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  1. Obsessive-compulsive disorder

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/000929.htm Obsessive-compulsive disorder To use the sharing features on this page, please enable JavaScript. Obsessive-compulsive disorder (OCD) is a mental disorder in which people ...

  2. Obsessive-Compulsive Disorder

    MedlinePlus

    ... Loss Surgery? A Week of Healthy Breakfasts Shyness Obsessive-Compulsive Disorder KidsHealth > For Teens > Obsessive-Compulsive Disorder A A ... Diagnosing OCD Getting Therapy for OCD What Is Obsessive-Compulsive Disorder? Everyone feels anxiety, fear, uncertainty, or worry at ...

  3. [Obsessive-compulsive disorder].

    PubMed

    van Grootheest, D S; van den Heuvel, O A; Cath, D C; van Oppen, P; van Balkom, A J L M

    2008-10-25

    Obsessive-compulsive disorder is a complex psychiatric disorder characterised by obsessions and/or compulsions. Obsessive-compulsive disorder has a relatively high prevalence and is a highly disabling disease. The disorder is associated with shame, which causes long delays in accessing treatment. Obsessive-compulsive disorder is caused by a complex interplay between genetic and environmental factors. Effective treatments exist in the form of either pharmacotherapy--clomipramine or selective serotonin reuptake inhibitors--or cognitive behaviour therapy.

  4. Obsessive-Compulsive Disorder

    MedlinePlus

    ... What Is Obsessive-Compulsive Disorder? Everyone feels anxiety, fear, uncertainty, or worry at some time. These normal ... is a constant stream of uncertainty, doubt, or fear in the person's mind. OCD is a type ...

  5. Management of obsessive-compulsive disorder with fluvoxamine extended release

    PubMed Central

    Ordacgi, Lídia; Mendlowicz, Mauro V; Fontenelle, Leonardo F

    2009-01-01

    The pharmacodynamic properties of fluvoxamine maleate include the modulation of different populations of serotonergic, dopaminergic, and sigma receptors and/or transporters, a complex pattern of activity that may account for its efficacy in the treatment of obsessive-compulsive disorder (OCD). Nevertheless, its pharmacokinetic profile and its pattern of side effects may hinder a rapid dose escalation, a therapeutic strategy that might be utterly desirable in patients with OCD. In preclinical studies, the maximum plasma concentration and bioavailability of an extended-release (CR) formulation of fluvoxamine were, respectively, 38% and 16% lower than those of the standard (ie, non-CR) formulation. Recently, the US Food and Drug Administration approved the fluvoxamine CR formulation for the treatment of OCD in adults. This approval was based on the results of a double-blind, placebo-controlled study with 253 OCD patients in which fluvoxamine CR showed a consistently earlier onset of therapeutic effects than other selective serotonin reuptake inhibitors, as reported in previous studies. The use of the CR formulation of fluvoxamine allowed a particularly aggressive dosing strategy at the beginning of the titration phase, ie, treatment could be started with a single dose of fluvoxamine CR 100 mg at bedtime, while keeping the occurrence of side effects and the rate of compliance at levels comparable to those reported for the use of immediate-release fluvoxamine. PMID:19557140

  6. Obsessive compulsive disorder

    PubMed Central

    2012-01-01

    Introduction Obsessions or compulsions that cause personal distress or social dysfunction affect about 1% of adult men and 1.5% of adult women. About half of adults with obsessive compulsive disorder (OCD) have an episodic course, whereas the other half have continuous problems. Prevalence in children and adolescents is 2.7%. The disorder persists in about 40% of children and adolescents at mean follow-up of 5.7 years. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of initial treatments for obsessive compulsive disorder in adults? What are the effects of initial treatments for obsessive compulsive disorder in children and adolescents? What are the effects of maintenance treatment for obsessive compulsive disorder in adults? What are the effects of maintenance treatment for obsessive compulsive disorder in children and adolescents? What are the effects of treatments for obsessive compulsive disorder in adults who have not responded to initial treatment with serotonin reuptake inhibitors (SRIs)? We searched: Medline, Embase, The Cochrane Library, and other important databases up to April 2011 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 43 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: addition of antipsychotics to serotonin reuptake inhibitors, behavioural therapy alone or with serotonin reuptake inhibitors, cognitive therapy or cognitive behavioural therapy (CBT) (alone or

  7. Obsessive-compulsive disorder.

    PubMed

    Goodman, Wayne K; Grice, Dorothy E; Lapidus, Kyle A B; Coffey, Barbara J

    2014-09-01

    This article reviews the clinical features and neurochemical hypotheses of obsessive-compulsive disorder (OCD) with a focus on the serotonin system. In DSM-5, OCD was moved from the anxiety disorders to a new category of Obsessive-Compulsive and Related Disorders. OCD is a common, typically persistent disorder marked by intrusive and disturbing thoughts (obsessions) and repetitive behaviors (compulsions) that the person feels driven to perform. The preferential efficacy of serotonin reuptake inhibitors (SRIs) in OCD led to the so-called serotonin hypothesis. However, direct support for a role of serotonin in the pathophysiology (e.g., biomarkers in pharmacological challenge studies) of OCD remains elusive. A role of the glutamatergic system in OCD has been gaining traction based on imaging data, genomic studies and animal models of aberrant grooming behavior. These findings have spurred interest in testing the efficacy of medications that modulate glutamate function. A role of glutamate is compatible with circuit-based theories of OCD.

  8. Managing Obsessive Compulsive Disorder

    PubMed Central

    Weston, Christina G.

    2007-01-01

    Obsessive compulsive disorder (OCD) in children and adolescents is much the same as in adults with regard to symptoms and basic treatment modalities. There are some distinct considerations to note in the approach to treatment methods. Empirically supported treatments include both medications and cognitive behavioral therapy (CBT). It is important that psychotherapeutic treatment be tailored to the developmental level of the child. In this article, we will present, through case example, samples of varying the psychotherapeutic approach used for both child and adolescent cases of OCD. We will focus on exposure and response prevention techniques. PMID:20806030

  9. Obsessive-compulsive personality disorder

    MedlinePlus

    American Psychiatric Association. Obsessive-compulsive personality disorder. Diagnostic and Statistical Manual of Mental Disorders: DSM-5 . 5th ed. Arlington, VA: American Psychiatric Publishing. 2013;678-682. Blais MA, Smallwood ...

  10. Obsessive-compulsive disorder.

    PubMed

    Bokor, Gyula; Anderson, Peter D

    2014-04-01

    Obsessive-compulsive disorder (OCD) is a common heterogeneous psychiatric disorder manifesting with obsessions and compulsions. Obsessions are intrusive, recurrent, and persistent unwanted thoughts. Compulsions are repetitive behaviors or mental acts that an individual feels driven to perform in response to the obsessions. The heterogeneity of OCD includes themes of obsessions, types of rituals, presence or absence of tics, etiology, genetics, and response to pharmacotherapy. Complications of OCD include interpersonal difficulties, unemployment, substance abuse, criminal justice issues, and physical injuries. Areas of the brain involved in the pathophysiology include the orbitofrontal cortex, anterior cingulate gyrus, and basal ganglia. Overall, OCD may be due to a malfunction in the cortico-striato-thalamo-cortical circuit in the brain. Neurotransmitters implicated in OCD include serotonin, dopamine, and glutamate. Numerous drugs such as atypical antipsychotics and dopaminergic agents can cause or exacerbate OCD symptoms. The etiology includes genetics and neurological insults. Treatment of OCD includes psychotherapy, pharmacotherapy, electroconvulsive therapy, transcranial magnetic simulation, and in extreme cases surgery. Exposure and response prevention is the most effective form of psychotherapy. Selective serotonin reuptake inhibitors (SSRIs) are the preferred pharmacotherapy. Higher doses than listed in the package insert and a longer trial are often needed for SSRIs than compared to other psychiatric disorders. Alternatives to SSRIs include clomipramine and serotonin/norepinephrine reuptake inhibitors. Treatment of resistant cases includes augmentation with atypical antipsychotics, pindolol, buspirone, and glutamate-blocking agents.

  11. Obsessive-compulsive spectrum disorders

    PubMed Central

    Allen, Andrea; King, Audrey; Hollander, Eric

    2003-01-01

    The obsessive-compulsive spectrum is an important concept referring to a number of disorders drawn from several diagnostic categories that share core obsessive-compulsive features. These disorders can be grouped by the focus of their symptoms: bodily preoccupation, impulse control, or neurological disorders. Although the disorders are clearly distinct from one another, they have intriguing similarities in phenomenology, etiology, pathophysiology, patient characteristics, and treatment response. In combination with the knowledge gained through many years of research on obsessive-compulsive disorder (OCD), the concept of a spectrum has generated much fruitful research on the spectrum disorders. It has become apparent that these disorders can also be viewed as being on a continuum of compulsivity to impulsivity, characterized by harm avoidance at the compulsive end and risk seeking at the impulsive end. The compulsive and impulsive disorders differ in systematic ways that are just beginning to be understood. Here, we review these concepts and several representative obsessive-compulsive spectrum disorders including both compulsive and impulsive disorders, as well as the three different symptom clusters: OCD, body dysmorphic disorder, pathological gambling, sexual compulsivity, and autism spectrum disorders. PMID:22033547

  12. Seasonal obsessive-compulsive disorder

    PubMed Central

    Sinha, Prakriti; Bakhla, Ajay Kumar; Patnaik, Ashok Kumar; Chaudhury, Suprakash

    2014-01-01

    A case of obsessive-compulsive disorder (OCD) with seasonal variation in symptoms of 10-years duration is reported because of its rarity. The phenomenology of the observed disorder was obsessions related to dirt and contamination resulting in washing compulsions with onset in October and complete resolution in April-May every year. The patient responded to phototherapy along with exposure and response prevention therapy and pharmacotherapy. PMID:25788807

  13. Seasonal obsessive-compulsive disorder.

    PubMed

    Sinha, Prakriti; Bakhla, Ajay Kumar; Patnaik, Ashok Kumar; Chaudhury, Suprakash

    2014-01-01

    A case of obsessive-compulsive disorder (OCD) with seasonal variation in symptoms of 10-years duration is reported because of its rarity. The phenomenology of the observed disorder was obsessions related to dirt and contamination resulting in washing compulsions with onset in October and complete resolution in April-May every year. The patient responded to phototherapy along with exposure and response prevention therapy and pharmacotherapy.

  14. Psilocybin and Obsessive Compulsive Disorder.

    PubMed

    Wilcox, James Allen

    2014-01-01

    Obsessive Compulsive Disorder (OCD) is a psychiatric disorder with considerable morbidity and mortality. This condition disables many individuals and is often refractory to treatment. Research suggests that serotonin plays a role in OCD symptom reduction. We present a case of an individual who successfully used psilocybin, a serotonergic agent, to reduce the core symptoms of OCD for several years. Although not endorsing this form of treatment, we feel that the successful use of this agent highlights the role of serotonergic factors in OCD and the need for further, legitimate research into the value of psilocybin in the treatment of anxiety disorders.

  15. [Obsessive-compulsive disorder. A hidden disorder].

    PubMed

    Haraldsson, Magnús

    2015-02-01

    Obsessive-compulsive disorder is a common and often chronic psychiatric illness that significantly interferes with the patient´s functioning and quality of life. The disorder is characterized by excessive intrusive and inappropriate anxiety evoking thoughts as well as time consuming compulsions that cause significant impairment and distress. The symptoms are often accompanied by shame and guilt and the knowledge of the general public and professional community about the disorder is limited. Hence it is frequently misdiagnosed or diagnosed late. There are indications that the disorder is hereditary and that neurobiological processes are involved in its pathophysiology. Several psychological theories about the causes of obsessive-compulsive disorder are supported by empirical evidence. Evidence based treatment is either with serotoninergic medications or cognitive behavioral therapy, particularly a form of behavioral therapy called exposure response prevention. Better treatment options are needed because almost a third of people with obsessive-compulsive disorder respond inadequatly to treatment. In this review article two cases of obsessive-compulsive disorder are presented. The former case is a young man with typical symptoms that respond well to treatment and the latter is a middle aged lady with severe treatment resistant symptoms. She underwent stereotactic implantation of electrodes and received deep brain stimulation, which is an experimental treatment for severe obsessive-compulsive disorder that does not respond to any conventional treatment. Landspitali University Hospital, Division of Psychiatry. Faculty of Medicine, University of Iceland.

  16. Dysregulation in pediatric obsessive compulsive disorder.

    PubMed

    McGuire, Joseph F; Small, Brent J; Lewin, Adam B; Murphy, Tanya K; De Nadai, Alessandro S; Phares, Vicky; Geffken, Gary; Storch, Eric A

    2013-10-30

    Although obsessive compulsive disorder (OCD) and common co-occurring conditions share deficits in self-regulatory abilities, there has been minimal examination of impaired self-regulation (dysregulation) in youth with OCD. This study examined the association of dysregulation with symptom severity, impairment, and treatment outcome in pediatric OCD. Clinicians assessed obsessive-compulsive severity, family accommodation and global severity in 144 youth with OCD. Youth completed self-report severity ratings of anxiety and depressive symptoms. Parents completed the Child Behavior Checklist (CBCL), and both children and parents completed parallel ratings of obsessive-compulsive impairment. Ninety-seven youth received cognitive behavioral therapy (CBT) and were re-assessed after treatment. Dysregulation was assessed using the CBCL-Dysregulation Profile. Before treatment, dysregulated youth exhibited greater obsessive-compulsive symptom severity, depressive mood, family accommodation, and impairment than non-dysregulated youth. The magnitude of dysregulation directly predicted child-rated impairment, parent-rated impairment, and family accommodation, beyond obsessive-compulsive severity. The magnitude of pretreatment dysregulation predicted treatment discontinuation but not treatment response. Obsessive-compulsive symptom severity and dysregulation level significantly decreased after CBT. Dysregulated youth with OCD presented as more clinically severe than their non-dysregulated counterparts, and may require more individualized interventions to reduce dysregulated behavior to prevent CBT attrition. For treatment completers, CBT was associated with a decrease in dysregulation level. © 2013 Elsevier Ireland Ltd. All rights reserved.

  17. [Perinatal obsessive-compulsive disorder].

    PubMed

    Mavrogiorgou, P; Illes, F; Juckel, G

    2011-09-01

    A perinatal obsessive-compulsive disorder (OCD) is defined as an illness exhibiting first symptoms in the context of pregnancy and the postpartal period. There are no valid data up to date concerning the incidence of OCD, which might be of multifactorial origin, in this period in which females are highly vulnerable for psychiatric diseases. From a clinical point of view, obsessions and compulsions are mainly related to the well-being of the foetus or newborn baby. Differential diagnosis of perinatal OCD including pregnancy psychosis and post-partum depression is often difficult. Concerning treatment, non-pharmacological approaches should be preferred. Administration of SSRIs should be strongly restricted. However, there are no controlled therapy studies in patients with perinatal OCD. Furthermore, current knowledge about these patients is still limited. The aim of this review article is the presentation of phenomenology, pathogenesis, differential diagnosis and treatment of perinatal OCD. The mental situation of the female patients can be improved and stabilised if early diagnosis of a perinatal OCD leads to early initiation of an adequate therapy. This will then enable a good and stable mother-child relationship to develop.

  18. Trichotillomania and obsessive-compulsive disorder.

    PubMed

    Stein, D J; Simeon, D; Cohen, L J; Hollander, E

    1995-01-01

    Trichotillomania, a disorder characterized by repetitive hair pulling, has been only recently systemically investigated. Such research was encouraged by data that showed obsessive-compulsive disorder, which is also characterized by ritual behaviors, responds selectively to serotonin reuptake inhibitors. In this review, we consider similarities and contrasts in the diagnosis, demographics, phenomenology, neurochemistry, neuropsychiatry, and treatment of trichotillomania and obsessive-compulsive disorder. We argue that a view of trichotillomania as an obsessive-compulsive spectrum disorder that may involve disturbances in grooming behaviors comprises a useful clinical and research heuristic. Nevertheless, there may also be important differences between the two disorders; in particular, trichotillomania has a number of characteristics in common with impulsive disorders. Further empirical investigation is necessary to determine the nature of these complex disorders and their relationship to one another.

  19. Nicotine treatment of obsessive-compulsive disorder.

    PubMed

    Lundberg, Stefan; Carlsson, Arvid; Norfeldt, Per; Carlsson, Maria L

    2004-11-01

    Following initial observations of marked effects of nicotine self-medication in a patient with obsessive-compulsive disorder (OCD), another four OCD patients were treated with nicotine for eight weeks in an open label fashion. Patients fulfilling DSM-IV criteria for OCD and with initial Yale-Brown Obsessive-Compulsive Scale (YBOCS) score>15 were included in the study. The patients were scored with YBOCS, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), NIMH Global Obsessive-Compulsive Scale (NIMH) and Global Assessment of Functioning (GAF). Four of five patients receiving nicotine treatment displayed a favourable response with reductions in YBOCS scores. For these four patients, the nicotine chewing gum enabled a more adequate behaviour in stressful, OCD-eliciting, situations. We feel that these results are encouraging enough to warrant a larger, controlled study on nicotine treatment of OCD.

  20. Anxiety Sensitivity and Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Calamari, John E.; Rector, Neil A.; Woodard, John L.; Cohen, Robyn J.; Chik, Heather M.

    2008-01-01

    Anxiety sensitivity (AS), a cognitive risk factor for anxiety disorders, was evaluated in a homogeneous obsessive-compulsive disorder (OCD) sample. A total of 280 individuals with OCD completed measures. Evaluation of the Anxiety Sensitivity Index revealed a latent structure that was congruent with previous studies showing a single higher order…

  1. Anxiety Sensitivity and Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Calamari, John E.; Rector, Neil A.; Woodard, John L.; Cohen, Robyn J.; Chik, Heather M.

    2008-01-01

    Anxiety sensitivity (AS), a cognitive risk factor for anxiety disorders, was evaluated in a homogeneous obsessive-compulsive disorder (OCD) sample. A total of 280 individuals with OCD completed measures. Evaluation of the Anxiety Sensitivity Index revealed a latent structure that was congruent with previous studies showing a single higher order…

  2. Teaching Students with Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Leininger, Melissa; Dyches, Tina Taylor; Prater, Mary Anne; Heath, Melissa Allen

    2010-01-01

    Obsessive-compulsive disorder (OCD) is a neurobiological condition affecting 1 of every 200 school-age children. OCD greatly affects students' academic, behavioral, and social functioning, and it can lead to additional problem such as depression. To effectively collaborate with other individuals providing appropriate support to students with OCD,…

  3. Comparing Treatment Approaches for Obsessive Compulsive Disorder.

    ERIC Educational Resources Information Center

    Gariglietti, Kelli P.; Schemmel, Todd A.

    The current status of research literature relevant to obsessive compulsive disorder (OCD) is reviewed. Models proposing the etiology and maintenance of OCD, empirically established treatments for OCD, and research supporting cognitive approaches to treatment are also included in the review. Until recently, most of the controlled research…

  4. Obsessive Compulsive Disorder and the School Counselor

    ERIC Educational Resources Information Center

    Wertlieb, Ellen C.

    2008-01-01

    The current article is designed to provide school counselors an understanding of obsessive-compulsive disorder (OCD). The causes, characteristics, and treatment approaches are presented with examples focusing on school-related issues. The article concludes with a discussion about the role that the school counselor can take in helping the child…

  5. 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…

  6. A Case of Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Twohig, Michael P.; Whittal, Maureen L.

    2009-01-01

    This article presents the case of a 51-year old woman with obsessive-compulsive disorder. "Caroline" reported obsessions of harming people secondary to spreading her "bad energy," which is experienced as dust on her hands and in her mouth. To prevent harm coming to others she mentally "vacuums" the dust, creates…

  7. A Case of Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Twohig, Michael P.; Whittal, Maureen L.

    2009-01-01

    This article presents the case of a 51-year old woman with obsessive-compulsive disorder. "Caroline" reported obsessions of harming people secondary to spreading her "bad energy," which is experienced as dust on her hands and in her mouth. To prevent harm coming to others she mentally "vacuums" the dust, creates…

  8. Teaching Students with Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Leininger, Melissa; Dyches, Tina Taylor; Prater, Mary Anne; Heath, Melissa Allen

    2010-01-01

    Obsessive-compulsive disorder (OCD) is a neurobiological condition affecting 1 of every 200 school-age children. OCD greatly affects students' academic, behavioral, and social functioning, and it can lead to additional problem such as depression. To effectively collaborate with other individuals providing appropriate support to students with OCD,…

  9. 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…

  10. Obsessive Compulsive Disorder Presenting for Redundant Clothing

    PubMed Central

    Uvais, N. A.; Sreeraj, V. S.

    2016-01-01

    This is a case report of a 15-year-old girl who presented with redundant clothing. On evaluation, it was found that she had obsessive compulsive disorder (OCD), and redundant clothing was a symptom of OCD, which has hitherto not been reported. PMID:27011408

  11. Trajectory in obsessive-compulsive disorder comorbidities.

    PubMed

    de Mathis, Maria Alice; Diniz, Juliana B; Hounie, Ana G; Shavitt, Roseli G; Fossaluza, Victor; Ferrão, Ygor; Leckman, James F; de Bragança Pereira, Carlos; do Rosario, Maria Conceição; Miguel, Eurípedes C

    2013-07-01

    The main goal of this study is to contribute to the understanding of the trajectory of comorbid disorders associated with obsessive-compulsive disorder (OCD) according to the first manifested psychiatric disorder and its impact in the clinical course of OCD and subsequent psychiatric comorbidities. One thousand and one OCD patients were evaluated at a single time point. Standardized instruments were used to determine the current and lifetime psychiatric diagnoses (Structured Clinical Interview for DSM-IV Axis I and for impulse-control disorders) as well as to establish current obsessive-compulsive, depressive and anxiety symptom severity (Yale-Brown Obsessive-Compulsive Scale; Dimensional Yale-Brown Obsessive-Compulsive Scale, Beck Depression and Anxiety Inventories and the OCD Natural History Questionnaire). To analyze the distribution of comorbidities according to age at onset Bayesian approach was used. Five hundred eight patients had the first OC symptom onset till the age of 10 years old. The first comorbidity to appear in the majority of the sample was separation anxiety disorder (17.5%, n=175), followed by ADHD (5.0%, n=50) and tic disorders (4.4%, n=44). OCD patients that presented with separation anxiety disorder as first diagnosis had higher lifetime frequency of post-traumatic stress disorder (p=0.003), higher scores in the Sexual/Religious dimension (p=0.04), Beck Anxiety (p<0.001) and Depression (p=0.005) Inventories. OCD patients that initially presented with ADHD had higher lifetime frequencies of substance abuse and dependence (p<0.001) and worsening OCD course (p=0.03). OCD patients that presented with tic disorders as first diagnosis had higher lifetime frequencies of OC spectrum disorders (p=0.03). OCD is a heterogeneous disorder and that the presence of specific comorbid diagnoses that predate the onset of OCD may influence its clinical presentation and course over the lifetime.

  12. Aripiprazole Improved Obsessive Compulsive Symptoms in Asperger's Disorder

    PubMed Central

    Tahiroglu, Aysegul Yolga; Firat, Sunay; Avci, Ayşe

    2011-01-01

    There are many comorbid disorders associated with autism spectrum disorders in child and adolescent population. Although obsessive compulsive disorder and autism spectrum disorders (ASD) comorbidity has common in clinical practice, there are few reports about psychopharmacological treatment for obsessive compulsive symptoms in children with ASD in the literacy. We report a successful treatment case with aripiprazole in Asperger's Disorder with obsessive compulsive symptoms. The Yale Brown Obsessive Compulsive Scale was performed to assess symptom variety. This case report supports the effectiveness of aripiprazole in treatment of obsessive compulsive symptoms in Asperger's Disorder or ASDs. Aripiprazole may be beneficial to obsessive compulsive disorder comorbid autism spectrum disorders in child and adolescent age group. PMID:23429759

  13. 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.

  14. [Irrational anxiety: obsessive-compulsive disorder].

    PubMed

    Vera, Luis

    2010-06-20

    Obsessive-compulsive disorder is an exemplar of an anxiety disorder where irrational thoughts and compulsive behaviors succeed each other in a mental system where every negative outcome can occur. Affects like doubt and guilt reinforce the need to prevent catastrophic consequences from occurring. Magical thinking replaces logical thoughts. The risk of suicide becomes high when compulsive acts cannot control anxiety. Behavior and cognitive therapy is the most frequent type of psychological help: the principal target is the change of emotional reactions.

  15. 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.

  16. 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

  17. Comorbid bipolar disorder and obsessive-compulsive disorder

    PubMed Central

    PENG, Daihui; JIANG, Kaida

    2015-01-01

    Summary Obsessive-compulsive symptoms are common in patients with bipolar disorders. This comorbid condition complicates the clinical treatment of the two disorders, so identifying these individuals is important. We discuss the comorbid occurrence of obsessive-compulsive disorder and bipolar disorder, introduce possible etiological mechanisms that could result in this common comorbid condition, discuss recent research advances in the area, and propose some clinical principles for managing such patients. PMID:26549961

  18. Pharmacological treatment of obsessive-compulsive disorder.

    PubMed

    Pittenger, Christopher; Bloch, Michael H

    2014-09-01

    Obsessive-compulsive disorder (OCD) affects up to 2.5% of the population of the course of a lifetime and produces substantial morbidity. Approximately 70% of patients can experience significant symptomatic relief with appropriate pharmacotherapy. Selective serotonin reuptake inhibitors are the mainstay of pharmacological treatment. These drugs are typically used at higher doses and for longer periods than in depression. Proven second-line treatments include the tricyclic clomipramine and the addition of low-dose neuroleptic medications. OCD refractory to available treatments remains a profound clinical challenge.

  19. Obsessive compulsive disorder: report of six cases.

    PubMed

    Ovuga, E

    2001-05-01

    Obsessive-compulsive disorder (OCD) refers to interloping and interative thoughts, ideas, images, fantasies, impulses and actions accompanied by feelings of distress and declarations of resistance. It is assumed that OCD is rare among black Africans. This paper reports six cases from Uganda. The report indicates that OCD exists among black Africans and that those affected experience considerable amounts of emotional, social and occupational distress. It is suggested that OCD should be taught adequately to medical students to enable future general-duty medical officers to recognise and manage it appropriately. The names that appear in the text are pseudonyms.

  20. Superstitiousness in obsessive-compulsive disorder.

    PubMed

    Brugger, Peter; Viaud-Delmon, Isabelle

    2010-01-01

    It has been speculated that superstitiousness and obsessive-compulsive disorder (OCD) exist along a continuum. The distinction between superstitious behavior and superstitious belief, however, is crucial for any theoretical account of claimed associations between superstitiousness and OCD. By demonstrating that there is a dichotomy between behavior and belief, which is experimentally testable, we can differentiate superstitious behavior from superstitious belief, or magical ideation. Different brain circuits are responsible for these two forms of superstitiousness; thus, determining which type of superstition is prominent in the symptomatology of an individual patient may inform us about the primarily affected neurocognitive systems.

  1. Understudied Clinical Dimensions in Pediatric Obsessive Compulsive Disorder

    ERIC Educational Resources Information Center

    Lewin, Adam B.; Caporino, Nicole; Murphy, Tanya K.; Geffken, Gary R.; Storch, Eric A.

    2010-01-01

    The present study aimed to assess the phenomenology and treatment sensitivity of insight, avoidance, indecisiveness, overvalued responsibility, pervasive slowness, and pathological doubting among youth with Obsessive-compulsive disorder (OCD) using the ancillary items on the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS). These factors…

  2. Understudied Clinical Dimensions in Pediatric Obsessive Compulsive Disorder

    ERIC Educational Resources Information Center

    Lewin, Adam B.; Caporino, Nicole; Murphy, Tanya K.; Geffken, Gary R.; Storch, Eric A.

    2010-01-01

    The present study aimed to assess the phenomenology and treatment sensitivity of insight, avoidance, indecisiveness, overvalued responsibility, pervasive slowness, and pathological doubting among youth with Obsessive-compulsive disorder (OCD) using the ancillary items on the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS). These factors…

  3. 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

  4. 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.

  5. Obsessive Compulsive Disorder among Adults

    MedlinePlus

    ... EE. Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication ( ... Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication ( ...

  6. Childhood obsessive-compulsive disorder.

    PubMed

    King, N J; Tonge, B J

    1991-06-01

    Childhood OCD is a distressing and debilitating condition. Childhood OCD is not a simple exaggeration of the rituals and superstitions that occur over the course of normal development. More males than females are diagnosed as having OCD. Not unexpectedly, anxiety and affective disorders are often associated with childhood OCD. Compulsive personality disorder is also an associated feature for a proportion of children with OCD. Treatment usually involves individual psychotherapy and family counselling, although behavioural treatment and medication (clomipramine) have also been used by clinicians.

  7. Cognitive Dysfunction in Obsessive-Compulsive Disorder.

    PubMed

    Benzina, Nabil; Mallet, Luc; Burguière, Eric; N'Diaye, Karim; Pelissolo, Antoine

    2016-09-01

    Obsessive-compulsive disorder (OCD) is a mental disorder featuring obsessions (intrusive thoughts) and compulsions (repetitive behaviors performed in the context of rigid rituals). There is strong evidence for a neurobiological basis of this disorder, involving limbic cortical regions and related basal ganglion areas. However, more research is needed to lift the veil on the precise nature of that involvement and the way it drives the clinical expression of OCD. Altered cognitive functions may underlie the symptoms and thus draw a link between the clinical expression of the disorder and its neurobiological etiology. Our extensive review demonstrates that OCD patients do present a broad range of neuropsychological dysfunctions across all cognitive domains (memory, attention, flexibility, inhibition, verbal fluency, planning, decision-making), but some methodological issues temper this observation. Thus, future research should have a more integrative approach to cognitive functioning, gathering contributions of both experimental psychology and more fundamental neurosciences.

  8. Obsessive Compulsive and Tic Related Disorders

    PubMed Central

    Franklin, Martin E.; Harrison, Julie; Benavides, Kristin

    2012-01-01

    Synopsis Youth affected by obsessive compulsive disorder (OCD) and by chronic tic disorders (CTDs) often experience significant distress, functional impairment, and psychiatric comorbidity which collectively compromise quality of life and achievement of developmental milestones. We review the extant literature on the phenomenology and treatment of these conditions in youth, and summarize the state of the treatment literature, focusing particularly on the application of psychosocial interventions that have yielded substantial symptom improvements. Comorbidity of OCD and CTDs is common, and we provide clinical recommendations for managing patients when both disorders are present. We conclude with a brief discussion of clinical controversies, particularly the central role ascribed to habituation as the mechanism by which these treatments' effects are realized. PMID:22800994

  9. [Neuropsychological aspects of obsessive compulsive disorder].

    PubMed

    Andrés-Perpiñá, S; Lázaro-García, L; Canalda-Salhi, G; Boget-Llucià, T

    Neuropsychological performance in obsessive compulsive disorder (OCD) and its association with disfunctions in neuroanatomic structures and clinical symptoms of disorder has been reviewed. OCD symptoms and different aspects between children and adult psychopatology are presented. Briefly neurobiologic studies related with the etiology and patophisiology of OCD has been revised. This article summarizes some last studies about OCD cognitive functioning and its impairment. The more impaired cognitive functions in OCD are executive functions and visual abilities, specially non verbal memory. In addition, other studies have identified verbal memory deficits. These deficits are consistent with neurodevelopmental models, which hypothesizes that abnormalities of ventral prefrontal striatal and thalamic circuits may be involved in the etiology and patophisiology of OCD. The cognitive deficits could be functioning as a intermediate variable between neurobiological abnormalities and OCD symptoms. More studies are needed to analize the OCD cognitive impairment.

  10. Obsessive-compulsive disorder in dermatology.

    PubMed

    Kestenbaum, Thelda

    2013-06-01

    Obsessive-compulsive disorder (OCD) is a very common disorder affecting 2% to 3% of the general population. Up to 25% of patients presenting to physicians with skin disease suffer from OCD. Only 20% of all patients with OCD are receiving treatment. Unfortunately, those few receiving treatment remained undiagnosed for many years. Standard treatment includes behavioral therapy and psychotropic drugs (ie, selective serotonin re-uptake inhibitors and clomipramine). The highest dosages of these medications must be used for at least 3 months to see proper effectiveness and maintained for lengthy periods of time. Not only are there abnormalities in the serotonin pathway of patients with OCD but also the glutamate pathway is abnormal, leading to possible new treatment strategies.

  11. Pure Obsessive Compulsive Disorder in Three Generations

    PubMed Central

    Rahimi, Alireza; Haghighi, Mohammad; Shamsaei, Farshid

    2015-01-01

    Introduction: Obsessive-compulsive disorder (OCD) is a psychiatric disorder, which has been shown to affect 2 - 3.5% of people, during their lifetimes. Identification of familial more homogenous characteristics of OCD may help to define relevant subtypes and increase the power of genetic and neurobiological studies of OCD. Case Presentation; This case report describes an adult woman suffering from symptoms of energy loss, insomnia, lack of appetite, and depressed mood. The patient history was positive for counting coercion. The patient’s genogram revealed counting coercion in three generations of her family. Conclusions: This case highlights the issue whether counting can be a distinctive feature among inflicted and not inflicted individuals, such as hoarding. Also, it is still unclear what is it really transferred; the vulnerability to disease, which is transferred among three generations, or the symptoms of counting itself, by genes. Further studies are required to answer the debates on this issue. PMID:26288641

  12. Psychometric Properties of the Obsessive Compulsive Inventory: Child Version in Children and Adolescents with Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Jones, Anna M.; De Nadai, Alessandro S.; Arnold, Elysse B.; McGuire, Joseph F.; Lewin, Adam B.; Murphy, Tanya K.; Storch, Eric A.

    2013-01-01

    The psychometric properties of the Obsessive Compulsive Inventory-Child Version (OCI-CV) were examined in ninety-six youth with a primary/co-primary diagnosis of obsessive-compulsive disorder (OCD). A confirmatory factor analysis revealed an acceptable model of fit with factors consisting of doubting/checking, obsessing, hoarding, washing,…

  13. Psychometric Properties of the Obsessive Compulsive Inventory: Child Version in Children and Adolescents with Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Jones, Anna M.; De Nadai, Alessandro S.; Arnold, Elysse B.; McGuire, Joseph F.; Lewin, Adam B.; Murphy, Tanya K.; Storch, Eric A.

    2013-01-01

    The psychometric properties of the Obsessive Compulsive Inventory-Child Version (OCI-CV) were examined in ninety-six youth with a primary/co-primary diagnosis of obsessive-compulsive disorder (OCD). A confirmatory factor analysis revealed an acceptable model of fit with factors consisting of doubting/checking, obsessing, hoarding, washing,…

  14. 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…

  15. Obsessive-compulsive disorder in Tourette's syndrome.

    PubMed

    Como, Peter G; LaMarsh, Jennifer; O'Brien, Katherine A

    2005-01-01

    A substantial body of scientific evidence suggests that obsessive-compulsive behavior occurs in a large percentage of patients with TS. Reliable estimates suggest that nearly 50% of patients with TS have some degree of obsessive-compulsive features. Most patients with TS have only mild OCB and thus would not meet the DSM-IV diagnostic criteria for OCD. Therefore, OCB is perhaps a more appropriate characterization of this behavioral phenomenon that occurs in TS. OCB in TS appears similar to the spectrum of the tic disorder in terms of its onset, severity, and course. As with tics, OCB is typically mild and not always substantially disabling. Although clinical features between TS + OCB and primary OCD overlap considerably, patients with TS + OCB appear to experience different types of obsessive thoughts and compulsive rituals. Compelling genetic evidence suggests that OCB may be an alternative expression of the TS phenotype, which may selectively affect female gene carriers. Identifying the TS gene in the future will substantially broaden our knowledge of this intriguing neurobehavioral disorder. Finally, neurobiologic evidence points to similar anatomic and chemical substrates in the pathogenesis of TS and OCD, suggesting that these two disorders share a common pathophysiology. The clinical evaluation of patients with TS and their families should always include an assessment for OCB. Self-rated inventories of OCD such as the LOI, LOI-CV, and MOCI are useful screening scales. A more structured interview using the Y-BOCS (CY-BOCS) is useful for determining the degree and severity of OCB in TS as well as the response to therapy. Clinicians should keep in mind that OCB may be the most disabling feature of TS and may require treatment. Pharmacologic agents, such as SSRIs, and traditional behavioral therapy are proven effective treatments for OCB, which can substantially reduce the full effect of TS on patients and their families.

  16. Organicity in obsessive-compulsive disorder.

    PubMed

    Yaryura-Tobias, J A; Anderson, M C; Neziroglu, F A

    2000-09-01

    Though pharmacological and/or behavioral interventions have proven highly effective, 20 to 30% of the obsessive-compulsive disorder (OCD) population is treatment refractory. This study describes the OCD clinical profile that is correlated to organicity. Two groups of OCD patients were presented: an organic group and a control nonorganic group. The 9 organic patients exhibit an indifference to their illness, a lack of motivation, are nonanxious even during exposure exercises, are nondepressed, have rigid and concrete thinking, are treatment refractory, and have some type of organic impairment. The 10 nonorganic patients are also treatment refractory but do not exhibit the clinical profile correlated to the organic OCD patients. Furthermore, MRI results indicate that no organic impairment exists in this control group. All of these patients were tried on medication and behavior therapy to no avail. Reasons for lack of response in organic OCD patients, based on cerebral anatomical changes, are discussed.

  17. Pharmacological treatment of obsessive-compulsive disorder

    PubMed Central

    Bloch, Michael H.

    2014-01-01

    Synopsis Obsessive-compulsive disorder (OCD) affects up to 2.5% of the population of the course of a lifetime and produces substantial morbidity. Approximately 70% of patients can experience significant symptomatic relief with appropriate pharmacotherapy. The selective serotonin reuptake inhibitors (SSRIs) are the main stay of pharmacological treatment. These are typically used at higher doses and for longer periods than in depression. Remission is, unfortunately, uncommon. Proven second-line treatments include the tricyclic clomipramine and the addition of low-dose neuroleptic medications. Other augmentation strategies have been explored for patients refractory to proven interventions, but they are not as of yet robustly supported by controlled studies. The combination of medication with psychotherapy is often used, though careful studies have not documented synergistic benefit in adult patients. OCD refractory to available treatments remains a profound clinical challenge. PMID:25150568

  18. Standards of care for obsessive-compulsive disorder centres.

    PubMed

    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

    2016-09-01

    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.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. Obsessive-Compulsive Symptoms in Schizophrenia and in Obsessive-Compulsive Disorder: Differences and Similarities.

    PubMed

    Tonna, Matteo; Ottoni, Rebecca; Paglia, Francesca; Monici, Alberto; Ossola, Paolo; DE Panfilis, Chiara; Marchesi, Carlo

    2016-03-01

    A growing literature suggests that obsessive-compulsive (OC) phenomena represent a distinct dimension in schizophrenia, independent of nuclear psychotic symptoms. Nevertheless, the OC psychopathologic profile in schizophrenia, compared with "pure" obsessive-compulsive disorder (OCD), has not yet been investigated extensively. This study investigated the clinical features of the OC dimension in patients with schizophrenia compared with patients with pure OCD. The main psychopathologic features of obsessions and compulsions were rated in 35 patients with schizophrenia and 31 patients with OCD, using the Structured Clinical Interview for DSM-IV Axis I Disorders, the Positive and Negative Syndrome Scale, the Yale-Brown Obsessive-Compulsive Scale, and the Leyton Obsessional Inventory. OC phenomena were indistinguishable in terms of their severity, resistance, interference, and control in both groups. However, patients with OCD showed higher rates of aggressive, contamination-related, sexual, and somatic themes; moreover, in the group with schizophrenia, a positive relationship was found between washing compulsions and delusions and between hoarding obsessions and delusions. These results indicate that patients with schizophrenia exhibit a narrower range of obsessive content compared with patients with OCD; in addition, OC and delusional themes tend to be related in schizophrenia as a unique symptomatic phenomenon.

  5. Conscientiousness and obsessive-compulsive personality disorder.

    PubMed

    Samuel, Douglas B; Widiger, Thomas A

    2011-07-01

    A dimensional perspective on personality disorder hypothesizes that the current diagnostic categories represent maladaptive variants of general personality traits. However, a fundamental foundation of this viewpoint is that dimensional models can adequately account for the pathology currently described by these categories. While most of the personality disorders have well established links to dimensional models that buttress this hypothesis, obsessive-compulsive personality disorder (OCPD) has obtained only inconsistent support. The current study administered multiple measures of 1) conscientiousness-related personality traits, 2) DSM-IV OCPD, and 3) specific components of OCPD (e.g., compulsivity and perfectionism) to a sample of 536 undergraduates who were oversampled for elevated OCPD scores. Six existing measures of conscientiousness-related personality traits converged strongly with each other supporting their assessment of a common trait. These measures of conscientiousness correlated highly with scales assessing specific components of OCPD, but obtained variable relationships with measures of DSM-IV OCPD. More specifically, there were differences within the conscientiousness instruments such that those designed to assess general personality functioning had small to medium relationships with OCPD, but those assessing more maladaptive variants obtained large effect sizes. These findings support the view that OCPD does represent a maladaptive variant of normal-range conscientiousness.

  6. 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.

  7. Sleep and obsessive-compulsive disorder (OCD).

    PubMed

    Paterson, Jessica L; Reynolds, Amy C; Ferguson, Sally A; Dawson, Drew

    2013-12-01

    Obsessive-compulsive disorder (OCD) is a chronic mental illness that can have a debilitating effect on daily functioning. A body of research reveals altered sleep behaviour in OCD sufferers; however, findings are inconsistent and there is no consensus on the nature of this relationship. Understanding sleep disturbance in OCD is of critical importance given the known negative consequences of disturbed sleep for mood and emotional wellbeing. A systematic literature search was conducted of five databases for studies assessing sleep in adults diagnosed with OCD. Fourteen studies met inclusion criteria and qualitative data analysis methods were used to identify common themes. There was some evidence of reduced total sleep time and sleep efficiency in OCD patients. Many of the sleep disturbances noted were characteristic of depression. However, some OCD sufferers displayed delayed sleep onset and offset and an increased prevalence of delayed sleep phase disorder (DSPD). Severe OCD symptoms were consistently associated with greater sleep disturbance. While the sleep of OCD patients has not been a major focus to date, the existing literature suggests that addressing sleep disturbance in OCD patients may ensure a holistic approach to treatment, enhance treatment efficacy, mitigate relapse and protect against the onset of co-morbid psychiatric illnesses.

  8. 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

  9. Family accommodation in obsessive-compulsive disorder.

    PubMed

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

    2012-02-01

    Family accommodation refers to ways in which family members take part in the performance of rituals, avoidance of anxiety-provoking situations or modification of daily routines to assist a relative with obsessive-compulsive disorder (OCD). Our goal is to review the available data on the role of family accommodation in both children and adults with OCD. A search of available peer-reviewed English language papers was conducted through PubMed and PsycINFO cross-referencing the keyword OCD with accommodation, family relations and parents. The resulting 641 papers were individually evaluated for relevance to the scope of the review. It was found that accommodation is common in OCD and is strongly and consistently correlated with OCD symptom severity. Family accommodation also appears to be increased when the proband has cleaning contamination symptoms and increased internalizing or externalizing problems. Family accommodation is associated with increased parental OCD and anxiety symptoms. Levels of accommodation are associated with treatment outcomes for both behavioral and pharmacological treatment. Significant improvement of OCD symptoms with treatment is associated with reductions in family accommodation. Family accommodation represents important clinical data that is worth measuring, monitoring and tracking in clinical care. Therapies targeting family accommodation may be successful in improving treatment outcomes in OCD.

  10. Pathophysiology of refractory obsessive-compulsive disorder

    PubMed Central

    Liu, Qingxiao; Tan, Bo; Zhou, Jing; Zheng, Zhong; Li, Ling; Yang, Yanchun

    2017-01-01

    Abstract Based on both functional and structural studies of excessive activity, fronto-striatal-thalamic-cortical and cortico-striatal circuits have been hypothesized to underlie the pathophysiology of obsessive-compulsive disorder (OCD). However, the neurobiological underpinnings of OCD refractory to medication and therapy remain controversial. This study aimed to evaluate neuroanatomical abnormalities of the whole brain and to evaluate visual processing in patients with refractory OCD. This study was comprised of 2 experiments. The neuroanatomical abnormalities of the whole brain were evaluated using a visual search in combination with overactive performance monitoring (Experiment I), and visual processing was evaluated using event-related potentials recorded from subjects during performance of a visual search task. We also examined the amplitudes and latency of the error-related negativity (ERN) using a modified flanker task (Experiment II). Standard low-resolution electromagnetic tomography analysis was applied to determine the special areas. Patients with refractory OCD had a significantly greater number of saccades and prolonged latencies relative to the healthy controls. Scalp map topography confirmed that visual cognitive and executive dysfunction was localized to the fusiform gyrus. Furthermore, we found that during a modified flanker task, ERNs had a greater amplitude and a prolonged latency relative to those of the healthy controls. Further data analysis suggested that cognitive dysfunction and compulsive behavior in OCD patients were linked to abnormalities within the dorsolateral prefrontal cortex (DLPFC). We identified abnormal activities within the fusiform gyrus and DLPFC that likely play important roles in the pathophysiology of OCD. PMID:28072701

  11. Defining Clinical Severity in Adults with Obsessive-Compulsive Disorder

    PubMed Central

    Storch, Eric A.; De Nadai, Alessandro S.; do Rosário, Maria Conceição; Shavitt, Roseli G.; Torres, Albina R.; Ferrão, Ygor A.; Miguel, Euripedes C.; Lewin, Adam B.; Fontenelle, Leonardo F.

    2015-01-01

    Objective The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) is the most commonly used instrument to assess the clinical severity of obsessive-compulsive symptoms. Treatment determinations are often based on Y-BOCS score thresholds. However, these benchmarks are not empirically based, which may result in non-evidence based treatment decisions. Accordingly, the present study sought to derive empirically-based benchmarks for defining obsessive-compulsive symptom severity. Method Nine hundred and fifty-four adult patients with obsessive-compulsive disorder (OCD), recruited through the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders, were evaluated by experienced clinicians using a structured clinical interview, the Y-BOCS, and the Clinical Global Impressions–Severity scale (CGI-Severity). Results Similar to results in treatment-seeking children with OCD, our findings demonstrated convergence between the Y-BOCS and global OCD severity assessed by the CGI-Severity (Nagelkerke R2=.48). Y-BOCS scores of 0–13 corresponded with ‘mild symptoms’ (CGI-Severity = 0–2), 14–25 with ‘moderate symptoms’ (CGI-Severity = 3), 26–34 with ‘moderate-severe symptoms’ (CGI-Severity = 4) and 35–40 with ‘severe symptoms’ (CGI-Severity = 5–6). Neither age nor ethnicity was associated with Y-BOCS scores, but females demonstrated more severe obsessive-compulsive symptoms than males (d=.34). Time spent on obsessions/compulsions, interference, distress, resistance, and control were significantly related to global OCD severity although the symptom resistance item pairing demonstrated a less robust relationship relative to other components of the Y-BOCS. Conclusions These data provide empirically-based benchmarks on the Y-BOCS for defining the clinical severity of treatment seeking adults with OCD, which can be used for normative comparisons in the clinic and for future research. PMID:26555489

  12. Defining clinical severity in adults with obsessive-compulsive disorder.

    PubMed

    Storch, Eric A; De Nadai, Alessandro S; Conceição do Rosário, Maria; Shavitt, Roseli G; Torres, Albina R; Ferrão, Ygor A; Miguel, Euripedes C; Lewin, Adam B; Fontenelle, Leonardo F

    2015-11-01

    The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) is the most commonly used instrument to assess the clinical severity of obsessive-compulsive symptoms. Treatment determinations are often based on Y-BOCS score thresholds. However, these benchmarks are not empirically based, which may result in non-evidence based treatment decisions. Accordingly, the present study sought to derive empirically-based benchmarks for defining obsessive-compulsive symptom severity. Nine hundred fifty-four adult patients with obsessive-compulsive disorder (OCD), recruited through the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders, were evaluated by experienced clinicians using a structured clinical interview, the Y-BOCS, and the Clinical Global Impressions-Severity scale (CGI-Severity). Similar to results in treatment-seeking children with OCD, our findings demonstrated convergence between the Y-BOCS and global OCD severity assessed by the CGI-Severity (Nagelkerke R(2)=.48). Y-BOCS scores of 0-13 corresponded with 'mild symptoms' (CGI-Severity=0-2), 14-25 with 'moderate symptoms' (CGI-Severity=3), 26-34 with 'moderate-severe symptoms' (CGI-Severity=4) and 35-40 with 'severe symptoms' (CGI-Severity=5-6). Neither age nor ethnicity was associated with Y-BOCS scores, but females demonstrated more severe obsessive-compulsive symptoms than males (d=.34). Time spent on obsessions/compulsions, interference, distress, resistance, and control were significantly related to global OCD severity although the symptom resistance item pairing demonstrated a less robust relationship relative to other components of the Y-BOCS. These data provide empirically-based benchmarks on the Y-BOCS for defining the clinical severity of treatment seeking adults with OCD, which can be used for normative comparisons in the clinic and for future research. Copyright © 2015 Elsevier Inc. All rights reserved.

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

    PubMed Central

    2011-01-01

    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.] PMID:21284843

  14. 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.

  15. 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

  16. An overview of Indian research in obsessive compulsive disorder

    PubMed Central

    Reddy, Y. C. Janardhan; Rao, Naren P.; Khanna, Sumant

    2010-01-01

    Obsessive-compulsive disorder (OCD) was considered a relatively rare disorder until about two decades ago. Since then, considerable advance has been made in understanding the various aspects of OCD that include epidemiology, clinical features, comorbidity, biology and treatment. In the last one decade, there has also been interest in a group of related disorders called obsessive-compulsive spectrum disorders. There is substantial research from India on various aspects of OCD, particularly from the National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore. We attempt to review all the relevant Indian data on OCD. PMID:21836679

  17. Cognitive inflexibility in Obsessive-Compulsive Disorder.

    PubMed

    Gruner, Patricia; Pittenger, Christopher

    2017-03-14

    Obsessive-Compulsive Disorder (OCD) is characterized by maladaptive patterns of repetitive, inflexible cognition and behavior that suggest a lack of cognitive flexibility. Consistent with this clinical observation, many neurocognitive studies suggest behavioral and neurobiological abnormalities in cognitive flexibility in individuals with OCD. Meta-analytic reviews support a pattern of cognitive inflexibility, with effect sizes generally in the medium range. Heterogeneity in assessments and the way underlying constructs have been operationalized point to the need for better standardization across studies, as well as more refined overarching models of cognitive flexibility and executive function (EF). Neuropsychological assessments of cognitive flexibility include measures of attentional set shifting, reversal and alternation, cued task-switching paradigms, cognitive control measures such as the Trail-Making and Stroop tasks, and several measures of motor inhibition. Differences in the cognitive constructs and neural substrates associated with these measures suggest that performance within these different domains should be examined separately. Additional factors, such as the number of consistent trials prior to a shift and whether a shift is explicitly signaled or must be inferred from a change in reward contingencies, may influence performance, and thus mask or accentuate deficits. Several studies have described abnormalities in neural activation in the absence of differences in behavioral performance, suggesting that our behavioral probes may not be adequately sensitive, but also offering important insights into potential compensatory processes. The fact that deficits of moderate effect size are seen across a broad range of classic neuropsychological tests in OCD presents a conceptual challenge, as clinical symptomatology suggests greater specificity. Traditional cognitive probes may not be sufficient to delineate specific domains of deficit in this and other

  18. The extended fronto-striatal model of obsessive compulsive disorder: convergence from event-related potentials, neuropsychology and neuroimaging

    PubMed Central

    Melloni, Margherita; Urbistondo, Claudia; Sedeño, Lucas; Gelormini, Carlos; Kichic, Rafael; Ibanez, Agustin

    2012-01-01

    In this work, we explored convergent evidence supporting the fronto-striatal model of obsessive-compulsive disorder (FSMOCD) and the contribution of event-related potential (ERP) studies to this model. First, we considered minor modifications to the FSMOCD model based on neuroimaging and neuropsychological data. We noted the brain areas most affected in this disorder -anterior cingulate cortex (ACC), basal ganglia (BG), and orbito-frontal cortex (OFC) and their related cognitive functions, such as monitoring and inhibition. Then, we assessed the ERPs that are directly related to the FSMOCD, including the error-related negativity (ERN), N200, and P600. Several OCD studies present enhanced ERN and N2 responses during conflict tasks as well as an enhanced P600 during working memory (WM) tasks. Evidence from ERP studies (especially regarding ERN and N200 amplitude enhancement), neuroimaging and neuropsychological findings suggests abnormal activity in the OFC, ACC, and BG in OCD patients. Moreover, additional findings from these analyses suggest dorsolateral prefrontal and parietal cortex involvement, which might be related to executive function (EF) deficits. Thus, these convergent results suggest the existence of a self-monitoring imbalance involving inhibitory deficits and executive dysfunctions. OCD patients present an impaired ability to monitor, control, and inhibit intrusive thoughts, urges, feelings, and behaviors. In the current model, this imbalance is triggered by an excitatory role of the BG (associated with cognitive or motor actions without volitional control) and inhibitory activity of the OFC as well as excessive monitoring of the ACC to block excitatory impulses. This imbalance would interact with the reduced activation of the parietal-DLPC network, leading to executive dysfunction. ERP research may provide further insight regarding the temporal dynamics of action monitoring and executive functioning in OCD. PMID:23015786

  19. Perfectionism in depression, obsessive-compulsive disorder and eating disorders.

    PubMed

    Sassaroli, Sandra; Lauro, Leonor J Romero; Ruggiero, Giovanni Maria; Mauri, Massimo C; Vinai, Piergiuseppe; Frost, Randy

    2008-06-01

    High levels of perfectionism have been observed in major depression, anxiety disorders and eating disorders. Though few studies have compared levels of perfectionism across these disorders, there is reason to believe that different dimensions of perfectionism may be involved in eating disorders than in depression or anxiety [Bardone-Cone, A. M. et al. (2007). Perfectionism and eating disorders: Current status and future directions. Clinical Psychology Review, 27, 84-405]. The present study compared patients with major depression, obsessive-compulsive disorder, and eating disorders on dimensions of perfectionism. Concern over Mistakes was elevated in each of the patient groups while Pure Personal Standards was only elevated in the eating disorder sample. Doubts about Actions was elevated in both patients with obsessive-compulsive disorder and eating disorders, but not in depressed patients. Analyses of covariance indicated that Concern over Mistakes accounted for most of the variance in the relationship of perfectionism to these forms of psychopathology.

  20. 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.

  1. 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.

  2. Neuropsychological Assessment in Obsessive-Compulsive Disorder

    PubMed Central

    Kohli, Adarsh; Rana, Devender Kumar; Gupta, Nitin; Kulhara, Parmanand

    2015-01-01

    Background: Neuropsychological deficits in obsessive-compulsive disorder (OCD) have been encouraged by brain imaging studies suggesting a putative fron to- striatial biological basis of the condition. Studies of neuropsychological functions in OCD have documented deficits in several cognitive domains, particularly with regard to visuospatial abilities, executive functioning, motor speed and memory. The Aim of the present study was to assess neuropsychological profile of patients with OCD. Objectives of the study were to assess and compare the neuropsychological profile of patients with OCD and matched healthy controls. Materials and Methods: Twenty clinically stable outpatients with ICD-10 diagnosis of OCD and equal number of normal controls matched for age, education, gender and handedness were studied using a battery of neuropsychological tests. The tests consisted of verbal and performance tests of intelligence, memory, perceptual motor functions, set test and Wisconsin Card Sorting Test (WCST). Results: On perceptual-motor functions, verbal fluency, executive functions (WCST), intelligence and memory patients with OCD did not show impairments comparable to healthy controls. An attempt to correlate the test findings with the duration of illness, stability of illness and the average drug dose was made and it was found that there was no correlation between the two. Conclusion: The present study does not provide evidence for a localized neuropsychological/cognitive impairment in OCD in cases that are stable for at least three months. Absence of impairments in perceptual-motor functions, verbal fluency, executive functions (WCST), intelligence, and memory does not agree with the results of other studies using these tests. PMID:25969608

  3. Interpersonal ambivalence in obsessive-compulsive disorder.

    PubMed

    Moritz, Steffen; Niemeyer, Helen; Hottenrott, Birgit; Schilling, Lisa; Spitzer, Carsten

    2013-10-01

    The social attitudes and interpersonal relationships of patients with obsessive-compulsive disorder (OCD) are subject to a longstanding controversy. Whereas cognitive-behavioural researchers emphasize exaggerated pro-social attitudes in OCD like inflated responsibility and worry for other people (especially significant others), dynamic theories traditionally focus on anti-social attitudes such as latent aggression and hostility. In two recent studies, we gathered support not only for a co-existence of these seemingly opposing attitudes in OCD, but also for a functional connection: inflated responsibility in part appears to serve as a coping strategy (or “defense”) against negative interpersonal feelings. In the present study, we tested a shortened version of the Responsibility and Interpersonal Behaviours and Attitudes Questionnaire (RIBAQ-R). The scale was administered to 34 participants with OCD and 34 healthy controls. The questionnaire concurrently measures pro-social and anti-social interpersonal attitudes across three subscales. In line with our prior studies, patients displayed higher scores on both exaggerated pro-social attitudes (e.g. “I suffer from a strict conscience concerning my relatives”) as well as latent aggression (e.g. “Sometimes I would like to harm strangers on the street“) and suspiciousness/distrust (e.g. “I cannot even trust my own family”). A total of 59% of the patients but only 12% of the healthy controls showed marked interpersonal ambivalence (defined as scores higher than one standard deviation from the mean of the nonclinical controls on both the prosocial and at least one of the two anti-social subscales). The study asserts high interpersonal ambivalence in OCD. Further research is required to pinpoint both the dynamic and causal links between opposing interpersonal styles. Normalization and social competence training may prove beneficial to resolve the apparent problems of patients with OCD regarding anger

  4. 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.

  5. Manifestation of Incompleteness in Obsessive-Compulsive Disorder (OCD) as Reduced Functionality and Extended Activity beyond Task Completion

    PubMed Central

    Zor, Rama; Szechtman, Henry; Hermesh, Haggai; Fineberg, Naomi A.; Eilam, David

    2011-01-01

    Background This study focused on hypotheses regarding the source of incompleteness in obsessive-compulsive disorder (OCD). For this, we had to document the behavioral manifestation of incompleteness in compulsive rituals, predicting that an exaggerated focus on acts that are appropriate for the task will support the hypothesis on heightened responsibility/perfectionism. In contrast, activity past the expected terminal act for the motor task would support the “stop signal deficiency” hypothesis. Methodology and Principal Findings We employed video-telemetry to analyze 39 motor OCD rituals and compared each with a similar task performed by a non-OCD individual, in order to objectively and explicitly determine the functional end of the activity. We found that 75% of OCD rituals comprised a “tail,” which is a section that follows the functional end of the task that the patients ascribed to their activity. The other 25% tailless rituals comprised a relatively high number and higher rate of repetition of non-functional acts. Thus, in rituals with tail, incompleteness was manifested by the mere presence of the tail whereas in tailless rituals, incompleteness was manifested by the reduced functionality of the task due to an inflated execution and repetition of non-functional acts. Conclusions The prevalence of activity after the functional end (“tail”) and the elevated non-functionality in OCD motor rituals support the “lack of stop signal” theories as the underlying mechanism in OCD. Furthermore, the presence and content of the tail might have a therapeutic potential in cognitive-behavior therapy. PMID:21966460

  6. 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…

  7. WILSON'S DISEASE PRESENTING WITH OBSESSIVE-COMPULSIVE DISORDER

    PubMed Central

    Duggal, Harpreet S.; Nizamie, Haque S.

    2000-01-01

    Wilson's disease, a disorder of copper metabolism, is known to be associated with psychiatric symptoms. Psychiatrists see about 20% of these cases before they are labeled as Wilson's disease. Reports of these patients treated mistakenly as primary psychiatric illnesses exist in literature. This report thus emphasizes a thorough underpinning in this disease on the part of psychiatrists in order to arrive at the correct diagnosis at first contact. Besides this, the emergence of obsessive-compulsive symptoms in a case of Wilson's disease is described, which is a rare association. Finally, the authors discuss the role of basal ganglia in obsessive-compulsive disorder. PMID:21407963

  8. 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.

  9. Obsessive-Compulsive Disorder in School-Age Children

    ERIC Educational Resources Information Center

    Helbing, Mary-Lee C.; Ficca, Michelle

    2009-01-01

    Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by disturbing thoughts, impulses, or images (obsessions); repetitive or ritualistic behaviors (compulsions); or the presence of both. Although some may believe this disorder is isolated to the adult population, it affects anywhere from 1% to 4% of children in the United…

  10. Obsessive-Compulsive Disorder in School-Age Children

    ERIC Educational Resources Information Center

    Helbing, Mary-Lee C.; Ficca, Michelle

    2009-01-01

    Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by disturbing thoughts, impulses, or images (obsessions); repetitive or ritualistic behaviors (compulsions); or the presence of both. Although some may believe this disorder is isolated to the adult population, it affects anywhere from 1% to 4% of children in the United…

  11. Parent-Child Agreement in the Assessment of Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Canavera, Kristin E.; Wilkins, Kendall C.; Pincus, Donna B.; Ehrenreich-May, Jill T.

    2009-01-01

    The purpose of the current study was to extend research regarding parent-child agreement in the assessment of anxiety disorders to include youth with obsessive-compulsive disorder (OCD). Ninety-three children and adolescents with OCD (50 female, 43 male), ages 6 to 17 years, and their parents were administered the Anxiety Disorders Interview…

  12. Parent-Child Agreement in the Assessment of Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Canavera, Kristin E.; Wilkins, Kendall C.; Pincus, Donna B.; Ehrenreich-May, Jill T.

    2009-01-01

    The purpose of the current study was to extend research regarding parent-child agreement in the assessment of anxiety disorders to include youth with obsessive-compulsive disorder (OCD). Ninety-three children and adolescents with OCD (50 female, 43 male), ages 6 to 17 years, and their parents were administered the Anxiety Disorders Interview…

  13. Situation awareness in obsessive-compulsive disorder.

    PubMed

    Tumkaya, Selim; Karadag, Filiz; Mueller, Shane T; Ugurlu, Tugce T; Oguzhanoglu, Nalan K; Ozdel, Osman; Atesci, Figen C; Bayraktutan, Mustafa

    2013-10-30

    Past studies have suggested that OCD patients suffer memory impairment on tasks using complex stimuli that require memory for combined elements to be maintained, but not for more simplistic memory tests. We tested this with 42 OCD patients and 42 healthy controls performed a computerized situation awareness task. In addition, participants completed the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and Maudsley Obsessive-Compulsive Inventory (MOCI). The OCD patients had poorer accuracy in integration/comprehension and perception levels than controls. There were significant correlations between situational awareness scores (i.e., visuo-spatial monitoring and processing) and Y-BOCS obsession-compulsion and slowness and doubt scores of MOCI in OCD patients. In addition, there were also significant correlations between situational awareness and controlling, cleaning, slowness, rumination and total scores of MOCI in control group. Results indicated that (I) OCD patients have problems of perception, integration, and comprehension of complex visual perceptions; (II) situation awareness deficits associated with severity and prevalence of obsessions and compulsions.

  14. Group Behavior Therapy for Obsessive-Compulsive Disorder.

    ERIC Educational Resources Information Center

    Kobak, Kenneth A.; And Others

    1995-01-01

    Outlines some of the advantages in using a group approach for the treatment of Obsessive-Compulsive Disorder (OCD). Reviews the published literature on group behavioral treatment for OCD and discusses the unique therapeutic factors associated with group treatment that provide a rationale for developing a group approach for this disorder. (RJM)

  15. 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

  16. 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…

  17. Children, Adolescents, and Obsessive-Compulsive Disorder in the Classroom.

    ERIC Educational Resources Information Center

    Purcell, John

    This paper explores how obsessive-compulsive disorder (OCD) affects students and how teachers can help such students lead productive lives in the classroom and elsewhere. It describes the symptoms of OCD in students, including trouble getting to school on time because of rituals while getting cleaned and ready in the morning, inability to finish…

  18. Obsessive-Compulsive Disorder in Adults with Down's Syndrome.

    ERIC Educational Resources Information Center

    Prasher, V. P.; Day, S.

    1995-01-01

    This study investigated demographic and phenomenological characteristics of obsessive compulsive disorder (OCD) in nine adults with Down syndrome (DS), and possible effects on adaptive behavior. Results suggest OCD is more common in the DS population than the non-DS population. Ordering and tidiness was the most common form of OCD found, and…

  19. Family Accommodation in Pediatric Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Storch, Eric A.; Geffken, Gary R.; Merlo, Lisa J.; Jacob, Marni L.; Murphy, Tanya K.; Goodman, Wayne K.; Larson, Michael J.; Fernandez, Melanie; Grabill, Kristen

    2007-01-01

    Despite the importance of the family in the treatment of pediatric obsessive-compulsive disorder (OCD), relatively little empirical attention has been directed to family accommodation of symptoms. This study examined the relations among family accommodation, OCD symptom severity, functional impairment, and internalizing and externalizing behavior…

  20. Obsessive-Compulsive Disorder in Childhood and Adolescence.

    ERIC Educational Resources Information Center

    McGough, James J.; And Others

    1993-01-01

    Reviews literature on Obsessive-Compulsive Disorder (OCD) in children and adolescents, emphasizing clinical presentation, evaluation, and treatment options. Notes that patients with OCD show remarkable similarities in clinical presentations, and have distinct profiles on cognitive, behavioral, and psychological measures. Concludes that advances in…

  1. Stepped Care for Obsessive-Compulsive Disorder: A Pilot Study

    ERIC Educational Resources Information Center

    Tolin, David F.; Diefenbach, Gretchen J.; Maltby, Nicholas; Hannan, Scott

    2005-01-01

    Cognitive-behavioral therapy incorporating exposure and ritual prevention (EX/RP) is the first-line psychosocial treatment of choice for obsessive-compulsive disorder (OCD). However, several barriers to care prevent many OCD patients from receiving this treatment. Previous research has indicated that some OCD patients may benefit from less…

  2. 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 =…

  3. Obsessive-Compulsive Disorder in Childhood and Adolescence.

    ERIC Educational Resources Information Center

    McGough, James J.; And Others

    1993-01-01

    Reviews literature on Obsessive-Compulsive Disorder (OCD) in children and adolescents, emphasizing clinical presentation, evaluation, and treatment options. Notes that patients with OCD show remarkable similarities in clinical presentations, and have distinct profiles on cognitive, behavioral, and psychological measures. Concludes that advances in…

  4. Obsessive-Compulsive Spectrum Disorder Symptoms in College Students

    ERIC Educational Resources Information Center

    Sulkowski, Michael L.; Mariaskin, Amy; Storch, Eric A.

    2011-01-01

    Objective: This study investigated the occurrence of obsessive-compulsive spectrum disorders (OCSDs) and associated symptomology in college students. Participants: Participants included 358 undergraduate students. Results: Results suggest that clinically significant levels of OCSD symptoms are relatively common. Additionally, OCSD symptoms…

  5. Students with Obsessive Compulsive Disorder Participating in Recess

    ERIC Educational Resources Information Center

    Lucas, Matthew D.; Sturgis, Amanda L.

    2012-01-01

    The participation of a student with Obsessive Compulsive Disorder (OCD) in recess can often be both challenging and rewarding for the student and teacher. This paper will address common characteristics of students with OCD and present basic solutions to improve the experience of these students in the recess setting. Initially the definition,…

  6. Correlates of Insight among Youth with Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Lewin, Adam B.; Bergman, R. Lindsey; Peris, Tara S.; Chang, Susanna; McCracken, James T.; Piacentini, John

    2010-01-01

    Background: Individuals with Obsessive-Compulsive Disorder (OCD) may lack insight into the irrational nature of their symptoms. Among adults with OCD, poor insight has been linked to greater symptom severity, increased likelihood of comorbid symptoms, lower adaptive functioning, and worse treatment outcomes. Parallel work regarding insight among…

  7. Family Accommodation in Pediatric Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Storch, Eric A.; Geffken, Gary R.; Merlo, Lisa J.; Jacob, Marni L.; Murphy, Tanya K.; Goodman, Wayne K.; Larson, Michael J.; Fernandez, Melanie; Grabill, Kristen

    2007-01-01

    Despite the importance of the family in the treatment of pediatric obsessive-compulsive disorder (OCD), relatively little empirical attention has been directed to family accommodation of symptoms. This study examined the relations among family accommodation, OCD symptom severity, functional impairment, and internalizing and externalizing behavior…

  8. Correlates of Insight among Youth with Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Lewin, Adam B.; Bergman, R. Lindsey; Peris, Tara S.; Chang, Susanna; McCracken, James T.; Piacentini, John

    2010-01-01

    Background: Individuals with Obsessive-Compulsive Disorder (OCD) may lack insight into the irrational nature of their symptoms. Among adults with OCD, poor insight has been linked to greater symptom severity, increased likelihood of comorbid symptoms, lower adaptive functioning, and worse treatment outcomes. Parallel work regarding insight among…

  9. Obsessive-Compulsive Spectrum Disorder Symptoms in College Students

    ERIC Educational Resources Information Center

    Sulkowski, Michael L.; Mariaskin, Amy; Storch, Eric A.

    2011-01-01

    Objective: This study investigated the occurrence of obsessive-compulsive spectrum disorders (OCSDs) and associated symptomology in college students. Participants: Participants included 358 undergraduate students. Results: Results suggest that clinically significant levels of OCSD symptoms are relatively common. Additionally, OCSD symptoms…

  10. Stepped Care for Obsessive-Compulsive Disorder: A Pilot Study

    ERIC Educational Resources Information Center

    Tolin, David F.; Diefenbach, Gretchen J.; Maltby, Nicholas; Hannan, Scott

    2005-01-01

    Cognitive-behavioral therapy incorporating exposure and ritual prevention (EX/RP) is the first-line psychosocial treatment of choice for obsessive-compulsive disorder (OCD). However, several barriers to care prevent many OCD patients from receiving this treatment. Previous research has indicated that some OCD patients may benefit from less…

  11. 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 =…

  12. Inflammation in the Neurocircuitry of Obsessive-Compulsive Disorder.

    PubMed

    Attwells, Sophia; Setiawan, Elaine; Wilson, Alan A; Rusjan, Pablo M; Mizrahi, Romina; Miler, Laura; Xu, Cynthia; Richter, Margaret Anne; Kahn, Alan; Kish, Stephen J; Houle, Sylvain; Ravindran, Lakshmi; Meyer, Jeffrey H

    2017-08-01

    For a small percentage of obsessive-compulsive disorder (OCD) cases exhibiting additional neuropsychiatric symptoms, it was proposed that neuroinflammation occurs in the basal ganglia as an autoimmune response to infections. However, it is possible that elevated neuroinflammation, inducible by a diverse range of mechanisms, is important throughout the cortico-striato-thalamo-cortical circuit of OCD. Identifying brain inflammation is possible with the recent advance in positron emission tomography (PET) radioligands that bind to the translocator protein (TSPO). Translocator protein density increases when microglia are activated during neuroinflammation and the TSPO distribution volume (VT) is an index of TSPO density. To determine whether TSPO VT is elevated in the dorsal caudate, orbitofrontal cortex, thalamus, ventral striatum, dorsal putamen, and anterior cingulate cortex in OCD. This case-control study was conducted at a tertiary care psychiatric hospital from May 1, 2010, to November 30, 2016. Participants with OCD (n = 20) and age-matched healthy control individuals (n = 20) underwent a fluorine F 18-labeled N-(2-(2-fluoroethoxy)benzyl)-N-(4-phenoxypyridin-3-yl)acetamide PET scan. It is a high-quality second-generation TSPO-binding PET radiotracer. All participants were drug and medication free, nonsmoking, and otherwise healthy. The TSPO VT was measured in the dorsal caudate, orbitofrontal cortex, thalamus, ventral striatum, dorsal putamen, and anterior cingulate cortex. Compulsions were assessed with the Yale-Brown Obsessive Compulsive Scale. In the OCD and healthy groups, the mean (SD) ages were 27.4 (7.1) years and 27.6 (6.6) years, respectively, and 11 (55%) and 8 (40%) were women, respectively. In OCD, TSPO VT was significantly elevated in these brain regions (mean, 32%; range, 31%-36% except anterior cingulate cortex, 24%; analysis of variance, effect of diagnosis: P < .001 to P = .004). Slightly lower elevations in TSPO VT (22

  13. 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.

  14. Obsessive-compulsive disorder and its related disorders: a reappraisal of obsessive-compulsive spectrum concepts

    PubMed Central

    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. PMID:20623919

  15. DSM-III personality disorders in generalized anxiety, panic/agoraphobia, and obsessive-compulsive disorders.

    PubMed

    Mavissakalian, M R; Hamann, M S; Abou Haidar, S; de Groot, C M

    1993-01-01

    In an earlier report, we stated that personality profiles of patients with panic disorder/agoraphobia (n = 187) and obsessive-compulsive disorder ([ODC] n = 51) were similar, albeit more pronounced in OCD, suggesting that the link between panic disorder/agoraphobia and DSM-III personality disorders (PDs) or traits may be nonspecific. The present report extends the comparative study of DSM-III PDs/traits, as assessed by the Personality Diagnostic Questionnaire (PDQ), by adding a third diagnostic group of 39 patients with generalized anxiety disorder (GAD). The personality assessment of panic disorder/agoraphobia and GAD patients yielded virtually identical results on the PDQ and Eysenck Personality Inventory (EPI). Because GAD lacks the prominent panic, phobic, and obsessive-compulsive symptoms of other anxiety disorders, the present findings provide strong support for a nonspecific link between panic disorder/agoraphobia and DSM-III PDs/traits and for the presence of common personality characteristics in anxiety disorders.

  16. 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.

  17. 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

  18. 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.

  19. Genetics of obsessive-compulsive disorder and related disorders.

    PubMed

    Browne, Heidi A; Gair, Shannon L; Scharf, Jeremiah M; Grice, Dorothy E

    2014-09-01

    Twin and family studies support a significant genetic contribution to obsessive-compulsive disorder (OCD) and related disorders, such as chronic tic disorders, trichotillomania, skin-picking disorder, body dysmorphic disorder, and hoarding disorder. Recently, population-based studies and novel laboratory-based methods have confirmed substantial heritability in OCD. Genome-wide association studies and candidate gene association studies have provided information on specific gene variations that may be involved in the pathobiology of OCD, though a substantial portion of the genetic risk architecture remains unknown.

  20. Symptoms Analysis of Obsessive-Compulsive Disorder in Adolescents and Adults in a Teaching Hospital.

    PubMed

    Goit, B K; Ghimire, S R

    2014-01-01

    Obsessive-compulsive disorder has a broadly diverse clinical expression that reflects heterogeneity. Several studies have identified consistent symptom dimensions of obsessive-compulsive disorder. The purpose of this study was to conduct an exploratory symptoms analysis of obsessive-compulsive symptoms in adolescents and adults with obsessive-compulsive disorder. This was a cross-sectional study conducted in the Department of Psychiatry, National Medical College. This study examined lifetime occurrence of obsessive-compulsive symptoms included in the 13 symptom categories of the Yale-Brown Obsessive Compulsive Scale. Symptoms analysis was performed on 60 patients with obsessive-compulsive disorder. Eight categories of obsessions and six categories of compulsions from Yale-Brown Obsessive Compulsive Scale were included in the analyses. SPSS software package (version 16) was used to analyze the data and shown in the table. Of 60 adolescents and adults, female and male were in the ratio of 1.2:1. Contamination was the most common occurring obsession followed by aggressive obsession. The most common occurring compulsion was checking followed by washing. Only a minority of patients (13.33%) presented predominantly with obsessions however 18.33% patients presented predominantly with compulsions. Certain obsessions and compulsions co-occur to form a cluster. In adolescents and adults, obsessive-compulsive disorder is a multidimensional disorder. Symptom dimensions are predominantly congruent with those described in similar studies of adults with obsessive-compulsive disorder.

  1. Neuroinflammatory pathways in anxiety, posttraumatic stress, and obsessive compulsive disorders.

    PubMed

    Furtado, Melissa; Katzman, Martin A

    2015-09-30

    As prevalence of anxiety, posttraumatic stress, and obsessive compulsive disorders continue to rise worldwide, increasing focus has been placed on immune mediated theories in understanding the underlying mechanisms of these disorders. Associations between the dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and these disorders have been recognized in the scientific literature, specifically in regard to cortisol levels, as well as changes in pro- and anti-inflammatory cytokines. The present commentary will systematically assess the scientific literature within the past decade in regard to the psychoneuroimmunology of anxiety, posttraumatic stress, and obsessive compulsive disorders. Understanding the mechanisms of these disorders is essential in order to determine efficacious and targeted treatment strategies, which may lead to substantial improvements in overall functioning, as well as significant decreases in societal and economic burden.

  2. [Prevalence of Obsessive Compulsive Disorder and its comorbidity with Major Depressive Disorder in adolescent students].

    PubMed

    Rueda-Jaimes, Germán Eduardo; Camacho López, Paul Anthony; Navarro-Mancilla, Alvaro Andrés

    2008-01-01

    at least two-thirds of the adolescents with Obsessive Compulsive Disorder have another psychiatric disorder. The objective of this study was to estimate the prevalence of Obsessive Compulsive Disorder and Major Depressive Disorder in adolescent students and its comorbidity. 390 adolescents were performed a structured clinical interview, clinical version: Obsessive Compulsive Disorder and Major Depressive Disorder modules. The inquired sociodemographic factors were analyzed with bivariate and multivariate statistical analysis and with non conditional logistic regression. Obsessive Compulsive Disorder was 7.63, its comorbility with major depressive disorder was 48.27 and there was an association between both disorders (OR 6.6 IC 3.45 - 12.61); Major Depressive Disorder prevalence was 11.7; when we controlled confusing variables in women we found that work (OR 3,14), age (OR 1,45) and major depressive disorder (OR 3,88), showed higher risk of having Obsessive Compulsive Disorder; in contrast with the men just Major Depressive Disorder showed higher risk of having obsessive compulsive disorder (OR 10,88). the Obsessive Compulsive Disorder and Major Depressive Disorder prevalence and its association in adolescent students are high; age and work could be a risk factor of having Obsessive Compulsive Disorder.

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

    SciTech Connect

    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.

  4. Comorbidity in obsessive-compulsive disorder (OCD): a report from the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS).

    PubMed

    Lochner, Christine; Fineberg, Naomi A; Zohar, Joseph; van Ameringen, Michael; Juven-Wetzler, Alzbeta; Altamura, Alfredo Carlo; Cuzen, Natalie L; Hollander, Eric; Denys, Damiaan; Nicolini, Humberto; Dell'Osso, Bernardo; Pallanti, Stefano; Stein, Dan J

    2014-10-01

    Obsessive-compulsive disorder (OCD) is often associated with significant psychiatric comorbidity. Comorbid disorders include mood and anxiety disorders as well as obsessive-compulsive spectrum disorders (OCSDs). This paper aims to investigate comorbidity of DSM Axis I-disorders, including OCSDs, in patients with OCD from 10 centers affiliated with the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS). This is a cross-sectional study of comorbidity of Axis I disorders including OCSDs in 457 outpatients with primary OCD (37% male; 63% female), with ages ranging from 12 to 88years (mean: 39.8±13). Treating clinicians assessed Axis I disorders using the Mini International Neuropsychiatric Interview and assessed OCSDs using the Structured Clinical Interview for OCD related/spectrum disorders (SCID-OCSD). In terms of the OCSDs, highest comorbidity rates were found for tic disorder (12.5%), BDD (8.71%) and self-injurious behavior (7.43%). In terms of the other Axis I-disorders, major depressive disorder (MDD; 15%), social anxiety disorder (SAD; 14%), generalized anxiety disorder (GAD; 13%) and dysthymic disorder (13%) were most prevalent. High comorbidity of some OCSDs in OCD supports the formal recognition of these conditions in a separate chapter of the nosology. Rates of other Axis I disorders are high in both the general population and in OCSDs, indicating that these may often also need to be the focus of intervention in OCD. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. 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.

  6. Altered relationship between electrophysiological response to errors and gray matter volumes in an extended network for error-processing in pediatric obsessive-compulsive disorder.

    PubMed

    Liu, Yanni; Hanna, Gregory L; Carrasco, Melisa; Gehring, William J; Fitzgerald, Kate D

    2014-04-01

    Pediatric patients with obsessive-compulsive disorder (OCD) show an increased electrophysiological response to errors that is thought to be localized to the posterior medial prefrontal cortex (pMFC). However, the relation of this response, the error-related negativity (ERN), to underlying brain structures remains unknown. In an examination of 20 pediatric OCD patients and 20 healthy youth, we found that more negative ERN amplitude was correlated with lower gray matter (GM) density in pMFC and orbital frontal cortex. The association of the ERN with pMFC gray matter volume was driven by the patient group. In addition, a group difference in the association of ERN with gray matter in right insula was observed, showing an association of these measures in healthy youth (more negative ERN amplitude was associated with lower GM density in insula), but not in patients. These findings provide preliminary evidence linking gray matter volumes in an extended network for error processing to the ERN, and suggest that structural alterations in this network may underlie exaggeration of the ERN in pediatric OCD.

  7. Comorbid bipolar affective disorder and obsessive compulsive disorder in childhood: a case study and brief review.

    PubMed

    Jana, Amlan K; Praharaj, Samir Kumar; Sinha, Vinod Kumar

    2012-07-01

    Obsessive compulsive disorder and bipolar affective disorder in the pediatric population show a bidirectional overlap. Few studies that have addressed this issue show that the prevalence of obsessive compulsive disorder in bipolar affective disorder patients ranges from 0 to 54%, and 1.85 to 36% of the obsessive compulsive disorder patients have a comorbid bipolar affective disorder. We report a case of a patient with an onset of obsessive compulsive disorder at two-and-a-half years of age, who developed mania after exposure to escitalopram. We suggest that in pediatric obsessive compulsive disorder cases, antidepressants be used with caution, especially in cases with a positive family history of bipolar affective disorder.

  8. Obsessive-compulsive disorder and acquired toxoplasmosis in two children.

    PubMed

    Brynska, A; Tomaszewicz-Libudzic, E; Wolanczyk, T

    2001-09-01

    Two children presenting symptoms of obsessive-compulsive disorder (OCD) and with acquired toxoplasmosis are described and the possibility of a previously rarely reported association between OCD and acquired toxoplasmosis is discussed. Case 1 is a 14-year-old boy with Tourette syndrome (TS), attention deficit hyperactivity disorder (ADHD) in partial remission and a three-year history of OCD referred to our department due to an acute deterioration of obsessive-compulsive (OC) symptoms. Case 2 is an 11-year-old boy referred to our department because of a two-year history of OCD. The OC symptoms were observed immediately following an infection. In both cases laboratory tests confirmed the diagnosis of acquired toxoplasmosis. The pharmacological therapy of T.gondi infection without any psychopharmacological treatment caused remission or significant improvement regarding OC symptoms.

  9. 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

  10. Obsessive-compulsive disorder: an integrative genetic and neurobiological perspective.

    PubMed

    Pauls, David L; Abramovitch, Amitai; Rauch, Scott L; Geller, Daniel A

    2014-06-01

    Obsessive-compulsive disorder (OCD) is characterized by repetitive thoughts and behaviours that are experienced as unwanted. Family and twin studies have demonstrated that OCD is a multifactorial familial condition that involves both polygenic and environmental risk factors. Neuroimaging studies have implicated the cortico-striato-thalamo-cortical circuit in the pathophysiology of the disorder, which is supported by the observation of specific neuropsychological impairments in patients with OCD, mainly in executive functions. Genetic studies indicate that genes affecting the serotonergic, dopaminergic and glutamatergic systems, and the interaction between them, play a crucial part in the functioning of this circuit. Environmental factors such as adverse perinatal events, psychological trauma and neurological trauma may modify the expression of risk genes and, hence, trigger the manifestation of obsessive-compulsive behaviours.

  11. 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.

  12. Latent Class Analysis of YBOCS Symptoms in Obsessive Compulsive Disorder

    PubMed Central

    Delucchi, Kevin L.; Katerberg, Hilga; Stewart, S. Evelyn; Denys, Damiaan A.J.P.; Lochner, Christine; Stack, Denise E.; den Boer, Johan A.; van Balkom, Anton J.L.M.; Jenike, Michael A.; Stein, Dan J.; Cath, Danielle C.; Mathews, Carol A.

    2010-01-01

    Objective Obsessive-compulsive disorder (OCD) is phenomenologically heterogeneous, and findings of underlying structure classification based on symptom grouping have been ambiguous to date. Variable-centered approaches, primarily factor analysis, have been used to identify homogeneous groups of symptoms, but person-centered latent methods have seen little use. This study was designed to uncover sets of homogeneous groupings within 1611 individuals with OCD, based on symptoms. Method Latent class analysis (LCA) models using 61 obsessive-compulsive symptoms (OCS) collected from the Yale-Brown Obsessive-Compulsive Scale were fit. Relationships between latent class membership and treatment response, gender, symptom severity and comorbid tic disorders were tested for relationship to class membership. Results LCA models of best fit yielded three classes. Classes differed only in frequency of symptom endorsement. Classes with higher symptom endorsement were associated with earlier age of onset, being male, higher YBOCS symptom severity scores, and comorbid tic disorders. There were no differences in treatment response between classes. Conclusions These results provide support for the validity of a single underlying latent OCD construct, in addition to the distinct symptom factors identified previously via factor analyses. PMID:21145539

  13. Hoarding pet animals in obsessive-compulsive disorder.

    PubMed

    Campos-Lima, André L; Torres, Albina R; Yücel, Murat; Harrison, Ben J; Moll, Jorge; Ferreira, Gabriela M; Fontenelle, Leonardo F

    2015-02-01

    Although severe hoarding symptoms have been considered rare among obsessive-compulsive disorder (OCD) samples, the prevalence of animal hoarding in OCD is unknown. To help clarifying this issue, we searched for cases of animal hoarding among patients attending a university OCD clinic (n=420). Chart review. Only two patients from our sample exhibited animal hoarding (<0.5%) and only one of them presented additional obsessive-compulsive symptoms. Both cases also collected inanimate objects, presented low insight, exhibited poor response to serotonin reuptake inhibitors and did not adhere to therapy. There seems to be a lack of relationship between animal hoarding and OCD. However, further studies with larger numbers of patients are needed to better define their psychopathological profile and more appropriate nosological insertion.

  14. Venlafaxine augmentation with agomelatine in a patient with obsessive-compulsive disorder and suicidal behaviors

    PubMed Central

    Concerto, Carmen; Battaglia, Eliana; Costanzo, Maria C; Battaglia, Fortunato; Aguglia, Eugenio

    2014-01-01

    Obsessive-compulsive disorder is a chronic and disabling condition that often proves to be treatment resistant. Of the patients suffering from obsessive-compulsive disorder, 10%–27% may attempt suicide at least once in their life. We report the case of a patient who presented severe obsessive-compulsive disorder symptoms and attempted suicide ingesting 25 tablets of fluoxetine (20 mg). The patient was treated with venlafaxine and agomelatine and showed improvement of obsessive symptoms and suicidal ideation. Future studies are needed to investigate this treatment regime in large cohorts of obsessive-compulsive disorder patients with suicidal ideation. PMID:27489668

  15. 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.

  16. Incompleteness as a link between obsessive-compulsive personality traits and specific symptom dimensions of obsessive-compulsive disorder.

    PubMed

    Ecker, Willi; Kupfer, Jochen; Gönner, Sascha

    2014-01-01

    This paper examines the contribution of incompleteness/'not just right experiences' (NJREs) to an understanding of the relationship between obsessive-compulsive disorder (OCD) and obsessive-compulsive personality traits (OCPTs). It investigates the association of specific OCD symptom dimensions with OCPTs, conceptualized as continuous phenomena that are also observable below the diagnostic threshold. As empirical findings and clinical observation suggest that incompleteness feelings/NJREs may play a significant affective and motivational role for certain OCD subtypes, but also for patients with accentuated OCPTs, we hypothesized that OCPTs are selectively linked with incompleteness-associated OCD symptom dimensions (ordering, checking, hoarding and counting). Moreover, we assumed that this selective relationship cannot be demonstrated any more after statistical control of incompleteness, whereas it is preserved after statistical control of anxiety, depression, pathological worry and harm avoidance. Results from a study with a large clinical sample (n = 185) partially support these hypotheses and suggest that NJREs may be an important connecting link between specific OCD symptom dimensions, in particular ordering and checking, and accentuated OCPTs. Obsessive-compulsive personality traits (OCPTs) are positively related to obsessive-compulsive disorder symptom dimensions (ordering, checking, hoarding and counting) hypothesized or found to be associated with incompleteness/'not just right experiences' (NJREs), but not to washing and obsessions. This positive relationship, which is strongest for ordering and checking, is eliminated when NJREs are statistically controlled. Ordering, checking and accentuated OCPTs may share NJREs as a common affective-motivational underpinning.Dysfunctional behaviour patterns of people with accentuated OCPTs or obsessive-compulsive personality disorder (OCPD) may be viewed as efforts to avoid or reduce subjectively intolerable NJREs

  17. Relationship Obsessive-Compulsive Disorder: Interference, Symptoms, and Maladaptive Beliefs.

    PubMed

    Doron, Guy; Derby, Danny; Szepsenwol, Ohad; Nahaloni, Elad; Moulding, Richard

    2016-01-01

    Obsessive preoccupation, doubts, and compulsive behaviors focusing on one's romantic relationship and partner are receiving increasing clinical, theoretical, and empirical attention. Commonly referred to as relationship obsessive-compulsive disorder (ROCD), such symptoms have been linked with decreased relational and sexual functioning and lower mood, even after controlling for other obsessive-compulsive disorder (OCD) symptoms. To date, however, these symptoms have been studied in community samples alone. In the present study, we compared levels of interference, OCD, and mood symptoms between clinical participants with ROCD, OCD, and community controls. We also examined group differences in maladaptive beliefs previously linked with OCD and ROCD. Participants included 22 ROCD clients, 22 OCD clients, and 28 community controls. The Mini International Neuropsychiatric Interview was used to attain clinical diagnoses of OCD and ROCD. The Yale-Brown Obsessive-Compulsive Scale was used to evaluate primary-symptoms severity. All participants completed measures of symptoms and dysfunctional beliefs. ROCD clients reported more severe ROCD symptoms than the OCD and control groups. ROCD and OCD clients did not differ in severity of their -primary-symptoms. ROCD clients scored higher than the other groups on maladaptive OCD-related and relationship-related beliefs. Finally, ROCD clients showed more severe depression symptoms than community controls. ROCD is a disabling presentation of OCD that warrants research attention. Maladaptive OCD-related and relationship-related beliefs may be implicated in the development and maintenance of ROCD.

  18. Trauma-related obsessive-compulsive disorder: a review.

    PubMed

    Dykshoorn, Kristy L

    2014-01-01

    Obsessive-compulsive disorder (OCD) is a highly researched and conceptualized disorder, and yet it remains one of the most debilitating, widespread, and expensive disorders one can be afflicted with [Real, E., Labad, J., Alonso, P., Segalas, C., Jimenez-Murcia, S., Bueno, B., … Menchon, J. M. (2011). Stressful life events at onset of obsessive-compulsive disorder are associated with a distinct clinical pattern. Depression and Anxiety, 28, 367-376. doi:10.1002/da.20792]. Exposure treatments and cognitive-behavioural therapy (CBT) have been largely accepted as best practice for those with OCD, and yet there are still many who are left with "treatment-resistant OCD" [Rowa, K., Antony, M., & Swinson, R. (2007). Exposure and response prevention. In C. Purdon, M. Antony, & L. J. Summerfeldt (Eds.), Psychological treatment of obsessive-compulsive disorder: Fundamentals and beyond (pp. 79-109). Washington, DC: American Psychological Association; Foa, E. B. (2010). Cognitive behavioural therapy of obsessive-compulsive disorder. Dialogues of Clinical Neuroscience, 12, 199-207]. Similarly, exposure treatments and CBT have been accepted as best practice for trauma-related distress (i.e. post-traumatic stress disorder; Foa, E. B., Keane, T. M., Friedman, M. J., & Cohen, J. A. (2009). Effective treatments for PTSD: Practice guidelines from the international society for traumatic studies (2nd ed.). New York, NY: The Guilford Press). From a literature review, evidence has been provided that demonstrates a high prevalence rate (30-82%) of OCD among individuals with a traumatic history in comparison to the prevalence rate of the general population (1.1-1.8%; [Cromer, K. R., Schmidt, N. B., & Murphy, D. L. (2006). An investigation of traumatic life events and obsessive-compulsive disorder. Behaviour Research and Therapy, 45, 1683-1691. doi:10.1016/j.brat.2006.08.018; Fontenelle, L. F., Cocchi, L., Harrison, B. J., Shavitt, R. G., do Rosario, M. C., Ferrao, Y. A

  19. Predicting Obsessive Compulsive Disorder Subtypes Using Cognitive Factors

    PubMed Central

    Ramezani, Zahra; Mohammadi, Nourollah

    2016-01-01

    Objective: Recent studies have emphasized the important role of cognitive beliefs in etiology and maintenance of obsessive-compulsive disorder (OCD). OCD has different subtypes, but the specific role of cognitive beliefs in OCD symptomatology is not clear. The aim of the current study was to determine whether the cognitive factors proposed by Obsessive Compulsive Cognitions Working Group (OCCWG) could specifically predict subtypes of OCD. Method: The question was investigated in a sample of 208 university students (mean age = 21, SD = 1.6). The target population was selected by cluster sampling. All participants completed two questionnaires including Obsessive Beliefs Questionnaire (OBQ-44) and Obsessive Compulsive Inventory-Revised (OCI-R). Data were analyzed using descriptive statistics and regression analysis. Results: Regression analysis demonstrated that “responsibility/ threat over estimation” was a significant predictor of obsessive and compulsive behaviors and predicted washing, checking, obsessing, hoarding, and neutralizing subtypes of OCD. Furthermore, “perfectionism and intolerance of uncertainty” was the most significant predictor of ordering and hoarding while “importance/ control of thought” predicted ordering only. Conclusion: This study found evidence in support of Salkovskis’ cognitive theory about the central role of inflated responsibility beliefs in developing different subtypes of OCD. Besides, the results revealed those other cognitive beliefs had less important role in the development of OCD symptoms. PMID:27437003

  20. Defining Treatment Response and Remission in Obsessive-Compulsive Disorder: A Signal Detection Analysis of the Children's Yale-Brown Obsessive Compulsive Scale

    ERIC Educational Resources Information Center

    Storch, Eric A.; Lewin, Adam B.; De Nadai, Alessandro S.; Murphy, Tanya K.

    2010-01-01

    Objective: To examine the optimal Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) percent reduction cutoffs for predicting treatment response and clinical remission among children and adolescents with obsessive-compulsive disorder (OCD). Method: Youth with OCD (N = 109; range 7 to 19 years) received 14 sessions of weekly or intensive…

  1. Defining Treatment Response and Remission in Obsessive-Compulsive Disorder: A Signal Detection Analysis of the Children's Yale-Brown Obsessive Compulsive Scale

    ERIC Educational Resources Information Center

    Storch, Eric A.; Lewin, Adam B.; De Nadai, Alessandro S.; Murphy, Tanya K.

    2010-01-01

    Objective: To examine the optimal Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) percent reduction cutoffs for predicting treatment response and clinical remission among children and adolescents with obsessive-compulsive disorder (OCD). Method: Youth with OCD (N = 109; range 7 to 19 years) received 14 sessions of weekly or intensive…

  2. Dance-Like Movements in Obsessive Compulsive Disorder

    PubMed Central

    Bavle, Amar; Kumar, Kottur; Sharath, Vishwaraj

    2016-01-01

    The presentation of Obsessive Compulsive Disorder (OCD) is sometimes unusual and can mimic other disorders. There are a number of rare and varied manifestations of this disorder, reported in literature. The case reported here, presented with a hitherto unreported symptom; a dance-like compulsion in a case of OCD. This symptom is notable for the influence of cultural environment, on the content of symptom manifestation, in a psychiatric disorder. When one symptom in a disorder presents itself very prominently, the other symptoms, which are less prominent become masked; and need to be elicited by detailed assessment. PMID:27114632

  3. The relationship between metacognitions and insight in obsessive-compulsive disorder.

    PubMed

    Önen, Sinay; Karakaş Uğurlu, Görkem; Çayköylü, Ali

    2013-07-01

    This study aimed to determine the relationship between metacognitions and insight in obsessive compulsive disorder. One hundred individuals who had been diagnosed according to "Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision" criteria as having obsessive compulsive disorder and 50 healthy controls are included in the study. A sociodemographic and clinical data form, the Yale-Brown Obsession and Compulsion Scale and the Beck Depression Inventory were given to the participants. Insight is assessed by the 11th item of the Yale-Brown Obsession and Compulsion Scale. The Metacognition Questionnaire-30 was administered to both the obsessive compulsive disorder and the control groups to assess metacognitions. We found that the metacognition scores were statistically different in all groups and that the metacognition scores were higher in the obsessive compulsive disorder with good insight group than in the obsessive compulsive disorder with poor insight and control groups. In the obsessive compulsive disorder with poor insight group, all of the metacognition subscale scores were lower than those in the obsessive compulsive disorder with good insight group. Our findings elucidate the relationship between metacognitions and insight in obsessive compulsive disorder.

  4. 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…

  5. 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…

  6. Obsessive-Compulsive Disorder Presenting with Compulsions to Urinate Frequently

    PubMed Central

    Jiwanmall, Stephen Amarjeet; Kattula, Dheeraj

    2016-01-01

    Obsessive compulsive disorder (OCD) is a common psychiatric disorder which is easily recognized. However, sometimes patients of OCD present in such an atypical presentation of symptoms and a pathway to care involving multiple specialities. We report a case of a girl who had consulted several physicians and a urologist for frequent micturition, who was treated as a case of OCD after clarifying the compulsive nature of her symptom. There was significant improvement in her condition following 8 weeks of treatment with 200 mg of Sertraline and behaviour therapy. PMID:27570353

  7. Cobalamin deficiency presenting as obsessive compulsive disorder: case report.

    PubMed

    Sharma, Vivek; Biswas, Devdutta

    2012-01-01

    Cobalamin deficiency commonly presents with a wide range of neuropsychiatric manifestations ranging from myelopathy, neuropathy, optic neuritis and dementia to mood disorders, chronic fatigue and psychosis even without classical hematological abnormalities like anemia and macrocytosis. However, obsessive compulsive disorder (OCD) in relation to vitamin B12 deficiency has not been described so far. We report a case of middle-aged man presenting with OCD, low serum cobalamin and a positive family history of vitamin B12 deficiency who responded well to methylcobalamin replacement. Copyright © 2012 Elsevier Inc. All rights reserved.

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

    SciTech Connect

    Altemus, M.; Murphy, D.L.; Greenberg, B.; Lesch, K.P.

    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 role for alteration in the primary structure of the coding region of the serotonin-transporter gene in the pathogenesis of obsessive-compulsive disorder. 27 refs.

  9. 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…

  10. 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…

  11. 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…

  12. Serum Cytokine Profiles of Children with Obsessive-Compulsive Disorder Shows the Evidence of Autoimmunity.

    PubMed

    Şimşek, Şeref; Yüksel, Tuğba; Çim, Abdullah; Kaya, Savaş

    2016-08-01

    Previous reports have described an association between autoimmunity and primary obsessive compulsive disorder. This study aimed to investigate any differences in the levels of T helper 1, 2, and 17 effector cell cytokines between obsessive compulsive disorder patients and the control group. The study included 34 children (23 males, 11 females), aged between 7 and 17 years, with a diagnosis of obsessive compulsive disorder prior to receiving treatment. The control group consisted of age- and gender-matched children. Study participants were assessed using the Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime version, Children's Yale Brown Obsession Compulsion Scale, and Children's Depression Inventory. Cytokine serum concentrations were measured using the BD Cytometric Bead Array Human Th1/Th2/Th17 Cytokine Kit. Interleukin-17A, tumor necrosis factor-α, and interleukin-2 levels were significantly higher in obsessive compulsive disorder patients, However, there was no correlation between T helper 1 and 17 cytokine profiles in the obsessive compulsive disorder group. The duration and severity of obsessive compulsive disorder symptoms were not significantly associated with interleukin-17A, interferon-gamma-γ, interleukin-10, interleukin-6, interleukin-4, and interleukin-2 levels. Interestingly, a negative correlation was found between tumor necrosis factor-α levels and Clinical Global Impression scores. These findings suggest, in some cases, obsessive compulsive disorder may develop on a background of autoimmunity, and interleukin-2, tumor necrosis factor-α, and interleukin-17A may play a role in these autoimmune processes. Therefore, we believe it is important to investigate for obsessive compulsive disorder symptoms in patients with autoimmune disease and, conversely, autoimmune diseases in obsessive compulsive disorder patients. © The Author 2016. Published by Oxford University Press on behalf of CINP.

  13. Toward understanding the heterogeneity in obsessive-compulsive disorder: Evidence from narratives in adult patients.

    PubMed

    Van Schalkwyk, Gerrit I; Bhalla, Ish P; Griepp, Matthew; Kelmendi, Benjamin; Davidson, Larry; Pittenger, Christopher

    2016-01-01

    Current attempts at understanding the heterogeneity in obsessive-compulsive disorder have relied on quantitative methods. The results of such work point toward a dimensional structure for obsessive-compulsive disorder. Existing qualitative work in obsessive-compulsive disorder has focused on understanding specific aspects of the obsessive-compulsive disorder experience in greater depth. However, qualitative methods are also of potential value in furthering our understanding of obsessive-compulsive disorder heterogeneity by allowing for open-ended exploration of the obsessive-compulsive disorder experience and correlating identified subtypes with patient narratives. We explored variations in patients' experience prior to, during and immediately after performing their compulsions. Semi-structured interviews were conducted with 20 adults with obsessive-compulsive disorder, followed by inductive thematic analysis. Participant responses were not analyzed within the context of an existing theoretical framework, and themes were labeled descriptively. The previous dichotomy of 'anxiety' vs 'incompleteness' emerged organically during narrative analysis. In addition, we found that some individuals with obsessive-compulsive disorder utilized their behaviors as a way to cope with stress and anxiety more generally. Other participants did not share this experience and denied finding any comfort in their obsessive-compulsive behaviors. The consequences of attentional difficulties were highlighted, with some participants describing how difficulty focusing on a task could influence the need for it to be repeated multiple times. The extent to which patients use obsessive-compulsive disorder as a coping mechanism is a relevant distinction with potential implications for treatment engagement. Patients may experience ambivalence about suppressing behaviors that they have come to rely upon for management of stress and anxiety, even if these behaviors represent symptoms of a psychiatric

  14. Quality of life in obsessive-compulsive disorder: the role of mediating variables.

    PubMed

    Kugler, Brittany B; Lewin, Adam B; Phares, Vicky; Geffken, Gary R; Murphy, Tanya K; Storch, Eric A

    2013-03-30

    This study examined the association of various clinical features of obsessive-compulsive disorder (OCD) with quality of life (QoL) in 102 adults with a principal diagnosis of OCD. Participants were assessed by trained clinicians using the Anxiety Disorders Interview Schedule 4th edition, the Yale-Brown Obsessive-Compulsive Scale, and an unstructured clinical interview. Subjects completed the MOS-36 Item Short Form Health Survey, and Beck Depression Inventory-II. Obsessive-compulsive symptom severity was negatively correlated with emotional health, social functioning and general health QoL. Depressive symptoms mediated the relationship between obsessive-compulsive symptom severity and emotional health, social functioning and general health QoL. Additionally, interference of obsessive-compulsive symptoms mediated the relationship between obsessive-compulsive symptom severity and emotional health, social functioning and general health QoL. Resistance against obsessive-compulsive symptoms mediated the relationship between obsessive-compulsive symptom severity and social functioning QoL. Diminished QoL is present in persons with OCD and is essential in understanding the complete clinical picture of OCD. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  15. Obsessive-compulsive disorder and obsessive-compulsive symptoms in Japanese inpatients with chronic schizophrenia - a possible schizophrenic subtype.

    PubMed

    Owashi, Toshimi; Ota, Arimitsu; Otsubo, Tempei; Susa, Yuko; Kamijima, Kunitoshi

    2010-10-30

    To investigate the prevalence of obsessive-compulsive disorder (OCD) and obsessive-compulsive symptoms (OCS) and their association with demographic and clinical factors, 92 inpatients with chronic schizophrenia participated in this study. Demographic factors, severity of psychiatric symptoms as determined by Brief Psychiatric Rating Scale and OCS by Yale-Brown Obsessive Compulsive Scale, general functioning, extrapyramidal symptoms, and dose of antipsychotics were compared between patients with and without OCD or OCS. The Mini-International Neuropsychiatric Interview was employed for diagnosis of OCD and OCS. OCD and OCS were observed in 14.1% and 51.1% of inpatients with schizophrenia, respectively. Schizophrenic patients with OCS exhibited significantly earlier onset of schizophrenia, lower socioeconomic status, and more severe psychiatric symptoms than those without OCS. Earlier hospitalization of schizophrenia, family history of psychosis, and more severe schizophrenic symptoms were associated with comorbidity of OCS, as determined by logistic regression analysis, and younger age was associated with more severe OCS. However, negative symptoms were associated with comorbidity of OCD in chronic schizophrenia. Our findings suggest there is a subtype of schizophrenia with OCS, which is related to earlier onset and more severe psychotic symptoms.

  16. Symptoms of obsessive-compulsive disorder predict cannabis misuse.

    PubMed

    Spradlin, Alexander; Mauzay, Dakota; Cuttler, Carrie

    2017-09-01

    Cannabis use has been linked to many psychological disorders. There is, however, a paucity of research investigating the link between cannabis use and obsessive-compulsive disorder (OCD). The present study sought to examine this link by exploring associations between severity of OCD symptoms, cannabis use, and cannabis misuse; determining whether these associations exist above and beyond symptoms of anxiety, depression, and stress; and testing the mediating role of cannabis coping motives (i.e., using cannabis to cope with negative affect and other problems). A large sample of young adult cannabis users (n=430) completed an online survey containing measures of OCD symptoms, cannabis use, cannabis misuse, and cannabis use motives. Severity of OCD (as indexed by higher scores on the Obsessive-Compulsive Inventory-Revised) was unrelated to frequency and quantity of cannabis use, but it was significantly, positively related to increased cannabis misuse. These effects persisted after controlling for anxiety, depression, and stress. The specific feature of obsessing was found to consistently predict cannabis misuse. Finally, an indirect effect of severity of OCD on cannabis misuse via coping motives was discovered. Together, these findings indicate that there may be an association between OCD and cannabis misuse that is independent of anxiety, depression, and stress, and that is mediated by coping motives. Based on these findings, we recommend that individuals with OCD symptoms avoid using cannabis because they may be more vulnerable to the development of problematic use and cannabis use disorder. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Prevalence and correlates of obsessive-compulsive disorder and subthreshold obsessive-compulsive disorder among college students in Kerala, India.

    PubMed

    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

    There are scarce data on the prevalence of adult obsessive-compulsive disorder (OCD) in India. 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. A cross-sectional survey of 5784 students of the age range of 18-25 years from 58 colleges was conducted. 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. 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. 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. 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.

  18. 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

  19. The relationship between eating disorder symptoms and obsessive compulsive disorder in primigravida women.

    PubMed

    Mohamadirizi, Soheila; Kordi, Masoumeh; Shakeri, Mohamad Taghi; Modares-Gharavi, Morteza

    2015-01-01

    Eating Disorder Symptoms are among the most common disorders in perinatal period and are influenced by various environmental and psychosocial factors such as anxiety disorders. So, the aim of this study was to determine the relationship between Eating Disorder symptoms and Obsessive Compulsive disorder in primigravida women. This cross-sectional study was carried on 213 in primigravida women referring to Mashhad health care centers, selected through a two stage sampling method (cluster-convenience) in Mashhad in 2013. Demographic and prenatal characteristics Questionnaire, Eating Disorder Examination Questionnaire (EDE-Q)(26Q) and Maudsley Obsessive Compulsive Questionnaire (30Q) were completed by the subjects. The statistical analysis was performed with various statistical tests such as Pearson correlation coefficient, t-test, one-way ANOVA and linear regression. Significance level was considered as P < 0.05. Based on the findings 94.6% of the subjects had Obsessive Compulsive disorder, and 18% had Eating Disorder Symptoms. In addition, there was a poor positive correlation between the rate of Eating Disorder Symptoms and Obsessive Compulsive. There was a correlation between the Eating Disorder Symptoms and Obsessive Compulsive in pregnant women. It is recommended to eliminate or decrease Eating Disorder Symptoms and Obsessive Compulsive among Iranian pregnant women through preventive measures.

  20. 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.

  1. Symptom Dimensions in Obsessive-Compulsive Disorder and Obsessive Beliefs

    PubMed Central

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

    2015-01-01

    Background: 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. Materials and Methods: 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. Results: Perfectionism predicted both aggressive and symmetry dimensions whereas responsibility beliefs predicted sexual and religious dimensions. Conclusions: 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. PMID:26702171

  2. 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.

  3. Bipolar obsessive-compulsive disorder and personality disorders.

    PubMed

    Maina, Giuseppe; Albert, Umberto; Pessina, Enrico; Bogetto, Filippo

    2007-11-01

    Relatively few systematic data exist on the clinical impact of bipolar comorbidity in obsessive-compulsive disorder (OCD) and no studies have investigated the influence of such a comorbidity on the prevalence and pattern of Axis II comorbidity. The aim of the present study was to explore the comorbidity of personality disorders in a group of patients with OCD and comorbid bipolar disorder (BD). The sample consisted of 204 subjects with a principal diagnosis of OCD (DSM-IV) and a Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score>or=16 recruited from all patients consecutively referred to the Anxiety and Mood Disorders Unit, Department of Neuroscience, University of Turin over a period of 5 years (January 1998-December 2002). Diagnostic evaluation and Axis I comorbidities were collected by means of the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Personality status was assessed by using the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II). Socio-demographic and clinical features (including Axis II comorbidities) were compared between OCD patients with and without a lifetime comorbidity of BD. A total of 21 patients with OCD (10.3%) met DSM-IV criteria for a lifetime BD diagnosis: 4 (2.0%) with BD type I and 17 (8.3%) with BD type II. Those without a BD diagnosis showed significantly higher rates of male gender, sexual and hoarding obsessions, repeating compulsions and lifetime comorbid substance use disorders, when compared with patients with BD/OCD. With regard to personality disorders, those with BD/OCD showed higher prevalence rates of Cluster A (42.9% versus 21.3%; p=0.027) and Cluster B (57.1% versus 29.0%; p=0.009) personality disorders. Narcissistic and antisocial personality disorders were more frequent in BD/OCD. Our results point towards clinically relevant effects of comorbid BD on the personality profiles of OCD patients, with higher rates of narcissistic and antisocial personality disorders in BD/OCD patients.

  4. 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.

  5. Cingulate and thalamic metabolites in obsessive-compulsive disorder.

    PubMed

    O'Neill, Joseph; Lai, Tsz M; Sheen, Courtney; Salgari, Giulia C; Ly, Ronald; Armstrong, Casey; Chang, Susanna; Levitt, Jennifer G; Salamon, Noriko; Alger, Jeffry R; Feusner, Jamie D

    2016-08-30

    Focal brain metabolic effects detected by proton magnetic resonance spectroscopy (MRS) in obsessive-compulsive disorder (OCD) represent prospective indices of clinical status and guides to treatment design. Sampling bilateral pregenual anterior cingulate cortex (pACC), anterior middle cingulate cortex (aMCC), and thalamus in 40 adult patients and 16 healthy controls, we examined relationships of the neurometabolites glutamate+glutamine (Glx), creatine+phosphocreatine (Cr), and choline-compounds (Cho) with OCD diagnosis and multiple symptom types. The latter included OC core symptoms (Yale-Brown Obsessive-Compulsive Scale - YBOCS), depressive symptoms (Montgomery-Åsberg Depression Rating Scale - MADRS), and general functioning (Global Assessment Scale - GAS). pACC Glx was 9.7% higher in patients than controls. Within patients, Cr and Cho correlated negatively with YBOCS and MADRS, while Cr correlated positively with the GAS. In aMCC, Cr and Cho correlated negatively with MADRS, while Cr in thalamus correlated positively with GAS. These findings present moderate support for glutamatergic and cingulocentric perspectives on OCD. Based on our prior metabolic model of OCD, we offer one possible interpretation of these group and correlational effects as consequences of a corticothalamic state of elevated glutamatergic receptor activity alongside below-normal glutamatergic transporter activity.

  6. Genetics of Obsessive-Compulsive Disorder and Related Disorders

    PubMed Central

    Browne, Heidi A.; Gair, Shannon L.; Scharf, Jeremiah M.; Grice, Dorothy E.

    2014-01-01

    Synopsis Twin and family studies support a significant genetic contribution to obsessive-compulsive disorder (OCD) and related disorders such as chronic tic disorders, trichotillomania, skin picking disorder, body dysmorphic disorder, and hoarding disorder. Recently, population-based studies and novel laboratory-based methods have confirmed substantial heritability in OCD. Genome-wide association studies and candidate gene association studies have provided information on specific genes that may be involved in the pathobiology of OCD and also of related disorders, particularly chronic tic disorders, though these genes each contribute only a small portion of the total genetic risk and a substantial portion of the specific genetic risk profile in OCD is still unknown. Nevertheless, there are some examples of genes for which perturbations produce OCD-like phenotypes in animal model systems, allowing a laboratory platform for investigating the pathobiology of --- and new treatments for --- OCD and related disorders. Future work promises to continue to clarify the specific genes involved in risk for OCD as well as their interaction with environmental variables. PMID:25150565

  7. Attachment Style and Resiliency in Patients with Obsessive-Compulsive Personality Disorder.

    PubMed

    Zakiei, Ali; Alikhani, Mostafa; Farnia, Vahid; Khkian, Zinab; Shakeri, Jalal; Golshani, Sanobar

    2017-01-01

    The goal of the present study was to determine the relationships between attachment styles and resiliency in obsessive-compulsive personality disorder. A random sample of 260 subjects was obtained from the population of undergraduate students of the Nour Branch of Islamic Azad University, which is located in Mazandaran, and these subjects were enrolled in this descriptive and correlational study. The collected data included the subjects' responses to an adult attachment style questionnaire, resilience scale, and obsessive-compulsive personality disorder questionnaire. The data were analyzed with Pearson correlation coefficient indices and multiple regressions. The results of the data analysis showed a positive correlation (relationship) between ambivalent/avoidant attachment styles and obsessive-compulsive personality disorder and a negative correlation between resilience and obsessive-compulsive personality disorder. Furthermore, these results demonstrated that attachment style and resiliency can predict obsessive-compulsive personality disorder. In addition, no significant relationships were found between the demographic variables (convertibles) and obsessive-compulsive personality disorder. These results suggested that attachment style and resiliency contribute to the development of obsessive-compulsive personality disorder.

  8. Attachment Style and Resiliency in Patients with Obsessive-Compulsive Personality Disorder

    PubMed Central

    Zakiei, Ali; Farnia, Vahid; Khkian, Zinab; Shakeri, Jalal; Golshani, Sanobar

    2017-01-01

    Background The goal of the present study was to determine the relationships between attachment styles and resiliency in obsessive-compulsive personality disorder. Methods A random sample of 260 subjects was obtained from the population of undergraduate students of the Nour Branch of Islamic Azad University, which is located in Mazandaran, and these subjects were enrolled in this descriptive and correlational study. The collected data included the subjects' responses to an adult attachment style questionnaire, resilience scale, and obsessive-compulsive personality disorder questionnaire. The data were analyzed with Pearson correlation coefficient indices and multiple regressions. Results The results of the data analysis showed a positive correlation (relationship) between ambivalent/avoidant attachment styles and obsessive-compulsive personality disorder and a negative correlation between resilience and obsessive-compulsive personality disorder. Furthermore, these results demonstrated that attachment style and resiliency can predict obsessive-compulsive personality disorder. In addition, no significant relationships were found between the demographic variables (convertibles) and obsessive-compulsive personality disorder. Conclusion These results suggested that attachment style and resiliency contribute to the development of obsessive-compulsive personality disorder. PMID:28197331

  9. Delusional misidentification syndromes in obsessive-compulsive disorder.

    PubMed

    Melca, Isabela A; Rodrigues, Clarissa L; Serra-Pinheiro, Maria A; Pantelis, Christos; Velakoulis, Dennis; Mendlowicz, Mauro V; Fontenelle, Leonardo F

    2013-06-01

    Delusional misidentification syndromes (DMS) have been rarely reported in patients with conditions other than schizophrenia-related disorders, diffuse brain disease (dementia) and focal neurological illness. In this report, we describe DMS (i.e. Capgras and Fregoli syndromes) in two patients with severe and treatment resistant obsessive-compulsive disorder (OCD), one with paranoid personality disorder (PPD) and the other with a pervasive developmental disorder (PDD) not otherwise specified. While our findings highlight an interesting phenomenon (the occurrence of DMS in OCD), it is presently unclear whether this association is rare or underreported. Misidentification syndromes might be the ultimate result of a combination of obsessive fears and preexisting cognitive bias/deficits, such as mistrustfulness (in PPD) or poor theory of mind (in PDD).

  10. The Genetics of Obsessive-Compulsive Disorder

    PubMed Central

    Bloch, Michael H.; Pittenger, Christopher

    2013-01-01

    OCD is a psychiatric disorder with a lifetime prevalence of 1–3% and is a significant cause of disability worldwide. Family studies indicate that OCD has a significant hereditable component, with relatives of OCD cases being 4 times more likely to develop the disorder than the general population. Linkage studies in OCD have generally been underpowered and have failed to reach the statistical threshold for genome-wide significance, but they have nevertheless been useful for revealing potential regions of interest for future candidate gene studies. Candidate gene studies in OCD have thus far focused on genes involved in the serotonergic, dopaminergic, and glutamatergic pathways. These studies have been for the most part inconclusive, and failures to replicate have been the norm until very recently. The only genetic association replicated by multiple groups was with a glutamate transporter gene (SLC1A1). Genome-wide association studies in OCD are in progress, but final results have not yet been reported. As with the study of many other psychiatric disorders, an improved understanding of OCD will only be achieved (1) with larger collaborative efforts involving more probands, (2) the use of probands and controls drawn from epidemiologically-based populations rather than clinical samples, (3) developing a more precise phenotypic description of OCD and (4) measuring important environmental influences that affect OCD pathogenesis and severity. PMID:23970845

  11. Superstitiousness in obsessive-compulsive disorder

    PubMed Central

    Brugger, Peter; Viaud-Delmon, Isabelle

    2010-01-01

    It has been speculated that superstitiousness and obsessivecompulsive disorder (OCD) exist along a continuum. The distinction between superstitious behavior italic>and superstitious belief, however, is crucial for any theoretical account of claimed associations between superstitiousness and OCD. By demonstrating that there is a dichotomy between behavior and belief, which is experimentally testable, we can differentiate superstitious behavior from superstitious belief, or magical ideation. Different brain circuits are responsible for these two forms of superstitiousness; thus, determining which type of superstition is prominent in the symptomatology of an individual patient may inform us about the primarily affected neurocognitive systems. PMID:20623929

  12. The Children's Yale-Brown Obsessive Compulsive Scale: Reliability and Validity for Use among 5 to 8 Year Olds with Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Freeman, Jennifer; Flessner, Christopher A.; Garcia, Abbe

    2011-01-01

    The Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) is the instrument of choice for assessing symptom severity in older children (i.e., 8-18 years) diagnosed with obsessive-compulsive disorder (OCD). The reliability and validity of this measure for use among younger children (i.e., 5-8 years of age), however, has never been examined.…

  13. The Children's Yale-Brown Obsessive Compulsive Scale: Reliability and Validity for Use among 5 to 8 Year Olds with Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Freeman, Jennifer; Flessner, Christopher A.; Garcia, Abbe

    2011-01-01

    The Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) is the instrument of choice for assessing symptom severity in older children (i.e., 8-18 years) diagnosed with obsessive-compulsive disorder (OCD). The reliability and validity of this measure for use among younger children (i.e., 5-8 years of age), however, has never been examined.…

  14. Obsessive-compulsive disorder in children and adolescents

    PubMed Central

    Krebs, Georgina; Heyman, Isobel

    2015-01-01

    Obsessive-compulsive disorder (OCD) in childhood and adolescence is an impairing condition, associated with a specific set of distressing symptoms incorporating repetitive, intrusive thoughts (obsessions) and distressing, time-consuming rituals (compulsions). This review considers current knowledge of causes and mechanisms underlying OCD, as well as assessment and treatment. Issues relating to differential diagnosis are summarised, including the challenges of distinguishing OCD from autism spectrum disorders and tic disorders in youth. The recommended treatments, namely cognitive behaviour therapy and serotonin reuptake inhibiting/selective serotonin reuptake inhibitor medications, are outlined along with the existing evidence-based and factors associated with treatment resistance. Finally, novel clinical developments that are emerging in the field and future directions for research are discussed. PMID:25398447

  15. Microgenetic styles in histrionic and obsessive-compulsive personality disorders.

    PubMed

    Rubino, I A; Greco, E; Zanna, V; Pezzarossa, B

    1994-02-01

    Microgenetic styles of regulation of subjects with (n = 46) and without (n = 44) psychometric evidence of personality disorders were assessed by means of the Serial Color-Word Test. The disordered group were characterized by the primary Dissociative pattern and by very low values of the initial strategy called ITa. Subjects with psychometric evidence of Histrionic (n = 21) and Obsessive-Compulsive (n = 21) Personality Disorders were then compared. Histrionic personality corresponded most often to a primary Stabilized style, with a progressive slight increase of dissociation over time (Cv type). The compulsive trait was instead associated with high primary cumulation (and moderately elevated dissociation), concomitantly with secondary dissociative patterns (CDr and Dv/CDv). These results seem to encourage further clinical research with the Serial Color-Word Test.

  16. [Obsessive-compulsive disorder--clinical picture, diagnosis, and therapy].

    PubMed

    Zaudig, Michael

    2011-01-01

    This article reviews the present state of knowledge concerning obsessive-compulsive disorder (OCD) with respect to its classification, epidemiology, pathogenesis, and therapy. Epidemiological evidence has indicated that OCD may be one of the most prevalent and disabling psychiatric disorders. There is also a high comorbidity with depression and anxiety disorders. OCD is characterized by repetitive, intrusive thoughts and images, and/or by repetitive, ritualistic physical or mental acts performed to reduce the attended anxiety. OCD is relatively common, affecting 1-3% of both adult and paediatric samples. OCD is clinically a heterogeneous condition in that two different patients with clear OCD can display completely distinct symptom patterns. Furthermore, neurobiological and psychological models concerning OCD as well as the present state of therapy are presented in detail.

  17. Shared or induced obsessive compulsive disorder: Is it a reality?

    PubMed Central

    Kirpekar, V. C.; Gawande, S.; Tadke, R.; Bhave, S. H.; Faye, A. D.

    2014-01-01

    Background: Shared or induced obsessive compulsive disorder (OCD) is not yet a distinct diagnosis in classification of psychiatric disorders. In fact, though recognized as a diagnostic category, shared or induced psychotic disorders are rare and most of the literature is based on the case reports. Materials and Methods: We are reporting three case studies manifested with shared or induced OCD (cases with obsessive symptoms that were shared from the primary case in their family). Results: All the cases were treated considering shared or induced OCD as psychopathology. Response to treatment modalities in first and second case and poor response to treatment in third case is suggestive of shared or induced OCD as a distinct entity. It is different from shared psychosis in many ways. Conclusion: Shared or induced OCD is a distinct diagnosis. Greater awareness about this entity among mental health professionals is needed. PMID:24574562

  18. 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

    2017-04-01

    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.

  19. Management of obsessive-compulsive disorder comorbid with bipolar disorder

    PubMed Central

    Kazhungil, Firoz; Mohandas, E.

    2016-01-01

    Obsessive-compulsive disorder (OCD) is one of the most common comorbidities in bipolar disorder (BD). Clinicians often get perplexed in making treatment decisions when encountering comorbid OCD and BD as treatment of OCD by pharmacotherapy may induce or exacerbate mood instability and psychotherapeutic approaches for OCD may not be feasible in acute manic or depressive state of BD. In this study, we reviewed literature, whether existing guideline-based treatments of BD may be effective in OCD and whether newer agents will be of use for treating this comorbidity. We could find that treatment of such comorbid disorder is largely understudied. Adjuvant topiramate or olanzapine- selective serotonin reuptake inhibitor/clomipramine combination along with mood stabilizer is found to be effective for treating OCD in BD. Use of other conventional pharmacological agents and psychotherapy for treating comorbid OCD in BD lacks evidence and is limited to case reports. Our review also highlights the need for further studies regarding the treatment strategies in this highly prevalent comorbid disorder. PMID:28066002

  20. Management of obsessive-compulsive disorder comorbid with bipolar disorder.

    PubMed

    Kazhungil, Firoz; Mohandas, E

    2016-01-01

    Obsessive-compulsive disorder (OCD) is one of the most common comorbidities in bipolar disorder (BD). Clinicians often get perplexed in making treatment decisions when encountering comorbid OCD and BD as treatment of OCD by pharmacotherapy may induce or exacerbate mood instability and psychotherapeutic approaches for OCD may not be feasible in acute manic or depressive state of BD. In this study, we reviewed literature, whether existing guideline-based treatments of BD may be effective in OCD and whether newer agents will be of use for treating this comorbidity. We could find that treatment of such comorbid disorder is largely understudied. Adjuvant topiramate or olanzapine- selective serotonin reuptake inhibitor/clomipramine combination along with mood stabilizer is found to be effective for treating OCD in BD. Use of other conventional pharmacological agents and psychotherapy for treating comorbid OCD in BD lacks evidence and is limited to case reports. Our review also highlights the need for further studies regarding the treatment strategies in this highly prevalent comorbid disorder.

  1. Amygdala activation and symptom dimensions in obsessive-compulsive disorder.

    PubMed

    Via, Esther; Cardoner, Narcís; Pujol, Jesús; Alonso, Pino; López-Solà, Marina; Real, Eva; Contreras-Rodríguez, Oren; Deus, Joan; Segalàs, Cinto; Menchón, José M; Soriano-Mas, Carles; Harrison, Ben J

    2014-01-01

    Despite knowledge of amygdala involvement in fear and anxiety, its contribution to the pathophysiology of obsessive-compulsive disorder (OCD) remains controversial. In the context of neuroimaging studies, it seems likely that the heterogeneity of the disorder might have contributed to a lack of consistent findings. To assess the influence of OCD symptom dimensions on amygdala responses to a well-validated emotional face-matching paradigm. Cross-sectional functional magnetic resonance imaging (fMRI) study of 67 patients with OCD and 67 age-, gender- and education-level matched healthy controls. The severity of aggression/checking and sexual/religious symptom dimensions were significantly associated with heightened amygdala activation in those with OCD when responding to fearful faces, whereas no such correlations were seen for other symptom dimensions. Amygdala functional alterations in OCD appear to be specifically modulated by symptom dimensions whose origins may be more closely linked to putative amygdala-centric processes, such as abnormal fear processing.

  2. Recognition of facial expressions in obsessive-compulsive disorder.

    PubMed

    Corcoran, Kathleen M; Woody, Sheila R; Tolin, David F

    2008-01-01

    Sprengelmeyer et al. [Sprengelmeyer, R., Young, A. W., Pundt, I., Sprengelmeyer, A., Calder, A. J., Berrios, G., et al. (1997). Disgust implicated in obsessive-compulsive disorder. Proceedings of the Royal Society of London, 264, 1767-1773] found that patients with OCD showed severely impaired recognition of facial expressions of disgust. This result has potential to provide a unique window into the psychopathology of OCD, but several published attempts to replicate this finding have failed. The current study compared OCD patients to normal controls and panic disorder patients on ability to recognize facial expressions of negative emotions. Overall, the OCD patients were impaired in their ability to recognize disgust expressions, but only 33% of patients showed this deficit. These deficits were related to OCD symptom severity and general functioning, factors that may account for the inconsistent findings observed in different laboratories.

  3. Prepulse Inhibition Deficits only in Females with Obsessive Compulsive Disorder

    PubMed Central

    Steinman, Shari A.; Ahmari, Susanne E.; Choo, Tse; Kimeldorf, Marcia B.; Feit, Rachel; Loh, Sarah; Risbrough, Victoria; Geyer, Mark A.; Steinglass, Joanna E.; Wall, Melanie; Schneier, Franklin R.; Fyer, Abby J.; Simpson, H. Blair

    2016-01-01

    Background Deficits in sensorimotor gating have been hypothesized to underlie the inability to inhibit repetitive thoughts and behaviors. To test this hypothesis, this study assessed prepulse inhibition (PPI), a measure of sensorimotor gating, across three psychiatric disorders (obsessive-compulsive disorder [OCD], social anxiety disorder [SAD], and anorexia nervosa [AN]) whose clinical presentation includes repetitive thoughts and behaviors. Methods We tested acoustic PPI in unmedicated individuals with OCD (n=45), SAD (n=37), and AN (n=26), and compared their results to matched healthy volunteers (n=62). All participants completed a structured clinical interview and a clinical assessment of psychiatric symptom severity. Results Percent PPI was significantly diminished in females with OCD compared to healthy female volunteers (p=0.039). No other differences between healthy volunteers and participants with disorders (male or female) were observed. Percent PPI was not correlated with severity of obsessions and compulsions, as measured by the Yale-Brown Obsessive Compulsive Scale. Conclusions This is the first study to assess PPI in participants with SAD or AN, and the largest study to assess PPI in participants with OCD. We found PPI deficits only in females with OCD, which suggests that the cortico-striato-pallido-thalamic and pontine circuitry (believed to underlie PPI) differs between males and females with OCD. Given that PPI deficits were only present in females with OCD and not related to repetitive thoughts and behaviors, our results do not support the hypothesis that sensorimotor gating deficits, as measured by PPI, underlie the inability to inhibit repetitive thoughts and behaviors in individuals with OCD, SAD, and AN. PMID:26878422

  4. 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.

  5. Learning from Animal Models of Obsessive-Compulsive Disorder

    PubMed Central

    Monteiro, Patricia; Feng, Guoping

    2015-01-01

    Obsessive-Compulsive Disorder (OCD) affects 2–3% of the worldwide population and can cause significant distress and disability to its sufferers. Substantial challenges remain in the field of OCD research and therapeutics. Approved interventions only partially alleviate symptoms, with 30–40% of patients being resistant to treatment. Research evidence points towards the involvement of cortico-striato-thalamocortical circuitry (CSTC) although OCD’s etiology is still unknown. This review will focus on the most recent behavior, genetics and neurophysiological findings from animal models of OCD. Based on evidence from these models and parallels with human studies, we discuss the circuit hyperactivity hypothesis for OCD, a potential circuitry dysfunction of action termination, and the involvement of candidate genes. Adding a more biologically-valid framework to OCD will help us define and test new hypotheses and facilitate the development of targeted therapies based on disease-specific mechanisms. PMID:26037910

  6. Somatic treatments excluding psychopharmacology in obsessive- compulsive disorder: a review.

    PubMed

    Atmaca, Murad

    2013-06-01

    Somatic treatments other than psychotropic drugs are increasingly used in the patients with obsessive compulsive disorder (OCD), however there has been little systematic review of them. Therefore, the present review deals with a variety of somatic treatment methods excluding psychotropic drugs. A literature search was performed on the PubMed database from the beginning of 1980, to September 2012, for published English, Turkish and French-language articles of somatic treatment approaches (excluding psychopharmacological agents) in the treatment of OCD. The search was carried out by using some terms in detail. Afterwards, the obtained investigations on electroconvusive therapy (ECT), deep brain stimulation (DBS), neurosurgical methods and transcranial magnetic stimulation (TMS) were presented. Although psychopharmacological treatment and psychotherapeutic approaches are primary treatment modalities in the management of OCD, other somatic treatment options seem to be used as alternatives, especially for patients with treatmentresistant OCD.

  7. [Explicative psychopathology in obsessive-compulsive disorder: a postrationalist viewpoint].

    PubMed

    Mannino, Gherardo

    2011-01-01

    While descriptive psychopathology of obsessive-compulsive disorder (OCD) is now well-established, there is still a lack of a satisfying model of explicative psychopathology that explains the mechanisms that generate obsessive phenomenology. The main attempts to delineate such a model are based on cognitive therapy: according to this approach OCD is a consequence of dysfunctional beliefs (i.e. overestimation of the risk or of the influence of one's own mind on the reality). On the contrary, according to postrationalist cognitive approach, OCD would be based on a characteristic personality structure, which could be identified not only in patients with OCD but also in those who will never develop symptoms. In symptomatic individuals this organization ("Obsessive" Personal Meaning Organization) is more rigidly structured. In particular, there is crystallization of so-called diachronic attitude, which is the key to explain most of the symptoms.

  8. Neuroimaging Studies in Obsessive Compulsive Disorder: A Narrative Review

    PubMed Central

    Parmar, Arpit; Sarkar, Siddharth

    2016-01-01

    Obsessive compulsive disorder (OCD) is a relatively common psychiatric illness with a lifetime prevalence of 2–3% in general population. The pathophysiology of OCD is not yet fully understood, however over the last few decades, evidence for abnormalities of cortico-striatal-thalamic-cortico (CSTC) circuitry in etiopathogenesis of OCD has accumulated. Recent brain imaging techniques have been particularly convincing in suggesting that CSTC circuits are responsible for mediation of OCD symptoms. Neuroimaging studies, especially more recent studies using functional neuroimaging methods have looked for possible changes seen in the brain of patients with OCD, the specificity of the findings (as compared to other psychiatric illnesses) and the effects of treatment (pharmacotherapy/psychotherapy) on such changes were observed. This narrative review discusses the neuroimaging findings seen in patients with OCD with a special focus on relatively more recent neuroimaging modalities such as magnetic resonance spectroscopy and magnetoencephalography. PMID:27833219

  9. Learning From Animal Models of Obsessive-Compulsive Disorder.

    PubMed

    Monteiro, Patricia; Feng, Guoping

    2016-01-01

    Obsessive-compulsive disorder (OCD) affects 2%-3% of the population worldwide and can cause significant distress and disability. Substantial challenges remain in the field of OCD research and therapeutics. Approved interventions alleviate symptoms only partially, with 30%-40% of patients being resistant to treatment. Although the etiology of OCD is still unknown, research evidence points toward the involvement of cortico-striato-thalamocortical circuitry. This review focuses on the most recent behavioral, genetics, and neurophysiologic findings from animal models of OCD. Based on evidence from these models and parallels with human studies, we discuss the circuit hyperactivity hypothesis for OCD, a potential circuitry dysfunction of action termination, and the involvement of candidate genes. Adding a more biologically valid framework to OCD will help researchers define and test new hypotheses and facilitate the development of targeted therapies based on disease-specific mechanisms.

  10. [Pathology of the anterior cingulate cortex in obsessive compulsive disorder].

    PubMed

    Kireev, M V; Medvedev, N S; Korotkov, A D; Poliakov, Iu I; Anichkov, A D; Medvedev, S V

    2013-01-01

    In the present article the features of the functional activity of the anterior cingulate cortex (ACC), a key element of neuroanatomical brain system of an error detection, in drug-resistant forms of obsessive-compulsive disorder (OCD) are discussed on a basis of both original and literature data. Available data indicate the presence of functional deficit in the ACC during OCD. This allows to suggest that functions of the ACC in OCD patient are partially redistributed between other brain areas. Thus in contrast to the previously accepted notion, the ACC as the target ofstereotactic surgery for OCD is pathologically altered brain region. Probably this is the reason why stereotactic destruction of ACC does not lead to significant changes in the patient's psyche. The essence of the pathological reorganisation of the functional activity of the brain in OCD remains unclear and requires further investigation.

  11. Presentation and treatment of complicated obsessive-compulsive disorder.

    PubMed

    Brady, Charles F

    2014-03-01

    Some of the most common complicating factors for clinicians treating a person with obsessive-compulsive disorder include suicidal obsessions, dangerous compulsions, overvalued ideation, and low motivation. When a patient reports suicidal thoughts, clinicians must assess whether these thoughts are ego-syntonic or ego-dystonic because patients with ego-dystonic suicidal obsessions have less risk of imminent harm. For individuals whose compulsions are dangerous, clinicians must determine the best type of treatment facility to reduce the risk of harm. Patients with overvalued ideation may require unique interviewing approaches and the support of family members. Finally, clinicians should assess for health problems that can cause low energy and fatigue and consider motivational interviewing and additional therapies for patients who have low motivation to continue treatment.

  12. Platelet alpha2-adrenoreceptors in obsessive-compulsive disorder.

    PubMed

    Marazziti, Donatella; Baroni, Stefano; Masala, Irene; Giannaccini, Gino; Mungai, Francesco; Di Nasso, Elena; Cassano, Giovanni B

    2004-01-01

    The need for new therapeutic targets in obsessive-compulsive disorder (OCD) prompted us to investigate the putative involvement of the norepinephrine system by means of platelet alpha(2)-adrenoreceptors in a group of 20 OCD patients and healthy control subjects, matched for sex and age. Platelet membranes were prepared according to standard protocols, and the alpha(2)-adrenoreceptors were measured by means of the specific binding of [(3)H]rauwolscine, a highly selective antagonist for this receptor subtype. The results, which showed no difference between patients and controls in the binding parameters of [(3)H]rauwolscine, suggest that the role of alpha(2)-adrenoreceptors, as reflected by the platelet model, is quite limited in OCD and may, perhaps, be restricted purely to some symptoms or dimensions such as motricity, as suggested by the higher density of alpha(2)-adrenoreceptors found in patients concomitantly affected by motor tics. Copyright 2004 S. Karger AG, Basel

  13. Treatment compliance and outcome in obsessive-compulsive disorder.

    PubMed

    Abramowitz, Jonathan S; Franklin, Martin E; Zoellner, Lori A; DiBernardo, Corrie L

    2002-09-01

    Exposure and ritual prevention (EX/RP) is an effective treatment for obsessive compulsive-disorder (OCD), although it is neither universally nor completely helpful. Compliance with EX/RP treatment procedures has been linked theoretically to posttreatment outcome, yet empirical exploration of this relationship has been insufficient. In this study, therapists were asked to rate the treatment compliance of 28 consecutive patients who received EX/RP on a fee-for-service basis. Results indicated that understanding the treatment rationale and compliance with in-session and homework exposure instructions, but not with ritual prevention and self-monitoring of rituals, was significantly related to posttreatment OCD symptom severity. Clinical implications of these findings and future directions in treatment compliance research with OCD patients are discussed.

  14. Organizational strategy use in obsessive-compulsive disorder.

    PubMed

    Roth, Robert M; Milovan, Denise L; Baribeau, Jacinthe; O'Connor, Kieron; Todorov, Cristo

    2004-10-30

    Patients with obsessive-compulsive disorder (OCD) have been demonstrated to be less likely to use spontaneously generated organizational strategies during verbal episodic memory and visuoconstruction tasks. However, whether this organizational deficit is generalizable to other areas of cognitive functioning has not been established. In the present study, we assessed whether adults with OCD are less likely to spontaneously generate organizational strategies during performance of an executive function test, the Self-Ordered Pointing Task (SOPT). Participants included 30 adults with OCD and 24 healthy controls. Groups did not differ with respect to the time to complete or number of errors made on the SOPT. Furthermore, group differences were not observed in the ability to generate organizational strategies or in the specific types of strategies employed to complete the SOPT. These findings indicate that a reduced use of organizational strategies in OCD is not present across all cognitive domains.

  15. Cognitive behavioral therapy of obsessive-compulsive disorder

    PubMed Central

    Foa, Edna B.

    2010-01-01

    Until the mid-1960s, obsessive-compulsive disorder (OCD) was considered to be treatment-resistant, as both psychodynamic psychotherapy and medication had been unsuccessful in significantly reducing OCD symptoms. The first real breakthrough came in 1966 with the introduction of exposure and ritual prevention. This paper will discuss the cognitive behavioral conceptualizations that influenced the development of cognitive behavioral treatments for OCD. There will be a brief discussion of the use of psychodynamic psychotherapy and early behavioral therapy, neither of which produced successful outcomes with OCD. The main part of the paper will be devoted to current cognitive behavioral therapy (CBT) with an emphasis on variants of exposure and ritual or response prevention (EX/RP) treatments, the therapy that has shown the most empirical evidence of its efficacy. PMID:20623924

  16. 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.

  17. Contemporary models of pediatric obsessive-compulsive disorder: An evaluation with a large clinical sample.

    PubMed

    De Nadai, Alessandro; Nagpal, Prianka S; Piacentini, John; Peris, Tara S; Geffken, Gary R; Geller, Daniel A; Murphy, Tanya K; Storch, Eric A; Lewin, Adam B

    2015-09-30

    We evaluated the construct validity of the Child Yale-Brofwn Obsessive-Compulsive Scale (CYBOCS) in a large clinical sample (N=730) using confirmatory factor analysis. Results found inadequate fit for a priori models, though a model accounting for overlapping item content displayed good fit. Parallel obsessions/compulsions items may provide largely redundant information on the CYBOCS. Findings suggest modifying the CYBOCS to reduce burden on researchers, patients, and clinicians, and to more accurately measure pediatric obsessive-compulsive disorder (OCD). Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Subthalamic nucleus stimulation in severe obsessive-compulsive disorder.

    PubMed

    Mallet, Luc; Polosan, Mircea; Jaafari, Nematollah; Baup, Nicolas; Welter, Marie-Laure; Fontaine, Denys; du Montcel, Sophie Tezenas; Yelnik, Jérôme; Chéreau, Isabelle; Arbus, Christophe; Raoul, Sylvie; Aouizerate, Bruno; Damier, Philippe; Chabardès, Stephan; Czernecki, Virginie; Ardouin, Claire; Krebs, Marie-Odile; Bardinet, Eric; Chaynes, Patrick; Burbaud, Pierre; Cornu, Philippe; Derost, Philippe; Bougerol, Thierry; Bataille, Benoit; Mattei, Vianney; Dormont, Didier; Devaux, Bertrand; Vérin, Marc; Houeto, Jean-Luc; Pollak, Pierre; Benabid, Alim-Louis; Agid, Yves; Krack, Paul; Millet, Bruno; Pelissolo, Antoine

    2008-11-13

    Severe, refractory obsessive-compulsive disorder (OCD) is a disabling condition. Stimulation of the subthalamic nucleus, a procedure that is already validated for the treatment of movement disorders, has been proposed as a therapeutic option. In this 10-month, crossover, double-blind, multicenter study assessing the efficacy and safety of stimulation of the subthalamic nucleus, we randomly assigned eight patients with highly refractory OCD to undergo active stimulation of the subthalamic nucleus followed by sham stimulation and eight to undergo sham stimulation followed by active stimulation. The primary outcome measure was the severity of OCD, as assessed by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), at the end of two 3-month periods. General psychopathologic findings, functioning, and tolerance were assessed with the use of standardized psychiatric scales, the Global Assessment of Functioning (GAF) scale, and neuropsychological tests. After active stimulation of the subthalamic nucleus, the Y-BOCS score (on a scale from 0 to 40, with lower scores indicating less severe symptoms) was significantly lower than the score after sham stimulation (mean [+/-SD], 19+/-8 vs. 28+/-7; P=0.01), and the GAF score (on a scale from 1 to 90, with higher scores indicating higher levels of functioning) was significantly higher (56+/-14 vs. 43+/-8, P=0.005). The ratings of neuropsychological measures, depression, and anxiety were not modified by stimulation. There were 15 serious adverse events overall, including 1 intracerebral hemorrhage and 2 infections; there were also 23 nonserious adverse events. These preliminary findings suggest that stimulation of the subthalamic nucleus may reduce the symptoms of severe forms of OCD but is associated with a substantial risk of serious adverse events. (ClinicalTrials.gov number, NCT00169377.) 2008 Massachusetts Medical Society

  19. Anterior Cingulate Implant for Obsessive-Compulsive Disorder.

    PubMed

    De Ridder, Dirk; Leong, Sook Ling; Manning, Patrick; Vanneste, Sven; Glue, Paul

    2017-01-01

    Obsessive-compulsive disorder (OCD) is a brain disorder with a lifetime prevalence of 2.3%, causing severe functional impairment as a result of anxiety and distress, persistent and repetitive, unwanted, intrusive thoughts (obsessions), and repetitive ritualized behavior (compulsions). Approximately 40%-60% of patients with OCD fail to satisfactorily respond to standard treatments. Intractable OCD has been treated by anterior capsulotomy and cingulotomy, but more recently, neurostimulation approaches have become more popular because of their reversibility. Implants for OCD are commonly being used, targeting the anterior limb of the internal capsula or the nucleus accumbens, but an implant on the anterior cingulate cortex has never been reported. We describe a patient who was primarily treated for alcohol addiction, first with transcranial magnetic stimulation, then by implantation of 2 electrodes overlying the rostrodorsal part of the anterior cingulate cortex bilaterally. Her alcohol addiction developed as she was relief drinking to self-treat her OCD, anxiety, and depression. After the surgical implant, she underwent placebo stimulation followed by real stimulation of the dorsal anterior cingulate cortex, which dramatically improved her OCD symptoms (decrease of 65.5% on the Yale-Brown Obsessive Compulsive Drinking Scale) as well as her alcohol craving (decrease of 87.5%) after 36 weeks of treatment. Although there were improvements in all the scores, there was only a modest reduction in the patient's weekly alcohol consumption (from 50 units to 32 units). Based on these preliminary positive results we propose to further study the possible beneficial effect of anterior cingulate cortex stimulation for intractable OCD. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Differential-diagnosis of obsessive-compulsive symptoms in the borderline personality disorder.

    PubMed

    Brunnhuber, Stefan

    2003-01-01

    Obsessive-compulsive symptoms are clinically unspecific and can be found in numerous disorders. Within the framework of psychotherapeutically treatable illnesses, the classical obsessive-compulsive neurosis can be distinguished from early anancastia in the case of borderline personality disorder. The text refers to some aspects of the obsessive-compulsive disorder within these earlier disorders. At least five characteristics can be discussed: In the course of this, the varying functions of obsessive-compulsive symptoms for the inner-psychological organization become clear and specifically show that on a low structural level, symptoms do not appear to be primarily pathological but are a part of a "quasi-physiological" and ego-sustaining mechanism. What remains open to discussion in the end is, whether there may be an important substratum for the basis of a historiographical biology as called repeatedly for from psychosomatic theory repeatedly. In addition to this, the awareness of both forms is an important requirement for treatment.

  1. Subclinical autism spectrum symptoms in pediatric obsessive-compulsive disorder.

    PubMed

    Arildskov, Trine Wigh; Højgaard, David R M A; Skarphedinsson, Gudmundur; Thomsen, Per Hove; Ivarsson, Tord; Weidle, Bernhard; Melin, Karin Holmgren; Hybel, Katja A

    2016-07-01

    The literature on subclinical autism spectrum (ASD) symptoms in pediatric obsessive-compulsive disorder (OCD) is scarce, and it remains unclear whether ASD symptoms are related to OCD severity. The aims of the present study were to assess the prevalence of ASD symptoms and age and sex differences in children and adolescents with OCD, and to explore the relation between ASD symptoms and OCD severity. This is the largest study of ASD symptoms in an OCD population to date, and the first directly aimed at elucidating sex and age differences in this matter. The study used baseline data from the Nordic Long-term OCD Treatment Study in which parents of 257 children and adolescents with OCD aged 7-17 completed the Autism Spectrum Screening Questionnaire. OCD severity was assessed with the Children's Yale-Brown Obsessive Compulsive Scale. Pediatric OCD patients were found to exhibit elevated rates of ASD symptoms compared to a norm group of school-age children. ASD symptoms were concentrated in a subgroup with a prevalence of 10-17 %. This subgroup was characterized by a male preponderance with a sex ratio of approximately 2.6:1, while children versus adolescents with OCD exhibited similar rates. Autism-specific social and communication difficulties were not related to OCD severity, while restricted repetitive behavior was positively related to OCD severity. The results indicate that clinicians need to be aware of ASD symptoms in children and adolescents with OCD since one out of ten exhibits such symptoms at a clinical sub-threshold.

  2. Neuropsychological performance across symptom dimensions in pediatric obsessive compulsive disorder.

    PubMed

    McGuire, Joseph F; Crawford, Erika A; Park, Jennifer M; Storch, Eric A; Murphy, Tanya K; Larson, Michael J; Lewin, Adam B

    2014-12-01

    Few studies have examined neuropsychological functioning among youth with obsessive compulsive disorder (OCD), with inconclusive results. Although methodological differences may contribute to inconsistent findings, clinical factors may also account for differential performance. Symptom dimensions are associated with specific patterns of genetic transmission, comorbidity, and treatment outcome, and may also be uniquely associated with neuropsychological performance. This study examined differences in cognitive sequelae and neurocognitive impairment across symptom dimensions among youth with OCD. Participants included 93 treatment-seeking youth diagnosed with OCD. A trained clinician administered the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) to parents and children together. Afterward, youth completed a battery of neuropsychological tests that assessed nonverbal memory and fluency, verbal memory, verbal fluency, verbal learning, processing speed, and inhibition/switching. Across five symptom dimensions, youth exhibiting Hoarding symptoms (χ(2) = 5.21, P = .02) and Symmetry/Ordering symptoms had a greater occurrence of cognitive sequelae (χ(2) = 4.86, P = .03). Additionally, youth with Symmetry/Ordering symptoms had a greater magnitude of cognitive impairment (Mann-Whitney U = 442.50, Z = -2.49, P < .02), with specific deficits identified on nonverbal fluency (P < .01), processing speed (P < .01), and inhibition and switching (P < .02). Neuropsychological deficits identified in youth with Hoarding and Symmetry/Ordering symptoms may suggest that these symptoms have characteristics specific to neurocognitive impairment. Alternatively, symptoms associated with these dimensions may impede youth's performance during testing. Findings advise neuropsychological testing for youth with symptoms on either of these dimensions when concerns about neuropsychological and/or academic impairment are present. © 2014 Wiley Periodicals, Inc.

  3. [Eating disorders (ED) and obsessive-compulsive disorders (OCD): common factors].

    PubMed

    Bertrand, Audrey; Bélanger, Claude; O'Connor, Kieron

    2011-01-01

    Several similarities exist in the phenomenology of obsessive-compulsive disorder (OCD) and eating disorders (ED : anorexia nervosa and bulimia). Both disorders include obsessive thoughts and compulsive or ritualized behaviours. Furthermore, these two disorders frequently present with similar comorbid disorders. In this article, the authors examine similarities between ED and OCD, and whether eating disorders can be conceptualized as a variant of obsessive-compulsive disorders. This raises the possibility that treatments proven effective for OCD could be successfully adapted for ED. The authors consequently further examine both treatments utilized for both disorders.

  4. Family functioning in paediatric obsessive compulsive and related disorders.

    PubMed

    Murphy, Yolanda E; Flessner, Christopher A

    2015-11-01

    Research among youths with obsessive compulsive disorder (OCD) has shown a significant relationship between illness severity, treatment outcome, and the family environment yet little work has been undertaken among the broader class of obsessive compulsive and related disorders (OCRDs) - Trichotillomania, body dysmorphic disorder (BDD), skin picking disorder (SPD), and hoarding. The aim of this study was to (1) review the family functioning literature among paediatric OCRDs, (2) address limitations to previous studies, and (3) highlight areas in need of further research. A review of the literature was conducted using several databases (i.e., Google Scholar, PubMed, ScienceDirect) and employing key search terms (e.g., 'family functioning', 'paediatric OCD'). The resultant articles examined several domains subsumed under the broader heading of family environment including parental mental health, parenting practices, family dynamics, family involvement with symptoms, and family emotional climate. The literature reviewed demonstrated a strong relationship between paediatric OCD and adverse family functioning (e.g., parental symptoms of anxiety and depression, family accommodation, family strain and stress, parental guilt and fear) in all identified domains. While family functioning research in paediatric HPD was relatively scant, research suggested similar familial dysfunction (e.g., limited independence, low family cohesion, family violence). Collectively, only 1 article, examining BDD, assessed family functioning within other OCRDs. This review supports the need for further research in the OCRDs. Limitations to the available literature and targeted suggestions for future research are discussed. The domains of family environment in this study indicate specific family functioning deficits that may serve as aetiological and/or maintenance factors in paediatric OCRDs, possibly contributing to the understanding of these complex disorders. The recognition of family deficits

  5. Pharmacologic treatment of obsessive-compulsive disorder comorbidity.

    PubMed

    Pallanti, Stefano; Grassi, Giacomo

    2014-12-01

    Obsessive-compulsive disorder (OCD) is clearly a heterogeneous syndrome in which comorbidity is the rule rather than the exception and is often 'phase-specific'. Comorbid conditions have a negative impact on OCD outcome and may clearly impact the disease trajectory. Nevertheless, in the current literature there is an impressive neglect of comorbidities in clinical trials and treatment approaches for these conditions are still not evidence-based. In this paper we summarized the available data on the treatment of the main OCD comorbidities (mood and anxiety disorders, 'bipolar neurosis', tics and OCD-related disorders, addictions and impulsive disorders, eating disorders, attention deficit hyperactivity disorder, psychoses, and post-infective syndromes). To achieve the goals of 'precision medicine' there is a critical need for deconstructing current diagnostic groups with biomarkers to predict and improve response to treatment. Despite the continuous efforts of several researchers in subtyping homogeneous samples of OCD patients (for example the comorbidity-based subclassification), current available treatments are still syndrome-based rather than network dysfunctions-based. Identifying the homogenous subgroup, subtyping patients according to comorbidity patterns, symptom dimensions, clinical course, neurocognitive and neurophysiological dysfunctions, could represent an essential first step in the direction of a 'precision medicine' approach.

  6. 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.

  7. 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

  8. Familial clustering of tic disorders and obsessive-compulsive disorder.

    PubMed

    Browne, Heidi A; Hansen, Stefan N; Buxbaum, Joseph D; Gair, Shannon L; Nissen, Judith B; Nikolajsen, Kathrine H; Schendel, Diana E; Reichenberg, Abraham; Parner, Erik T; Grice, Dorothy E

    2015-04-01

    Tourette syndrome/chronic tic disorder (TS/CT) and obsessive-compulsive disorder (OCD) overlap in their phenomenological features and often co-occur in affected individuals and families. Understanding how these disorders cluster in families provides important clinical information and is an important step in understanding the causes of these disorders. To determine familial recurrence for TS/CT and OCD using a national epidemiologic sample. We performed a population-based study of national health registries in Denmark, including all individuals (n = 1 741 271) born in Denmark from January 1, 1980, through December 31, 2007, and followed up through December 31, 2013. We identified those with TS/CT and/or OCD. The prevalence of TS/CT and OCD and relative recurrence risk (RRR) for TS/CT or OCD among individuals with an oldest sibling or a parent diagnosed as having TS/CT or OCD compared with individuals without an affected oldest sibling or an affected parent. In this sample, 5596 individuals were diagnosed as having TS/CT; 6191, OCD; and 412, both disorders. The overall cohort prevalence of TS/CT was 0.42% (95% CI, 0.41%-0.43%) and of OCD, 0.84% (95% CI, 0.81%-0.87%). The mean sibling recurrence risk for TS/CT across all birth years was 9.88% (95% CI, 8.02%-12.16%) and for OCD, 4.01% (95% CI, 2.78%-5.76%). The sibling RRR for TS/CT was 18.63 (95% CI, 15.34-22.63). In contrast, the sibling RRR for OCD was 4.89 (95% CI, 3.45-6.93). The parent-offspring RRR for TS/CT was 61.02 (95% CI, 44.43-83.82), whereas the parent-offspring RRR for OCD was 6.25 (95% CI, 4.82-8.11). The sibling and parent-offspring cross-disorder risks were also significant, ranging from 3.20 (95% CI, 2.22-4.62) to 10.27 (95% CI, 5.17-20.39). Tourette syndrome/CT and OCD cluster in families. The familial aggregation of TS/CT is profound and substantially higher than the familial aggregation for OCD. The recurrence risk estimates provide an important clinical framework for identifying

  9. [Adolescent onset obsessive compulsive disorder presented as dissociative disorders: role of drug assisted interview].

    PubMed

    Narayana, Narayana Manjunatha; John, John P; Math, Suresh Bada; Sundar, Sundar G S Keerthi; Mehta, Urvakhsk Meherwan; Phutane, Vivek H

    2010-01-01

    Paediatric Obsessive Compulsive Disorder (OCD) is still under-diagnosed, despite significant advances made in identifying obsessive-compulsive symptoms. The authors report a case of adolescent-onset OCD presenting as a mixed dissociative disorder. The drug assisted interview provided a breakthrough in revising the correct diagnosis of the clinical condition. The psychopathology of the patient contains sexual and aggressive obsessions without any compulsions. Adolescent OCD can present as dissociative disorders and a thiopentone interview can be helpful in revealing the distress associated with OCD.

  10. The public's knowledge and beliefs about obsessive compulsive disorder.

    PubMed

    Coles, Meredith E; Heimberg, Richard G; Weiss, Barry D

    2013-08-01

    Obsessive compulsive disorder (OCD) is a disabling condition associated with significant personal and societal burdens. Despite the availability of efficacious treatments, in most cases, the disorder remains unrecognized and untreated. Lack of knowledge (i.e. poor mental health literacy, MHL) regarding OCD may be an impediment to seeking treatment. Therefore, the current study assessed public knowledge and beliefs about OCD and examined factors influencing MHL. Five hundred seventy-seven US adults participated in a telephone survey. After hearing a vignette describing someone with OCD, participants' MHL for OCD was assessed across three domains as follows: recognition of OCD, knowledge and beliefs about available help, and concerns about being negatively evaluated for reporting symptoms. The majority of participants (90.9%) reported that the symptoms were a cause for concern and that the person in the vignette should seek professional help (89.5%). However, only one-third of respondents correctly labeled the disorder as OCD. More respondents were optimistic about the likely success of psychotherapy than medication, but primary care physicians were the most frequently reported source of professional help. Finally, less education, lower income, and being in an older cohort were associated with poorer recognition of OCD. When presented with brief vignettes describing a person with OCD, most community members can recognize the benefits of seeking professional help. However, recognition of the disorder and knowledge of treatment options can be improved. © 2013 Wiley Periodicals, Inc.

  11. GLUTAMATE ABNORMALITIES IN OBSESSIVE COMPULSIVE DISORDER: NEUROBIOLOGY, PATHOPHYSIOLOGY, AND TREATMENT

    PubMed Central

    Pittenger, Christopher; Bloch, Michael H.; Williams, Kyle

    2011-01-01

    Obsessive compulsive disorder is prevalent, disabling, incompletely understood, and often resistant to current therapies. Established treatments consist of specialized cognitive-behavioral psychotherapy and pharmacotherapy with medications targeting serotonergic and dopaminergic neurotransmission. However, remission is rare, and more than a quarter of OCD sufferers receive little or no benefit from these approaches, even when they are optimally delivered. New insights into the disorder, and new treatment strategies, are urgently needed. Recent evidence suggests that the ubiquitous excitatory neurotransmitter glutamate is dysregulated in OCD, and that this dysregulation may contribute to the pathophysiology of the disorder. Here we review the current state of this evidence, including neuroimaging studies, genetics, neurochemical investigations, and insights from animal models. Finally, we review recent findings from small clinical trials of glutamate-modulating medications in treatment-refractory OCD. The precise role of glutamate dysregulation in OCD remains unclear, and we lack blinded, well-controlled studies demonstrating therapeutic benefit from glutamate-modulating agents. Nevertheless, the evidence supporting some important perturbation of glutamate in the disorder is increasingly strong. This new perspective on the pathophysiology of OCD, which complements the older focus on monoaminergic neurotransmission, constitutes an important focus of current research and a promising area for the ongoing development of new therapeutics. PMID:21963369

  12. Hoarding in Children and Adolescents with Obsessive-Compulsive Disorder

    PubMed Central

    Samuels, Jack; Grados, Marco A.; Riddle, Mark A.; Bienvenu, O. Joseph; Goes, Fernando S.; Cullen, Bernadette; Wang, Ying; Greenberg, Benjamin D.; Fyer, Abby J.; McCracken, James T.; Geller, Dan; Murphy, Dennis L.; Knowles, James A.; Rasmussen, Steven A.; McLaughlin, Nicole C.; Piacentini, John; Pauls, David L.; Stewart, S. Evelyn; Shugart, Yin-Yao; Maher, Brion; Pulver, Ann E.; Nestadt, Gerald

    2014-01-01

    Compared to studies in adults, there have been few studies of hoarding in children and adolescents with obsessive-compulsive disorder (OCD). In the current study, we evaluated OCD clinical features, Axis I disorders, and social reciprocity scores in 641 children and adolescents with OCD, of whom 163 (25%) had hoarding compulsions and 478 did not. We found that, as a group, youth with hoarding had an earlier age at onset and more severe lifetime OCD symptoms, poorer insight, more difficulty making decisions and completing tasks, and more overall impairment. The hoarding group also had a greater lifetime prevalence of panic disorder, specific phobia, Tourette disorder, and tics. As measured with the Social Reciprocity Scale, the hoarding group had more severe deficits in parent-rated domains of social communication, social motivation, and restricted interests and repetitive behavior. In a multivariable model, the overall social reciprocity score, age at onset of OCD symptoms, symmetry obsessions, and indecision were independently related to hoarding in these children and adolescents with OCD. These features should be considered as candidate risk factors for the development of hoarding behavior in pediatric OCD. PMID:25309849

  13. Hoarding in Children and Adolescents with Obsessive-Compulsive Disorder.

    PubMed

    Samuels, Jack; Grados, Marco A; Riddle, Mark A; Bienvenu, O Joseph; Goes, Fernando S; Cullen, Bernadette; Wang, Ying; Greenberg, Benjamin D; Fyer, Abby J; McCracken, James T; Geller, Dan; Murphy, Dennis L; Knowles, James A; Rasmussen, Steven A; McLaughlin, Nicole C; Piacentini, John; Pauls, David L; Stewart, S Evelyn; Shugart, Yin-Yao; Maher, Brion; Pulver, Ann E; Nestadt, Gerald

    2014-10-01

    Compared to studies in adults, there have been few studies of hoarding in children and adolescents with obsessive-compulsive disorder (OCD). In the current study, we evaluated OCD clinical features, Axis I disorders, and social reciprocity scores in 641 children and adolescents with OCD, of whom 163 (25%) had hoarding compulsions and 478 did not. We found that, as a group, youth with hoarding had an earlier age at onset and more severe lifetime OCD symptoms, poorer insight, more difficulty making decisions and completing tasks, and more overall impairment. The hoarding group also had a greater lifetime prevalence of panic disorder, specific phobia, Tourette disorder, and tics. As measured with the Social Reciprocity Scale, the hoarding group had more severe deficits in parent-rated domains of social communication, social motivation, and restricted interests and repetitive behavior. In a multivariable model, the overall social reciprocity score, age at onset of OCD symptoms, symmetry obsessions, and indecision were independently related to hoarding in these children and adolescents with OCD. These features should be considered as candidate risk factors for the development of hoarding behavior in pediatric OCD.

  14. Study of obsessive compulsive beliefs: relationship with eating disorders.

    PubMed

    Roncero, María; Perpiñá, Conxa; García-Soriano, Gemma

    2011-07-01

    The relationship between Eating Disorders (ED) and Obsessive Compulsive Disorder (OCD) has been extensively studied in the last few years. However, little effort has been devoted to studying the link between these disorders with regard to their distorted beliefs. The first objective of the study was to analyze the differences in OCD-related beliefs among ED subtypes and the general population, controlling for age, Body Mass Index, and obsessionality. The second objective was to explore which OCD beliefs explain ED symptomatology. Seventy-nine ED patients without OCD comorbidity, divided into diagnostic subtypes, and 50 community participants completed the Obsessive Beliefs Spanish Inventory-Revised and measures of ED and OCD symptomatology. There were no differences found among clinical ED subtypes in obsessive beliefs, but the bulimia nervosa purgative subtype and binge eating groups obtained significantly different scores from the community group on Thought-Action-Fusion (TAF)-likelihood and TAF-moral, respectively. OCD symptomatology had the most important predictive effect on ED symptoms, followed by Overestimation of Threat, BMI and FPA-moral. The different patterns of beliefs among subtypes reflect what other studies have suggested about the relevance of the presentation of ED symptoms associated with restriction, purges and binge without purges. Our results agree with the transdiagnostic perspective of ED.

  15. [Hoarding as a Disorder of the Obsessive-Compulsive Spectrum].

    PubMed

    Schön, Daniela; Wahl-Kordon, Andreas; Zurowski, Bartosz

    2015-06-01

    Hoarding often occurs without obsessive-compulsive disorder (OCD), it shows distinguishable neuropsychological and neurobiological correlates and a distinct comorbidity spectrum. Further, it occurs secondarily to other psychiatric and neurobiological disorders. Therefore hoarding disorder has been included as a distinct diagnosis in DSM-5.Neuroimaging studies point to functional and structural abnormalities of networks subserving decision making, attention, action planning and emotional regulation.The cognitive-behavioral model outlines the most important characteristics of pathological hoarding, comprising deficits of information processing, maladaptive beliefs about information processing deficits, maladaptive beliefs about posessions as well as emotional attachment to them accompanied with emotional distress and avoidance.Because of a low willingness for therapy plus a high rate of discontinuation of therapy, a manualized cognitive-behavioral therapy approach for pathological hoarding has been established. It builds on observational learning, cognitive strategies, graduated exposure, response prevention, training/coaching to sort out, and relapse prevention are key components of the treatment. Particularily in case of lacking motivation for any kind of behavioral therapy or other psychological treatments, a pharmacotherapy with SSRIs is recommended.

  16. Neurological soft signs in obsessive-compulsive disorder.

    PubMed

    Guz, H; Aygun, D

    2004-03-01

    Neurological soft signs (NSSs) are defined as abnormal motor or sensory findings, including involuntary movements, a variety of dispraxia, difficulties in performing rapid alternating movements, difficulties in two-point discrimination, and graphesthesia in a person without a neurological disorder which can be determined as its focus. to investigate the relationship of NSSs with obsessive-compulsive disorder (OCD). This study was designed in the Psychiatry Polyclinic of Ondokuz Mayis University Hospital. After signing an informed consent form, all the subjects were divided into 2 groups: (1) the patient group and (2) the control group. Thirty consecutive patients presenting with DSM-IV OCD were included in this study. The control group consisted of 30 healthy subjects without a psychiatric/neurological disorder. All subjects underwent a physical and neurological examination for soft signs (PANESS). The Mann-Whitney U test was used for statistical analysis of data. It was seen that graphesthesia, two-point discrimination, and total PANESS scores were significantly higher in the group with OCD than the control group. In other NSSs, there was no significant difference between the patient and control groups. Unlike some studies, in the present study, the difference between the groups in graphesthesia compared to other NSSs was significant. The results of this preliminary study suggest that there is a relationship between NSSs and OCD. We think that NSSs may point to a structural brain abnormality in patients with OCD.

  17. Shame in the obsessive compulsive related disorders: A conceptual review

    PubMed Central

    Weingarden, Hilary; Renshaw, Keith D.

    2014-01-01

    Background Theoretical and anecdotal support for the role of shame in obsessive compulsive related disorders (OCRDs) is prominent. Developing our understanding of shame’s role in OCRDs is important to building knowledge about this new diagnostic category. This review aims to consolidate our understanding of shame in each OCRD, through summarizing existing clinical, conceptual, and empirical work. Methods We provide an overview of shame, its measurement considerations, and a full review of 110 articles addressing shame in OCRDs. Results General shame and shame about having a mental illness are the broadest types of shame relevant to OCRDs; symptom-based shame and body shame may be more specific to OCRDs. In OCD, violent, sexual, or blasphemous obsessions may trigger symptom-based shame. In trichotillomania (TTM) and skin picking (SP), symptom-based shame may be related to pulling, picking, and post-pulling/picking behaviors. In hoarding disorder, symptom-based shame may accompany beliefs about being defective due to living with clutter. Body shame appears inherent to body dysmorphic disorder, while in TTM and SP it may arise as a secondary response to damage resulting from body focused repetitive behaviors. Limitations Much of the current knowledge on shame in OCRDs comes from anecdotal, case, and conceptual work. Empirical studies do not always assess specific types of shame, instead assessing shame as a general construct. Conclusions Shame is closely related to OCRDs. Clinical and research recommendations drawing from the literature are provided. PMID:25299438

  18. Obsessive beliefs and neurocognitive flexibility in obsessive-compulsive disorder.

    PubMed

    Bradbury, Cheryl; Cassin, Stephanie E; Rector, Neil A

    2011-05-15

    A substantial proportion of individuals with obsessive-compulsive disorder (OCD) do not endorse the dysfunctional beliefs proposed by cognitive models of OCD to be important in the onset and maintenance of symptoms. Previous research has attempted to characterize Low and High obsessive beliefs groups in terms of cognitive and symptom correlates to distil potential etiological differences in these subgroups of OCD patients. The current study sought to further examine potential neurocognitive differences between obsessive beliefs subgroups. Performance on the Wisconsin Card Sorting Test (WCST) was compared between a Low Beliefs OCD subgroup, a High Beliefs OCD subgroup, and two anxious control groups: Panic Disorder with Agoraphobia (PDA) and Social Phobia (SP). The High Beliefs OCD subgroup performed significantly poorer on WCST subscales compared to the other diagnostic groups. These findings were not accounted for by severity of OCD or depressive symptoms. The Low Beliefs OCD subgroup performed similar to the anxiety disorder control groups. The results suggest a potential interplay between heightened obsessive beliefs and neurocognitive inflexibility. Copyright © 2010 Elsevier Ltd. All rights reserved.

  19. Predictors of Parental Accommodation in Pediatric Obsessive-Compulsive Disorder: Findings from the Pediatric Obsessive-Compulsive Disorder Treatment Study (POTS) Trial

    ERIC Educational Resources Information Center

    Flessner, Christopher A.; Freeman, Jennifer B.; Sapyta, Jeffrey; Garcia, Abbe; Franklin, Martin E.; March, John S.; Foa, Edna

    2011-01-01

    Objective: Few studies have examined predictors of parental accommodation (assessed with the Family Accommodation Scale-Parent Report) among families of children with obsessive-compulsive disorder (OCD). No studies have examined this phenomenon using empirically derived subscales of the Family Accommodation Scale-Parent Report (i.e., Caregiver…

  20. Predictors of Parental Accommodation in Pediatric Obsessive-Compulsive Disorder: Findings from the Pediatric Obsessive-Compulsive Disorder Treatment Study (POTS) Trial

    ERIC Educational Resources Information Center

    Flessner, Christopher A.; Freeman, Jennifer B.; Sapyta, Jeffrey; Garcia, Abbe; Franklin, Martin E.; March, John S.; Foa, Edna

    2011-01-01

    Objective: Few studies have examined predictors of parental accommodation (assessed with the Family Accommodation Scale-Parent Report) among families of children with obsessive-compulsive disorder (OCD). No studies have examined this phenomenon using empirically derived subscales of the Family Accommodation Scale-Parent Report (i.e., Caregiver…

  1. 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.

  2. Neurosteroid Levels in Patients with Obsessive-Compulsive Disorder

    PubMed Central

    Kartalci, Sukru

    2015-01-01

    Objective Changes in serum neurosteroid levels have been reported in stress-related disorders such as anxiety and depression, but not in patients with obsessive-compulsive disorder (OCD). We thus investigated such changes in patients with OCD. Methods We compared the serum levels of progesterone, pregnanolone, dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEA-S), cortisol and testosterone in 30 patients with OCD and 30 healthy controls. Results When male and female patients were evaluated together, DHEA and cortisol levels were significantly higher in patients with OCD than the control group. When the genders were evaluated separately, DHEA and cortisol levels were higher in female patients than the female controls. The increase in DHEA levels in female patients is likely an effect of the hypothalamic-pituitary-adrenal (HPA) axis. In contrast, cortisol levels in male patients were higher than the control group, while testosterone levels were lower. The increased cortisol and decreased testosterone levels in male patients likely involves the hypothalamic-pituitary-gonadal (HPG) axis. Conclusion These findings suggest that neurosteroid levels in patients with OCD should be investigated together with the HPA and HPG axes in future studies. PMID:26508966

  3. Patient-reported outcomes in obsessive-compulsive disorder

    PubMed Central

    Subramaniam, Mythily; Soh, Pauline; Ong, Clarissa; Esmond Seow, Lee Seng; Picco, Louisa; Vaingankar, Janhavi Ajit; Chong, Siow Ann

    2014-01-01

    The purpose of the article was to provide an overview of patient-reported outcomes (PROs) and related measures that have been examined in the context of obsessive-compulsive disorder (OCD). The current review focused on patient-reported outcome measures (PROMs) that evaluated three broad outcome domains: functioning, health-related quality of life (HRQoL), and OCD-related symptoms. The present review ultimately included a total of 155 unique articles and 22 PROMs. An examination of the PROs revealed that OCD patients tend to suffer from significant functional disability, and report lower HRQoL than controls. OCD patients report greater symptom severity than patients with other mental disorders and evidence indicates that PROMs are sensitive to change and may be even better than clinician-rated measures at predicting treatment outcomes. Nonetheless, it should be noted that the measures reviewed lacked patient input in their development. Future research on PROMs must involve patient perspectives and include rigorous psychometric evaluation of these measures. PMID:25152661

  4. Overview of genetics and obsessive-compulsive disorder.

    PubMed

    Nicolini, Humberto; Arnold, Paul; Nestadt, Gerald; Lanzagorta, Nuria; Kennedy, James L

    2009-11-30

    This paper reviews the current state of research into the genetics of obsessive-compulsive disorder (OCD). Heredity has a major role in OCD etiology. This evidence comes from several methodological approaches such as family, twin, and segregation analysis studies. A major single gene effect as well as a polygenic hypothesis has been suggested based on segregation studies. In addition, candidate gene association and linkage analyses have shown not only one gene, but a few interesting genes and areas of the genome that may be relevant in OCD. In this search for genes, new definitions of the OCD phenotype have emerged, and some of them may be considered intermediate phenotypes between the gene effect and OCD-DSM-IV diagnosis. The phenotypic and genetic heterogeneity of OCD magnifies the challenge of locating susceptibility genes; at the same time, the identification of vulnerability genes will elucidate the identification of subtypes or dimensions of the disorder. Therefore research strategies that take advantage of clinical subtyping and that redefine the OCD phenotype in the context of genetic studies may potentially contribute to the nosology of OCD and ultimately pathophysiology. There is a lack of understanding about how genes and environment interact in OCD. However, there are some reports that will be discussed, which have attempted to evaluate how the environment contributes to OCD.

  5. Current animal models of obsessive compulsive disorder: an update.

    PubMed

    Albelda, N; Joel, D

    2012-06-01

    During the last 30 years there have been many attempts to develop animal models of obsessive compulsive disorder (OCD), in the hope that they may provide a route for furthering our understanding and treatment of this disorder. The present review provides the reader with an overview of the currently active animal models of OCD, their strengths and limitations, so that the reader can use the review as a guide for establishing new animal models of OCD, evaluating existing animal models and choosing among them according to one's needs. We review current genetic, pharmacological, neurodevelopmental and behavioral animal models of OCD, and evaluate their face validity (derived from phenomenological similarity between the behavior in the animal model and the specific symptoms of the human condition), predictive validity (derived from similarity in response to treatment) and construct validity (derived from similarity in the underlying mechanisms [physiological or psychological]). On the basis of this evaluation we discuss the usefulness of the different models for screening drugs for anti-compulsive activity, detecting new targets for high frequency stimulation, studying the neural mechanisms of OCD and unraveling the role of gonadal hormones. We then describe potential new treatment strategies that emerge from the convergence of data obtained in different models on the one hand, and how different models can be used to model different subtypes or dimensions of OCD, on the other hand.

  6. Obsessive-compulsive disorder: a "sensory-motor" problem?

    PubMed

    Russo, M; Naro, A; Mastroeni, C; Morgante, F; Terranova, C; Muscatello, M R; Zoccali, R; Calabrò, R S; Quartarone, A

    2014-05-01

    Obsessive-compulsive disorder (OCD) is a clinically heterogeneous condition. Although its pathophysiology is not completely understood, neurophysiologic and neuroimaging data have disclosed functional abnormalities in the networks linking frontal cortex, supplementary motor and premotor areas, striatum, globus pallidus, and thalamus (CSPT circuits). By means of transcranial magnetic stimulation (TMS) it is possible to test inhibitory and excitatory circuits within motor cortex. Previous studies on OCD patients under medication have demonstrated altered cortical inhibitory circuits as tested by TMS. On the other hand there is growing evidence suggesting an alteration of sensory-motor integration. Therefore, the aim of the present study was to evaluate sensory-motor integration (SAI and LAI), intracortical inhibition, and facilitation in drug-naïve OCD patients, using TMS. In our sample, we have demonstrated a significant SAI reduction in OCD patients when compared to a cohort of healthy individuals. SAI abnormalities may be related to a dysfunction of CSPT circuits which are involved in sensory-motor integration processes. Thus, it can be speculated that hypofunctioning of such system might impair the ability of OCD patients to suppress internally triggered intrusive and repetitive movements and thoughts. In conclusion, our data suggest that OCD may be considered as a sensory motor disorder where a dysfunction of sensory-motor integration may play an important role in the release of motor compulsions.

  7. Anhedonia in obsessive-compulsive disorder: beyond comorbid depression.

    PubMed

    Abramovitch, Amitai; Pizzagalli, Diego A; Reuman, Lillian; Wilhelm, Sabine

    2014-05-15

    Obsessive-compulsive disorder (OCD) has been linked to reward dysfunctions, highlighting a possible role of anhedonia in OCD. Surprisingly, anhedonia in OCD has never been evaluated. Moreover, although nicotine typically has anti-anhedonic effects, anecdotal reports suggest low prevalence rates of smoking in OCD. To address these two phenomena, 113 individuals with OCD completed a battery of questionnaires assessing symptom severity, anhedonia, and smoking. 28.3% of the sample met criteria for clinically significant anhedonia, which correlated with Y-BOCS scores (r=0.44), even when controlling for depressive symptoms. 13.3% of the sample endorsed current smoking, a lower rate than seen in psychiatric disorders (40-90%) and the general adult population (19%). Results highlight high rates of anhedonia and yet reduced prevalence of smoking in OCD. In contrast to the known positive association between anhedonia and smoking, a negative association emerged. Future research is needed to address the unique interface between anhedonia and reward responsiveness in OCD. Potential clinical implications are discussed.

  8. Patient-reported outcomes in obsessive-compulsive disorder.

    PubMed

    Subramaniam, Mythily; Soh, Pauline; Ong, Clarissa; Esmond Seow, Lee Seng; Picco, Louisa; Vaingankar, Janhavi Ajit; Chong, Siow Ann

    2014-06-01

    The purpose of the article was to provide an overview of patient-reported outcomes (PROs) and related measures that have been examined in the context of obsessive-compulsive disorder (OCD). The current review focused on patient-reported outcome measures (PROMs) that evaluated three broad outcome domains: functioning, health-related quality of life (HRQoL), and OCD-related symptoms. The present review ultimately included a total of 155 unique articles and 22 PROMs. An examination of the PROs revealed that OCD patients tend to suffer from significant functional disability, and report lower HRQoL than controls. OCD patients report greater symptom severity than patients with other mental disorders and evidence indicates that PROMs are sensitive to change and may be even better than clinician-rated measures at predicting treatment outcomes. Nonetheless, it should be noted that the measures reviewed lacked patient input in their development. Future research on PROMs must involve patient perspectives and include rigorous psychometric evaluation of these measures.

  9. A Comparison of Obsessive-Compulsive Personality Disorder Scales

    PubMed Central

    Samuel, Douglas B.; Widiger, Thomas A.

    2010-01-01

    The current study utilized a large undergraduate sample (n = 536), oversampled for DSM-IV-TR obsessive-compulsive personality disorder (OCPD) pathology, to compare eight self-report measures of OCPD. No prior study has compared more than three measures and the results indicated that the scales had only moderate convergent validity. We also went beyond the existing literature to compare these scales to two external reference points: Their relationships with a well established measure of the five-factor model of personality (FFM) and clinicians' ratings of their coverage of the DSM-IV-TR criterion set. When the FFM was used as a point of comparison the results suggested important differences among the measures with respect to their divergent representation of conscientiousness, neuroticism, and agreeableness. Additionally, an analysis of the construct coverage indicated that the measures also varied in terms of their representation of particular diagnostic criteria. For example, while some scales contained items distributed across the diagnostic criteria, others were concentrated more heavily on particular features of the DSM-IV-TR disorder. PMID:20408023

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

    PubMed

    Bipeta, Rajshekhar; 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

  11. 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

  12. Clinical correlates of obsessive-compulsive symptom dimensions in at-risk mental states and psychotic disorders at early stages.

    PubMed

    Mariné, Rosa; Creus, Marta; Solé, Montse; Cabezas, Ángel; Algora, Maria José; Moreno, Irene; Izquierdo, Eduard; Stojanovic-Pérez, Alexander; Labad, Javier

    2015-08-30

    We studied the clinical correlates of obsessive-compulsive symptom dimensions in 109 individuals with early psychosis (31 At-Risk Mental States [ARMS], 78 psychotic disorders with <3 years of illness) and 59 healthy subjects. Obsessive-compulsive symptoms were assessed by the Obsessive-Compulsive Inventory - Revised. We also assessed the severity of psychotic symptoms, depressive symptoms and functioning. ARMS and psychotic disorder patients reported more obsessive-compulsive symptoms than did healthy subjects. The ARMS individuals also reported more overall and checking obsessive-compulsive symptoms compared with the PD patients. Different types of obsessive-compulsive symptoms were related with depressive symptoms in both diagnostic groups. However, a different pattern was observed in the relationship between obsessive-compulsive dimensions and functioning by diagnosis (better functioning in ARMS; poorer functioning in psychotic disorders). Our study suggests that obsessive-compulsive symptoms are present in the early stages of psychotic illness, as well as in individuals at risk for psychosis. Future prospective studies are needed to elucidate how obsessive-compulsive symptoms in ARMS may influence the prognosis in terms of global functioning and the risk of psychosis transition.

  13. Patterns of Default Mode Network Deactivation in Obsessive Compulsive Disorder

    PubMed Central

    Gonçalves, Óscar F.; Soares, José Miguel; Carvalho, Sandra; Leite, Jorge; Ganho-Ávila, Ana; Fernandes-Gonçalves, Ana; Pocinho, Fernando; Carracedo, Angel; Sampaio, Adriana

    2017-01-01

    The objective of the present study was to research the patterns of Default Mode Network (DMN) deactivation in Obsessive Compulsive Disorder (OCD) in the transition between a resting and a non-rest emotional condition. Twenty-seven participants, 15 diagnosed with OCD and 12 healthy controls (HC), underwent a functional neuroimaging paradigm in which DMN brain activation in a resting condition was contrasted with activity during a non-rest condition consisting in the presentation of emotionally pleasant and unpleasant images. Results showed that HC, when compared with OCD, had a significant deactivation in two anterior nodes of the DMN (medial frontal and superior frontal) in the non-rest pleasant stimuli condition. Additional analysis for the whole brain, contrasting the resting condition with all the non-rest conditions grouped together, showed that, compared with OCD, HC had a significantly deactivation of a widespread brain network (superior frontal, insula, middle and superior temporal, putamen, lingual, cuneus, and cerebellum). Concluding, the present study found that OCD patients had difficulties with the deactivation of DMN even when the non-rest condition includes the presentation of emotional provoking stimuli, particularly evident for images with pleasant content. PMID:28287615

  14. Growth hormone response to apomorphine in obsessive-compulsive disorder.

    PubMed Central

    Pitchot, W; Hansenne, M; Moreno, A G; Ansseau, M

    1996-01-01

    Several lines of evidence suggest that dopamine plays a role in the pathophysiology of obsessive-compulsive disorder (OCD). Indeed, some trials have shown the efficacy of neuroleptic addition in the treatment of OCD patients. In this study, we assessed the growth hormone (GH) response to 0.5 mg apomorphine(sc) in 8 drug-free inpatients (6 male, 2 female; mean age +/- SD = 34.7 +/- 12.6) meeting DSM-III-R criteria for OCD without major depression and compared their responses with those of 8 healthy male volunteers (mean age = 27.1 +/- 8.5). The groups did not differ in their mean GH peak response: 12.4 +/- 9.7 ng/mL in OCD patients versus 21.1 +/- 14.2 ng/mL in normal controls (F = 0.9, df1, 14, P = 0.37). These results do not support the hypothesis of dopaminergic overactivity in OCD. In fact, the completely blunted GH response to apomorphine in 2 OCD patients suggests the biological heterogeneity of OCD. Some dopaminergic disturbances could be observed in patients with comorbid diagnoses or patients unresponsive to serotonin reuptake inhibitors, but the results of this study require confirmation from a larger sample with a precise assessment of comorbidity. PMID:8973055

  15. Inverse reasoning processes in obsessive-compulsive disorder.

    PubMed

    Wong, Shiu F; Grisham, Jessica R

    2017-04-01

    The inference-based approach (IBA) is one cognitive model that aims to explain the aetiology and maintenance of obsessive-compulsive disorder (OCD). The model proposes that certain reasoning processes lead an individual with OCD to confuse an imagined possibility with an actual probability, a state termed inferential confusion. One such reasoning process is inverse reasoning, in which hypothetical causes form the basis of conclusions about reality. Although previous research has found associations between a self-report measure of inferential confusion and OCD symptoms, evidence of a specific association between inverse reasoning and OCD symptoms is lacking. In the present study, we developed a task-based measure of inverse reasoning in order to investigate whether performance on this task is associated with OCD symptoms in an online sample. The results provide some evidence for the IBA assertion: greater endorsement of inverse reasoning was significantly associated with OCD symptoms, even when controlling for general distress and OCD-related beliefs. Future research is needed to replicate this result in a clinical sample and to investigate a potential causal role for inverse reasoning in OCD. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Approach and avoidance learning in obsessive-compulsive disorder.

    PubMed

    Endrass, Tanja; Kloft, Lisa; Kaufmann, Christian; Kathmann, Norbert

    2011-02-01

    Current neurobiological models of obsessive-compulsive disorder (OCD) propose a dysfunction of cortico-striato-thalamo-cortical circuits that leads to enhanced activity in frontal and striatal brain regions. In accordance with that, OCD patients show alterations in learning and flexible adaptation to changing task requirements. The purpose of this study was to examine feedback-based learning and to investigate whether learning from positive and negative feedback is differentially altered in OCD. In this study, 18 OCD patients and 18 healthy comparison subjects conducted a probabilistic selection task. The task consisted of an acquisition and a test phase and allowed disentangling the extent of learning based on positive and negative feedback. Groups did not differ during probabilistic feedback learning in the acquisition phase. In the test phase, OCD patients showed a negative learning bias in contrast to comparison subjects who showed a positive learning bias. Patients were better at avoiding stimuli that were initially associated with negative outcomes than at approaching stimuli that were associated with positive feedbacks. This interaction was also found for reaction times in that patients were faster in avoiding negative and slower in approaching positive stimuli. Enhanced avoidance learning was found in OCD patients that points to exaggerated anticipation and avoidance of aversive outcomes. Further studies are required to investigate whether neurobiological mechanisms, such as dopaminergic signaling or outcome processing, in the orbitofrontal cortex relate to enhanced negative learning in OCD. © 2010 Wiley-Liss, Inc.

  17. Arbitration between Action Strategies in Obsessive-Compulsive Disorder.

    PubMed

    Gruner, Patricia; Anticevic, Alan; Lee, Daeyeol; Pittenger, Christopher

    2016-04-01

    Decision making in a complex world, characterized both by predictable regularities and by frequent departures from the norm, requires dynamic switching between rapid habit-like, automatic processes and slower, more flexible evaluative processes. These strategies, formalized as "model-free" and "model-based" reinforcement learning algorithms, respectively, can lead to divergent behavioral outcomes, requiring a mechanism to arbitrate between them in a context-appropriate manner. Recent data suggest that individuals with obsessive-compulsive disorder (OCD) rely excessively on inflexible habit-like decision making during reinforcement-driven learning. We propose that inflexible reliance on habit in OCD may reflect a functional weakness in the mechanism for context-appropriate dynamic arbitration between model-free and model-based decision making. Support for this hypothesis derives from emerging functional imaging findings. A deficit in arbitration in OCD may help reconcile evidence for excessive reliance on habit in rewarded learning tasks with an older literature suggesting inappropriate recruitment of circuitry associated with model-based decision making in unreinforced procedural learning. The hypothesized deficit and corresponding circuitry may be a particularly fruitful target for interventions, including cognitive remediation.

  18. Emotional distress and pain tolerance in obsessive-compulsive disorder.

    PubMed

    Hezel, Dianne M; Riemann, Bradley C; McNally, Richard J

    2012-12-01

    Physical pain can reduce emotional distress, perhaps especially the psychic pain of guilt. This implies that people who continually experience guilt may exhibit greater tolerance for pain relative to people who do not. To test this hypothesis, we administered a pressure algometer procedure to assess pain tolerance in patients with obsessive-compulsive disorder (OCD) plagued by moral obsessions (e.g., concerns about harming others, violating religious values), in patients with OCD with non-moral obsessions (e.g., regarding contamination and symmetry), and in healthy comparison subjects. The results indicated that the OCD groups did not differ in levels of guilt, emotional distress tolerance, or in pain endurance. However, when we collapsed across subtypes, OCD subjects endured pain significantly longer than did healthy subjects. Limitations included small sample size and use of a sample with complex OCD symptoms that were, in some instances, difficult to categorize. The results suggest that individuals with severe OCD might be willing to endure physical pain as a distraction from emotional distress, an expression of negative self-worth, or as a means to gain control over some aspect of suffering. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Fear conditioning and extinction in pediatric obsessive-compulsive disorder.

    PubMed

    Geller, Daniel A; McGuire, Joseph F; Orr, Scott P; Pine, Daniel S; Britton, Jennifer C; Small, Brent J; Murphy, Tanya K; Wilhelm, Sabine; Storch, Eric A

    2017-02-01

    Fear acquisition and extinction are central constructs in the cognitive-behavioral model of obsessive-compulsive disorder (OCD), which underlies exposure-based cognitive-behavioral therapy. Youths with OCD may have impairments in fear acquisition and extinction that carry treatment implications. Eighty youths (39 OCD, 41 healthy controls [HC]) completed clinical interviews, rating scales, and a differential conditioning task that included habituation, acquisition, and extinction phases. Skin conductance response (SCR) served as the primary dependent measure. During habituation, participants with OCD exhibited a stronger orienting SCR to initial stimuli relative to HC participants. During acquisition, differential fear conditioning was observed for both groups as evidenced by larger SCRs to the visual conditioned stimulus paired with an aversive unconditioned stimulus (CS+) compared with a CS-; OCD participants exhibited a larger SCR to the CS+ relative to HC participants. The absolute magnitude of the unconditioned fear response was significantly larger in participants with OCD, compared with HC participants. During extinction, OCD participants continued to exhibit a differential SCR to the CS+ and CS-, whereas HC participants exhibited diminished SCR to both stimuli. Participants with OCD exhibit a different pattern of fear extinction relative to HC participants, suggestive of greater fear acquisition and impaired inhibitory learning.

  20. Enhanced Avoidance Habits in Obsessive-Compulsive Disorder

    PubMed Central

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

    2014-01-01

    Background Obsessive-compulsive disorder (OCD) is a psychiatric condition that typically manifests in compulsive urges to perform irrational or excessive avoidance behaviors. A recent account has suggested that compulsivity in OCD might arise from excessive stimulus-response habit formation, rendering behavior insensitive to goal value. We tested if OCD patients have a bias toward habits using a novel shock avoidance task. To explore how habits, as a putative model of compulsivity, might relate to obsessions and anxiety, we recorded measures of contingency knowledge, explicit fear, and physiological arousal. Methods Twenty-five OCD patients and 25 control subjects completed a shock avoidance task designed to induce habits through overtraining, which were identified using goal-devaluation. The relationship between habitual behavior, erroneous cognitions, and physiological arousal was assessed using behavior, questionnaires, subjective report, and skin conductance responses. Results A devaluation sensitivity test revealed that both groups could inhibit unnecessary behavioral responses before overtraining. Following overtraining, OCD patients showed greater avoidance habits than control subjects. Groups did not differ in conditioned arousal (skin conductance responses) at any stage. Additionally, groups did not differ in contingency knowledge or explicit ratings of shock expectancy following the habit test. Habit responses were associated with a subjective urge to respond. Conclusions These data indicate that OCD patients have a tendency to develop excessive avoidance habits, providing support for a habit account of OCD. Future research is needed to fully characterize the causal role of physiological arousal and explicit fear in habit formation in OCD. PMID:23510580

  1. Anxiety and selective attention in obsessive-compulsive disorder.

    PubMed

    Cohen, Yoav; Lachenmeyer, Juliana Rasic; Springer, Craig

    2003-11-01

    Recently, there has been increasing evidence for information-processing deficits in individuals with obsessive-compulsive disorder (OCD). While impairments in selective attention have been identified to be central to the symptomatology of OCD, the role that situational anxiety plays in attentional processes has not been fully explored. Previous research findings were limited to tasks containing anxiety-relevant materials, only permitting for the evaluation of the impact of anxiety on simultaneous cognitive processing. Furthermore, it has not yet been determined whether the impact of anxiety is limited to selective attention or is indicative of a more general cognitive impairment. This study was designed to examine the role that situational anxiety plays in selective attention impairments. OCD participants and controls were presented with an anxiety producing statement and a neutral statement, followed by the Stroop Task. Results indicated that situational anxiety plays a significant role in the performance of tasks that require selective attention in OCD. A significant deterioration was detected in performance on selective attention tasks for the OCD participants after confronting anxiety-provoking scenarios, as compared to neutral scenarios. Anxiety did not impair performance on simple reading tasks. Possible explanations are discussed.

  2. Italian prescribing patterns in obsessive-compulsive disorder.

    PubMed

    Marazziti, Donatella; Albert, Umberto; Dell'Osso, Bernardo; Tundo, Antonio; Cuniberti, Francesco; Maina, Giuseppe; Moroni, Ilenia; Benatti, Beatrice; Mucci, Federico; Massimetti, Gabriele; Piccinni, Armando; Brakoulias, Vlasios

    2017-10-02

    The aim of the present study was to investigate psychopharmacological prescribing patterns in a large sample (n = 1815) of patients suffering from obsessive-compulsive disorder (OCD) recruited in 4 Italian centers specialized in OCD, in comparison to available national and international guidelines. The centers were asked to complete a specific data sheet questionnaire on patients' therapeutic status. Statistical analyses were carried out by SPSS. The results showed that almost all patients referred to the centers of Milan, Pisa and Rome received psychotropic medications, whereas only 59.9% (313) did so in Turin. Selective serotonin reuptake inhibitors were the most used drugs ranging between 49.0% and 71.5%. Clomipramine was prescribed more often in Rome and Pisa than in Milan and Turin. The same was true for other tricyclic antidepressants. Second-generation antipsychotics were more often prescribed in Pisa and in Milan. Mood stabilizers were almost exclusively used in Pisa. Taken together, the overall findings would suggest that, although the main Italian centers specialized in OCD follow available guidelines, a certain degree of variability does exist. This may depend on the different educational background, availability of other specific therapeutic strategies, as well as varying levels of severity and comorbidity of the patients. Copyright © 2017 John Wiley & Sons, Ltd.

  3. Quality of Web-based information on obsessive compulsive disorder

    PubMed Central

    Klila, Hedi; Chatton, Anne; Zermatten, Ariane; Khan, Riaz; Preisig, Martin; Khazaal, Yasser

    2013-01-01

    Background The Internet is increasingly used as a source of information for mental health issues. The burden of obsessive compulsive disorder (OCD) may lead persons with diagnosed or undiagnosed OCD, and their relatives, to search for good quality information on the Web. This study aimed to evaluate the quality of Web-based information on English-language sites dealing with OCD and to compare the quality of websites found through a general and a medically specialized search engine. Methods Keywords related to OCD were entered into Google and OmniMedicalSearch. Websites were assessed on the basis of accountability, interactivity, readability, and content quality. The “Health on the Net” (HON) quality label and the Brief DISCERN scale score were used as possible content quality indicators. Of the 235 links identified, 53 websites were analyzed. Results The content quality of the OCD websites examined was relatively good. The use of a specialized search engine did not offer an advantage in finding websites with better content quality. A score ≥16 on the Brief DISCERN scale is associated with better content quality. Conclusion This study shows the acceptability of the content quality of OCD websites. There is no advantage in searching for information with a specialized search engine rather than a general one. Practical implications: The Internet offers a number of high quality OCD websites. It remains critical, however, to have a provider–patient talk about the information found on the Web. PMID:24235835

  4. Obsessive Compulsive Disorder with Bipolar Mood Disorder: A Rare Comorbidity in India

    PubMed Central

    Annigeri, Bindu; Raman, Rajesh; Appaji, Rashmi

    2011-01-01

    Obsessive compulsive features occurring in mania have been well documented. Though there have been some studies on obsessive compulsive disorder (OCD) comorbid with mania in the western countries, there are very few case reports and studies in India. Our aim is to report one such case here, who presented with OC features which are not typical of the symptom cluster of the OCD commonly seen with mania in earlier reports. Also, the comorbidities in OCD should be recognized as this can have important diagnostic and therapeutic implications. PMID:22021961

  5. 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.

  6. Mortality Among Persons With Obsessive-Compulsive Disorder in Denmark.

    PubMed

    Meier, Sandra M; Mattheisen, Manuel; Mors, Ole; Schendel, Diana E; Mortensen, Preben B; Plessen, Kerstin J

    2016-03-01

    Several mental disorders have consistently been found to be associated with decreased life expectancy, but little is known about whether this is also the case for obsessive-compulsive disorder (OCD). To determine whether persons who receive a diagnosis of OCD are at increased risk of death. Using data from Danish registers, we conducted a nationwide prospective cohort study with 30 million person-years of follow-up. The data were collected from Danish longitudinal registers. A total of 3 million people born between 1955 and 2006 were followed up from January 1, 2002, through December 31, 2011. During this period, 27,236 people died. The data were analyzed primarily in June 2015. We estimated mortality rate ratios (MRRs), adjusted for calendar year, age, sex, maternal and paternal age, place of residence at birth, and somatic comorbidities, to compare persons with OCT with persons without OCD. Of 10,155 persons with OCD (5935 women and 4220 men with a mean [SD] age of 29.1 [11.3] years who contributed a total of 54,937 person-years of observation), 110 (1.1%) died during the average follow-up of 9.7 years. The risk of death by natural or unnatural causes was significantly higher among persons with OCD (MRR, 1.68 [95% CI, 1.31-2.12] for natural causes; MRR, 2.61 [95% CI, 1.91-3.47] for unnatural causes) than among the general population. After the exclusion of persons with comorbid anxiety disorders, depression, or substance use disorders, OCD was still associated with increased mortality risk (MRR, 1.88 [95% CI, 1.27-2.67]). The presence of OCD was associated with a significantly increased mortality risk. Comorbid anxiety disorders, depression, or substance use disorders further increased the risk. However, after adjusting for these and somatic comorbidities, we found that the mortality risk remained significantly increased among persons with OCD.

  7. 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.

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

    PubMed Central

    2014-01-01

    Introduction 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. Case presentation 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. Conclusions 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. PMID:25418908

  9. Prevalence and clinical correlates of obsessive-compulsive disorder in schizophrenia.

    PubMed

    Devi, Sugnyani; Rao, Naren P; Badamath, Suresh; Chandrashekhar, C R; Janardhan Reddy, Y C

    2015-01-01

    Obsessive compulsive symptoms frequently occur in a substantial proportion of patients with schizophrenia. The term schizoobsessive has been proposed to delineate this subgroup of schizophrenia patients who present with obsessive-compulsive symptoms/disorder. However, whether this co-occurrence is more than just co-morbidity and represents a distinct subgroup remains controversial. A striking variation is noted across studies examining prevalence of obsessive-compulsive symptoms/disorder in schizophrenia patients and their impact on clinical profile of schizophrenia. Hence, in this study, we examined the prevalence of obsessive-compulsive symptoms/disorder in a large sample of consecutively hospitalized schizophrenia patients and compared the clinical and functional characteristics of schizophrenia patients with and without obsessive-compulsive symptoms/disorder. We evaluated 200 consecutive subjects with the DSM-IV diagnosis of schizophrenia using the Structured Clinical Interview for DSM-IV Axis I disorders, Positive and Negative Syndrome Scale, Yale-Brown Obsessive-Compulsive Scale, Brown Assessment of Beliefs Scale, Clinical Global Impression-Severity scale, Global Assessment of Functioning Scale, Family Interview for Genetic Studies and World Health Organization Quality of Life scale. The prevalence of obsessive-compulsive symptoms in patients with schizophrenia was 24% (n=48); 37 of them had obsessive-compulsive disorder (OCD) and 11 had obsessive-compulsive symptoms not amounting to a clinical diagnosis of OCD (OCS). Schizophrenia patients with OCS/OCD had an earlier age at onset of schizophrenia symptoms, lower positive symptoms score, higher co-morbidity with Axis II disorders, higher occurrence of OCD in family and better quality of life. Findings of the study indicate a higher prevalence of OCS/OCD in schizophrenia. Schizophrenia patients with and without OCS/OCD have comparable clinical profile with few exceptions. High rates of OCD in first degree

  10. 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.

  11. Body image in social anxiety disorder, obsessive-compulsive disorder, and panic disorder.

    PubMed

    Aderka, Idan M; Gutner, Cassidy A; Lazarov, Amit; Hermesh, Haggai; Hofmann, Stefan G; Marom, Sofi

    2014-01-01

    Body dysmorphic disorder falls under the category of obsessive-compulsive and related disorders, yet research has suggested it may also be highly associated with social anxiety disorder. The current study examined body image variables among 68 outpatients with primary obsessive-compulsive disorder (OCD; n=22), social anxiety disorder (SAD; n=25), and panic disorder (PD; n=21). Participants filled out self-report measures of body image disturbance, attitudes toward one's appearance, and anxiety. Body image disturbance and attitudes toward appearance did not significantly differ between the groups. However, SAD symptoms predicted body image disturbance, Appearance Evaluation and Body Areas Satisfaction, and OCD symptoms predicted Appearance Orientation. These findings suggest that SAD and OCD may be associated with different facets of body image. Implications for the treatment of anxiety disorders and for future research are discussed.

  12. Tourette's syndrome, trichotillomania, and obsessive-compulsive disorder: how closely are they related?

    PubMed

    Ferrão, Ygor Arzeno; Miguel, Euripedes; Stein, Dan Joseph

    2009-11-30

    The question of whether Tourette's syndrome (TS) and trichotillomania (TTM) are best conceptualized as obsessive-compulsive spectrum disorders was raised by family studies demonstrating a close relationship between TS and obsessive-compulsive disorder (OCD), and by psychopharmacological research indicating that both TTM and OCD respond more robustly to clomipramine than to desipramine. A range of studies have subsequently allowed comparison of the phenomenology, psychobiology, and management of TS and TTM, with that of OCD. Here we briefly review this literature. The data indicate that there is significant psychobiological overlap between TS and OCD, supporting the idea that TS can be conceptualized as an OCD spectrum disorder. TTM and OCD have only partial overlap in their phenomenology and psychobiology, but there are a number of reasons for why it may be useful to classify TTM and other habit disorders as part of the obsessive-compulsive spectrum of disorders.

  13. Animal models of obsessive-compulsive disorder: utility and limitations.

    PubMed

    Alonso, Pino; López-Solà, Clara; Real, Eva; Segalàs, Cinto; Menchón, José Manuel

    2015-01-01

    Obsessive-compulsive disorder (OCD) is a disabling and common neuropsychiatric condition of poorly known etiology. Many attempts have been made in the last few years to develop animal models of OCD with the aim of clarifying the genetic, neurochemical, and neuroanatomical basis of the disorder, as well as of developing novel pharmacological and neurosurgical treatments that may help to improve the prognosis of the illness. The latter goal is particularly important given that around 40% of patients with OCD do not respond to currently available therapies. This article summarizes strengths and limitations of the leading animal models of OCD including genetic, pharmacologically induced, behavioral manipulation-based, and neurodevelopmental models according to their face, construct, and predictive validity. On the basis of this evaluation, we discuss that currently labeled "animal models of OCD" should be regarded not as models of OCD but, rather, as animal models of different psychopathological processes, such as compulsivity, stereotypy, or perseverance, that are present not only in OCD but also in other psychiatric or neurological disorders. Animal models might constitute a challenging approach to study the neural and genetic mechanism of these phenomena from a trans-diagnostic perspective. Animal models are also of particular interest as tools for developing new therapeutic options for OCD, with the greatest convergence focusing on the glutamatergic system, the role of ovarian and related hormones, and the exploration of new potential targets for deep brain stimulation. Finally, future research on neurocognitive deficits associated with OCD through the use of analogous animal tasks could also provide a genuine opportunity to disentangle the complex etiology of the disorder.

  14. 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.…

  15. Characterization of SLITRK1 Variation in Obsessive-Compulsive Disorder

    PubMed Central

    Ozomaro, Uzoezi; Yoon, Seungtai; Makarov, Vladimir; Delorme, Richard; Betancur, Catalina; Ruhrmann, Stephan; Falkai, Peter; Grabe, Hans Jörgen; Maier, Wolfgang; Wagner, Michael; Lennertz, Leonhard; Moessner, Rainald; Murphy, Dennis L.; Buxbaum, Joseph D.; Züchner, Stephan; Grice, Dorothy E.

    2013-01-01

    Obsessive compulsive disorder (OCD) is a syndrome characterized by recurrent and intrusive thoughts and ritualistic behaviors or mental acts that a person feels compelled to perform. Twin studies, family studies, and segregation analyses provide compelling evidence that OCD has a strong genetic component. The SLITRK1 gene encodes a developmentally regulated stimulator of neurite outgrowth and previous studies have implicated rare variants in this gene in disorders in the OC spectrum, specifically Tourette syndrome (TS) and trichotillomania (TTM). The objective of the current study was to evaluate rare genetic variation in SLITRK1 in risk for OCD and to functionally characterize associated coding variants. We sequenced SLITRK1 coding exons in 381 individuals with OCD as well as in 356 control samples and identified three novel variants in seven individuals. We found that the combined mutation load in OCD relative to controls was significant (p = 0.036). We identified a missense N400I change in an individual with OCD, which was not found in more than 1000 control samples (P<0.05). In addition, we showed the the N400I variant failed to enhance neurite outgrowth in primary neuronal cultures, in contrast to wildtype SLITRK1, which enhanced neurite outgrowth in this assay. These important functional differences in the N400I variant, as compared to the wildtype SLITRK1 sequence, may contribute to OCD and OC spectrum symptoms. A synonymous L63L change identified in an individual with OCD and an additional missense change, T418S, was found in four individuals with OCD and in one individual without an OCD spectrum disorder. Examination of additional samples will help assess the role of rare SLITRK1 variation in OCD and in related psychiatric illness. PMID:23990902

  16. Neural basis of impaired safety signaling in Obsessive Compulsive Disorder.

    PubMed

    Apergis-Schoute, Annemieke M; Gillan, Claire M; Fineberg, Naomi A; Fernandez-Egea, Emilio; Sahakian, Barbara J; Robbins, Trevor W

    2017-03-06

    The ability to assign safety to stimuli in the environment is integral to everyday functioning. A key brain region for this evaluation is the ventromedial prefrontal cortex (vmPFC). To investigate the importance of vmPFC safety signaling, we used neuroimaging of Pavlovian fear reversal, a paradigm that involves flexible updating when the contingencies for a threatening (CS+) and safe (CS-) stimulus reverse, in a prototypical disorder of inflexible behavior influenced by anxiety, Obsessive Compulsive Disorder (OCD). Skin conductance responses in OCD patients (n = 43) failed to differentiate during reversal compared with healthy controls (n = 35), although significant differentiation did occur during early conditioning and amygdala BOLD signaling was unaffected in these patients. Increased vmPFC activation (for CS+ > CS-) during early conditioning predicted the degree of generalization in OCD patients during reversal, whereas vmPFC safety signals were absent throughout learning in these patients. Regions of the salience network (dorsal anterior cingulate, insula, and thalamus) showed early learning task-related hyperconnectivity with the vmPFC in OCD, consistent with biased processing of the CS+. Our findings reveal an absence of vmPFC safety signaling in OCD, undermining flexible threat updating and explicit contingency knowledge. Although differential threat learning can occur to some extent in the absence of vmPFC safety signals, effective CS- signaling becomes crucial during conflicting threat and safety cues. These results promote further investigation of vmPFC safety signaling in other anxiety disorders, with potential implications for the development of exposure-based therapies, in which safety signaling is likely to play a key role.

  17. An autistic dimension: a proposed subtype of obsessive-compulsive disorder.

    PubMed

    Bejerot, Susanne

    2007-03-01

    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 clinical experience of OCD and ASD, and literature searches on MEDLINE. Neuropsychological deficits are more common in OCD than in panic disorder and depression. Moreover, obsessive-compulsive and schizotypal personality disorders are over-represented in OCD. These may constitute mis-perceived clinical manifestations of ASD. Furthermore, repetitive behaviours and hoarding are common in Asperger syndrome. It is suggested that the comorbidity results in a more severe and treatment resistant form of OCD. OCD with comorbid ASD should be recognized as a valid OCD subtype, analogous to OCD with comorbid tics. An odd personality, with paranoid, schizotypal, avoidant or obsessive-compulsive traits, may indicate these autistic dimensions in OCD patients.

  18. 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

  19. Rage attacks in pediatric obsessive-compulsive disorder: phenomenology and clinical correlates.

    PubMed

    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

    2012-06-01

    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). Participants were 86 children (ages 6-16 years) with a primary diagnosis of OCD. Patients and their primary caregiver were administered clinician-rated measures of obsessive-compulsive severity and rage severity. Children completed the Center for Epidemiologic Studies Depression Scale and the Child Sheehan Disability Scale-Child, whereas parents completed the Rage Attacks Questionnaire, Aberrant Behavior Checklist-Irritability Scale, Children's Affective Lability Scale, and Child Sheehan Disability Scale-Parent. Rage was common among youth with OCD and was associated with varied clinical characteristics. Rage severity accounted for functional impairment beyond the influence of obsessive-compulsive symptom severity; however, these relations were explained by the impact of family accommodation. These data suggest that rage attacks are relatively common, have a negative impact on illness presentation, and contribute to functional impairment above and beyond obsessive-compulsive symptom severity. Rage may contribute to family accommodation of symptoms, which may further affect obsessive-compulsive symptom severity and impairment. Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  20. Cortical and brainstem plasticity in Tourette syndrome and obsessive-compulsive disorder.

    PubMed

    Suppa, Antonio; Marsili, Luca; Di Stasio, Flavio; Berardelli, Isabella; Roselli, Valentina; Pasquini, Massimo; Cardona, Francesco; Berardelli, Alfredo

    2014-10-01

    Gilles de la Tourette syndrome is characterized by motor/vocal tics commonly associated with psychiatric disorders, including obsessive-compulsive disorder. We investigated primary motor cortex and brainstem plasticity in Tourette patients, exposed and unexposed to chronic drug treatment, with and without psychiatric disturbances. We also investigated primary motor cortex and brainstem plasticity in obsessive-compulsive disorder. We studied 20 Tourette patients with and without psychiatric disturbances, 15 with obsessive-compulsive disorder, and 20 healthy subjects. All groups included drug-naïve patients. We conditioned the left primary motor cortex with intermittent/continuous theta-burst stimulation and recorded motor evoked potentials. We conditioned the supraorbital nerve with facilitatory/inhibitory high-frequency stimulation and recorded the blink reflex late response area. In healthy subjects, intermittent theta-burst increased and continuous theta-burst stimulation decreased motor evoked potentials. Differently, intermittent theta-burst failed to increase and continuous theta-burst stimulation failed to decrease motor evoked potentials in Tourette patients, with and without psychiatric disturbances. In obsessive-compulsive disorder, intermittent/continuous theta-burst stimulation elicited normal responses. In healthy subjects and in subjects with obsessive-compulsive disorder, the blink reflex late response area increased after facilitatory high-frequency and decreased after inhibitory high-frequency stimulation. Conversely, in Tourette patients, with and without psychiatric disturbances, facilitatory/inhibitory high-frequency stimulation left the blink reflex late response area unchanged. Theta-burst and high-frequency stimulation elicited similar responses in drug-naïve and chronically treated patients. Tourette patients have reduced plasticity regardless of psychiatric disturbances. These findings suggest that abnormal plasticity contributes to the

  1. How can technology enhance cognitive behavioral therapy: the case of pediatric obsessive compulsive disorder.

    PubMed

    Wolters, Lidewij H; Op de Beek, Vivian; Weidle, Bernhard; Skokauskas, Norbert

    2017-06-23

    Many children with mental health disorders do not receive adequate treatment due to the uneven dissemination of resources, and other barriers to treatment. In the case of pediatric obsessive compulsive disorder treatment progress is also hindered by partial or non-response to treatment in addition to poor compliance. This debate paper focuses on new technologies as a potential vehicle to address the challenges faced by traditional treatment, with special reference to cognitive behavioral therapy for pediatric obsessive compulsive disorder. We discuss the achievements and challenges that previous studies have faced, debate ways to overcome them, and we offer specific suggestions for further research in the area.

  2. Genome-wide Association Study of Obsessive-Compulsive Disorder

    PubMed Central

    Stewart, S Evelyn; Yu, Dongmei; Scharf, Jeremiah M; Neale, Benjamin M; Fagerness, Jesen A; Mathews, Carol A; Arnold, Paul D; Evans, Patrick D; Gamazon, Eric R; Osiecki, Lisa; McGrath, Lauren; Haddad, Stephen; Crane, Jacquelyn; Hezel, Dianne; Illman, Cornelia; Mayerfeld, Catherine; Konkashbaev, Anuar; Liu, Chunyu; Pluzhnikov, Anna; Tikhomirov, Anna; Edlund, Christopher K; Rauch, Scott L; Moessner, Rainald; Falkai, Peter; Maier, Wolfgang; Ruhrmann, Stephan; Grabe, Hans-Jörgen; Lennertz, Leonard; Wagner, Michael; Bellodi, Laura; Cavallini, Maria Cristina; Richter, Margaret A; Cook, Edwin H; Kennedy, James L; Rosenberg, David; Stein, Dan J; Hemmings, Sian MJ; Lochner, Christine; Azzam, Amin; Chavira, Denise A; Fournier, Eduardo; Garrido, Helena; Sheppard, Brooke; Umaña, Paul; Murphy, Dennis L; Wendland, Jens R; Veenstra-VanderWeele, Jeremy; Denys, Damiaan; Blom, Rianne; Deforce, Dieter; Van Nieuwerburgh, Filip; Westenberg, Herman GM; Walitza, Susanne; Egberts, Karin; Renner, Tobias; Miguel, Euripedes Constantino; Cappi, Carolina; Hounie, Ana G; Conceição do Rosário, Maria; Sampaio, Aline S; Vallada, Homero; Nicolini, Humberto; Lanzagorta, Nuria; Camarena, Beatriz; Delorme, Richard; Leboyer, Marion; Pato, Carlos N; Pato, Michele T; Voyiaziakis, Emanuel; Heutink, Peter; Cath, Danielle C; Posthuma, Danielle; Smit, Jan H; Samuels, Jack; Bienvenu, O Joseph; Cullen, Bernadette; Fyer, Abby J; Grados, Marco A; Greenberg, Benjamin D; McCracken, James T; Riddle, Mark A; Wang, Ying; Coric, Vladimir; Leckman, James F; Bloch, Michael; Pittenger, Christopher; Eapen, Valsamma; Black, Donald W; Ophoff, Roel A; Strengman, Eric; Cusi, Daniele; Turiel, Maurizio; Frau, Francesca; Macciardi, Fabio; Gibbs, J Raphael; Cookson, Mark R; Singleton, Andrew; Hardy, John; Crenshaw, Andrew T; Parkin, Melissa A; Mirel, Daniel B; Conti, David V; Purcell, Shaun; Nestadt, Gerald; Hanna, Gregory L; Jenike, Michael A; Knowles, James A; Cox, Nancy; Pauls, David L

    2014-01-01

    Obsessive-compulsive disorder (OCD) is a common, debilitating neuropsychiatric illness with complex genetic etiology. The International OCD Foundation Genetics Collaborative (IOCDF-GC) is a multi-national collaboration established to discover the genetic variation predisposing to OCD. A set of individuals affected with DSM-IV OCD, a subset of their parents, and unselected controls, were genotyped with several different Illumina SNP microarrays. After extensive data cleaning, 1,465 cases, 5,557 ancestry-matched controls and 400 complete trios remained, with a common set of 469,410 autosomal and 9,657 X-chromosome SNPs. Ancestry-stratified case-control association analyses were conducted for three genetically-defined subpopulations and combined in two meta-analyses, with and without the trio-based analysis. In the case-control analysis, the lowest two p-values were located within DLGAP1 (p=2.49×10-6 and p=3.44×10-6), a member of the neuronal postsynaptic density complex. In the trio analysis, rs6131295, near BTBD3, exceeded the genome-wide significance threshold with a p-value=3.84 × 10-8. However, when trios were meta-analyzed with the combined case-control samples, the p-value for this variant was 3.62×10-5, losing genome-wide significance. Although no SNPs were identified to be associated with OCD at a genome-wide significant level in the combined trio-case-control sample, a significant enrichment of methylation-QTLs (p<0.001) and frontal lobe eQTLs (p=0.001) was observed within the top-ranked SNPs (p<0.01) from the trio-case-control analysis, suggesting these top signals may have a broad role in gene expression in the brain, and possibly in the etiology of OCD. PMID:22889921

  3. 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.

  4. Cognitive retraining for organizational impairment in obsessive-compulsive disorder.

    PubMed

    Buhlmann, Ulrike; Deckersbach, Thilo; Engelhard, Iris; Cook, Laura M; Rauch, Scott L; Kathmann, Norbert; Wilhelm, Sabine; Savage, Cary R

    2006-11-15

    Individuals with obsessive-compulsive disorder (OCD) have difficulties in organizing information during encoding associated with subsequent memory impairments. This study was designed to investigate whether impairments in organization in individuals with OCD can be alleviated with cognitive training. Thirty-five OCD subjects and 36 controls copied and recalled the Rey-Osterrieth Complex Figure Test (RCFT) [Osterrieth, P.A., 1944. Le test de copie d'une figure complexe: Contribution a l'étude de la perception et de la memoire (The test of copying a complex figure: A contribution to the study of perception and memory). Archive de Psychologie 30, 286-350.] before being randomly assigned to a training or non-training condition. The training condition was designed to improve the ability to organize complex visuospatial information in a meaningful way. The intervention phase was followed by another copy and recall trial of the RCFT. Both OCD and control subjects who underwent training improved more in organization and memory than subjects who did not receive organizational training, providing evidence that the training procedure was effective. OCD subjects improved more in organizational during encoding than control subjects, irrespective of whether or not they had received training. This suggests that organization impairment in OCD affects primarily the ability to spontaneously utilize strategies when faced with complex, ambiguous information but that the ability to implement such strategies when provided with additional trials is preserved. These findings support a distinction in OCD between failure to utilize a strategy and incapacity to implement a strategy.

  5. Evidence for a Shared Etiological Mechanism of Psychotic Symptoms and Obsessive-Compulsive Symptoms in Patients with Psychotic Disorders and Their Siblings.

    PubMed

    Swets, Marije; Van Dael, Frank; Roza, Sabine; Schoevers, Robert; Myin-Germeys, Inez; de Haan, Lieuwe

    2015-01-01

    The prevalence of obsessive-compulsive disorder in subjects with psychotic disorder is much higher than in the general population. The higher than chance co-occurrence has also been demonstrated at the level of subclinical expression of both phenotypes. Both extended phenotypes have been shown to cluster in families. However, little is known about the origins of their elevated co-occurrence. In the present study, evidence for a shared etiological mechanism was investigated in 3 samples with decreasing levels of familial psychosis liability: 987 patients, 973 of their unaffected siblings and 566 healthy controls. The association between the obsessive-compulsive phenotype and the psychosis phenotype c.q. psychosis liability was investigated. First, the association was assessed between (subclinical) obsessive-compulsive symptoms and psychosis liability. Second, in a cross-sib cross-trait analysis, it was examined whether (subclinical) obsessive-compulsive symptoms in the patient were associated with (subclinical) psychotic symptoms in the related unaffected sibling. Evidence was found for both associations, which is compatible with a partially shared etiological pathway underlying obsessive-compulsive and psychotic disorder. This is the first study that used a cross-sib cross-trait design in patients and unaffected siblings, thus circumventing confounding by disease-related factors present in clinical samples.

  6. Obsessive Compulsive Symptoms/disorder in patients with schizophrenia: Prevalence, relationship with other symptom dimensions and impact on functioning.

    PubMed

    Grover, Sandeep; Dua, Devakshi; Chakrabarti, Subho; Avasthi, Ajit

    2017-04-01

    The aim of this study was to evaluate the prevalence of comorbid obsessive compulsive symptoms/disorder and its impact on outcome among patients with schizophrenia. 181 patients with schizophrenia were evaluated on Yale-Brown Obsessive-Compulsive Symptom Checklist, Yale-Brown Obsessive-Compulsive Scale, Calgary Depression Scale for Schizophrenia, Positive and Negative Symptom Scale, Social Occupational Functioning Scale, Global Assessment of Functioning Scale and Indian Disability Evaluation and Assessment Scale. Slightly more than one-fourth of patients fulfilled the diagnosis of current (28.2%) and lifetime (29.8%) diagnosis of obsessive compulsive disorder. On Yale Brown Obsessive Compulsive Symptom Checklist, the most common lifetime obsessions were those of contamination (25.4%), followed by obsessions of need for symmetry or exactness (11.6%). The most common compulsions were those of cleaning/washing (27.1%), followed by those of checking (24.3%). Presence of obsessive compulsive symptoms was associated with younger age of onset, higher prevalence of comorbid depression, and current suicidal ideations. Thus, it can be concluded that a significant proportion of patients with schizophrenia have obsessive compulsive symptoms/disorder. Clinicians managing patients of schizophrenia should evaluate the patients thoroughly for presence of comorbid obsessive compulsive symptoms/disorder and must take the same into account while managing the patients. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  7. 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…

  8. 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…

  9. Imbalance in habitual versus goal directed neural systems during symptom provocation in obsessive-compulsive disorder

    PubMed Central

    Banca, Paula; Voon, Valerie; Vestergaard, Martin D.; Philipiak, Gregor; Almeida, Inês; Pocinho, Fernando; Relvas, João

    2015-01-01

    Intrusive thoughts and compulsive urges to perform stereotyped behaviours are typical symptoms of obsessive-compulsive disorder. Emerging evidence suggests a cognitive bias towards habit formation at the expense of goal-directed performance in obsessive-compulsive disorder. In this study, we test this hypothesis using a novel individualized ecologically valid symptom provocation design: a live provocation functional magnetic resonance imaging paradigm with synchronous video-recording of behavioural avoidance responses. By pairing symptom provocation with online avoidance responses on a trial-by-trial basis, we sought to investigate the neural mechanisms leading to the compulsive avoidance response. In keeping with the model of habit formation in obsessive-compulsive disorder, we hypothesized that this disorder would be associated with lower activity in regions implicated in goal-directed behaviours and higher activity in regions implicated in habitual behaviours. Fifteen patients with obsessive-compulsive disorder and 15 healthy control volunteers participated in this functional magnetic resonance imaging study. Online stimuli were individually tailored to achieve effective symptom provocation at neutral, intermediate and strong intensity levels. During the symptom provocation block, the participant could choose to reject or terminate the provoking stimuli resulting in cessation of the symptom provocation. We thus separately analysed the neural correlates of symptom provocation, the urge to avoid, rejection and relief. Strongly symptom-provoking conditions evoked a dichotomous pattern of deactivation/activation in patients, which was not observed either in control conditions or in healthy subjects: a deactivation of caudate-prefrontal circuits accompanied by hyperactivation of subthalamic nucleus/putaminal regions. This finding suggests a dissociation between regions engaged in goal-directed and habitual behaviours. The putaminal hyperactivity during patients

  10. Imbalance in habitual versus goal directed neural systems during symptom provocation in obsessive-compulsive disorder.

    PubMed

    Banca, Paula; Voon, Valerie; Vestergaard, Martin D; Philipiak, Gregor; Almeida, Inês; Pocinho, Fernando; Relvas, João; Castelo-Branco, Miguel

    2015-03-01

    Intrusive thoughts and compulsive urges to perform stereotyped behaviours are typical symptoms of obsessive-compulsive disorder. Emerging evidence suggests a cognitive bias towards habit formation at the expense of goal-directed performance in obsessive-compulsive disorder. In this study, we test this hypothesis using a novel individualized ecologically valid symptom provocation design: a live provocation functional magnetic resonance imaging paradigm with synchronous video-recording of behavioural avoidance responses. By pairing symptom provocation with online avoidance responses on a trial-by-trial basis, we sought to investigate the neural mechanisms leading to the compulsive avoidance response. In keeping with the model of habit formation in obsessive-compulsive disorder, we hypothesized that this disorder would be associated with lower activity in regions implicated in goal-directed behaviours and higher activity in regions implicated in habitual behaviours. Fifteen patients with obsessive-compulsive disorder and 15 healthy control volunteers participated in this functional magnetic resonance imaging study. Online stimuli were individually tailored to achieve effective symptom provocation at neutral, intermediate and strong intensity levels. During the symptom provocation block, the participant could choose to reject or terminate the provoking stimuli resulting in cessation of the symptom provocation. We thus separately analysed the neural correlates of symptom provocation, the urge to avoid, rejection and relief. Strongly symptom-provoking conditions evoked a dichotomous pattern of deactivation/activation in patients, which was not observed either in control conditions or in healthy subjects: a deactivation of caudate-prefrontal circuits accompanied by hyperactivation of subthalamic nucleus/putaminal regions. This finding suggests a dissociation between regions engaged in goal-directed and habitual behaviours. The putaminal hyperactivity during patients

  11. Selective Serotonin Reuptake Inhibitors for the Treatment of Obsessive-Compulsive Disorder in Children and Adolescents

    PubMed Central

    Williams, Jennifer Schoelles; Moore, Thea; Collins, Candace L.; Thomas, Kerry-Ann E.

    2003-01-01

    The introduction of the selective serotonin reuptake inhibitors (SSRIs) has been a major advance in pediatric psychiatry, while contemporary advances in the understanding of obsessive-compulsive disorder (OCD) phenomenon in children have facilitated its identification and treatment. Currently, fluvoxamine and sertraline are the only SSRIs that have received FDA approval for the treatment of childhood OCD. The purpose of this article is to review the safety and efficacy of SSRIs in the treatment of obsessive-compulsive disorder (OCD) in children and adolescents. PMID:23118677

  12. Mortality Among Persons With Obsessive-Compulsive Disorder in Denmark

    PubMed Central

    Meier, Sandra M.; Mattheisen, Manuel; Mors, Ole; Schendel, Diana E.; Mortensen, Preben B.; Plessen, Kerstin J.

    2016-01-01

    IMPORTANCE Several mental disorders have consistently been found to be associated with decreased life expectancy, but little is known about whether this is also the case for obsessive-compulsive disorder (OCD). OBJECTIVE To determine whether persons who receive a diagnosis of OCD are at increased risk of death. DESIGN, SETTING, AND PARTICIPANTS Using data from Danish registers, we conducted a nationwide prospective cohort study with 30 million person-years of follow-up. The data were collected from Danish longitudinal registers. A total of 3 million people born between 1955 and 2006 were followed up from January 1, 2002, through December 31, 2011. During this period, 27 236 people died. The data were analyzed primarily in June 2015. MAIN OUTCOMES AND MEASURES We estimated mortality rate ratios (MRRs), adjusted for calendar year, age, sex, maternal and paternal age, place of residence at birth, and somatic comorbidities, to compare persons with OCT with persons without OCD. RESULTS Of 10 155 persons with OCD (5935 women and 4220 men with a mean [SD] age of 29.1 [11.3] years who contributed a total of 54 937 person-years of observation), 110 (1.1%) died during the average follow-up of 9.7 years. The risk of death by natural or unnatural causes was significantly higher among persons with OCD (MRR, 1.68 [95% CI, 1.31–2.12] for natural causes; MRR, 2.61 [95% CI, 1.91–3.47] for unnatural causes) than among the general population. After the exclusion of persons with comorbid anxiety disorders, depression, or substance use disorders, OCD was still associated with increased mortality risk (MRR, 1.88 [95% CI, 1.27–2.67]). CONCLUSIONS AND RELEVANCE The presence of OCD was associated with a significantly increased mortality risk. Comorbid anxiety disorders, depression, or substance use disorders further increased the risk. However, after adjusting for these and somatic comorbidities, we found that the mortality risk remained significantly increased among persons with OCD

  13. Comparative Study of Neurological Soft Signs in Patients with Schizophrenia or Obsessive-compulsive Disorder, and Healthy Controls.

    PubMed

    Tripathi, R; Soni, A; Tyagi, A; Mehta, S; Gupta, S

    2015-06-01

    The primary objective of this study was to examine neurological soft signs in patients with obsessive-compulsive disorder compared with patients with schizophrenia and a control group in the Indian setting. The secondary objective was to find any correlation between age at onset and neurological soft signs scores, as well as that between severity of obsessive-compulsive disorder symptoms (total Yale-Brown Obsessive Compulsive Scale score) and neurological soft signs scores. This was a cross-sectional hospital-based study of 135 individuals (45 patients with schizophrenia, 45 patients with obsessive-compulsive disorder who were attending the psychiatric outpatient department of Sawai Man Singh Medical College, Jaipur, India, and 45 matched healthy controls) from 20 June 2013 to 22 December 2014. After applying strict inclusion and exclusion criteria, the participants completed the study instruments (Cambridge Neurological Inventory [Part 2] and Yale-Brown Obsessive Compulsive Scale). Their socio-demographic data were also recorded. The neurological soft signs total score and domain scores (motor coordination, sensory integration, and disinhibition) were significantly higher in patients with schizophrenia (p < 0.05) than in the obsessive-compulsive disorder group or the control group. The obsessive-compulsive disorder group did not significantly differ from the control group in terms of neurological soft signs scores. No correlation was found between neurological soft signs scores and age at onset as well as that between neurological soft signs scores and total Yale-Brown Obsessive Compulsive Scale score. Neurological soft signs assessed by the Cambridge Neurological Inventory and Yale-Brown Obsessive Compulsive Scale, which discriminate patients with schizophrenia from controls, appear to be relatively specific to schizophrenia. Further studies are required to explore neurological soft signs in patients with obsessive-compulsive disorder.

  14. Comorbidity of Obsessive-Compulsive Disorder and Schizophrenia in an Adolescent

    PubMed Central

    Rosli, Ahmad Nabil Md.; Wan Ismail, Wan Salwina

    2015-01-01

    We report a case of a girl with a history of obsessive-compulsive disorder (OCD) subsequently exhibiting psychosis. She never attained remission since the outset. Initially she seemed to be resistant to most antipsychotics, namely, risperidone, haloperidol, paliperidone, quetiapine, and clozapine. However, she later responded remarkably better to risperidone after it was reintroduced for the second time. Recognizing and understanding the various pathogenesis of OCD or obsessive-compulsive symptoms (OCS) in schizophrenia are vital in laying out plan to manage the patient effectively. PMID:26483984

  15. Current Educational Practices in Classifying and Serving Students with Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Adams, Gail B.; Smith, Thomas J.; Bolt, Sara E.; Nolten, Patrick

    2007-01-01

    Current educational practices for classifying and serving students with mental health disorders such as obsessive-compulsive disorder (OCD) have been associated with specific problems. These include the stigma of labeling, misalignment of school-based categories (e.g., E/BD, OHI) with clinical diagnoses, and concerns regarding the provision of…

  16. Assessment of Pediatric Obsessive-Compulsive Disorder: A Critical Review of Current Methodology

    ERIC Educational Resources Information Center

    Merlo, Lisa J.; Storch, Eric A.; Murphy, Tanya K.; Goodman, Wayne K.; Geffken, Gary R.

    2005-01-01

    Obsessive-compulsive disorder (OCD) is a relatively common disorder among children and adolescents, and is associated with increased risk for concurrent and future distress and impairment. Many youth who suffer from OCD go undiagnosed or misdiagnosed, and do not attain appropriate treatment in a timely manner. As a result, researchers have focused…

  17. 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…

  18. 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…

  19. Repetitive Behaviors in Autism and Obsessive-Compulsive Disorder: New Perspectives from a Network Analysis

    ERIC Educational Resources Information Center

    Ruzzano, Laura; Borsboom, Denny; Geurts, Hilde M.

    2015-01-01

    The association between autism and obsessive-compulsive disorder (OCD) seems largely dependent upon observed similarities in the repetitive behaviors that manifest in both disorders. The aim of this study was to use a network approach to explore the interactions between these behaviors. We constructed a network based on clinician's…

  20. 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…

  1. Assessment of Pediatric Obsessive-Compulsive Disorder: A Critical Review of Current Methodology

    ERIC Educational Resources Information Center

    Merlo, Lisa J.; Storch, Eric A.; Murphy, Tanya K.; Goodman, Wayne K.; Geffken, Gary R.

    2005-01-01

    Obsessive-compulsive disorder (OCD) is a relatively common disorder among children and adolescents, and is associated with increased risk for concurrent and future distress and impairment. Many youth who suffer from OCD go undiagnosed or misdiagnosed, and do not attain appropriate treatment in a timely manner. As a result, researchers have focused…

  2. Repetitive Behaviors in Autism and Obsessive-Compulsive Disorder: New Perspectives from a Network Analysis

    ERIC Educational Resources Information Center

    Ruzzano, Laura; Borsboom, Denny; Geurts, Hilde M.

    2015-01-01

    The association between autism and obsessive-compulsive disorder (OCD) seems largely dependent upon observed similarities in the repetitive behaviors that manifest in both disorders. The aim of this study was to use a network approach to explore the interactions between these behaviors. We constructed a network based on clinician's…

  3. 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…

  4. 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…

  5. Children with Very Early Onset Obsessive-Compulsive Disorder: Clinical Features and Treatment Outcome

    ERIC Educational Resources Information Center

    Nakatani, Eriko; Krebs, Georgina; Micali, Nadia; Turner, Cynthia; Heyman, Isobel; Mataix-Cols, David

    2011-01-01

    Background: There is emerging evidence that early onset obsessive-compulsive disorder (OCD) may be a phenomenologically distinct subtype of the disorder. Previous research has shown that individuals who report an early onset display greater severity and persistence of symptoms, and they may be less responsive to treatment. To date, this question…

  6. Assessment and Treatment of Obsessive-Compulsive Disorder in College Age Students and Adults.

    ERIC Educational Resources Information Center

    Spengler, Paul M.; Jacobi, David M.

    1998-01-01

    The potential for clinical-judgment errors in assessing obsessive-compulsive disorder (OCD) makes this a good example for illustrating methods of debiasing and hypothesis testing. This article provides information about this frequently misdiagnosed disorder, delineates methods for assessment and treatment of OCD, and discusses implications of…

  7. 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,…

  8. Children with Very Early Onset Obsessive-Compulsive Disorder: Clinical Features and Treatment Outcome

    ERIC Educational Resources Information Center

    Nakatani, Eriko; Krebs, Georgina; Micali, Nadia; Turner, Cynthia; Heyman, Isobel; Mataix-Cols, David

    2011-01-01

    Background: There is emerging evidence that early onset obsessive-compulsive disorder (OCD) may be a phenomenologically distinct subtype of the disorder. Previous research has shown that individuals who report an early onset display greater severity and persistence of symptoms, and they may be less responsive to treatment. To date, this question…

  9. 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,…

  10. 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…

  11. Repetitive Behaviour in Children with High Functioning Autism and Obsessive Compulsive Disorder

    ERIC Educational Resources Information Center

    Zandt, Fiona; Prior, Margot; Kyrios, Michael

    2007-01-01

    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…

  12. Repetitive Behaviour in Children with High Functioning Autism and Obsessive Compulsive Disorder

    ERIC Educational Resources Information Center

    Zandt, Fiona; Prior, Margot; Kyrios, Michael

    2007-01-01

    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…

  13. 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…

  14. 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…

  15. Local-Global Processing in Obsessive-Compulsive Disorder and Comorbid Tourette's Syndrome

    ERIC Educational Resources Information Center

    Rankins, D.; Bradshaw, J. L.; Georgiou-Karistianis, N.

    2005-01-01

    Neuropsychological and neuroimaging studies implicate attentional difficulties in obsessive-compulsive disorder (OCD), but results are inconsistent due possibly to sample heterogeneity and lack of control of comorbid disorders, such as Tourette's syndrome (TS). Nevertheless, it has been suggested that OCD symptomatology may be a result of…

  16. The Semantic Simon Effect in Tourette's Syndrome and Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Rankins, D.; Bradshaw, J. L.; Georgiou-Karistianis, N.

    2006-01-01

    Core symptoms of Tourette's syndrome (TS) and obsessive-compulsive disorder (OCD) may be attributed to an impairment in inhibitory control. Neuropsychological studies have addressed inhibition in both disorders, but findings have been inconsistent. The aim of this study was to examine cognitive inhibition, using a semantic Simon effect paradigm,…

  17. Correlation between Overactive Bladder Syndrome and Obsessive Compulsive Disorder in Women.

    PubMed

    Ahn, Keun-Soo; Hong, Hyun-Pyo; Kweon, Hyuk-Jung; Ahn, Ah-Leum; Oh, Eun-Jung; Choi, Jae-Kyung; Cho, Dong-Yung

    2016-01-01

    Overactive bladder syndrome is characterized by urinary urgency, usually accompanied by Frequent urination and nocturia, with or without urgent urinary incontinence. There must be the absence of causative infection or pathological conditions. Overactive bladder syndrome is related to mental disorders, particularly depression and anxiety. However, obsessive-compulsive symptoms are investigated much less frequently. The purpose of the present study was thus to assess obsessive-compulsive symptoms in overactive bladder syndrome patients. Fifty-seven women patients with overactive bladder syndrome and fifty-seven women without it (age matched control group) were prospectively enrolled. They completed the overactive bladder syndrome-validated 8-question screener and the Korean version of the Maudsley Obsessional-Compulsive Inventory Questionnaire at the same time they visited the clinic. Patients were compared with controls on the Korean version of the Maudsley Obsessional-Compulsive Inventory Questionnaire and its checking, tidiness, doubting, and fear of contamination components. Patients showed more obsessive traits than controls on the Korean version of the Maudsley Obsessional-Compulsive Inventory Questionnaire total score (P=0.006) and on the checking subscale (P=0.001). Odds ratio for the overactive bladder syndrome group's obsessive-compulsive symptoms traits (score≥14) was 5.47 (P=0.001). The Korean version of the Maudsley Obsessional-Compulsive Inventory Questionnaire total score was associated with the overactive bladder syndrome-validated 8-question screener score in patients (P=0.03). Obsessive-compulsive symptoms may constitute an important aspect of the psychiatric profile of overactive bladder syndrome patients. The severity of obsessive-compulsive symptoms seems to be related to the degree of the overactive bladder syndrome severity. Clinicians may consider screening women with overactive bladder syndrome for obsessive-compulsive symptoms.

  18. Treatment of internet addiction in patient with panic disorder and obsessive compulsive disorder: a case report.

    PubMed

    Santos, Veruska; Nardi, Antonio Egidio; King, Anna Lucia Spear

    2015-01-01

    Problematic Internet use is a worldwide social issue and it can be found in any age, social, educational, or economic range. In some countries like China and South Korea internet addiction (IA) is considered a public health condition and this governments support research, education and treatment. Internet addiction has been associated with others psychiatric disorders. Panic disorder (PD) and Obsessive Compulsive Disorder (OCD) are anxiety disorders that involve a lot of damages in patient's life. We report a treatment of a patient with Panic Disorder and Obsessive Compulsive Disorder and internet addition involving pharmacotherapy and Cognitive Behavioral Therapy (CBT). The Cognitive Behavioral Therapy was conducted 1 time per week during 10 weeks and results suggest that the treatment was an effective treatment for the anxiety and for the internet addiction.

  19. 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

  20. Exploring the role of obsessive-compulsive relevant self-worth contingencies in obsessive-compulsive disorder patients.

    PubMed

    García-Soriano, Gemma; Belloch, Amparo

    2012-06-30

    This article examines whether self-worth contingencies in the personal domains of cleanliness, morality, hoarding, certainty, accuracy, religion and respect for others have specific associations with obsessive symptoms and cognitions in individuals with obsessive-compulsive disorder (OCD). Fifty-seven patients with a primary diagnosis of OCD completed the Obsessional Concerns and Self Questionnaire (OCSQ), designed to assess the extent to which respondents consider OCD content domains relevant to their self-worth, along with a battery of other instruments. Results indicate that the OCSQ is more associated with OCD than with non-OCD anxiety symptoms, and that it is also associated with comorbid depressive symptoms in OCD patients. Moreover, the OCSQ-Order and Cleanliness and Hoarding dimensions are associated with their symptom counterparts (i.e., contamination, checking, order, hoarding and neutralizing). OCSQ domains were highly associated with dysfunctional beliefs about obsessions. However, only the OCSQ scores, but not the dysfunctional beliefs, predicted OCD symptoms. These results support cognitive conceptualizations implicating self-concept in OCD development, and they suggest the need to further analyze the influence of self-worth in OCD development and maintenance. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. [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.

  2. 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…

  3. Understanding Obsessive-Compulsive Disorder in Students: Symptoms and School-Based Interventions

    ERIC Educational Resources Information Center

    Dyches, Tina Taylor; Leininger, Melissa; Heath, Melissa Allen; Prater, Mary Anne

    2010-01-01

    This article provides current information relevant to school social workers who serve students with obsessive-compulsive disorder (OCD), including how OCD is defined in children and adolescents, the impact of OCD on schooling, issues in identifying students with OCD, and effective interventions. The authors offer suggestions for collaboration…

  4. 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…

  5. Treatment of Refractory Obsessive-Compulsive Disorder: The St. Louis Model

    ERIC Educational Resources Information Center

    VanDyke, Melanie M.; Pollard, C. Alec

    2005-01-01

    In this article, we describe a cognitive behavioral treatment approach to cases of obsessive-compulsive disorder (OCD) that have not responded to standard outpatient evidence-based treatment. The approach begins with an assessment of the reasons why patients have not responded to treatment, which can be grouped into two categories: (a)…

  6. 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…

  7. Two-Year Stability and Change of Schizotypal, Borderline, Avoidant, and Obsessive-Compulsive Personality Disorders

    ERIC Educational Resources Information Center

    Grilo, Carlos M.; Sanislow, Charles A.; Gunderson, John G.; Pagano, Maria E.; Yen, Shirley; Zanarini, Mary C.; Shea, Tracie M.; Skodol, Andrew E.; Stout, Robert L.; Morey, Leslie C.; McGlashan, Thomas H.

    2004-01-01

    The authors examined the stability of schizotypal (STPD), borderline (BPD), avoidant (AVPD) and obsessive-compulsive (OCPD) personality disorders (PDs) over 2 years of prospective multiwave follow-up. Six hundred thirty-three participants recruited at 4 collaborating sites who met criteria for 1 or more of the 4 PDs or for major depressive…

  8. Evidence-Based Psychosocial Treatments for Child and Adolescent Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Barrett, Paula M.; Farrell, Lara; Pina, Armando A.; Peris, Tara S.; Piacentini, John

    2008-01-01

    Child and adolescent obsessive-compulsive disorder (OCD) is a chronic and debilitating condition associated with a wide range of impairments. This article briefly discusses the phenomenology of OCD, the theory underlying current treatment approaches, and the extant psychosocial treatment literature for child and adolescent OCD relative to the…

  9. An Inference-Based Approach to Treating Obsessive-Compulsive Disorders

    ERIC Educational Resources Information Center

    O'Connor, Kieron; Koszegi, Natalia; Aardema, Frederick; van Niekerk, Jan; Taillon, Annie

    2009-01-01

    This article outlines the conceptual and empirical basis for an inference-based approach (IBA) to treating obsessive-compulsive disorder (OCD). The IBA considers that in most cases the obsessional process begins with an initial doubt (e.g., "Maybe my hands are not clean"; "Perhaps the door was not locked"; "There's a chance I made an error"; "I…

  10. The Effectiveness of Treatment for Pediatric Obsessive-Compulsive Disorder: A Meta-Analysis

    ERIC Educational Resources Information Center

    Abramowitz, Jonathan S.; Whiteside, Sephen P.; Deacon, Brett J.

    2005-01-01

    The last decade has seen a noticeable increase in the number of treatment outcome studies for pediatric obsessive-compulsive disorder (OCD). The present article describes a meta-analysis of this literature with the aim of quantifying treatment effects and examining the extent to which various patient or treatment variables are related to outcome.…

  11. Cognitive-Behavioral Family Treatment of Childhood Obsessive-Compulsive Disorder: A Controlled Trial.

    ERIC Educational Resources Information Center

    Barrett, Paula; Healy-Farrell, Lara; March, John S.

    2004-01-01

    Objective: To evaluate the relative efficacy of (1) individual cognitive-behavioral family-based therapy (CBFT); (2) group CBFT; and (3) a waitlist control group in the treatment of childhood obsessive-compulsive disorder (OCD). Method: This study, conducted at a university clinic in Brisbane, Australia, involved 77 children and adolescents with…

  12. Children's Yale-Brown Obsessive Compulsive Scale Modified for Pervasive Developmental Disorders

    ERIC Educational Resources Information Center

    Scahill, Lawrence; McDougle, Christopher J.; Williams, Susan K.; Dimitropoulos, Anastasia; Aman, Michael G.; McCracken, James T.; Tierney, Elaine; Arnold, L. Eugene; Cronin, Pegeen; Grados, Marco; Ghuman, Jaswinder; Koenig, Kathleen; Lam, Kristen S. L.; McGough, James; Posey, David J.; Ritz, Louise; Swiezy, Naomi B.; Vitiello, Benedetto

    2006-01-01

    Objective: To examine the psychometric properties of the Children's Yale-Brown Obsessive Compulsive Scales (CYBOCS) modified for pervasive developmental disorders (PDDs). Method: Raters from five Research Units on Pediatric Psychopharmacology (RUPP) Autism Network were trained to reliability. The modified scale (CYBOCS-PDD), which contains only…

  13. 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…

  14. A School-Based Treatment Model for Pediatric Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Sloman, Glenn M.; Gallant, Jason; Storch, Eric A.

    2007-01-01

    School psychologists have expertise in the realm of school-based assessment and intervention for behavioral, educational, and psychological difficulties. Recent evidence indicates that many school psychologists lack evidenced based knowledge about assessment and treatment of pediatric Obsessive-Compulsive Disorder (OCD). Pediatric OCD is a…

  15. Is Obsessive-Compulsive Disorder a Disturbance of Security Motivation? Comment on Szechtman and Woody (2004)

    ERIC Educational Resources Information Center

    Taylor, Steven; McKay, Dean; Abramowitz, Jonathan S.

    2005-01-01

    H. Szechtman and E. Woody proposed that obsessive-compulsive disorder (OCD) is caused by a malfunctioning brain security motivation system. In the current article, the authors' review of the model suggests that it is limited in the following ways: (a) It is built on a selective review of the empirical literature, (b) it offers no explanation for…

  16. 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…

  17. 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.

  18. Clinical and Cognitive Correlates of Depressive Symptoms among Youth with Obsessive Compulsive Disorder

    ERIC Educational Resources Information Center

    Peris, Tara S.; Bergman, R. Lindsey; Asarnow, Joan R.; Langley, Audra; McCracken, James T.; Piacentini, John

    2010-01-01

    Depression is the most common comorbidity among adults with obsessive compulsive disorder (OCD), yet little is known about depressive symptoms in childhood OCD. This study examined clinical and cognitive variables associated with depressive symptomatology in 71 youths (62% male, M age = 12.7 years) with primary OCD. Youths presented with a range…

  19. 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…

  20. 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.

  1. 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…

  2. 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…

  3. 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…

  4. Increasing Knowledge about Obsessive Compulsive Disorder and Support for Parents and Schools: Evaluation of Initiatives

    ERIC Educational Resources Information Center

    Jassi, Amita D.; Kolvenbach, Sarah; Heyman, Isobel; Macleod, Trish; Rose, Joel; Diamond, Holly

    2016-01-01

    Objective: Obsessive compulsive disorder (OCD) in children can be difficult to detect. Schools and families need to be made aware of the signs and symptoms of OCD in order to facilitate access to treatment. Parents of children with OCD may require support as well as knowledge. This study evaluated two initiatives aimed at increasing knowledge and…

  5. 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…

  6. 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…

  7. Four-Factor Structure of Obsessive-Compulsive Disorder Symptoms in Children, Adolescents, and Adults

    ERIC Educational Resources Information Center

    Stewart, S. Evelyn; Rosario, Maria C.; Baer, Lee; Carter, Alice S.; Brown, Timothy A.; Scharf, Jeremiah M.; Illmann, Cornelia; Leckman, James F.; Sukhodolsky, Denis; Katsovich, Lilya; Rasmussen, Steven; Goodman, Wayne; Delorme, Richard; Leboyer, Marion; Chabane, Nadia; Jenike, Michael A.; Geller, Daniel A.; Pauls, David L.

    2008-01-01

    A study was conducted to establish the efficacy of four-factor obsessive-compulsive disorder (OCD) symptom structure for use in child, adolescent and adult groups. Results indicated that the four-factor OCD structure is inadequate for use in children, adolescent and adult age groups.

  8. 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…

  9. 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…

  10. Case Series: Transformation Obsession in Young People with Obsessive-Compulsive Disorder (OCD)

    ERIC Educational Resources Information Center

    Volz, Chloe; Heyman, Isobel

    2007-01-01

    This article presents a previously unreported symptom of obsessive-compulsive disorder. The young people reported describe a fear of turning into someone or something else or taking on unwanted characteristics. We have called this transformation obsession. The bizarre nature of this obsession had led to misdiagnosis and inappropriate treatments in…

  11. 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…

  12. 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…

  13. 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…

  14. 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…

  15. Orbital frontal cortex in treatment naïve pediatric obsessive-compulsive disorder

    PubMed Central

    MacMaster, Frank; Vora, Anvi; Easter, Phillip; Rix, Carrie; Rosenberg, David

    2010-01-01

    The orbital frontal cortex (OFC) has been implicated in obsessive-compulsive disorder (OCD). Twenty-eight treatment-naïve pediatric OCD patients and twenty-one controls were examined using magnetic resonance imaging. OCD patients had larger right but not left OFC white matter volume than controls. This is fresh evidence implicating white matter in OCD. PMID:20074911

  16. 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…

  17. 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…

  18. 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…

  19. 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.

  20. 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…

  1. 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.

  2. 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…

  3. 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…

  4. Understanding Obsessive-Compulsive Disorder in Students: Symptoms and School-Based Interventions

    ERIC Educational Resources Information Center

    Dyches, Tina Taylor; Leininger, Melissa; Heath, Melissa Allen; Prater, Mary Anne

    2010-01-01

    This article provides current information relevant to school social workers who serve students with obsessive-compulsive disorder (OCD), including how OCD is defined in children and adolescents, the impact of OCD on schooling, issues in identifying students with OCD, and effective interventions. The authors offer suggestions for collaboration…

  5. The Application of Acceptance and Commitment Therapy to Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Twohig, Michael P.

    2009-01-01

    This paper is part of a case series illustrating the application of different therapies to a case of obsessive-compulsive disorder (OCD). It describes the hypothetical application of Acceptance and Commitment Therapy (ACT). This paper covers the philosophy and basic research on language and cognition that inform ACT. It also provides an ACT-based…

  6. Acceptance and Commitment Therapy as a Treatment for Scrupulosity in Obsessive Compulsive Disorder

    ERIC Educational Resources Information Center

    Dehlin, John P.; Morrison, Kate L.; Twohig, Michael P.

    2013-01-01

    This study evaluated acceptance and commitment therapy (ACT) for scrupulosity-based obsessive compulsive disorder (OCD). Five adults were treated with eight sessions of ACT, without in-session exposure, in a multiple baseline across participants design. Daily monitoring of compulsions and avoided valued activities were tracked throughout the…

  7. 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…

  8. 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…

  9. Case Series: Transformation Obsession in Young People with Obsessive-Compulsive Disorder (OCD)

    ERIC Educational Resources Information Center

    Volz, Chloe; Heyman, Isobel

    2007-01-01

    This article presents a previously unreported symptom of obsessive-compulsive disorder. The young people reported describe a fear of turning into someone or something else or taking on unwanted characteristics. We have called this transformation obsession. The bizarre nature of this obsession had led to misdiagnosis and inappropriate treatments in…

  10. 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…

  11. 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…

  12. 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…

  13. 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,…

  14. 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…

  15. Clinical and Cognitive Correlates of Depressive Symptoms among Youth with Obsessive Compulsive Disorder

    ERIC Educational Resources Information Center

    Peris, Tara S.; Bergman, R. Lindsey; Asarnow, Joan R.; Langley, Audra; McCracken, James T.; Piacentini, John

    2010-01-01

    Depression is the most common comorbidity among adults with obsessive compulsive disorder (OCD), yet little is known about depressive symptoms in childhood OCD. This study examined clinical and cognitive variables associated with depressive symptomatology in 71 youths (62% male, M age = 12.7 years) with primary OCD. Youths presented with a range…

  16. 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…

  17. Increasing Knowledge about Obsessive Compulsive Disorder and Support for Parents and Schools: Evaluation of Initiatives

    ERIC Educational Resources Information Center

    Jassi, Amita D.; Kolvenbach, Sarah; Heyman, Isobel; Macleod, Trish; Rose, Joel; Diamond, Holly

    2016-01-01

    Objective: Obsessive compulsive disorder (OCD) in children can be difficult to detect. Schools and families need to be made aware of the signs and symptoms of OCD in order to facilitate access to treatment. Parents of children with OCD may require support as well as knowledge. This study evaluated two initiatives aimed at increasing knowledge and…

  18. 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…

  19. Four-Factor Structure of Obsessive-Compulsive Disorder Symptoms in Children, Adolescents, and Adults

    ERIC Educational Resources Information Center

    Stewart, S. Evelyn; Rosario, Maria C.; Baer, Lee; Carter, Alice S.; Brown, Timothy A.; Scharf, Jeremiah M.; Illmann, Cornelia; Leckman, James F.; Sukhodolsky, Denis; Katsovich, Lilya; Rasmussen, Steven; Goodman, Wayne; Delorme, Richard; Leboyer, Marion; Chabane, Nadia; Jenike, Michael A.; Geller, Daniel A.; Pauls, David L.

    2008-01-01

    A study was conducted to establish the efficacy of four-factor obsessive-compulsive disorder (OCD) symptom structure for use in child, adolescent and adult groups. Results indicated that the four-factor OCD structure is inadequate for use in children, adolescent and adult age groups.

  20. 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…

  1. No Evidence for Object Alternation Impairment in Obsessive-Compulsive Disorder (OCD)

    ERIC Educational Resources Information Center

    Moritz, Steffen; Jelinek, Lena; Hottenrott, Birgit; Klinge, Ruth; Randjbar, Sarah

    2009-01-01

    Recent neuroimaging studies have consistently ascribed the orbito-frontal cortex (OFC) a pivotal role in the pathogenesis of obsessive-compulsive disorder (OCD). Cognitive tests presumed sensitive to this region, such as the Object Alternation Task (OAT), are considered important tools to verify this assumption and to investigate the impact of…

  2. 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…

  3. The Application of Acceptance and Commitment Therapy to Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Twohig, Michael P.

    2009-01-01

    This paper is part of a case series illustrating the application of different therapies to a case of obsessive-compulsive disorder (OCD). It describes the hypothetical application of Acceptance and Commitment Therapy (ACT). This paper covers the philosophy and basic research on language and cognition that inform ACT. It also provides an ACT-based…

  4. Acceptance and Commitment Therapy as a Treatment for Scrupulosity in Obsessive Compulsive Disorder

    ERIC Educational Resources Information Center

    Dehlin, John P.; Morrison, Kate L.; Twohig, Michael P.

    2013-01-01

    This study evaluated acceptance and commitment therapy (ACT) for scrupulosity-based obsessive compulsive disorder (OCD). Five adults were treated with eight sessions of ACT, without in-session exposure, in a multiple baseline across participants design. Daily monitoring of compulsions and avoided valued activities were tracked throughout the…

  5. 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…

  6. No Evidence for Object Alternation Impairment in Obsessive-Compulsive Disorder (OCD)

    ERIC Educational Resources Information Center

    Moritz, Steffen; Jelinek, Lena; Hottenrott, Birgit; Klinge, Ruth; Randjbar, Sarah

    2009-01-01

    Recent neuroimaging studies have consistently ascribed the orbito-frontal cortex (OFC) a pivotal role in the pathogenesis of obsessive-compulsive disorder (OCD). Cognitive tests presumed sensitive to this region, such as the Object Alternation Task (OAT), are considered important tools to verify this assumption and to investigate the impact of…

  7. Two-Year Stability and Change of Schizotypal, Borderline, Avoidant, and Obsessive-Compulsive Personality Disorders

    ERIC Educational Resources Information Center

    Grilo, Carlos M.; Sanislow, Charles A.; Gunderson, John G.; Pagano, Maria E.; Yen, Shirley; Zanarini, Mary C.; Shea, Tracie M.; Skodol, Andrew E.; Stout, Robert L.; Morey, Leslie C.; McGlashan, Thomas H.

    2004-01-01

    The authors examined the stability of schizotypal (STPD), borderline (BPD), avoidant (AVPD) and obsessive-compulsive (OCPD) personality disorders (PDs) over 2 years of prospective multiwave follow-up. Six hundred thirty-three participants recruited at 4 collaborating sites who met criteria for 1 or more of the 4 PDs or for major depressive…

  8. 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…

  9. 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…

  10. 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,…

  11. Children's Yale-Brown Obsessive Compulsive Scale Modified for Pervasive Developmental Disorders

    ERIC Educational Resources Information Center

    Scahill, Lawrence; McDougle, Christopher J.; Williams, Susan K.; Dimitropoulos, Anastasia; Aman, Michael G.; McCracken, James T.; Tierney, Elaine; Arnold, L. Eugene; Cronin, Pegeen; Grados, Marco; Ghuman, Jaswinder; Koenig, Kathleen; Lam, Kristen S. L.; McGough, James; Posey, David J.; Ritz, Louise; Swiezy, Naomi B.; Vitiello, Benedetto

    2006-01-01

    Objective: To examine the psychometric properties of the Children's Yale-Brown Obsessive Compulsive Scales (CYBOCS) modified for pervasive developmental disorders (PDDs). Method: Raters from five Research Units on Pediatric Psychopharmacology (RUPP) Autism Network were trained to reliability. The modified scale (CYBOCS-PDD), which contains only…

  12. Evidence-Based Psychosocial Treatments for Child and Adolescent Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Barrett, Paula M.; Farrell, Lara; Pina, Armando A.; Peris, Tara S.; Piacentini, John

    2008-01-01

    Child and adolescent obsessive-compulsive disorder (OCD) is a chronic and debilitating condition associated with a wide range of impairments. This article briefly discusses the phenomenology of OCD, the theory underlying current treatment approaches, and the extant psychosocial treatment literature for child and adolescent OCD relative to the…

  13. The Effectiveness of Treatment for Pediatric Obsessive-Compulsive Disorder: A Meta-Analysis

    ERIC Educational Resources Information Center

    Abramowitz, Jonathan S.; Whiteside, Sephen P.; Deacon, Brett J.

    2005-01-01

    The last decade has seen a noticeable increase in the number of treatment outcome studies for pediatric obsessive-compulsive disorder (OCD). The present article describes a meta-analysis of this literature with the aim of quantifying treatment effects and examining the extent to which various patient or treatment variables are related to outcome.…

  14. Meta-Analysis of Randomized, Controlled Treatment Trials for Pediatric Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Watson, Hunna J.; Rees, Clare S.

    2008-01-01

    Objective: To conduct a meta-analysis on randomized, controlled treatment trials of pediatric obsessive-compulsive disorder (OCD). Method: Studies were included if they employed randomized, controlled methodology and treated young people (19 years or under) with OCD. A comprehensive literature search identified 13 RCTs containing 10…

  15. 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…

  16. Meta-Analysis of Randomized, Controlled Treatment Trials for Pediatric Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Watson, Hunna J.; Rees, Clare S.

    2008-01-01

    Objective: To conduct a meta-analysis on randomized, controlled treatment trials of pediatric obsessive-compulsive disorder (OCD). Method: Studies were included if they employed randomized, controlled methodology and treated young people (19 years or under) with OCD. A comprehensive literature search identified 13 RCTs containing 10…

  17. 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…

  18. School Psychologists' Views and Management of Obsessive-Compulsive Disorder in Children and Adolescents

    ERIC Educational Resources Information Center

    Gallant, Jason; Storch, Eric A.; Valderhaug, Robert; Geffken, Gary R.

    2007-01-01

    Over the past decade, an increasing body of research has been conducted on evidence-based psychological and psychiatric treatment for pediatric obsessive-compulsive disorder (OCD). Despite this improved understanding, however, these treatments are not being performed. This study descriptively examined the practices and views of school…

  19. School Psychologists' Views and Management of Obsessive-Compulsive Disorder in Children and Adolescents

    ERIC Educational Resources Information Center

    Gallant, Jason; Storch, Eric A.; Valderhaug, Robert; Geffken, Gary R.

    2007-01-01

    Over the past decade, an increasing body of research has been conducted on evidence-based psychological and psychiatric treatment for pediatric obsessive-compulsive disorder (OCD). Despite this improved understanding, however, these treatments are not being performed. This study descriptively examined the practices and views of school…

  20. 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…

  1. 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…

  2. A School-Based Treatment Model for Pediatric Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Sloman, Glenn M.; Gallant, Jason; Storch, Eric A.

    2007-01-01

    School psychologists have expertise in the realm of school-based assessment and intervention for behavioral, educational, and psychological difficulties. Recent evidence indicates that many school psychologists lack evidenced based knowledge about assessment and treatment of pediatric Obsessive-Compulsive Disorder (OCD). Pediatric OCD is a…

  3. Early Maladaptive Schemas in Obsessive-Compulsive Disorder and Anxiety Disorders.

    PubMed

    Yoosefi, Afsaneh; RajeziEsfahani, Sepideh; Pourshahbaz, Abbas; Dolatshahee, Behrooz; Assadi, Abbasali; Maleki, Fahime; Momeni, Sara

    2016-10-01

    Purpose of this study is comparing early maladaptive schemas which are active in patients suffering from obsessive-compulsive disorder and anxiety disorders together, considering recent DSM-5 changes through which OCD has been placed in a separate and new diagnostic level. This research is a causal-comparative study. 151 persons were categorized in three groups of people suffering from OCD (50), suffering from anxiety disorders (50), and control group (51). Early diagnosis of disorders in two clinical groups were verified based on structured clinical interview for DSM )SCID-I) and Yale-Brown obsessive-compulsive scale (Y-BOCS). General health questionnaire (GHQ-28), the short versions of the Young schemas questionnaire (YSQ), and Padua inventory-Washington State University Revision (PI-WSUR) were also implemented. Findings revealed that mean scores of all schemas of those suffering from anxiety disorders, except for Self-Sacrifice, Unrelenting-Standards/Hypercriticalness, Entitlement/Grandiosity schemas, and mean scores of all early maladaptive schemas of those suffering from obsessive compulsive disorder are significantly higher than those of control group. OCD group had significantly higher scores in Emotional Deprivation, Mistrust/Abuse, and Defectiveness/Shame schemas than anxiety disorders group. Defectiveness/Shame and Vulnerability to Harm or Illness schemas can explain 38 percent of variance of obsessive compulsive symptoms. The dominant and specific early maladaptive schemas of OCD are Defectiveness/Shame, Mistrust/Abuse, and Emotional Deprivation Schemas. This study besides supporting the theory of early maladaptive schemas, suggests that interventions based on specific schemas can be useful methods in treatment of OCD and anxiety disorders.

  4. Schizophrenia and obsessive-compulsive disorder: from comorbidity to schizo-obsessive disorder.

    PubMed

    Attademo, Luigi; De Giorgio, Giuseppina; Quartesan, Roberto; Moretti, Patrizia

    2012-01-01

    Current genetic, neurobiological, clinical-descriptive and pharmacological data about obsessive-compulsive symptoms (OCS) and/or obsessive-compulsive disorder (OCD) in schizophrenia hypothesize that schizophrenia combined with OCD is more than a mere comorbidity. To prove this hypothesis, “dimensional diagnosis”, based on the identification of a dysfunctional area common to different clinical cases, should replace “categorical diagnosis”, that focuses on discrete parameters that define specific disorders. It is our hope that the DSM-V will make reference to principles based on psychopathological “spectra” because these reflect the integration of pharmacotherapeutic, descriptive and etiopathogenetic aspects (genotypes common to various disorders, temperamental predispositions, neurobiological and chemical alteration). These three aspects explain how obsessive phenomena can develop into delusional phenomena.

  5. Health anxiety in obsessive compulsive disorder and obsessive compulsive symptoms in severe health anxiety: An investigation of symptom profiles.

    PubMed

    Hedman, Erik; Ljótsson, Brjánn; Axelsson, Erland; Andersson, Gerhard; Rück, Christian; Andersson, Erik

    2017-01-01

    Severe health anxiety (SHA) shares features with obsessive-compulsive disorder (OCD) and in recent years there has been a debate as to whether the two disorders may represent two facets of the same condition. Few studies have however investigated the overlap and differences in symptom profiles between the disorders. The primary aim of the present study was to investigate these aspects using one sample of participants with a principal diagnosis of SHA and one sample of participants with a principal OCD diagnosis. The second aim was to examine differences in improvement trajectories on measures of health anxiety and OCD symptoms in patients with SHA receiving treatment with exposure and response prevention. We compared persons participating in clinical trials with a principal diagnosis of SHA (N=290) to persons with a principal diagnosis of OCD (n=95) on measures of health anxiety, OCD symptoms, and depressive symptoms. A subsample of SHA participants (n=99) received exposure and response prevention (ERP) for SHA over 12 weeks and was assessed at baseline and post-treatment. The results showed large and significant differences between SHA and OCD patients on measures of health anxiety (ds=2.99-3.09) and OCD symptoms (ds=1.64-2.14), while they had equivalent levels of depressive symptoms (d=0.19, 95% CI [-0.04, 0.43]). In the SHA sample 7.6% had comorbid OCD, and in the OCD sample 9.5% had SHA. For participants with a principal diagnosis of SHA, ERP led to large reductions of health anxiety, but effects on OCD symptoms were small to moderate. Among participants with comorbid OCD, effect sizes were large on measures of health anxiety and moderate to large on OCD measures. We conclude that SHA and OCD are separate psychiatric disorders with limited overlap in symptom profiles. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. 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.

  7. Review of behavioral psychotherapy, I: Obsessive-compulsive disorders.

    PubMed

    Marks, I M

    1981-05-01

    Obsessive-compulsive ritualizers have maintained their improvement after exposure in vivo for up to 3 years' follow-up in the United States, Britain, Greece, and Australia. Unlike exposure in vivo, relaxation is of little value. Early gains in treatment predict long-term outcome. Exposure therapy is usually on an outpatient basis and takes 1-30 sessions. Self-exposure homework is critical. Sessions at home are also required, together with relatives cooperating as exposure cotherapists. Some patients can treat themselves almost unaided, while others need extensive assistance. Clomipramine is helpful for ritualizers with coexisting depression, but depression tends to recur when clomipramine therapy is stopped.

  8. 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).

  9. An Internet administered treatment program for obsessive-compulsive disorder: a feasibility study.

    PubMed

    Wootton, Bethany M; Titov, Nickolai; Dear, Blake F; Spence, Jay; Andrews, Gavin; Johnston, Luke; Solley, Karen

    2011-12-01

    The present study evaluates efficacy of a new Internet-administered cognitive behavioral therapy (CBT) protocol, The OCD Program, designed to treat obsessive-compulsive disorder (OCD) remotely. This protocol comprises 8 online lessons delivered over 8 weeks and incorporates cognitive and behavioral techniques. Twenty-two individuals with a principal diagnosis of OCD received CBT-based online lessons, homework assignments, twice weekly contact from a clinical psychologist, and automated emails. Eighty-one percent of participants completed the lessons within the 8-week program. Post-treatment and 3-month follow-up data were collected from 21/21 (100%) and 19/21 (91%) participants, respectively. Participants improved significantly on the primary outcome measures, the Yale-Brown Obsessive Compulsive Scale and Obsessive Compulsive Inventory-Revised, with within-groups effect sizes (Cohen's d) at follow-up of 1.28 and 0.60, respectively. Participants rated the procedure as highly acceptable despite receiving an average of only 86min (SD=54.4min) telephone contact with the therapist over the 8 weeks. These results provide preliminary support for efficacy of Internet-administered treatment for obsessive-compulsive disorder. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Neuromodulation of the inferior thalamic peduncle for major depression and obsessive compulsive disorder.

    PubMed

    Jiménez, F; Velasco, F; Salín-Pascual, R; Velasco, M; Nicolini, H; Velasco, A L; Castro, G

    2007-01-01

    Neuromodulation of the inferior thalamic peduncle is a new surgical treatment for major depression and obsessive-compulsive disorder. The inferior thalamic peduncle is a bundle of fibers connecting the orbito-frontal cortex with the non-specific thalamic system in a small area behind the fornix and anterior to the polar reticular thalamic nucleus. Electrical stimulation elicits characteristic frontal cortical responses (recruiting responses and direct current (DC)-shift) that confirm correct localization of this anatomical structure. A female with depression for 23 years and a male with obsessive-compulsive disorder for 9 years had stereotactic implantation of electrodes in the inferior thalamic peduncle and were evaluated over a long-term period. Initial OFF stimulation period (1 month) showed no consistent changes in the Hamilton Depression Scale (HAM-D), Yale Brown Obsessive Compulsive Scale (YBOCS), or Global Assessment of Functioning scale (GAF). The ON stimulation period (3-5 V, 130-Hz frequency, 450-msec pulse width in a continuous program) showed significant decrease in depression, obsession, and compulsion symptoms. GAF improved significantly in both cases. The neuropsychological tests battery showed no significant changes except from a reduction in the perseverative response of the obsessive-compulsive patient and better performance in manual praxias of the female depressive patient. Moderate increase in weight (5 kg on average) was observed in both cases.

  11. Deep brain stimulation for treatment-refractory obsessive compulsive disorder: a systematic review.

    PubMed

    Kohl, Sina; Schönherr, Deva M; Luigjes, Judy; Denys, Damiaan; Mueller, Ulf J; Lenartz, Doris; Visser-Vandewalle, Veerle; Kuhn, Jens

    2014-08-02

    Obsessive-compulsive disorder is one of the most disabling of all psychiatric illnesses. Despite available pharmacological and psychotherapeutic treatments about 10% of patients remain severely affected and are considered treatment-refractory. For some of these patients deep brain stimulation offers an appropriate treatment method. The scope of this article is to review the published data and to compare different target structures and their effectiveness. PubMed search, last update June 2013, was conducted using the terms "deep brain stimulation" and "obsessive compulsive disorder". In total 25 studies were found that reported five deep brain stimulation target structures to treat obsessive-compulsive disorder: the anterior limb of the internal capsule (five studies including 14 patients), nucleus accumbens (eight studies including 37 patients), ventral capsule/ventral striatum (four studies including 29 patients), subthalamic nucleus (five studies including 23 patients) and inferior thalamic peduncle (two studies including 6 patients). Despite the anatomical diversity, deep brain stimulation treatment results in similar response rates for the first four target structures. Inferior thalamic peduncle deep brain stimulation results in higher response rates but these results have to be interpreted with caution due to a very small number of cases. Procedure and device related adverse events are relatively low, as well as stimulation or therapy related side effects. Most stimulation related side effects are transient and decline after stimulation parameters have been changed. Deep brain stimulation in treatment-refractory obsessive-compulsive disorder seems to be a relatively safe and promising treatment option. However, based on these studies no superior target structure could be identified. More research is needed to better understand mechanisms of action and response predictors that may help to develop a more personalized approach for these severely affected

  12. Corpus callosum abnormalities in medication-naïve adult patients with obsessive compulsive disorder.

    PubMed

    Jose, Dania; Narayanaswamy, Janardhanan C; Agarwal, Sri Mahavir; Kalmady, Sunil V; Venkatasubramanian, Ganesan; Reddy, Y C Janardhan

    2015-03-30

    Emerging evidence demonstrates widespread abnormalities involving white matter (WM) tracts connecting different cortical regions in obsessive-compulsive disorder (OCD). The corpus callosum (CC), the largest inter-hemispheric tract connecting the association cortices, has been shown to be affected in OCD. This study examines CC abnormalities in a large sample of medication-naïve OCD patients in comparison to matched healthy controls (HCs). We examined the mid-sagittal area of the CC in medication-naïve OCD patients (n=49) in comparison with age-, sex-, and handedness-matched HCs (n=38). Witelson's method was used to measure the sub-regions of the CC - namely, the genu, body, isthmus and splenium - with good inter-rater reliability. The area of the body of the CC and total CC area were significantly larger in OCD patients than in HCs after controlling for age, sex and intracranial area. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) compulsion score had a significant negative correlation with the areas of the isthmus and splenium of the CC in addition to the total CC area. The region-specific differences in the body of the CC and the region-specific association of severity score with posterior regions of the CC might be indicative of the involvement of additional areas like the dorsolateral prefrontal cortex, posterior parietal areas, occipital and association cortices in OCD that extend beyond the conventional orbito-fronto-striatal circuitry that is often posited to be involved in OCD. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. 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

  14. Efficacy of drug treatment in obsessive-compulsive disorder. A meta-analytic review.

    PubMed

    Piccinelli, M; Pini, S; Bellantuono, C; Wilkinson, G

    1995-04-01

    A review of the efficacy of antidepressant drug treatment in patients with obsessive-compulsive disorder (OCD), using a meta-analytic approach. Randomised double-blind clinical trials of antidepressant drugs, carried out among patients with OCD and published in peer-reviewed journals between 1975 and May 1994, were selected together with three studies currently in press. Forty-seven trials were located by searching the Medline and Excerpta Medica-Psychiatry data bases, scanning psychiatric and psychopharmacological journals, consulting recent published reviews and bibliographies, contacting pharmaceutical companies and through cross-references. Hedges' g was computed in pooled data at the conclusion of treatment under double-blind conditions or at the latest reported point of time during this treatment period. For each trial, effect sizes were computed for all available outcome measures of the following dependent variables: obsessive-compulsive symptoms considered together; obsessions; compulsions; depression; anxiety; global clinical improvement; psychosocial adjustment; and physical symptoms. Clomipramine was superior to placebo in reducing both obsessive-compulsive symptoms considered together (g = 1.31; 95% CI = 1.15 to 1.47) as well as obsessions (g = 0.89, 95% CI = 0.36 to 1.42) and compulsions (g = 0.79; 95% CI = 0.34 to 1.24) taken separately. Also, selective serotonin re-uptake inhibitors (SSRIs) as a class were superior to placebo, weighted mean g being respectively 0.47 (95% CI = 0.33 to 0.61), 0.54 (95% CI = 0.34 to 0.74) and 0.52 (95% CI = 0.34 to 0.70) for obsessive-compulsive symptoms considered together, and obsessions and compulsions taken separately. Although on Y-BOCS the increase in improvement rate over placebo was 61.3%, 28.5%, 28.2% and 21.6% for clomipramine, fluoxetine, fluvoxamine, and sertraline respectively, the trials testing clomipramine against fluoxetine and fluvoxamine showed similar therapeutic efficacy between these drugs. Finally

  15. Aetiological overlap between obsessive-compulsive related and anxiety disorder symptoms: multivariate twin study.

    PubMed

    López-Solà, Clara; Fontenelle, Leonardo F; Bui, Minh; Hopper, John L; Pantelis, Christos; Yücel, Murat; Menchón, José M; Alonso, Pino; Harrison, Ben J

    2016-01-01

    The aetiological boundary between obsessive-compulsive related disorders (OCRDs) including obsessive-compulsive disorder (OCD) and anxiety disorders is unclear and continues to generate debate. To determine the genetic overlap and the pattern of causal relationships among OCRDs and anxiety disorders. Multivariate twin modelling methods and a new regression analysis to infer causation were used, involving 2495 male and female twins. The amount of common genetic liability observed for OCD symptoms was higher when considering anxiety disorders and OCRDs in the model v. modelling OCRD symptoms alone. OCD symptoms emerged as risk factors for the presence of generalised anxiety, panic and hoarding symptoms, whereas social phobia appeared as a risk factor for OCD symptoms. OCD represents a complex phenotype that includes important shared features with anxiety disorders and OCRDs. The novel patterns of risk identified between OCD and anxiety disorder may help to explain their frequent co-occurrence. © The Royal College of Psychiatrists 2016.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. [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.

  2. 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

  3. Pituitary volume in medication-naïve adults with obsessive compulsive disorder.

    PubMed

    Narayanaswamy, Janardhanan C; Jose, Dania; Kalmady, Sunil V; Venkatasubramanian, Ganesan; Reddy, Y C Janardhan

    2015-01-01

    Pituitary volume is considered to reflect hypothalamic-pituitary-adrenal axis dysregulation, and this has been studied in various psychiatric disorders. This study demonstrates that pituitary volume as assessed through the region of interest manual tracing method in 50 medication-naïve adult patients with obsessive-compulsive disorder was not significantly different compared with 40 healthy control subjects (687.80 ± 126.60 versus 694.73 ± 131.59, F=0.55, p=0.46). The authors also compared the patients with obsessive-compulsive disorder without any comorbid axis I conditions (N=35) with healthy control subjects and found no difference in the pituitary volumes (681.62 ± 130.85 versus 694.72 ± 131.59, F=0.90, p=0.35). This emphasizes the need to examine hypothalamo-pituitary axis structures after taking into consideration various potential confounders such as medications and depression.

  4. Dissociative symptoms and dissociative disorder comorbidity in patients with obsessive-compulsive disorder.

    PubMed

    Belli, Hasan; Ural, Cenk; Vardar, Melek Kanarya; Yesılyurt, Sema; Oncu, Fatıh

    2012-10-01

    The present study attempted to assess the dissociative symptoms and overall dissociative disorder comorbidity in patients with obsessive-compulsive disorder (OCD). In addition, we examined the relationship between the severity of obsessive-compulsive symptoms and dissociative symptoms. All patients admitted for the first time to the psychiatric outpatient unit were included in the study. Seventy-eight patients had been diagnosed as having OCD during the 2-year study period. Patients had to meet the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for OCD. Most (76.9%; n = 60) of the patients were female, and 23.1% (n = 18) of the patients were male. Dissociation Questionnaire was used to measure dissociative symptoms. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Dissociative Disorders interviews and Yale-Brown Obsessive Compulsive Checklist and Severity Scale were used. Eleven (14%) of the patients with OCD had comorbid dissociative disorder. The most prevalent disorder in our study was dissociative depersonalization disorder. Dissociative amnesia and dissociative identity disorder were common as well. The mean Yale-Brown score was 23.37 ± 7.27 points. Dissociation Questionnaire scores were between 0.40 and 3.87 points, and the mean was 2.23 ± 0.76 points. There was a statistically significant positive correlation between Yale-Brown points and Dissociation Questionnaire points. We conclude that dissociative symptoms among patients with OCD should alert clinicians for the presence of a chronic and complex dissociative disorder. Clinicians may overlook an underlying dissociative process in patients who have severe symptoms of OCD. However, a lack of adequate response to cognitive-behavioral and drug therapy may be a consequence of dissociative process. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Differences in Affective Temperaments in Anxiety Disorders: Comparison of Panic Disorder and Obsessive Compulsive Disorder

    PubMed Central

    FISTIKÇI, Nurhan; HACIOĞLU, Münevver; EREK, Şakire; TABO, Abdülkadir; ERTEN, Evrim; GÜLER, Ayşegül Selcen; KALKAN, Murat; SAATÇİOĞLU, Ömer

    2013-01-01

    Introduction In this study, probable differences in affective temperament among anxiety disorders were investigated via a comparison of panic disorder (PD) and obsessive-compulsive disorder (OCD). Method 44 patients with OCD and 42 patients with PD, who were admitted to Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Neurology and Neurosurgery outpatient clinics with complaints of OCD and PD and were diagnosed according to DSM IV criteria, were consecutively included in the study after informed consent was taken. A sociodemographic form, the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID I), Hamilton Depression Rating Scale (HAM-D), Beck Anxiety Inventory, Panic and Agoraphobia Scale, Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the temperament evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) were given to the patients. PD and OCD patients were compared in terms of affective temperament characteristics. Results Mean age, educational status and gender distribution of OCD and PD patients were similar (p>0.05). Dominant depressive temperament was more prominent in OCD group than in PD group (p=0.021). Hyperthymic temperament scores were higher in PD group than in OCD group (p=0.002). Dominant hyperthymic temperament was not encountered in either group. Conclusion Dominant depressive temperament was more prominent in OCD group whereas hyperthymic temperament scores were higher in PD group. These findings should be evaluated in studies with larger sample sizes. PMID:28360567

  6. Cognitive-behavioral treatment of obsessive-compulsive disorder in a child with Asperger syndrome: a case report.

    PubMed

    Reaven, Judy; Hepburn, Susan

    2003-06-01

    This case report outlines the cognitive-behavioral treatment of obsessive-compulsive disorder in a 7-year-old female with Asperger syndrome. Interventions were based upon the work of March and Mulle and were adapted in light of the patient's cognitive, social, and linguistic characteristics. Obsessive-compulsive symptoms improved markedly after approximately 6 months of treatment. Issues regarding symptom presentation, assessment, and treatment of a dually diagnosed patient are discussed.

  7. Cross-Disorder Genetic Analysis of Tic Disorders, Obsessive-Compulsive, and Hoarding Symptoms.

    PubMed

    Zilhão, Nuno R; Smit, Dirk J; Boomsma, Dorret I; Cath, Danielle C

    2016-01-01

    Hoarding, obsessive-compulsive disorder (OCD), and Tourette's disorder (TD) are psychiatric disorders that share symptom overlap, which might partly be the result of shared genetic variation. Population-based twin studies have found significant genetic correlations between hoarding and OCD symptoms, with genetic correlations varying between 0.1 and 0.45. For tic disorders, studies examining these correlations are lacking. Other lines of research, including clinical samples and GWAS or CNV data to explore genetic relationships between tic disorders and OCD, have only found very modest if any shared genetic variation. Our aim was to extend current knowledge on the genetic structure underlying hoarding, OC symptoms (OCS), and lifetime tic symptoms and, in a trivariate analysis, assess the degree of common and unique genetic factors contributing to the etiology of these disorders. Data have been gathered from participants in the Netherlands Twin Register comprising a total of 5293 individuals from a sample of adult monozygotic (n = 2460) and dizygotic (n = 2833) twin pairs (mean age 33.61 years). The data on Hoarding, OCS, and tic symptoms were simultaneously analyzed in Mplus. A liability threshold model was fitted to the twin data, analyzing heritability of phenotypes and of their comorbidity. Following the criteria for a probable clinical diagnosis in all phenotypes, 6.8% of participants had a diagnosis of probable hoarding disorder (HD), 6.3% of OCS, and 12.8% of any probable lifetime tic disorder. Genetic factors explained 50.4, 70.1, and 61.1% of the phenotypic covariance between hoarding-OCS, hoarding-tics, and OCS-tics, respectively. Substantial genetic correlations were observed between hoarding and OCS (0.41), hoarding and tics (0.35), and between OCS and tics (0.37). These results support the contribution of genetic factors in the development of these disorders and their comorbidity. Furthermore, tics were mostly influenced by specific

  8. 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.

  9. 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

  10. Family study of obsessive-compulsive disorder in a Mexican population.

    PubMed

    Nicolini, H; Weissbecker, K; Mejía, J M; Sánchez de Carmona, M

    1993-01-01

    Twenty seven obsessive-compulsive disorder (OCD) patients were studied at the Instituto Mexicano de Psiquiatría in Mexico City. This is the first sample of OCD patients studied in Latin America. There was a significant sex ratio difference and a significant difference in the type of obsessions and compulsions displayed by males and females. Co-morbidity data demonstrated a high frequency of obsessive-compulsive personality disorders, depression, sexual abuse, suicidal attempts and neurological damage. Approximately one third of OCD cases demonstrated a positive family history. There was a higher than expected frequency of first degree relatives affected with OCD. In addition, this study may support the hypothesis that OCD and tics are genetically related.

  11. Early sleep psychiatric intervention for acute insomnia: implications from a case of obsessive-compulsive disorder.

    PubMed

    Abe, Yuichiro; Nishimura, Go; Endo, Takuro

    2012-04-15

    Insomnia is a common problem among patients with obsessive-compulsive disorder (OCD), and patients suffering from acute insomnia with psychiatric comorbidity are more likely to develop chronic insomnia without appropriate intervention. Here we report a case of obsessive-compulsive disorder with acute insomnia, successfully treated with early sleep psychiatric non-pharmacological intervention. The augmentation of medication runs a risk of exacerbating daytime impairment. Clinicians usually prescribe medication, such as antidepressants and hypnotics without reflections for such complaints. However, the use of these sedative agents is often problematic, especially when patients have kept a good QOL activity in daily life. The rapid recovery from acute insomnia in this case suggests that the appropriate use of actigraphy is a favorable non-pharmacological intervention in acute insomnia.

  12. Comparative Prevalence of Eating Disorders in Obsessive-Compulsive Disorder and Other Anxiety Disorders

    PubMed Central

    Tyagi, Himanshu; Patel, Rupal; Rughooputh, Fabienne; Abrahams, Hannah; Watson, Andrew J.; Drummond, Lynne

    2015-01-01

    Objective. The purpose of this study was to compare the prevalence of comorbid eating disorders in Obsessive-Compulsive Disorder (OCD) and other common anxiety disorders. Method. 179 patients from the same geographical area with a diagnosis of OCD or an anxiety disorder were divided into two groups based on their primary diagnosis. The prevalence of a comorbid eating disorder was calculated in both groups. Results. There was no statistically significant difference in the prevalence of comorbid eating disorders between the OCD and other anxiety disorders group. Conclusions. These results suggest that the prevalence of comorbid eating disorders does not differ in anxiety disorders when compared with OCD. However, in both groups, it remains statistically higher than that of the general population. PMID:26366407

  13. Hypomania with hypersexuality following bilateral anterior limb stimulation in obsessive-compulsive disorder.

    PubMed

    Chang, Chun-Hung; Chen, Shin-Yuan; Hsiao, Yi-Ling; Tsai, Sheng-Tzung; Tsai, Hsin-Chi

    2010-06-01

    This 28-year-old Chinese man was referred for deep brain stimulation (DBS) evaluation for an 8-year history of refractory obsessive-compulsive disorder. After the patient had signed an informed consent, the authors implanted DBS leads. Hypomania with hypersexuality was noted on stimulation at Contact 2 and became aggravated with a higher voltage (> or = 3 V) during chronic bilateral DBS. After the voltage was decreased to 1 V, the patient's hypomanic symptoms subsided and his libido returned to baseline.

  14. A neuropsychiatric review of pediatric obsessive-compulsive disorder: etiology and efficacious treatments

    PubMed Central

    Lewin, Adam B; Storch, Eric A; Geffken, Gary R; Goodman, Wayne K; Murphy, Tanya K

    2006-01-01

    Pediatric obsessive-compulsive disorder (OCD) is a chronic neuropsychiatric condition associated with broad impairments in functioning. This paper outlines current etiological theories of OCD, providing a review of neuroanatomical, neurochemical, neuroimmunological, and cognitive–behavioral explanations. Subsequently, first-line treatment modalities are discussed (serotonin reuptake inhibitors [SRIs] and cognitive–behavioral therapy [CBT] with exposure and response prevention [E/RP]) in the context of recent pharmacological, CBT, and combined trials. PMID:19412443

  15. Endophenotypes and serotonergic polymorphisms associated with treatment response in obsessive-compulsive disorder

    PubMed Central

    Corregiari, Fábio M; Bernik, Márcio; Cordeiro, Quirino; Vallada, Homero

    2012-01-01

    OBJECTIVES: Approximately 40-60% of obsessive-compulsive disorder patients are nonresponsive to serotonin reuptake inhibitors. Genetic markers associated with treatment response remain largely unknown. We aimed (1) to investigate a possible association of serotonergic polymorphisms in obsessive-compulsive disorder patients and therapeutic response to selective serotonin reuptake inhibitors and (2) to examine the relationship between these polymorphisms and endocrine response to intravenous citalopram challenge in responders and non-responders to serotonin reuptake inhibitors and in healthy volunteers. METHODS: Patients with obsessive-compulsive disorder were classified as either responders or non-responders after long-term treatment with serotonin reuptake inhibitors, and both groups were compared with a control group of healthy volunteers. The investigated genetic markers were the G861C polymorphism of the serotonin receptor 1Dβ gene and the T102C and C516T polymorphisms of the serotonin receptor subtype 2A gene. RESULTS: The T allele of the serotonin receptor subtype 2A T102C polymorphism was more frequent among obsessive-compulsive disorder patients (responders and non-responders) than in the controls (p<0.01). The CC genotype of the serotonin receptor subtype 2A C516T polymorphism was more frequent among the non-responders than in the responders (p<0.01). The CC genotype of the serotonin receptor subtype 1Dβ G681C polymorphism was associated with higher cortisol and prolactin responses to citalopram (p<0.01 and p<0.001, respectively) and with a higher platelet-rich plasma serotonin concentration among the controls (p<0.05). However, this pattern was not observed in the non-responders with the same CC genotype after chronic treatment with serotonin reuptake inhibitors. This CC homozygosity was not observed in the responders. PMID:22522758

  16. Scrupulosity and obsessive compulsive disorder: the cognitive perspective in Islamic sources.

    PubMed

    Besiroglu, Lutfullah; Karaca, Sitki; Keskin, Ibrahim

    2014-02-01

    A moral/religious subtype of obsessive compulsive disorder has been termed as scrupulosity by mental health professionals. Since ultimate feared consequence in scrupulous individuals is religious or moral in nature, it also presents interesting and difficult issue for religious authorities. This article focuses on various aspects of scrupulosity that have until now been poorly conceptualized in Islamic world and provides a conceptual cognitive framework and analysis of scrupulosity according to Islamic sources.

  17. 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

    2017-07-26

    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. Key Pratictioner Message The current study provides evidence about the discrimination between clinical obsessions, worries, and illness intrusions from a transdiagnostic perspective. The differentiation between them is crucial for the diagnosis, formulation, and psychological treatment of obsessive-compulsive disorder

  18. Course of illness in comorbid bipolar disorder and obsessive-compulsive disorder patients.

    PubMed

    Amerio, A; Tonna, M; Odone, A; Stubbs, B; Ghaemi, S N

    2016-04-01

    Psychiatric comorbidity is extremely common. One of the most common and difficult to manage comorbid conditions is the co-occurrence of bipolar disorder (BD) and obsessive compulsive disorder (OCD). We updated our recent systematic review searching the electronic databases MEDLINE, Embase, and PsycINFO to investigate course of illness in BD-OCD patients. We identified a total of 13 relevant papers which found that the majority of comorbid OCD cases appeared to be related to mood episodes. OC symptoms in comorbid patients appeared more often during depressive episodes, and comorbid BD and OCD cycled together, with OC symptoms often remitting during manic/hypomanic episodes.

  19. Deep brain stimulation for obsessive-compulsive disorder: using functional magnetic resonance imaging and electrophysiological techniques: technical case report.

    PubMed

    Baker, Kenneth B; Kopell, Brian H; Malone, Donald; Horenstein, Craig; Lowe, Mark; Phillips, Micheal D; Rezai, Ali R

    2007-11-01

    To demonstrate the pattern of activation associated with electrical stimulation through bilateral deep brain stimulation electrodes placed within the anterior limb of the internal capsule to the level of the ventral striatum for treatment of obsessive-compulsive disorder. A 44-year-old man with a 26-year history of obsessive-compulsive disorder underwent functional magnetic resonance imaging (fMRI) and deep brain stimulation-evoked cortical potential testing after bilateral implantation of deep brain stimulation leads. Stimulation was delivered independently through the distal two contacts of each percutaneously extended lead using an external pulse generator. On postoperative Day 2, we used a 3-Tesla magnetic resonance system to measure changes in the fMRI blood oxygen level-dependent signal using stimulation parameters that were predetermined to demonstrate behavioral effects. All studies were well tolerated. Trial stimulations performed intraoperatively as well as on postsurgical Day 1 were associated with acutely elevated mood and reduced anxiety. Although the benefit achieved acutely was relatively symmetric between the bilaterally placed leads, follow-up programming showed a clear advantage to right-sided stimulation. Three of the four fMRI trials demonstrated good activation, with the fourth being moderately corrupted by motion artifact. The beneficial effects observed with right-sided stimulation were associated with activation of the ipsilateral head of the caudate, medial thalamus, and anterior cingulate cortex as well as the contralateral cerebellum. The distribution of the cortical evoked potentials was consistent with the locus of cortical activation observed with fMRI. High-frequency stimulation via a lead placed in the anterior limb of the internal capsule induced widespread hemodynamic changes at both the cortical and subcortical levels including areas typically associated with the pathogenesis of obsessive-compulsive disorder.

  20. Predictors associated with improved cognitive-behavioral therapy outcome in pediatric obsessive-compulsive disorder.

    PubMed

    Torp, Nor Christian; Dahl, Kitty; Skarphedinsson, Gudmundur; Compton, Scott; Thomsen, Per Hove; Weidle, Bernhard; Hybel, Katja; Valderhaug, Robert; Melin, Karin; Nissen, Judit Becker; Ivarsson, Tord

    2015-03-01

    To identify predictors of treatment response in a large sample of pediatric participants with obsessive-compulsive disorder (OCD). The Nordic Long-term Obsessive compulsive disorder (OCD) Treatment Study (NordLOTS) included 269 children and adolescents, 7 to 17 years of age, with a DSM-IV diagnosis of OCD. Outcomes were evaluated after 14 weekly sessions of exposure-based cognitive-behavioral therapy (CBT). The association of 20 potential predictors, identified by literature review, along with their outcomes, was evaluated using the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) posttreatment. A CY-BOCS total score of ≤15 was the primary outcome measure. The univariate analyses showed that children and adolescents who were older had more severe OCD, greater functional impairment, higher rates of internalizing and externalizing symptoms, and higher levels of anxiety and depression symptoms before treatment had significantly poorer outcomes after 14 weeks of treatment. However, only age was a significant predictor in the multivariate model. In the multivariate analysis, only age predicted better treatment outcome. Using univariate analysis, a variety of predictors of poorer treatment outcome after CBT was identified. The high impact of comorbid symptoms on outcome in pediatric OCD suggests that treatment should address comorbidity issues. The lack of a family predictor may be related to high family involvement in this study. Future research strategies should focus on optimizing intervention in the presence of these characteristics to achieve greater benefits for patients with OCD. Clinical trial registration information-Nordic Long-term Obsessive compulsive disorder (OCD) Treatment Study; www.controlled-trials.com; ISRCTN66385119. Copyright © 2015 American Academy of Child & Adolescent Psychaitry. Published by Elsevier Inc. All rights reserved.

  1. 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

    2016-10-11

    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.

  2. Exploring the role of external criticism in Obsessive Compulsive Disorder: a narrative review.

    PubMed

    Pace, Sonia M; Thwaites, Richard; Freeston, Mark H

    2011-04-01

    The concept of external criticism has been associated with different aspects of Obsessive Compulsive phenomena. The various threads of evidence highlight the potential role of criticism within different areas of the cognitive model of Obsessive Compulsive Disorder (OCD) with often overlapping ideas. However, the fragmented nature of the findings makes it difficult to identify how or why criticism impacts on OCD. This review collates the existing findings and maps these onto the cognitive model of OCD to provide a better understanding of the potential role of criticism. It proposes criticism could play a role in OCD as a vulnerability factor, but also as a perpetuating factor. Furthermore potential research questions have been generated which could help inform future understanding. Future research should consider the complexity of the concept when defining criticism as well as developing methodological designs which could answer questions of causality.

  3. Sequential administration of augmentation strategies in treatment-resistant obsessive-compulsive disorder: preliminary findings.

    PubMed

    Blier, P; Bergeron, R

    1996-03-01

    Given that an important proportion of patients with obsessive-compulsive disorder (OCD) fail to respond adequately to serotonin (5-HT) reuptake inhibitors (SRI), augmentation strategies aimed at enhancing further 5-HT transmission by different mechanisms were attempted sequentially in 13 SRI-resistant patients. Addition of the 5-HT1A l beta-adrenergic antagonist pindolol did not alter OCD symptomatology but produced a rapid improvement of depressive symptoms. The 5-HT1A agonist buspirone as well as 5-hydroxytryptophan, the immediate precursor of 5-HT, added to the SRI-pindolol regimen, were not effective in attenuating the intensity of OCD. Tryptophan, added to the SRI-pindolol regimen, produced a significant improvement after 4 weeks, with further amelioration after 6 weeks (36% decrease of the Yale-Brown Obsessive Compulsive Score), which was maintained with treatment prolongation.

  4. The effectiveness of acceptance and commitment therapy in treating a case of obsessive compulsive disorder.

    PubMed

    Vakili, Yaghoob; Gharraee, Banafshe

    2014-04-01

    The aim of this study was to evaluate the effectiveness of acceptance and commitment therapy (ACT) in treating obsessive compulsive disorder (OCD). In a single-subject experiment trial, the treatment process was carried out on a 39-year old male subject. The patient satisfied the DSM-IV-TR criteria for OCD and was assessed for pre-duration and post treatment. The scales used in this study included: The Yale-Brown Obsessive Compulsive Scale(Y-BOCS), Beck Depression Inventory-II-second edition (BDI-II), and Beck Anxiety Inventory (BAI). In addition, all scales were again completed by the subject at 1-month, 3-months, and 6-months follow-ups. The treatment led to reductions in symptoms of OCD, depression and anxiety. Gains were maintained at follow-ups. The treatment approach appears to be effective in the treatment of OCD.

  5. 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

  6. Treatment of obsessive-compulsive disorder complicated by comorbid eating disorders.

    PubMed

    Simpson, H Blair; Wetterneck, Chad T; Cahill, Shawn P; Steinglass, Joanna E; Franklin, Martin E; Leonard, Rachel C; Weltzin, Theodore E; Riemann, Bradley C

    2013-01-01

    Eating disorders and obsessive-compulsive disorder (OCD) commonly co-occur, but there is little data for how to treat these complex cases. To address this gap, we examined the naturalistic outcome of 56 patients with both disorders, who received a multimodal treatment program designed to address both problems simultaneously. A residential treatment program developed a cognitive-behavioral approach for patients with both OCD and an eating disorder by integrating exposure and response prevention (ERP) treatment for OCD with ERP strategies targeting eating pathology. Patients also received a supervised eating plan, medication management, and social support. At admission and discharge, patients completed validated measures of OCD severity (the Yale-Brown Obsessive-Compulsive Scale--Self Report [Y-BOCS-SR]), eating disorder severity (the Eating Disorders Examination-Questionnaire), and depressive severity (the Beck Depression Inventory II [BDI-II]). Body mass index (BMI) was also measured. Paired-sample t-tests examined change on these measures. Between 2006 and 2011, 56 individuals completed all study measures at admission and discharge. Mean length of stay was 57 days (SD = 27). Most (89%) were on psychiatric medications. Significant decreases were observed in OCD severity, eating disorder severity, and depression. Those with bulimia nervosa showed more improvement than those with anorexia nervosa. BMI significantly increased, primarily among those underweight at admission. Simultaneous treatment of OCD and eating disorders using a multimodal approach that emphasizes ERP techniques for both OCD and eating disorders can be an effective treatment strategy for these complex cases.

  7. Mindfulness-based cognitive therapy in obsessive-compulsive disorder: protocol of a randomized controlled trial.

    PubMed

    Külz, Anne Katrin; Landmann, Sarah; Cludius, Barbara; Hottenrott, Birgit; Rose, Nina; Heidenreich, Thomas; Hertenstein, Elisabeth; Voderholzer, Ulrich; Moritz, Steffen

    2014-11-18

    Obsessive-compulsive disorder (OCD) is a very disabling condition with a chronic course, if left untreated. Though cognitive behavioral treatment (CBT) with or without selective serotonin reuptake inhibitors (SSRI) is the method of choice, up to one third of individuals with obsessive-compulsive disorder (OCD) do not respond to treatment in terms of at least 35% improvement of symptoms. Mindfulness based cognitive therapy (MBCT) is an 8-week group program that could help OCD patients with no or only partial response to CBT to reduce OC symptoms and develop a helpful attitude towards obsessions and compulsive urges. This study is a prospective, bicentric, assessor-blinded, randomized, actively-controlled clinical trial. 128 patients with primary diagnosis of OCD according to DSM-IV and no or only partial response to CBT will be recruited from in- and outpatient services as well as online forums and the media. Patients will be randomized to either an MBCT intervention group or to a psycho-educative coaching group (OCD-EP) as an active control condition. All participants will undergo eight weekly sessions with a length of 120 minutes each of a structured group program. We hypothesize that MBCT will be superior to OCD-EP in reducing obsessive-compulsive symptoms as measured by the Yale-Brown-Obsessive-Compulsive Scale (Y-BOCS) following the intervention and at 6- and 12-months-follow-up. Secondary outcome measures include depressive symptoms, quality of life, metacognitive beliefs, self-compassion, mindful awareness and approach-avoidance tendencies as measured by an approach avoidance task. The results of this study will elucidate the benefits of MBCT for OCD patients who did not sufficiently benefit from CBT. To our knowledge, this is the first randomized controlled study assessing the effects of MBCT on symptom severity and associated parameters in OCD. German Clinical Trials Register DRKS00004525 . Registered 19 March 2013.

  8. Clomipramine demethylation rate is important on the outcome of obsessive-compulsive disorder treatment.

    PubMed

    Marcourakis, Tania; Bernik, Márcio A; Lotufo Neto, Francisco; Gedanke Shavitt, Roseli; Gorenstein, Clarice

    2015-01-01

    The aim of this study was to investigate the influence of demethylation rate on the outcome of obsessive-compulsive disorder patients treated with clomipramine. Eighteen patients meeting the DSM-IV criteria for obsessive-compulsive disorder received 150-300 mg of clomipramine daily in a single-blind design for 12 weeks. The patients were evaluated with the Clinical Global Impression scale and the Yale-Brown Obsessive-Compulsive Scale (YBOCS). Clinical assessment and serum measurements of clomipramine and desmethylclomipramine were carried out at baseline and after 3, 6, 8, 10, and 12 weeks. A greater improvement in Clinical Global Impression scale rating was associated with a lower desmethylclomipramine/daily dose and the total clomipramine and desmethylclomipramine/daily dose. Moreover, an improved response on the YBOCS-obsession score was associated with higher serum levels of clomipramine and the total clomipramine and desmethylclomipramine/daily dose. Patients with a greater reduction in baseline YBOCS rating had a lower desmethylclomipramine/clomipramine ratio. These data suggest that a lower demethylation rate correlates with better clinical outcome.

  9. 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

  10. Six-Nine Year Follow-Up of Deep Brain Stimulation for Obsessive-Compulsive Disorder

    PubMed Central

    Fayad, Sarah M.; Guzick, Andrew G.; Reid, Adam M.; Mason, Dana M.; Bertone, Agustina; Foote, Kelly D.; Okun, Michael S.; Goodman, Wayne K.; Ward, Herbert E.

    2016-01-01

    Objective Deep brain stimulation (DBS) of the ventral capsule/ventral striatum (VC/VS) region has shown promise as a neurosurgical intervention for adults with severe treatment-refractory obsessive-compulsive disorder (OCD). Pilot studies have revealed improvement in obsessive-compulsive symptoms and secondary outcomes following DBS. We sought to establish the long-term safety and effectiveness of DBS of the VC/VS for adults with OCD. Materials and Methods A long term follow-up study (73–112 months) was conducted on the six patients who were enrolled in the original National Institute of Mental Health pilot study of DBS for OCD. Qualitative and quantitative data were collected. Results Reduction in OCD symptoms mirrored the one-year follow-up data. The same four participants who were treatment responders after one year of treatment showed a consistent OCD response (greater than 35% reduction in Yale Brown Obsessive Compulsive Scale (YBOCS)). Another subject, classified as a non-responder, achieved a 26% reduction in YBOCS score at long term follow-up. The only patient who did not achieve a 25% or greater reduction in YBOCS was no longer receiving active DBS treatment. Secondary outcomes generally matched the one-year follow-up with the exception of depressive symptoms, which significantly increased over the follow-up period. Qualitative feedback indicated that DBS was well tolerated by the subjects. Discussion These data indicate that DBS was safe and conferred a long-term benefit in reduction of obsessive-compulsive symptoms. DBS of the VC/VS region did not reveal a sustained response for comorbid depressive symptoms in patients with a primary diagnosis of OCD. PMID:27930748

  11. 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.

  12. [Cognitive function in the obsessive-compulsive disorder associated with cerebral lesions].

    PubMed

    Berthier, M L

    Although obsessive-compulsive symptoms are uncommon among patients with neurological diseases, structural neuroimaging (CAT or MRI) disclose focal brain lesions in some patients. However, little is know about the clinical phenomenology of obsessive-compulsive symptoms and the cognitive deficits that occur in neurological conditions. To review the cognitive functioning of patients who develop an obsessive-compulsive disorder (OCD) in association with focal brain lesions. In the present study, the author review recent studies which suggest that OCD associated with brain lesions is relatively similar to idiopathic or 'functional' OCD (i.e., OCD unassociated with gross brain damage). Idiopathic and acquired forms of OCD are clinically heterogeneous. The content of obsessions and compulsions in acquired OCD depends, at least in part, of the causative lesion, whereas the pattern of cognitive deficits is more homogeneous affecting attention, general intelligence, verbal and visuospatial memory, and executive function. It is suggested that the study of different subgroups of patients with acquired OCD would detect differences in the phenomenology of obsessions and compulsions as well as in the pattern of cognitive deficits. Moreover, this approach can improve our understanding about the pathophysiological mechanisms underlying idiopathic OCD.

  13. Deep brain stimulation for treatment refractory obsessive-compulsive disorder--a case report.

    PubMed

    Csigó, Katalin; Dome, Lászó; Valálik, I; Harsányi, András; Demeter, Gyula; Racsmány, Mihály

    2010-03-30

    In the past 30 years it has been a great development in the unders-anding and therapy of obsessive-compulsive disorder. Adequate pharmaco- and cognitive-behavior therapies reduce the symptoms in 40-60% of patients, so a remarkable portion of patients still remains refractory to conventional treatment. Neurosurgery--with it's reversible and irreversible techniques--brought a breakthrough in the therapy of treatment refractory patients. In the present case, we represent a 3 months follow-up of an obsessive-compulsive pctient treated by deep brain stimulation. In our case, the stimulation target was the anterior limb of internal capsule. The clinical symptoms were measured by Y-BOCS. In addition various neuropsychological tests were used to monitor patient's executive functions before and 3 months after the deep brain stimulation. We found that obsessive-compu sive symptoms improved after three months of the stimulation. The neuropsychological tests showed improvement in some executive functions (e.g. fluency, set-shifting, decision making). On the other hand our results revealed severe neurocognitive--mainly attention skill--deficits in a treatment refractory obsessive-compulsive patient.

  14. Fluvoxamine in obsessive-compulsive disorder: similar efficacy but superior tolerability in comparison with clomipramine.

    PubMed

    Mundo, Emanuela; Rouillon, Frédéric; Figuera, M. Luisa; Stigler, Michael

    2001-08-01

    Some meta-analyses have suggested that the selective serotonin reuptake inhibitors (SSRIs) are less effective than clomipramine in the treatment of obsessive-compulsive disorder (OCD). The aim of this double-blind, randomised, multicentre study was to directly compare the efficacy and safety of fluvoxamine and clomipramine in patients with OCD. A total of 227 patients were randomised to flexible doses of fluvoxamine or clomipramine (both 150-300 mg/day) for 10 weeks. Fluvoxamine and clomipramine were both clinically effective and there were no statistically significant differences between the two treatment groups, at any visit, on the National Institute of Mental Health Obsessive-Compulsive global rating scale, the Yale-Brown Obsessive-Compulsive scale (total score and obsession and compulsion subscores), the Clinical Global Impression severity of illness and global improvement subscales, the Clinical Anxiety Scale and the 17-item Hamilton Depression Rating Scale. However, there were differences in safety between the two treatments. Compared with fluvoxamine-treated patients, those treated with clomipramine had more anticholinergic side effects (dry mouth, constipation and tremor) and premature withdrawals due to adverse events (18 versus 9). The results from this controlled study indicate that fluvoxamine is as effective as clomipramine in the treatment of OCD but has a better tolerability profile. Copyright 2001 John Wiley & Sons, Ltd.

  15. Predicting obsessive-compulsive disorder severity combining neuroimaging and machine learning methods.

    PubMed

    Hoexter, Marcelo Q; Miguel, Euripedes C; Diniz, Juliana B; Shavitt, Roseli G; Busatto, Geraldo F; Sato, João R

    2013-09-25

    Recently, machine learning methods have been used to discriminate, on an individual basis, patients from healthy controls through brain structural magnetic resonance imaging (MRI). However, the application of these methods to predict the severity of psychiatric symptoms is less common. Herein, support vector regression (SVR) was employed to evaluate whether gray matter volumes encompassing cortical-subcortical loops contain discriminative information to predict obsessive-compulsive disorder (OCD) symptom severity in 37 treatment-naïve adult OCD patients. The Pearson correlation coefficient between predicted and observed symptom severity scores was 0.49 (p=0.002) for total Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS) and 0.44 (p=0.006) for total Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). The regions that contained the most discriminative information were the left medial orbitofrontal cortex and the left putamen for both scales. Our sample is relatively small and our results must be replicated with independent and larger samples. These results indicate that machine learning methods such as SVR analysis may identify neurobiological markers to predict OCD symptom severity based on individual structural MRI datasets. © 2013 Elsevier B.V. All rights reserved.

  16. 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.

  17. Obsessive-compulsive disorder in the postpartum period: diagnosis, differential diagnosis and management.

    PubMed

    Sharma, Verinder; Sommerdyk, Christina

    2015-07-01

    Childbirth can trigger or exacerbate a variety of psychiatric disorders but the extant literature has focused primarily on mood disorders. Obsessive-compulsive disorder (OCD) after childbirth can occur alone or in combination with other psychiatric disorders such as major depressive disorder. Due to the general lack of awareness of the relationship between childbirth and OCD among clinicians as well as patients, the disorder may be underdiagnosed or misdiagnosed as major depressive disorder. This article describes the prevalence, clinical features, common psychiatric comorbidities, differential diagnosis and potential consequences of underdiagnosis or misdiagnosis. Using case vignettes strategies for its detection and clinical management are suggested. Finally, areas in need of further research are proposed.

  18. Transcranial magnetic stimulation for the treatment of obsessive-compulsive disorder.

    PubMed

    Martin, J L R; Barbanoj, M J; Pérez, V; Sacristán, M

    2003-01-01

    Transcranial magnetic stimulation (TMS) was introduced as a neurophysiological technique in 1985 when Anthony Barker and his team developed a compact machine that permitted non-invasive stimulation of the cerebral cortex (Barker 1985). Since its introduction, TMS has been used to evaluate the motor system, to study the function of several cerebral regions, and for the pathophysiology of several neuropsychiatric illnesses. In addition, it has been suggested that TMS might have therapeutic potential. Some controlled studies have evaluated the effects of repetitive TMS (rTMS) in patients with obsessive-compulsive disorder (OCD). Greenberg (Greenberg 1997) observed that a single session of right prefrontal cortex stimulation produced a significant decrease in compulsive urges in OCD patients lasting over eight hours. Other studies have reported transitory improvements in mood but there are no observations for changes in anxiety or obsessions. To develop a systematic review on the clinical efficacy and safety of transcranial magnetic stimulation from randomised controlled trials in the treatment of obsessive-compulsive disorder. An electronic search was performed including the Cochrane Collaboration Depression, Anxiety and Neurosis Review Group trials register (last searched June, 2002), the Cochrane Controlled Trials Register (Issue 2, 2002), MEDLINE (1966-2002), EMBASE (1974-2002), PsycLIT (1980-2002), and bibliographies from reviewed articles. Randomised controlled trials assessing the therapeutic efficacy and safety of transcranial magnetic stimulation for obsessive-compulsive disorder. All reviewers independently extracted the information and verified it by cross-checking. Disagreements were resolved through discussion. Three trials were included in the review and only two contained data in a suitable form for quantitative analysis. It was not possible to pool any results for a meta-analysis. No difference was seen between rTMS and sham TMS using the Yale

  19. Shared executive dysfunctions in unaffected relatives of patients with autism and obsessive-compulsive disorder

    PubMed Central

    Delorme, Richard; Goussé, Véronique; Roy, Isabelle; Trandafir, Anca; Mathieu, Flavie; Mouren-Siméoni, Marie-Christine; Betancur, Catalina; Leboyer, Marion

    2007-01-01

    Background Executive dysfunctions have been studied as a potential endophenotype associated with the genetic basis of autism. Given that recent findings from clinical and molecular genetic studies suggest that autism and obsessive-compulsive disorder (OCD) could share a common pattern of heritability, we assessed executive functions as a possible common cognitive endophenotype in unaffected family members of individuals with either autism or OCD. Methods Five tests assessing executive functions (Tower of London, verbal fluency, design fluency, trail making and association fluency) were proposed to 58 unaffected first-degree relatives (parents and siblings) of probands with autism and 64 unaffected first-degree relatives of OCD patients. Results were compared with those of 47 healthy controls matched for age, sex, and level of education. Results In the Tower of London test, both groups of unaffected relatives showed significantly lower scores and longer response times compared with controls. No differences were observed between autism and OCD relatives and healthy controls in the four other tasks (verbal fluency, design fluency, trail making test and association fluency). Conclusions Our findings show the existence of executive dysfunction in the unaffected first-degree relatives of probands with OCD, similar to those observed in the relatives of patients with autism. These results support and extend previous cognitive studies on probands indicating executive dysfunctions in autism and OCD. Planning and working memory processes could thus represent a common cognitive endophenotype in autism and OCD that could help in the identification of genes conferring vulnerability to these disorders. PMID:17127035

  20. Implicit aggressiveness in patients with obsessive-compulsive disorder as assessed by an Implicit Association Test.

    PubMed

    Cludius, Barbara; Schmidt, Alexander F; Moritz, Steffen; Banse, Rainer; Jelinek, Lena

    2017-06-01

    Cognitive models of obsessive-compulsive disorder (OCD) highlight the role of cognitive biases for the development of the disorder. One of these biases, an inflated sense of responsibility has been associated with higher anger scores and latent aggression on self-report scales, especially in patients with compulsive checking. Validity of self-report assessment is, however, compromised by inaccuracy, social desirability, and low metacognitive awareness of traits and behaviors in patients. The aim of the present study was to extend the research on latent aggression in individuals with OCD by using an indirect, implicit measure of aggression. Fifty-eight patients with OCD and 25 healthy controls were assessed with an Aggressiveness-Implicit Association Test (IAT), which is a reaction time task that assesses the strength of associations between the concept of "aggressiveness" and "me" compared to others. Contrary to our expectation, OCD patients with checking symptoms showed a more peaceful implicit self-concept than healthy controls. This result was corroborated by negative correlations between checking symptoms and implicit aggressiveness in the OCD sample. No self-report measures on aggression or anger were included in the study. In comparison to previous research using self-report measures, our study indicates that implicit aspects of aggression do indeed differ from controlled aspects in patients with checking compulsions. Future research is necessary to better understand the role of aggressiveness in OCD and to derive implications for therapy. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

    PubMed

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

    2016-04-01

    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. 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. 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. Our findings provide evidence that this augmentation is well tolerated and may be an effective strategy for patients with refractory obsessive-compulsive disorder.

  2. Impulse control disorders in children and adolescents with obsessive compulsive disorder

    PubMed Central

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

    2009-01-01

    The aim of this study was to examine current prevalences, clinical correlates and patterns of co-occurrence of impulse control disorders (ICDs) in children and adolescents with obsessive compulsive disorder (OCD). We examined rates and clinical correlates of comorbid ICDs in 70 consecutive child and adolescent subjects with lifetime DSM-IV OCD (32.9% females; mean age = 13.8 ± 2.9 years). Comorbidity data were obtained with structured clinical interviews using DSM-IV criteria. OCD severity was assessed with the Child Yale-Brown Obsessive Compulsive Scale. All variables were compared in OCD subjects with and without current ICDs. 12 (17.1%) subjects met criteria for a current ICD. Pathological skin picking and compulsive nail biting were the most common ICDs with current rates of 12.8% and 10.0%, respectively. OCD subjects with current ICDs were significantly more likely to have a co-occurring tic disorder (66.7% vs. 20.7%; p=.003). Although having an ICD was associated with greater numerical scores of OCD symptomatology, these differences were not statistically significant. There were no sex-specific patterns of ICD occurrence in children and adolescents with OCD. Certain ICDs are common among children and adolescents with OCD. Better identification of ICDs in children and adolescents with OCD is needed, as are empirically validated treatments for youth with co-occurring ICDs. PMID:20004481

  3. The PANDAS subgroup of tic disorders and childhood-onset obsessive-compulsive disorder.

    PubMed

    Martino, Davide; Defazio, Giovanni; Giovannoni, Gavin

    2009-12-01

    Diagnosis and treatment of the PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections) variant of Gilles de la Tourette syndrome (GTS) and childhood-onset obsessive-compulsive disorder (OCD) are still controversial issues. Most cross-sectional studies confirm a significant association between GTS and the development of an immune response against group A beta-hemolytic streptococcus (GABHS). Moreover, longitudinal retrospective studies suggest that a recent exposure to GABHS might be a risk factor for the onset of tics and obsessive-compulsive symptoms. However, further evidence from longitudinal prospective research is needed to verify whether a temporal association between GABHS infections and symptom exacerbations is a useful and reliable criterion for the diagnosis of PANDAS. In addition, preliminary results suggest that the PANDAS spectrum might be enlarged to include attention deficit/hyperactivity disorder. Although a number of immunological biomarkers have been proposed as markers of the PANDAS variant, at present, none of these has been conclusively proved useful to diagnose and monitor disease course in children with a suspicion of PANDAS. Finally, despite their empirical use in community settings, we still lack conclusive, evidence-based data regarding the usefulness of antibiotic and immunomodulatory treatments in children with PANDAS. Given the relevance of this topic for general pediatric health, additional research efforts to solve all the pending issues and the hottest points of debate are warranted.

  4. Impact of age at onset and duration of illness on the expression of comorbidities in obsessive-compulsive disorder.

    PubMed

    Diniz, Juliana B; Rosario-Campos, Maria C; Shavitt, Roseli G; Curi, Mariana; Hounie, Ana G; Brotto, Sergio A; Miguel, Euripedes C

    2004-01-01

    Obsessive-compulsive disorder (OCD) patients usually experience comorbidities including tics, trichotillomania, body dysmorphic disorder, and mood and anxiety disorders. The present report verifies how age at onset of obsessive-compulsive symptoms and duration of illness are associated with comorbid diagnoses in OCD patients. Psychiatric comorbidity was assessed using a structured clinical interview in 161 consecutive outpatients referred for treatment between 1996 and 2001 who met DSM-IV criteria for OCD. Age at onset and duration of illness were retrospectively assessed by direct interviews. An earlier age at onset of obsessive-compulsive symptoms was associated with tic disorders, while longer illness duration was associated with depressive disorder (major depressive disorder or dysthymia) and social phobia. Age at onset and duration of OCD illness are meaningful variables affecting the expression of comorbidities in OCD. Tic disorders and OCD may share common etiologic pathways. Depressive disorders, in contrast, may be secondary complications of OCD.

  5. Quality of Life in Children with Obsessive-Compulsive Disorder.

    PubMed

    Vieira, Joana; Ramalho E Silva, Filipa

    2016-09-01

    Introdução: A perturbação obsessiva-compulsiva foi apontada como uma das doenças mais debilitantes do mundo desenvolvido. Contudo, muito pouco é conhecido sobre esta doença relativamente ao modo como ela afeta a qualidade de vida das crianças. Material e Métodos: Conduzimos uma pesquisa na PubMed e Thomson Reuters Web Of Science usando os seguintes termos de pesquisa: ‘Quality of life’, ‘Obsessive-compulsive disorder’, ‘Child’, ‘Pediatrics’ e ‘Adolescent’. Dos 138 artigos obtidos, cinco correspondiam aos objetivos desta revisão. Analisámos a qualidade de vida de crianças com perturbação obsessiva-compulsiva comparando com a população geral e procurando a relação com outras variáveis clinicas como o sexo, idade, comorbilidades, categoria de sintomas, severidade dos sintomas e acomodação familiar. Resultados: Apesar dos estudos não serem concordantes relativamente às diferentes dimensões analisadas, os nossos resultados apontam para um decréscimo global da qualidade de vida em crianças com perturbação obsessiva-compulsiva. A presença de comorbilidades, a severidade dos sintomas e as obsessões de agressão/dano são as variáveis que têm maior influência na qualidade de vida dos pacientes. Discussão: O reduzido número de artigos encontrados e o facto de estes apresentarem uma metodologia extremamente heterogénea torna difícil alcançar conclusões robustas. Apesar disto, os nossos resultados são concordantes com estudos realizados em adultos. Conclusão: A qualidade de vida em crianças e adolescentes deve ser melhor explorada em futuros estudos. Sugerimos a introdução da qualidade de vida como instrumento usado rotineiramente para avaliar a resposta ao tratamento e evolução do paciente.

  6. Connectomics-based structural network alterations in obsessive-compulsive disorder

    PubMed Central

    Reess, T J; Rus, O G; Schmidt, R; de Reus, M A; Zaudig, M; Wagner, G; Zimmer, C; van den Heuvel, M P; Koch, K

    2016-01-01

    Given the strong involvement of affect in obsessive-compulsive disorder (OCD) and recent findings, the current cortico-striato-thalamo-cortical (CSTC) model of pathophysiology has repeatedly been questioned regarding the specific role of regions involved in emotion processing such as limbic areas. Employing a connectomics approach enables us to characterize structural connectivity on a whole-brain level, extending beyond the CSTC circuitry. Whole-brain structural networks of 41 patients and 42 matched healthy controls were analyzed based on 83 × 83 connectivity matrices derived from cortical and subcortical parcellation of structural T1-weighted magnetic resonance scans and deterministic fiber tracking based on diffusion tensor imaging data. To assess group differences in structural connectivity, the framework of network-based statistic (NBS) was applied. Graph theoretical measures were calculated to further assess local and global network characteristics. The NBS analysis revealed a single network consistently displaying decreased structural connectivity in patients comprising orbitofrontal, striatal, insula and temporo-limbic areas. In addition, graph theoretical measures indicated local alterations for amygdala and temporal pole while the overall topology of the network was preserved. To the best of our knowledge, this is the first study combining the NBS with graph theoretical measures in OCD. Along with regions commonly described in the CSTC model of pathophysiology, our results indicate an involvement of mainly temporo-limbic regions typically associated with emotion processing supporting their importance for neurobiological alterations in OCD. PMID:27598966

  7. Increased decision thresholds enhance information gathering performance in juvenile Obsessive-Compulsive Disorder (OCD)

    PubMed Central

    Iannaccone, Reto; Brem, Silvia; Walitza, Susanne

    2017-01-01

    Patients with obsessive-compulsive disorder (OCD) can be described as cautious and hesitant, manifesting an excessive indecisiveness that hinders efficient decision making. However, excess caution in decision making may also lead to better performance in specific situations where the cost of extended deliberation is small. We compared 16 juvenile OCD patients with 16 matched healthy controls whilst they performed a sequential information gathering task under different external cost conditions. We found that patients with OCD outperformed healthy controls, winning significantly more points. The groups also differed in the number of draws required prior to committing to a decision, but not in decision accuracy. A novel Bayesian computational model revealed that subjective sampling costs arose as a non-linear function of sampling, closely resembling an escalating urgency signal. Group difference in performance was best explained by a later emergence of these subjective costs in the OCD group, also evident in an increased decision threshold. Our findings present a novel computational model and suggest that enhanced information gathering in OCD can be accounted for by a higher decision threshold arising out of an altered perception of costs that, in some specific contexts, may be advantageous. PMID:28403139

  8. Increased decision thresholds enhance information gathering performance in juvenile Obsessive-Compulsive Disorder (OCD).

    PubMed

    Hauser, Tobias U; Moutoussis, Michael; Iannaccone, Reto; Brem, Silvia; Walitza, Susanne; Drechsler, Renate; Dayan, Peter; Dolan, Raymond J

    2017-04-01

    Patients with obsessive-compulsive disorder (OCD) can be described as cautious and hesitant, manifesting an excessive indecisiveness that hinders efficient decision making. However, excess caution in decision making may also lead to better performance in specific situations where the cost of extended deliberation is small. We compared 16 juvenile OCD patients with 16 matched healthy controls whilst they performed a sequential information gathering task under different external cost conditions. We found that patients with OCD outperformed healthy controls, winning significantly more points. The groups also differed in the number of draws required prior to committing to a decision, but not in decision accuracy. A novel Bayesian computational model revealed that subjective sampling costs arose as a non-linear function of sampling, closely resembling an escalating urgency signal. Group difference in performance was best explained by a later emergence of these subjective costs in the OCD group, also evident in an increased decision threshold. Our findings present a novel computational model and suggest that enhanced information gathering in OCD can be accounted for by a higher decision threshold arising out of an altered perception of costs that, in some specific contexts, may be advantageous.

  9. Comorbid Personality Disorders in Obsessive-Compulsive Disorder and Its Symptom Dimensions.

    PubMed

    Bulli, Francesco; Melli, Gabriele; Cavalletti, Veronica; Stopani, Eleonora; Carraresi, Claudia

    2016-06-01

    The current paper was aimed at: (1) investigating the comorbidity between obsessive-compulsive disorder (OCD) and personality disorders (PDs) using an OCD sample and clinician-administered structured interviews; (2) exploring the associations of different cluster comorbid PDs with the specific symptom dimensions of OCD; (3) analyzing the variables which could play a significant role in the probability of having at least one comorbid PD, controlling for confounding variables. The SCID-II and Y-BOCS, together with a series of self-report measures of OCD, depression and anxiety symptoms were administered to a clinical sample of 159 patients with a primary diagnosis of OCD. 20.8 % of the participants suffered from at least one comorbid PD; the most common was obsessive-compulsive PD (9.4 %), followed by narcissistic PD (6.3 %). In OCD patients with comorbid cluster C PDs, the percentage of responsibility for harm, injury, or bad luck symptoms was significantly greater than other OCD symptom dimensions (p < .005). Logistic regression found some evidence supporting the association between severity of OCD symptoms and comorbid PDs. PDs are prevalent among Italian people with OCD and should be routinely assessed, as comorbidity may affect help-seeking behaviour and response to treatment.

  10. Correlates of DSM-III personality disorder in obsessive-compulsive disorder.

    PubMed

    Mavissakalian, M; Hamann, M S; Jones, B

    1990-01-01

    Forty-three patients with primary obsessive-compulsive disorder (OCD) completed the Personality Diagnostic Questionnaire (PDQ), a self-rating scale designed to assess axis II personality disorders (PD) from DSM-III. Results showed that 53% of the patients received at least one PD diagnosis. The most frequent diagnoses were avoidant (30%), histrionic (26%), dependent (19%), and schizotypal (16%). Consideration of the personality traits irrespective of diagnostic category showed that in addition to avoidant and dependent personality characteristics, the sample had strong passive aggressive and compulsive tendencies and substantial histrionic, paranoid, and schizotypal traits. Patients exhibiting a greater number of personality traits were also significantly more symptomatic. However, anxiety, phobic, and obsessive-compulsive symptoms were not selected as unique predictors of any personality variables in the regression analyses. Rather, the most important correlate of PD in these patients consisted of dysphoric mood as assessed by the Beck Depression Inventory (BDI) and, to a lesser degree, younger age or shorter duration of illness. These findings do not support a specific link between OCD and PD in general and compulsive PD in particular.

  11. Modified Cognitive Behavior Therapy for Severe, Treatment-Resistant Obsessive-Compulsive Disorder in an Adolescent With Autism Spectrum Disorder.

    PubMed

    Krebs, Georgina; Murray, Kim; Jassi, Amita

    2016-11-01

    There is a high rate of comorbidity between obsessive-compulsive disorder (OCD) and autism spectrum disorders (ASD). Standard cognitive-behavior therapy (CBT) protocols have been shown to be less effective in treating OCD in young people with ASD than in typically developing youth. This case study describes the treatment of an adolescent boy with severe, treatment-resistant OCD and ASD using a modified CBT approach. Modifications to a standard evidence-based CBT for OCD protocol included extended psychoeducation about anxiety; regular home-based sessions; and increased involvement of systems, including family and school. Multi-informant outcome data indicated significant improvements in OCD symptoms over the course of treatment with gains being maintained over a 12-month follow-up period. These findings demonstrate the potential efficacy of modified CBT for pediatric OCD in the context of ASD. © 2016 Wiley Periodicals, Inc.

  12. Sensitive domains of self-concept in obsessive-compulsive disorder (OCD): further evidence for a multidimensional model of OCD.

    PubMed

    Doron, Guy; Kyrios, Michael; Moulding, Richard

    2007-01-01

    Aspects of self-concept have been implicated in recent empirical and theoretical investigations of obsessive-compulsive disorder (OCD). This article extends previous theory and research by investigating the proposal that specific self-structures may be linked with OCD [e.g., Doron, G., & Kyrios, M. (2005). Obsessive-compulsive disorder: a review of possible specific internal representations within a broader cognitive theory. Clinical Psychology Review, 25, 415-432]. In particular, it was hypothesized that individuals who value the domains of morality, job and scholastic competence, and social acceptability, but who feel incompetent in these domains (i.e., "sensitive" domains of self), would hold a greater level of OC-related beliefs and display more OC-symptoms. The study was performed in 198 non-clinical participants, using a multidimensional measure of self-concept. As predicted, it was found that sensitivity in the four domains was related to higher levels of OC-related beliefs. Sensitivity in the domains of morality, job competence and social acceptability also related to higher levels of OC-symptoms. Further, these findings were generally maintained when controlling for global self-worth. Based on these results, it is argued that sensitivity of self-concept may be associated with OC cognitions and phenomena. Implications for theory and treatment are discussed.

  13. Obsessive-compulsive disorder: implications of the efficacy of an SSRI, paroxetine.

    PubMed

    Ninan, Philip T

    2003-01-01

    Obsessive-compulsive disorder (OCD) is an anxiety disorder that commonly presents comorbidly with other psychiatric disorders. The underlying neurobiology of OCD is associated with circuits involving the basal ganglia, thalamus, and the frontal cortex. Randomized, placebo-controlled trials indicate acute and long-term efficacy of potent selective serotonin reuptake inhibitors (SSRIs), such as paroxetine. There is suggestive evidence that higher doses of paroxetine than those used in major depression are needed for benefit in OCD. Because of their safety and beneficial adverse-event profile, the SSRIs have become the leading choice in the pharmacological management of OCD.

  14. Vitamin D insufficiency in a boy with obsessive-compulsive disorder.

    PubMed

    Celik, Gonca; Tas, Didem Arslan; Varmıs, Dilek Altun; Tahiroglu, Aysegul; Avci, Ayse

    2016-07-01

    Vitamin D deficiency not only causes low bone mass but also may lead to neuropsychiatric disorders. In the present case, vitamin D supplementation reduced obsessive-compulsive disorder (OCD) symptoms associated with streptococcal infection in a 7-year-old boy. Sudden onset of symptoms, including excessive hand washing and fear of touching anything, had occurred 1 month before presentation. Although there are few studies on a possible causal relationship between vitamin D and neuropsychiatric disorders, the present report; together with previous data, suggest an etiological role of vitamin D-related immune processes. © 2016 Japan Pediatric Society.

  15. Deficits in Limb Praxis in Patients With Obsessive-Compulsive Disorder.

    PubMed

    Rounis, Elisabeth; Banca, Paula; Voon, Valerie

    2016-01-01

    There is recent evidence of deficits in praxis in patients with primary dystonia. Obsessive-compulsive disorder (OCD) has been linked to disorders of higher-order motor function, such as dystonia. However, no clear mechanism underlying such a relationship has been found. This pilot study aimed to identify whether patients with OCD might also show deficits in praxis. Patients with OCD were compared with healthy volunteers on a meaningless gesture imitation task. Patients showed significantly lower scores in this task. Further studies are needed to elucidate the nature of patients' deficits in praxis. This might reveal similar mechanisms underlying OCD and some types of movement disorders.

  16. [Obsessive-compulsive disorder in the child and adolescent: developmental aspects and therapeutic strategies].

    PubMed

    Bouvard, M

    1995-01-01

    The obsessive-compulsive disorder has only recently been recognized as a specific pathological entity in children, despite the fact that the first descriptions of pediatric manifestations date back to the beginning of this century (P. Janet, 1903) with further reports having been published regularly since that time. The first assessment of the complete epidemiologic, clinical and functional repercussions of the obsessive-compulsive disorder was reported by the Pediatric Psychiatric Group of the NIMH (Pr Judith Rapoport); of their various publications, one is well known in France: The Child who Couldn't Stop Washing (17). Among possible reasons for this delayed recognition are the special conditions for diagnosis and the frequent underestimation of its importance by the family, and sometimes by doctors. This underassessment could be due to confusion between the normal developmental rituals which are frequently seen between the ages of 3 and 5 years, and which do not cause any particular handicaps, and a more severe symptomatology which interferes with normal academic and social adaptation, presenting a substantially worse long-term prognosis. Having recognized the disorder, questions have arisen as to its possible linkage with the form seen in adults. There are numerous convergent argument suggesting a certain long-term persistence of this disorder throughout development and later life: 1) the relative stability of the incidence and prevalence of the disorder; 2) phenomenologic and developmental similarities; 3) most recently, comparable efficacy of treatments for pediatric and adult obsessive-compulsive disorder, whether by the behavioral modification approaches or by pharmacologic treatment, notably with the serotonin re-uptake inhibitors (clomipramine, fluoxetine, fluvoxamine).(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Mental play in Gilles de la Tourette's syndrome and obsessive-compulsive disorder.

    PubMed

    Cath, D C; van de Wetering, B J; van Woerkom, T C; Hoogduin, C A; Roos, R A; Rooijmans, H G

    1992-10-01

    A new phenomenon, found only in Gilles de la Tourette (GTS) patients, and which we have called 'mental play', is described. It was compared with the phenomenon of counting, which occurred in both GTS and obsessive-compulsive patients. In the GTS patients both mental play and counting were best characterised as playful impulsions. In contrast to the GTS patients, the counting of the obsessive-compulsive patients was in line with their obsessive-compulsive behaviour. These findings suggest that repetitive symptoms in GTS patients, even when they share superficial similarities with obsessive-compulsive symptoms, should not be diagnosed automatically as obsessive-compulsive.

  18. A single nucleotide polymorphism in SLC1A1 gene is associated with age of onset of obsessive-compulsive disorder.

    PubMed

    Dallaspezia, S; Mazza, M; Lorenzi, C; Benedetti, F; Smeraldi, E

    2014-06-01

    Different genetic polymorphisms in the SLC1A1 have been shown to be associated with obsessive-compulsive disorder. Rs301430 is a T/C functional polymorphism affecting the gene expression and extrasynaptic glutamate concentration.We observed that Rs301430 influence age at onset in obsessive-compulsive disorder.

  19. Paroxetine Treatment in Children and Adolescents with Obsessive-Compulsive Disorder: A Randomized, Multicenter, Double-Blind, Placebo-Controlled Trial

    ERIC Educational Resources Information Center

    Geller, Daniel A.; Wagner, Karen Dineen; Emslie, Graham; Murphy, Tanya; Carpenter, David J.; Wetherhold, Erica; Perera, Phil; Machin, Andrea; Gardiner, Christel

    2004-01-01

    Objective: To assess the efficacy and safety of paroxetine for the treatment of pediatric obsessive-compulsive disorder.Method: Children (7-11 years of age) and adolescents (12-17 years of age) meeting DSM-IV criteria for obsessive-compulsive disorder were randomized to paroxetine (10-50 mg/day) or placebo for 10 weeks. The primary efficacy…

  20. Genome Wide Association Study (GWAS) between Attention Deficit Hyperactivity Disorder (ADHD) and Obsessive Compulsive Disorder (OCD)

    PubMed Central

    Ritter, McKenzie L.; Guo, Wei; Samuels, Jack F.; Wang, Ying; Nestadt, Paul S.; Krasnow, Janice; Greenberg, Benjamin D.; Fyer, Abby J.; McCracken, James T.; Geller, Daniel A.; Murphy, Dennis L.; Knowles, James A.; Grados, Marco A.; Riddle, Mark A.; Rasmussen, Steven A.; McLaughlin, Nicole C.; Nurmi, Erika L.; Askland, Kathleen D.; Cullen, Bernadette; Piacentini, John; Pauls, David L.; Bienvenu, Joseph; Stewart, Evelyn; Goes, Fernando S.; Maher, Brion; Pulver, Ann E.; Mattheisen, Manuel; Qian, Ji; Nestadt, Gerald; Shugart, Yin Yao

    2017-01-01

    Objective: The aim of this study was to identify any potential genetic overlap between attention deficit hyperactivity disorder (ADHD) and obsessive compulsive disorder (OCD). We hypothesized that since these disorders share a sub-phenotype, they may share common risk alleles. In this manuscript, we report the overlap found between these two disorders. Methods: A meta-analysis was conducted between ADHD and OCD, and polygenic risk scores (PRS) were calculated for both disorders. In addition, a protein-protein analysis was completed in order to examine the interactions between proteins; p-values for the protein-protein interaction analysis was calculated using permutation. Conclusion: None of the single nucleotide polymorphisms (SNPs) reached genome wide significance and there was little evidence of genetic overlap between ADHD and OCD. PMID:28386217

  1. Genome Wide Association Study (GWAS) between Attention Deficit Hyperactivity Disorder (ADHD) and Obsessive Compulsive Disorder (OCD).

    PubMed

    Ritter, McKenzie L; Guo, Wei; Samuels, Jack F; Wang, Ying; Nestadt, Paul S; Krasnow, Janice; Greenberg, Benjamin D; Fyer, Abby J; McCracken, James T; Geller, Daniel A; Murphy, Dennis L; Knowles, James A; Grados, Marco A; Riddle, Mark A; Rasmussen, Steven A; McLaughlin, Nicole C; Nurmi, Erika L; Askland, Kathleen D; Cullen, Bernadette; Piacentini, John; Pauls, David L; Bienvenu, Joseph; Stewart, Evelyn; Goes, Fernando S; Maher, Brion; Pulver, Ann E; Mattheisen, Manuel; Qian, Ji; Nestadt, Gerald; Shugart, Yin Yao

    2017-01-01

    Objective: The aim of this study was to identify any potential genetic overlap between attention deficit hyperactivity disorder (ADHD) and obsessive compulsive disorder (OCD). We hypothesized that since these disorders share a sub-phenotype, they may share common risk alleles. In this manuscript, we report the overlap found between these two disorders. Methods: A meta-analysis was conducted between ADHD and OCD, and polygenic risk scores (PRS) were calculated for both disorders. In addition, a protein-protein analysis was completed in order to examine the interactions between proteins; p-values for the protein-protein interaction analysis was calculated using permutation. Conclusion: None of the single nucleotide polymorphisms (SNPs) reached genome wide significance and there was little evidence of genetic overlap between ADHD and OCD.

  2. Drug treatment of canine acral lick. An animal model of obsessive-compulsive disorder.

    PubMed

    Rapoport, J L; Ryland, D H; Kriete, M

    1992-07-01

    Canine acral lick dermatitis is a naturally occurring disorder in which excessive licking of paws or flank can produce ulcers and infection that require medical treatment. Forty-two dogs with severe chronic canine acral lick dermatitis were treated in three double-blind crossover comparisons of clomipramine hydrochloride/desipramine hydrochloride, fluoxetine hydrochloride/fenfluramine hydrochloride, and sertraline hydrochloride/placebo. The serotonin uptake blocking drugs were clinically effective, while the other drugs were not. Based on phenomenology and pharmacological response, we propose canine acral lick dermatitis as an animal model of obsessive-compulsive disorder.

  3. Sexual dysfunction in obsessive compulsive disorder and panic disorder.

    PubMed

    Aksoy, Umut Mert; Aksoy, Sennur G; Maner, Fulya; Gokalp, Peykan; Yanik, Medaim

    2012-12-01

    Clinical research has provided conflicting evidence regarding sexual dysfunction in patients with OCD and PD. This study was undertaken to assess and compare certain parameters of sexual functioning in OCD and PD patients. The study population consisted of 80 patients between 20 and 60 years of age with a diagnosis of OCD or PD who were followed and treated at the anxiety outpatient unit of Bakirkoy Research and Training Hospital for Psychiatric and Neurological Disorders between 2005 and 2006. The total study population comprised of 40 patients with OCD, 40 patients with PD, and 40 healthy volunteers as the control group. Of the two questionnaires used for study purposes, the first provided information on demographic data and certain parameters of sexual functioning, while the second was the validated Turkish translation of the Golombok-Rust Sexual Satisfaction Inventory with transliteral equivalence. Male subjects with OCD had a lower age of first masturbation and first nocturnal ejaculation. Infrequency problem among female and male patients with OCD occurred in 63.6% and 57.1%, respectively. Corresponding figures for PD patients were 36% and 38%. Thus, infrequency problem was more frequent among OCD patients. Sexual avoidance was found in 60.6% of female OCD patients and in 64% of female PD patients. Anorgasmia was detected in 24.2% of the female subjects with OCD. Sexual dysfunction unrelated to pharmacotherapy has been found to occur in OCD and PD. Assessment of sexual functioning in these individuals before treatment may help prevent deterioration of sexual function that may occur upon introduction of psychotropic medications.

  4. Restricted, Repetitive Behaviors in Autism Spectrum Disorder and Obsessive-Compulsive Disorder: A Comparative Review.

    PubMed

    Jiujias, Marina; Kelley, Elizabeth; Hall, Layla

    2017-03-09

    This review paper critically examines literature regarding restricted and repetitive behaviors (RRBs) in Autism Spectrum Disorder (ASD) and Obsessive-Compulsive Disorder (OCD). The similar behavioral profiles of these disorders presents the potential for confusion regarding diagnoses and intervention efforts. As such, this review highlights the similarities and differences between RRBs in ASD and OCD. The developmental trajectories of RRBs are presented, followed by an exploration of three constructs implicated in RRB manifestation: anxiety, executive functioning, and sensory phenomena. While RRBs tend to develop with some similarity in both disorders, the differing role of anxiety highlights important distinctions between ASD and OCD. We urge researchers and clinicians to think critically about the dimensions that affect RRB presentation. Future research should use this review as a starting point to further elucidate the differences between RRBs in these two populations.

  5. Treatment of Obsessive-Compulsive Disorder Complicated by Comorbid Eating Disorders

    PubMed Central

    Simpson, H. Blair; Wetterneck, Chad T.; Cahill, Shawn P.; Steinglass, Joanna E.; Franklin, Martin E.; Leonard, Rachel C.; Weltzin, Theodore E.; Riemann, Bradley C.

    2014-01-01

    Purpose Eating disorders and obsessive-compulsive disorder (OCD) commonly co-occur, but there is little data for how to treat these complex cases. To address this gap, we examined the naturalistic outcome of 56 patients with both disorders, who received a multimodal treatment program designed to address both problems simultaneously. Methods A residential treatment program developed a cognitive-behavioral approach for patients with both OCD and an eating disorder by integrating exposure and response prevention (ERP) treatment for OCD with ERP strategies targeting eating pathology. Patients also received a supervised eating plan, medication management, and social support. At admission and discharge, patients completed validated measures of OCD severity (the Yale-Brown Obsessive-Compulsive Scale—Self Report [Y-BOCS-SR]), eating disorder severity (the Eating Disorders Examination-Questionnaire), and depressive severity (the Beck Depression Inventory II [BDI-II]). Body mass index (BMI) was also measured. Paired-sample t-tests examined change on these measures. Main Results Between 2006 and 2011, 56 individuals completed all study measures at admission and discharge. Mean length of stay was 57 days (SD = 27). Most (89%) were on psychiatric medications. Significant decreases were observed in OCD severity, eating disorder severity, and depression. Those with bulimia nervosa showed more improvement than those with anorexia nervosa. BMI significantly increased, primarily among those underweight at admission. Conclusion Simultaneous treatment of OCD and eating disorders using a multimodal approach that emphasizes ERP techniques for both OCD and eating disorders can be an effective treatment strategy for these complex cases. PMID:23316878

  6. Comorbidity between obsessive-compulsive disorder and body dysmorphic disorder: prevalence, explanatory theories, and clinical characterization.

    PubMed

    Frías, Álvaro; Palma, Carol; Farriols, Núria; González, Laura

    2015-01-01

    With the advent of the fifth edition of Diagnostic and Statistical Manual of Mental Disorders, body dysmorphic disorder (BDD) has been subsumed into the obsessive-compulsive disorders and related disorders (OCDRD) category. We aimed to determine the empirical evidence regarding the potential relationship between BDD and obsessive-compulsive disorder (OCD) based on the prevalence data, etiopathogenic pathways, and clinical characterization of patients with both disorders. A comprehensive search of databases (PubMed and PsycINFO) was performed. Published manuscripts between 1985 and May 2015 were identified. Overall, 53 studies fulfilled inclusion criteria. Lifetime comorbidity rates of BDD-OCD are almost three times higher in samples with a primary diagnosis of BDD than those with primary OCD (27.5% vs 10.4%). However, other mental disorders, such as social phobia or major mood depression, are more likely among both types of psychiatric samples. Empirical evidence regarding the etiopathogenic pathways for BDD-OCD comorbidity is still inconclusive, whether concerning common shared features or one disorder as a risk factor for the other. Specifically, current findings concerning third variables show more divergences than similarities when comparing both disorders. Preliminary data on the clinical characterization of the patients with BDD and OCD indicate that the deleterious clinical impact of BDD in OCD patients is greater than vice versa. Despite the recent inclusion of BDD within the OCDRD, data from comparative studies between BDD and OCD need further evidence for supporting this nosological approach. To better define this issue, comparative studies between BDD, OCD, and social phobia should be carried out.

  7. Comorbidity between obsessive-compulsive disorder and body dysmorphic disorder: prevalence, explanatory theories, and clinical characterization

    PubMed Central

    Frías, Álvaro; Palma, Carol; Farriols, Núria; González, Laura

    2015-01-01

    Background With the advent of the fifth edition of Diagnostic and Statistical Manual of Mental Disorders, body dysmorphic disorder (BDD) has been subsumed into the obsessive-compulsive disorders and related disorders (OCDRD) category. Objective We aimed to determine the empirical evidence regarding the potential relationship between BDD and obsessive-compulsive disorder (OCD) based on the prevalence data, etiopathogenic pathways, and clinical characterization of patients with both disorders. Method A comprehensive search of databases (PubMed and PsycINFO) was performed. Published manuscripts between 1985 and May 2015 were identified. Overall, 53 studies fulfilled inclusion criteria. Results Lifetime comorbidity rates of BDD–OCD are almost three times higher in samples with a primary diagnosis of BDD than those with primary OCD (27.5% vs 10.4%). However, other mental disorders, such as social phobia or major mood depression, are more likely among both types of psychiatric samples. Empirical evidence regarding the etiopathogenic pathways for BDD–OCD comorbidity is still inconclusive, whether concerning common shared features or one disorder as a risk factor for the other. Specifically, current findings concerning third variables show more divergences than similarities when comparing both disorders. Preliminary data on the clinical characterization of the patients with BDD and OCD indicate that the deleterious clinical impact of BDD in OCD patients is greater than vice versa. Conclusion Despite the recent inclusion of BDD within the OCDRD, data from comparative studies between BDD and OCD need further evidence for supporting this nosological approach. To better define this issue, comparative studies between BDD, OCD, and social phobia should be carried out. PMID:26345330

  8. Deep brain stimulation and treatment-resistant obsessive-compulsive disorder: A systematic review.

    PubMed

    Vázquez-Bourgon, Javier; Martino, Juan; Sierra Peña, María; Infante Ceberio, Jon; Martínez Martínez, M Ángeles; Ocón, Roberto; Menchón, José Manuel; Crespo Facorro, Benedicto; Vázquez-Barquero, Alfonso

    2017-07-01

    At least 10% of patients with Obsessive-compulsive Disorder (OCD) are refractory to psychopharmacological treatment. The emergence of new technologies for the modulation of altered neuronal activity in Neurosurgery, deep brain stimulation (DBS), has enabled its use in severe and refractory OCD cases. The objective of this article is to review the current scientific evidence on the effectiveness and applicability of this technique to refractory OCD. We systematically reviewed the literature to identify the main characteristics of deep brain stimulation, its use and applicability as treatment for obsessive-compulsive disorder. Therefore, we reviewed PubMed/Medline, Embase and PsycINFO databases, combining the key-words 'Deep brain stimulation', 'DBS' and 'Obsessive-compulsive disorder' 'OCS'. The articles were selected by two of the authors independently, based on the abstracts, and if they described any of the main characteristics of the therapy referring to OCD: applicability; mechanism of action; brain therapeutic targets; efficacy; side-effects; co-therapies. All the information was subsequently extracted and analysed. The critical analysis of the evidence shows that the use of DBS in treatment-resistant OCD is providing satisfactory results regarding efficacy, with assumable side-effects. However, there is insufficient evidence to support the use of any single brain target over another. Patient selection has to be done following analyses of risks/benefits, being advisable to individualize the decision of continuing with concomitant psychopharmacological and psychological treatments. The use of DBS is still considered to be in the field of research, although it is increasingly used in refractory-OCD, producing in the majority of studies significant improvements in symptomatology, and in functionality and quality of life. It is essential to implement random and controlled studies regarding its long-term efficacy, cost-risk analyses and cost/benefit. Copyright

  9. [A Case with Multiple Comorbidities of Obsessive-Compulsive and Related Disorders].

    PubMed

    Arikawa, Ayako; Mito, Hironori; Motoyama, Mikuni; Yamanishi, Kyosuke; Hayashida, Kazuhisa; Maebayashi, Kensei; Matsunaga, Hisato

    2015-01-01

    Obsessive-compulsive and related disorders (OCRDs) have been introduced in a revision to DSM-5 as a novel category that is distinct from other anxiety disorders in DSM-IV. OCRDs consist of 5 primary disorders: obsessive-compulsive disorder (OCD), body dysmorphic disorder (BDD), hoarding disorder (HD), skin picking disorder (SPD), and hair pulling disorder (HPD), which share core clinical features such as preoccupation or recurrent thoughts and/or repetitive behaviors. Repetitive behaviors in BDD and HD can be differentially characterized by the presence of cognitive components associated with preceding anxiety from those in SPD or HPD, which are only observed as motoric components that regulate emotions or alleviate tension. Thus, the validity of the OCRD category and specific interrelationships between each OCRD remain uncertain. In the present study, therefore, we presented a case of multiple comorbidities of OCRDs in order to discuss the nature of the OCRD category. Our patient was a 20-year-old female university student. At the age of 11 years old, she started picking at acne on her face. The psychopathological, and treatment features observed in this case indicated possible interrelationships among OCRDs, especially between cognitive and motoric OCRDs, which supported the clinical utility and continuous nature of this category.

  10. 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 (dadj=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 (dadj=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.

  11. Comparison of attachment styles in borderline personality disorder and obsessive-compulsive personality disorder.

    PubMed

    Aaronson, Cindy J; Bender, Donna S; Skodol, Andrew E; Gunderson, John G

    2006-01-01

    The intense, unstable interpersonal relationships characteristic of patients with borderline personality disorder (BPD) are thought to represent insecure attachment. The Reciprocal Attachment Questionnaire was used to compare the attachment styles of patients with BPD to the styles of patients with a contrasting personality disorder, obsessive-compulsive personality disorder (OCPD). The results showed that patients with BPD were more likely to exhibit angry withdrawal and compulsive care-seeking attachment patterns. Patients with BPD also scored higher on the dimensions of lack of availability of the attachment figure, feared loss of the attachment figure, lack of use of the attachment figure, and separation protest. The findings may be relevant for understanding the core interpersonal psychopathology of BPD and for managing therapeutic relationships with these patients.

  12. Anxiety disorders and control related beliefs: the exemplar of Obsessive-Compulsive Disorder (OCD).

    PubMed

    Moulding, Richard; Kyrios, Michael

    2006-09-01

    Beliefs about control have been postulated to be important to anxiety and mood disorders. In particular, the phenomenology of Obsessive-Compulsive Disorder (OCD) suggests that it may be an exemplar of an anxiety disorder where control issues related to the self (behavior and thoughts) and world (the external environment) are particularly important. However, only beliefs concerning the need to control thoughts have been incorporated into contemporary theories of OCD. This article summarizes the theoretical and empirical research relevant to control-related beliefs in OCD. It is suggested that discrepancies between an individual's desired level of control and their perceived level of control could contribute to OCD symptoms, and exacerbate the tendency for individuals with OCD to engage in magical ideation and superstitious rituals. Overall, this review demonstrates how consideration of control cognitions could enhance our understanding of OCD and further improve its treatment.

  13. What is the association between obsessive-compulsive disorder and eating disorders?

    PubMed

    Altman, Sarah E; Shankman, Stewart A

    2009-11-01

    Because eating disorders (EDs) and obsessive compulsive disorder (OCD) co-occur at high rates and can have functionally similar clinical presentations, it has been suggested that both constructs might be part of a common spectrum of disorders. Identifying the relationship between EDs and OCD may lead to the discovery of important shared core disease processes and/or mechanisms for maintenance. The objective of this paper is to understand the relationship between EDs and OCD by systematically reviewing epidemiological, longitudinal and family studies guided by five models of comorbidity posited by Klein and Riso (1993) and others. Though this literature is relatively small, the preponderance of evidence from these studies largely suggests that OCD/ED co-occur because of a shared etiological relationship. Limitations to extant literature, and suggestions for future research are discussed.

  14. 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.

  15. 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.

  16. [The treatment of hypersexuality in a male with obsessive compulsive disorder as psychiatric co-morbidity].

    PubMed

    Jairam, J; van Marle, H J C

    2008-01-01

    Patients with paraphilias often also have psychiatric co-morbidity. In this study of a case from an outpatient clinic we discuss the treatment of paraphilia not otherwise specified, characterised by hypersexuality, in a patient with paraphilia and psychiatric co-morbidity. After explaning the diagnosis and treatment plan we describe how the treatment proceeded. We begin by focusing on interventions to tackle the symptoms of obsessive-compulsive disorder and then concentrate more on the patient's hypersexuality and treatment by means of pharmacology. Thereafter we make a more detailed study of the role played by libido-reducing drug in the treatment of the patient's hypersexuality.

  17. Cross MFF—analysis in studying the obsessive-compulsive disorder

    NASA Astrophysics Data System (ADS)

    Demin, S. A.; Panischev, O. Yu; Demina, N. Yu

    2016-08-01

    There were demonstrated capabilities of the Memory Function Formalism (MFF) in analyzing cross correlations in human brain bioelectric activity at obsessive-compulsive disorder (OCD). To extract the information about collective phenomena in (electroencephalogram) EEG brain activity we use the power spectra of memory functions and the memory quantifiers. We discover the pairs of the electrodes with the greatest differences in dynamic and stochastic parameters for patients with the different condition. The high OCD condition is characterized by the influence of the memory effects. The MFF cross correlation analysis allow to describe the collective phenomena in EEG dynamics at OCD including the dynamic, spectral and stochastic behavior.

  18. Pharmacological treatments for obsessive-compulsive disorder in children and adolescents: a qualitative review.

    PubMed

    Rosa-Alcázar, Ana I; Iniesta-Sepúlveda, Marina; Rosa-Alcázar, Angel

    2013-01-01

    We present the results of a systematic review on the effectiveness of pharmacological treatments for children and adolescents with obsessive-compulsive disorder. Sixty-four studies fulfilled the selection criteria, being the most of them focused in SSRI and Clomipramine. The trials on augmentation strategies and third line monotherapies are scarce, being the majority open-trials and case series. Similarly, studies on combined treatment (psychological and pharmacological) are few; furthermore this is a relevant future research line. It is also remarkable the lack of quasi-experimental and experimental comparison studies and the long-term follow-up measures.

  19. When religion and obsessive-compulsive disorder collide: treating scrupulosity in Ultra-Orthodox Jews.

    PubMed

    Huppert, Jonathan D; Siev, Jedidiah; Kushner, Elyssa S

    2007-10-01

    Evidence-based practice suggests that clinicians should integrate the best available research with clinical judgment and patient values. Treatment of religious patients with scrupulosity provides a paradigmatic example of such integration. The purpose of this study is to describe potential adaptations to make exposure and response prevention, the first-line treatment for obsessive-compulsive disorder, acceptable and consistent with the values of members of the Ultra-Orthodox Jewish community. We believe that understanding these challenges will enhance the clinician's ability to increase patient motivation and participation in therapy and thereby provide more effective treatment for these and other religious patients. (c) 2007 Wiley Periodicals, Inc.

  20. 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.

  1. Ziprasidone Augmentation in an Adolescent with Obsessive Compulsive Disorder: A Case Report

    PubMed Central

    Demirkaya, Sevcan Karakoç; Alyanak, Behiye

    2016-01-01

    Obsessive compulsive disorder (OCD) is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Although selective serotonin reuptake inhibitors are widely used to treat OCD, only half of the patients respond well. Several potentiation strategies including off-label use of antipsychotics (mostly risperidone, quetiapine) have been tried. Ziprasidone is an atypical antipsychotic with the best affinity ratio of 5 HT 2A/D2 and 5HT2C/D2 receptors. There is a limited data on ziprasidone in pediatric groups. The case described in the following is an example for the augmentation with ziprasidone to treatment refractory OCD. PMID:27738375

  2. OBSESSIVE COMPULSIVE DISORDER: IS IT A PROBLEM OF COMPLEX MOTOR PROGRAMMING?*

    PubMed Central

    Khanna, Sumant; Mukundan, C.R.; Channabasavanna, S.M.

    1987-01-01

    SUMMARY 44 subjects with Obsessive compulsive disorder (OCD) and 40 normals were compared using an experimental paradigm involving recording of the bereitschaftspotential. A decreased onset latency and increased amplitude was found in the OCD sample as compared to normals. A neurophysiological substrate for the bereitschaftspotential has been proposed. The implications of these findings in OCD as compared to Gilles de la Tourette syndrome, and for a focal neuro-physiological dysfunction have also been discussed. The findings of this study implicate a dysfunction in complex motor programming in OCD, with the possibility of this dysfunction being in the prefrontal area. PMID:21927207

  3. Obsessive-compulsive disorder: a new risk factor for Alzheimer disease?

    PubMed

    Mrabet Khiari, Hela; Achouri, Afef; Ben Ali, Nadia; Cherif, Aroua; Batti, Hend; Messaoud, Taieb; Mrabet, Amel

    2011-10-01

    We describe a case of a 75-year-old woman referred to the Memory Clinic of the neurological Department of Charles Nicolle Hospital, Tunis, for cognitive decline and behavioral disturbances. Her past medical history was marked by severe obsessive-compulsive disorder (OCD) with contamination obsessions and washing compulsions. She has a family history for OCD and/or of dementia in 15 members. Clinical features, along with neuropsychological findings and Brain imaging were in favor of Alzheimer disease (AD). The present report is the first family study reporting the possible association of OCD and AD. The glutamatergic dysfunction may be a common pathophysiology of OCD and AD explaining this association.

  4. Change in obsessive beliefs as predictor and mediator of symptom change during treatment of obsessive-compulsive disorder - a process-outcome study.

    PubMed

    Diedrich, Alice; Sckopke, Philipp; Schwartz, Caroline; Schlegl, Sandra; Osen, Bernhard; Stierle, Christian; Voderholzer, Ulrich

    2016-07-07

    Cognitive models of obsessive-compulsive disorder suggest that changes in obsessive beliefs are a key mechanism of treatments for obsessive-compulsive disorder. Thus, in the present process-outcome study, we tested whether changes in obsessive beliefs during a primarily cognitive behavioral inpatient treatment predicted treatment outcome and whether these changes mediated symptom changes over the course of treatment. Seventy-one consecutively admitted inpatients with obsessive-compulsive disorder were assessed with the Yale-Brown Obsessive-Compulsive Scale and the Obsessive Beliefs Questionnaire at treatment intake, after six weeks of treatment and at discharge, and with the Beck-Depression-Inventory-II at intake and discharge. Changes in obsessive beliefs during the first six weeks of treatment predicted obsessive-compulsive symptoms at discharge when controlling for obsessive-compulsive and depressive symptoms at intake in a hierarchical regression analysis. Multilevel mediation analyses showed that reductions in obsessive beliefs partially mediated improvements in obsessive-compulsive symptoms over time. Our findings indicate that decreasing obsessive beliefs in inpatient cognitive behavioral therapy for obsessive-compulsive disorder might be a promising treatment approach.

  5. 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.…

  6. 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.…

  7. Change Factors in the Process of Cognitive-Behavioural Therapy for Obsessive-Compulsive Disorder.

    PubMed

    Schwartz, C; Hilbert, S; Schubert, C; Schlegl, S; Freyer, T; Löwe, B; Osen, B; Voderholzer, U

    2017-05-01

    While there is a plethora of evidence for the efficacy of cognitive-behavioural therapy (CBT) in obsessive-compulsive disorder (OCD), studies on change factors of the therapeutic process that account for this success are scarce. In the present study, 155 participants with primary OCD were investigated during CBT inpatient treatment. The Yale-Brown Obsessive-Compulsive Scale-SR served as a measure of symptom severity. In addition, the following process change factors were measured: therapeutic relationship, experience of self-esteem during therapy, experience of mastery, problem actualization and clarification. All variables were assessed on a weekly basis for seven weeks. Linear mixed growth curve analyses were conducted to model the decrease of symptoms over time and to analyse whether the change factors predicted symptom reduction. The analyses revealed a linear decrease of symptoms with high inter-individual variation. Results further showed that increase in self-esteem and mastery experiences as well as the initial score on mastery experience and clarification predicted decrease on the Y-BOCS. We conclude that CBT therapists should focus on clarification in the very first sessions, and try to boost self-esteem and self-efficacy, which is related to mastery, throughout the treatment of OCD. Copyright © 2016 John Wiley & Sons, Ltd. Increase in mastery and self-esteem experiences are associated with symptom decrease in obsessive-compulsive disorder (OCD) during cognitive-behavioural therapy (CBT). Initial score of mastery experiences and problem clarification predict symptom decrease in OCD during CBT. CBT therapists should focus on problem clarification in the very first sessions and try to boost self-esteem and self-efficacy throughout the treatment of OCD. Copyright © 2016 John Wiley & Sons, Ltd.

  8. Psychometric properties of the Family Accommodation Scale for Obsessive-Compulsive Disorder-Patient Version.

    PubMed

    Wu, Monica S; Pinto, Anthony; Horng, Betty; Phares, Vicky; McGuire, Joseph F; Dedrick, Robert F; Van Noppen, Barbara; Calvocoressi, Lisa; Storch, Eric A

    2016-03-01

    In obsessive-compulsive disorder (OCD), family accommodation is a frequently occurring phenomenon that has been linked to attenuated treatment response, increased obsessive-compulsive symptom severity, and lower levels of functioning. No patient-report version of family accommodation exists, with available measures relying on relatives as informants. However, adult patients with OCD often present to clinical services alone, frequently making it impractical to obtain information from these informants. Consequently, a standardized patient-reported measure of family accommodation proves salient in clinical practice. The present study examined the psychometric properties of the Family Accommodation Scale for Obsessive-Compulsive Disorder-Patient Version (FAS-PV). Sixty-one adults with OCD were administered clinician-rated measures of OCD symptom severity and self-report questionnaires examining functional impairment, family functioning, and emotional/behavioral difficulties. Fifty-four relatives completed self-report measures assessing family accommodation and family functioning. The majority of the adult OCD participants (89%) endorsed at least 1 type of accommodating behavior in the previous week. The FAS-PV total score demonstrated good internal consistency and test-retest reliability. Convergent validity was evidenced by strong associations with scores on another measure of family accommodation, OCD symptom severity, OCD-related family functioning, anxiety, and functional impairment. Divergent validity was supported through nonsignificant correlations with depressive symptoms and impulsivity. The FAS-PV did not significantly differ from the relative-reported measure of family accommodation in terms of the internal consistency or mean of the total scores. Ultimately, the FAS-PV scores demonstrated sound psychometric properties and validity in assessing family accommodation from the patient's perspective, encouraging its use in research and clinical practice. (c

  9. White matter abnormalities in obsessive-compulsive disorder: a diffusion tensor imaging study.

    PubMed

    Szeszko, Philip R; Ardekani, Babak A; Ashtari, Manzar; Malhotra, Anil K; Robinson, Delbert G; Bilder, Robert M; Lim, Kelvin O

    2005-07-01

    Several neurobiological models of obsessive-compulsive disorder (OCD) posit a primary role for dysfunction of the anterior cingulate gyrus. Both functional and structural neuroimaging studies have implicated anterior cingulate gray matter abnormalities in the pathophysiology of OCD, but there has been little investigation of the anterior cingulate white matter in this disorder. To test the hypothesis that patients with OCD have abnormal white matter microstructure in the anterior cingulate gyrus compared with healthy volunteers as inferred from diffusion tensor imaging. Additional analyses examined group differences in white matter integrity across the entire brain. Fifteen patients with a DSM-IV diagnosis of OCD and 15 healthy volunteers matched for age, sex, and handedness underwent diffusion tensor imaging and structural magnetic resonance imaging examinations. Fractional anisotropy (FA), a robust intravoxel measure of water self-diffusion, was compared between groups on a voxel-by-voxel basis in the anterior cingulate white matter after standardization in Talairach space. Clinical ratings of symptom severity (ie, Yale-Brown Obsessive-Compulsive Scale) and FA. Compared with healthy volunteers, patients demonstrated significantly lower FA bilaterally in 3 areas of the anterior cingulate gyrus white matter. Additional analyses conducted across the rest of the brain white matter revealed lower FA bilaterally in the parietal region (supramarginal gyri), right posterior cingulate gyrus, and left occipital lobe (lingual gyrus). No areas of significantly higher FA were observed in patients compared with healthy volunteers. Lower FA in the parietal region correlated significantly with higher Yale-Brown Obsessive-Compulsive Scale scores. These preliminary findings provide evidence of an abnormality that involves the anterior cingulate white matter in the pathogenesis of OCD and are consistent with neurobiological models that posit a defect in connectivity in the anterior

  10. 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.

  11. Factors Associated with Depression in Obsessive-Compulsive Disorder: A Cross-Sectional Study

    PubMed Central

    ALTINTAŞ, Ebru; TAŞKINTUNA, Nilgün

    2015-01-01

    Introduction Major depressive disorder (MDD) is the most frequent comorbid psychiatric condition associated with obsessive-compulsive disorder (OCD). This study aimed to evaluate the prevalence of current depression in OCD, differences in socio-demographic and clinical characteristics, and obsessive-compulsive symptoms between OCD patients with and without depression. Additionally, factors associated with comorbid depression were investigated in our study. Methods In total, 140 OCD patients, of which 63 were OCD patients with MDD (OCD+MDD, n=63) and 77 were OCD patients without depression (OCD−MDD, n=77) were included in the study. All patients were diagnosed with OCD using the Structured Clinical Interview for DSM-IV. The Yale–Brown Obsessive-Compulsive Scale, Beck Anxiety Scale, and Beck Depression Scale were administered to all patients. After the socio-demographic and clinical variables and scales were accomplished, the OCD patients divided into two groups as OCD with or without depression and we compared their mean scores of the variables and scales. Univariate analyses were followed by logistic regression. Results There were no significant differences in age, gender, marital status, period without treatment, profession, medical and family history, and social support between the two groups. Anxiety, depression, and obsession and compulsion scores were significantly higher in the OCD+MDD group. The avoidance, insight, instability, and retardation scores of the OCD+MDD group were also significantly higher than those of the OCD−MDD group. Conclusion Our study suggests that many factors are strongly associated with depression in OCD. Positive correlations between poor insight, severity of obsession and compulsion, and stressful life events during the last six months increased the risk of depression in OCD. Our study suggests that high level of avoidance, instability and retardation, history of suicidal attempt, and delayed treatment are other notable factors

  12. Changes in metabolism of cerebral glucose after stereotactic leukotomy for refractory obsessive-compulsive disorder: a case report.

    PubMed Central

    Biver, F; Goldman, S; François, A; De La Porte, C; Luxen, A; Gribomont, B; Lotstra, F

    1995-01-01

    Brain glucose metabolism was investigated with PET and [18F]fluorodeoxyglucose, before and after a bifrontal stereotactic leukotomy in a 37 year old woman with refractory obsessive-compulsive disorder. A bilateral decrease in glucose metabolism was found in the orbital frontal cortex after psychosurgery. Glucose metabolism was decreased to a lesser degree in Brodmann's area 25, in the thalamus, and in the caudate nucleus. Clinical improvement in obsessive-compulsive disorder after stereotactic tractotomy seems to be associated with metabolic changes in the brain, in particular, in the orbital part of the frontal lobe. Images PMID:7738568

  13. Emotional Functioning in Obsessive-Compulsive Personality Disorder: Comparison to Borderline Personality Disorder and Healthy Controls.

    PubMed

    Steenkamp, Maria M; Suvak, Michael K; Dickstein, Benjamin D; Shea, M Tracie; Litz, Brett T

    2015-12-01

    Few studies have investigated emotional functioning in obsessive-compulsive personality disorder (OCPD). To explore the nature and extent of emotion difficulties in OCPD, the authors examined four domains of self-reported emotional functioning--negative affectivity, anger, emotion regulation, and emotion expressivity--in women with OCPD and compared them to a borderline personality disorder (BPD) group and a healthy control group. Data were collected as part of a larger psychophysiological experimental study on emotion regulation and personality. Compared to healthy controls, participants with OCPD reported significantly higher levels of negative affectivity, trait anger, emotional intensity, and emotion regulation difficulties. Emotion regulation difficulties included lack of emotional clarity, nonacceptance of emotional responses, and limited access to effective emotion regulation strategies. Participants with OCPD scored similarly to participants with BPD on only one variable, namely, problems engaging in goal-directed behavior when upset. Results suggest that OCPD may be characterized by notable difficulties in several emotional domains.

  14. Discovering brain regions relevant to obsessive-compulsive disorder identification through bagging and transduction.

    PubMed

    Parrado-Hernández, Emilio; Gómez-Verdejo, Vanessa; Martínez-Ramón, Manel; Shawe-Taylor, John; Alonso, Pino; Pujol, Jesús; Menchón, José M; Cardoner, Narcis; Soriano-Mas, Carles

    2014-04-01

    In the present study we applied a multivariate feature selection method based on the analysis of the sign consistency of voxel weights across bagged linear Support Vector Machines (SVMs) with the aim of detecting brain regions relevant for the discrimination of subjects with obsessive-compulsive disorder (OCD, n=86) from healthy controls (n=86). Each participant underwent a structural magnetic resonance imaging (sMRI) examination that was pre-processed in Statistical Parametric Mapping (SPM8) using the standard pipeline of voxel-based morphometry (VBM) studies. Subsequently, we applied our multivariate feature selection algorithm, which also included an L2 norm regularization to account for the clustering nature of MRI data, and a transduction-based refinement to further control overfitting. Our approach proved to be superior to two state-of-the-art feature selection methods (i.e., mass-univariate t-Test selection and recursive feature elimination), since, following the application of transductive refinement, we obtained a lower test error rate of the final classifier. Importantly, the regions identified by our method have been previously reported to be altered in OCD patients in studies using traditional brain morphometry methods. By contrast, the discrimination patterns obtained with the t-Test and the recursive feature elimination approaches extended across fewer brain regions and included fewer voxels per cluster. These findings suggest that the feature selection method presented here provides a more comprehensive characterization of the disorder, thus yielding not only a superior identification of OCD patients on the basis of their brain anatomy, but also a discrimination map that incorporates most of the alterations previously described to be associated with the disorder. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Imaging genetics in obsessive-compulsive disorder: linking genetic variations to alterations in neuroimaging.

    PubMed

    Grünblatt, Edna; Hauser, Tobias U; Walitza, Susanne

    2014-10-01

    Obsessive-compulsive disorder (OCD) occurs in ∼1-3% of the general population, and its often rather early onset causes major disabilities in the everyday lives of patients. Although the heritability of OCD is between 35 and 65%, many linkage, association, and genome-wide association studies have failed to identify single genes that exhibit high effect sizes. Several neuroimaging studies have revealed structural and functional alterations mainly in cortico-striato-thalamic loops. However, there is also marked heterogeneity across studies. These inconsistencies in genetic and neuroimaging studies may be due to the heterogeneous and complex phenotypes of OCD. Under the consideration that genetic variants may also influence neuroimaging in OCD, researchers have started to combine both domains in the field of imaging genetics. Here, we conducted a systematic search of PubMed and Google Scholar literature for articles that address genetic imaging in OCD and related disorders (published through March 2014). We selected 8 publications that describe the combination of imaging genetics with OCD, and extended it with 43 publications of comorbid psychiatric disorders. The most promising findings of this systematic review point to the involvement of variants in genes involved in the serotonergic (5-HTTLPR, HTR2A), dopaminergic (COMT, DAT), and glutamatergic (SLC1A1, SAPAP) systems. However, the field of imaging genetics must be further explored, best through investigations that combine multimodal imaging techniques with genetic profiling, particularly profiling techniques that employ polygenetic approaches, with much larger sample sizes than have been used up to now. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. 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.

  17. Effectiveness of Risperidone Augmentation in 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

    2016-08-01

    Risperidone is the most widely used augmenting agent in the treatment of obsessive-compulsive disorder (OCD). However, a recent controlled study found risperidone to be no different from placebo, raising doubts about its effectiveness. In this context, we sought to examine the real-world effectiveness of risperidone from the large database of an OCD clinic in India. A total of 1314 consecutive patients who registered at the OCD clinic between 2004 and 2014 were evaluated with structured interviews and scales. Patients with OCD initiated on risperidone augmentation without concurrent cognitive behavior therapy and who were on stable and adequate doses of serotonin reuptake inhibitors for at least 12 preceding weeks were included for analysis. The primary outcome measure was all-cause discontinuation. Logistic regression was performed to identify the factors predicting improvement with risperidone augmentation. A total of 92 patients were eligible for analysis. Risperidone continued to be used in 23 patients (25%) at the time of last follow-up, and the remaining discontinued either because of ineffectiveness or intolerability. The fall in the Yale-Brown Obsessive-Compulsive Scale scores was significantly greater in patients who continued to take risperidone when compared with those who did not (41.6% vs 3.7%, t = 6.95, P < 0.001). A total of 22 patients (24%) were noted to have at least a 25% reduction on the Yale-Brown Obsessive-Compulsive Scale scores. On regression analysis, no predictors of improvement with risperidone augmentation could be identified. The study demonstrated, in a real-world setting, that risperidone may be a useful augmenting agent in a proportion of patients with partial/poor response to serotonin reuptake inhibitors.

  18. Obsessive-compulsive disorder in pregnancy and the postpartum period: course of illness and obstetrical outcome.

    PubMed

    House, Samuel J; Tripathi, Shanti P; Knight, Bettina T; Morris, Natalie; Newport, D Jeffrey; Stowe, Zachary N

    2016-02-01

    The study aimed to examine the course of obsessive-compulsive disorder (OCD) across pregnancy and its impact on obstetric and neonatal outcomes. Women enrolled prior to 20-week gestation in a prospective, observational study. The Structured Clinical Interview for DSM-IV was completed to obtain lifetime Axis I diagnoses. A total of 56 women with OCD were followed at 1 to 3-month intervals through 52 weeks postpartum. Each visit, the Yale-Brown Obsessive Compulsive Scale (YBOCS), clinical assessment, and medication/exposure tracking were performed. Obstetric and neonatal data were abstracted from the medical record. In subjects with OCD, associations between perinatal obsessive-compulsive symptoms (OCSs) and outcomes were examined. Additionally, outcomes were compared to 156 matched psychiatric patients without OCD. Maternal age inversely correlated with the YBOCS scores across the study period (β = -0.5161, p = .0378). Cesarean section was associated with increased OCSs in the postpartum period compared to vaginal delivery (β = 5.3632, p = 0.043). No associations were found between severity of perinatal obsessions or compulsions and any specific obstetric or neonatal complications. Subjects without OCD had higher frequency of fetal loss compared to mothers with OCD (χ (2) = 4.03, p = 0.043). These novel prospective data fail to identify an association of OCSs with adverse outcomes. In contrast, there is an association of delivery method and younger maternal age with increased postnatal symptoms of OCD. Psychiatric subjects without OCD may have a higher risk of miscarriage and intrauterine fetal demise compared to subjects with OCD.

  19. 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.…

  20. 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.…