERP with a 7-year-old boy. The delivery of ERP for this case was guided by 3 main principles: (a) family involvement with a focus on reducing family accommodation, (b) understanding the functional relation between the client's obsessions and compulsions, and (c) creating conditions to facilitate habituation during exposure. Outcomes for this case indicate significant improvement in functioning and OCD symptoms. Results highlight the importance of family involvement and the applicability of using a function-based habituation framework when delivering ERP to this unique population. © 2016 Wiley Periodicals, Inc.

Obsessive-compulsive characteristics: from symptoms to syndrome.

PubMed

Apter, A; Fallon, T J; King, R A; Ratzoni, G; Zohar, A H; Binder, M; Weizman, A; Leckman, J F; Pauls, D L; Kron, S; Cohen, D J

1996-07-01

To assess the distribution and severity of obsessions and compulsions in a nonclinical adolescent population. During preinduction military screening, 861 sixteen-year-old Israelis completed a questionnaire regarding the lifetime presence of eight obsessive-compulsive (OC) symptoms and three severity measures. The presence or absence of obsessive-compulsive disorder (OCD) or subclinical OCD was ascertained by an independent interview. Although only 8.0% and 6.3% of respondents reported disturbing and intrusive thoughts, respectively, 27% to 72% of subjects endorsed the six remaining OCD symptoms. Twenty percent of subjects regarded the symptoms they endorsed as senseless and 3.5% found them disturbing; 8% reported spending more than an hour daily on symptoms. OCD and subclinical OCD cases differed significantly from non-OCD cases, but not from each other, in distress and mean number of symptoms. Although the distribution of nine of the items differed for noncases, compared with OCD and subclinical OCD cases, the distributions for all items overlapped markedly across the three groups. OC phenomena appear to be on a continuum with few symptoms and minimal severity at one end and many symptoms and severe impairment on the other. Defining optimal cutoff points for distinguishing between psychiatric disorder and OC phenomena that are common in the general population remains an open question.

Sensory phenomena related to tics, obsessive-compulsive symptoms, and global functioning in Tourette syndrome.

PubMed

Kano, Yukiko; Matsuda, Natsumi; Nonaka, Maiko; Fujio, Miyuki; Kuwabara, Hitoshi; Kono, Toshiaki

2015-10-01

Sensory phenomena, including premonitory urges, are experienced by patients with Tourette syndrome (TS) and obsessive-compulsive disorder (OCD). The goal of the present study was to investigate such phenomena related to tics, obsessive-compulsive symptoms (OCS), and global functioning in Japanese patients with TS. Forty-one patients with TS were assessed using the University of São Paulo Sensory Phenomena Scale (USP-SPS), the Premonitory Urge for Tics Scale (PUTS), the Yale Global Tic Severity Scale (YGTSS), the Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS), and the Global Assessment of Functioning (GAF) Scale. USP-SPS and PUTS total scores were significantly correlated with YGTSS total and vocal tics scores. Additionally, both sensory phenomena severity scores were significantly correlated with DY-BOCS total OCS scores. Of the six dimensional OCS scores, the USP-SPS scores were significantly correlated with measures of aggression and sexual/religious dimensions. Finally, the PUTS total scores were significantly and negatively correlated with GAF scores. By assessing premonitory urges and broader sensory phenomena, and by viewing OCS from a dimensional approach, this study provides significant insight into sensory phenomena related to tics, OCS, and global functioning in patients with TS. Copyright © 2015 Elsevier Inc. All rights reserved.

Prevalence of Childhood Obsessive-Compulsive Personality Traits in Adults with Obsessive Compulsive Disorder versus Obsessive Compulsive Personality Disorder.

PubMed

Pinto, Anthony; Greene, Ashley L; Storch, Eric A; Simpson, H Blair

2015-01-01

Identifying risk factors of psychopathology has been an important research challenge. Prior studies examining the impact of childhood temperament on adult disorder have largely focused on undercontrolled and inhibited presentations, with little study of overcontrolled traits such as obsessive-compulsive personality traits (OCPTs). We compared rates of childhood OCPTs in adults with OCD (without OCPD) (n = 28) to adults with OCPD (without OCD) (n = 27), adults with both OCD and OCPD (n = 28), and healthy controls (HC) (n= 28), using the Childhood Retrospective Perfectionism Questionnaire, a validated measure of perfectionism, inflexibility, and drive for order. Adults with OCPD (both with and without comorbid OCD) reported higher rates of all three childhood OCPTs relative to HC. Individuals with OCD (without OCPD) reported higher rates of inflexibility and drive for order relative to HC, suggesting that these traits may presage the development of OCD, independent of OCPD. Childhood OCPTs were associated with particular OCD symptom dimensions in adulthood (contamination/cleaning, doubt/checking, and symmetry/ordering), independent of OCD onset age and OCPD diagnosis. Longitudinal prospective studies evaluating OCPTs in children are needed to better understand the progression of these traits from childhood to adulthood and their ability to predict future psychopathology.

Clarifying the convergence between obsessive compulsive personality disorder criteria and obsessive compulsive disorder.

PubMed

Eisen, Jane L; Coles, Meredith E; Shea, M Tracie; Pagano, Maria E; Stout, Robert L; Yen, Shirley; Grilo, Carlos M; Rasmussen, Steven A

2006-06-01

In this study we examined the convergence between obsessive-compulsive personality disorder (OCPD) criteria and obsessive-compulsive disorder (OCD). Baseline assessments of 629 participants of the Collaborative Longitudinal Personality Disorders Study were used to examine the associations between OCPD criteria and diagnoses of OCD. Three of the eight OCPD criteria--hoarding, perfectionism, and preoccupation with details--were significantly more frequent in subjects with OCD (n = 89) than in subjects without OCD (n = 540). Logistic regressions were used to predict the probability of each OCPD criterion as a function of Axis I diagnoses (OCD, additional anxiety disorders, and major depressive disorder). Associations between OCD and these three OCPD criteria remained significant in the logistic regressions, showing unique associations with OCD and odds ratios ranging from 2.71 to 2.99. In addition, other anxiety disorders and major depressive disorder showed few associations with specific OCPD criteria. This study suggests variability in the strength of the relationships between specific OCPD criteria and OCD. The findings also support a unique relationship between OCPD symptoms and OCD, compared to other anxiety disorders or major depression. Future efforts to explore the link between Axis I and Axis II disorders may be enriched by conducting analyses at the symptom level.

CLARIFYING THE CONVERGENCE BETWEEN OBSESSIVE COMPULSIVE PERSONALITY DISORDER CRITERIA AND OBSESSIVE COMPULSIVE DISORDER

PubMed Central

Eisen, Jane L.; Coles, Meredith E.; Shea, M. Tracie; Pagano, Maria E.; Stout, Robert L.; Yen, Shirley; Grilo, Carlos M.; Rasmussen, Steven A.

2008-01-01

In this study we examined the convergence between obsessive-compulsive personality disorder (OCPD) criteria and obsessive-compulsive disorder (OCD). Baseline assessments of 629 participants of the Collaborative Longitudinal Personality Disorders Study were used to examine the associations between OCPD criteria and diagnoses of OCD. Three of the eight OCPD criteria—hoarding, perfectionism, and preoccupation with details—were significantly more frequent in subjects with OCD (n = 89) than in subjects without OCD (n = 540). Logistic regressions were used to predict the probability of each OCPD criterion as a function of Axis I diagnoses (OCD, additional anxiety disorders, and major depressive disorder). Associations between OCD and these three OCPD criteria remained significant in the logistic regressions, showing unique associations with OCD and odds ratios ranging from 2.71 to 2.99. In addition, other anxiety disorders and major depressive disorder showed few associations with specific OCPD criteria. This study suggests variability in the strength of the relationships between specific OCPD criteria and OCD. The findings also support a unique relationship between OCPD symptoms and OCD, compared to other anxiety disorders or major depression. Future efforts to explore the link between Axis I and Axis II disorders may be enriched by conducting analyses at the symptom level. PMID:16776557

Comorbid obsessive-compulsive personality disorder in obsessive-compulsive disorder (OCD): a marker of severity.

PubMed

Lochner, Christine; Serebro, Paul; van der Merwe, Lize; Hemmings, Sian; Kinnear, Craig; Seedat, Soraya; Stein, Dan J

2011-06-01

Comorbid obsessive-compulsive personality disorder (OCPD) is well-described in obsessive-compulsive disorder (OCD). It remains unclear, however, whether OCPD in OCD represents a distinct subtype of OCD or whether it is simply a marker of severity in OCD. The aim of this study was to compare a large sample of OCD subjects (n=403) with and without OCPD on a range of demographic, clinical and genetic characteristics to evaluate whether comorbid OCPD in OCD represents a distinct subtype of OCD, or is a marker of severity. Our findings suggest that OCD with and without OCPD are similar in terms of gender distribution and age at onset of OC symptoms. Compared to OCD-OCPD (n=267, 66%), those with OCD+OCPD (n=136, 34%) are more likely to present with the OC symptom dimensions which reflect the diagnostic criteria for OCPD (e.g., hoarding), and have significantly greater OCD severity, comorbidity, functional impairment, and poorer insight. Furthermore there are no differences in distribution of gene variants, or response to treatment in the two groups. The majority of our findings suggest that in OCD, patients with OCPD do not have a highly distinctive phenomenological or genetic profile, but rather that OCPD represents a marker of severity. Copyright © 2011 Elsevier Inc. All rights reserved.

The Impact of Obsessive Compulsive Personality Disorder on Cognitive Behaviour Therapy for Obsessive Compulsive Disorder.

PubMed

Gordon, Olivia M; Salkovskis, Paul M; Bream, Victoria

2016-07-01

It is often suggested that, in general, co-morbid personality disorders are likely to interfere with CBT based treatment of Axis I disorders, given that personality disorders are regarded as dispositional and are therefore considered less amenable to change than axis I psychiatric disorders. The present study aimed to investigate the impact of co-occurring obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) on cognitive-behavioural treatment for OCD. 92 individuals with a diagnosis of OCD participated in this study. Data were drawn from measures taken at initial assessment and following cognitive-behavioural treatment at a specialist treatment centre for anxiety disorders. At assessment, participants with OCD and OCPD had greater overall OCD symptom severity, as well as doubting, ordering and hoarding symptoms relative to those without OCPD; however, participants with co-morbid OCD and OCPD demonstrated greater treatment gains in terms of OCD severity, checking and ordering than those without OCPD. Individuals with OCD and OCPD had higher levels of checking, ordering and overall OCD severity at initial assessment; however, at post-treatment they had similar scores to those without OCPD. The implications of these findings are discussed in the light of research on axis I and II co-morbidity and the impact of axis II disorders on treatment for axis I disorders.

Prevalence of Childhood Obsessive-Compulsive Personality Traits in Adults with Obsessive Compulsive Disorder versus Obsessive Compulsive Personality Disorder

PubMed Central

Pinto, Anthony; Greene, Ashley L.; Storch, Eric A.; Simpson, H. Blair

2014-01-01

Identifying risk factors of psychopathology has been an important research challenge. Prior studies examining the impact of childhood temperament on adult disorder have largely focused on undercontrolled and inhibited presentations, with little study of overcontrolled traits such as obsessive-compulsive personality traits (OCPTs). We compared rates of childhood OCPTs in adults with OCD (without OCPD) (n = 28) to adults with OCPD (without OCD) (n = 27), adults with both OCD and OCPD (n = 28), and healthy controls (HC) (n= 28), using the Childhood Retrospective Perfectionism Questionnaire, a validated measure of perfectionism, inflexibility, and drive for order. Adults with OCPD (both with and without comorbid OCD) reported higher rates of all three childhood OCPTs relative to HC. Individuals with OCD (without OCPD) reported higher rates of inflexibility and drive for order relative to HC, suggesting that these traits may presage the development of OCD, independent of OCPD. Childhood OCPTs were associated with particular OCD symptom dimensions in adulthood (contamination/cleaning, doubt/checking, and symmetry/ordering), independent of OCD onset age and OCPD diagnosis. Longitudinal prospective studies evaluating OCPTs in children are needed to better understand the progression of these traits from childhood to adulthood and their ability to predict future psychopathology. PMID:25574456

Seasonal mood changes in patients with obsessive-compulsive disorder.

PubMed

Tan, Oğuz; Metin, Barış; Ünsalver, Barış Önen; Sayar, Gökben Hızlı

2017-12-01

Obsessive-compulsive disorder (OCD) is frequently associated with mood disorders. However, to date, the co-occurrence of OCD with seasonal affective disorder (SAD) has not been investigated. We have aimed to estimate the prevalence of seasonal mood changes in patients with OCD and explore the contribution of seasonality in mood to the severity of OCD. The Seasonal Pattern Assessment Questionnaire (SPAQ), the Yale-Brown Obsession and Compulsion Scale (Y-BOCS), the Hamilton Depression Rating Scale-17 Items (HDRS-17), and the Beck Anxiety Inventory (BAI) were administered to patients with OCD (n=104) and controls (n=125). The degree of seasonality was measured by the Global Seasonality Score (GSS) calculated from the SPAQ. SAD and subsyndromal seasonal affective disorder (S-SAD) were significantly more prevalent in patients with OCD (53%, n=55) than controls (25%, n=31). When patients were assessed in the season in which SAD occurs, depression and compulsions (but not obsessions, OCD or anxiety) were more severe than those assessed in a season during which SAD does not occur. SAD frequently co-occurs with OCD and, given this co-occurrence, depression symptoms in some patients with OCD might be expected to vary on a seasonal basis. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Symptom dimensions, clinical course and comorbidity in men and women with obsessive-compulsive disorder.

PubMed

Torresan, Ricardo C; Ramos-Cerqueira, Ana Teresa A; Shavitt, Roseli G; do Rosário, Maria Conceição; de Mathis, Maria Alice; Miguel, Euripedes C; Torres, Albina R

2013-09-30

The study aimed to compare male and female patients with obsessive-compulsive disorder (OCD) across symptom dimensions, clinical course and comorbidity. A cross-sectional study was undertaken with 858 adult OCD patients (DSM-IV) from the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders. Patients were evaluated using structured interviews, including the Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS) and the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I). The sample was composed of 504 women (58.7%) and 354 men (41.3%) with a mean age of 35.4 years-old (range: 18-77). Men were younger, more frequently single and presented more tics, social phobia and alcohol use disorders. Among men, symptom interference occurred earlier and symptoms of the sexual/religious dimension were more common and more severe. Conversely, women were more likely to present symptoms of the aggressive, contamination/cleaning and hoarding dimension and comorbidity with specific phobias, anorexia nervosa, bulimia, trichotillomania, skin picking and "compulsive" buying. In the logistic regression, female gender remained independently associated with the aggressive and contamination/cleaning dimensions. In both genders the aggressive dimension remained associated with comorbid post-traumatic stress disorder, the sexual/religious dimension with major depression and the hoarding dimension with tic disorders. Gender seems to be relevant in the determination of OCD clinical presentation and course and should be considered an important aspect when defining more homogeneous OCD subgroups. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Fluorinated Cannabidiol Derivatives: Enhancement of Activity in Mice Models Predictive of Anxiolytic, Antidepressant and Antipsychotic Effects.

PubMed

Breuer, Aviva; Haj, Christeene G; Fogaça, Manoela V; Gomes, Felipe V; Silva, Nicole Rodrigues; Pedrazzi, João Francisco; Del Bel, Elaine A; Hallak, Jaime C; Crippa, José A; Zuardi, Antonio W; Mechoulam, Raphael; Guimarães, Francisco S

2016-01-01

Cannabidiol (CBD) is a major Cannabis sativa constituent, which does not cause the typical marijuana psychoactivity. However, it has been shown to be active in a numerous pharmacological assays, including mice tests for anxiety, obsessive-compulsive disorder, depression and schizophrenia. In human trials the doses of CBD needed to achieve effects in anxiety and schizophrenia are high. We report now the synthesis of 3 fluorinated CBD derivatives, one of which, 4'-F-CBD (HUF-101) (1), is considerably more potent than CBD in behavioral assays in mice predictive of anxiolytic, antidepressant, antipsychotic and anti-compulsive activity. Similar to CBD, the anti-compulsive effects of HUF-101 depend on cannabinoid receptors.

Suicide in patients treated for obsessive-compulsive disorder: a prospective follow-up study.

PubMed

Alonso, P; Segalàs, C; Real, E; Pertusa, A; Labad, J; Jiménez-Murcia, S; Jaurrieta, N; Bueno, B; Vallejo, J; Menchón, J M

2010-08-01

To describe the occurrence of persistent suicidal ideation and suicide attempts in a sample of obsessive-compulsive patients followed-up prospectively during 1 to 6years, and to determine the existence of predictors of suicide behavior. Two hundred and eighteen outpatients with DSM-IV OCD, recruited from a specialized OCD Unit in Barcelona, Spain, between February 1998 and December 2007, were included in the study. Suicide ideation was assessed by item 3 of the Hamilton Depression Rating Scale. Suicide attempts were evaluated by the Beck Suicide Intent Scale. Patients with and without persistent suicidal thoughts and suicide attempters and non-attempters were compared on sociodemographic and clinical variables. A Cox proportional hazards regression analysis was used to estimate potential predictors of suicide. Patients completed a mean follow-up period of treatment of 4.1years (SD: 1.7; range: 1-6years). During this period, eighteen patients (8.2%) reported persistent suicidal ideation, two patients (0.91%) committed suicide and 11 (5.0%) attempted suicide. Being unmarried, presenting higher basal scores in the HDRS, current or previous history of affective disorders and symmetry/ordering obsessions were independently associated with suicidal behaviors. Patients were recruited from a specialized OCD clinic and received exhaustive treatment. Influence of variables including social support, life events, hopelessness and substance abuse/dependence was not assessed. Suicide behavior is not a highly common phenomenon in OCD, but it should not be disregarded, especially in unmarried patients, with comorbid depression and symmetry/ordering obsessions and compulsions, who appear to be at a greater risk for suicide acts. Copyright 2009 Elsevier B.V. All rights reserved.

Transcranial direct current stimulation for obsessive-compulsive disorder: A randomized, controlled, partial crossover trial.

PubMed

D'Urso, Giordano; Brunoni, Andre R; Mazzaferro, Maria Pia; Anastasia, Annalisa; de Bartolomeis, Andrea; Mantovani, Antonio

2016-12-01

Presupplementary motor area (pre-SMA) hyperactivity has been detected in obsessive-compulsive disorder (OCD) patients. However, it is not understood whether this is a putative primary cause or a compensatory mechanism in OCD pathophysiology. Considering the polarity-dependent effects on cortical excitability of transcranial direct current stimulation (tDCS), we applied cathodal and/or anodal tDCS to the pre-SMA of OCD patients to test which current polarity might better improve symptoms. Twelve OCD patients received initially 10 anodal (n = 6) or cathodal (n = 6) daily consecutive 2 mA/20 min tDCS sessions with the active electrode placed bilaterally on the pre-SMA. In case of improvement or no change in symptoms severity, the subjects were maintained on the same current polarity for 10 more sessions. In case of symptoms worsening after the first 10 sessions they were switched to the other polarity for 10 more sessions to test the hypothesis of a polarity-dependent effect. Therefore, each subject received 20 tDCS sessions. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the Sheehan Disability Scale (SDS) were administered biweekly to assess changes in symptoms severity. After 10 sessions, 50% of patients who initially received anodal stimulation were switched to cathodal, while 100% of patients initially assigned to cathodal stimulation continued on the same polarity. At the end of the study, a statistically significant decrease was observed in the mean Y-BOCS scores of those patients who underwent cathodal tDCS. No pre-post difference was found in the scores of patients following anodal tDCS. Cathodal but not anodal tDCS over the pre-SMA significantly improved OCD symptoms. © 2016 Wiley Periodicals, Inc.

The Impact of Symptom Dimensions on Outcome for Exposure and Ritual Prevention Therapy in Obsessive-Compulsive Disorder

PubMed Central

Williams, Monnica T.; Farris, Samantha G.; Turkheimer, Eric N.; Franklin, Martin E.; Simpson, H. Blair; Liebowitz, Michael; Foa, Edna B.

2014-01-01

Objective Obsessive-compulsive disorder (OCD) is a severe condition with varied symptom presentations. The behavioral treatment with the most empirical support is exposure and ritual prevention (EX/RP). This study examined the impact of symptom dimensions on EX/RP outcomes in OCD patients. Method The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was used to determine primary symptoms for each participant. An exploratory factor analysis (EFA) of 238 patients identified five dimensions: contamination/cleaning, doubts about harm/checking, hoarding, symmetry/ordering, and unacceptable/taboo thoughts (including religious/moral and somatic obsessions among others). A linear regression was conducted on those who had received EX/RP (n = 87) to examine whether scores on the five symptom dimensions predicted post-treatment Y-BOCS scores, accounting for pre-treatment Y-BOCS scores. Results The average reduction in Y-BOCS score was 43.0%, however the regression indicated that unacceptable/taboo thoughts (β = .27, p = .02) and hoarding dimensions (β = .23, p = .04) were associated with significantly poorer EX/RP treatment outcomes. Specifically, patients endorsing religious/moral obsessions, somatic concerns, and hoarding obsessions showed significantly smaller reductions in Y-BOCS severity scores. Conclusions EX/RP was effective for all symptom dimensions, however it was less effective for unacceptable/taboo thoughts and hoarding than for other dimensions. Clinical implications and directions for research are discussed. PMID:24983796

[On the history of obsessive compulsive disorders: their place in the nosological classifications up to the beginning of the 20th century].

PubMed

Oberbeck, A; Stengler, K; Steinberg, H

2013-12-01

Influenced by French psychiatry, the first German works on obsessive-compulsive phenomena were published in the second half of the 19th century. First they were seen as one form of the unitary psychosis, later they became involved in the dispute about the concept of paranoia. The first German definition, proposed by Carl Westphal in 1877 and of crucial importance in the conceptual history of obsessive disorders as an illness (OCD) ever since, stood in this tradition. Still the adequate nosological classification of obsessive phenomena was still heavily disputed. As more and more varied forms of obsessive disorders were described, the highly unspecific concept of neurasthenia gained importance. Then degeneration theory was a widespread aetiological concept to integrate the large number of obsessive phenomena. Towards the end of the 19th century, when psychoanalysis emerged, psychological aspects started to interest psychiatrists and psychoanalytical suggestions like Sigmund Freud's concept of obsessional neurosis were discussed. However, none of these different nosological suggestions, nor any of the proposed definitions, found general approval. Above all the question to what extent affects were involved and whether certain phenomena were compulsive in nature or not remained the subject of (ongoing) controversy. This led to a variety of highly inconsistent aetiopathogenetic concepts being proposed. © Georg Thieme Verlag KG Stuttgart · New York.

1H magnetic resonance spectroscopy evidence for occipital involvement in treatment-naive paediatric obsessive-compulsive disorder.

PubMed

Ljungberg, Maria; Nilsson, Marie K L; Melin, Karin; Jönsson, Lars; Carlsson, Arvid; Carlsson, Åsa; Forssell-Aronsson, Eva; Ivarsson, Tord; Carlsson, Maria; Starck, Göran

2017-06-01

Obsessive-compulsive disorder (OCD) is a chronic psychiatric disorder leading to considerable distress and disability. Therapies are effective in a majority of paediatric patients, however, many only get partial response. It is therefore important to study the underlying pathophysiology of the disorder. 1H magnetic resonance spectroscopy (MRS) was used to study the concentration of brain metabolites in four different locations (cingulate gyrus and sulcus, occipital cortex, thalamus and right caudate nucleus). Treatment-naive children and adolescents with OCD (13 subjects) were compared with a group of healthy age- and gender-matched subjects (11 subjects). Multivariate analyses were performed on the concentration values. No separation between controls and patients was found. However, a correlation between metabolite concentrations and symptom severity as measured with the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) was found. Strongest was the correlation with the CY-BOCS obsession subscore and aspartate and choline in the caudate nucleus (positively correlated with obsessions), lipids at 2 and 0.9 ppm in thalamus, and occipital glutamate+glutamine, N-acetylaspartate and myo-inosytol (negatively correlated with obsessions). The observed correlations between 1H MRS and CY-BOCS in treatment-naive patients further supports an occipital involvement in OCD. The results are consistent with our previous study on adult OCD patients. The 1H MRS data were not supportive of a separation between the patient and control groups.

The impact of symptom dimensions on outcome for exposure and ritual prevention therapy in obsessive-compulsive disorder.

PubMed

Williams, Monnica T; Farris, Samantha G; Turkheimer, Eric N; Franklin, Martin E; Simpson, H Blair; Liebowitz, Michael; Foa, Edna B

2014-08-01

Obsessive-compulsive disorder (OCD) is a severe condition with varied symptom presentations. The behavioral treatment with the most empirical support is exposure and ritual prevention (EX/RP). This study examined the impact of symptom dimensions on EX/RP outcomes in OCD patients. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was used to determine primary symptoms for each participant. An exploratory factor analysis (EFA) of 238 patients identified five dimensions: contamination/cleaning, doubts about harm/checking, hoarding, symmetry/ordering, and unacceptable/taboo thoughts (including religious/moral and somatic obsessions among others). A linear regression was conducted on those who had received EX/RP (n=87) to examine whether scores on the five symptom dimensions predicted post-treatment Y-BOCS scores, accounting for pre-treatment Y-BOCS scores. The average reduction in Y-BOCS score was 43.0%, however the regression indicated that unacceptable/taboo thoughts (β=.27, p=.02) and hoarding dimensions (β=.23, p=.04) were associated with significantly poorer EX/RP treatment outcomes. Specifically, patients endorsing religious/moral obsessions, somatic concerns, and hoarding obsessions showed significantly smaller reductions in Y-BOCS severity scores. EX/RP was effective for all symptom dimensions, however it was less effective for unacceptable/taboo thoughts and hoarding than for other dimensions. Clinical implications and directions for research are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Understanding the disease of addiction.

PubMed

Detar, D Todd

2011-03-01

Addiction is a chronic brain disease. Drug addiction manifests as a compulsive obsession to use a substance despite serious detrimental and sometimes irreversible consequences. Drug addiction is not the same as drug dependency because dependency may not manifest as an addictive behavior. This problem is fundamental to understanding the disease of addiction. This article discusses the neurobiology and genetics of drug addiction. Copyright © 2011. Published by Elsevier Inc.

The mediating role of disgust sensitivity and thought-action fusion between religiosity and obsessive compulsive symptoms.

PubMed

Inozu, Mujgan; Ulukut, Fulya Ozcanli; Ergun, Gokce; Alcolado, Gillian M

2014-10-01

Psychological theories of obsessions and compulsions have long recognised that strict religious codes and moral standards might promote thought-action fusion (TAF) appraisals. These appraisals have been implicated in the transformation of normally occurring intrusions into clinically distressing obsessions. Furthermore, increased disgust sensitivity has also been reported to be associated with obsessive compulsive (OC) symptoms. No research, however, has investigated the mediating roles of TAF and disgust sensitivity between religiosity and OC symptoms. This study was composed of 244 undergraduate students who completed measures of OC symptoms, TAF, disgust sensitivity, religiosity and negative effect. Analyses revealed that the relationship between religiosity and OC symptoms was mediated by TAF and disgust sensitivity. More importantly, the mediating role of TAF was not different across OC symptom subtypes, whereas the mediating role of disgust sensitivity showed different patterns across OC symptom subtypes. These findings indicate that the tendency for highly religious Muslims to experience greater OC symptoms is related to their heightened beliefs about disgust sensitivity and the importance of thoughts. © 2014 International Union of Psychological Science.

Intravenous Clomipramine for Treatment-Resistant Obsessive-Compulsive Disorder.

PubMed

Karameh, Wael Karameh; Khani, Munir

2015-07-28

This open trial was conducted to evaluate the effectiveness of intravenous clomipramine (CMI) in refractory obsessive-compulsive disorder (OCD). Thirty OCD poor responders to previous multiple trials of anti-obsessive medications were selected and admitted to the hospital. Severity of the illness and response to treatment were primarily assessed by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). CMI was gradually administered intravenously for one week. All patients were thereafter switched to oral CMI with a maximum dose of 225 mg/day. The Y-BOCS total score mean at admission was in the severe range (24-31), and dropped on discharge and follow-ups to the moderate range (16-23). At discharge, 23 patients (76.7%) had a decrease in Y-BOCS ≥ 25% and were considered responders, while only 18 (60%) were still responders at 24 weeks. No relevant persistent side effects were reported. Intravenous clomipramine could be of benefit for severe OCD cases that have not adequately responded to several therapies, including oral clomipramine. © The Author 2015. Published by Oxford University Press on behalf of CINP.

Personality Disorders in Obsessive-Compulsive Disorder: A Comparative Study versus Other Anxiety Disorders

PubMed Central

Pena-Garijo, Josep; Edo Villamón, Silvia; Ruipérez, M. Ángeles

2013-01-01

Objective. The purpose of this paper is to provide evidence for the relationship between personality disorders (PDs), obsessive compulsive disorder (OCD), and other anxiety disorders different from OCD (non-OCD) symptomatology. Method. The sample consisted of a group of 122 individuals divided into three groups (41 OCD; 40 non-OCD, and 41 controls) matched by sex, age, and educational level. All the individuals answered the IPDE questionnaire and were evaluated by means of the SCID-I and SCID-II interviews. Results. Patients with OCD and non-OCD present a higher presence of PD. There was an increase in cluster C diagnoses in both groups, with no statistically significant differences between them. Conclusions. Presenting anxiety disorder seems to cause a specific vulnerability for PD. Most of the PDs that were presented belonged to cluster C. Obsessive Compulsive Personality Disorder (OCPD) is the most common among OCD. However, it does not occur more frequently among OCD patients than among other anxious patients, which does not confirm the continuum between obsessive personality and OCD. Implications for categorical and dimensional diagnoses are discussed. PMID:24453917

Anterior capsulotomy for refractory OCD: First case as per the core group guidelines.

PubMed

Doshi, Paresh K

2011-07-01

Obsessive-compulsive disorder (OCD) is a psychiatric disease characterized by anxiety-provoking thoughts (obsessions) leading to repeated, time-consuming behaviors (compulsions) that may or may not provide temporary relief. With an approximate prevalence of 2-3% of the general population and 0.6% in the Indian population, OCD is a debilitating disorder that can significantly affect nearly every aspect of a patient's life, and in some cases, lead to suicide.

Obsessive-compulsive symptoms in clozapine-treated schizophrenic patients.

PubMed

Ertugrul, Aygun; Anil Yagcioglu, A Elif; Eni, Nurhayat; Yazici, Kâzim M

2005-04-01

The aim of the present study was to assess the occurrence of obsessive-compulsive symptoms (OCS) in schizophrenic patients treated with clozapine, and to examine the relationship between OCS and other clinical variables. The results support earlier findings which suggest that clozapine produces or unmasks OCS. In addition, the severity of OCS was not related to other dimensions of psychopathology, severity of illness, clinical improvement or dose and duration of clozapine treatment.

Performance monitoring during associative learning and its relation to obsessive-compulsive characteristics.

PubMed

Doñamayor, Nuria; Dinani, Jakob; Römisch, Manuel; Ye, Zheng; Münte, Thomas F

2014-10-01

Neural responses to performance errors and external feedback have been suggested to be altered in obsessive-compulsive disorder. In the current study, an associative learning task was used in healthy participants assessed for obsessive-compulsive symptoms by the OCI-R questionnaire. The task included a condition with equivocal feedback that did not inform about the participants' performance. Following incorrect responses, an error-related negativity and an error positivity were observed. In the feedback phase, the largest feedback-related negativity was observed following equivocal feedback. Theta and beta oscillatory components were found following incorrect and correct responses, respectively, and an increase in theta power was associated with negative and equivocal feedback. Changes over time were also explored as an indicator for possible learning effects. Finally, event-related potentials and oscillatory components were found to be uncorrelated with OCI-R scores in the current non-clinical sample. Copyright © 2014 Elsevier B.V. All rights reserved.

Dream recall and dream content in obsessive-compulsive patients: is there a change during exposure treatment?

PubMed

Kuelz, Anne K; Stotz, Ulrike; Riemann, Dieter; Schredl, Michael; Voderholzer, Ulrich

2010-08-01

Very little is known about dreams in patients with obsessive compulsive disorder, especially regarding changes over the course of treatment with stimulus exposure and response prevention. By use of dream content analysis, 40 dreams of 9 obsessive compulsive (OC) inpatients were compared with 84 dreams of 10 matched OC outpatients and 63 dreams of 11 healthy control participants. Dream protocols of inpatients were collected at the beginning of treatment and after the first exposure exercises. Controls filled in dream protocols in respective intervals. Before treatment, dreams of patients showed significantly less positive contents than dreams of healthy controls. Under treatment with exposure, a significant reduction of OC themes was observed. The findings support the continuity hypothesis of dreaming by showing a link between day-time symptoms and OC symptoms in dreams. Contrary to expectations, however, exposure treatment does not intensify dreams.

Moderators of Impairment Agreement among Parent-Child Dyads in Pediatric Obsessive-Compulsive Disorder

PubMed Central

Storch, Eric A.; Rudy, Brittany M.; Wu, Monica S.; Lewin, Adam B.; Murphy, Tanya K.

2014-01-01

Inter-rater agreement for symptom impairment associated with obsessive-compulsive disorder (OCD) varies between parents and children. However, extraneous variables that may influence these agreement differences have scarcely been examined. Therefore, the purpose of this paper was to examine moderators of parent and child agreement on ratings of overall OCD-related impairment and impairment across three domains (i.e., school, social, home) as measured by the Children’s OCD Impact Scale – Child and Parent versions (COIS-C/P). One hundred sixty-six children with OCD and their parents completed ratings of symptom severity, impairment, and demographics, among other measures, prior to psychosocial treatment initiation. Overall parent-child agreement of impairment was in the moderate range. Age, OCD symptom severity, resistance and control, obsession and compulsion severity, and insight emerged as moderator variables, with the direction of moderation varying by domain. Results, implications, and study limitations are discussed. PMID:26190901

Interpersonal functioning in obsessive-compulsive personality disorder.

PubMed

Cain, Nicole M; Ansell, Emily B; Simpson, H Blair; Pinto, Anthony

2015-01-01

The core symptoms of obsessive-compulsive personality disorder (OCPD) often lead to interpersonal difficulties. However, little research has explored interpersonal functioning in OCPD. This study examined interpersonal problems, interpersonal sensitivities, empathy, and systemizing, the drive to analyze and derive underlying rules for systems, in a sample of 25 OCPD individuals, 25 individuals with comorbid OCPD and obsessive-compulsive disorder (OCD), and 25 healthy controls. We found that OCPD individuals reported hostile-dominant interpersonal problems and sensitivities with warm-dominant behavior by others, whereas OCPD+OCD individuals reported submissive interpersonal problems and sensitivities with warm-submissive behavior by others. Individuals with OCPD, with and without OCD, reported less empathic perspective taking relative to healthy controls. Finally, we found that OCPD males reported a higher drive to analyze and derive rules for systems than OCPD females. Overall, results suggest that there are interpersonal deficits associated with OCPD and the clinical implications of these deficits are discussed.

Development and Examination of the Five-Factor Obsessive-Compulsive Inventory-Short Form.

PubMed

Griffin, Sarah A; Suzuki, Takakuni; Lynam, Donald R; Crego, Cristina; Widiger, Thomas A; Miller, Joshua D; Samuel, Douglas B

2018-01-01

The Five-Factor Obsessive-Compulsive Inventory (FFOCI) is an assessment of obsessive-compulsive personality disorder (OCPD) that is based on the conceptual framework of the five-factor model (FFM) of personality. The FFOCI has 12 subscales that assess those five-factor model facets relevant to the description of OCPD. Research has suggested that the FFOCI scores relate robustly to existing measures of OCPD and relevant scales from general personality inventories. Nonetheless, the FFOCI's length-120 items-may limit its clinical utility. This study derived a 48-item FFOCI-Short Form (FFOCI-SF) from the original measure using item response theory methods. The FFOCI-SF scales successfully recreated the nomological network of the original measure and improved discriminant validity relative to the long form. These results support the use of the FFOCI-SF as a briefer measure of the lower-order traits associated with OCPD.

Interpersonal Functioning in Obsessive-Compulsive Personality Disorder

PubMed Central

Cain, Nicole M.; Ansell, Emily B.; Simpson, H. Blair; Pinto, Anthony

2014-01-01

The core symptoms of obsessive-compulsive personality disorder (OCPD) often lead to interpersonal difficulties. However, little research has explored interpersonal functioning in OCPD. The current study examined interpersonal problems, interpersonal sensitivities, empathy, and systemizing, the drive to analyze and derive underlying rules for systems, in a sample of 25 OCPD individuals, 25 individuals with comorbid OCPD and obsessive-compulsive disorder (OCD), and 25 healthy controls. We found that OCPD individuals reported hostile-dominant interpersonal problems and sensitivities with warm-dominant behavior by others while OCPD+OCD individuals reported submissive interpersonal problems and sensitivities with warm-submissive behavior by others. Individuals with OCPD, with and without OCD, reported less empathic perspective taking relative to healthy controls. Finally, we found that OCPD males reported a higher drive to analyze and derive rules for systems than OCPD females. Overall, results suggest that there are interpersonal deficits associated with OCPD and the clinical implications of these deficits are discussed. PMID:25046040

Relations between Obsessive-Compulsive Disorder and personality: beyond Axis I-Axis II comorbidity.

PubMed

Wu, Kevin D; Clark, Lee Anna; Watson, David

2006-01-01

Most research on relations between Obsessive-Compulsive Disorder (OCD) and personality addresses only comorbidity rates between OCD and Obsessive-Compulsive Personality Disorder (OCPD). We first investigated empirical OCD-OCPD relations, but then also examined patterns of dimensional traits in OCD patients versus students and general outpatients. Results did not support a specific OCD-OCPD relation and the implications of this conclusion are discussed. Regarding traits, OCD patients shared with other patients elevated negative affectivity and lower positive affectivity. Differences on several lower order dimensions, including lower scores on manipulativeness, mistrust, and disinhibition distinguished the personality profile of OCD patients from others. Also noteworthy was a pattern of very low self-image for OCD patients, as suggested by the combination of low self-esteem and low entitlement scores. Overall, OCD patients showed a more specific pattern of personality pathology than did general outpatients, who were elevated more generally across personality disorders and negative affectivity scales.

Obsessive-compulsive symptoms in schizophrenia: prevalence and associated factors in a Nigerian population.

PubMed

Opakunle, Tolulope; Akinsulore, Adesanmi; Aloba, Olutayo O; Fatoye, Femi O

2017-09-01

The objectives of this study were to determine the prevalence of obsessive-compulsive symptoms (OCS) among subjects with schizophrenia and also to determine their associated factors. A cross-sectional study involving 232 patients with schizophrenia were recruited from a teaching hospital in Nigeria. Socio-demographic questionnaire, Obsessive-Compulsive Inventory, Positive and Negative Syndrome Scale and Suicidality module of the MINI International Neuropsychiatric Inventory were administered. The prevalence of OCS was 54.3% among patients with schizophrenia, and washing symptom was the most common (51.7%). Patients with schizophrenia that had OCS had more severe psychopathologies and higher levels of suicidality. OCS among patients with schizophrenia were also associated with the use of second-generation antipsychotic medications. OCS are common in schizophrenia. Hence, there is a need for routine screening of patients with schizophrenia for OCS and then, manage them appropriately.

Pediatric obsessive-compulsive disorder: an update for advanced practice psychiatric nurses.

PubMed

Kameg, Kirstyn Marie; Richardson, Luann; Szpak, Janene Luther

2015-05-01

Obsessive-compulsive disorder (OCD) may have an onset in childhood or adolescence resulting in significant functional impairment and disability into adulthood. There are frequently developmental differences in the content of the obsessions and compulsions in youth compared to adults. Lack of insight or shame may result in failure of the youth to seek treatment. This delay in treatment may lead to the development of other psychiatric comorbidities, including suicide. Evidence-based treatments for OCD include cognitive behavioral therapy and exposure/response prevention, and in moderate to severe cases, use of selective serotonin reuptake inhibitors is indicated. Advanced practice psychiatric nurses are in a unique position to provide psychoeducation, psychotherapy, and medications, if indicated, to youth with this condition to improve functioning and reduce morbidity and mortality. This article will provide an overview of the diagnostic criteria for OCD, etiologies, assessment strategies, differential diagnoses, common comorbidities, and evidence-based treatment options. © 2015 Wiley Periodicals, Inc.

Deficits of organizational strategy and visual memory in obsessive-compulsive disorder.

PubMed

Shin, M S; Park, S J; Kim, M S; Lee, Y H; Ha, T H; Kwon, J S

2004-10-01

This study was conducted to investigate the deficits of organizational strategy and visual memory in obsessive-compulsive disorder (OCD). Thirty OCD patients and 30 healthy controls aged 20-35 years participated. The Maudsley Obsessive-Compulsive Inventory, Beck Anxiety Inventory, Wechsler Adult Intelligence Scale, and Rey-Osterrieth Complex Figure (ROCF) test were administered to participants. The authors scored ROCF performances using the Boston Qualitative Scoring System. The OCD patients showed poorer planning ability and higher fragmentation than did healthy controls when copying the ROCF, and they showed even poorer performances in the immediate and delayed recall conditions. The authors found that the Organization score in the copy condition mediated the difference between the OCD group and the healthy group in immediate recall. The direct effect of diagnosis (OCD or healthy) on the immediate recall condition of the ROCF was also significant. This study indicates that people with OCD have poor memory function and organizational deficits.

Hoarding behaviors in children with learning disabilities.

PubMed

Testa, Renée; Pantelis, Christos; Fontenelle, Leonardo F

2011-05-01

Our objective was to describe the prevalence, comorbidity, and neuropsychological profiles of children with hoarding and learning disabilities. From 61 children with learning disabilities, 16.4% exhibited hoarding as a major clinical issue. Although children with learning disabilities and hoarding displayed greater rates of obsessive-compulsive disorder (30%) as compared to those with learning disabilities without hoarding (5.9%), the majority of patients belonging to the former group did not display obsessive-compulsive disorder diagnosis. When learning disability patients with hoarding were compared to age-, sex-, and IQ-matched learning disability subjects without hoarding, hoarders exhibited a slower learning curve on word list-learning task. In conclusion, salient hoarding behaviors were found to be relatively common in a sample of children with learning disabilities and not necessarily associated with obsessive-compulsive disorder, supporting its nosological independence. It is unclear whether underlying cognitive features may play a major role in the development of hoarding behaviors in children with learning disabilities.

Obsessive-compulsive disorder: a disorder of pessimal (non-functional) motor behavior.

PubMed

Zor, R; Keren, H; Hermesh, H; Szechtman, H; Mort, J; Eilam, D

2009-10-01

To determine whether in addition to repetitiveness, the motor rituals of patients with obsessive-compulsive disorder (OCD) involve reduced functionality due to numerous and measurable acts that are irrelevant and unnecessary for task completion. Comparing motor rituals of OCD patients with behavior of non-patient control individuals who were instructed to perform the same motor task. Obsessive-compulsive disorder behavior comprises abundant acts that were not performed by the controls. These acts seem unnecessary or even irrelevant for the task that the patients were performing, and therefore are termed 'non-functional'. Non-functional acts comprise some 60% of OCD motor behavior. Moreover, OCD behavior consists of short chains of functional acts bounded by long chains of non-functional acts. The abundance of irrelevant or unnecessary acts in OCD motor rituals represents reduced functionality in terms of task completion, typifying OCD rituals as pessimal behavior (antonym of optimal behavior).

Aripiprazole augmentation in managing comorbid obsessive-compulsive disorder and bipolar disorder: a case with suicidal attempts.

PubMed

Lai, Jianbo; Lu, Qiaoqiao; Zhang, Peng; Xu, Tingting; Xu, Yi; Hu, Shaohua

2017-01-01

Comorbid obsessive-compulsive disorder (OCD) and bipolar disorder (BD) have long been an intractable problem in clinical practice. The increased risk of manic/hypomanic switch hinders the use of antidepressants for managing coexisting OCD symptoms in BD patients. We herein present a case of a patient with BD-OCD comorbidity, who was successfully treated with mood stabilizers and aripiprazole augmentation. The young female patient reported recurrent depressive episodes and aggravating compulsive behaviors before hospitalization. Of note, the patient repetitively attempted suicide and reported dangerous driving because of intolerable mental sufferings. The preexisting depressive episode and OCD symptoms prompted the use of paroxetine, which consequently triggered the manic switching. Her diagnosis was revised into bipolar I disorder. Minimal response with mood stabilizers prompted the addition of aripiprazole (a daily dose of 10 mg), which helped to achieve significant remission in emotional and obsessive-compulsive symptoms. This case highlights the appealing efficacy of a small dose of aripiprazole augmentation for treating BD-OCD comorbidity. Well-designed clinical trials are warranted to verify the current findings.

Towards a post-traumatic subtype of obsessive-compulsive disorder.

PubMed

Fontenelle, Leonardo F; Cocchi, Luca; Harrison, Ben J; Shavitt, Roseli G; do Rosário, Maria Conceição; Ferrão, Ygor A; de Mathis, Maria Alice; Cordioli, Aristides V; Yücel, Murat; Pantelis, Christos; Mari, Jair de Jesus; Miguel, Euripedes C; Torres, Albina R

2012-03-01

We evaluated whether traumatic events are associated with a distinctive pattern of socio-demographic and clinical features of obsessive-compulsive disorder (OCD). We compared socio-demographic and clinical features of 106 patients developing OCD after post-traumatic stress disorder (PTSD; termed post-traumatic OCD), 41 patients developing OCD before PTSD (pre-traumatic OCD), and 810 OCD patients without any history of PTSD (non-traumatic OCD) using multinomial logistic regression analysis. A later age at onset of OCD, self-mutilation disorder, history of suicide plans, panic disorder with agoraphobia, and compulsive buying disorder were independently related to post-traumatic OCD. In contrast, earlier age at OCD onset, alcohol-related disorders, contamination-washing symptoms, and self-mutilation disorder were all independently associated with pre-traumatic OCD. In addition, patients with post-traumatic OCD without a previous history of obsessive-compulsive symptoms (OCS) showed lower educational levels, greater rates of contamination-washing symptoms, and more severe miscellaneous symptoms as compared to post-traumatic OCD patients with a history of OCS. Copyright © 2011 Elsevier Ltd. All rights reserved.

Hypochondriasis Y-BOCS: a study of the psychometric properties of a clinician-administered semi-structured interview to assess hypochondriacal thoughts and behaviours.

PubMed

Greeven, Anja; Spinhoven, Philip; van Balkom, Anton J L M

2009-01-01

This study investigated the psychometric properties of the first clinician-administered semi-structured interview for assessing the severity of hypochondriacal symptoms. The Hypochondriasis Yale-Brown Obsessive-Compulsive Scale (H-YBOCS) consisted of three a priori dimensions: hypochondriacal obsessions, compulsions and avoidance. The 16-item interview was conducted with 112 participants with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, hypochondriasis. We analysed factor analytic structure, reliability, construct validity and sensitivity to change. Factor analysis supported a three-factor model similar to the a priori dimensions. Internal consistency ranged from satisfactory to good. Inter-rater reliability was excellent. The construct validity was low to moderate. The H-YBOCS was sensitive for measuring changes in symptom severity. The H-YBOCS is a (factorially) valid and coherent interview with a high level of agreement across different raters. The relatively low discriminant validity could be due to co-morbid anxiety and depressive disorders. Overall, the H-YBOCS seems to be a promising contribution to the assessment of hypochondriasis. *The hypochondriasis Y-BOCS is a feasible clinician rated interview to assess the severity of hypochondriacal complaints.

Dissociable Effects of Subthalamic Stimulation in Obsessive Compulsive Disorder on Risky Reward and Loss Prospects.

PubMed

Voon, Valerie; Droux, Fabien; Chabardes, Stephan; Bougerol, Thierry; Kohl, Sina; David, Olivier; Krack, Paul; Polosan, Mircea

2018-07-01

Our daily decisions involve an element of risk, a behavioral process that is potentially modifiable. Here we assess the role of the associative-limbic subthalamic nucleus (STN) in obsessive compulsive disorder (OCD) testing on and off deep-brain stimulation (DBS) on anticipatory risk taking to obtain rewards and avoid losses. We assessed 12 OCD STN DBS in a randomized double-blind within-subject cross-over design. STN DBS decreased risk taking to rewards (p = 0.02) and greater risk taking to rewards was positively correlated with OCD severity (p = 0.01) and disease duration (p = 0.01). STN DBS was also associated with impaired subjective discrimination of loss magnitude (p < 0.05), an effect mediated by acute DBS rather than chronic DBS. We highlight a role for the STN in mediating dissociable valence prospects on risk seeking. STN stimulation decreases risk taking to rewards and impairs discrimination of loss magnitude. These findings may have implications for behavioral symptoms related to STN DBS and the potential for STN DBS for the treatment of psychiatric disorders. Copyright © 2018. Published by Elsevier Ltd.

On the connection between autoimmunity, tic disorders and obsessive-compulsive disorders: a meta-analysis on anti-streptolysin O titres.

PubMed

Pozzi, Marco; Pellegrino, Paolo; Carnovale, Carla; Perrone, Valentina; Antoniazzi, Stefania; Perrotta, Cristiana; Radice, Sonia; Clementi, Emilio

2014-12-01

Anti-streptolysin O (ASO) titration is useful in the context of autoimmune pathologies, including specific cases of tic and obsessive-compulsive disorders occurring after streptococcal infections. There is currently a lack of consensus on the use of ASO titres; therefore we performed a meta-analysis to systematise available data and clarify the role of ASO titres in the context of neuropsychiatric disorders. A meta-analysis was performed on ASO titration in neuropsychiatric patients, including tic disorders and obsessive-compulsive disorders. Included studies reported numbers of positive subjects, depending on a chosen threshold, or detailed ASO titrations. Three hundred and twenty nine studies were identified, of which 13 were eligible for meta-analysis. Due to limited available data, only tic disorders were evaluated. The odds ratio of finding an abnormal ASO titre in patients was 3.22 (95% C.I. 1.51-6.88) as compared to healthy controls and 16.14 (95% C.I. 8.11-32.11) as compared to non-psychiatric patients. Studies using different thresholds were generally concordant. ASO titres were also compared quantitatively, finding an overall difference of the means of 70.50 U/ml (95% C.I. 25.21-115.80) in favour of patients with tic disorders. Based on current evidence, tic disorders are associated with a significant increase in ASO titres, evident both in a threshold-level perspective and on a quantitative level. These results encourage the systematisation of ASO titration in the context of tic disorders.

Cluster analysis of obsessive-compulsive spectrum disorders in patients with obsessive-compulsive disorder: clinical and genetic correlates.

PubMed

Lochner, Christine; Hemmings, Sian M J; Kinnear, Craig J; Niehaus, Dana J H; Nel, Daniel G; Corfield, Valerie A; Moolman-Smook, Johanna C; Seedat, Soraya; Stein, Dan J

2005-01-01

Comorbidity of certain obsessive-compulsive spectrum disorders (OCSDs; such as Tourette's disorder) in obsessive-compulsive disorder (OCD) may serve to define important OCD subtypes characterized by differing phenomenology and neurobiological mechanisms. Comorbidity of the putative OCSDs in OCD has, however, not often been systematically investigated. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition , Axis I Disorders-Patient Version as well as a Structured Clinical Interview for Putative OCSDs (SCID-OCSD) were administered to 210 adult patients with OCD (N = 210, 102 men and 108 women; mean age, 35.7 +/- 13.3). A subset of Caucasian subjects (with OCD, n = 171; control subjects, n = 168), including subjects from the genetically homogeneous Afrikaner population (with OCD, n = 77; control subjects, n = 144), was genotyped for polymorphisms in genes involved in monoamine function. Because the items of the SCID-OCSD are binary (present/absent), a cluster analysis (Ward's method) using the items of SCID-OCSD was conducted. The association of identified clusters with demographic variables (age, gender), clinical variables (age of onset, obsessive-compulsive symptom severity and dimensions, level of insight, temperament/character, treatment response), and monoaminergic genotypes was examined. Cluster analysis of the OCSDs in our sample of patients with OCD identified 3 separate clusters at a 1.1 linkage distance level. The 3 clusters were named as follows: (1) "reward deficiency" (including trichotillomania, Tourette's disorder, pathological gambling, and hypersexual disorder), (2) "impulsivity" (including compulsive shopping, kleptomania, eating disorders, self-injury, and intermittent explosive disorder), and (3) "somatic" (including body dysmorphic disorder and hypochondriasis). Several significant associations were found between cluster scores and other variables; for example, cluster I scores were associated with earlier age of onset of OCD and the presence of tics, cluster II scores were associated with female gender and childhood emotional abuse, and cluster III scores were associated with less insight and with somatic obsessions and compulsions. However, none of these clusters were associated with any particular genetic variant. Analysis of comorbid OCSDs in OCD suggested that these lie on a number of different dimensions. These dimensions are partially consistent with previous theoretical approaches taken toward classifying OCD spectrum disorders. The lack of genetic validation of these clusters in the present study may indicate the involvement of other, as yet untested, genes. Further genetic and cluster analyses of comorbid OCSDs in OCD may ultimately contribute to a better delineation of OCD endophenotypes.

Personality disorders: review and clinical application in daily practice.

PubMed

Angstman, Kurt B; Rasmussen, Norman H

2011-12-01

Personality disorders have been documented in approximately 9 percent of the general U.S. population. Psychotherapy, pharmacotherapy, and brief interventions designed for use by family physicians can improve the health of patients with these disorders. Personality disorders are classified into clusters A, B, and C. Cluster A includes schizoid, schizotypal, and paranoid personality disorders. Cluster B includes borderline, histrionic, antisocial, and narcissistic personality disorders. Cluster C disorders are more prevalent and include avoidant, dependent, and obsessive-compulsive personality disorders. Many patients with personality disorders can be treated by family physicians. Patients with borderline personality disorder may benefit from the use of omega-3 fatty acids, second-generation antipsychotics, and mood stabilizers. Patients with antisocial personality disorder may benefit from the use of mood stabilizers, antipsychotics, and antidepressants. Other therapeutic interventions include motivational interviewing and solution-based problem solving.

The effect of obsessive-compulsive symptomatology on executive functions in schizophrenia: a systematic review and meta-analysis.

PubMed

Cunill, Ruth; Huerta-Ramos, Elena; Castells, Xavier

2013-11-30

The presence of obsessive-compulsive symptoms (OCS) and obsessive-compulsive disorder (OCD) is frequent in patients with schizophrenia and has been associated with greater functional impairment. The impact of these features on cognitive function is unclear. In this article, we performed a systematic review and meta-analysis to assess the effect of OCS/OCD on executive functions in schizophrenia patients. Results indicate that schizophrenia patients with OCS/OCD were more impaired in abstract thinking than schizophrenia patients without OCS/OCD. This finding provides support to the double jeopardy hypothesis and may partially explain the greater functional impairment shown in schizo-obsessive patients compared to those with schizophrenia. Inconsistent results were found for set-shifting, cognitive flexibility, cognitive inhibition and verbal fluency, as indicated by the high statistical heterogeneity found. Potential sources of heterogeneity such as definition of OCS/OCD, age of onset, severity of negative symptoms and premorbid intelligence were planned to be explored but there was an insufficient number of studies to perform these analyses. Our findings highlight the complexity of the relationship between OCS/OCD and schizophrenia and warrant further investigation of the cognitive function of schizo-obsessive patients. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

A Comparison of Eating Attitudes Between Vegans/Vegetarians and Nonvegans/Nonvegetarians in Terms of Orthorexia Nervosa.

PubMed

Çiçekoğlu, Pınar; Tunçay, Güzin Yasemin

2018-04-01

This descriptive study was performed to compare signs of orthorexia nervosa and eating habits and attitudes of vegans/vegetarians and nonvegans/nonvegetarians. The study sample included 62 people, of whom 31 were vegan/vegetarian and 31 were nonvegan/nonvegetarian. Data were gathered with a personal characteristics form, Orthorexia Nervosa Evaluation Scale-11, Eating Attitudes Test-40 and Maudsley Obsessive Compulsive Inventory. There were not any significant differences between scores for Orthorexia Nervosa Evaluation Scale-11, Eating Attitudes Test-40 and Maudsley Obsessive Compulsive Inventory (p>0,05). As scores for Orthorexia Nervosa Evaluation Scale-11 decreased, predisposition to orthorexia nervosa increased. Therefore, although correlation coefficients were negative, they were considered positive. There was a significant, negative relation between Eating Habits Test-40 scores and Orthorexia Nervosa Evaluation Scale-11 scores (r=-0.290, p=0.002) and between Maudsley Obsessive Compulsive Inventory scores and Orthorexia Nervosa Evaluation Scale-11 scores (r=-0.319, p=0.012). As poor eating habits and obsessive symptoms increased, so did orthorectic symptoms. In light of obtained results, it seems that people become vegan/vegetarian mainly for ethical reasons and that veganism/vegetarianism is not associated with obsession of healthy eating. Copyright © 2017 Elsevier Inc. All rights reserved.

Three-Week Inpatient Treatment of Obsessive-Compulsive Disorder: A 6-Month Follow-Up Study.

PubMed

Grøtte, Torun; Hansen, Bjarne; Haseth, Svein; Vogel, Patrick A; Guzey, Ismail C; Solem, Stian

2018-01-01

Background: Specialized inpatient or residential treatment might be an alternative treatment approach for patients with obsessive-compulsive disorder (OCD) that do not respond satisfactorily to the standard outpatient treatment formats. Method: The aim of this open trial was to investigate the 6-month effectiveness of a 3-week inpatient treatment of OCD, where exposure with response prevention (ERP) was the main treatment intervention. The sample consisted of 187 adult patients with OCD, all with previous treatment attempts for OCD. Results: The sample showed significant reductions in symptoms of OCD and depression. The effect sizes were large for obsessive-compulsive symptoms and moderate to large for depressive symptoms. At discharge, 79.7% of the intent-to-treat (ITT) group were classified as treatment responders (≥35% reduction in Y-BOCS scores). However, some participants experienced relapse, as 61.5% of the ITT group were classified as treatment responders at 6-month follow-up. Antidepressant use appeared not to influence the outcome. Only pre-treatment levels of obsessive-compulsive symptoms emerged as a significant predictor of relapse. Conclusion: The 3-week inpatient programme produced similar treatment effects as previous inpatient and residential studies of longer duration (2 - 3 months). The results suggest that patients with severe OCD can be treated efficiently using this brief inpatient format. However, better relapse prevention interventions are needed.

Obsessive compulsive personality disorder and Parkinson's disease.

PubMed

Nicoletti, Alessandra; Luca, Antonina; Raciti, Loredana; Contrafatto, Donatella; Bruno, Elisa; Dibilio, Valeria; Sciacca, Giorgia; Mostile, Giovanni; Petralia, Antonio; Zappia, Mario

2013-01-01

To evaluate the frequency of personality disorders in Parkinson's disease (PD) patients and in a group of healthy controls. Patients affected by PD diagnosed according to the United Kingdom Parkinson's disease Society Brain Bank diagnostic criteria and a group of healthy controls were enrolled in the study. PD patients with cognitive impairment were excluded from the study. Structured Clinical Interview for Personality Disorders-II (SCID-II) has been performed to evaluate the presence of personality disorders. Presence of personality disorders, diagnosed according to the DSM-IV, was confirmed by a psychiatric interview. Clinical and pharmacological data were also recorded using a standardized questionnaire. 100 PD patients (57 men; mean age 59.0 ± 10.2 years) and 100 healthy subjects (52 men; mean age 58.1 ± 11.4 years) were enrolled in the study. The most common personality disorder was the obsessive-compulsive personality disorder diagnosed in 40 PD patients and in 10 controls subjects (p-value<0.0001) followed by the depressive personality disorder recorded in 14 PD patients and 4 control subjects (p-value 0.02). Obsessive-compulsive personality disorder was also found in 8 out of 16 de novo PD patients with a short disease duration. PD patients presented a high frequency of obsessive-compulsive personality disorder that does not seem to be related with both disease duration and dopaminergic therapy.

Validation of the Yale-Brown Obsessive-Compulsive Severity Scale in African Americans with obsessive-compulsive disorder.

PubMed

Williams, Monnica T; Wetterneck, Chad T; Thibodeau, Michel A; Duque, Gerardo

2013-09-30

The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is widely used in the assessment of obsessive-compulsive disorder (OCD), but the psychometric properties of the instrument have not been examined in African Americans with OCD. Therefore, the purpose of this study is to explore the properties of the Y-BOCS severity scale in this population. Participants were 75 African American adults with a lifetime diagnosis of OCD. They completed the Y-BOCS, the Beck Anxiety Inventory (BAI), the Beck Depression Inventory-II (BDI-II), and the Multigroup Ethnic Identity Measure (MEIM). Evaluators rated OCD severity using the Clinical Global Impression Scale (CGI) and their global assessment of functioning (GAF). The Y-BOCS was significantly correlated with both the CGI and GAF, indicating convergent validity. It also demonstrated good internal consistency (α=0.83) and divergent validity when compared to the BAI and BDI-II. Confirmatory factor analyses tested five previously reported models and supported a three-factor solution, although no model exhibited excellent fit. An exploratory factor analysis was conducted, supporting a three-factor solution. A linear regression was conducted, predicting CGI from the three factors of the Y-BOCS and the MEIM, and the model was significant. The Y-BOCS appears to be a valid measure for African American populations. © 2013 Elsevier Ireland Ltd. All rights reserved.

The relationship between obsessive-compulsive personality disorder traits, obsessive-compulsive disorder and excessive exercise in patients with anorexia nervosa: a systematic review.

PubMed

Young, Sarah; Rhodes, Paul; Touyz, Stephen; Hay, Phillipa

2013-01-01

Obsessive-compulsive personality disorder (OCPD) traits and obsessive-compulsive disorder (OCD) are commonly associated with patients with Anorexia Nervosa (AN). The aim of this review was to systematically search the literature to examine whether OCPD and OCD are positively associated with excessive exercise in patients with AN. A systematic electronic search of the literature (using PsycInfo, Medline and Web of Knowledge) was undertaken to identify relevant publications until May 2012. A total of ten studies met criteria for inclusion in the review. The design of the studies varied from cross-sectional to retrospective and quasi-experimental. Seven out of the ten studies reviewed demonstrated a positive relationship between OCPD and/or OCD in AN patients who exercise excessively, whilst three studies found a lack of relationship, or a negative relationship, between these constructs. There is evidence from the literature to suggest that there is a positive relationship between OCPD and excessive exercise in patients with AN. However, the relationship between OCD and excessive exercise is less clear and further research is required to qualify the strength of such relationships. Future research should utilise the most comprehensive and reliable clinical assessment tools, and address prognostic factors, treatment factors and specific interventions for patients with OCPD and/or OCD and excessive exercise.

The relationship between obsessive-compulsive personality disorder traits, obsessive-compulsive disorder and excessive exercise in patients with anorexia nervosa: a systematic review

PubMed Central

2013-01-01

Objective Obsessive-compulsive personality disorder (OCPD) traits and obsessive-compulsive disorder (OCD) are commonly associated with patients with Anorexia Nervosa (AN). The aim of this review was to systematically search the literature to examine whether OCPD and OCD are positively associated with excessive exercise in patients with AN. Method A systematic electronic search of the literature (using PsycInfo, Medline and Web of Knowledge) was undertaken to identify relevant publications until May 2012. Results A total of ten studies met criteria for inclusion in the review. The design of the studies varied from cross-sectional to retrospective and quasi-experimental. Seven out of the ten studies reviewed demonstrated a positive relationship between OCPD and/or OCD in AN patients who exercise excessively, whilst three studies found a lack of relationship, or a negative relationship, between these constructs. Conclusion There is evidence from the literature to suggest that there is a positive relationship between OCPD and excessive exercise in patients with AN. However, the relationship between OCD and excessive exercise is less clear and further research is required to qualify the strength of such relationships. Future research should utilise the most comprehensive and reliable clinical assessment tools, and address prognostic factors, treatment factors and specific interventions for patients with OCPD and/or OCD and excessive exercise. PMID:24999397

Prevalence and associated factors for suicidal ideation and behaviors in obsessive-compulsive disorder.

PubMed

Torres, Albina Rodrigues; de Abreu Ramos-Cerqueira, Ana Teresa; Torresan, Ricardo Cezar; de Souza Domingues, Mariana; Hercos, Ana Carolina R; Guimarães, Aron Barbosa C

2007-10-01

Patients with obsessive-compulsive disorder (OCD) have historically been considered at low risk for suicide, but recent studies are controversial. To study the prevalence of suicidal thoughts and attempts in OCD patients and to compare those with and without suicidality according to demographic and clinical variables. Fifty outpatients with primary OCD (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) from a Brazilian public university were evaluated. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was used to assess OCD severity, the Beck Depression Inventory to evaluate depressive symptoms and the Alcohol Use Disorders Identification Test to assess alcohol problems. All patients had obsessions and compulsions, 64% a chronic fluctuating course and 62% a minimum Y-BOCS score of 16. Half of the patients presented relevant depressive symptoms, but only three had a history of alcohol problems. Seventy percent reported having already thought that life was not worth living, 56% had wished to be dead, 46% had suicidal ideation, 20% had made suicidal plans, and 10% had already attempted suicide. Current suicidal ideation occurred in 14% of the sample and was significantly associated with a Y-BOCS score >16. Previous suicidal thoughts were associated with a Beck Depression Inventory score >19. Suicidality has been underestimated in OCD and should be investigated in every patient, so that appropriate preventive measures can be taken.

The Advantages of Parental Involvement in Cognitive-Behavioral Treatment of Childhood Obsessive-Compulsive Disorder: A Single-Case Example.

PubMed

Oldham-Cooper, Rose; Glasman, David; Loades, Maria

2016-04-01

Interventions for the treatment of anxiety disorders in children have a growing evidence base. Cognitive-behavioral therapy for the treatment of specific anxiety disorders in children and adolescents, including obsessive-compulsive disorder, is now an established intervention. However, a question remains concerning the benefits of parental involvement in treatment. Some studies report limited or no benefit of including parents in treatment, whereas other studies have indicated additional advantages of parental involvement. The present case report describes the treatment of an 11-year-old girl with obsessive-compulsive disorder using cognitive-behavioral therapy derived largely from the treatment approaches outlined in Carr (2006), March and Mulle (1998), and Derisley, Heyman, Robinson, and Turner (2008). The child's mother attended all sessions and also a one-off parent-only session toward the end of treatment. The report considers the benefits of involving the child's mother in treatment and possible factors that could suggest parental involvement is indicated in future cases. Both child and mother, and the therapist, believed that parental involvement had been an important and useful element of treatment. Possible reasons for benefits of parental involvement were considered to be high parental anxiety at the outset of treatment, age of the client, and involvement of the parent in obsessions and compulsions. © 2016 Wiley Periodicals, Inc.

Social cognition and metacognition in obsessive-compulsive disorder: an explorative pilot study.

PubMed

Mavrogiorgou, Paraskevi; Bethge, Mareike; Luksnat, Stefanie; Nalato, Fabio; Juckel, Georg; Brüne, Martin

2016-04-01

Obsessive-compulsive disorder (OCD) is a severe psychiatric condition that is, among other features, characterized by marked impairment in social functioning. Although theoretically plausible with regard to neurobiological underpinnings of OCD, there is little research about possible impairments in social cognitive and meta-cognitive abilities and their connections with social functioning in patients with OCD. Accordingly, we sought to examine social cognitive skills and metacognition in OCD. Twenty OCD patients and age-, sex-, and education-matched 20 healthy controls were assessed using neurocognitive and diverse social cognitive skills including the Ekman 60 Faces test, the Hinting Task, the faux pas test, and a proverb test. In addition, the Metacognition Questionnaire-30 was administered to both the OCD and the control groups. Social functioning was measured using the Personal and Social Performance Scale. Symptom severity in patients was determined by the Yale-Brown Obsessive-Compulsive Scale and the Maudsley Obsessive-Compulsive Inventory. No group differences emerged in basic social cognitive abilities. In contrast, compared to controls, OCD patients scored higher on all MCQ dimensions, particularly negative beliefs about worry, uncontrollability, and danger; beliefs about need to control thoughts; and cognitive self-consciousness. There were no significant correlations between social or metacognitive parameters and OCD symptom severity. However, in the patient group, depression and metacognition predicted social functioning. OCD patients show normal basal social cognitive abilities, but dysfunctional metacognitive profiles, which may contribute to their psychosocial impairment.

N-Acetyl Cysteine in the Treatment of Obsessive Compulsive and Related Disorders: A Systematic Review

PubMed Central

Oliver, Georgina; Dean, Olivia; Camfield, David; Blair-West, Scott; Ng, Chee; Berk, Michael; Sarris, Jerome

2015-01-01

Objective Obsessive compulsive and related disorders are a collection of debilitating psychiatric disorders in which the role of glutamate dysfunction in the underpinning neurobiology is becoming well established. N-acetyl cysteine (NAC) is a glutamate modulator with promising therapeutic effect. This paper presents a systematic review of clinical trials and case reports exploring the use of NAC for these disorders. A further objective was to detail the methodology of current clinical trials being conducted in the area. Methods PubMed, Web of Science and Cochrane Library Database were searched for human clinical trials or case reports investigating NAC in the treatment of obsessive compulsive disorder (OCD) or obsessive compulsive related disorders. Researchers with known involvement in NAC studies were contacted for any unpublished data. Results Four clinical trials and five case reports/series were identified. Study durations were commonly 12-weeks, using 2,400–3,000 mg/day of NAC. Overall, NAC demonstrates activity in reducing the severity of symptoms, with a good tolerability profile and minimal adverse effects. Currently there are three ongoing randomized controlled trials using NAC for OCD (two adults and one pediatric), and one for excoriation. Conclusion Encouraging results have been demonstrated from the few pilot studies that have been conducted. These results are detailed, in addition to a discussion of future potential research. PMID:25912534

Obsessive-compulsive disorder spectrum as a scientific "metaphor".

PubMed

Pallanti, Stefano; Hollander, Eric

2008-09-01

As a result of clinical, epidemiological, neuroimaging, and therapy studies that took place in the late 1980s, obsessive-compulsive disorder (OCD) has been well-characterized in the field of anxiety disorders. Other disorders attracted attention for their similarities to OCD, and were located in the orbit of the disorder. OCD has become known as the "primary domain" of a scientific "metaphor" comprising the putative cluster of OCD-related disorders (OCRDs). It is a "paradigm" with which to explore basal ganglia dysfunction. The OCRDs share common phenomenology, comorbidities, lifetime course, demographics, possible genetics, and frontostriatal dysfunction (particularly caudate hyperactivity.) The adoption of this metaphor analogy has proven useful. However, 15 years since its emergence, the spectrum of obsessive-compulsive disorders remains controversial. Questions under debate include whether OCD is a unitary or split condition, whether it is an anxiety disorder, and whether there exists only one spectrum or several possible spectrums. Further work is needed to clarify obsessive-compulsive symptoms, subtypes, and endophenotypes. There is need to integrate existing databases, better define associated symptom domains, and create a more comprehensive endophenotyping protocol for OCRDs. There is also a need to integrate biological and psychological perspectives, concepts, and data to drive this evolution. By increasing research in this field, the OCD spectrum may evolve from a fragmented level of conceptualization as a "metaphor" to one that is more comprehensive and structured.

Differences between autogenous and reactive obsessions in terms of metacognitions and automatic thoughts.

PubMed

Keleş Altun, İlkay; Uysal, Emel; Özkorumak Karagüzel, Evrim

2017-01-01

Obsessive compulsive disorder (OCD) is characterized by obsessions and compulsions. Obsessions have been classified as autogenous obsessions and reactive obsessions on the basis of the cognitive theory of Lee and Kwon. The aim of this study was to investigate the differences between autogenous groups (AG) and reactive groups (RG) in terms of metacognition and automatic thoughts, for the purpose of investigating the differences of cognitive appraisals. One hundred and thirty-three patients diagnosed with OCD were included in the study as the patient group. A control group was formed of 133 age, gender and education-matched healthy individuals. The OCD group patients were separated into subgroups according to the primary obsessions. The sociodemographic data, and the Yale-Brown Obsessive Compulsive Scale, Metacognition Questionnaire-30 (MCQ-30), Automatic Thoughts Questionnaire (ATQ), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) scores of the AG, RG, and control groups were compared. The MCQ-30 (total) and the subscales of MCQ-30 and ATQ scale points were seen to be significantly higher in the AG than in the RG and significantly higher in the RG than in the control group. In the reactive obsession group, the predictive variables of the ATQ points were determined to be MCQ-30 (total), BDI and BAI. In the autogenous obsession group, the predictive variables of the ATQ points were determined to be BDI and BAI. In the current study, differences were determined between the AG and the RG in respect of metacognitions and automatic thoughts. In light of these results, the recommended grouping can be considered useful in the identification of OCD sub-types. There is a need for further studies to identify more homogenous sub-types of OCD. Future multi-centered studies of sub-typing with larger samples using more specific instruments to sub-type and dimensional evaluation will be useful for detailed evaluation and better understanding of the subject.

The effects of the non-contingent presentation of safety signals on the elimination of safety behaviors: An experimental comparison between individuals with low and high obsessive-compulsive profiles.

PubMed

Angelakis, Ioannis; Austin, Jennifer L

2018-06-01

Safety behaviors, defined as engagement in avoidance within safe environments, are a key symptom of obsessive-compulsive and related disorders. They may interfere with daily functioning and as such their emission should be reduced. The purpose of the current study is to investigate the effects of the non-contingent presentation of safety signals (cues produced by safety behaviors) on reducing safety behaviors in participants self-reporting low and high OCD profiles. In total, 32 participants were asked to play a game to gain points and avoid their loss. After having developed avoidance behavior, evidenced by maintaining all of their earned points, they were exposed to safe environments where no point loss was programmed. In Test 1, safety cues (blue bar) were produced contingent on performing safety behaviors. In Test 2, safety cues were presented continuously without any response requirement. Findings demonstrated that high OCD group displayed higher rates of safety behaviors than low OCD group. However, exposure to the non-contingent presentation of safety signals eliminated their emission in both groups. Future studies need to evaluate the effects of different non-contingent schedules on the suppression of safety behaviors. These findings contribute to the literature by demonstrating that non-contingent introduction of safety signals eliminated safety behaviors completely, even in high OCD participants, who performed safety behavior at higher rates. Such a treatment protocol may ameliorate exposure therapy in which response prevention constitutes a key element and is generally associated with increased drop-out rates. Copyright © 2017 Elsevier Ltd. All rights reserved.

Fluorinated Cannabidiol Derivatives: Enhancement of Activity in Mice Models Predictive of Anxiolytic, Antidepressant and Antipsychotic Effects

PubMed Central

Fogaça, Manoela V.; Gomes, Felipe V.; Silva, Nicole Rodrigues; Pedrazzi, João Francisco; Del Bel, Elaine A.; Hallak, Jaime C.; Crippa, José A.; Zuardi, Antonio W.; Guimarães, Francisco S.

2016-01-01

Cannabidiol (CBD) is a major Cannabis sativa constituent, which does not cause the typical marijuana psychoactivity. However, it has been shown to be active in a numerous pharmacological assays, including mice tests for anxiety, obsessive-compulsive disorder, depression and schizophrenia. In human trials the doses of CBD needed to achieve effects in anxiety and schizophrenia are high. We report now the synthesis of 3 fluorinated CBD derivatives, one of which, 4'-F-CBD (HUF-101) (1), is considerably more potent than CBD in behavioral assays in mice predictive of anxiolytic, antidepressant, antipsychotic and anti-compulsive activity. Similar to CBD, the anti-compulsive effects of HUF-101 depend on cannabinoid receptors. PMID:27416026

Compulsivity in obsessive-compulsive disorder and addictions.

PubMed

Figee, Martijn; Pattij, Tommy; Willuhn, Ingo; Luigjes, Judy; van den Brink, Wim; Goudriaan, Anneke; Potenza, Marc N; Robbins, Trevor W; Denys, Damiaan

2016-05-01

Compulsive behaviors are driven by repetitive urges and typically involve the experience of limited voluntary control over these urges, a diminished ability to delay or inhibit these behaviors, and a tendency to perform repetitive acts in a habitual or stereotyped manner. Compulsivity is not only a central characteristic of obsessive-compulsive disorder (OCD) but is also crucial to addiction. Based on this analogy, OCD has been proposed to be part of the concept of behavioral addiction along with other non-drug-related disorders that share compulsivity, such as pathological gambling, skin-picking, trichotillomania and compulsive eating. In this review, we investigate the neurobiological overlap between compulsivity in substance-use disorders, OCD and behavioral addictions as a validation for the construct of compulsivity that could be adopted in the Research Domain Criteria (RDoC). The reviewed data suggest that compulsivity in OCD and addictions is related to impaired reward and punishment processing with attenuated dopamine release in the ventral striatum, negative reinforcement in limbic systems, cognitive and behavioral inflexibility with diminished serotonergic prefrontal control, and habitual responding with imbalances between ventral and dorsal frontostriatal recruitment. Frontostriatal abnormalities of compulsivity are promising targets for neuromodulation and other interventions for OCD and addictions. We conclude that compulsivity encompasses many of the RDoC constructs in a trans-diagnostic fashion with a common brain circuit dysfunction that can help identifying appropriate prevention and treatment targets. Copyright © 2016. Published by Elsevier B.V.

[An evaluation of some of the relationships between thought-action fusion, attributional styles, and depressive and obsessive-compulsive symptoms].

PubMed

Piri, Serap; Kabakçi, Elif

2007-01-01

Thought-action fusion (TAF) is a cognitive bias presumed to underlie the development of obsessional problems. Two domains of TAF have been identified. The first, TAF-moral, is characterized by the belief that having morally unacceptable thoughts is as bad as actually carrying them out. The second, TAF-likelihood, refers to the belief that certain thoughts cause particular events. The event can be related to one's self (likelihood-self) or to someone else (likelihood-others). The other cognitive variable of the study is attributional style. The theory of attributional styles, in terms of the causes of good and bad events, is taken into account especially in the context of depression and has four dimensions: internality-externality, stability-instability, globality-specifity, and importance-unimportance. The first objective of the present study was to investigate the relationships between TAF, and attributional style, and depressive and obsessive-compulsive symptoms. The second objective was to determine the predictors of TAF when the effects of depressive and obsessive-compulsive symptoms are statistically controlled. The sample consisted of 312 students randomly selected from different departments at Hacettepe University. The Thought-Action Fusion Scale (TAFS), Attributional Style Questionnaire (ASQ), Maudsley Obsessive-Compulsive Inventory (MOCI), and Beck Depression Inventory (BDI) were administered to these students. The correlations among all the subtypes of TAF (TAF-moral, likelihood-self, and likelihood-others), and the global attributions for bad events, BDI, and MOCI were significant. In addition, the correlation between TAF-moral and the importance of the attribution for bad events was significant. TAF-likelihood-others and TAF-likelihood-self were predicted by global attributions for bad events and TAF-moral was predicted by the importance of the attributions for bad events. TAF, and attributional styles, and depressive and obsessive-compulsive symptoms may be related to each other. The results also suggest a possible effect of other variables not controlled in this study, both on TAF and the dimensions of attributional styles.

Hoarding disorder: a new diagnosis for DSM-V?

PubMed

Mataix-Cols, David; Frost, Randy O; Pertusa, Alberto; Clark, Lee Anna; Saxena, Sanjaya; Leckman, James F; Stein, Dan J; Matsunaga, Hisato; Wilhelm, Sabine

2010-06-01

This article provides a focused review of the literature on compulsive hoarding and presents a number of options and preliminary recommendations to be considered for DSM-V. In DSM-IV-TR, hoarding is listed as one of the diagnostic criteria for obsessive-compulsive personality disorder (OCPD). According to DSM-IV-TR, when hoarding is extreme, clinicians should consider a diagnosis of obsessive-compulsive disorder (OCD) and may diagnose both OCPD and OCD if the criteria for both are met. However, compulsive hoarding seems to frequently be independent from other neurological and psychiatric disorders, including OCD and OCPD. In this review, we first address whether hoarding should be considered a symptom of OCD and/or a criterion of OCPD. Second, we address whether compulsive hoarding should be classified as a separate disorder in DSM-V, weighing the advantages and disadvantages of doing so. Finally, we discuss where compulsive hoarding should be classified in DSM-V if included as a separate disorder. We conclude that there is sufficient evidence to recommend the creation of a new disorder, provisionally called hoarding disorder. Given the historical link between hoarding and OCD/OCPD, and the conservative approach adopted by DSM-V, it may make sense to provisionally list it as an obsessive-compulsive spectrum disorder. An alternative to our recommendation would be to include it in an Appendix of Criteria Sets Provided for Further Study. The creation of a new diagnosis in DSM-V would likely increase public awareness, improve identification of cases, and stimulate both research and the development of specific treatments for hoarding disorder. (c) 2010 Wiley-Liss, Inc.

Diagnostic validity of early-onset obsessive-compulsive disorder in the Danish Psychiatric Central Register: findings from a cohort sample

PubMed Central

Powell, Shelagh; Koch, Susanne V; Crowley, James J; Matthiesen, Manuel; Grice, Dorothy E; Thomsen, Per H; Parner, E

2017-01-01

Objectives Employing national registers for research purposes depends on a high diagnostic validity. The aim of the present study was to examine the diagnostic validity of recorded diagnoses of early-onset obsessive-compulsive disorder (OCD) in the Danish Psychiatric Central Register (DPCR). Design Review of patient journals selected randomly through the DPCR. Method One hundred cases of OCD were randomly selected from DPCR. Using a predefined coding scheme based on the Children’s Yale Brown Obsessive Compulsive Scale (CYBOCS), experienced research nurse or child and adolescent psychiatrists assessed each journal to determine the presence/absence of OCD diagnostic criteria. The detailed assessments were reviewed by two senior child and adolescent psychiatrists to determine if diagnostic criteria were met. Primary outcome measurements Positive predictive value (PPV) was used as the primary outcome measurement. Results A total of 3462 children/adolescents received an OCD diagnosis as the main diagnosis between 1 January 1995 and 31 December 2015. The average age at diagnosis was 13.21±2.89 years. The most frequent registered OCD subcode was the combined diagnosis DF42.2. Of the 100 cases we examined, 35 had at least one registered comorbidity. For OCD, the PPV was good (PPV 0.85). Excluding journals with insufficient information, the PPV was 0.96. For the subcode F42.2 the PPV was 0.77. The inter-rater reliability was 0.94. The presence of the CYBOCS in the journal significantly increased the PPV for the OCD diagnosis altogether and for the subcode DF42.2. Conclusion The validity and reliability of International Classification of Disease 10th revision codes for OCD in the DPCR is generally high. The subcodes for predominant obsessions/predominant compulsions are less certain and should be used with caution. The results apply for both children and adolescents and for both older and more recent cases. Altogether, the study suggests that there is a high validity of the OCD diagnosis in the Danish National Registers. PMID:28928194

Perceived parental characteristics of patients with obsessive compulsive disorder, depression, and panic disorder.

PubMed

Merkel, W T; Pollard, C A; Wiener, R L; Staebler, C R

1993-01-01

It has been hypothesized that parents of patients with obsessive compulsive disorder exhibit specific traits. 320 consecutive inpatient admissions who met criteria for OCD, depression, and panic disorder checked a list of adjectives to describe their parents. Patients with OCD were 1) less likely to perceive their mothers as disorganized than depressives, 2) more likely to perceive their mothers as overprotective than depressives and 3) less likely to perceive their fathers as demanding than patients with panic.

An Epidemiological Perspective of Obsessive-Compulsive Disorder in Children and Adolescents

PubMed Central

Fogel, Joshua

2003-01-01

Obsessive-compulsive disorder (OCD) is reviewed from an epidemiological perspective. OCD is defined according to the DSM-IV and ICD-10, with differences noted between these two classification systems. The epidemiological rubrics of quantity (prevalence), location (genetic methods and gender differences), cause (genetic etiology), and causal mechanisms (natural history and clinical course) are reviewed. The review concludes that more research is needed to further understand the epidemiology of OCD in children and adolescents, both from a Canadian and worldwide perspective. PMID:19030478

Stability of the Pregnancy Obsessive-Compulsive Personality Disorder Symptoms Checklist.

PubMed

van Broekhoven, Kiki E M; Karreman, Annemiek; Hartman, Esther E; Pop, Victor J M

2018-02-01

Because stability over time is central to the definition of personality disorder, aim of the current study was to determine the stability of the Pregnancy Obsessive-Compulsive Personality Disorder (OCPD) Symptoms Checklist (N = 199 women). Strong positive correlations between assessments at 32 weeks of pregnancy and 2 and 3-3.5 years after childbirth were found (r between .62-.72), and the group mean score did not change over time. The Pregnancy OCPD Symptoms Checklist assesses stable, trait-like symptoms of OCPD.

'Mastication rage': a review of misophonia - an under-recognised symptom of psychiatric relevance?

PubMed

Bruxner, George

2016-04-01

To explore the condition of misophonia, its definition, possible neurological correlates, its associated morbidity, its possible psychiatric relevance and potential treatment. Provision of an illustrative case vignette and a review of the limited literature. Misophonia is a symptom associated with obsessive-compulsive disorder and anxiety disorders and may be a syndrome in itself associated with significant distress and avoidance. Treatments are not well validated. Misophonia may be an under-recognised condition of psychiatric relevance. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Parsing the phenotype of obsessive-compulsive tic disorder (OCTD): a multidisciplinary consensus.

PubMed

Dell'Osso, Bernardo; Marazziti, Donatella; Albert, Umberto; Pallanti, Stefano; Gambini, Orsola; Tundo, Antonio; Zanaboni, Carlotta; Servello, Domenico; Rizzo, Renata; Scalone, Luciana; Benatti, Beatrice; Altamura, A Carlo; Porta, Mauro

2017-06-01

Obsessive-Compulsive Disorder (OCD) and Tic Disorder (TD) are highly disabling and often comorbid conditions. Of note, the DSM-5 acknowledged a new 'tic-related' specifier for OCD, which might be referred to as Obsessive-Compulsive Tic Disorder (OCTD), raising new interest toward a better clinical characterisation of affected patients. Available literature indicates that early onset, male gender, sensory phenomena and obsessions of symmetry, aggressiveness, hoarding, exactness and sounds as well as comorbidity with Attention Deficit Hyperactivity Disorder (ADHD) may be of more frequent observation in patients with OCTD. In order to share expertise in the field from different perspectives, a multidisciplinary panel of Italian clinicians, specifically involved in the clinical care of OCD and TD patients, participated into a consensus initiative, aimed to produce a shared document. As a result, after having examined the most relevant literature, authors sought to critically identify and discuss main epidemiologic, socio-demographic and clinical features characterising OCTD patients, along with other specific aspects including Health-Related Quality-of-Life (HRQoL), economic consequences related with the condition and its management, as well as treatment-related issues, that need to be further investigated.

Obsessive-compulsive disorder with and without bipolar disorder.

PubMed

Mahasuar, Rajnarayan; Janardhan Reddy, Y C; Math, Suresh Bada

2011-08-01

Bipolar disorder (BD) is often comorbid with obsessive-compulsive disorder (OCD). In this study, we compared clinical profile and course of subjects with a primary diagnosis of OCD with and without BD. We compared 34 subjects with primary diagnosis of OCD with BD and 57 subjects with a diagnosis of OCD without BD. Structured interview schedules, clinical rating scales, and information from clinical charts were utilized to assess patients. OCD with BD was characterized by: (i) an episodic course; (ii) a higher number of depressive episodes, greater suicidality and a higher rate of hospitalization; (iii) fewer pathological doubts and more miscellaneous compulsions; and (iv) poorer insight into obsessive-compulsive symptoms. Episodic course appears to be typical of OCD with BD. Bipolarity has a pathoplastic effect on OCD and it is possible that some forms of OCD and BD are pathophysiologically related. Bipolar OCD is associated with a higher rate of depressive episodes, higher suicidality and more frequent hospitalizations, suggesting greater morbidity. Long-term prospective follow-up studies and studies addressing pathophysiology and genetic basis are needed to understand the complexity of such comorbidity. © 2011 The Authors. Psychiatry and Clinical Neurosciences © 2011 Japanese Society of Psychiatry and Neurology.

Deontological guilt and obsessive compulsive disorder.

PubMed

Mancini, Francesco; Gangemi, Amelia

2015-12-01

The emotion of guilt plays a pivotal role in the genesis and maintenance of Obsessive-Compulsive Disorder (OCD). But what kind of guilt do OC patients want to prevent? Several studies suggest the existence of two different types of guilt emotions, namely deontological and altruistic guilt. This research suggests that the former, more than the latter, is involved in OCD. Studies in which people must hypothetically choose between killing one person to save a few (consequentialist choice) or take no action and allow things to take their course (omission choice), have found that the latter is consistent with the "Do not play God" moral principle whereas the former is consistent with altruistic motivations. This paper is aimed at verifying whether both OC patients, with no induction, and nonclinical participants, after the induction of deontological guilt prefer omission more often than a consequentialist option. It is hypothesized that people with OCD will be motivated to avoid feeling deontological guilt and thus will be more likely to opt for omission. Similarly, nonclinical participants who receive a deontological guilt induction will also be more likely to choose omission. In two studies participants were given seven scenarios (four moral dilemmas, three control scenarios). Twenty patients with OCD, 20 anxious controls, and 20 healthy participants took part in study 1. In study 2, we recruited 70 healthy participants who were randomly assigned to receive a deontological guilt or a control induction. Consistent with hypotheses, in Study 1 OC patients preferred omission, instead of the consequentialist option, moreso than did the clinical and nonclinical controls. In Study 2, the group receiving the deontological guilt induction preferred omission to a greater extent than did the altruistic group. The present study cannot establish that the goal of preventing or neutralizing deontological guilt actually drives obsessions and compulsions. These results provide further evidence that people with OCD are more sensitive to deontological guilt, compared to other people. They thus contribute to improve the moral appraisal theory of OCD. Copyright © 2015 Elsevier Ltd. All rights reserved.

Common Pitfalls in Exposure and Response Prevention (EX/RP) for OCD

PubMed Central

Gillihan, Seth J.; Williams, Monnica T.; Malcoun, Emily; Yadin, Elna; Foa, Edna B.

2012-01-01

Obsessive-compulsive disorder (OCD) is a highly debilitating disorder. Fortunately there are treatments that help the majority of OCD sufferers. The behavioral treatment with the most empirical support for its efficacy is exposure and response prevention (EX/RP). Over the years in our supervision meetings and in our clinical practice we have noted a number of relatively common therapist pitfalls that decrease the effectiveness of EX/RP. These pitfalls include not encouraging patients to approach the most distressing situations, doing imaginal exposure when in vivo is called for (and vice versa), encouraging distraction during exposure, providing reassurance, failing to address the core fear, ineffective handling of mental compulsions, and difficulty working with close others in the patient’s life. In the current article we describe these common pitfalls and how to avoid them. PMID:22924159

Frequency and severity of obsessive-compulsive symptoms/disorders, violence and suicidal in schizophrenic patients.

PubMed

Hosseini, S H; Zarghami, M; Moudi, S; Mohammadpour, A R

2012-06-01

This study determined the prevalence and severity of obsessive-compulsive symptoms/disorder (OCS/OCD), aggression and suicidal in schizophrenic patients. Also we compared the prevalence and severity of aggression and suicidal in schizophrenic patients with and without OCS/OCD considering anxiety, depression and substance abuse as confounding factors. During 2007 and 2008, 100 schizophrenic patients were evaluated with Yale-Brown Obsessive Compulsive Scale, Positive and Negative Syndrome Scale, Beck Depression Inventory, Spilberger State/Trait Anxiety Inventory, Beck Scale for suicide Ideation, and Overt Aggression Scale. OCS/OCD and suicidal attempts were seen in 33%, 10% and 12% of patients respectively. The most common form of aggression was against others (55%), and aggressive obsessions were seen in 10% of the patients. Comparing patients with and without OCS/OCD, there were no significant differences in the severity of schizophrenia, suicidal and overt aggression. The severity of overt aggression was related to the patients' age and education reversely. Also, there was a relationship between their suicidal thoughts and residence in the cities. High rate of aggressive obsessions and lack of relationship between severity of aggression and presence of OCD indicated that these patients did not act on these thoughts. The risk of suicide was more serious in patients living in the cities, and risk of violence was more serious in younger and less educated patients.

OCD? Not Me! Protocol for the development and evaluation of a web-based self-guided treatment for youth with obsessive-compulsive disorder.

PubMed

Rees, Clare S; Anderson, Rebecca A; Finlay-Jones, Amy

2015-04-29

OCD? Not Me! is a novel, web-based, self-guided intervention designed to treat obsessive-compulsive disorder (OCD) in young people aged 12-18, using the principles of exposure and response prevention. The current paper presents the protocol for the development of the programme and for an open trial that will evaluate the effectiveness of this programme for OCD in young people, and associated distress and symptom accommodation in their parents and caregivers. We will measure the impact of the OCD? Not Me! programme on OCD symptoms using the Children's Florida Obsessive Compulsive Inventory (C-FOCI), and both the self-report and parent report of the Children's Obsessional Compulsive Inventory-Revised (ChOCI-R). The impact of the programme on OCD-related functional impairment will be measured using the parent report of the Child Obsessive-Compulsive Impact Scale-Revised (COIS-R). Secondary outcome measures include the Rosenberg Self-Esteem Scale and the Youth Quality of Life-Short Form (YQoL-SF). The 21-item Depression Anxiety Stress Scales (DASS-21) will be used to measure the impact of the programme on parent/caregiver distress, while the Family Accommodation Scale (FAS) will be used to measure change in family accommodation of OCD symptoms. Multilevel mixed effects linear regression will be used to analyse the impact of the intervention on the outcome measures. This study has been approved by the Curtin University Human Research Ethics Committee. The results of the study will be reported in international peer-reviewed journals. Australian New Zealand Clinical Trials Registry: ACTRN12613000152729. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

OCD? Not Me! Protocol for the development and evaluation of a web-based self-guided treatment for youth with obsessive-compulsive disorder

PubMed Central

Rees, Clare S; Anderson, Rebecca A

2015-01-01

Background OCD? Not Me! is a novel, web-based, self-guided intervention designed to treat obsessive-compulsive disorder (OCD) in young people aged 12–18, using the principles of exposure and response prevention. The current paper presents the protocol for the development of the programme and for an open trial that will evaluate the effectiveness of this programme for OCD in young people, and associated distress and symptom accommodation in their parents and caregivers. Methods We will measure the impact of the OCD? Not Me! programme on OCD symptoms using the Children's Florida Obsessive Compulsive Inventory (C-FOCI), and both the self-report and parent report of the Children's Obsessional Compulsive Inventory—Revised (ChOCI-R). The impact of the programme on OCD-related functional impairment will be measured using the parent report of the Child Obsessive-Compulsive Impact Scale—Revised (COIS-R). Secondary outcome measures include the Rosenberg Self-Esteem Scale and the Youth Quality of Life—Short Form (YQoL-SF). The 21-item Depression Anxiety Stress Scales (DASS-21) will be used to measure the impact of the programme on parent/caregiver distress, while the Family Accommodation Scale (FAS) will be used to measure change in family accommodation of OCD symptoms. Multilevel mixed effects linear regression will be used to analyse the impact of the intervention on the outcome measures. Ethics and dissemination This study has been approved by the Curtin University Human Research Ethics Committee. The results of the study will be reported in international peer-reviewed journals. Trial registration number Australian New Zealand Clinical Trials Registry: ACTRN12613000152729. PMID:25926148

Anxiety and Shame as Risk Factors for Depression, Suicidality, and Functional Impairment in Body Dysmorphic Disorder and Obsessive Compulsive Disorder.

PubMed

Weingarden, Hilary; Renshaw, Keith D; Wilhelm, Sabine; Tangney, June P; DiMauro, Jennifer

2016-11-01

Body dysmorphic disorder (BDD) and obsessive compulsive disorder (OCD) are associated with elevated depression, suicidality, functional impairment, and days housebound, yet little research has identified risk factors for these outcomes. Using path analysis, the present study examined anxiety and shame as risk factors for these outcomes across Internet-recruited self-report groups (BDD [n = 114], OCD [n = 114], and healthy control [HC; n = 133]). Paths from anxiety and shame to outcomes were similar and mostly significant across BDD and OCD, compared to non-significant paths for HCs, with one exception: the path from shame to depression was significant in the BDD group (b = 0.32) but non-significant in the OCD group (b = 0.07). Findings underscore similarities in BDD and OCD, supporting their reclassification into the same Obsessive Compulsive Related Disorders category. Results emphasize the importance of targeting shame, in addition to anxiety, in treatments for BDD and OCD.

Psychometric evaluation of the thought-action fusion scale in a large clinical sample.

PubMed

Meyer, Joseph F; Brown, Timothy A

2013-12-01

This study examined the psychometric properties of the 19-item Thought-Action Fusion (TAF) Scale, a measure of maladaptive cognitive intrusions, in a large clinical sample (N = 700). An exploratory factor analysis (n = 300) yielded two interpretable factors: TAF Moral (TAF-M) and TAF Likelihood (TAF-L). A confirmatory bifactor analysis was conducted on the second portion of the sample (n = 400) to account for possible sources of item covariance using a general TAF factor (subsuming TAF-M) alongside the TAF-L domain-specific factor. The bifactor model provided an acceptable fit to the sample data. Results indicated that global TAF was more strongly associated with a measure of obsessive-compulsiveness than measures of general worry and depression, and the TAF-L dimension was more strongly related to obsessive-compulsiveness than depression. Overall, results support the bifactor structure of the TAF in a clinical sample and its close relationship to its neighboring obsessive-compulsiveness construct.

Psychometric Evaluation of the Thought–Action Fusion Scale in a Large Clinical Sample

PubMed Central

Meyer, Joseph F.; Brown, Timothy A.

2015-01-01

This study examined the psychometric properties of the 19-item Thought–Action Fusion (TAF) Scale, a measure of maladaptive cognitive intrusions, in a large clinical sample (N = 700). An exploratory factor analysis (n = 300) yielded two interpretable factors: TAF Moral (TAF-M) and TAF Likelihood (TAF-L). A confirmatory bifactor analysis was conducted on the second portion of the sample (n = 400) to account for possible sources of item covariance using a general TAF factor (subsuming TAF-M) alongside the TAF-L domain-specific factor. The bifactor model provided an acceptable fit to the sample data. Results indicated that global TAF was more strongly associated with a measure of obsessive-compulsiveness than measures of general worry and depression, and the TAF-L dimension was more strongly related to obsessive-compulsiveness than depression. Overall, results support the bifactor structure of the TAF in a clinical sample and its close relationship to its neighboring obsessive-compulsiveness construct. PMID:22315482

The Yale-Brown Obsessive Compulsive Scale: A Reliability Generalization Meta-Analysis.

PubMed

López-Pina, José Antonio; Sánchez-Meca, Julio; López-López, José Antonio; Marín-Martínez, Fulgencio; Núñez-Núñez, Rosa Maria; Rosa-Alcázar, Ana I; Gómez-Conesa, Antonia; Ferrer-Requena, Josefa

2015-10-01

The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is the most frequently applied test to assess obsessive compulsive symptoms. We conducted a reliability generalization meta-analysis on the Y-BOCS to estimate the average reliability, examine the variability among the reliability estimates, search for moderators, and propose a predictive model that researchers and clinicians can use to estimate the expected reliability of the Y-BOCS. We included studies where the Y-BOCS was applied to a sample of adults and reliability estimate was reported. Out of the 11,490 references located, 144 studies met the selection criteria. For the total scale, the mean reliability was 0.866 for coefficients alpha, 0.848 for test-retest correlations, and 0.922 for intraclass correlations. The moderator analyses led to a predictive model where the standard deviation of the total test and the target population (clinical vs. nonclinical) explained 38.6% of the total variability among coefficients alpha. Finally, clinical implications of the results are discussed. © The Author(s) 2014.

Tic Severity and Treatment in Children: The Effect of Comorbid Attention Deficit Hyperactivity Disorder and Obsessive Compulsive Behaviors.

PubMed

Pringsheim, Tamara

2017-12-01

While attention deficit hyperactivity disorder (ADHD) and obsessive compulsive disorder have been shown to have major impacts on quality of life in individuals with Tourette syndrome, there is comparatively little data on how the presence of these comorbidities influence tic severity and treatment. 114 children (mean age 10.25 years) were extensively clinically phenotyped at a single specialty clinic. While there was no difference in Yale Global Tic Severity Scale (YGTSS) scores in children with versus without ADHD, children with obsessive compulsive behaviors had significantly higher YGTSS scores (p = 0.008). There was a significant correlation between YGTSS scores and age (r = 0.344, p < 0.001). Children with ADHD were more likely to be treated for their tics within the first two years of diagnosis (OR 3.51, p = 0.009). As tic severity does not appear to be greater in children with ADHD, this association may relate to greater overall psychosocial impairment in children with this comorbidity.

Examination of the Phenomenology and Clinical Correlates of Emetophobia in a Sample of Salvadorian Youths.

PubMed

Wu, Monica S; Selles, Robert R; Novoa, Juan Carlos; Zepeda, Raquel; Guttfreund, Daniel; McBride, Nicole M; Storch, Eric A

2017-06-01

Emetophobia is an under-researched disorder characterized by a specific fear of vomiting. There is a paucity of research on this impairing condition, with extant examinations being largely limited to adult samples and online communities. The present study examined the incidence, phenomenology, and correlates of emetophobia in 305 Salvadorian youths. Caregivers completed a battery of questionnaires regarding the youth's symptoms of emetophobia, internalizing/externalizing symptoms, health anxiety, and obsessive-compulsive symptoms. Approximately 7.5 % of the sample was elevated on emetophobia symptoms, and higher levels of emetophobia symptoms were correlated with higher levels of internalizing, externalizing, health anxiety, and obsessive-compulsive symptoms, and lower levels of adaptive functioning. Youths meeting the cutoff for elevated emetophobia symptoms versus those who did not demonstrated significantly higher levels of externalizing behaviors, as well as general obsessive-compulsive symptoms, especially doubting/checking and neutralizing behaviors. These findings are hoped to help improve the conceptualization and treatment of this poorly understood disorder.

Anxiety and Shame as Risk Factors for Depression, Suicidality, and Functional Impairment in Body Dysmorphic Disorder and Obsessive Compulsive Disorder

PubMed Central

Weingarden, Hilary; Renshaw, Keith D.; Wilhelm, Sabine; Tangney, June P.; DiMauro, Jennifer

2016-01-01

Body dysmorphic disorder (BDD) and obsessive compulsive disorder (OCD) are associated with elevated depression, suicidality, functional impairment, and days housebound, yet little research has identified risk factors for these outcomes. Using path analysis, the present study examined anxiety and shame as risk factors for these outcomes across Internet-recruited self-report groups (BDD [n = 114], OCD [n = 114], and healthy control [HC; n = 133]. Paths from anxiety and shame to outcomes were similar and mostly significant across BDD and OCD, compared to non-significant paths for HCs, with one exception: the path from shame to depression was significant in the BDD group (b = .32) but non-significant in the OCD group (b = .07). Findings underscore similarities in BDD and OCD, supporting their reclassification into the same Obsessive Compulsive Related Disorders category. Results emphasize the importance of targeting shame, in addition to anxiety, in treatments for BDD and OCD. PMID:26998694

Aripiprazole augmentation in highly treatment-resistant obsessive-compulsive disorder - experience from a specialty clinic in India.

PubMed

Hegde, Aditya; Kalyani, Bangalore G; Arumugham, Shyam Sundar; Narayanaswamy, Janardhanan C; Math, Suresh Bada; Reddy, Y C Janardhan

2017-03-01

To study the effectiveness and tolerability of aripiprazole augmentation in patients with highly treatment-resistant obsessive-compulsive disorder (OCD) in a real-world scenario. We conducted a chart review of patients who were initiated on aripiprazole augmentation at a specialty OCD clinic in India between 2004 and 2014. Primary outcome measure was all-cause discontinuation. 23 patients were eligible for analysis. Patients had not achieved symptom remission despite a mean of over 3 prior SRI trials. Aripiprazole was continued to be used in seven patients (30%) at the time of last follow-up. Thirteen patients (57%) discontinued the drug due to side effects, and three patients (13%) discontinued aripiprazole citing no improvement. Six patients (26%) were noted to have ≥25% reduction on the Yale-Brown Obsessive-Compulsive Scale. The study demonstrated, in a real-world setting, that aripiprazole may be a useful augmenting agent in a proportion of patients with highly treatment-resistant OCD. However, side effects may lead to premature discontinuation in many of them.

An empirical investigation of incompleteness in a large clinical sample of obsessive compulsive disorder.

PubMed

Sibrava, Nicholas J; Boisseau, Christina L; Eisen, Jane L; Mancebo, Maria C; Rasmussen, Steven A

2016-08-01

Obsessive Compulsive Disorder (OCD) is a disorder with heterogeneous clinical presentations. To advance our understanding of this heterogeneity we investigated the prevalence and clinical features associated with incompleteness (INC), a putative underlying core feature of OCD. We predicted INC would be prominent in individuals with OCD and associated with greater severity and impairment. We examined the impact of INC in 307 adults with primary OCD. Participants with clinically significant INC (22.8% of the sample) had significantly greater OCD severity, greater rates of comorbidity, poorer ratings of functioning, lower quality of life, and higher rates of unemployment and disability. Participants with clinically significant INC were also more likely to be diagnosed with OCPD and to endorse symmetry/exactness obsessions and ordering/arranging compulsions than those who reported low INC. Our findings provide evidence that INC is associated with greater severity, comorbidity, and impairment, highlighting the need for improved assessment and treatment of INC in OCD. Copyright © 2016 Elsevier Ltd. All rights reserved.

Obsessive-compulsive personality traits: how are they related to OCD severity?

PubMed

Wetterneck, Chad T; Little, Tannah E; Chasson, Gregory S; Smith, Angela H; Hart, John M; Stanley, Melinda A; Björgvinsson, Thröstur

2011-12-01

Previous research has demonstrated that comorbid obsessive-compulsive personality disorder (OCPD) in patients with obsessive-compulsive disorder (OCD) is associated with greater overall OCD severity, functional impairment, and poorer treatment outcomes (Coles et al., 2008; Lochner et al., 2010; Pinto, 2009). However, research has only examined the effects of OCPD categorically and has yet to thoroughly examine the impact of individual OCPD characteristics dimensionally. Thus, the present study sought to investigate the relationships between various OCPD-related dimensions (e.g., perfectionism, rigidity) and OCD symptomology and severity. The study recruited a sample of OCD patients (n=51) in the OCD units of two residential treatment facilities. Findings yielded significant relationships between OCD severity and the following OCPD dimensions: flexibility, doubts about actions (a dimension of perfectionism), and hoarding. Interpretations of these results and the implications for diagnosis, prognosis, and treatment outcome are discussed. Furthermore, the current study provides insight into a unique perspective which leaves room for more symptom overlap and variability between OCD and OCPD. Published by Elsevier Ltd.

An Empirical Investigation of Incompleteness in a Large Clinical Sample of Obsessive Compulsive Disorder

PubMed Central

Sibrava, Nicholas J.; Boisseau, Christina L.; Eisen, Jane L.; Mancebo, Maria C.; Rasmussen, Steven A.

2016-01-01

Obsessive Compulsive Disorder (OCD) is a disorder with heterogeneous clinical presentations. To advance our understanding of this heterogeneity we investigated the prevalence and clinical features associated with incompleteness (INC), a putative underlying core feature of OCD. We predicted INC would be prominent in individuals with OCD and associated with greater severity and impairment. We examined the impact of INC in 307 adults with primary OCD. Participants with clinically significant INC (22.8% of the sample) had significantly greater OCD severity, greater rates of comorbidity, poorer ratings of functioning, lower quality of life, and higher rates of unemployment and disability. Participants with clinically significant INC were also more likely to be diagnosed with OCPD and to endorse symmetry/exactness obsessions and ordering/arranging compulsions than those who reported low INC. Our findings provide evidence that INC is associated with greater severity, comorbidity, and impairment, highlighting the need for improved assessment and treatment of INC in OCD. PMID:27268401

Insight in pediatric obsessive-compulsive disorder: associations with clinical presentation.

PubMed

Storch, Eric A; Milsom, Vanessa A; Merlo, Lisa J; Larson, Michael; Geffken, Gary R; Jacob, Marni L; Murphy, Tanya K; Goodman, Wayne K

2008-08-15

Insight has emerged as a significant treatment outcome predictor in adult obsessive-compulsive disorder (OCD), with some suggesting that OCD with poor insight represents a distinct clinical subtype. Despite its clinical relevance, limited data exist on insight in pediatric OCD patients. The present study investigated the relation between poor insight and clinical characteristics among children and adolescents with OCD (N=78, ages 6-20 years). Forty-five percent of the sample (n=35) was considered to have low levels of insight into their symptoms, as determined by clinician rating on item 11 of the Children's Yale-Brown Obsessive-Compulsive Scale. Pearson product-moment correlations showed a significant, inverse relation between insight and OCD severity. Relative to the high insight group, parents of patients with low insight reported higher levels of OCD-related impairment and family accommodation. These findings suggest that OCD with poor insight may represent a distinct clinical feature that may require more intensive and multimodal treatment approaches.

Successful anterior capsulotomy in comorbid anorexia nervosa and obsessive-compulsive disorder: case report.

PubMed

Barbier, Johan; Gabriëls, Loes; van Laere, Koen; Nuttin, Bart

2011-09-01

State-of-the-art treatment of anorexia nervosa (AN) and obsessive-compulsive disorder (OCD) often proves ineffective. Both disorders have common features, and anterior capsulotomy is a last-resort treatment for OCD. We document the effect of bilateral anterior capsulotomy in a patient with comorbid AN and OCD. A 38-year-old woman with life-threatening, chronic, treatment-refractory AN and OCD underwent anterior capsulotomy. Psychiatric and neuropsychological evaluations at baseline and at follow-up document the severity and progress of the case. Bilateral anterior capsulotomy resulted in normalization of eating pattern and weight and a significant decrease of food-related and overall obsessive-compulsive symptoms. Psychiatric evaluations and exposure to food cues confirmed the clinical improvement that was evident immediately after surgery and sustained at 3-month follow-up. This case report suggests that bilateral anterior capsulotomy can be a therapeutic option for patients with comorbid AN and OCD. However, a well-controlled study is warranted.

Short-term psychodynamic therapy for obsessive-compulsive disorder: A manual-guided approach to treating the "inhibited rebel".

PubMed

Leichsenring, Falk; Steinert, Christiane

2017-01-01

Obsessive-compulsive disorder (OCD) is a chronic disabling disorder characterized by recurrent obsessions and uncontrolled compulsions. Recent research on anxiety disorders suggests that manual-guided short-term psychodynamic therapy (STPP) may be a promising approach. Building on this, a model of STPP for OCD was developed based on Luborsky's supportive-expressive (SE) therapy. Treatment consists of 12 modules, which include the characteristic elements of SE therapy, that is, a focus on the Core Conflictual Relationship Theme (CCRT) associated with OCD symptoms and on establishing a secure alliance. Disorder-specific treatment elements were integrated, including addressing ambivalence, differentiating between thinking and acting, mitigating the superego, addressing existential issues, and, last but not least, implementing Freud's original recommendation to induce OCD patients to face the feared situation and to use the aroused experiences to work on the underlying conflict (i.e., CCRT). There are reasons to assume that the empirically derived model of STPP described here may be beneficial in OCD.

Pastoral theory and practice in the team approach to treatment of scrupulosity as a component of obsessive compulsive disorder.

PubMed

Kennemer, Darren L

2007-01-01

The statistical estimates of the prevalence of Obsessive Compulsive Disorder (OCD) in the general population have increased dramatically in recent years. "Blasphemous" obsessions and religious compulsions dominate the clinical picture of many sufferers of OCD. Freud proposed that religion might be a contributing factor for many patients with mental illness. He hedged, however, that observation--something that many of his followers have not done. Others have noted the pathoplasticity of strict religious upbringing and images of God as vindictive or otherwise harsh. Only recently--since the 1970s--has much clinical attention been focused on this disorder by the other disciplines within the mental health community. The church, however, is ahead of the curve in diagnosis and treatment of scrupulosity. It has long been a concern for pastoral counselors--particularly pre-Vatican II Roman Catholic priests. Pathological religion influences OCD and pastoral counseling, the author proposes, can contributes to recovery.

Mediation of symptom changes during inpatient treatment for eating disorders: the role of obsessive-compulsive features.

PubMed

Olatunji, Bunmi O; Tart, Candyce D; Shewmaker, Shona; Wall, David; Smits, Jasper A J

2010-10-01

The present study examined the relative contributions of changes in obsessive-compulsive symptoms among eating-disorder patients with (n = 254) and without (n = 254) obsessive-compulsive disorder (OCD) to eating-disorder symptom improvement observed with inpatient treatment. Consistent with hypothesis, multilevel mediation analyses revealed that improvements in OCD symptoms over time accounted for significant variance in the improvements in eating-disorder symptoms over time, with stronger mediation evident among eating-disorder patients with comorbid OCD (percent mediated; P(M) = 22.5%) compared to those without OCD (P(M) = 12.2%). However, decreases in eating-disorder symptoms over time fully mediated improvements in OCD symptoms over time, and this mediated pathway did not vary substantially as a function of comorbid OCD status. The theoretical and treatment implications of these findings for conceptualizing the relationship between eating disorders and OCD are discussed. Copyright © 2010 Elsevier Ltd. All rights reserved.

Mindfulness-based cognitive therapy as an augmentation treatment for obsessive-compulsive disorder.

PubMed

Key, Brenda L; Rowa, Karen; Bieling, Peter; McCabe, Randi; Pawluk, Elizabeth J

2017-09-01

A significant number of obsessive-compulsive disorder (OCD) patients continue to experience symptoms that interfere with their functioning following cognitive behavioural therapy (CBT). Providing an additional augmentation treatment following CBT could help reduce these residual symptoms. Mindfulness interventions that facilitate less reactivity to thoughts and feelings may be helpful for patients suffering from residual OCD symptoms. The purpose of the current randomized waitlist control trial was to evaluate the feasibility and impact of providing an 8-week mindfulness-based cognitive therapy (MBCT) intervention following completion of a CBT intervention to OCD patients who continued to suffer from significant symptoms. Results indicated that compared to the waitlist control group, MBCT participants reported decreases in OCD symptoms (d = 1.38), depression symptoms (d = 1.25), anxiety symptoms (d = 1.02), and obsessive beliefs (d = 1.20) along with increases in self-compassion (d = 0.77) and mindfulness skills (d = 0.77). Additionally, participants reported high levels of satisfaction with the MBCT intervention. The results suggest that the use of MBCT for OCD as an augmentation therapy is acceptable to patients who continue to suffer from OCD symptoms after completing CBT and provides some additional relief from residual symptoms. Mindfulness interventions teach skills that facilitate disengaging from cognitive routines and accepting internal experience, and these skills may be valuable in treating obsessive-compulsive disorder (OCD), as individuals describe getting "stuck" in repetitive thoughts and consequent rituals. The results of this study suggest that teaching mindfulness skills using an 8-week mindfulness-based cognitive therapy (MBCT) intervention provides an added benefit (decreases in OCD, depression, and anxiety symptoms) for patients with OCD who have completed a cognitive behavioural therapy intervention and continued to suffer from significant symptoms. Participation in MBCT was also associated with increases in mindfulness skills including increased ability to be nonjudgmental and nonreactive. By fostering a nonjudgmental stance towards intrusive thoughts, mindfulness may discourage suppression and avoidance of thoughts and this could lead to increased habituation and a decreased reliance on compulsions. The use of MBCT as an augmentation treatment should be further explored to elucidate whether this treatment is beneficial for preventing relapse of OCD and could be compared against further cognitive behavioural therapy to see if offering participants a different and theoretically compelling intervention, such as MBCT, would outperform "more of the same" for individuals with OCD. Copyright © 2017 John Wiley & Sons, Ltd.

Prevalence and clinical characteristics of obsessive-compulsive disorder and obsessive compulsive symptoms in Afrikaner schizophrenia and schizoaffective disorder patients.

PubMed

Seedat, F; Roos, J L; Pretorius, H W; Karayiorgou, M; Nel, B

2007-11-01

There is evidence of variation in the prevalence of co-morbid obsessive-compulsive disorder in schizophrenia amongst ethnic groups. This study evaluated the lifetime prevalence and clinical characteristics of obsessive-compulsive disorder (OCD)/ obsessive-compulsive symptoms (OCS) in Afrikaner schizophrenic and schizoaffective disorder patients. An ongoing genetic study of schizophrenia is currently being conducted on the Afrikaner founder population. In this cohort of 400 subjects from the original genetic study, we identified 53 subjects with schizophrenia or schizoaffective disorder and co-morbid OCD/OCS (study group). They were matched for gender and age of onset of illness with 59 subjects who do not have OCD/OCS (control group). The diagnostic instrument used in this cohort is the Diagnostic Interview for Genetic Studies (DIGS) version 2, which has been translated into Afrikaans. In addition to the DIGS, information for the relevant clinical characteristics reported in this study was also drawn from a detailed narrative chronological summary report and clinical files. A checklist was completed. The prevalence of co-morbid OCD/OCS amongst 400 subjects with schizophrenia or schizoaffective disorder was 13.2% [n=53] of which 40 were male and 13 female patients. The prevalence of OCD was 10.7% and OCS was 2.5%. Contamination obsessions [n=17] were the most common type of obsession reported, followed by religious obsessions [n=8]. The most prevalent compulsions were repetitive rituals [n=32] followed by checking behaviour [n=22]. Onset of psychotic symptoms was found to be insidious in 86.8% of the study group compared to 24.6% of the control group (p<0.0001). Second-generation antipsychotic use was found to be statistically more prevalent in the study group (77.4%), compared to the control group (45.8%) (p=0.0008). 73% of the study group experienced depressive symptoms compared to 50.8% of the control group. Both groups were found to have a similar incidence of suicidal thoughts and suicide attempts. Substance abuse amongst the control group was significantly higher (35.9%) compared to the study group (19.2%) (p <0.05). Cannabis was most commonly abused in both groups, followed by alcohol. The prevalence rate of 13.2% of co-morbid OCD/OCS in Afrikaner schizophrenia and schizoaffective disorder patients differs from findings in other ethnic groups, suggesting the possible role of genetic and cultural factors in the prevalence of co-morbid OCD/OCS. Second-generation antipsychotic use amongst schizophrenia and schizoaffective disorder patients with co-morbid OCD/OCS was found to be significantly higher than in those without co-morbid OCD/OCS. Clinical characteristics of Afrikaner schizophrenics and schizoaffective disorder patients with and without co-morbid OCD/OCS are the same, both groups were associated with significant psychopathology and a poor prognosis.

Components of inhibition in autogenous- and reactive-type obsessive-compulsive disorder: Dissociation of interference control.

PubMed

Fan, Jie; Liu, Wanting; Lei, Hui; Cai, Lin; Zhong, Mingtian; Dong, Jiaojiao; Zhou, Cheng; Zhu, Xiongzhao

2016-05-01

Obsessive-compulsive disorder (OCD) is characterized by unwanted, intrusive thoughts (obsessions) and/or repetitive, ritualistic behaviors (compulsions). Findings related to the two components of inhibition, namely interference control and behavioral inhibition, among OCD patients have been inconsistent. It might be that this inconsistency is due to the heterogeneity among OCD cases representing multiple subtypes of OCD, such as autogenous obsessions and reactive obsessions types (AOs vs. ROs). AOs and ROs are distinguished by the category of their most disturbing obsessions. The purpose of this study was to systematically examine whether inhibition functions differ between AO and RO patients. We assessed interference control and behavioral inhibition with the emotional Stroop task (EST) and stop-signal task (SST), respectively, in 42 AOs, 55 ROs and 62 healthy controls (HCs) and event-related potentials (ERPs) were recorded in a random subset of these subjects (25 AOs, 25 ROs, and 31HCs). Results showed that in the EST, AOs exhibited longer reaction times (RTs) for color-naming positive-, negative-, and neutral-valence word stimulus than both ROs and HCs, and demonstrated larger P2 and less negative N450 amplitudes than HCs and larger P3 amplitudes than ROs and HCs. In the SST, both AOs and ROs showed lengthened stop signal reaction time (SSRT) and reduced Stop-P3 amplitudes in successful inhibition (SI) trials compared to the HC group. These present findings suggest that behavioral inhibition impairment may reflect a common pathology in both the autogenous- and reactive-type OCD patients, whereas interference inhibition impairment appears to be specific to patients with autogenous obsessions. These findings strengthened the insight into the clinical heterogeneity and pathophysiology of OCD. Copyright © 2016 Elsevier B.V. All rights reserved.

Symptom Dimensions, Smoking and Impulsiveness in Obsessive-Compulsive Disorder.

PubMed

Tan, Oguz; Taş, Cumhur

2015-12-01

Obsessive-compulsive disorder (OCD) has distinct symptom dimensions with possibly subtle differences in the underlying neurobiology. One behavioral habit, smoking, has been widely investigated in psychiatric disorders, though received less attention in OCD. Here, we aimed to investigate the relationship between symptom dimensions and smoking behavior in OCD. OCD patients (n=167) with the symptom dimensions of washing, taboo thoughts and symmetry-counting-repeating-ordering (S+C+R+O) were questioned in terms of smoking status and assessed with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Fagerström Test for Nicotine Dependence (FTND), Hamilton Depression Rating Scale-17 Items (HDRS-17), Beck Anxiety Inventory (BAI) and Barratt Impulsiveness Scale-11 (BIS 11). Smoking status differed significantly among patients with distinct symptom dimensions (p=0.009).The ratio of smokers was the lowest in those with the washing (30%, N=12) and the highest in the S+C+R+O (68.2%, N=15) group. Those with taboo thoughts had a smoking ratio of 37.14% (N=39). In post hoc analysis, smoking ratio was significantly higher in the S+C+R+O group than in those with washing symptoms (p=0.004) and taboo thoughts (p=0.007) though it did not differ significantly between washers and taboo thought groups. The BIS-11 did not differ across symptom dimensions. OCD is a heterogeneous disorder in terms of smoking. Impulsiveness, which does not significantly vary across distinct symptom dimensions, cannot explain this heterogeneity. The severity of addiction does not differ in smokers with OCD across symptom dimensions.

Utility of the Leyton Obsessional Inventory to distinguish OCD and OCPD.

PubMed

Wellen, David; Samuels, Jack; Bienvenu, O Joseph; Grados, Marco; Cullen, Bernadette; Riddle, Mark; Liang, Kung-Yee; Nestadt, Gerald

2007-01-01

The Leyton Obsessional Inventory (LOI) is a self-report questionnaire that assesses obsessional symptoms. The ability of the LOI to distinguish between obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) has not been adequately addressed. Our purpose is to identify dimensions of obsessional symptoms from the LOI and determine how well they distinguish between OCD and OCPD. The LOI was completed by 488 participants diagnosed by trained clinicians. Factor analysis was performed on responses to the interference items of the LOI. The relationship between the factors, OCD and OCPD was evaluated using logistic regression. Five factors underlying the LOI were identified: (I) obsessional ruminations and compulsions, (II) ordering and arranging, (III) organizing activities, (IV) contamination, and (V) parsimony. Factors I, III, and IV were strongly associated with OCD. Only Factor II was associated with OCPD. Factor IV was negatively associated with obsessive-compulsive personality traits. LOI factors are useful in discriminating between OCD and OCPD. Obsessional ruminations and compulsions, organizing activities, and contamination fears may indicate OCD, and ordering and arranging symptoms may indicate OCPD rather than OCD. Parsimony may indicate neither disorder, and contamination, the absence of OCPD traits compared with the other LOI factors. These findings may contribute to effective diagnosis and treatment by allowing the LOI to screen for OCD and OCPD in a population exhibiting obsessional symptoms and traits.

The neuropsychology of obsessive-compulsive personality disorder: a new analysis.

PubMed

Fineberg, Naomi A; Day, Grace A; de Koenigswarter, Nica; Reghunandanan, Samar; Kolli, Sangeetha; Jefferies-Sewell, Kiri; Hranov, Georgi; Laws, Keith R

2015-10-01

Obsessive compulsive personality disorder (OCPD) is characterized by perfectionism, need for control, and cognitive rigidity. Currently, little neuropsychological data exist on this condition, though emerging evidence does suggest that disorders marked by compulsivity, including obsessive-compulsive disorder (OCD), are associated with impairment in cognitive flexibility and executive planning on neurocognitive tasks. The current study investigated the neurocognitive profile in a nonclinical community-based sample of people fulfilling diagnostic criteria for OCPD in the absence of major psychiatric comorbidity. Twenty-one nonclinical subjects who fulfilled Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for OCPD were compared with 15 healthy controls on selected clinical and neurocognitive tasks. OCPD was measured using the Compulsive Personality Assessment Scale (CPAS). Participants completed tests from the Cambridge Automated Neuropsychological Test Battery including tests of set shifting (Intra-Extra Dimensional [IED] Set Shifting) executive planning (Stockings of Cambridge [SOC]), and decision making (Cambridge Gamble Task [CGT]). The OCPD group made significantly more IED-ED shift errors and total shift errors, and also showed longer mean initial thinking time on the SOC at moderate levels of difficulty. No differences emerged on the CGT. Nonclinical cases of OCPD showed significant cognitive inflexibility coupled with executive planning deficits, whereas decision-making remained intact. This profile of impairment overlaps with that of OCD and implies that common neuropsychological changes affect individuals with these disorders.

To What Extent do Clinical Practice Guidelines Respond to the Needs and Preferences of Patients Diagnosed with Obsessive-Compulsive Disorder?

PubMed

Villena-Jimena, Amelia; Gómez-Ocaña, Clara; Amor-Mercado, Gisela; Núñez-Vega, Amanda; Morales-Asencio, José Miguel; Hurtado, María Magdalena

The number of Clinical Practice Guidelines (CPG) to help in making clinical decisions is increasing. However, there is currently a lack of CPG for Obsessive-Compulsive Disorder that take into account the requirements and expectations of the patients. The aim of the present study was to determine whether recommendations of the NICE guideline, "Obsessive-compulsive disorder: core interventions in the treatment of obsessive-compulsive disorder and body dysmorphic disorder" agrees with the needs and preferences of patients diagnosed with OCD in the mental health service. Two focal groups were formed with a total of 12 participants. They were asked about the impact of the disorder in their lives, their experiences with the mental health services, their satisfaction with treatments, and about their psychological resources. Preferences and needs were compared with the recommendations of the guidelines, and to facilitate their analysis, they were classified into four topics: information, accessibility, treatments, and therapeutic relationship. The results showed a high agreement between recommendations and patients preferences, particularly as regards high-intensity psychological interventions. Some discrepancies included the lack of prior low-intensity psychological interventions in mental health service, and the difficulty of rapid access the professionals. There is significant concordance between recommendations and patients preferences and demands, which are only partially responded to by the health services. Copyright © 2017 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Predictive validity of neurotic disorders: a 50-year follow-up study.

PubMed

Jepsen, Peter Winning; Butler, Birgitte; Rasmussen, Stig; Juel, Knud; Bech, Per

2014-06-01

In 1965, Erling Jacobsen (1919-1988) defended his doctoral thesis on neurosis in which he tested the psychoanalytic theory of eridophobia as an internalising hostility factor with a specific causality for anxiety neurosis. He found no marked difference between anxiety neurosis and obsessive-compulsive neurosis, which, however, both differed from hysterical neurosis. The aim of this follow-up study was to evaluate to which extent anxiety neurosis and obsessive-compulsive neurosis when compared with hysterical neurosis co-existed with depression, both at the level of diagnostic behaviour, including committed suicide, and with regard to symptom profile. A total of 112 patients were followed on the Danish Central Psychiatric Research Register and the Danish Cause of Death Register with regard to their diagnostic behaviour. In a subset of the sample (n = 24), the patients were assessed using the Hopkins Symptom Checklist (SCL)-90. Both at the diagnostic level, including suicide rate, and at the level of symptom severity (SCL-90), anxiety neurosis and obsessive-compulsive neurosis were similar, in contrast to hysterical neurosis which had no more association with the other two categories of neurosis than would be expected by chance. Anxiety neurosis and obsessive-compulsive neurosis are more severe disorders than hysterical neurosis, both in terms of symptom profile and depression, including suicidal behaviour. The identified suicides were committed within the first two decades after discharge from the index hospitalisation. Poul M. Færgemann's Grant and the Neurosis Grant of 22 July 1959. not relevant.

Choreatic Side Effects of Deep Brain Stimulation of the Anteromedial Subthalamic Nucleus for Treatment-Resistant Obsessive-Compulsive disorder.

PubMed

Mulders, Anne E P; Leentjens, Albert F G; Schruers, Koen; Duits, Annelien; Ackermans, Linda; Temel, Yasin

2017-08-01

Patients with treatment-resistant obsessive-compulsive disorder (OCD) are potential candidates for deep brain stimulation (DBS). The anteromedial subthalamic nucleus (STN) is among the most commonly used targets for DBS in OCD. We present a patient with a 30-year history of treatment-resistant OCD who underwent anteromedial STN-DBS. Despite a clear mood-enhancing effect, stimulation caused motor side effects, including bilateral hyperkinesia, dyskinesias, and sudden large amplitude choreatic movements of arms and legs when stimulating at voltages greater than approximately 1.5 V. DBS at lower amplitudes and at other contact points failed to result in a significant reduction of obsessions and compulsions without inducing motor side effects. Because of this limitation in programming options, we decided to reoperate and target the ventral capsule/ventral striatum (VC/VS), which resulted in a substantial reduction in key obsessive and compulsive symptoms without serious side effects. Choreatic movements and hemiballismus have previously been linked to STN dysfunction and have been incidentally reported as side effects of DBS of the dorsolateral STN in Parkinson disease (PD). However, in PD, these side effects were usually transient, and they rarely interfered with DBS programming. In our patient, the motor side effects were persistent, and they made optimal DBS programming impossible. To our knowledge, such severe and persistent motor side effects have not been described previously for anteromedial STN-DBS. Copyright © 2017 Elsevier Inc. All rights reserved.

Toxoplasma-infected subjects report an Obsessive-Compulsive Disorder diagnosis more often and score higher in Obsessive-Compulsive Inventory.

PubMed

Flegr, J; Horáček, J

2017-02-01

Latent toxoplasmosis, the life-long presence of dormant stages of Toxoplasma in immunoprivileged organs and of anamnestic IgG antibodies in blood, affects about 30% of humans. Infected subjects have an increased incidence of various disorders, including schizophrenia. Several studies, as well as the character of toxoplasmosis-associated disturbance of neurotransmitters, suggest that toxoplasmosis could also play an etiological role in Obsessive-Compulsive Disorder (OCD). The aim of the present cross-sectional study performed on a population of 7471 volunteers was to confirm the association between toxoplasmosis and OCD, and toxoplasmosis and psychological symptoms of OCD estimated by the standard Obsessive-Compulsive Inventory-Revised (OCI-R). Incidence of OCD was 2.18% (n=39) in men and 2.28% (n=83) in women. Subjects with toxoplasmosis had about a 2.5 times higher odds of OCD and about a 2.7 times higher odds of learning disabilities. The incidence of 18 other neuropsychiatric disorders did not differ between Toxoplasma-infected and Toxoplasma-free subjects. The infected subjects, even the OCD-free subjects, scored higher on the OCI-R. Examined subjects provided the information about their toxoplasmosis and OCD statuses themselves, which could result in underrating the strength of observed associations. The results confirmed earlier reports of the association between toxoplasmosis and OCD. They also support recent claims that latent toxoplasmosis is in fact a serious disease with many impacts on quality of life of patients. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

The association of the metabolic profile in diabetes mellitus type 2 patients with obsessive-compulsive symptomatology and depressive symptomatology: new insights.

PubMed

Kontoangelos, Konstantinos; Raptis, Athanasios E; Papageorgiou, Charalabos C; Papadimitriou, George N; Rabavilas, Andreas D; Dimitriadis, George; Raptis, Sotirios A

2013-02-01

The aim of the present study was to explore the relationship between diabetes mellitus type 2, Obsessive- compulsive disorder (OCD) symptomatology and depressive symptomatology with the metabolic profile of diabetic patients. One hundred and thirty-one diabetic patients were randomly selected. In the first assessment all participants completed the Zung Self Rating Scale (ZUNG) and the Maudsley O-C Inventory Questionnaire (MOCI). After 1 year, diabetic patients that were initially uncontrolled (n = 31) (HbA1c > 7) were re-evaluated by the same psychometric tools. From those 31 patients, 10 had managed to control their metabolic profile. In the first evaluation MOCI and the sub-scale of slowness were statistically related with the diabetic profile (controlled, HbA1c ≤ 7; uncontrolled, HbA1c > 7), with uncontrolled patients scoring significantly higher on the overall MOCI score and the factor of slowness of MOCI scale (P = 0.028). The analysis revealed a positive association between depressive symptomatology (P = 0.004) and obsessive-compulsive disorder symptomatology (P < 0.001) and the metabolic profile of the patients. In the second evaluation the patients that managed to control their metabolic profile scored lower in both ZDRS and MOCI, although these differences in scores failed to reach significance levels were indicative of a tendency. The present results provide initial evidence that diabetes mellitus type 2 is associated with obsessive-compulsive disorder symptomatology and depressive symptomatology.

Evaluation of quality of life therapy for parents of children with obsessive-compulsive disorders in Iran.

PubMed

Abedi, Mohammad Reza; Vostanis, Panos

2010-07-01

Previous research has provided evidence on the effectiveness of CBT in the symptomatic improvement of children with obsessive-compulsive disorders. There is also increasing recognition of the importance of involving parents and families in treatment. The aim of this study was to evaluate the short-term effectiveness of such an intervention that promoted family strengths [(quality of life therapy (QoLT)] for mothers of children with obsessive-compulsive disorders (OCD). The sample consisted of 40 children with OCD and their mothers, who had been referred to clinics in Esfahan city in Iran. Mothers were randomly allocated to an experimental (QoLT) and waiting list control group. Mothers participated in eight QoLT group sessions over 4 weeks. QoLT incorporated CBT techniques in managing OCD symptoms. Measures were completed pre- and post-intervention by both groups. Children completed the Yale-Brown obsession compulsion scale for Children, the Revised children's manifest anxiety scale, and the brief multidimensional student's life satisfaction scale; mothers completed the quality of life inventory (QoLI). QoLT was associated with decrease in OCD and anxiety symptoms and increase in children's satisfaction in the global, family and environment domains, as well as with increased QoLI scores in their mothers. Parenting interventions like QoLT can complement individual modalities such as CBT in the presence of family-related difficulties. This can be particularly applicable in countries and settings with limited resources and high stigma of child mental health problems.

A meta-analysis of family accommodation and OCD symptom severity.

PubMed

Wu, Monica S; McGuire, Joseph F; Martino, Charitie; Phares, Vicky; Selles, Robert R; Storch, Eric A

2016-04-01

Family accommodation in obsessive-compulsive disorder (OCD) is characterized by myriad behaviors, such as modifying family routines, facilitating avoidance, and engaging in compulsions to reduce obsessional distress. It has been linked to various deleterious outcomes including increased functional impairment and poorer treatment response for OCD. Although extant literature suggests a linear relationship between family accommodation and OCD symptom severity, the magnitude and statistical significance of this association has been inconsistent across studies, indicating that moderators may be influencing this relationship. The present study examined this relationship using meta-analytic techniques, and investigated sample-dependent (age, gender, comorbid anxiety/mood disorders) and methodological (administration method and number of items used in family accommodation measure, informant type, sample size, publication year) moderators. Forty-one studies were included in the present meta-analysis, and the overall effect size (ES) for the correlation between family accommodation and OCD symptom severity was moderate (r=.42). Moderator analyses revealed that the number of items on the family accommodation scale moderated the ES. No other sample-dependent or methodological characteristics emerged as moderators. In addition to being the first systematic examination of family accommodation moderators, these results highlight the moderate relationship between family accommodation and OCD severity that is influenced by measurement scales. Findings may be used to guide clinical care and inform future investigations by providing a more nuanced understanding of family accommodation in OCD. Copyright © 2016 Elsevier Ltd. All rights reserved.

Validity and reliability of the Brazilian version of Yale-Brown obsessive compulsive scale-shopping version (YBOCS-SV).

PubMed

Leite, Priscilla Lourenço; Filomensky, Tatiana Zambrano; Black, Donald W; Silva, Adriana Cardoso

2014-08-01

The Yale-Brown Obsessive Compulsive Scale-Shopping Version (YBOCS-SV) is considered the gold standard in the assessment of shopping severity. It is designed to assess cognitions and behaviors relating to compulsive buying behavior. The present study aims to assess the validity of the Brazilian version of this scale. For the study, composed the sample 610 participants: 588 subjects of a general population and 22 compulsive buyers. Factorial analysis was performed to assess the relations and the correlation between the YBOCS-SV, the Compulsive Buying Scale (CBS), and Richmond Compulsive Buying Scale (RCBS), was assessed using Pearson coefficient, for study of convergent and divergent validity. Cronbach's alpha coefficients were used to assess internal consistency. The results show good to excellent psychometric parameters for the YBOCS-SV in its Brazilian version. With regard to correlations, the YBOCS-SV is inversely and proportionally correlated with CBS and the RCBS, indicating that the YBOCS-SV is an excellent instrument for screening compulsive buying. The YBOCS-SV presented high alpha coefficient of Cronbach's alpha (0.92), demonstrating good reliability. The Brazilian version of the YBOCS-SV is indicated to diagnose compulsive buying disorder, and likely use for the purposes intended in the Brazilian population. Copyright © 2014 Elsevier Inc. All rights reserved.

Personality Disorders in Hypochondriasis: Prevalence and comparison with two anxiety disorders

PubMed Central

Fallon, Brian A.; Harper, Katy M.; Landa, Alla; Pavlicova, Martina; Schneier, Franklin R.; Carson, Amanda; Harding, Kelli; Keegan, Kathryn; Schwartz, Theresa; Liebowitz, Michael R.

2012-01-01

Objective Symptoms of hypochondriasis are sometimes attributed to personality psychopathology by health care providers. The goals of this study were to assess the prevalence of personality disorder comorbidity (PD) in hypochondriasis (HYP) and to compare the PD comorbidity profile of patients with HYP to that found among patients with other disorders characterized by intrusive thoughts and fears. Methods SCID-I and SCID-II were administered to 179 individuals: 62 with HYP, 46 with Obsessive Compulsive Disorder (OCD), and 71 with Social Anxiety Disorder (SAD). For group contrasts, the samples were “purified” of the comparison comorbid disorders. General linear models were used to test the combined effect of group (HYP, OCD, SAD), age, and gender on the PD outcome variables. Results 59.7% of HYP subjects had no Axis II comorbidity. The most common PDs in HYP were paranoid (19.4%), avoidant (17.7%), and obsessive compulsive (14.5%). HYP significantly differed from SAD in the likelihood of a cluster C disorder, whereas no significant difference was noted for HYP vs OCD. The proportion of subjects having at least two PDs was not significantly different for HYP vs OCD or for HYP vs SAD. Conclusion Although 40% of patients with hypochondriasis have PD comorbidity as assessed by the SCID-II, the amount of PD comorbidity is not significantly different than found among individuals with two comparison anxiety disorders. Therefore, health providers should be aware that PD may complicate the clinical profile of HYP but they should avoid assuming that PD psychopathology is the primary source of hypochondriacal distress. PMID:22658329

Anorexia nervosa 6 years after onset: Part I. Personality disorders.

PubMed

Gillberg, I C; Råstam, M; Gillberg, C

1995-01-01

Fifty-one adolescent-onset anorexia nervosa (AN) cases recruited after community screening were compared with 51 age-, sex-, and school-matched cases with regard to personality disorders and autism-spectrum disorders (ASD)/empathy disorders at age 21 years. All 102 cases had originally been examined at a mean age of 16 years, slightly over a year after the reported onset of the eating disorder. Structured Clinical Interview for DSM-III-R (SCID) interviews were performed by a psychiatrist blind to the original eating disorder diagnosis. Most of the former AN cases were recovered with respect to weight, but the outcome in social areas was restricted. Personality disorders coded on axis II in the DSM-III-R and empathy disorders were much more common in the AN group than in the comparison (COMP) group. Obsessive-compulsive (OCD) and avoidant personality disorders were particularly common. Obsessive-compulsive behaviors showed a high degree of stability over time and were unrelated to weight problems. Together with empathy disorder, they tended to predict outcome better than the eating disorder as such. It is concluded that in some cases, AN may be seen to reflect but one axis I diagnosis occurring in the life of an individual with a chronic personality disorder.

Obsessive-compulsive disorder and trichotillomania: a phenomenological comparison

PubMed Central

Lochner, Christine; Seedat, Soraya; du Toit, Pieter L; Nel, Daniel G; Niehaus, Dana JH; Sandler, Robin; Stein, Dan J

2005-01-01

Background Similarities between obsessive-compulsive disorder (OCD) and trichotillomania (TTM) have been widely recognized. Nevertheless, there is evidence of important differences between these two disorders. Some authors have conceptualized the disorders as lying on an OCD spectrum of conditions. Methods Two hundred and seventy eight OCD patients (n = 278: 148 male; 130 female) and 54 TTM patients (n = 54; 5 male; 49 female) of all ages were interviewed. Female patients were compared on select demographic and clinical variables, including comorbid axis I and II disorders, and temperament/character profiles. Results OCD patients reported significantly more lifetime disability, but fewer TTM patients reported response to treatment. OCD patients reported higher comorbidity, more harm avoidance and less novelty seeking, more maladaptive beliefs, and more sexual abuse. OCD and TTM symptoms were equally likely to worsen during menstruation, but OCD onset or worsening was more likely associated with pregnancy/puerperium. Conclusions These findings support previous work demonstrating significant differences between OCD and TTM. The classification of TTM as an impulse control disorder is also problematic, and TTM may have more in common with conditions characterized by stereotypical self-injurious symptoms, such as skin-picking. Differences between OCD and TTM may reflect differences in underlying psychobiology, and may necessitate contrasting treatment approaches. PMID:15649315

Self-Regulation of Anterior Insula with Real-Time fMRI and Its Behavioral Effects in Obsessive-Compulsive Disorder: A Feasibility Study.

PubMed

Buyukturkoglu, Korhan; Roettgers, Hans; Sommer, Jens; Rana, Mohit; Dietzsch, Leonie; Arikan, Ezgi Belkis; Veit, Ralf; Malekshahi, Rahim; Kircher, Tilo; Birbaumer, Niels; Sitaram, Ranganatha; Ruiz, Sergio

2015-01-01

Obsessive-compulsive disorder (OCD) is a common and chronic condition that can have disabling effects throughout the patient's lifespan. Frequent symptoms among OCD patients include fear of contamination and washing compulsions. Several studies have shown a link between contamination fears, disgust over-reactivity, and insula activation in OCD. In concordance with the role of insula in disgust processing, new neural models based on neuroimaging studies suggest that abnormally high activations of insula could be implicated in OCD psychopathology, at least in the subgroup of patients with contamination fears and washing compulsions. In the current study, we used a Brain Computer Interface (BCI) based on real-time functional magnetic resonance imaging (rtfMRI) to aid OCD patients to achieve down-regulation of the Blood Oxygenation Level Dependent (BOLD) signal in anterior insula. Our first aim was to investigate whether patients with contamination obsessions and washing compulsions can learn to volitionally decrease (down-regulate) activity in the insula in the presence of disgust/anxiety provoking stimuli. Our second aim was to evaluate the effect of down-regulation on clinical, behavioural and physiological changes pertaining to OCD symptoms. Hence, several pre- and post-training measures were performed, i.e., confronting the patient with a disgust/anxiety inducing real-world object (Ecological Disgust Test), and subjective rating and physiological responses (heart rate, skin conductance level) of disgust towards provoking pictures. Results of this pilot study, performed in 3 patients (2 females), show that OCD patients can gain self-control of the BOLD activity of insula, albeit to different degrees. In two patients positive changes in behaviour in the EDT were observed following the rtfMRI trainings. Behavioural changes were also confirmed by reductions in the negative valence and in the subjective perception of disgust towards symptom provoking images. Although preliminary, results of this study confirmed that insula down-regulation is possible in patients suffering from OCD, and that volitional decreases of insula activation could be used for symptom alleviation in this disorder.

Influence of Culture in Obsessive-compulsive Disorder and Its Treatment

PubMed Central

Nicolini, Humberto; Salin-Pascual, Rafael; Cabrera, Brenda; Lanzagorta, Nuria

2017-01-01

Background: The aspects of cultural identity and its impact on obsessive-compulsive disorder (OCD) have been un-derstudied. There are different opinions, ranging from the idea that culture does not affect the symptoms of this condition to the idea that cultures with high religiosity may have more severity of OCD. Also, the concept of OCD has considerably var-ied across history and cultures, from being considered an issue related to lack of control of blasphemous ideas, and a part of anxious issues, to the description of complex neurobiological systems in its causation. Objective: The aim of this review was to address OCD as a well-characterized disorder with a proposed neurobiological ba-sis which may or may not have variations depending on cultural diversity. The question that was asked in this review is whether or not there are cultural differences in the manifestations of the OCD symptomatology and which factors of cultural diversity have a major influence on such manifestations along with the differences among some cultures regarding OCD is-sues, where the difference among countries has also been highlighted. Methods: A review of the literature was conducted that includes the following words: obsessive-compulsive disorder, cul-ture, cultural identity and religion in a period of 10 years. Conclusion: Cultural variations do not seem to differ from symptomatic clusters of OCD, which may be indicating that a se-ries of adaptive behaviors is evolutionarily evolving to be constantly altered, perhaps by well-determined pathophysiological mechanisms. Some aspects that have been related to some dimensions of OCD symptomatology are religion and religiosity, affecting the content of obsessions and the severity of manifestations. Properly evaluating the education background, access to health services, food, and the genetic structure of populations, using investigational instruments sensitive to these cultural elements, will increase our understanding of the importance of culture on OCD and its treatment. PMID:29657563

Influence of Culture in Obsessive-compulsive Disorder and Its Treatment.

PubMed

Nicolini, Humberto; Salin-Pascual, Rafael; Cabrera, Brenda; Lanzagorta, Nuria

2017-12-01

The aspects of cultural identity and its impact on obsessive-compulsive disorder (OCD) have been un-derstudied. There are different opinions, ranging from the idea that culture does not affect the symptoms of this condition to the idea that cultures with high religiosity may have more severity of OCD. Also, the concept of OCD has considerably var-ied across history and cultures, from being considered an issue related to lack of control of blasphemous ideas, and a part of anxious issues, to the description of complex neurobiological systems in its causation. The aim of this review was to address OCD as a well-characterized disorder with a proposed neurobiological ba-sis which may or may not have variations depending on cultural diversity. The question that was asked in this review is whether or not there are cultural differences in the manifestations of the OCD symptomatology and which factors of cultural diversity have a major influence on such manifestations along with the differences among some cultures regarding OCD is-sues, where the difference among countries has also been highlighted. A review of the literature was conducted that includes the following words: obsessive-compulsive disorder, cul-ture, cultural identity and religion in a period of 10 years. Cultural variations do not seem to differ from symptomatic clusters of OCD, which may be indicating that a se-ries of adaptive behaviors is evolutionarily evolving to be constantly altered, perhaps by well-determined pathophysiological mechanisms. Some aspects that have been related to some dimensions of OCD symptomatology are religion and religiosity, affecting the content of obsessions and the severity of manifestations. Properly evaluating the education background, access to health services, food, and the genetic structure of populations, using investigational instruments sensitive to these cultural elements, will increase our understanding of the importance of culture on OCD and its treatment.

Field Potential Oscillations in the Bed Nucleus of the Stria Terminalis Correlate with Compulsion in a Rat Model of Obsessive-Compulsive Disorder.

PubMed

Wu, Hemmings; Tambuyzer, Tim; Nica, Ioana; Deprez, Marjolijn; van Kuyck, Kris; Aerts, Jean-Marie; Van Huffel, Sabine; Nuttin, Bart

2016-09-28

The bed nucleus of the stria terminalis (BNST) is implicated in anxiety and reward processing, both of which are associated with obsessive-compulsive disorder (OCD). Specific neuronal groups in the BNST related to anxiety and reward have been identified, but quantitative data about the information carried by local field potential (LFP) signals in this area during obsession/compulsion are lacking. Here we investigate the BNST LFP in the schedule-induced polydipsia, an animal model of OCD. We implanted electrodes bilaterally in the BNST and random control brain regions in 32 male Wistar rats, and recorded corresponding LFP during compulsive and noncompulsive behavior. We first applied high-frequency (100 Hz) electrical stimulation through the implanted electrodes and analyzed its effects on compulsive behavior. We then performed time-frequency analysis of LFPs and statistically compared the normalized power of δ (1-4 Hz), θ (4-8 Hz), α (8-12 Hz), β (12-30 Hz), and lower γ (30-45 Hz) bands between different groups. Our data showed that the normalized δ, β, and γ powers in the right BNST were specifically correlated with compulsive behaviors. δ and γ oscillations increased and decreased during the initiation phase of compulsion, respectively, whereas β increased after compulsion stopped. Moreover, the effect of BNST electrical stimulation, in terms of suppression of compulsion, was significantly correlated with the percentage change of these bands during compulsion. Our research reveals potential biomarkers and underlying neurophysiological mechanisms of compulsion and warrants further assessment of the use of LFP for closed-loop neuromodulation in OCD. Although specific neuronal groups in the bed nucleus of the stria terminalis (BNST) related to anxiety and reward circuitries have been identified, psychopathological information carried by local field potentials in the BNST has not yet been described. We discovered that normalized powers of the right BNST δ, β, and γ oscillations were highly correlated with compulsion. Specifically, δ and γ oscillations increased and decreased during the initiation phase of compulsion, respectively, whereas β increased after compulsion stopped. Such correlations were not found in other parts of the brain during compulsion, or in the BNST during noncompulsive behavior. Current findings reveal real-time neurophysiological biomarkers of compulsion and warrant further assessment of the use of local field potentials for closed-loop neuromodulation for OCD. Copyright © 2016 the authors 0270-6474/16/3610051-10$15.00/0.

Long-term follow-up study of patients with refractory obsessive-compulsive disorder.

PubMed

Ross, Stephen; Fallon, Brian A; Petkova, Eva; Feinstein, Suzanne; Liebowitz, Michael R

2008-01-01

The authors prospectively followed patients with treatment-resistant obsessive-compulsive disorder (OCD). Between 1988 and 1995, 56 patients with a history of inadequate response to oral clomipramine received 14 infusions of intravenous clomipramine. The follow-up period ranged from 4 to 11 years after treatment. Of the 44 subjects interviewed at follow-up, 70.5% had current OCD and 29.5% had sub-threshold OCD. Almost half reported feeling much improved or very much improved compared to their state prior to treatment with intravenous clomipramine.

A 5-year course of predominantly obsessive vs. mixed subtypes of obsessive-compulsive disorder

PubMed Central

Math, S. B.; Thoduguli, Jaideep; Janardhan Reddy, Y. C.; Manoj, P. N.; Zutshi, A.; Rajkumar, R. P.; Adarsh, A. M.

2007-01-01

Background: Obsessive-compulsive disorder (OCD) is considered a heterogeneous disorder. One of the traditional approaches to subtype OCD is based on the predominance of obsessions, compulsions or both. Some studies suggest that the “predominantly obsessive” subtype of OCD may have poor outcome, whereas few other studies suggest that “mixed” OCD is associated with poor outcome. Therefore, it is not clear if the long-term course of “predominantly obsessive” subjects is different from those with “mixed” OCD. In the establishment of diagnostic validity of psychiatric conditions, differential course is an important validating factor. Aim: This study compares the 5-6 year course of the “predominantly obsessive” subtype with that of the “mixed” subtype of OCD with the objective of determining if the course of OCD differs according to subtypes and whether course could be a validating factor for subtyping OCD based on predominance of obsessions, compulsions or both. Setting and Design: Tertiary hospital, institutional setting. The study has a retrospective cohort design. Materials and Methods: Fifty-four subjects with “predominantly obsessions” and an equal number of the “mixed” subtype of OCD were recruited from the database of a specialty OCD clinic of a major psychiatric hospital. They were followed up after 5-6 years. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) checklist and severity rating scale was used for assessing OCD. The course of OCD was determined according to predefined criteria. Statistics: The Chi-square/Fisher's exact test and the independent samples “t” test were used to compare categorical and continuous variables, respectively. Correlations were tested using the Pearson's correlation analysis. Results: Thirty-eight “predominantly obsessive” (70%) and 39 “mixed” (72%) OCD subjects could be traced and evaluated. The course of illness was similar in the two subtypes. A majority of the sample (72%) did not have clinical OCD at follow-up. Conclusions: “Predominantly obsessive” subjects have a course similar to those with “mixed” OCD. Clinically, it is reassuring to know that obsessive subjects do not have an unfavorable course as was suggested by some previous studies. In this sample, course did not validate the subtyping method employed, but it would be premature to conclude that the subtyping method employed is incorrect based on the course alone. Prospective study of the course in larger samples and neurobiological and family-genetic data may help further validation. PMID:20680136

Clinical features and imaging findings in a case of Capgras syndrome.

PubMed

Luca, Maria; Bordone, Andrea; Luca, Antonina; Patti, Andrea; Sortino, Giuseppe; Calandra, Carmela

2013-01-01

Capgras syndrome consists of the delusional belief that a person or persons have been replaced by doubles or impostors. It can occur in the context of both psychiatric and organic illness, and seems to be related to lesions of the bifrontal and right limbic and temporal regions. Indeed, magnetic resonance imaging has revealed brain lesions in patients suffering from Capgras syndrome. This case study reports the findings of a thorough diagnostic evaluation in a woman suffering from Capgras syndrome and presenting with the following clinical peculiarities: obsessive modality of presentation of the delusional ideation, intrusiveness of such ideation (that even disturbed her sleep), as well as a sense of alienation and utter disgust towards the double. These characteristics bring to mind the typical aspects of obsessive-compulsive disorder. Neuroanatomic investigation, through magnetic resonance imaging, performed on this patient showed alteration of the bilateral semioval centers, which are brain regions associated with the emotion of disgust and often show alterations in subjects suffering from obsessive-compulsive disorder. Hence, neuroimaging allows researchers to put forward the hypothesis of a common neuroanatomic basis for Capgras syndrome and obsessive-compulsive disorder, at least for cases in which the delusional ideation is associated with deep feelings of disgust and presents with a certain pervasiveness.

Clinical features and imaging findings in a case of Capgras syndrome

PubMed Central

Luca, Maria; Bordone, Andrea; Luca, Antonina; Patti, Andrea; Sortino, Giuseppe; Calandra, Carmela

2013-01-01

Capgras syndrome consists of the delusional belief that a person or persons have been replaced by doubles or impostors. It can occur in the context of both psychiatric and organic illness, and seems to be related to lesions of the bifrontal and right limbic and temporal regions. Indeed, magnetic resonance imaging has revealed brain lesions in patients suffering from Capgras syndrome. This case study reports the findings of a thorough diagnostic evaluation in a woman suffering from Capgras syndrome and presenting with the following clinical peculiarities: obsessive modality of presentation of the delusional ideation, intrusiveness of such ideation (that even disturbed her sleep), as well as a sense of alienation and utter disgust towards the double. These characteristics bring to mind the typical aspects of obsessive-compulsive disorder. Neuroanatomic investigation, through magnetic resonance imaging, performed on this patient showed alteration of the bilateral semioval centers, which are brain regions associated with the emotion of disgust and often show alterations in subjects suffering from obsessive-compulsive disorder. Hence, neuroimaging allows researchers to put forward the hypothesis of a common neuroanatomic basis for Capgras syndrome and obsessive-compulsive disorder, at least for cases in which the delusional ideation is associated with deep feelings of disgust and presents with a certain pervasiveness. PMID:23950650

Cortical asymmetries in unaffected siblings of patients with obsessive-compulsive disorder.

PubMed

Peng, Ziwen; Li, Gang; Shi, Feng; Shi, Changzheng; Yang, Qiong; Chan, Raymond C K; Shen, Dinggang

2015-12-30

Obsessive-compulsive disorder (OCD) is considered to be associated with atypical brain asymmetry. However, no study has examined the asymmetry in OCD from the perspective of cortical morphometry. This study is aimed to describe the characteristics of cortical asymmetry in OCD patients, and to investigate whether these features exist in their unaffected siblings - a vital step in identifying putative endophenotypes for OCD. A total of 48 subjects (16 OCD patients, 16 unaffected siblings, and 16 matched controls) were recruited who had complete magnetic resonance imaging scans. Left-right hemispheric asymmetries of cortical thickness were measured using a surface-based threshold-free cluster enhancement method. OCD patients and siblings both showed leftward asymmetries of cortical thickness in the anterior cingulate cortex (ACC), which showed a significant positive correlation with compulsive subscale scores. In addition, siblings and healthy controls showed significantly decreased leftward asymmetries in the orbitofrontal cortex (OFC), and the decreased leftward bias in the OFC was accompanied by lower scales on the Yale-Brown Obsessive-Compulsive Scale. To sum up, leftward asymmetries of cortical thickness in the ACC may represent an endophenotype of increased hereditary risk for OCD, while decreased leftward asymmetries of cortical thickness in the OFC may represent a protective factor. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Trapped in a Daydream: Daily Elevations in Maladaptive Daydreaming Are Associated With Daily Psychopathological Symptoms.

PubMed

Soffer-Dudek, Nirit; Somer, Eli

2018-01-01

Background: Maladaptive Daydreaming (MD) characterizes individuals who engage in vivid, fanciful daydreaming for hours on end, neglecting real-life relationships and responsibilities, resulting in clinical distress and functional impairment. Sufferers have embraced the term MD in cyber-communities devoted to this problem because it seemed to uniquely fit their experience and since existing diagnostic labels and their therapies seemed inadequate. However, scientific research in the field has been scarce, relying on cross-sectional or case study designs. Existing knowledge on MD suggests the involvement of dissociative and obsessive-compulsive symptoms, as well as positive reinforcement comparable to processes in addiction disorders. The present study aimed to rigorously explore factors that accompany MD employing a longitudinal daily-diary design, hypothesizing that temporal increases in MD will associate concurrently with, and will temporally precede, other symptoms and emotional changes. In addition, we aimed to explore which symptoms may act as precursors to increases in MD, in order to identify possible mechanisms bringing about daydreaming in these individuals. Methods: In a sample of 77 self-diagnosed individuals with MD we assessed relevant daily symptoms for 14 days, including MD, depression, general anxiety, social anxiety, obsessive-compulsive symptoms, and dissociation, as well as positive and negative emotion. Results: Increases in MD were strongly related to concurrent increases in all other symptoms and negative emotion, and to decreased positive emotion. Obsessive-compulsive symptoms, dissociation, and negative emotion also temporally followed MD. Obsessive-compulsive symptoms were the only consistent temporal antecedent of MD. Conclusions: MD and obsessive-compulsive symptoms coincided in what seems to be a vicious cycle; understanding possible shared mechanisms between these symptoms may inform our understanding of the etiology of MD. For example, Serotonin levels may possibly be involved in the development or maintenance of this condition. The findings may also provide clues as to potentially beneficial interventions for treating MD. For example, perhaps utilizing response prevention techniques may be useful for curbing or intercepting unwanted daydreaming. Future studies on MD should address its compulsory nature.

A study of novel bilateral thermal capsulotomy with focused ultrasound for treatment-refractory obsessive-compulsive disorder: 2-year follow-up.

PubMed

Kim, Se Joo; Roh, Daeyoung; Jung, Hyun Ho; Chang, Won Seok; Kim, Chan-Hyung; Chang, Jin Woo

2018-05-02

Recently, a new thermal lesioning approach using magnetic-resonance-guided focused ultrasound (MRgFUS) was introduced for the treatment of neurologic disorders. However, only 2 studies have used this approach for treatment-refractory obsessive-compulsive disorder (OCD), and follow-up was short-term. We investigated the efficacy and safety of bilateral thermal lesioning of the anterior limb of the internal capsule using MRgFUS in patients with treatment-refractory OCD and followed them for 2 years. Eleven patients with treatment-refractory OCD were included in the study. Clinical outcomes were evaluated using the Yale-Brown Obsessive Compulsive Scale, the Clinical Global Impression scale (including improvement and severity), the Hamilton Rating Scale for Depression (HAM-D) and the Hamilton Rating Scale for Anxiety (HAM-A) at 1 week and 1, 3, 6, 12 and 24 months following MRgFUS. Neuropsychological functioning, Global Assessment of Functioning and adverse events were also assessed. After MRgFUS, Yale-Brown Obsessive Compulsive Scale scores decreased significantly across the 24-month follow-up period (mean ± standard deviation, 34.4 ± 2.3 at baseline v. 21.3 ± 6.2 at 24 months, p < 0.001). Scores on the Hamilton rating scales for depression and anxiety also significantly decreased from baseline to 24 months (HAM-D, 19.0 ± 5.3 v. 7.6 ± 5.3, p < 0.001; HAM-A, 22.4 ± 5.9 v. 7.9 ± 3.9, p < 0.001). Global Assessment of Functioning scores improved significantly (35.8 ± 4.9 at baseline v. 56.0 ± 10.3 at 24 months, p < 0.001) and Memory Quotient significantly improved, but other neuropsychological functions were unchanged. The side effects of MRgFUS included headache and vestibular symptoms, but these were mild and transient. The main limitations of this study were the small sample size and the open-label design. Bilateral thermal lesioning of the anterior limb of the internal capsule using MRgFUS may improve obsessive-compulsive, depressive and anxiety symptoms in patients with treatment-refractory OCD, without serious adverse effects.

Initial validation of a transdiagnostic compulsivity questionnaire: the Cambridge-Chicago Compulsivity Trait Scale.

PubMed

Chamberlain, Samuel R; Grant, Jon E

2018-05-07

Compulsivity refers to a tendency toward repetitive habitual behaviors. Multiple disorders have compulsive symptoms at their core, including substance use disorders, gambling disorder, and obsessive-compulsive disorder. The aim of this study was to validate a scale for the objective, transdiagnostic measurement of compulsivity. The 15-item Cambridge-Chicago Compulsivity Trait Scale (CHI-T) was developed for the rapid but comprehensive measurement of compulsivity. Adults aged 18-29y were recruited using media advertisements, and completed the CHI-T in addition to demographic, clinical, and cognitive assessment. The validity and psychometric properties of the scale were quantified. A total of 112 participants completed the study. The scale yielded a normal distribution with very few outliers. It had excellent psychometric properties, with high internal consistency (Cronbach's alpha=0.8), and excellent convergent validity against gold-standard assessments of compulsive symptoms (each p<0.001 for gambling disorder, obsessive-compulsive, and substance use disorder symptoms). Total scores on the scale correlated significantly with less risk-adjustment on the decision-making task (rigid response style), and divergent validity was confirmed against other cognitive domains (response inhibition and executive planning). The above significant findings withstood Bonferroni correction. Factor analysis suggested the existence of two latent factors: one related mainly to reward-seeking and the need for perfection, and the other relating to anxiolytic/soothing features of compulsivity. The CHI-T, a scale designed to measure transdiagnostic compulsivity, appears to show excellent psychometric properties in a normative population and merits further investigation in the context of clinical patient populations, including in treatment trials.

Examining the Psychometric Properties of the Family Accommodation Scale-Parent-Report (FAS-PR)

PubMed Central

Sapyta, Jeffrey; Garcia, Abbe; Freeman, Jennifer B.; Franklin, Martin E.; Foa, Edna; March, John

2011-01-01

Growing research has examined parental accommodation among the families of children with obsessive-compulsive disorder (OCD). However, these studies have utilized a parent-report (PR) version of a measure, the Family Accommodation Scale (FAS) that has never received proper psychometric validation. In turn, previously derived subscales have been developed via clinical rather than empirical evidence. This study aims to conduct a comprehensive psychometric analysis of the FAS-PR utilizing data collected from 96 youths with OCD. Exploratory factors analysis was conducted and revealed a 12-item scale yielding two separate, yet related subscales, Avoidance of Triggers (AT) and Involvement in Compulsions (IC). Subsequent analyses revealed good internal consistency and convergent and discriminant validity. These findings suggest that future research should seek to examine factors that may impact various facets to accommodation as well as the role these facets plays in predicting treatment outcome. Limitations are discussed. PMID:21743772

Cross-cutting issues and future directions for the OCD spectrum.

PubMed

Hollander, Eric; Kim, Suah; Braun, Ashley; Simeon, Daphne; Zohar, Joseph

2009-11-30

The research planning agenda for DSM-V examined possible similarities in phenomenology, comorbidity, familial and genetic features, brain circuitry, and treatment response between obsessive-compulsive disorder (OCD) and several related disorders that are characterized by repetitive thoughts or behaviors. Such data support a re-examination of the DSM-IV-TR classification of OCD and the anxiety disorders, with possible inclusion of a group of obsessive-compulsive spectrum disorders (OCSDs) in DSM-V. Various disorders were systematically examined for inclusion in such a grouping, and later a smaller number were determined to meet threshold criteria for inclusion in the OCSDs. The disorders that were originally examined included OCD, obsessive-compulsive personality disorder (OCPD), Tourette's syndrome (TS) and other tic disorders, Sydenham's chorea, Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS), trichotillomania (TTM), body dysmorphic disorder (BDD), autism, eating disorders, Huntington's and Parkinson's disease, impulse control disorders, as well as substance and behavioral addictions. Certain disorders such as BDD, OCPD, TS, and TTM share many commonalities with OCD in phenomenology, comorbidity, familial and genetic features, brain circuitry, and treatment response. Other disorders, such as the impulse control disorders (ICDs) share some common features with OCD, but also differ in many ways as well. The articles presented in this issue of Psychiatry Research are a result of this international collaboration, which examined diagnostic and classification issues of OCSDs for DSM-V in a conference titled "The Future of Psychiatric Diagnosis: Refining the Research Agenda: Obsessive-Compulsive Behavior Spectrum" held in June 2006 at the American Psychiatric Association's headquarters in Arlington, VA.

Alexithymia and perfectionism traits are associated with suicidal risk in patients with obsessive-compulsive disorder.

PubMed

Kim, Heeyeon; Seo, Jiwoo; Namkoong, Kee; Hwang, Eun Hee; Sohn, Sung Yun; Kim, Se Joo; Kang, Jee In

2016-03-01

There is limited evidence on suicidality and its associated factors in patients with obsessive-compulsive disorder (OCD). The present study investigated the potential contributing traits such as alexithymia and perfectionism and clinical risk factors including symptom dimensions associated with high suicidality in OCD patients. A total of 81 patients with OCD were included (mean age: 28.89 years, SD=7.95 years, 62% men). Suicidal risk was assessed using the Scale for Suicide Ideation and history taking. To assess alexithymia and perfectionism, the Toronto Alexithymia Scale-20 and the Measure of Constructs Underlying Perfectionism were applied. Clinical characteristics of OCD were assessed with the Yale-Brown Obsessive-Compulsive Scale, the Dimensional Obsessive-Compulsive Scale, and the Montgomery-Asberg Depression Rating Scale. Among OCD patients, 37% had a history of previous suicidal attempt, and 56.8% had current suicidal ideation. Those with lifetime suicide attempts scored significantly higher for alexithymia and ego-dystonic perfectionism than those without such history. In the binary logistic regression analysis, high score for alexithymia and the responsibility for harm, injury, or bad luck were significant determinants for lifetime suicide attempts. As for current suicide ideation, ego-dystonic perfectionism and the dimension of unacceptable thought were significant predictors of suicidal risk. The classification of suicidal risk and personality traits relied on self-report measures. The present findings indicate that personality traits such as alexithymia and perfectionism may contribute to high suicidality in patients with OCD, and patients suffering with unacceptable thoughts need to be assessed more carefully for warning signs of suicide. Copyright © 2015 Elsevier B.V. All rights reserved.

Hoarding in obsessive-compulsive disorder: clinical and genetic correlates.

PubMed

Lochner, Christine; Kinnear, Craig J; Hemmings, Sian M J; Seller, Cathlene; Niehaus, Dana J H; Knowles, James A; Daniels, Willie; Moolman-Smook, Johanna C; Seedat, Soraya; Stein, Dan J

2005-09-01

Hoarding may be an important symptom dimension in obsessive-compulsive disorder (OCD). Hoarding in OCD has been associated with poor insight, poorer response to selective serotonin reuptake inhibitors than other OCD symptom dimensions, and a distinctive psychobiological profile. The clinical and genetic correlates of hoarding in OCD therefore deserve additional investigation. Adult OCD patients (N = 315) underwent a comprehensive clinical assessment that included the Structured Clinical Interview for DSM-IV Axis I Disorders (Patient Edition) and for Diagnosis of Obsessive-Compulsive Spectrum Disorders. DNA extracted from venous blood (10-30 mL) in a Caucasian subset of the interviewed OCD patients (N = 204) and Caucasian controls (N = 169), including patients (N = 94) and controls (N = 138) of Afrikaner descent, was genotyped to investigate polymorphisms in genes involved in monoamine function and previously hypothesized to be relevant to OCD. Data were collected from 1998 through 2004. OCD patients with hoarding made up 18.1% of the total sample. Compared with nonhoarding OCD, OCD with hoarding was associated with a number of comorbid Axis I disorders, obsessive-compulsive personality disorder, significantly higher OCD severity scores, and more functional impairment. In subjects of Afrikaner descent, the L/L genotype of the COMT Val158Met polymorphism was significantly more common in the OCD hoarding group, with a preponderance of low activity alleles, compared with nonhoarding patients and controls. These data are consistent with the hypothesis that hoarding represents a unique symptom subtype in OCD with a distinctive clinical and psychobiological profile. Further work is needed to determine the psychobiological mechanisms responsible for hoarding and to replicate the genetic findings noted here.

Obsessive-compulsive disorder: a review of the diagnostic criteria and possible subtypes and dimensional specifiers for DSM-V.

PubMed

Leckman, James F; Denys, Damiaan; Simpson, H Blair; Mataix-Cols, David; Hollander, Eric; Saxena, Sanjaya; Miguel, Euripedes C; Rauch, Scott L; Goodman, Wayne K; Phillips, Katharine A; Stein, Dan J

2010-06-01

Since the publication of the DSM-IV in 1994, research on obsessive-compulsive disorder (OCD) has continued to expand. It is timely to reconsider the nosology of this disorder, assessing whether changes to diagnostic criteria as well as subtypes and specifiers may improve diagnostic validity and clinical utility. The existing criteria were evaluated. Key issues were identified. Electronic databases of PubMed, ScienceDirect, and PsycINFO were searched for relevant studies. This review presents a number of options and preliminary recommendations to be considered for DSM-V. These include: (1) clarifying and simplifying the definition of obsessions and compulsions (criterion A); (2) possibly deleting the requirement that people recognize that their obsessions or compulsions are excessive or unreasonable (criterion B); (3) rethinking the clinical significance criterion (criterion C) and, in the interim, possibly adjusting what is considered "time-consuming" for OCD; (4) listing additional disorders to help with the differential diagnosis (criterion D); (5) rethinking the medical exclusion criterion (criterion E) and clarifying what is meant by a "general medical condition"; (6) revising the specifiers (i.e., clarifying that OCD can involve a range of insight, in addition to "poor insight," and adding "tic-related OCD"); and (7) highlighting in the DSM-V text important clinical features of OCD that are not currently mentioned in the criteria (e.g., the major symptom dimensions). A number of changes to the existing diagnostic criteria for OCD are proposed. These proposed criteria may change as the DSM-V process progresses. (c) 2010 Wiley-Liss, Inc.

Memantine as an Adjuvant Treatment for Obsessive Compulsive Symptoms in Manic Phase of Bipolar Disorder: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

PubMed

Sahraian, Ali; Jahromi, Leila Razeghian; Ghanizadeh, Ahmad; Mowla, Arash

2017-04-01

The aim of this study is to examine the effects of memantine as an adjuvant treatment for obsessive compulsive (OC) symptoms in patients with bipolar disorder (BD) type I, manic phase. In this 16-week double-blind placebo-controlled randomized clinical trial, 58 patients in the manic phase of BD who had OC symptoms were randomly allocated to receive memantine or placebo plus their routine medications (lithium + olanzapine + clonazepam). The Yale Brown Obsessive Compulsive Behavior Scale was used to assess the outcomes. Adverse effects were also recorded. Thirty-eight patients (19 in the memantine group and 19 in the placebo group) completed the trial. Throughout the trial, the mean score decreased from 20.26 ± 5.91 to 9.73 ± 5.44 in the memantine group (P < 0.000) and from 22.89 ± 5.70 to 16.63 ± 4.00 in the placebo group (P < 0.000). At the end of the study, 15 (78.94%) patients in the memantine group and 7 (36.84%) patients in the placebo group demonstrated more than 34% decline in the Yale Brown Obsessive Compulsive Behavior Scale score (P < 0.01). No serious adverse effects were reported. Our double-blind controlled clinical trial showed that memantine is an effective adjuvant agent for reducing OC symptoms in patients with BD. However, it needs to be noted that our study is preliminary, and larger double-blind controlled studies are needed to confirm the results.

Body Dysmorphic Symptoms, Functional Impairment, and Depression: The Role of Appearance-Based Teasing.

PubMed

Weingarden, Hilary; Renshaw, Keith D

2016-01-01

Body dysmorphic disorder is associated with elevated social and occupational impairment and comorbid depression, but research on risk factors for body dysmorphic symptoms and associated outcomes is limited. Appearance-based teasing may be a potential risk factor. To examine the specificity of this factor, the authors assessed self-reported appearance-based teasing, body dysmorphic, and obsessive-compulsive symptom severity, functional impairment (i.e., social, occupational, family impairment), and depression in a nonclinical sample of undergraduates. As hypothesized, appearance-based teasing was positively correlated with body dysmorphic symptoms. The correlation between teasing and body dysmorphic symptoms was stronger than that between teasing and obsessive-compulsive symptom severity. Last, body dysmorphic symptom severity and appearance-based teasing interacted in predicting functional impairment and depression. Specifically, appearance-based teasing was positively associated with depression and functional impairment only in those with elevated body dysmorphic symptoms. When a similar moderation was tested with obsessive-compulsive, in place of body dysmorphic, symptom severity, the interaction was nonsignificant. Findings support theory that appearance-based teasing is a specific risk factor for body dysmorphic symptoms and associated functional impairment.