Jones, Anna M.; De Nadai, Alessandro S.; Arnold, Elysse B.; McGuire, Joseph F.; Lewin, Adam B.; Murphy, Tanya K.; Storch, Eric A.
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,…
Unlike obsessive compulsive personality traits or occasional repetitive habits, obsessive compulsive disorder can be highly distressing and associated with significant disability. Treatment should always be offered.
Peris, Tara S.; Bergman, R. Lindsey; Langley, Audra; Chang, Susanna; McCracken, James T.; Piacentini, John
The article examines family's involvement in child and adolescent obsessive-compulsive (OC) symptoms in relation to parent-, child- and family-level correlates. Results suggest that greater parental involvement in OC symptoms results in higher levels of child symptom severity and higher level of parental anxiety and hostility.
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Canavera, Kristin E.; Wilkins, Kendall C.; Pincus, Donna B.; Ehrenreich-May, Jill T.
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…
Andersen, Pia Aaron Skovby; Bilenberg, Niels
Obsessive-compulsive disorder (OCD) is a prevalent psychiatric disorder in children and adolescents associated with significant functional impairment. Early and correct diagnosis is essential for an optimal treatment outcome. The purpose of this study was to determine which of four subscales...... derived from the Child Behavior Checklist best discriminates OCD patients from clinical and population-based controls....
... Images Obsessive-compulsive disorder References American Psychiatric Association. Diagnostic and statistical manual of mental disorders . 5th ed. Arlington, VA: American Psychiatric Publishing. 2013. ...
Booth, Bradley D; Friedman, Susan Hatters; Curry, Susan; Ward, Helen; Stewart, S Evelyn
Obsessive-compulsive disorder (OCD) is a common illness that remains underdiagnosed and undertreated. Distressing obsessions of violence are a frequent manifestation of OCD, related to overattribution of meaning to passing thoughts, a sense of overresponsibility, and concurrent confessing rituals to decrease related anxiety. These intrusive thoughts can include infanticidal or filicidal obsessions in new parents. There is little to no evidence to suggest that these thoughts pose a significant risk of harm, which is reflected in related professional treatment guidelines. In this study, we sought to examine the recognition and risk management preferences among psychiatry professionals and trainees regarding a case example description of filicide obsessions as a manifestation of OCD. A questionnaire regarding a case marked by filicide obsessions was emailed to psychiatrists and psychiatry residents. Respondents provided their preferred and differential diagnoses, reporting their perceptions of risk and optimal case management. Of the 43 respondents, only 62 percent considered OCD in the differential diagnosis. Those considering OCD in the differential diagnosis assessed risk of harm as being lower than did those who did not consider it (3.7 versus 6.6; F(1,36) = 12.18; p obsessions. PMID:24618521
Soomro, G Mustafa
Obsessions or compulsions that cause personal distress or social dysfunction affect about 1% of adult men and 1.5% of adult women. Prevalence in children and adolescents is 2.7%. About half of adults with obsessive compulsive disorder (OCD) have an episodic course, whereas the other half have continuous problems. Up to half of adults show improvement of symptoms over time. The disorder persists in about 40% of children and adolescents at mean follow-up of 5.7 years.
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Bokor, Gyula; Anderson, Peter D
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. PMID:24576790
Agustín E Martínez-González
Full Text Available In recent years, there has been a considerable increase in the development of assessment tools for obsessive-compulsive symptomatology in children and adolescents. The Obsessive Compulsive Inventory-Child Version (OCI-CV is a well-established assessment self-report, with special interest for the assessment of dimensions of Obsessive Compulsive Disorder (OCD. This instrument has shown to be useful for clinical and non-clinical populations in two languages (English and European Spanish. Thus, the aim of this study was to analyze the psychometric properties of the OCI-CV in a Chilean community sample. The sample consisted of 816 children and adolescents with a mean age of 14.54 years (SD = 2.21; range = 10-18 years. Factor structure, internal consistency, test-retest reliability, convergent/divergent validity, and gender/age differences were examined. Confirmatory factor analysis showed a 6-factor structure (Doubting/Checking, Obsessing, Hoarding, Washing, Ordering, and Neutralizing with one second-order factor. Good estimates of reliability (including internal consistency and test-retest, evidence supporting the validity, and small age and gender differences (higher levels of OCD symptomatology among older participants and women, respectively are found. The OCI-CV is also an adequate scale for the assessment of obsessions and compulsions in a general population of Chilean children and adolescents.
... Images Obsessive-compulsive disorder References American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013. ...
Goodman, Wayne K; Grice, Dorothy E; Lapidus, Kyle A B; Coffey, Barbara J
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. PMID:25150561
This booklet provides an overview of the causes, symptoms, and incidence of obsessive-compulsive disorder (OCD) and addresses the key features of OCD, including obsessions, compulsions, realizations of senselessness, resistance, and shame and secrecy. Research findings into the causes of OCD are reviewed which indicate that the brains of…
Celik, Gonca; Tahiroglu, Aysegul Yolga; Firat, Sunay; Avci, Ayşe
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
Lewin, Adam B.; Piacentini, John
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…
Celik, Gonca; Tahiroglu, Aysegul Yolga; Firat, Sunay; AVCI, Ayşe
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 Obs...
Obsessive compulsive disorders (OCD) are a nosographic entity. Their biological rating in serotonergic pathways and the efficacy of serotonergic antidepressants allows for developing a clinical and biological models of OCD. J. Guyotat, one of the first in 1959 to observe the favorable effects of antidepressants on OCD, presents their history. Epidemiological surveys conducted since 1980 have shown that the prevalence of OCD was underestimated until then. The prevalence is 2 to 3% in the adult population, with more women affected. The disorder develops early in childhood and adolescence. Loss of time is an important criteria for OCD but, according to M. Bourgeois, who reviewed the symptoms precisely, this does not warrant identifying a separate "primary obsessive slowness" syndrome. According to M. Bouvard, the prognosis of the disorder, in contrast to that for rituals observed in children between 3 and 5 years of age, is poor, with a risk of chronicity and social disturbances. The prevalence of OCD in children and adolescents is 0.8% and remains stable. The comorbidity, in particular with tics, is discussed. The favorable effects of fluoxetine are reported. J.M. Chignon reviews the concept of comorbidity, developed in internal medicine, and explains that it could be rigorously applied to psychiatry only starting with the DSM III-R. The comorbidity of OCD with other psychiatric diseases is highly variable: it is reviewed for personality disorders (0 to 55%), schizophrenia (4%), substance abuse (10%) and especially depression: one third of patients with OCD will develop a major depressive episode. Based on a clinical case report, M. Faruch leads us from symptoms to behavior therapy. The symptom must be considered for itself, whether it is part or not of the obsessive neurosis. It is legitimate to use antidepressants in combination with behavior therapy.
Full Text Available Obsessive-compulsive disorder (OCD is one of the most prevalent psychiatric disorders in children and adolescents. The phenomenology of OCD in children and adolescent is strikingly similar to that of adults. But at times, the presentation of OCD may be so atypical or unusual in children and adolescents that may lead to misdiagnosis or delay in diagnosis. We report a case of 10-year-old child who was initially misdiagnosed with schizophrenia, and treated with antipsychotic for 2 months. But once the core symptoms were recognized as obsessions and compulsions and appropriately treated in the line of OCD, the symptoms resolved significantly.
Jagadheesan, K.; Nizamie, Haque S.; Thakur, Anupam
Catatonia occurs in a wide range of neuropsychiatric conditions. Among the psychiatric disorders, occurrence of catatonia has rarely been documented in obsessive-complsive disorder. Given the paucity of reports, we report two cases of obsessive compulsive disorder that presented as catatonia.
Esra Porgali Zayman
There have been some changes of the Obsessive Compulsive Disorder in DSM-V in terms of its classification and description. First of all, it has been suggested that the disorder should be out of a lower cap of the anxiety disorders and with DSM-5 a new heading has become an issue like obsessive compulsive disorder and related disorders. The ones that suggest the obsessive compulsive spectrum disorders fundamentally assume that the obsessive compulsive disorder and the disorders defined as rel...
Seibell, Phillip J.; Hollander, Eric
Obsessive-compulsive disorder (OCD) is a common, often debilitating disorder characterized by the presence of obsessions and compulsions. Obsessions are repetitive thoughts or images which are experienced as intrusive and unwanted; they cause marked anxiety and distress. Compulsions (also known as rituals) are repetitive behaviors or mental acts that individuals with OCD perform in an attempt to decrease their anxiety. Patients tend to hide their symptoms due to shame; the amount of time betw...
Full Text Available Background and Objectives: Obsessive symptoms among children and adolescent age groups are increasing, an observation made by mental health professionals working with this age group. Our epidemiological study targeted secondary school students to estimate the prevalence of obsessive symptoms, obsessive compulsive disorder and their different obsessive compulsive contents. Methods: The study is cross sectional carried on 1299 secondary school students, the sample size was chosen based on an estimated Obsessive Compulsive Disorder (OCD prevalence of 2% in literature. Equal samples were recruited from the 3 educative zones in Alexandria Governorate. Obsessive compulsive symptoms were assessed by the Arabic version of Lyeton obsessive inventory child version LOI-CV. Students scoring above 35 were subjected to the Mini International Neuropsychiatric Interview for children MINI-KID Arabic. OCD patient students detected by MINI-KID were assessed by psychiatric interview to confirm fulfilling criteria of OCD according to DSM IV-TR criteria. Different obsessive compulsive symptoms were assessed by a standardized questionnaire. Results: Among the studied sample (n = 1299, 201 students scored > 35 on LOI-CV i.e. 15.5% of the total sample have OCS. The prevalence of OCD among studied sample was 2.2% as 29 students from the OCS students were fulfilling diagnostic criteria for OCD according to DSM-IV TR. Common obsessive symptoms were of excessive conscience 65.5%, blasphemous 55.2%, repeated words 51.7% and sexual obsessions 48.2%. Conclusions: The prevalence of obsessive compulsive symptoms is high among adolescent age group. Cultural impact should be considered to better understand obsessive phenomenology, raising the importance of OCD study from a transcultural perspective.
Calamari, John E.; Pontarelli, Noelle K.; Armstrong, Kerrie M.; Salstrom, Seoka A.
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…
Murat Erdem; Ibrahim Durukan; Dursun Karaman
Childhood-onset obsessive-compulsive disorder affects 1%-2% of children and adolescents. While symptoms reported by children and behavioral therapies and pharmacological interventions administered to children are similar to those seen among individuals who develop obsessive compulsive disorder in adulthood, there are several differences with regards to sex ratios, comorbidity patterns, neuroimaging findings. Family and twin studies support the role of genetics in some forms of obsessive compu...
Wilcox, James Allen
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.
Piacentini, John; Bergman, R. Lindsey; Chang, Susanna; Langley, Audra; Peris, Tara; Wood, Jeffrey J.; McCracken, James
Objective: To examine the efficacy of exposure-based cognitive-behavioral therapy (CBT) plus a structured family intervention (FCBT) versus psychoeducation plus relaxation training (PRT) for reducing symptom severity, functional impairment, and family accommodation in youths with obsessive-compulsive disorder (OCD). Method: A total of 71…
Reaven, Judy; Hepburn, Susan
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. Symptoms improved markedly after 6 months of treatment.…
Full Text Available The comorbidity of bipolar disorder and anxiety disorders is a well known concept. Obsessive-compulsive disorder is the most commonly seen comorbid anxiety disorder in bipolar patients. Some genetic variants, neurotransmitters especially serotonergic systems and second-messenger systems are thought to be responsible for its etiology. Bipolar disorder alters the clinical aspects of obsessive compulsive disorder and is associated with poorer outcome. The determination of comorbidity between bipolar disorder and obsessive compulsive disorder is quite important for appropriate clinical management and treatment. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(4.000: 429-437
Full Text Available In this article the metacognitive model which is one of the approaches in explaining the obsessive compulsive disorder is reviewed. A key feature of the metacognitive model is that irrespective of the content of both intrusions and beliefs about the self or the world, obsessive compulsive symptoms are caused by a small set of specific metacognitions concerning the power and significance of thoughts and how to react to them. Studies support the role of metacognitive beliefs and processes in predicting obsessive compulsive disorder symptoms and emphasize the importance of metacognitive beliefs and processes in formulating obsessive compulsive problems. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2015; 7(2: 190-207
Full Text Available Suicide is a complex term. Suicide attempts are common in women, but completed suicide rates are higher in men. Several demographic factors, stressful life events, previous suicide attempts, childhood abuse, physical or psychiatric disorders are risk factors for suicide. Suicide rates in a variety of mental disorders is more than the normal population. Data on rates and risk factors of suicide in patients with obsessive-compulsive disorder and related disorders are limited. Present data are often associated with patients with obsessive compulsive disorder and body dysmorphic disorder. Lifetime suicidal ideation rates in patients with obsessive compulsive disorder is within a range of 36-63%. Any comorbid psychiatric diagnosis is an important risk factor for suicide in this disorder. This article aims to review the relationship between suicide and obsessive compulsive and related disorders [Archives Medical Review Journal 2015; 24(3.000: 402-413
Bais, Melisse; Figee, Martijn; Denys, D.
Neuromodulation techniques in obsessive-compulsive disorder (OCD) involve electroconvulsive therapy (ECT), transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (TMS), and deep brain stimulation (DBS). This article reviews the available literature on the efficacy and appl
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Franklin, Martin E; Foa, Edna B
Obsessive compulsive disorder (OCD) is characterized by the presence of intrusive, anxiety-provoking thoughts, images, or impulses along with repetitive behaviors or mental acts designed to reduce obsessional distress. OCD is associated with significant functional impairment, psychiatric comorbidity, and compromised quality of life. Fortunately, substantive progress has been made in the past several decades in the development and empirical evaluation of treatments for OCD across the developmental spectrum. The current review begins with a discussion of the clinical presentation of OCD and psychological theories regarding its etiology and maintenance. A detailed discussion follows of exposure plus response prevention, the psychosocial treatment that has garnered the most evidence for its efficacy. A summary of the extant treatment outcome literature related to exposure plus response prevention as well as cognitive therapies, pharmacotherapies, and combined approaches is then presented. Recommendations for future clinical and research directions are then provided. PMID:21443448
Twohig, Michael P.; Whittal, Maureen L.
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 mental protective barriers around…
Emmelkamp, PMG; Aardema, A
Cognitive distortions and beliefs have been found to be associated with obsessive-compulsive disorder. Most of these cognitive distortions are supposed to be non-specifically related to obsessive-compulsive behaviour in general, rather than specific domains of beliefs being related to specific forms
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. PMID:25682808
Nitesh Prakash Painuly
Full Text Available Background: Research on anger attacks has been mostly limited to depression, and only a few studies have focused on anger attacks in obsessive compulsive disorder. Materials and Methods: In a cross-sectional study all new obsessive compulsive disorder patients aged 20-60 years attending an outpatient clinic were assessed using the anger attack questionnaire, irritability, depression and anxiety scale (for the direction of the aggressive behavior and quality of life (QOL. Results: The sample consisted of 42 consecutive subjects with obsessive compulsive disorder, out of which 21 (50% had anger attacks. The obsessive compulsive disorder subjects with and without anger attacks did not show significant differences in terms of sociodemographic variables, duration of illness, treatment, and family history. However, subjects with anger attacks had significantly higher prevalence of panic attacks and comorbid depression. Significantly more subjects with anger attacks exhibited aggressive acts toward spouse, parents, children, and other relatives in the form of yelling and threatening to hurt, trying to hurt, and threatening to leave. However, the two groups did not differ significantly in terms of QOL, except for the psychological domain being worse in the subjects with anger attacks. Conclusion: Anger attacks are present in half of the patients with obsessive compulsive disorder, and they correlate with the presence of comorbid depression.
Klein, R G; Rapoport, J L
The research recently conducted and ongoing in adolescent obsessive-compulsive disorder indicates that the clinical signs and symptoms are indistinguishable from those seen in adults. Comorbidity appears to follow the same trends in adolescents and adults, with anxiety and affective symptomatology predominating. Contrary to expectation, Gilles de la Tourette disorder does not appear either as a concurrent syndrome, or as an eventual outcome in obsessive-compulsive adolescents. Males are greatly over-represented among adolescents with an early childhood onset. The neurological and neuropsychological findings are the only ones that appear to distinguish the adolescent and adult obsessive-compulsive patients. The findings point to frequent neurological abnormalities in adolescents with obsessive-compulsive disorder. The natural history over the short-term seems to be negatively affected by severity. The clinical efficacy of clomipramine and the failure of another tricyclic antidepressant parallels the therapeutic experience reported in adult patients. The presence of depression is unrelated to the efficacy of clomipramine. The neuropsychological and neurological abnormalities, together with the data from the longitudinal and treatment studies, strongly suggest that obsessive-compulsive disorder in adolescents is not a variant of the overall group of anxiety disorders.
Goli, Veeraindar; Krishnan, Ranga; Ellinwood, Everett
An estimated three to seven million Americans suffer from obsessive compulsive disorder at some time in their lives. Until recently, obsessive compulsive disorder was considered refractory to most treatments. However, recent studies indicate a better prognosis with behavioral therapy, antidepressant medications, or both. Behavioral treatment is generally more effective for compulsions than for obsessions.
Full Text Available Abstract 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.
Stein, D J; Simeon, D; Cohen, L J; Hollander, E
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.
Coles, Meredith E; Schubert, Jessica R; Sharkey, Katherine M
There is increasing recognition of an important interplay between psychiatric disorders and sleep. Clinical observations and several empirical studies have shown that later bedtimes are associated with obsessive-compulsive disorder (OCD). This study examined the relation of delayed bedtimes (DBs) and symptoms of OCD. Two hundred and sixty-six undergraduates completed a battery of questionnaires assessing sleep patterns, mood, and obsessive-compulsive (OC) symptoms. Results showed that participants with DBs reported increased rates of OC symptoms, as compared with non-DB participants. Further, this relation remained significant when controlling for negative affect. Additional work examining the interplay between sleep and OC symptoms is warranted. PMID:22946735
Figee, Martijn; Pattij, Tommy; Willuhn, Ingo; Luigjes, Judy; van den Brink, Wim; Goudriaan, Anneke; Potenza, Marc N; Robbins, Trevor W; Denys, Damiaan
Compulsive behaviors are driven by repetitive urges and typically involve the experience of limited voluntary control over these urges, a diminished ability to delay or inhibit these behaviors, and a tendency to perform repetitive acts in a habitual or stereotyped manner. Compulsivity is not only a central characteristic of obsessive-compulsive disorder (OCD) but is also crucial to addiction. Based on this analogy, OCD has been proposed to be part of the concept of behavioral addiction along with other non-drug-related disorders that share compulsivity, such as pathological gambling, skin-picking, trichotillomania and compulsive eating. In this review, we investigate the neurobiological overlap between compulsivity in substance-use disorders, OCD and behavioral addictions as a validation for the construct of compulsivity that could be adopted in the Research Domain Criteria (RDoC). The reviewed data suggest that compulsivity in OCD and addictions is related to impaired reward and punishment processing with attenuated dopamine release in the ventral striatum, negative reinforcement in limbic systems, cognitive and behavioral inflexibility with diminished serotonergic prefrontal control, and habitual responding with imbalances between ventral and dorsal frontostriatal recruitment. Frontostriatal abnormalities of compulsivity are promising targets for neuromodulation and other interventions for OCD and addictions. We conclude that compulsivity encompasses many of the RDoC constructs in a trans-diagnostic fashion with a common brain circuit dysfunction that can help identifying appropriate prevention and treatment targets. PMID:26774279
Full Text Available 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.
Uvais, N. A.; V S Sreeraj
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.
Calamari, John E.; Rector, Neil A.; Woodard, John L.; Cohen, Robyn J.; Chik, Heather M.
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…
Sharma Parul; Sharma Ravi; Kumar Ramesh; Sharma Dinesh
Obsessive compulsive disorder (OCD) is a common disorder, but some of its atypical presentations are uncommon and difficult to diagnose. We report one such case which on initial presentation appeared to be psychotic protocol but after detailed workup was diagnosed as OCD with marked avoidance symptoms.
N A Uvais
Full Text Available 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.
Leininger, Melissa; Dyches, Tina Taylor; Prater, Mary Anne; Heath, Melissa Allen
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,…
Wertlieb, Ellen C.
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…
Pani, Adyapad; Santra, Gouranga; Biswas, Kali Das
We report the case of an adolescent female, previously nonobese, belonging to educated average socioeconomic Muslim family. She stopped taking food, developed a perception of distorted body image with occasional episodes of binge eating and forced vomiting. She became amenorrheic and emaciated with loss of secondary sexual characters. She satisfied the criteria for anorexia nervosa with obsessive-compulsive disorder. PMID:27608877
Stephen Amarjeet Jiwanmall
Full Text Available 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.
Jiwanmall, Stephen Amarjeet; Kattula, Dheeraj
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
Full Text Available Background: Obsessive compulsive symptoms in schizophrenia are well recognized but are a less-researched entity. These symptoms have important implications for management and prognosis. Aim: To find out the prevalence of obsessive compulsive symptoms among patients with schizophrenia. Materials and Methods: A total of 90 hospitalized patients with schizophrenia diagnosed according to DCR of ICD-10 criteria were selected for the study. Padua inventory and Yale-Brown Obsessive Compulsive Scale were applied to find out the prevalence and nature of obsessive compulsive symptoms . Results: It was found that 10% of schizophrenic patients had obsessive compulsive symptoms. Conclusion: Obsessive compulsive symptoms are prevalent in patients with schizophrenia. The presence of comorbidity should be explored for adequate management.
Ferrari, J R; McCown, W
Participants diagnosed with obsessive-compulsive disorder (OCD; 39 women, 26 men; M age = 40) and their family relatives (11 women, 7 men; M age = 45) completed standardized measures of obsessions, compulsions, decisional procrastination (indecision), and avoidant procrastination. Among the OCDs, obsessions were related significantly to decisional procrastination, and compulsions were related significantly to decisional and avoidant procrastination. In comparison to family members of obsessive compulsives, the OCDs reported significantly greater obsessions, compulsions, and indecisions, but not procrastination motivated by avoidance. Results suggest that individuals with clinical obsessive-compulsive tendencies do, in fact, report states of indecision, as claimed by DSM-III-R. However, these clinical individuals may not differ significantly from nonclinical samples (e.g., family members) in avoidant procrastination.
Nielen, Maria Margaretha Anna
Obsessive-compulsion diorder (ocd) is characterized by recurrent obsessions and/or compulsions. Obsessions are intrusive and unwanted thoughts, images or feelings which elicit considerable anxiety and discomfort. Commonly recurring themes in obsessions are aggression, blasphemy, death and (unaccepta
Full Text Available This case report describes a 74-year-old woman with obsessive-compulsive behaviors that disappeared following a left capsular genu infarction. The patient’s capsular genu infarction likely resulted in thalamocortical disconnection in the cortico-basal ganglia-thalamocortical loop, which may have caused the disappearance of her obsessive-compulsive symptoms. The fact that anterior capsulotomy has been demonstrated to be effective for treating refractory obsessive-compulsive disorder further supports this hypothesis.
de Haan, Sanneke; Rietveld, Erik; Denys, Damiaan
In this chapter, we give an overview of current and historical conceptions of the nature of obsessions and compulsions. We discuss some open questions pertaining to the primacy of the affective, volitional or affective nature of obsessive-compulsive disorder. Furthermore, we add some phenomenological suggestions of our own. In particular, we point to the patients' need for absolute certainty and the lack of trust underlying this need. Building on insights from Wittgenstein, we argue that the kind of certainty the patients strive for is unattainable in principle via the acquisition of factual knowledge. Moreover, we suggest that the patients' attempts to attain certainty are counter-productive as their excessive conscious control in fact undermines the trust they need.
Benzina, Nabil; Mallet, Luc; Burguière, Eric; N'Diaye, Karim; Pelissolo, Antoine
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. PMID:27423459
Bais, Melisse; Figee, Martijn; Denys, Damiaan
Neuromodulation techniques in obsessive-compulsive disorder (OCD) involve electroconvulsive therapy (ECT), transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (TMS), and deep brain stimulation (DBS). This article reviews the available literature on the efficacy and applicability of these techniques in OCD. ECT is used for the treatment of comorbid depression or psychosis. One case report on tDCS showed no effects in OCD. Low-frequency TMS provides significant but mostly transient improvement of obsessive-compulsive symptoms. DBS shows a response rate of 60% in open and sham-controlled studies. In OCD, it can be concluded that DBS, although more invasive, is the most efficacious technique. PMID:25150569
Sahin CIFTCI; Tacettin KURU
Thought Action Fusion (TAF) is defined as tought and action percieved as equivalent to each other or as an exaggerated power given to idea. With the usage of “Thought Action Fusion Scale” which is created by Shafran (1996), is began to investigate its role in psychopathologies. Researches about the three-component structure which has TAF-Likelihood-Self, TAF-Likelihood-Others, TAF-Moral, are concentrated especially around the obsessive compulsive disorder (OCD). TAF alleged in...
Michael P. Philpot
Full Text Available Four cases of obsessive-compulsive disorder arising in late life in association with a presumed organic aetiology are described. Three of the four had brief episodes of OCD earlier in their lives. Neuropsychological assessment demonstrated impairments in verbal fluency and visuo-spatial tasks. No case exhibited global intellectual impairment. The two patients who complied with appropriate treatment became asymptomatic after 4–6 months.
Full Text Available A number of studies have reported neuropsychological deficits in obsessive-compulsive disorder (OCD. These have mainly implicated frontal or temporal dysfunction. In this study, we compared the performances of OCD patients and normal subjects using a factorial interpretation of the Wechsler Memory Scale. Our results do not demonstrate significant memory impairment in OCD patients but point to the possibility of frontal lobe dysfunction as a factor in the pathophysiology of OCD.
Full Text Available OBJECTIVES: To evaluate the frequency of personality disorders in Parkinson's disease (PD patients and in a group of healthy controls. METHODS: Patients affected by PD diagnosed according to the United Kingdom Parkinson's disease Society Brain Bank diagnostic criteria and a group of healthy controls were enrolled in the study. PD patients with cognitive impairment were excluded from the study. Structured Clinical Interview for Personality Disorders-II (SCID-II has been performed to evaluate the presence of personality disorders. Presence of personality disorders, diagnosed according to the DSM-IV, was confirmed by a psychiatric interview. Clinical and pharmacological data were also recorded using a standardized questionnaire. RESULTS: 100 PD patients (57 men; mean age 59.0 ± 10.2 years and 100 healthy subjects (52 men; mean age 58.1 ± 11.4 years were enrolled in the study. The most common personality disorder was the obsessive-compulsive personality disorder diagnosed in 40 PD patients and in 10 controls subjects (p-value<0.0001 followed by the depressive personality disorder recorded in 14 PD patients and 4 control subjects (p-value 0.02. Obsessive-compulsive personality disorder was also found in 8 out of 16 de novo PD patients with a short disease duration. CONCLUSION: PD patients presented a high frequency of obsessive-compulsive personality disorder that does not seem to be related with both disease duration and dopaminergic therapy.
Seibell, Phillip J; Hollander, Eric
Obsessive-compulsive disorder (OCD) is a common, often debilitating disorder characterized by the presence of obsessions and compulsions. Obsessions are repetitive thoughts or images which are experienced as intrusive and unwanted; they cause marked anxiety and distress. Compulsions (also known as rituals) are repetitive behaviors or mental acts that individuals with OCD perform in an attempt to decrease their anxiety. Patients tend to hide their symptoms due to shame; the amount of time between onset of symptoms and appropriate treatment is often many years. The disorder likely results from several etiological variables; functional imaging studies have consistently shown hyperactivity in the orbitofrontal cortex, anterior cingulate, thalamus, and striatum. The mainstays of treatment include cognitive-behavioral therapy in the form of exposure and response prevention (ERP) and serotonin reuptake inhibiting medications. Several pharmacological augmentation strategies exist for treatment-resistant OCD, with addition of antipsychotics being most commonly employed. Radio and neurosurgical procedures, including gamma knife radiation and deep brain stimulation, are reserved for severe, treatment-refractory disease that has not responded to multiple treatments, and some patients may benefit from transcranial magnetic stimulation. PMID:25165567
Mehmet Zihni Sungur
Full Text Available Several authors have suggested that not only appraisal of significance of external events and signals from the body, but also appraisal of the personal significance of thoughts are important, and emphasized the conceptual limitations of the schema approach in cognitive model and developed the integrative information processing model of emotional disorders. According to this approach, the assessment of the meaning of thought, rather than thought itself is more important in the development and maintenance of the psychopathology. In the metacognitive model of obsessive compulsive disorder, three types of metacognitive beliefs are emphasized. These are; thought-action fusion (thought-action, thought-event, thought-object, metacognitive beliefs on performing the rituals and metacognitive beliefs on the warning to stop to terminate the rituals. According to the model, targeting directly to change in metacognitive beliefs will increase success in therapy. In this article, the concept of metacognition in emotional disorders, the metacognitive model of obsessive compulsive disorder and the advances that the model introduced in conceptualization and treatment of obsessive compulsive disorder have been discussed.
Full Text Available Haruka Yamamoto,1 Hideto Tsuchida,1 Takashi Nakamae,1 Seiji Nishida,1 Yuki Sakai,1 Akihito Fujimori,1 Jin Narumoto,1 Yoshihisa Wada,1 Takafumi Yoshida,2 Chiaki Taga,3 Kenji Fukui11Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; 2Kyoto Cognitive Behavior Therapy Counseling Room, Kyoto, Japan; 3Department of Psychiatry, Kyoto Second Red Cross Hospital, Kyoto, JapanPurpose: Obsessive-compulsive disorder (OCD patients exhibit a noninhibition response pattern very similar to that observed in schizotypy patients in cognitive tasks. It has been suggested that the reduced cognitive inhibition observed in both schizotypy and OCD may result in the frequent entry into awareness of unacceptable urges and intrusive thoughts. The aim of this study was to investigate the relationship between the severity of obsession or compulsion and schizotypy in OCD.Patients and methods: Sixty subjects (25 males and 35 females who were OCD outpatients in the University Hospital at the Kyoto Prefectural University of Medicine during the period 2008–2010 were enrolled in the study. Assessments of these patients were made using the Yale–Brown Obsessive Compulsive Scale (Y-BOCS, the Schizotypal Personality Questionnaire (SPQ, the Hamilton Depression Rating Scale (HAM-D, and the Hamilton Anxiety Rating Scale (HAM-A. The Pearson correlation coefficients between Y-BOCS and SPQ scores were calculated. Furthermore, hierarchical multiple linear regression analyses were conducted to assess whether schizotypy predicted the severity of obsession and compulsion.Results: By calculating the Pearson correlation coefficient, it was found that the Y-BOCS obsession score, not the Y-BOCS compulsion score, was correlated with the SPQ total score. Results of the hierarchical multiple linear regression analysis showed that SPQ total score was a significant predictor of the Y-BOCS obsession score, after accounting for control
Helbing, Mary-Lee C.; Ficca, Michelle
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…
Lewin, Adam B.; Caporino, Nicole; Murphy, Tanya K.; Geffken, Gary R.; Storch, Eric A.
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…
Kishimoto, Toshifumi; Ikawa, Genro
Two men with obsessive-compulsive disorder showed abnormal behaviors including agitation and aggression without evidence of depression. They responded to electroconvulsive therapy (ECT) following failure of drug treatments. Further investigation of the utility of ECT in treating drug refractory obsessive-compulsive disorder is indicated.
M. Figee; M. Vink; F. de Geus; N. Vulink; D.J. Veltman; H. Westenberg; D. Denys
Background: Obsessive-compulsive disorder (OCD) is primarily conceived as an anxiety disorder but has features resembling addictive behavior. Patients with OCD may develop dependency upon compulsive behaviors because of the rewarding effects following reduction of obsession-induced anxiety. Reward p
... it like having OCD? For More Information Share Obsessive-Compulsive Disorder: When Unwanted Thoughts Take Over Download PDF Download ePub Order a free hardcopy En Español Introduction: Obsessive-Compulsive Disorder Do you feel the need to check and ...
Mircea Tampa; Maria Isabela Sarbu; Clara Matei; Vasile Benea; Simona Roxana Georgescu
Obsessive-compulsive disorder is a chronic, debilitating syndrome, consisting of intrusive thoughts- which are experienced as inappropriate by the patient and are producing anxiety- and compulsions, defined as repetitive behaviours produced to reduce anxiety. While patients with obsessive-compulsive disorder typically have xerosis, eczema or lichen simplex chronicus, as a result of frequent washing or rubbing their skin, several other disorders which are included in the group of factitious...
Raguraman, Janakiraman; Priyadharshini, Kothai R.; Chandrasekaran, R.; Vijaysagar, John
A male patient with homosexual obsession in obsessive compulsive disorder shows a better outcome following a combination of pharmacotherapy and psychotherapy. This case report emphasizes the importance of combination therapy in obsessive compulsive disorder with abnormal sexual impulses and behavior.
Morgado, P; Freitas, D; Bessa, J M; Sousa, N; Cerqueira, João José
Obsessive-compulsive disorder (OCD) is achronic psychiatric disorder characterized by recurrent intrusive thoughts and/or repetitive compulsory behaviors. This psychiatric disorder is known to be stress responsive, as symptoms increase during periods of stress but also because stressful events may precede the onset of OCD. However, only a few and inconsistent reports have been published about the stress perception and the stress-response in these patients. Herein, we have characterized the correlations of OCD symptoms with basal serum cortisol levels and scores in a stress perceived questionnaire (PSS-10). The present data reveals that cortisol levels and the stress scores in the PSS-10 were significantly higher in OCD patients that in controls. Moreover, stress levels self-reported by patients using the PSS-10 correlated positively with OCD severity in the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Interestingly, PSS-10 scores correlated with the obsessive component, but not with the compulsive component, of Y-BOCS. These results confirm that stress is relevant in the context of OCD, particularly for the obsessive symptomatology. PMID:23565098
Tükel, Raşit; Gürvit, Hakan; Ertekin, Banu Aslantaş; Oflaz, Serap; Ertekin, Erhan; Baran, Bengi; Kalem, Sükriye Akça; Kandemir, Pınar Elif; Ozdemiroğlu, Filiz Alyanak; Atalay, Figen
Obsessive-compulsive disorder (OCD) is a chronic disease characterized by repetitive, unwanted intrusive thoughts and ritualistic behaviors. Studies of neuropsychological functions in OCD have documented deficits in several cognitive domains, particularly with regard to visuospatial abilities, executive functioning, and motor speed. The objective of the present study was to investigate systematically the cognitive functioning of OCD patients who were free of medication and comorbid psychiatric disorders. In the present study, 72 OCD patients were compared with 54 healthy controls on their performance in a comprehensive neuropsychological battery. The Yale-Brown Obsessive Compulsive Scale and the Hamilton Depression Rating Scale were administered to the patients, and a semistructured interview form was used to evaluate the demographic features of the patients and control subjects. Overall, widespread statistically significant differences were found in tests related to verbal memory, global attention and psychomotor speed, and visuospatial and executive functions indicating a poorer performance of the OCD group. A closer scrutiny of these results suggests that the OCD group has difficulty in using an effective learning strategy that might be partly explained by their insufficient mental flexibility and somewhat poor planning abilities. PMID:21550029
Full Text Available Obsessive compulsive disorder is characterised by recurrent, unwanted, distressing thoughts, images, impulses and associated behaviours which generally emerge in the 2nd or 3rd decades of life. Elderly onset cases are rare. A 71 year old patient was admitted to our hospital because of left-sided weakness. Neurological examination revealed left hemiparesis, mild dysphasia and anosognosia. Using cranial magnetic resonance, infarcts were found in the MCA territories, in the posterior portion of the middle temporal gyrus supplied by the cortical (inferior branch and in the internal capsule, globus pallidus and putamen portions supplied by the lenticolostriate branch. An occlusion was also present in the right internal carotid artery (ICA. Fifteen days after presentation he developed an abnormal fear of urine contamination. He showered and handwashed excessively and exhibited insomnia and anxiety. The patient knew that his behaviour was ridiculous but could not prevent it. Formal neuropsychological testing found his simple attention to be mildly impared. His visuospatial function and construction abilities were also impaired. Obsessive compulsive disorder is usually an early onset disease. However this report seeks to draw attention to late-onset cases such as this, which are due to a cerebrovascular disorder.
Full Text Available Obsessive-compulsive disorder is a chronic, debilitating syndrome, consisting of intrusive thoughts- which are experienced as inappropriate by the patient and are producing anxiety- and compulsions, defined as repetitive behaviours produced to reduce anxiety. While patients with obsessive-compulsive disorder typically have xerosis, eczema or lichen simplex chronicus, as a result of frequent washing or rubbing their skin, several other disorders which are included in the group of factitious disorders have also been associated with obsessive-compulsive disorder. A close collaboration between the dermatologist and the psychiatrist is therefore mandatory in order to achieve favourable outcomes for these patients. The aim of the article is to present the most frequent dermatological disorders associated with obsessive-compulsive disorder and to look over some of the rare ones.
Melca, Isabela A; Yücel, Murat; Mendlowicz, Mauro V; de Oliveira-Souza, Ricardo; Fontenelle, Leonardo F
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.
João Pedro Ribeiro
Full Text Available Anxiety disorders have been described as features of Bipolar Disorder (BD, and Obsessive-compulsive-bipolar disorder (OCBD may occur in as many as 56% of obsessive-compulsive patients. Mania in Obsessive-Compulsive Disorder (OCD can occur either as an independent comorbidity or as a result of an antidepressant-induced switch. We report the case of a 38-year-old male with a 3 year diagnosis of OCD treated with antidepressants, admitted due to a manic episode, and describe diagnostic and treatment challenges of this comorbidity.
De Haan, Lieuwe; Sterk, Bouke; Wouters, Luuk; Linszen, Don H
Objective: To determine the course of obsessive-compulsive symptoms (OCS) and obsessive-compulsive disorder (OCD) in first-episode schizophrenia and related disorders and their relationship with clinical characteristics.
Yamamoto H; Tsuchida H; Nakamae T; Nishida S; Sakai Y; Fujimori A; Narumoto J; Wada Y.; Yoshida T.; Taga C; Fukui K
Haruka Yamamoto,1 Hideto Tsuchida,1 Takashi Nakamae,1 Seiji Nishida,1 Yuki Sakai,1 Akihito Fujimori,1 Jin Narumoto,1 Yoshihisa Wada,1 Takafumi Yoshida,2 Chiaki Taga,3 Kenji Fukui11Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; 2Kyoto Cognitive Behavior Therapy Counseling Room, Kyoto, Japan; 3Department of Psychiatry, Kyoto Second Red Cross Hospital, Kyoto, JapanPurpose: Obsessive-compulsive disorder (OCD) patients exhibit ...
Ashish Kumar Mittal; Pradipta Majumder; Alok Agrawal; Mamta Sood; Sudhir Kumar Khandelwal
Obsessive slowness is a rare entity and is conceptualized either as primary psychiatric illness or as part of obsessive compulsive disorder (OCD). Often its outcome is frustrating even with treatment. We report a case of early onset severe OCD with obsessive slowness which showed good response to combined pharmacotherapy and behavioral therapy.
Ashish Kumar Mittal
Full Text Available Obsessive slowness is a rare entity and is conceptualized either as primary psychiatric illness or as part of obsessive compulsive disorder (OCD. Often its outcome is frustrating even with treatment. We report a case of early onset severe OCD with obsessive slowness which showed good response to combined pharmacotherapy and behavioral therapy.
Volz, Chloe; Heyman, Isobel
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…
Honjo, S; Hirano, C; Murase, S; Kaneko, T; Sugiyama, T; Ohtaka, K; Aoyama, T; Takei, Y; Inoko, K; Wakabayashi, S
We investigated 61 patients (38 boys and 23 girls) under 18 years of age with obsessive-compulsive symptoms seen in the Department of Psychiatry, Nagoya University Hospital, from 1982 until 1986. In this period, a total of 1293 patients under 18 years of age visited the clinic. The percentage of patients with obsessive-compulsive symptoms was 5%. The earliest onset of symptoms was at age 3 years, and the average age of onset was 11.6 years. We found no particular tendency in terms of the number of siblings and the birth order of the patients. Obsessive traits were the fundamental personality traits of patients. Moreover, according to the other characteristics of personality, the patients were subdivided into schizothymic, viscous temperament, and cyclothymic. Parents of the patients were more apt than usual to have obsessive-compulsive personalities. Psychiatric disturbances and occupations were also investigated. Incidents related to school situations commonly triggered obsessive-compulsive symptoms. The most frequently noted obsessive thought was dirt phobia, and the most common compulsive behavior was washing. School refusal and violence at home were especially common as associated symptoms of obsessive-compulsive symptoms. We also describe the treatment regimen and the outcomes of the patients. PMID:2763863
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
In recent years, many assessment and care units for obsessive-compulsive disorder (OCD) have been set up in order to detect, diagnose and to properly manage this complex disorder, but there is no consensus regarding the key functions that these units should perform. The International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) together with the Obsessive Compulsive and Related Disorders Network (OCRN) of the European College of Neuropsychopharmacology (ECNP) and the Anxiety and Obsessive Compulsive Disorders Section of the World Psychiaric Association (WPA) has developed a standards of care programme for OCD centres. The goals of this collaborative initiative are promoting basic standards, improving the quality of clinical care and enhance the validity and reliability of research results provided by different facilities and countries. PMID:27359333
Ginsburg, Golda S.; Kingery, Julie Newman; Drake, Kelly L.; Grados, Marco A.
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.
MacMaster, Frank P.; O'Neill, Joseph; Rosenberg, David R.
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.
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
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.
Full Text Available Globally, 20% of children and adolescents suffer from a disabling psychologic illness. Among these, Obsessive Compulsive Disorder (OCD is listed by the World Health Organization (WHO as one of the 10 most disabling conditions, with prevalence rates of OCD in children ranging between 1 to 3%. Pediatric dentists are in a unique position to diagnose psychological problems in children and adolescents due to their ongoing relationship with children and their parents that starts at a very early age. Timely diagnosis of psychological illness can result in early intervention as well as better patient management for the dentist too. The purpose of this case report is to highlight a case of OCD in an adolescent girl diagnosed in a dental setting.
Catherine L. Harris
Full Text Available We administered neuropsychological measures considered sensitive to prefrontal dysfunction (both orbitofrontal and dorsolateral prefrontal neocortex to obsessive-compulsive disorder (OCD patients and control subjects. OCD subjects exhibited performance deficits, in comparison to community controls, on three measures sensitive to orbitofrontal neocortex dysfunction. Contrary to expectation, OCD patients also exhibited performance deficits on measures sensitive to dorsolateral prefrontal neocortex dysfunction. However, distinct neurocognitive profiles emerged when we examined the impact of comorbid schizotypal personality features on neuropsychological test performance. Primary OCD patients displayed impaired performance on measures sensitive to orbitofrontal dysfunction; however, they did not differ from control subjects on tests of dorsolateral function. OCD subjects presenting with schizotypal personality features performed poorly not only on tests sensitive to orbitofrontal dysfunction, but also on tests sensitive to dorsolateral dysfunction. Findings suggest that OCD can be subdivided into clinical subtypes, and distinct prefrontal subsystems may be differentially involved in these subtypes.
Irle, E; Exner, C; Thielen, K;
OBJECTIVE: The authors sought to determine the long-term outcome of subjects with severe and refractory obsessive-compulsive disorder (OCD) who had undergone ventromedial frontal leukotomy during the 1970s. Special emphasis was given to the analysis of specific lesion sites. METHOD: Sixteen OCD s...... but not obsessive personality disorder. Lesions of the ventral striatum were significantly related to the occurrence of substance dependence, suggesting a role of this area in human addictive behavior....... resonance imaging scans. RESULTS: The leukotomized OCD subjects showed significant improvement of obsessive-compulsive symptoms; subjects with frontostriatal lesions tended to have improved most. The subjects with combined diagnoses of OCD and obsessive personality disorder (N = 3) had improved......OBJECTIVE: The authors sought to determine the long-term outcome of subjects with severe and refractory obsessive-compulsive disorder (OCD) who had undergone ventromedial frontal leukotomy during the 1970s. Special emphasis was given to the analysis of specific lesion sites. METHOD: Sixteen OCD...
Parle Milind; Rana Tarapati
Obsessive-compulsive disorder (OCD) is a psychiatric affliction with a lifetime prevalence of 1-3%. OCD is an anxiety disorder characterized by obsessive thinking (persistent ideas, thoughts, impulses or images that are experienced as intrusive and inappropriate) and compulsive behaviour (repetitive behaviours or mental acts [e.g. hand-washing, checking, praying, and counting]) that causes marked distress or significant impairment. During the last 30 years there have been many attempts to dev...
Krebs, G.; Heyman, I
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 sp...
Solano Paola; Mattei Chiara; Rizzato Salvatore; Fornaro Stefania; Albano Claudio; Gabrielli Filippo; Fornaro Michele; Vinciguerra Valentina; Fornaro Pantaleo
Abstract 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 c...
Abramovitch, Amitai; McKay, Dean
Background Grassi et al. (2015) collected data to examine impulsivity in individuals with obsessive-compulsive disorder (OCD) compared to nonpsychiatric controls. Their aim was to examine whether OCD may be fully captured by the behavioral addiction model, using the prototypical mechanism underlying drug addiction as their framework. Based on their findings, Grassi et al. concluded that OCD shares behavioral components with addictions, particularly behavioral impulsivity and risky decision making. Furthermore, the authors suggested that this model may be superior to the prevailing psychological model of OCD. Findings We argue that based on the nature of their data as well as the current dominant conceptualization of OCD in the literature, this conclusion is untenable. The authors inferred behavioral impulsivity, whereas their main finding was concerning cognitive impulsivity or difficulties in planning. Such items on the Barratt impulsiveness scale have been shown in other research to overpredict behavioral impulsive tendencies in OCD, where the nature of the condition involves doubting of action and a conservative estimate of how one's cognitions may impact behavior. Conclusions We conclude that similar to drug addiction, compulsive rituals in OCD may be governed by a negative reinforcement mechanism; the available data indicate that OCD does not share the two main components seen in addiction, namely, behavioral impulsivity and risky decision making. PMID:27156379
Cavallotti, Simone; Casetta, Cecilia; Fanti, Valentina; Gambini, Orsola; Ostinelli, Edoardo G; Ranieri, Rebecca; Vanelli, Irene; D'Agostino, Armando
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. PMID:27525832
K.L. Delucchi; H. Katerberg; S.E. Stewart; D.A.J.P. Denys; C. Lochner; D.E. Stack; J.A. den Boer; A.J.L.M. van Balkom; M.A. Jenike; D.J. Stein; D.C. Cath; C.A. Mathews
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 sym
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.
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.
Caporino, Nicole E.; Morgan, Jessica; Beckstead, Jason; Phares, Vicky; Murphy, Tanya K.; Storch, Eric A.
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…
Obsessive compulsive symptoms are commonly reported in those with schizophrenia. Clozapine has previously been reported to induce, aggravate and alleviate these symptoms. It is unclear if these are similar to the symptoms experienced by those with obsessive compulsive disorder. This study describes the obsessive compulsive symptom profile of a population of patients with schizophrenia treated with clozapine (n = 62) and compares this with patients with Obsessive Compulsive Disorder (n = 35). All participants were attending an outpatient community mental health service. The Obsessive Compulsive Inventory (which measures the frequency and associated distress of a range of "behavioural" and "cognitive" symptoms), the Hospital Anxiety and Depression Scale and a demographic questionnaire were completed. In addition the schizophrenia group treated with clozapine completed the Brief Psychiatric Rating Scale. The OCD group reported significantly more symptoms for all OCI subscales compared to the clozapine group. Overall fourteen (22%) of the schizophrenia treated with clozapine group had clinically significant total OCI scores. Two (3%) had documented OCS pre clozapine. De novo OCS was reported in twelve (19%) cases. Nine (11%) had documented OC symptoms pre-clozapine while only two (3%) had symptoms after clozapine was initiated. In terms of OC symptom profile, the clozapine group scored highest on the Doubting scale, a cognitive symptom whereas the OCD group scored highest on Washing, a behavioural symptom. Both groups reported greater distress with cognitive rather than behavioural symptoms. Medication including clozapine dose was not correlated with symptom severity. Anxiety correlated highly with obsessive compulsive symptoms in the Clozapine group but not the OCD group. Within the Clozapine group, Obsessing correlated highly with Unusual Thought Content. Findings suggest that obsessive compulsive symptoms in the Clozapine group may reflect a subtype of \\'schizo-obsessive
Bhatia, Manjeet S.; Kaur, Jaswinder
Homosexual Obsessive Compulsive Disorder (HOCD) is marked by excessive fear of becoming or being homosexual. The subjects often experience intrusive, unwanted mental images of homosexual behaviour. The excessive uncontrolled thoughts/doubts are very distressing and lead to compulsions in form of checking. We present a rare such case who was suffering from HOCD.
Bhatia, Manjeet S; Kaur, Jaswinder
Homosexual Obsessive Compulsive Disorder (HOCD) is marked by excessive fear of becoming or being homosexual. The subjects often experience intrusive, unwanted mental images of homosexual behaviour. The excessive uncontrolled thoughts/doubts are very distressing and lead to compulsions in form of checking. We present a rare such case who was suffering from HOCD. PMID:25738067
Full Text Available Obsessive-compulsive disorder (OCD is a chronic psychiatric disorder characterized by recurrent intrusive thoughts and/or repetitive compulsory behaviors. This psychiatric disorder is known to be stress responsive, as symptoms increase during periods of stress but also because stressful events may precede the onset of OCD. However, only a few and inconsistent reports have been published about the stress perception and the stress response in these patients. Herein, we have characterized the correlations of OCD symptoms with basal serum cortisol levels and scores in a stress perceived questionnaire (PSS-10. The present data reveals that cortisol levels and the stress scores in the PSS-10 were significantly higher in OCD patients that in controls. Moreover, stress levels self-reported by patients using the PSS-10 correlated positively with OCD severity in the Y-BOCS. Interestingly, PSS-10 scores correlated with the obsessive component, but not with the compulsive component, of Y-BOCS. These results confirm that stress is relevant in the context of OCD, particularly for the obsessive symptomatology.
Rapp, Amy M; Bergman, R Lindsay; Piacentini, John; McGuire, Joseph F
Obsessive-compulsive disorder (OCD) is a neuropsychiatric illness that often develops in childhood, affects 1%-2% of the population, and causes significant impairment across the lifespan. The first step in identifying and treating OCD is a thorough evidence-based assessment. This paper reviews the administration pragmatics, psychometric properties, and limitations of commonly used assessment measures for adults and youths with OCD. This includes diagnostic interviews, clinician-administered symptom severity scales, self-report measures, and parent/child measures. Additionally, adjunctive measures that assess important related factors (ie, impairment, family accommodation, and insight) are also discussed. This paper concludes with recommendations for an evidence-based assessment based on individualized assessment goals that include generating an OCD diagnosis, determining symptom severity, and monitoring treatment progress. PMID:27594793
Jana, Amlan K.; Samir Kumar Praharaj; Vinod Kumar Sinha
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, w...
Berman, I; Kalinowski, A; Berman, S M; Lengua, J; Green, A I
The goals of the study were to determine the prevalence of obsessive or compulsive (OC) symptoms among chronic schizophrenic patients, and to elucidate the level of function and course of illness in chronic schizophrenic patients with and without such symptoms. Therapists of 102 patients with DSM-III-R diagnoses of chronic schizophrenia reported on their patients' OC symptoms, level of function, and course of illness. Twenty-five percent of the chronic schizophrenic patients presented with significant OC symptoms. The OC schizophrenics had significantly earlier onsets of their illnesses, had spent more time in the hospital in the previous 5 years, and were judged by their therapists to have a lower level of capacity for age-appropriate function. In addition, such patients had been less often employed and less often married, and were more dependent on others. The poorer prognosis for schizophrenic patients with OC symptoms than for those without these symptoms suggests the need for new therapeutic strategies for such patients. PMID:7705089
Mavrogiorgou, Paraskevi; Bader, Armin; Stockfleth, Eggert; Juckel, Georg
Patients with obsessive-compulsive (OCD) and related disorders - primarily trichotillomania, body dysmorphic disorder, and skin picking disorder - frequently present to dermatologists due to associated hair and skin symptoms. It is therefore crucial that dermatologists be familiar with these disorders. In this review article, we provide an update on clinical features, neurobiology factors, and treatment options for OCD spectrum disorders. Employing PubMed and Cochrane Library databases, a selective literature search was conducted using keywords related to dermatological disorders within the OCD spectrum. OCD and its related disorders share several phenomenological as well as pathophysiological similarities, thus warranting their classification within a separate nosological category of psychiatric disorders. Another similarity of OCD spectrum disorders is the frequent concurrence of hair and skin diseases. Besides symptomatic dermatological treatment, the combination of psychotherapy (behavioral therapy) and psychopharmacotherapy (SSRIs) may be helpful. Although recent insights into OCD have contributed to a better understanding and treatment thereof, more research is required, especially with respect to OCD spectrum disorders, for which large controlled treatment studies are still lacking. PMID:26408459
Coles, Meredith E; Schofield, Casey A; Pietrefesa, Ashley S
Behavioral inhibition is frequently cited as a vulnerability factor for development of anxiety. However, few studies have examined the unique relationship between behavioral inhibition and obsessive-compulsive disorder (OCD). Therefore, the current study addressed the relationship between behavioral inhibition and OCD in a number of ways. In a large unselected student sample, frequency of current OC symptoms was significantly correlated with retrospective self-reports of total levels of childhood behavioral inhibition. In addition, frequency of current OC symptoms was also significantly correlated with both social and nonsocial components of behavioral inhibition. Further, there was evidence for a unique relationship between behavioral inhibition and OC symptoms beyond the relationship of behavioral inhibition and social anxiety. In addition, results showed that reports of childhood levels of behavioral inhibition significantly predicted levels of OCD symptoms in adulthood. Finally, preliminary evidence suggested that behavioral inhibition may be more strongly associated with some types of OC symptoms than others, and that overprotective parenting may moderate the impact of behavioral inhibition on OC symptoms. The current findings suggest the utility of additional research examining the role of behavioral inhibition in the etiology of OCD. PMID:16621440
Nielen, Maria Margaretha Anna
Obsessive-compulsion diorder (ocd) is characterized by recurrent obsessions and/or compulsions. Obsessions are intrusive and unwanted thoughts, images or feelings which elicit considerable anxiety and discomfort. Commonly recurring themes in obsessions are aggression, blasphemy, death and (unacceptable) sexual urges. Compulsions are repetitive, ritualistic behaviours or mental acts that are performed to reduce or neutralise the anxiety that is elicited by the obsessions.The most frequently en...
Full Text Available Neurobiological factors had been shown to play an important role in the emergence of obsessive-compulsive disorder by the information obtained from the methods developed over the years. According to the neuropsychological perspective, the defects had been detected mainly in executive functions, in attention, memory, visual-spatial functions; and abnormalities had been described in the frontal lobe, cingulate cortex, basal ganglia, and thalamus regions of the patients with obsessive-compulsive disorder. The main and the most repeated abnormalities in patients with obsessive-compulsive disorder are dysfunctions in executive function and visual memory. Dysfunctions of the inhibitory processes associated with the dominant frontal area lead to an insufficiency on the inhibition of verbal functions. Excessive activation of the orbitofrontal cortex that mediate the behavioral response suppression function in obsessive-compulsive disorder demonstrated by functional imaging techniques. Repeated-resistant behaviors (eg: compulsions are composed by the deteriorations of the inhibitions of motor or cognitive programs in basal ganglions provided through cycles of frontal lobe. The findings of clinical observations in patients with obsessive-compulsive disorder could be considered as a reflection of excessive work in 'error detection system' which is the cause of the thoughts that something goes wrong and efforts to achieve perfection. As neurobiological, this finding is observed as excessive activity in orbitofrontal cortex and anterior cingulate cortex representing the ability of humans to provide and detect errors. It is is expected to develop the vehicles that are more sensitive to the characteristics of cognitive deficits in obsessive-compulsive disorder. In addition to the neuropsychological tests, using electrophysiological and advanced functional imaging techniques will put forward a better underlying the physiopathology of this disorder in order to
C. de Bruijn; S. Beun; R. de Graaf; M. ten Have; D. Denys
BACKGROUND: In this study we compared subjects with obsessive and/or compulsive symptoms who did not meet all criteria for obsessive-compulsive disorder (OCD) (subthreshold subjects) to subjects with full-blown OCD and also to subjects without obsessions or compulsions. METHOD: The data were derived
Yoshida, Takafumi; Taga, Chiaki; Matsumoto, Yoshitake; Fukui, Kenji
Previous studies have indicated that a parental rearing style showing a low level of care on the parental bonding instrument (PBI) is a risk factor for depression, and that there is a relationship between the overprotective rearing style on the PBI and obsessive-compulsive disorder (OCD). However, there is no study on the parental rearing attitudes in depressive patients divided into two groups based on their obsessive traits. In this study, we evaluated the parental rearing attitudes and examined the differences among four groups: depressive patients with severe obsessive traits, depressive patients with mild obsessive traits, OCD patients, and healthy volunteers. We divided the depressive patients into severe and mild groups based on their obsessive traits on the Mausdley Obsessional-Compulsive Inventory (MOCI). We compared PBI scores among four groups of 50 subjects matched for age and sex: depressive patients with severe obsessive traits, depressive patients with mild obsessive traits, OCD patients, and healthy volunteers. The paternal protection scores in the depressive patients with severely obsessive traits and the OCD patients were significantly higher than those in the depressive patients with mildly obsessive traits and healthy volunteers. This study indicated that the depressive patients with severe obsessive traits and the OCD patients have similar paternal controlling and interfering rearing attitudes. We conclude that the paternal controlling and interfering rearing attitudes are linked to the development of OCD and depression with obsessive traits, and are not linked to the development of depression itself. PMID:16194254
Stein, Dan J
Obsessive-compulsive disorder is currently classified as an anxiety disorder. However, there is growing interest in the concept of an obsessive-compulsive spectrum of disorders (OCSDs). The relationship between anxiety disorders and OCSDs has been questioned. The psychobiology of anxiety disorders and OCSDs is briefly reviewed in this article. While there appear to be several distinct contrasts in the underlying psychobiology of these conditions, there is also evidence of overlapping mechanisms. In addition, there are crucial gaps in our current database, confounding nosological decision-making. Conceptualizing various anxiety disorders and putative OCSDs as lying within a broader spectrum of emotional disorders may be useful. However, clinicians must also recognize that individual anxiety and obsessive-compulsive spectrum conditions, including disorders characterized by body-focused repetitive behaviors, have distinct psychobiological underpinnings and require different treatment approaches.
More than a half of patients with OCD are classified as early-onset. Early-onset OCD has been indicated to be associated with a greater OCD global severity and more frequently comorbid with tic disorders and other obsessive-compulsive (OC) spectrum disorders, compared with late-onset OCD. Early-onset OCD patients with severe impairment caused by both OC symptoms and comorbid OC spectrum disorders may be identified as being refractory. Tic disorders and autism spectrum disorder (ASD) are child and adolescent psychiatric disorders included in OC spectrum disorders. OCD comorbid with chronic tic disorders including Tourette syndrome (TS) is specified as tic-related OCD. Tic-related OCD is characterized by the high prevalence of early-onset and sensory phenomena including "just right" feeling. Self-injurious behaviors (SIB) such as head banging and body punching often occur in patients with TS. The patients' concern about SIB is likely to trigger them, suggesting that an impulse-control problem is a feature of TS. More than a half of patients with TS have OC symptoms. When OC symptoms in patients with TS were assessed with a dimensional approach, symmetry dimension symptoms were found most frequently over the lifetime. On the other hand, the severity of aggression dimension symptoms was the most stable during the course among all dimensions. Aggression dimension symptoms also exhibited a close relationship with impairment of global functioning and sensory phenomena. This tendency may be characteristic of tic-related OCD. It is sometimes difficult to differentiate between OC symptoms and restricted, repetitive behaviors which are core symptoms of ASD. Recently, ego-dystonia and insight are considered non-essential to diagnose OCD, whereas high-functioning and/or atypical ASD is recognized as being more prevalent than previously estimated. In this situation, attention to comorbidity of OCD and ASD is increasing, and the prevalence of OCD in children and adolescents with
M.J.H. Kas; C. Gelegen; F. van Nieuwerburgh; H.G.M. Westenberg; D. Deforce; D. Denys
Obsessive-compulsive disorder (OCD) is a severe anxiety disorder characterized by obsessions and compulsions. The core symptom of OCD is compulsivity, the inability to stop thinking or acting when you want to, despite being aware of the uselessness of the content or the adverse consequences. To init
Frost, R O; Steketee, G; Cohn, L; Griess, K
Theorists from a variety of perspectives have asserted that obsessive compulsives are more risk-aversive, perfectionistic and guilt-ridden than non-obsessive compulsives, and that these characteristics are central features of the disorder. Furthermore, several have hypothesized that the parents of obsessive compulsives are characterized by risk-aversion, perfectionism, and high levels of criticism. Little research exists which corroborates these hypotheses, however. The present investigation examined these hypotheses among subclinical obsessive compulsives. In two different samples, subclinical obsessive compulsives were found to be more risk-aversive, perfectionistic, and guilt-ridden. Subclinical obsessive compulsives also perceived their parents to be more overprotective. The findings regarding other parental traits were less clear. There was some support for the hypothesis that the parents of subclinical obsessive compulsives are more risk-aversive, and that fathers are more critical and perfectionistic. PMID:8135722
Kalra, Harish; Tandon, Rajul; Saluja, Bharat; Mohan, Indra
Comorbidity is known to occur among various psychiatric disorders. About the third of the patients with Obsessive Compulsive Disorder have major depressive disorder and anxiety disorder but coexistence of Obsessive Compulsive Disorder with mania is rare to see. Here we report a case of Obsessive Compulsive Disorder where manic phase was accompanied by obsessions of contamination and pathological doubts along with cleaning rituals and spitting rituals.
Sulkowski, Michael L.; Mariaskin, Amy; Storch, Eric A.
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…
Walitza, Susanne; Wendland, Jens R.; Gruenblatt, Edna; Warnke, Andreas; Sontag, Thomas A.; Tucha, Oliver; Lange, Klaus W.
Obsessive-compulsive disorder (OCD) is characterized by recurrent, intrusive and disturbing thoughts as well as by repetitive stereotypic behaviors. Epidemiological data are similar in children and adults, i.e., between 1 and 3% of the general population suffer from OCD. Children with OCD are often
Maryam Valizadeh; Nasim Valizadeh
B12 acts as a cofactor in synthesis of neurotransmitters such as serotonin and dopamine, thus B12 deficiency affects mood, emotions and sleeping and can lead to psychiatric disorders. Psychiatric manifestations of B12 deficiency are varied. They seldom precede anemia. We want to present a case of B12 deficiency which was presented with obsessive compulsive disorder.
Lewin, Adam B.; Bergman, R. Lindsey; Peris, Tara S.; Chang, Susanna; McCracken, James T.; Piacentini, John
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…
A high degree of comorbidity appears to exist between obsessive-compulsive disorder (OCD) and depression, both with respect to symptomatology and at the syndromal level. It has been argued that nonspecific effects on dysphoric mood, anxiety, and depressive symptoms account for the therapeutic effica
Mataix-Cols, David; Nakatani, Eriko; Micali, Nadia; Heyman, Isobel
The investigation of the structure of obsessive-compulsive disorder (OCD) symptoms observed in adults is similar to those observed in children is presented. This investigation indicates the structure of OCD symptoms is the same across the entire lifespan as compared to pediatric OCD and adulthood OCD.
Full Text Available A case of late onset sporadic startle syndrome in a patient with a right posterior fossa brain tumour is reported. The exaggerated startle response did not respond to treatment with clonazepam. In addition to anxiety and depression, the patient developed obsessive- compulsive symptoms which responded to behavioural therapy. The possible mechanisms for this unique pattern of symptoms are discussed.
Jonsson, H.; Kristensen, M.; Arendt, M.
Despite promising results from intensive formats of cognitive-behavioural therapy (CBT) for obsessive-compulsive disorder (OCD) the format is rarely used. The aim of the study was to systematically review the literature within this area of research and provide a meta-analysis of the effectiveness...
Menchón, José M; van Ameringen, Michael; Dell'Osso, Bernardo; Denys, D.; 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
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 Obse
Chaturvedi, Amrita; Murdick, Nikki L.; Gartin, Barbara C.
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…
曹倖; 王建平; 王馨蕊; 高扬
目的:引进强迫量表儿童版(Obsessive Compulsive Inventory-Child Version,OCI-CV),检验其在中国青少年中的信效度.方法:经双盲翻译的严格程序获得中文版OCI-CV;通过方便取样对2876名青少年进行测查;选用莱顿强迫问卷(儿童版)、儿童青少年多维度焦虑量表以及儿童抑郁量表作为效度量表;3-4周后对其中的329名青少年进行重测.结果:验证性因素分析表明中文版OCI-CV符合原六因素模型;其总量表内部一致性系数为0.856,各分量表内部一致性系数为0.462到0.747;重测信度为0.532到0.758;OCI-CV总分与强迫症状(存在与否/干扰程度)、焦虑和抑郁的相关系数分别为0.696/0.684、0.634和0.505(均P＜0.01).结论:中文版OCI-CV具有良好的信效度,可以在中国青少年中应用.%Objective:To evaluate psychometric properties of Obsessive Compulsive Inventory-Child Version(OCI-CV)in Chinese adolescents.Methods:A sample of 2876 adolescents was tested with a measuring battery including the Chinese version of OCI-CV,Leyton Obsessive Inventory-Child Version (LOI-CV),Multidimensional Anxiety Scale for Children(MASC) and Children's Depression Inventory(CDI).Results:Confirmatory factor analysis of the Chinese version of OCI-CV confirmed the six-factor model.The internal consistencies of the OCI-CV and its subscales were 0.462 to 0.856.The retest reliabilities were 0.532 to 0.785.For the total score of OCI-CV,the correlation coefficients were 0.696/0.684 to obsessive-compulsive symptoms (presence/interference),0.634 to anxiety and 0.505 to depression respectively (Ps＜0.01).Conclusion:Chinese version of OCI-CV is a reliable and valid instrument for assessing obsessive-compulsive symptoms in Chinese adolescents.
Gallant, Jason; Storch, Eric A; Merlo, Lisa J; Ricketts, Emily D; Geffken, Gary R; Goodman, Wayne K; Murphy, Tanya K
The Children's Yale-Brown Obsessive Compulsive Scale-Symptom Checklist (CY-BOCS-SC; Scahill, L., Riddle, M. A., McSwiggin-Hardin, M., Ort, S. I., King, R. A., Goodman, W. K., et al. (1997). Children's Yale-Brown Obsessive Compulsive Scale: Reliability and validity. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 844-852) is widely used to assess the presence of obsessions and compulsions in youth. Although factor analytic studies have established symptom dimensions of the CY-BOCS-SC, little is known of its psychometric properties. The present study sought to examine the convergent and discriminant validity of the CY-BOCS-SC. Eighty-six youth with obsessive compulsive disorder (OCD) and their parents were administered the CY-BOCS-SC, the CY-BOCS severity items, and the Anxiety Disorders Interview Schedule for DSM-IV: Parent Version (ADIS-IV-P). Children completed the Children's Depression Inventory and Multidimensional Anxiety Scale for Children. Internal consistency of CY-BOCS-SC symptom dimensions ranged from poor to good. The CY-BOCS-SC demonstrated good to excellent convergent validity, as demonstrated by large correlations with conceptually similar items on the ADIS-IV-P. The discriminant validity of the CY-BOCS-SC was also good, as evidenced by small, generally non-significant, correlations between the CY-BOCS-SC dimensions and depressive and anxiety symptoms, OCD symptom severity, and trichotillomania symptoms. These results provide initial psychometric support for the CY-BOCS-SC and support its use as a clinical and research instrument for assessing presence of a range of obsessive and compulsive symptoms in youth with OCD. PMID:18329843
Milad, Mohammed R; Rauch, Scott L
Obsessive-compulsive disorder (OCD) affects approximately 2-3% of the population and is characterized by recurrent intrusive thoughts (obsessions) and repetitive behaviors or mental acts (compulsions), typically performed in response to obsessions or related anxiety. In the past few decades, the prevailing models of OCD pathophysiology have focused on cortico-striatal circuitry. More recent neuroimaging evidence, however, points to critical involvement of the lateral and medial orbitofrontal cortices, the dorsal anterior cingulate cortex and amygdalo-cortical circuitry, in addition to cortico-striatal circuitry, in the pathophysiology of the disorder. In this review, we elaborate proposed features of OCD pathophysiology beyond the classic parallel cortico-striatal pathways and argue that this evidence suggests that fear extinction, in addition to behavioral inhibition, is impaired in OCD. PMID:22138231
Wetterneck, Chad T.; Siev, Jedidiah; Adams, Thomas G.; Slimowicz, Joseph C.; Smith, Angela H
Sexual obsessions are a common symptom of obsessive-compulsive disorder (OCD), often classified in a broader symptom dimension that includes aggressive and religious obsessions, as well. Indeed, the Dimensional Obsessive-Compulsive Scale (DOCS) Unacceptable Thoughts Scale includes obsessional content relating to sexual, violent, and religious themes associated with rituals that are often covert. However, there is reason to suspect that sexual obsessions differ meaningfully from other types of...
Storch, Eric A.; Lewin, Adam B.; De Nadai, Alessandro S.; Murphy, Tanya K.
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…
Black, Donald W; Shaw, Martha; Blum, Nancee
Both compulsive buying (CB) and pathological gambling (PG) have been proposed as members of a spectrum of disorders related to obsessive-compulsive disorder (OCD). The spectrum hypothesis originated in the early 1990s and has gained considerable support, despite the lack of empirical evidence. Interest in this hypothesis has become critical because some investigators have recommended the creation of a new category that includes these disorders in DSM-5, now under development. In this article,...
... difficulties with attention or concentration because of the intrusive thoughts. Among kids and teens with OCD, the most ... wastes lucky and unlucky numbers sexual or aggressive thoughts fear ... household items intrusive sounds or words These compulsions are the most ...
Wahl, Karina; Schönfeld, Sabine; Hissbach, Johanna; Küsel, Sebastian; Zurowski, Bartosz; Moritz, Steffen; Hohagen, Fritz; Kordon, Andreas
Repetitive, intrusive cognitive phenomena are central both to obsessive-compulsive patients - typically as obsessive thoughts - and to depressed patients - typically as ruminative thoughts. The objective of the present study is to compare obsessive and ruminative thoughts in non-depressed obsessive-compulsive and depressed patients. Thirty-four patients diagnosed with obsessive-compulsive disorder and 34 patients diagnosed with major depression disorder were asked to identify both a personally relevant obsessive and a personally relevant ruminative thought and to subsequently evaluate these thoughts on a modified version of the Cognitive Intrusions Questionnaire (CIQ) developed by Freeston, Ladouceur, Thibodeau, and Gagnon (1991). The CIQ assesses general descriptors, emotional reactions, appraisal and coping strategies on a nine-point Likert scale. A mixed-model ANOVA demonstrated that obsessive and ruminative thoughts are distinct cognitive processes, clearly distinguishable in form, appraisal and temporal orientation across disorders. In obsessive-compulsive patients, ruminative thoughts were more common and more emotionally distressing than predicted. In depressed patients, obsessive thoughts occurred infrequently and were not associated with high negative emotions. Clarifying similarities and differences between ruminative and obsessive thoughts and understanding their interaction might ultimately help to expand on the role of cognitive vulnerability factors in obsessive-compulsive and major depression disorder. PMID:21596010
Tumkaya, S; Karadag, F; Oguzhanoglu, N K
Obsessive compulsive symptoms are more frequent in patients with schizophrenia compared to normal population. Patients with obsessive compulsive disorder may also exhibit psychosis-like symptoms. Based on these findings, it has been suggested that there is a spectrum of disorders between OCD and schizophrenia. We compared two OCD groups (with good and poor insight) and two schizophrenia groups (with and without OCD) in this recommended spectrum especially in terms of neurological soft signs (NSSs) associated with sensory integration. The schizophrenia with OCD (schizo-obsessive) group exhibited worse performance than the schizophrenia group (p=0.002) in only graphesthesia tasks. Moreover, schizo-obsessive patients exhibited worse performance compared to OCD patients in terms of graphesthesia (p=0.001) and audiovisual integration (p=0.001). Interestingly, OCD patients with poor insight tended to exhibit graphesthesia deficit in a similar manner to schizo-obsessive patients rather than OCD patients. According to our results, graphesthesia disorder is strongly associated both with OCD and schizophrenia. This suggests that neurodevelopmental disorders that lead to graphesthesia disorder overlap in comorbid OCD and schizophrenia patients.
Bavle, Amar; Kumar, Kottur; Sharath, Vishwaraj
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
Full Text Available 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.
Abdul Latif Abdul Razak
Obsessive–Compulsive Disorder (OCD) is a type of anxiety in which a person suffers from obsessions i.e. unwanted intrusive ideas which recur to the person persistently; and compulsions i.e. behaviours that a person feels compelled to perform epeatedly in a ritualistic manner with the aim of relieving the anxiety from the unpleasant obsessive thoughts. Although compulsion and obsession are common, once the individual experiences xcessive discomfort, then he or she would be diagnosed as a pa...
Mattoo, S. K.; Gupta, Nitin
The textbook description of comorbid depressive and obsessive compulsive disorders is that of onset of one following the onset or peak severity of the other, and recovery of one usually following recovery of the other. We describe a case who developed first onset obsessive compulsive disorder at tail of first onset major depression. This case highlights need for studies on the course of comorbid depressive and obsessive compulsive disorders.
Krebs, Georgina; Heyman, Isobel
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
Stein, Dan J; Andersen, Elisabeth Anne Wreford; Overo, Kerstin Fredricson
-controlled study of citalopram in obsessive-compulsive disorder were analyzed. Factor analysis of individual items and symptom categories of the Yale-Brown Obsessive-Compulsive Scale Checklist were undertaken, and the impact of symptom dimensions on treatment outcomes was analysed. RESULTS: Factor analysis of Yale-Brown...... better outcome. Factor analysis of Yale-Brown Obsessive-Compulsive Scale Checklist symptom clusters yielded a 4 factor solution, but confirmed that symmetry/ordering was associated with male gender, early onset, and long duration of obsessive-compulsive disorder while high scores on the hoarding subscale...
Amir, Nader; Najmi, Sadia; Morrison, Amanda S.
Cognitive theories of obsessive-compulsive disorder (OCD) suggest that the disorder is characterized by an attention bias towards personally relevant threatening material. However, existing research on attention bias in OCD has yielded conflicting findings. One possibility that might account for the null findings is that attention bias may diminish over the course of the experiment. The present study tested this hypothesis using a visual dot-probe task with idiographic word selection. Results...
Uzoezi Ozomaro; Guiqing Cai; Yuji Kajiwara; Seungtai Yoon; Vladimir Makarov; Richard Delorme; Catalina Betancur; Stephan Ruhrmann; Peter Falkai; Hans Jörgen Grabe; Wolfgang Maier; Michael Wagner; Leonhard Lennertz; Rainald Moessner; Murphy, Dennis L.
International audience 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...
Sandler Robin; Niehaus Dana JH; Nel Daniel G; du Toit Pieter L; Seedat Soraya; Lochner Christine; Stein Dan J
Abstract 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 compar...
Full Text Available Obsessive-compulsive disorder (OCD is a psychiatric affliction with a lifetime prevalence of 1-3%. OCD is an anxiety disorder characterized by obsessive thinking (persistent ideas, thoughts, impulses or images that are experienced as intrusive and inappropriate and compulsive behaviour (repetitive behaviours or mental acts [e.g. hand-washing, checking, praying, and counting] that causes marked distress or significant impairment. 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 path for furthering our understanding and treatment of this disorder. The present review article provides the reader with an overview of the currently active animal models of OCD with their strengths and limitations. We have reviewed the genetic, pharmacological, neurodevelopmental and behavioural animal models of OCD, and discussed their face validity (derived from phenomenological similarity between the behavior of the animal 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.
Tan, Oguz; Metin, Baris; Metin, Sinem
Obsessive-compulsive disorder (OCD) and attention-deficit and hyperactivity disorder (ADHD) frequently coexist. To understand whether childhood ADHD can increase the risk of OCD in adulthood and whether it influences the phenomenology of OCD, we investigated the symptoms of ADHD during childhood in obsessive-compulsive adults who had never been diagnosed as ADHD. Adults with OCD (n = 83) were given the Wender Utah Rating Scale (WURS), Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Barratt Impulsiveness Scale-11 (BIS-11), Hamilton Depression Rating Scale-17 (HDRS-17) and Beck Anxiety Inventory (BAI). The prevalence of childhood ADHD symptoms was 40.9 % (n = 34) and that of adult ADHD was 16.9 % (n = 14). Patients with childhood ADHD symptoms had an earlier onset of OCD, higher scores of the BAI and BIS-11. The scores of the Y-BOCS and HDRS-17 did not differ between those having and not having childhood ADHD symptoms. Childhood history of ADHD symptoms is common in adult OCD patients who have never been diagnosed as ADHD. Childhood ADHD symptoms are associated with an earlier age of OCD, more severe anxiety and higher impulsiveness. Even remitted ADHD may be a risk factor for OCD in later life. PMID:27056070
Veale, David; Freeston, M; Krebs, Georgina; Heyman, Isobel; Salkovskis, Paul
Some people with obsessive–compulsive disorder (OCD) experience recurrent intrusive sexual, aggressive or death-related thoughts and as a result may be subjected to lengthy or inappropriate risk assessments. These apparent ‘primary’ risks can be dealt with relatively easily through a careful understanding of the disorder’s phenomenology. However, there are other, less obvious ‘secondary’ risks, which require more careful consideration. This article discusses the differentiation of intrusive t...
Journal of the American Academy of Child & Adolescent Psychiatry, 2012
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…
Wu, Ke; Hanna, Gregory L; Rosenberg, David R.; Arnold, Paul D.
Obsessive-compulsive disorder (OCD) is a common and often debilitating neuropsychiatric condition characterized by persistent intrusive thoughts (obsessions), repetitive ritualistic behaviours (compulsions) and excessive anxiety. While the neurobiology and etiology of OCD has not been fully elucidated, there is growing evidence that disrupted neurotransmission of glutamate within corticalstriatal-thalamocortical (CSTC) circuitry plays a role in OCD pathogenesis. This review summarizes the fin...
Fineberg, NA; Chamberlain, SR; E. Hollander; Boulougouris, V.; Robbins, TW
Obsessive-compulsive disorder (OCD) is characterized by obsessions (intrusive thoughts) and compulsions (repetitive ritualistic behaviours) leading to functional impairment. Accumulating evidence links these conditions with underlying dysregulation of fronto-striatal circuitry and monoamine systems. These abnormalities represent key targets for existing and novel treatment interventions. However, the brain bases of these conditions and treatment mechanisms are still not fully elucidated. Anim...
Arnold, Lesley M.
Background: There is emerging evidence that postpartum women are at risk for the development or worsening of obsessive-compulsive disorder. The purpose of this study was to provide data regarding the demographics, phenomenology, associated psychiatric comorbidity, family history, and response to open treatment with fluvoxamine in subjects with postpartum-onset obsessive-compulsive disorder.
Dewey, Stephen L. (Manorville, NY); Brodie, Jonathan D. (Cos Cob, CT); Ashby, Jr., Charles R. (Miller Place, NY)
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.
McKay, Dean; Andover, Margaret
Nonsuicidal self-injury (NSSI) has many behavioral and cognitive features that would make it appear to be closely tied to obsessive-compulsive disorder (OCD). Obsessive-compulsive-related disorders (OCRDs) have been described in the literature as conditions that share a common phenomenology, neurobiology, and treatment response. The authors…
van Velzen, Laura S.; de Wit, Stella J.; Curcic-Blake, Branisalava; Cath, Danielle C.; de Vries, Froukje E.; Veltman, Dick J.; van der Werf, Ysbrand D.; van den Heuvel, Odile A.
Background: 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 corre
O'Leary, Emily Marie; Rucklidge, Julia Jane; Blampied, Neville
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…
van Westen, Maarten; Rietveld, Erik; Figee, Martijn; Denys, D.
Clinical outcome of deep brain stimulation (DBS) for obsessive-compulsive disorder (OCD) shows robust effects in terms of a mean Yale-Brown Obsessive-Compulsive Scale (YBOCS) reduction of 47.7 % and a mean response percentage (minimum 35 % YBOCS reduction) of 58.2 %. It appears that most patients re
Chok, James T; Koesler, Bryan
The current project was an initial attempt to develop assessment procedures for distinguishing between obsessive-compulsive (OC) and stereotypic behavior and evaluate the impact of different treatments for these behaviors. Two individuals with autism, one with repetitive behavior characteristic of OC behavior and one with repetitive behavior not characteristic of OC behavior, participated in the study. In Experiment 1, given that individuals with Obsessive-Compulsive Disorder (OCD) report experiencing unpleasant urges that are relieved when they perform compulsive actions, an attempt was made to identify these experiences by measuring heart rate and affect when access to repetitive behavior was restricted and allowed. In Experiment 2, a multiple schedules treatment was conducted with each participant, and in Experiment 3, the participant with autism and OC behavior completed exposure and response prevention (ERP) treatment. The overall results across studies suggest that one potential way to discriminate between OC behavior and stereotypy in nonvocal children with autism is to consider the topography of repetitive behavior along with changes in physiology and affect. In addition, it may be worth considering the use of ERP, a traditional treatment for OCD, to treat repetitive behavior maintained by automatic reinforcement if treatments that provide access to repetitive behavior are not effective. PMID:24177034
Leung, Jonathan G; Palmer, Brian A
One underrecognized adverse event of clozapine is the emergence or worsening of obsessive-compulsive symptoms (OCS). OCS, particularly violent thoughts, can be inaccurately described as psychosis and result in a misdiagnosis. We report a case of a 42-year-old man, initially diagnosed with schizoaffective, who was placed on clozapine for the management of “violent delusions.” However, clozapine led to a worsening of these violent thoughts resulting in suicidal ideation and hospitalization. Aft...
Altemus, M.; Murphy, D.L.; Greenberg, B. [NIMH, NIH, Bethesda, MD (United States); Lesch, K.P. [Univ. of Wuerzburg (Germany)
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.
Hudak, Robert; Wisner, Katherine L
Obsessive-compulsive symptoms in the postpartum period often include intrusive thoughts of harming the infant and rituals that result in avoidance of the baby. The differential diagnosis of women who develop these symptoms includes postpartum major mood disorders, obsessive-compulsive disorder, and psychosis with infanticidal thoughts. The treatment of the most common diagnoses, mood disorders and obsessive-compulsive disorder, includes serotonergic drugs, psychoeducation to help the patient understand that she is highly unlikely to harm her infant, and exposure with response prevention therapy. This intervention involves exposure of the patient to the feared situations, which are usually related to infant care, while simultaneously preventing the compulsive rituals. PMID:22476676
Freeman, Jennifer; Flessner, Christopher A.; Garcia, Abbe
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.…
Privitera, Anna P.; Distefano, Rosario; Wefer, Hugo A.; Ferro, Alfredo; Pulvirenti, Alfredo; Giugno, Rosalba
Obsessive-compulsive disorder (OCD) is a psychiatric condition characterized by intrusive and unwilling thoughts (obsessions) giving rise to anxiety. The patients feel obliged to perform a behavior (compulsions) induced by the obsessions. The World Health Organization ranks OCD as one of the 10 most disabling medical conditions. In the class of Anxiety Disorders, OCD is a pathology that shows an hereditary component. Consequently, an online resource collecting and integrating scientific disco...
Denys, D.A.J.P.; Wingen, van, G.A.; Figee, M
Deep brain stimulation (DBS) is a neurosurgical technique that involves the implantation of electrodes in the brain. DBS enables electrical modulation of abnormal brain activity for treatment of neuropsychiatric disorders such as obsessive-compulsive disorder (OCD). Mrs. D. has been suffering from OCD for more than 20 years, which caused her to compulsively clean every detail of her house and have obsessive thoughts about dirt and contamination. DBS helped her to overcome all of her obsession...
Bourne, Sarah K.; Eckhardt, Christine A.; Sheth, Sameer A.; Eskandar, Emad N.
Deep brain stimulation (DBS) has emerged as a safe, effective, and reversible treatment for a number of movement disorders. This has prompted investigation of its use for other applications including psychiatric disorders. In recent years, DBS has been introduced for the treatment of obsessive compulsive disorder (OCD), which is characterized by recurrent unwanted thoughts or ideas (obsessions) and repetitive behaviors or mental acts performed in order to relieve these obsessions (compulsions...
Sarah Kathleen Bourne; Christine Ann Eckhardt; Sheth, Sameer A.; Eskandar, Emad N.
Deep brain stimulation (DBS) has emerged as a safe, effective, and reversible treatment for a number of movement disorders. This has prompted investigation of its use for other applications including psychiatric disorders. In recent years, DBS has been introduced for the treatment of obsessive-compulsive disorder (OCD), which is characterized by recurrent unwanted thoughts or ideas (obsessions) and repetitive behaviors or mental acts performed in order to relieve these obsessions (compulsions...
Diedrich, Alice; Sckopke, Philipp; Schwartz, Caroline; Schlegl, Sandra; Osen, Bernhard; Stierle, Christian; Voderholzer, Ulrich
Background 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. Methods Seventy-one consecutively admitted inpatients with obsess...
Besharat, Mohammad Ali; Kamali, Zeynab Sadat
Obsessive Compulsive Disorder (OCD) is characterized by intrusive images or impulses and/or ritualistic and rigid behaviors. Symptoms of OCD have different contents including contamination, harming and symmetry. Religion is one of the themes that has been observed in the context of OCD frequently. The aim of the present study was to examine the power of superego and ego characteristics in predicting scrupulosity and non-religious obsessions and compulsions, as well as comparing the two sets of obsessive-compulsive symptoms. Sixty six Iranian (19 men, 47 women) participated in the study. All participants were asked to complete Maudsley Obsessive-Compulsive Inventory, Penn Inventory of Scrupulosity, Perfectionism Cognitions Inventory, the Multidimensional Anger Inventory, and Ego Strength Scale. Results showed that perfectionism and anger were positively correlated with scrupulosity and non-religious obsessive-compulsive symptoms. Ego control was negatively correlated with scrupulosity, while ego resiliency was not correlated with any of these two sets of symptoms. Regression analysis indicated that among these variables, anger was the best predictor of non-religious obsessive-compulsive symptoms, while perfectionism and ego control were the best predictors of scrupulosity. PMID:26957343
Full Text Available According to the literature, inflated responsibility/sensitivity to guilt play a pivotal role in both the genesis and maintenance of Obsessive-Compulsive Disorder (OCD. They may be learned in childhood and adolescence, through particular experiences and parental rearing styles, involving criticism, excessively high standards, and social moralization. Preliminary data on the role of dysfunctional beliefs in the development/maintenance of OCD also show that non-affected family members of OC individuals score higher than controls in domains concerning responsibility, suggesting it might represent a candidate endophenotype for the disorder. Compulsive conducts, that far from being mechanical reactions are instead clearly goal-oriented, may be triggered by the need of preventing responsibility/guilt. Therefore, useful psychological interventions aimed at not only reappraising meanings associated with the specific early experiences connected to hyper-sensitivity to guilt, but also at developing a more general compassionate and forgiving stance towards oneself, may prove particularly effective.
Kocak, Orhan Murat; Ozpolat, Aysegul Yilmaz; Atbasoglu, Cem; Cicek, Metehan
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…
Banca, P; Voon, V.; Vestergaard, MD; Philipiak, G; Almeida, I.; Pocinho, F; Relvas, J; Castelo-Branco
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 behav...
Rassin, E; Muris, P; Schmidt, H; Merckelbach, H
Research has shown that there are strong similarities in content between the obsessions and compulsions that characterize obsessive-compulsive disorder and nonclinical obsessions and compulsions. However, clinical and nonclinical obsessions and compulsions do differ with respect to characteristics like frequency, intensity, discomfort and elicited resistance. Two separate concepts have been invoked to explain how normal obsessions and compulsions may develop into clinical phenomena. First, it is suggested that thought-action fusion (TAF) contributes to obsessive-compulsive symptoms. Second, thought suppression may intensify obsessive-compulsive symptoms due to its paradoxical effect on intrusive thoughts. Although both phenomena have been found to contribute to obsessive-compulsive symptoms, possible interactions between these two have never been investigated. The current study explored how TAF and thought suppression interact in the development of obsessive-compulsive symptoms. Undergraduate psychology students (N = 173) completed questionnaires pertaining to TAF, thought suppression and obsessive-compulsive symptoms. Covariances between the scores on these questionnaires were analyzed by means of structural equation modeling. Results suggest that TAF triggers thought suppression, while thought suppression, in turn, promotes obsessive-compulsive symptoms. PMID:10957823
Obsessive-compulsive disorder (OCD) is characterized by obsession (recurrent intrusive thoughts) and compulsion (repetitive behaviors or mental acts). There is no consensus regarding the pathogenesis of OCD, which could support the idea that this disorder is heterogeneous. However, functional imaging data and surgical findings in humans suggest that the hyperactivity of the specific circuit including the striatum, called the cortico-striato-thalamo-cortical circuit, plays a role in OCD pathogenesis. Recently, validated animal models of OCD have been established, and they provide us the opportunity to address how the altered functional activity of this circuit contributes to the repetitive behavior in OCD. To test the causal relationship between the altered function of the circuit and behavioral abnormalities in animals, cell-type-specific manipulation and detection of changes in the circuit will be required. Optogenetic approaches may be used as tools to dissect the complex circuit. Moreover, mouse functional magnetic resonance imaging may yield data comparable to human imaging data. PMID:22868881
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
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. PMID:27317876
Starcevic, Vladan; Berle, David; do Rosário, Maria Conceição; Brakoulias, Vlasios; Ferrão, Ygor A; Viswasam, Kirupamani; Shavitt, Roseli; Miguel, Euripedes; Fontenelle, Leonardo F
This study aimed to determine the frequency of benzodiazepine (BDZ) use in a large sample of patients with obsessive-compulsive disorder (OCD) and ascertain the type of BDZ used and the correlates and predictors of BDZ use in OCD. The sample consisted of 955 patients with OCD from a comprehensive, cross-sectional, multicentre study conducted by the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders between 2003 and 2009. The rate of BDZ use over time in this OCD sample was 38.4%. Of individuals taking BDZs, 96.7% used them in combination with other medications, usually serotonin reuptake inhibitors. The most commonly used BDZ was clonazepam. Current age, current level of anxiety and number of additional medications for OCD taken over time significantly predicted BDZ use. This is the first study to comprehensively examine BDZ use in OCD patients, demonstrating that it is relatively common, despite recommendations from treatment guidelines. Use of BDZs in combination with several other medications over time and in patients with marked anxiety suggests that OCD patients taking BDZs may be more complex and more difficult to manage. This calls for further research and clarification of the role of BDZs in the treatment of OCD. PMID:26426443
DeVylder, Jordan E.; Oh, Amy J.; Ben-David, Shelly; Azimov, Neyra; Harkavy-Friedman, Jill; Corcoran, Cheryl M.
Obsessive-compulsive symptoms, particularly aggressive obsessions, are prevalent in schizophrenia patients and associated with other symptom severity, suicidal ideation and functional impairment. In a psychosis-risk cohort, obsessive-compulsive diagnosis and symptoms were assessed in terms of prevalence and content, and for associations with clinical measures. Obsessive-compulsive symptoms were prevalent in the CHR cohort, as was suicidal ideation. The presence and severity of aggressive obse...
Leung, Jonathan G; Palmer, Brian A
One underrecognized adverse event of clozapine is the emergence or worsening of obsessive-compulsive symptoms (OCS). OCS, particularly violent thoughts, can be inaccurately described as psychosis and result in a misdiagnosis. We report a case of a 42-year-old man, initially diagnosed with schizoaffective, who was placed on clozapine for the management of "violent delusions." However, clozapine led to a worsening of these violent thoughts resulting in suicidal ideation and hospitalization. After exploration of the intrusive thoughts and noting these to be egodystonic, clearly disturbing, and time consuming, an alternative diagnosis of obsessive-compulsive disorder (OCD) was made. Clozapine was inevitably discontinued resulting in a significant reduction of the intrusive thoughts without emergence of psychosis or adverse events. While an overlapping phenomenology between OCD and psychotic disorders has been described, clozapine and other antiserotonergic antipsychotics have been implicated with the emergence or worsening of OCS. Unique to our case is that the patient's obsessions had been treated as psychosis leading to the inadequate treatment of his primary illness, OCD. This case highlights the potential for OCD to masquerade as a psychotic disorder and reminds clinicians that clozapine may worsen OCS. PMID:27313938
Jonathan G. Leung
Full Text Available One underrecognized adverse event of clozapine is the emergence or worsening of obsessive-compulsive symptoms (OCS. OCS, particularly violent thoughts, can be inaccurately described as psychosis and result in a misdiagnosis. We report a case of a 42-year-old man, initially diagnosed with schizoaffective, who was placed on clozapine for the management of “violent delusions.” However, clozapine led to a worsening of these violent thoughts resulting in suicidal ideation and hospitalization. After exploration of the intrusive thoughts and noting these to be egodystonic, clearly disturbing, and time consuming, an alternative diagnosis of obsessive-compulsive disorder (OCD was made. Clozapine was inevitably discontinued resulting in a significant reduction of the intrusive thoughts without emergence of psychosis or adverse events. While an overlapping phenomenology between OCD and psychotic disorders has been described, clozapine and other antiserotonergic antipsychotics have been implicated with the emergence or worsening of OCS. Unique to our case is that the patient’s obsessions had been treated as psychosis leading to the inadequate treatment of his primary illness, OCD. This case highlights the potential for OCD to masquerade as a psychotic disorder and reminds clinicians that clozapine may worsen OCS.
One underrecognized adverse event of clozapine is the emergence or worsening of obsessive-compulsive symptoms (OCS). OCS, particularly violent thoughts, can be inaccurately described as psychosis and result in a misdiagnosis. We report a case of a 42-year-old man, initially diagnosed with schizoaffective, who was placed on clozapine for the management of “violent delusions.” However, clozapine led to a worsening of these violent thoughts resulting in suicidal ideation and hospitalization. After exploration of the intrusive thoughts and noting these to be egodystonic, clearly disturbing, and time consuming, an alternative diagnosis of obsessive-compulsive disorder (OCD) was made. Clozapine was inevitably discontinued resulting in a significant reduction of the intrusive thoughts without emergence of psychosis or adverse events. While an overlapping phenomenology between OCD and psychotic disorders has been described, clozapine and other antiserotonergic antipsychotics have been implicated with the emergence or worsening of OCS. Unique to our case is that the patient's obsessions had been treated as psychosis leading to the inadequate treatment of his primary illness, OCD. This case highlights the potential for OCD to masquerade as a psychotic disorder and reminds clinicians that clozapine may worsen OCS. PMID:27313938
Full Text Available Introduction: Obsessive-compulsive disorder (OCD, even if the patient’s obsession content is not related to sexuality, may be a problem in the sexual lives of individuals. In this article, sexual function in obsessive compulsive disorder patients is discussed based on an OCD case. Case: Male 36 years old and female 32 years old couple. Man had complaints of lack of control of ejaculation and woman had complaints of lack of orgasm. Man was diagnosed with premature ejaculation and woman was diagnosed with aversion and anorgasmia according to DSM-IV (Diagnostic and Statistical Manual Of Mental Disorders criteria. During therapy, the female patient was diagnosed with OCD as well. Loss of control was not acceptable to the patient. Thus she was avoiding from exhilarating stimuli. After cognitive restructuring of her evaluations about control, sex therapy was continued. At the end of the therapy the avoidance of the patient disappeared and anorgasmia was treated and ejeculation time of the male patient was 15 minutes. Conclusion: Sexual dysfunction is a common problem in patients with OCD. Patient may have avoidance that may adversely affect her sexuality. If a patient has avoidance about sexuality, the reason of this avoidance may or may not be the usual and expected thought content like avoidance of contamination. The evaluations of OCD patients about control may also adversely affect their sexuallity. The thought leading to avoidance behavior, may vary from patient to patient. However, to identify these thoughts with cognitive interventions and work with them will improve.the patient.
A 57 years old married, retired official of Indian Railway service presented with two months complaints of recurrent fears of circulation of a duplicate CD of one of his presentations in an international conference, recurrent thoughts that the years of winning medals during his tenure in Indian Railways service were misrepresented in the records as early years. He recognized these fears as irrational, intrusive causing irritability and extreme anxiety, as he felt an urge to go and check the records, and feared it would cause humiliation. A diagnosis of obsessive compulsive disorder predominantly obsessions were made. Patient refused medication and a keen interest to receive insight. Patient had strong ego functions, stable heterosexual partnership, was open to interpretations and therapeutic contract of ten sessions of David Malan's school of brief dynamic therapy was initiated. Unconscious therapeutic alliance dominated over resistance. Displacement, isolation of affect and undoing were the neurotic defenses interpreted by the therapist. Therapeutic focus was relief of obsessions occurred by 9(th) session and therapy was successfully terminated. PMID:25035560
Full Text Available A 57 years old married , retired official of Indian Railway service presented with two months complaints of recurrent fears of circulation of a duplicate CD of one of his presentations in an international conference , recurrent thoughts that the years of winning medals during his tenure in Indian Railways service were misrepresented in the records as early years. He recognized these fears as irrational, intrusive causing irritability and extreme anxiety, as he felt an urge to go and check the records, and feared it would cause humiliation. A diagnosis of obsessive compulsive disorder predominantly obsessions were made. Patient refused medication and a keen interest to receive insight. Patient had strong ego functions, stable heterosexual partnership, was open to interpretations and therapeutic contract of ten sessions of David Malan′s school of brief dynamic therapy was initiated. Unconscious therapeutic alliance dominated over resistance. Displacement, isolation of affect and undoing were the neurotic defenses interpreted by the therapist. Therapeutic focus was relief of obsessions occurred by 9 th session and therapy was successfully terminated.
Pelchat, Marcia L
Is it more than a linguistic accident that the same term, craving, is used to describe intense desires for both foods and for a variety of drugs of abuse? There is strong evidence for common pathways that are affected by most addictive drugs. As the other contributors to this volume will indicate, a strong case can also be made for some shared substrates for food and drug rewards in animals. There has been less explicit work on this topic in humans but many lines of evidence support the common mechanism view: Opioid peptides seem to influence food palatability for humans. There is mounting evidence for comorbidity between drug/alcohol abuse and excessive craving or liking for sweets. Anecdotally, elderly individuals tend to 'age-out' of drug abuse, and the elderly also experience markedly fewer food cravings with age. If we focus on the compulsive aspects of food and drug cravings, there is also evidence for overlap: for example, activity in the orbitofrontal cortex is associated with cocaine and alcohol craving. This area is also implicated in the pathology of obsessive-compulsive disorder. Although there is no direct evidence of orbitofrontal involvement in food cravings, there is indirect evidence such as higher than expected co-occurrence of obsessive-compulsive behavior and eating disorders. As a result of bringing together evidence for common substrates for food and for drug rewards, we hope to be able to advance fundamental knowledge of motivational processes and to promote the development of better treatments for drug addiction and for eating disorders. PMID:12117571
Burcu Göksan Yavuz
Full Text Available Objective: We compared the childhood trauma, the severityof sexual functions, comorbidity of axis I psychiatricdisorder, the types and severity of obsessive-compulsivedisorder (OCD and sociodemographic data of patientswith or without sexual obsession in OCD.Methods: Eighty patients of OCD were recruited fromincluding consecutive admissions to an outpatient clinic.Primary OCD patients assessed each subject using theStructured Clinical Interview for DSM-IV Axis I Disorders(SCID-I. OCD symptoms and symptoms severity was assessedby the Yale-Brown Obsessive Compulsive Scale(YBOCS. Traumas were assessed by the ChildhoodTrauma Experiences Questionnaire. Sexual functions severitywas assessed by the Arizona Sexual ExperienceScale (ASEX. Current depressive and anxiety symptomsscore were assessed using the 17-item Hamilton RatingScale for Depression (HAM-D and the Hamilton AnxietyScale (HAM-A.Results: The frequency of sexual obsession was 15%in our clinical populations diagnosed with OCD. Historyof emotional abuse and incest were associated with asignificantly higher rate of OCD with sexual obsessions.Religious, aggressive, hoarding obsessions and hoardingcompulsions were associated with a significantly higherrate of OCD with sexual obsessions. Comorbidity of Somatoformdisorder was associated with a significantlyhigher rate of OCD with sexual obsessions. Subjects whohave OCD with sexual obsessions did not significantly differfrom those without sexual obsessions on any ASEX scores, Y-BOCS scores, HAM-D, HAM-A and demographicfeatures.Conclusion: Sexual obsessions were related to religious,aggressive, hoarding obsessions and hoarding compulsions,the emotional abuse, incest and a comorbidy ofsomatoform disorder.Key words: sexual obsessions, childhood trauma, comorbidity
Full Text Available Abstract Background Obsessive-compulsive disorder is associated with a relevant impairment in social and interpersonal functioning and severe disability. This seems to be particularly true for the poor insight subtype, characterised by a lack of consciousness of illness and, consequently, compliance with treatment. Poor responsiveness to serotonergic drugs in poor insight obsessive-compulsive patients may also require an augmentation therapy with atypical antipsychotics. Methods We reviewed a case in which a patient with a long history of poor insight obsessive-compulsive disorder was treated with a high dosage of serotonin reuptake inhibitors. Results The treatment resulted in a poor outcome. This patient was therefore augmentated with aripiprazole. Conclusion Doctors should consider aripiprazole as a possible augmentation strategy for serotonergic poor responder obsessive-compulsive patients, but further research on these subjects is needed.
J. Luigjes; M. Mantione; W. van den Brink; P.R. Schuurman; P. van den Munckhof; D. Denys
Deep brain stimulation (DBS) is an adjustable, reversible, nondestructive neurosurgical intervention using implanted electrodes to deliver electrical pulses to areas in the brain. DBS has recently shown promising results as an experimental treatment of refractory obsessive-compulsive disorder (OCD).
Full Text Available Obsessive-compulsive disorder (OCD is a neuropsychiatric disorder affecting approximately 1-3% of the population. OCD is probably an etiologically heterogeneous condition. Individuals with OCD frequently have additional psychiatric disorders concomitantly or at some time during their lifetime. Recently, some authors proposed an OCD sub-classification based on co-morbidity. An important issue in assessing comorbidity is the fact that the non-response to treatment often involves the presence of comorbid conditions. Non-responsive patients are more likely to meet criteria for comorbid axis I or axis II disorders and the presence of a specific comorbid condition could be a distinguishing feature in OCD, with influence on the treatment adequacy and outcome.
Corcoran, Kathleen M; Woody, Sheila R; Tolin, David F
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. PMID:17320346
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. PMID:21432837
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. PMID:24032546
Obsessive-compulsive inventory and obsessive-compulsive inventory-revised scales: translation into brazilian portuguese and cross-cultural adaptation Tradução e adaptação transcultural para o português (do Brasil das escalas: obsessive-compulsive inventoryeobsessive-compulsive inventory-revised
Fernanda Pasquoto de Souza
Full Text Available OBJECTIVE: The present study describes the process of translation into Brazilian Portuguese and the cross-cultural adaptation of the Obsessive-Compulsive Inventory and the Obsessive-Compulsive Inventory-Revised scales. The Obsessive-Compulsive Inventory was developed with the purpose of measuring the intensity of the various symptoms that characterize the obsessive-compulsive disorder, assessing their frequency and the distress they caused during the previous month, as well as estimating the overall severity of the disorder. Thus, different levels of severity among different obsessions and compulsions can be assessed and compared. METHOD: The scales were initially translated into Brazilian Portuguese by two bilingual psychiatrists and then independently back-translated by other two bilingual psychiatrists. The scales were then applied to 15 obsessive-compulsive disorder patients, deliberately chosen from different educational levels, to make language adjustments. The author accepted the final version of the Obsessive-Compulsive Inventory and the Obsessive-Compulsive Inventory-Revised scales after their back translation. RESULTS: The scales were easily understood and filled in by individuals and may be used with obsessive-compulsive disorder patients of different socioeconomic levels. CONCLUSION: The Obsessive-Compulsive Inventory and the Obsessive-Compulsive Inventory-Revised scales, in their Brazilian Portuguese version, can help health professionals to screen potential obsessive-compulsive disorder patients, assess the severity of obsessive-compulsive symptoms and reduce these symptoms using different treatments.OBJETIVO: Este artigo apresenta o processo de tradução e adaptação das escalas Obsessive-Compulsive Inventory e do Obsessive-Compulsive Inventory-Revisado versão em português do Brasil. O Obsessive-Compulsive Inventory foi desenvolvido com o objetivo de mensurar os diversos sintomas que caracterizam o transtorno obsessivo
Karim Abdel Aziz
Full Text Available Background: Aripiprazole is a novel antipsychotic medication that has been tried in the treatment of several psychiatric disorders. In an open clinical study, we evaluated the safety and efficacy of aripiprazole in patients with obsessive compulsive disorder resistant to normal regimen of treatment. Method: A total of nine hundred and sixty one patients were admitted over three year period of time (January 2012- December 2014 to the psychiatric department of Al Ain hospital, United Arab Emirates. All patients whose been fulfilled DSM-IV diagnosis of obsessive compulsive disorder (OCD (36 patients screened for further assessment. Patients with a diagnosis of schizophrenia (22 patients and one patient with eating disorder were excluded. Thirteen patients were contacted to be involved in the study. Participants were unstable although they were adherent to their medications (SSRIs when seen in the outpatient clinic two weeks after their discharge. One patient refused to participate in the study. A final number of 12 agreed to participate in the study. twelve patients aged 22 to 65 years who had DSM-IV diagnosis of OCD were treated with aripiprazole besides their normal treatment for a period of three months with daily doses ranging from ten to 20 mg daily. Results: a positive clinical response was noted in eight of the 12 patients within three months of study recruitment according to the Clinical Global Impression-Improvement scale. Aripiprazole was well tolerated by most of the patients. The most commonly reported side effect was headache. Conclusion: our findings suggest that aripiprazole may be an effective adjuvant and safe treatment for resistant OCD.
Arildskov, Trine Wigh; Højgaard, David R M A; Skarphedinsson, Gudmundur; Thomsen, Per Hove; Ivarsson, Tord; Weidle, Bernhard; Melin, Karin Holmgren; Hybel, Katja A
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. PMID:26518580
Snorrason, Ivar; Lee, Han Joo; de Wit, Sanne; Woods, Douglas W
In a sample of student volunteers (N=93), we found that obsessive-compulsive symptoms (although not hoarding) were associated with overreliance on stimulus-response habits at the expense of goal-directed control during instrumental responding. Only checking symptoms were associated with bias toward habits after negative affect was controlled for. Further research is warranted to examine if overreliance on habits represents an aberrant learning process that confers risk for obsessive-compulsive psychopathology. PMID:27183107
Tobiassen, Linn Graham
The aim of the present study was to examine the prevalence of eating disorder symptoms in patients with obsessive-compulsive disorder (OCD). Additional aims were to assess whether having comorbid eating disorders could influence the treatment outcome for OCD, and if symptoms of eating disorders were reduced after treatment for OCD. The sample consisted of 93 patients with a primary diagnosis of OCD. The patients underwent assessment with the Yale-Brown Obsessive-Compulsive Scale, Beck Depress...
Tómas Páll Þorvaldsson 1985
Recurrent intrusive images exist across mental disorders. However, the specific content of intrusive images varies depending on disorders. Theoretical models of how intrusive images develop into clinical obsessions are primarily cognitive-behavioral therapy (CBT) models on how obsessive-compulsive disorder (OCD) develops. In this study, it was hypothesized that individuals with social anxiety disorder (SAD) were likely to react to intrusive images with compulsive behaviors (including neutrali...
Willour, Virginia L.; Yao Shugart, Yin; Samuels, Jack; GRADOS, MARCO; Cullen, Bernadette; Bienvenu III, O. Joseph; Wang, Ying(School of Physics, Shandong University, Jinan, 250100, PR China); Liang, Kung-Yee; Valle, David; Hoehn-Saric, Rudolf; Riddle, Mark; Nestadt, Gerald
Obsessive-compulsive disorder (OCD) is a severe psychiatric illness that is characterized by intrusive and senseless thoughts and impulses (obsessions) and by repetitive behaviors (compulsions). Family, twin, and segregation studies support the presence of both genetic and environmental susceptibility factors, and the only published genome scan for OCD identified a candidate region on 9p24 at marker D9S288 that met criteria for suggestive significance (Hanna et al. 2002). In an attempt to rep...
SESIA, Thibaut; Bizup, Brandon; Grace, Anthony A.
Obsessive compulsive disorder (OCD) is a psychiatric condition defined by intrusive thoughts (obsessions) associated with compensatory and repetitive behavior (compulsions). However, advancement in our understanding of this disorder has been hampered by the absence of effective animal models, and correspondingly analysis of the physiological changes that may be present in these models To address this, we have evaluated two current rodent models of OCD; repeated injection of dopamine D2 agonis...
Abe, Yuichiro; Nishimura, Go; Endo, Takuro
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 pre...
Vinciguerra Valentina; Mattei Chiara; Gabrielli Filippo; Fornaro Michele; Fornaro Pantaleo
Abstract Background Obsessive-compulsive disorder is associated with a relevant impairment in social and interpersonal functioning and severe disability. This seems to be particularly true for the poor insight subtype, characterised by a lack of consciousness of illness and, consequently, compliance with treatment. Poor responsiveness to serotonergic drugs in poor insight obsessive-compulsive patients may also require an augmentation therapy with atypical antipsychotics. Methods We reviewed a...
Kim, Chan-Hyung; Jeong, Jae-Wook; Kim, Eun Ju; Shin, Yoon Shick; Suh, Ho Suk; Lee, Hong Shick; Koo, Min-Seong
Objective The aim of this study was to evaluate which clinical variables might influence the antiobsessional responses to proserotonergic drugs in a sample of patients with obsessive-compulsive disorder (OCD). Methods Two hundred forty-nine patients with DSM-IV OCD under-gone mean 13-month treatments with selective serotonin reuptake inhibitors. According to the treatment response, defined as a reductions of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) total score ≥35%, patients were di...
Najmi, Sadia; Kuckertz, Jennie M.; Amir, Nader
We used an Approach-Avoidance Task (AAT) to examine response to threatening stimuli in 20 individuals high in contamination-related obsessive-compulsive symptoms (HCs) and 21 individuals low in contamination-related obsessive-compulsive symptoms (LCs). Participants were instructed to respond to contamination-related and neutral pictures by pulling a joystick towards themselves or by pushing it away from themselves. Moving the joystick changed the size of the image to simulate approaching or d...
Samuel, Douglas B.; Riddell, Ashley D.B.; Lynam, Donald R.; Miller, Joshua D.; Widiger, Thomas A.
The current study provides convergent, discriminant, and incremental validity data for the Five-Factor Obsessive-Compulsive Inventory (FFOCI), a newly-developed measure of traits relevant to obsessive-compulsive personality disorder (OCPD) from the perspective of the five-factor model (FFM). Twelve scales were constructed as maladaptive variants of specific FFM facets (e.g., Perfectionism as a maladaptive variant of FFM competence). On the basis of data from 407 undergraduates (oversampled fo...
Lazarov, Amit; Liberman, Nira; Hermesh, Haggai; Dar, Reuven
Pervasive doubts are a central feature of obsessive-compulsive disorder (OCD). We have theorized that obsessive doubts can arise in relation to any internal state and lead to compensatory reliance on more discernible substitutes (proxies), including rules and rituals. Previous findings corroborated this hypothesis, but were based on students with high and low OCD tendencies and did not control for anxiety. The present study tested our hypothesis in OCD participants using both anxiety disorders and nonclinical controls. Twenty OCD participants, 20 anxiety disorders participants, and 20 nonclinical participants underwent 2 experimental procedures. In the first, participants had to produce specific levels of muscle tension with and without the aid of biofeedback. In the second, participants were asked to subjectively assess their own muscle tension after viewing preprogrammed false feedback showing either increasing or decreasing levels of muscle tension. As predicted, OCD participants were less accurate than anxiety disorder and nonclinical participants in producing designated levels of muscle tension when biofeedback was not available and more likely to request the biofeedback when given the opportunity to do so. In the false feedback procedure, OCD participants were more influenced by the false biofeedback when judging their own level of muscle tension compared with the 2 controls groups. In both procedures, anxiety disorder participants did not differ from the nonclinical controls. These results support the hypothesis that individuals with OCD have attenuated access to and reduced confidence in their internal states, and that this deficit is specific to OCD and not attributable to anxiety. PMID:25133987
Russo, M; Naro, A; Mastroeni, C; Morgante, F; Terranova, C; Muscatello, M R; Zoccali, R; Calabrò, R S; Quartarone, A
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. PMID:24631627
PJ Matt eTilley
Full Text Available Accurate assessment of obsessions and compulsions is a crucial step in treatment planning for Obsessive-Compulsive Disorder (OCD. In this pilot study, we sought to determine if the use of Ecological Momentary Assessment (EMA could provide additional symptom information beyond that captured during standard assessment of OCD. We studied three adults diagnosed with OCD and compared the number and types of obsessions and compulsions captured using the Yale-Brown Obsessive-compulsive Scale (Y-BOCS compared to EMA. Following completion of the Y-BOCS interview, participants then recorded their OCD symptoms into a digital voice recorder across a twelve-hour period in reply to randomly sent mobile phone SMS prompts. The EMA approach yielded a lower number of symptoms of obsessions and compulsions than the Y-BOCS but produced additional types of obsessions and compulsions not identified by the Y-BOCS. We conclude that the EMA-OCD procedure may represent a worthy addition to the suite of assessment tools used when working with clients who have OCD. Further research with larger samples is required to strengthen this conclusion.
Tilley, P J Matt; Rees, Clare S
Accurate assessment of obsessions and compulsions is a crucial step in treatment planning for Obsessive-Compulsive Disorder (OCD). In this clinical case study, we sought to determine if the use of Ecological Momentary Assessment (EMA) could provide additional symptom information beyond that captured during standard assessment of OCD. We studied three adults diagnosed with OCD and compared the number and types of obsessions and compulsions captured using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) compared to EMA. Following completion of the Y-BOCS interview, participants then recorded their OCD symptoms into a digital voice recorder across a 12-h period in reply to randomly sent mobile phone SMS prompts. The EMA approach yielded a lower number of symptoms of obsessions and compulsions than the Y-BOCS but produced additional types of obsessions and compulsions not previously identified by the Y-BOCS. We conclude that the EMA-OCD procedure may represent a worthy addition to the suite of assessment tools used when working with clients who have OCD. Further research with larger samples is required to strengthen this conclusion.
Tonna, Matteo; Ottoni, Rebecca; Paglia, Francesca; Ossola, Paolo; De Panfilis, Chiara; Marchesi, Carlo
The impact of obsessive-compulsive symptoms on functioning in schizophrenia is still debated. This study investigated the relationship between OC symptoms and functioning along a severity gradient of obsessive-compulsive dimension. Sixty patients affected by schizophrenia completed the SCID-IV, the Positive and Negative Syndrome Scale, the Yale-Brown Obsessive-Compulsive Scale and the Social and Occupational Functioning Assessment Scale. The relationship between functioning and obsessive-compulsive dimension was described by a reverse U-shaped curve; functioning was positively related to the presence of mild obsessive-compulsive symptoms and inversely related to moderate and severe symptoms, after controlling for the severity of positive, negative, disorganization and general psychopathological symptoms. The role of obsessive-compulsive symptoms on social functioning in schizophrenia occurs along a severity continuum with a gradual transition from a positive correlation (from absent to mild symptoms) to an inverse correlation (for symptoms ranging from moderate to severe) and independently from schizophrenia symptom dimensions.
Full Text Available Obsessive-compulsive disorder (OCD is a clinically heterogeneous condition. Although structural brain alterations have been consistently reported in OCD, their interaction with particular clinical subtypes deserves further examination. Among other approaches, a two-group classification in patients with autogenous and reactive obsessions has been proposed. The purpose of the present study was to assess, by means of a voxel-based morphometry analysis, the putative brain structural correlates of this classification scheme in OCD patients. Ninety-five OCD patients and 95 healthy controls were recruited. Patients were divided into autogenous (n = 30 and reactive (n = 65 sub-groups. A structural magnetic resonance image was acquired for each participant and pre-processed with SPM8 software to obtain a volume-modulated gray matter map. Whole-brain and voxel-wise comparisons between the study groups were then performed. In comparison to the autogenous group, reactive patients showed larger gray matter volumes in the right Rolandic operculum. When compared to healthy controls, reactive patients showed larger volumes in the putamen (bilaterally, while autogenous patients showed a smaller left anterior temporal lobe. Also in comparison to healthy controls, the right middle temporal gyrus was smaller in both patient subgroups. Our results suggest that autogenous and reactive obsessions depend on partially dissimilar neural substrates. Our findings provide some neurobiological support for this classification scheme and contribute to unraveling the neurobiological basis of clinical heterogeneity in OCD.
Arrindell, WA; de Vlaming, IH; Eisenhardt, BM; van Berkum, DE; Kwee, MGT
Some psychometric properties of an adaptation of the Yale-Brown Obsessive Compulsive Scale for use in the Netherlands (Y-BOCS-NL) were examined in 65 psychiatric inpatients. The factorial invariance of two-dimensional systems were determined, namely Severity and Disturbance versus Obsessions and Com
Dehlin, John P.; Morrison, Kate L.; Twohig, Michael P.
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…
Ginsburg, Golda S.; Burstein, Marcy; Becker, Kimberly D.; Drake, Kelly L.
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…
金可国; 缪咏梅; 牛晓棠; 智庆华
@@Background: Obsessive compulsive disorder(OCD) is a kind of neurosis.It is mostly that psychology flaws and inadaptability of environment bring on disturbance of psychology. Objective:To evaluate effect of psychotherapy,medication and behavior therapy on OCD in 18 cases. Subject: 18 patients with OCD were included in our study from 1999,5 male, 13 female .8 cases aged 15～ 20 years, 6 cases aged 21～ 30 years, 4 cases aged over 30 years. 2 recall compulsion, 1 association compulsion, 1 obsessive qualm, 1 getting to the bottom of the matter, 2 obsessive count, 6 obsessive examining ,5 obsessive washing one's hands and changing clothes.
Banca, Paula; Voon, Valerie; Vestergaard, Martin D; Philipiak, Gregor; Almeida, Inês; Pocinho, Fernando; Relvas, João; Castelo-Branco, Miguel
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
Flessner, Christopher A.; Freeman, Jennifer B.; Sapyta, Jeffrey; Garcia, Abbe; Franklin, Martin E.; March, John S.; Foa, Edna
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…
Leeuw, A.S. de
In this thesis several neurobiological oriented studies on obsessive-compulsive disorder (OCD) are described. Two pharmacological challenge studies have been performed investigating serotonin-2 and cholecystokinin-B receptor functioning in OCD. No direct relationship between these receptors and OCD
Full Text Available Objective: The aim of the present study was to test hypothesis that obsessive compulsive disorder (OCD patients who have autogenous obsessions and reactive obsessions show different sociodemographic and clinical characteristics with different insight and cognitive insight levels. Method: Sixty-one patients diagnosed as OCD according to the Structured Clinical Interview for DSM-III-R (SCID-I are recruited. 31 patients had reactive obsessions and 30 had autogenous obsessions. The sociodemographic characteristics of patients and the symptomatology were evaluated using psychiatric scales including SCID-I, Yale Brown Obsessive- Compulsive Scale (YBOCS, Yale Brown Obsessive-Compulsive Scale-Symptom Checklist (YBOCS-SC and Beck Insight Scale. Results: The percentage of women in reactive obsessive group was higher and also this group had significantly less antipsychotic medication prescribed than the autogenous obsessive group. No significant difference was found for the other demographic variables. No significant difference was identified for the Beck Insight Self-Reflectiveness subscale but for the Self-Certainty subscale, reactive obsessives had higher scores. Although there was no significant difference for the composit index points, which is the subtraction of the two subscales, the p value was close to the limit. On the other hand YBOCS item- 11 scores which evaluates insight were higher in autogenous obsessives meaning low levels of insight. Conclusion: For the sociodemographic and clinical characteristics; there was no significant difference between the groups except gender distribution and antipsychotic medication. Our data about insight seems inconsistent but insight and cognitive insight can be different entities which show different levels of insight. Further investigation with different obsession types is needed.
Full Text Available Abstract 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.
Gruner, Patricia; Anticevic, Alan; Lee, Daeyeol; Pittenger, Christopher
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.
Ozomaro, Uzoezi; Cai, Guiqing; Kajiwara, Yuji; 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
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 (Pdisorder. Examination of additional samples will help assess the role of rare SLITRK1 variation in OCD and in related psychiatric illness. PMID:23990902
Beucke, Jan Carl; Kaufmann, Christian; Linnman, Clas; Gruetzmann, Rosa; Endrass, Tanja; Deckersbach, Thilo; Dougherty, Darin D; Kathmann, Norbert
Neurobiological models of obsessive-compulsive disorder (OCD) assume abnormalities in corticostriatal networks involving cingulate and orbitofrontal cortices, but the connectivity within these systems is rarely addressed in experimental imaging studies in this patient group. Using an established monetary reinforcement paradigm known to involve the cingulate cortex and the ventral striatum, the present study sought to test for altered corticostriatal coupling in OCD patients anticipating potential punishment. The anterior midcingulate cortex (aMCC), a region integrating negative emotion, pain, and cognitive control, was chosen as a seed region due to its particular relevance in OCD, representing the neurosurgical target for cingulotomy, and showing increased responses to errors in OCD patients. Results from psychophysiological interaction analyses revealed that significantly altered, inverse coupling occurs between the aMCC and the ventral striatum when OCD patients anticipate potential punishment. This abnormality links the two major contemporary neurosurgical OCD target sites, and provides direct experimental evidence of altered corticostriatal connectivity in OCD. Noteworthy, an abnormal aMCC coupling with cortical areas outside of traditional corticostriatal circuitry was identified besides the alteration in the cingulostriatal pathway. In conclusion, these findings support the importance of applying connectivity methods to study corticostriatal networks in OCD, and favor the application of effective connectivity methods to study corticostriatal abnormalities in OCD patients performing tasks that involve symptom provocation and reinforcement learning. PMID:22823561
Pushkarskaya, Helen; Tolin, David; Ruderman, Lital; Kirshenbaum, Ariel; Kelly, J MacLaren; Pittenger, Christopher; Levy, Ifat
Obsessive compulsive disorder (OCD) produces profound morbidity. Difficulties with decision-making and intolerance of uncertainty are prominent clinical features in many patients. The nature and etiology of these deficits are poorly understood. We used a well-validated choice task, grounded in behavioral economic theory, to investigate differences in valuation and value-based choice during decision making under uncertainty in 20 unmedicated participants with OCD and 20 matched healthy controls. Participants' choices were used to assess individual decision-making characteristics. OCD participants did not differ from healthy controls in how they valued uncertain options when outcome probabilities were known (risk) but were more likely than healthy controls to avoid uncertain options when these probabilities were imprecisely specified (ambiguity). Compared to healthy controls, individuals with OCD were less consistent in their choices and less able to identify options that should be clearly preferable. These abnormalities correlated with symptom severity. These results suggest that value-based choices during decision-making are abnormal in OCD. Individuals with OCD show elevated intolerance of uncertainty, but only when outcome probabilities are themselves uncertain. Future research focused on the neural valuation network, which is implicated in value-based computations, may provide new neurocognitive insights into the pathophysiology of OCD. Deficits in decision-making processes may represent a target for therapeutic intervention. PMID:26343609
Full Text Available Background: 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. Aims: to investigate the relationship of NSSs with obsessive-compulsive disorder (OCD. Settings and Design: 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. Material and Methods: 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. Statistical analysis used: The Mann-Whitney U test was used for statistical analysis of data. Results: 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. Conclusions: 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.
Full Text Available Kelda H Walsh, Christopher J McDougleDepartment of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USAAbstract: Obsessive-compulsive disorder (OCD is a chronic anxiety disorder. While medication and psychotherapy advances have been very helpful to patients, many patients do not respond adequately to initial trials of serotonergic medication or cognitive-behavioral therapy (CBT and require multiple treatment trials or combination therapies. Comorbidity may also influence treatment response. The role of streptococcal infections in pediatric OCD has become an area of intense scrutiny and controversy. In this article, current treatment methods for OCD will be reviewed, with special attention to strategies for treating OCD in children and in patients with comorbid tic disorders. Alternative psychotherapy strategies for patients who are highly anxious about starting CBT, such as cognitive therapy or augmentation with D-cycloserine, will be reviewed. Newer issues regarding use of antibiotics, neuroleptics, and glutamate modulators in OCD treatment will also be explored.Keywords: OCD, exposure/response prevention therapy, PANDAS, tic disorder
Full Text Available Introduction: Parents interaction styles with children or teens have an important impact on shaping their character and mental health and the incidence of some psychiatric symptoms. The aim of this study was to predict anxiety thought and obsessive - compulsive symptoms of the adolescents based on parents' parenting styles. Methods: This was a descriptive study. 180 male students in Marand were selected by cluster random sampling. We used Baumrind parents parenting style questionnaire, Wales anxiety thoughts questionnaire and Maudsley obsessive- compulsive questionnaire. Data was analyzed by Pearson's correlation test and multiple regression analysis. Results: Data analysis showed that obsessive- compulsive symptoms and anxiety ideas were positively related to the authoritarian and permissive parenting styles and negatively related to authoritative parenting style. Parenting style is able to predict the level of obsessive - compulsive symptoms and adolescent anxiety ideas. Conclusion: The results showed that parents' parenting style is one of the influencing factors on adolescent health. Parents with authoritative parenting style, have the children with lower obsessive - compulsive symptoms and anxious thoughts.
Mohamadirizi, Soheila; Kordi, Masoumeh; Shakeri, Mohamad Taghi; Modares-Gharavi, Morteza
Background: 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. Materials and Methods: 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 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. Conclusions: 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. PMID:26793246
B. Sterk; K. Lankreijer; D.H. Linszen; L. de Haan
Objective: To determine the prevalence of obsessive-compulsive symptoms and obsessive compulsive disorder in patients with schizophrenia or related disorders or subjects at ultra high risk for development of psychosis. Secondly, to determine the time of occurrence of obsessive-compulsive symptoms re
Patel, Sapana R.; Carmody, James; Simpson, H. Blair
Obsessive-compulsive disorder (OCD) is an illness characterized by intrusive and distressing thoughts, images, or impulses (i.e., obsessions) and by repetitive mental or behavioral acts (i.e., compulsions) performed to prevent or reduce distress. Efficacious treatments for OCD include psychotropic medications and exposure and response prevention…
Polman, Annemiek; Bouman, Theo K.; van Hout, Wiljo J. P. J.; de Jong, Peter J.; den Boer, Johan A.
The present paper discusses theoretical and methodological issues involved in the processes of change in cognitive-behavioural treatment (CBT) of obsessive-compulsive disorder (OCD). Treatment outcome studies showed that CBT is effective in reducing obsessive-compulsive symptoms. However, why and ho
Obsessive-compulsive disorder(OCD) is characterized by intrusive frightening thoughts, images or impulses (obsessions; e.g., “did I stab my partner while doing the dishes?”) to which patients respond with repetitive behavior (compulsions; e.g., checking the knives and scissors in the house or callin
Maye, Kelly M.
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…
de Koning, P P; Figee, M; Endert, E; van den Munckhof, P; Schuurman, P R; Storosum, J G; Denys, D; Fliers, E
Improvement of obsessions and compulsions by deep brain stimulation (DBS) for obsessive-compulsive disorder (OCD) is often preceded by a rapid and transient mood elevation (hypomania). In a previous study we showed that improvement of mood by DBS for OCD is associated with a decreased activity of th
Borderline personality disorder, conversion disorder and obsessive compulsive disorder frequently have dissociative symptoms. The literature has demonstrated that the level of dissociation might be correlated with the severity of obsessive compulsive disorder (OCD) and that those not responding to treatment had high dissociative symptoms. The structured clinical interview for DSM-IV dissociative disorders, dissociation questionnaire, somatoform dissociation questionnaire and dissociative expe...
Abdul Latif Abdul Razak
Full Text Available Obsessive–Compulsive Disorder (OCD is a type of anxiety in which a person suffers from obsessions i.e. unwanted intrusive ideas which recur to the person persistently; and compulsions i.e. behaviours that a person feels compelled to perform epeatedly in a ritualistic manner with the aim of relieving the anxiety from the unpleasant obsessive thoughts. Although compulsion and obsession are common, once the individual experiences xcessive discomfort, then he or she would be diagnosed as a patient of this disorder. Most of the research outputs on this disorder are based on secular and irreligious perspectives. Thus, this research aims at religiously diagnosing its root causes and exploring its remedies based the Qur’an and Sunnah and the works of early Muslim scholars. The finding shows that this disorder, its etiology and treatment, has been extensively discussed in many works of early Muslim scholars that can be benefited by modern psychotherapists.
Igartua, Karine J
Objectives In synthesizing a homosexual or bisexual identity, an individual may go through different stages before coming to a positive healthy identity. It is likely that there will be a period in which homosexual yearnings will be unwanted. Sometimes this distress leads the person to consult a health professional. Conversion therapy has been proven both ineffective and harmful and therefore has been ethically prohibited by all major psychiatric and psychological associations. The responsible clinician will attempt to assist the individual in his acceptance of his sexual minority. Occasionally individuals without homoeroticism consult because of distress related to sexual identity questioning which poses a different problem for clinicians especially if the situation goes unrecognized. The objective of this paper is to describe homosexual obsessive compulsive disorder (HOCD) and distinguish it clinically from the normal process of sexual minority identity formation in western culture.Methods A literature review yielded very few descriptions of homosexual OCD. A retrospective chart review of all patients seen in the last 3 years at the McGill University Sexual Identity Centre was conducted to identify all the cases of OCD. Six cases were found, 4 of which were of HOCD and are presented. Similarities between cases are highlighted.Results All cases were young men with relatively little relationship and sexual experience. Most were rather shy and had some other obsessional history in the past though often at a sub-clinical threshold. Obsessional doubt about their orientation was very distressing and did not abate over time as would normally occur with a homoerotic individual. The four patients who had an obsession of being gay despite little or no homoerotism are presented in detail. They all presented mental compulsions, avoidance and physiological monitoring. Continuous internal debate trying to prove or disprove sexual orientation was a ubiquitous mental
Full Text Available 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.
Full Text Available Hedi Klila,1 Anne Chatton,2 Ariane Zermatten,2 Riaz Khan,2 Martin Preisig,1,3 Yasser Khazaal2,4 1Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland; 2Department of Mental Health and Psychiatry, Geneva University Hospitals, Geneva, Switzerland; 3Lausanne University, Lausanne, Switzerland; 4Geneva University, Geneva, Switzerland 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. Keywords: Internet, quality indicators, anxiety disorders, OCD, search engine
Full Text Available Wilson′s disease (WD is a genetic neurodegenerative disorder; it exhibits wide heterogeneity in symptoms and usually presents with liver disease and/ or neuropsychiatric manifestations. The common neurological manifestations observed are dysarthria, gait disturbance, dystonia, rigidity, tremor, dysphagia and chorea. The frequent psychiatric manifestations reported are personality and mood changes, depression, phobias, cognitive impairment, psychosis, anxiety, compulsive and impulsive behavior. Isolated obsessive-compulsive disorder (OCD is a rare presentation of WD. Reported herein is a case of a 17-year-old boy with isolated OCD. He presented to the psychiatrist with symptoms of contamination obsessions and washing compulsions, along with compulsion of repeated feet tapping, and was treated with adequate doses of fluoxetine for 6 months but did not improve. Later on, he was diagnosed as a case of WD and showed improvement with chelating and behavior therapy. This implies the importance of the occurrence of isolated psychological symptoms in WD.
Iancu, I; Kikenzon, L; Ratzoni, G; Apter, A
Anorexia nervosa is a psychiatric disorder characterized by excessive dieting, severe weight loss, disturbed body image and inexplicable fear of gaining weight. It afflicts mainly upper class women of developed countries. We present a 16-year-old recent immigrant from Russia, where she had developed anorexia nervosa, obsessive-compulsive disorder and depression. The management of this patient is presented in the light of the sociocultural theory of the pathogenesis of anorexia nervosa and the clinical link between eating disorders and depression and obsessive-compulsive disorders. PMID:8335272
Sathe, Harshal; Karia, Sagar; De Sousa, Avinash; Shah, Nilesh
Obsessive compulsive symptoms have been reported in frontal lobe tumours and basal ganglia lesions. We report herewith a case of an adolescent who had a vermian cystic mass for which he underwent excision surgery. Three months postsurgery family members noticed that he started with repeated hand washing and abnormal walking pattern. Also, he developed bedwetting in sleep at night. He was given clinical diagnosis of Obsessive-Compulsive Disorder (OCD) and Nocturnal enuresis following a cerebellar mass removal which improved with fluoxetine and impiramine respectively. PMID:27437334
Cordioli Aristides V
Full Text Available Objective: To develop a cognitive-behavioral group therapy protocol and to verify its efficacy to reduce obsessive-compulsive symptoms. Methods: An open clinical trial with 32 obsessive-compulsive patients was performed, in which a cognitive-behavioral group therapy protocol of 12 weekly sessions of two hours, in 5 consecutive groups, was applied. The severity of symptoms was rated with the Yale-Brown Obsessive-Compulsive (Y-BOCS, Hamilton Anxiety (HAM A and Hamilton Depression (HAM D scales. The patients were followed up for 3 months after the end of the treatment. Results: There was a significant reduction in the scores of Y-BOCS, HAM A and HAM D scales with the treatment regardless the use of anti-obsessive medications. The rate of improved patients (decrease of > or = 35% in Y-BOCS was 78.1%. Two patients (6.25% dropped out from the study. The effect size calculated for the Y-BOCS scale was 1.75. Conclusions: This study suggests that cognitive-behavioral group therapy reduces obsessive-compulsive symptoms. In addition, patients presented good compliance.
Bellino, Silvio; Patria, Luca; Ziero, Simona; Bogetto, Filippo
DSM-IV included a type of obsessive-compulsive disorder (OCD) with poor insight in the official classification. The present study was performed using a continuous measure of the level of insight to analyze the association between this variable and characteristics of the disorder. Seventy-four consecutive OCD outpatients (DSM-IV criteria) were assessed using: a semistructured interview for sociodemographic and clinical features, the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the National Institute of Mental Health Obsessive-Compulsive Scale (NIMH-OCS), the Hamilton Depression and Anxiety Rating Scales (HDRS, HARS), and the Overvalued Ideas Scale (OVIS) as a continuous measure of the level of insight. Stepwise multiple regression analysis revealed that demographic and clinical factors were related to the OVIS score. The following four factors were found to be significantly related to the OVIS score: the Y-BOCS score for compulsions, OCD chronic course, and family history of OCD were positively related, while obsessive-compulsive personality disorder was negatively related. These results suggest that poor insight identifies a group of OCD patients with distinct clinical characteristics.
Full Text Available Introduction. Gambling behaviour appears as repetitive and difficult to resist and seems to be aimed at neutralizing or reducing negative feelings such as anxiety and tension, confirming its similarities with the obsessive-compulsive spectrum. Aims. Estimating the prevalence of gambling behaviour in an Italian sample and assessing the effects of sociodemographic variables and the correlations between gambling behaviour and obsessive-compulsive features. Methods. A sample of 300 Italian subjects was evaluated based on gambling behaviours and obsessive-compulsive attitudes. The assessment was carried out in small centers in Italy, mainly in coffee and tobacco shops, where slot machines are located, using the South Oaks Gambling Screen (SOGS and the MOCQ-R, a reduced form of Maudsley Obsessional-Compulsive Questionnaire. Results. A negative correlation between SOGS and MOPQ-R, with reference to the control and cleaning subscales, was evidenced in the majority of the examined subjects. Both evaluating instruments showed reliability and a good discriminative capacity. Conclusions. Our study evidenced that the sample of gamblers we analysed did not belong to the obsessive-compulsive disorders area, supporting the validity of the model proposed by DSM-5 for the classification of PG. These data confirm the importance of investing in treatments similar to those used for substance use disorders.
Suneet Kumar Upadhyaya; Archana Sharma
Pica refers to eating of non-nutritious substances, which is usually seen in childhood or pregnancy. Here we report a case of an illiterate tribal woman who developed pica as the sole manifestation of obsessive compulsive disorder, with onset during pregnancy. The patient had compulsions of eating uncooked rice or wheat, which resulted in toothache and abdominal discomfort. She had this habit in three pregnancies, consecutively. In the first two pregnancies it resolved spontaneously after pue...
Morillo, Carmen; Belloch, Amparo; García-Soriano, Gemma
Contemporary cognitive models of obsessive-compulsive disorder (OCD) assume that clinical obsessions evolve from some modalities of intrusive thoughts (ITs) that are experienced by the vast majority of the population. These approaches also consider that the differences between "abnormal" obsessions and "normal" ITs rely on quantitative parameters rather than qualitative. The present paper examines the frequency, contents, emotional impact, consequences, cognitive appraisals and control strategies associated with clinical obsessions in a group of 31 OCD patients compared with the obsession-relevant ITs in three control groups: 22 depressed patients, 31 non-obsessive anxious patients, and 30 non-clinical community subjects. Between-group differences indicated that the ITs frequency, the unpleasantness and uncontrollability of having the IT, and the avoidance of thought triggers obtained the highest effect sizes, and they were specific to OCD patients. Moreover, two dysfunctional appraisals (worry that the thought will come true, and the importance of controlling thoughts) were specific to OCD patients. The OCD and depressed patients shared some dysfunctional appraisals about their most disturbing obsession or IT (guilt, unacceptability, likelihood thought would come true, danger, and responsibility for having the IT), whereas the non-obsessive anxious were nearer to the non-clinical participants than to the other two groups of patients. The OCD patients showed an increased use of thought control strategies, with overt neutralizing, thought suppression, and searching for reassurance being highly specific to this group. PMID:17208197
Leeuw, A.S. de
In this thesis several neurobiological oriented studies on obsessive-compulsive disorder (OCD) are described. Two pharmacological challenge studies have been performed investigating serotonin-2 and cholecystokinin-B receptor functioning in OCD. No direct relationship between these receptors and OCD symptoms was found. However, an enhanced susceptibility for the panic inducing properties of pentagastrin and an enhanced sensitivity of serotonin-2 receptors could be established in OCD patients c...
Finzi-Dottan, Ricky; Zubery, Eynat
Eating disorders are believed to range across a spectrum of varying degrees of obsessive-compulsive and impulsive behavior. Sixty anorexic (mean age = 19.8; sd = 5.9) and 109 bulimic (mean age = 26.9; sd = 11.3) female patients completed self-report questionnaires assessing obsessive-compulsiveness, impulsivity, depression and anxiety, as well as two eating disorder scales. Results yielded significantly higher levels of impulsivity and negative body image in the bulimic compared to the anorexic group. Regression analysis predicting impulsivity showed that bulimia and negative body image were the main contributors. Regression analysis for predicting obsessive-compulsive behavior suggested that depression and anxiety obscure the link between anorexia and obsessive-compulsive behavior, and a high BMI intensifies the association between anxiety and obsessive-compulsive behavior. The high rates of both impulsivity and obsessive-compulsiveness found in both groups, and their association with the severity of the eating disorder, may suggest that impulsivity and obsessive-compulsiveness are not mutually exclusive and can both be found among anorexic and bulimic patients. PMID:19242845
Harsányi, András; Csigó, Katalin; Rajkai, Csaba; Demeter, Gyula; Németh, Attila; Racsmány, Mihály
Impairments in executive functioning have been identified as an underlying cause of Obsessive-Compulsive Disorder (OCD). Obsessive patients attempt to suppress certain unwanted thoughts through a mechanism that Wegner referred to as 'chronic thought suppression', whereas compulsive patients are unable to inhibit their rituals. We tested 51 OCD patients using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the White Bear Suppression Inventory (WBSI) and the Dysexecutive Questionnaire (DEX). Executive functions were tested using a cognitive test battery. We found that the total WBSI score was correlated with the Y-BOCS obsessive score but not with the Y-BOCS compulsive score. A stronger correlation was observed between the Y-BOCS obsessive score and the 'unwanted intrusive thoughts' factor based on Blumberg's 3-factor model of the WBSI. The total WBSI score was not correlated with the cognitive test results. The DEX score was significantly correlated with the Y-BOCS compulsive score; however, no correlation was found between the DEX score and the Y-BOCS obsessive score. A stronger correlation was observed between the Y-BOCS compulsive score and the 'inhibition' component of the DEX score, as defined by Burgess's 5-factor model. The DEX scores were correlated with cognitive test results measuring attention, cognitive flexibility and inhibitory processes. We conclude that obsessions indicate a failure of cognitive inhibition but do not involve significant impairment of executive functions, whereas compulsions indicate ineffective behavior inhibition and impaired executive functions. PMID:24418048
Storch, Eric A.; Merlo, Lisa J.; Larson, Michael J.; Geffken, Gary R.; Lehmkuh, Heather D.; Jacob, Marni L.; Murphy, Tanya K.; Goodman, Wayne K.
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.
Ooms, Pieter; Mantione, Mariska; Figee, Martijn; Schuurman, P Richard; van den Munckhof, Pepijn; Denys, D.
OBJECTIVE: To evaluate the long-term effects of deep brain stimulation (DBS) on quality of life (QOL) in therapy-refractory obsessive-compulsive disorder (OCD) patients. DESIGN: 16 patients who met Diagnostic and Statistical Manual of Mental Disorders (4th ed) (DSM-IV) criteria for OCD and were cons
Twohig, Michael P.
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…
Polman, Annemiek; Bouman, Theo K.; van Geert, Paul L. C.; de Jong, Peter J.; den Boer, Johan A.
Cognitive behaviour therapy (CBT) is considered to be effective in the reduction of obsessive compulsive symptoms. However, questions remain as to how CBT works. Cognitive-behavioural models postulate that negative appraisals of intrusive thoughts and dysfunctional beliefs that give rise to them und
Simpson, Helen Blair; Zuckoff, Allan
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…
Polman, Annemiek; O'Connor, Kieron P.; Huisman, Mark
Cognitive-behavioural models emphasize the mediating role of dysfunctional beliefs in obsessive-compulsive disorder (OCD). However, recent studies indicated that beliefs related to responsibility and threat-estimation, Importance and Control of Thoughts, and perfectionism and intolerance of uncertai
Jónsson, Hjalti; Hougaard, Esben; Bennedsen, Birgit
The primary aim of the study was to investigate dysfunctional beliefs in the form of inflated responsibility (IR) and thought action fusion (TAF) as predictive and mediating variables in Individual (n = 33) and Group (n = 37) Cognitive Behavioral Therapy (CBT) for Obsessive Compulsive Disorder (OCD...
Norberg, Melissa M.; Gilliam, Christina M.; Villavicencio, Anna; Pearlson, Godfrey D.; Tolin, David F.
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…
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. PMID:25341245
Roth, Robert M.; Baribeau, Jacinthe; Milovan, Denise L.; O'Connor, Kieron
Slowness in obsessive-compulsive disorder (OCD) has been attributed to intrusive thoughts or meticulousness. Recent research suggests that slowness in OCD may be particularly evident on tests of executive function subserved by frontostriatal circuitry. In the present study, the speed and accuracy of responding on neuropsychological tests of…
Hanna, Gregory L.; Carrasco, Melisa; Harbin, Shannon M.; Nienhuis, Jenna K.; LaRosa, Christina E.; Chen, Poyu; Fitzgerald, Kate D.; Gehring, William J.
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…
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.
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…
Simpson, Helen Blair; Maher, Michael J.; Wang, Yuanjia; Bao, Yuanyuan; Foa, Edna B.; Franklin, Martin
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…
Peris, Tara S.; Bergman, R. Lindsey; Asarnow, Joan R.; Langley, Audra; McCracken, James T.; Piacentini, John
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…
Ye, Huan J.; Rice, Kenneth G.; Storch, Eric A.
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…
Kendurkar, Arvind; Kaur, Brinder
Objectives: Major depressive disorder (MDD), obsessive-compulsive disorder (OCD), and generalized anxiety disorder (GAD) are known to have significant impact on sexual functioning. They have been studied individually. Therefore, this study was planned to compare the sexual dysfunction between MDD, OCD, and GAD with healthy subjects as controls.
Peris, Tara S.; Sugar, Catherine A.; Bergman, R. Lindsey; Chang, Susanna; Langley, Audra; Piacentini, John
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…
Berman, Noah C.; Abramowitz, Jonathan S.
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…
Fitzgerald, Kate Dimond; Welsh, Robert C.; Stern, Emily R.; Angstadt, Mike; Hanna, Gregory L.; Abelson, James L.; Taylor, Stephan F.
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…
Nielen, M. M.; den Boer, J. A.; Smid, H. G. O. M.
Background. Patients with obsessive-compulsive disorder (OCD) have to repeat their actions before feeling satisfied that the action reached its intended goal. Learning theory predicts that this may be due to a failure in the processing of external feedback. Method. We examined the performance of 29
Rees, Clare S.; Anderson, Rebecca A.
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…
Moritz, Steffen; Jelinek, Lena; Hottenrott, Birgit; Klinge, Ruth; Randjbar, Sarah
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…
S. Fluitman; D. Denys; N. Vulink; S. Schutters; C. Heijnen; H. Westenberg
The immune system is implicated in the pathophysiology of various psychiatric disorders. In anxiety disorders such as obsessive-compulsive disorder (OCD) and generalized social anxiety disorder (GSAD), immunological findings are equivocal and sparse. In this study, we investigated the lipopolysaccha
L.A. Page; K. Rubia; Q. Deeley; E. Daly; F. Toal; D. Mataix-Cols; V. Giampietro; N. Schmitz; D.G.M. Murphy
People with obsessive-compulsive disorder (OCD) have abnormalities in cognitive and motor inhibition, and it has been proposed that these are related to dysfunction of fronto-striatal circuits. However, nobody has investigated neuro-functional abnormalities during a range of inhibition tasks in adul
de Haan, Lieuwe; Dudek-Hodge, Christine; Verhoeven, Yolanda; Denys, Damiaan
Introduction: The co-occurrence of obsessive-compulsive disorder (OCD) in patients with schizophrenia and related disorders has been increasingly recognized. However, the rate of psychosis comorbidity in OCD patients has yet to be systematically evaluated. Methods: The prevalence of the Diagnostic a
de Leeuw, Aart S; Oranje, Bob; van Megen, Harold J G M;
Obsessive-compulsive disorder (OCD) is associated with deficits in inhibition mechanisms. This is reflected in reports showing impaired sensorimotor and sensory gating in OCD patients, as measured with prepulse inhibition (PPI) of the startle reflex and P50 suppression paradigms. However, most of...
Dyches, Tina Taylor; Leininger, Melissa; Heath, Melissa Allen; Prater, Mary Anne
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…
Khodayarifard, Mohammad; McClenon, James
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,…
Ruzzano, Laura; Borsboom, Denny; Geurts, Hilde M.
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…
Full Text Available Individuals who are not clinically diagnosed with obsessive-compulsive disorder (OCD but still display obsessive-compulsive (OC tendencies may show cognitive impairments. The present study investigated whether there are subgroups within a healthy group showing characteristic cognitive and emotional performance levels similar to those found in OCD patients and whether they differ from OCD subgroups regarding performance levels. Of interest are those cases showing subclinical symptomatology. The results revealed no impairments in the subclinical OC participants on the neuropsychological tasks, while evidence suggests that there exist high and low scores on two standardised clinical instruments (Yale-Brown Obsessive Compulsive Scale and Cognitive Assessment Instrument of Obsessions and Compulsions in a healthy sample. OC symptoms may diminish the quality of life and prolong sustainable return to work. It may be that occupational rehabilitation programmes are more effective in rectifying subclinical OC tendencies compared to the often complex symptoms of diagnosed OCD patients. The relationship between cognitive style and subclinical OC symptoms is discussed in terms of how materials and information might be processed. Although subclinical OC tendencies would not seem to constitute a diagnosis of OCD, the quality of treatment programmes such as cognitive behavioural therapy can be improved based on the current investigation.
Johansen, Thomas; Dittrich, Winand H.
Individuals who are not clinically diagnosed with obsessive-compulsive disorder (OCD) but still display obsessive-compulsive (OC) tendencies may show cognitive impairments. The present study investigated whether there are subgroups within a healthy group showing characteristic cognitive and emotional performance levels similar to those found in OCD patients and whether they differ from OCD subgroups regarding performance levels. Of interest are those cases showing subclinical symptomatology. The results revealed no impairments in the subclinical OC participants on the neuropsychological tasks, while evidence suggests that there exist high and low scores on two standardised clinical instruments (Yale-Brown Obsessive Compulsive Scale and Cognitive Assessment Instrument of Obsessions and Compulsions) in a healthy sample. OC symptoms may diminish the quality of life and prolong sustainable return to work. It may be that occupational rehabilitation programmes are more effective in rectifying subclinical OC tendencies compared to the often complex symptoms of diagnosed OCD patients. The relationship between cognitive style and subclinical OC symptoms is discussed in terms of how materials and information might be processed. Although subclinical OC tendencies would not seem to constitute a diagnosis of OCD, the quality of treatment programmes such as cognitive behavioural therapy can be improved based on the current investigation. PMID:24236282
Carter, Nathan T; Guan, Li; Maples, Jessica L; Williamson, Rachel L; Miller, Joshua D
Although conscientiousness exhibits positive relations with psychological well-being, theoretical and empirical work suggests individuals can be too conscientious, resulting in obsessive-compulsiveness, and therein less positive individual outcomes. However, the potential for curvilinearity between conscientiousness and well-being has been underexplored. We measured 912 subjects on facets of conscientiousness, obsessive-compulsive personality, and well-being variables (life satisfaction, job satisfaction, self-esteem, positive affect, negative affect, work stress). Methods of scoring included traditional sum-scoring, traditional item response theory (IRT), and a relatively new IRT approach. Structural models were estimated to evaluate curvilinearity. Results confirmed the curvilinear relationship between conscientiousness and well-being, and demonstrated that differential facet-level relationships underlie weaker curvilinearity at the general trait level. Consistency was found in the strength of relation between conscientiousness facets with their obsessive-compulsive variants and their contribution to decreased well-being. The most common association was that higher standing on conscientiousness facets was positively related to negative affect. Findings support the idea that extreme standing on facets of conscientiousness more strongly linked to their obsessive-compulsive variants contributed to lower well-being, highlighting the importance of considering alternative functional representations of the relationship between personality and other constructs. Future work should seek to further clarify the link between conscientiousness and negative affect. PMID:25858019
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
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.
Ong, S B; Leng, Y K
The case history, treatment and follow-up of a thirteen-year-old girl with obsessive-compulsive neurosis of six months duration are reported. Results show that behaviour modification techniques were effective though a second course of treatment was required. Her illness and its treatment by behaviour therapy in relation to the Malaysian Chinese culture is discussed. PMID:293181
Objective To find the common neurocognitive deficits in patients with obsessive-compulsive disorder (OCD) and their unaffected first-degree relatives (UFDR) and to identify neurocognitive endophenotypes for OCD. Methods Forty patients with OCD,forty UFDR of OCD probands and forty healthy
Ooms, Pieter; Blankers, Matthijs; Figee, Martijn; Mantione, Mariska; van den Munckhof, Pepijn; Schuurman, P Richard; Denys, D.
BACKGROUND: Deep brain stimulation (DBS) is regarded as an effective way to treat refractory obsessive-compulsive disorder (OCD). Little is known about the effects of DBS cessation following a longer period of stimulation. OBJECTIVE: To determine the relapse and rebound effects of psychiatric sympto
Mantione, Mariska; Nieman, Dorien; Figee, Martijn; van den Munckhof, Pepijn; Schuurman, Rick; Denys, D.
BACKGROUND: Deep brain stimulation (DBS) is a promising treatment for treatment-refractory obsessive-compulsive disorder (OCD). However, the effects of DBS on cognitive functioning remain unclear. Therefore, we aimed to assess cognitive safety of DBS for treatment-refractory OCD and the association
Deep brain stimulation (DBS) is a neurosurgical technique that involves the implantation of electrodes in the brain. DBS enables electrical modulation of abnormal brain activity for treatment of neuropsychiatric disorders such as obsessive-compulsive disorder (OCD). Mrs. D. has been suffering from O
Baas, Johanna M P; Klumpers, Floris; Mantione, Mariska H.; Figee, Martijn; Vulink, Nienke C.; Richard Schuurman, P.; Mazaheri, Ali; Denys, Damiaan
Deep brain stimulation (DBS) of the ventral internal capsule is effective in treating therapy refractory obsessive-compulsive disorder (OCD). Given the close proximity of the stimulation site to the stria terminalis (BNST), we hypothesized that the striking decrease in anxiety symptoms following DBS
Baas, Johanna M P; Klumpers, Floris; Mantione, Mariska H; Figee, Martijn; Vulink, Nienke C; Schuurman, P Richard; Mazaheri, Ali; Denys, D.
Deep brain stimulation (DBS) of the ventral internal capsule is effective in treating therapy refractory obsessive-compulsive disorder (OCD). Given the close proximity of the stimulation site to the stria terminalis (BNST), we hypothesized that the striking decrease in anxiety symptoms following DBS
Denys, D; Fluitman, S; Kavelaars, A; Heijnen, C; Westenberg, HGM
Background: Obsessive-compulsive disorder (OCD) has been associated with an altered activity of the immune system. This study was carried out to investigate whether treatment with paroxetine and venlafaxine modifies the immune function in OCD and whether this modification is related to treatment out
McGrath, Lauren M; Yu, Dongmei; Marshall, Christian; Davis, Lea K; Thiruvahindrapuram, Bhooma; Li, Bingbin; Cappi, Carolina; Gerber, Gloria; Wolf, Aaron; Schroeder, Frederick A; Osiecki, Lisa; O'Dushlaine, Colm; Kirby, Andrew; Illmann, Cornelia; Haddad, Stephen; Gallagher, Patience; Fagerness, Jesen A; Barr, Cathy L; Bellodi, Laura; Benarroch, Fortu; Bienvenu, O Joseph; Black, Donald W; Bloch, Michael H; Bruun, Ruth D; Budman, Cathy L; Camarena, Beatriz; Cath, Danielle C; Cavallini, Maria C; Chouinard, Sylvain; Coric, Vladimir; Cullen, Bernadette; Delorme, Richard; Denys, D.; Derks, Eske M; Dion, Yves; Rosário, Maria C; Eapen, Valsama; Evans, Patrick; Falkai, Peter; Fernandez, Thomas V; Garrido, Helena; Geller, Daniel; Grabe, Hans J; Grados, Marco A; Greenberg, Benjamin D; Gross-Tsur, Varda; Grünblatt, Edna; Heiman, Gary A; Hemmings, Sian M J; Herrera, Luis D; Hounie, Ana G; Jankovic, Joseph; Kennedy, James L; King, Robert A; Kurlan, Roger; Lanzagorta, Nuria; Leboyer, Marion; Leckman, James F; Lennertz, Leonhard; Lochner, Christine; Lowe, Thomas L; Lyon, Gholson J; Macciardi, Fabio; Maier, Wolfgang; McCracken, James T; McMahon, William; Murphy, Dennis L; Naarden, Allan L; Neale, Benjamin M; Nurmi, Erika; Pakstis, Andrew J; Pato, Michele T; Pato, Carlos N; Piacentini, John; Pittenger, Christopher; Pollak, Yehuda; Reus, Victor I; Richter, Margaret A; Riddle, Mark; Robertson, Mary M; Rosenberg, David; Rouleau, Guy A; Ruhrmann, Stephan; Sampaio, Aline S; Samuels, Jack; Sandor, Paul; Sheppard, Brooke; Singer, Harvey S; Smit, Jan H; Stein, Dan J; Tischfield, Jay A; Vallada, Homero; Veenstra-VanderWeele, Jeremy; Walitza, Susanne; Wang, Ying; Wendland, Jens R; Shugart, Yin Yao; Miguel, Euripedes C; Nicolini, Humberto; Oostra, Ben A; Moessner, Rainald; Wagner, Michael; Ruiz-Linares, Andres; Heutink, Peter; Nestadt, Gerald; Freimer, Nelson; Petryshen, Tracey; Posthuma, Danielle; Jenike, Michael A; Cox, Nancy J; Hanna, Gregory L; Brentani, Helena; Scherer, Stephen W; Arnold, Paul D; Stewart, S Evelyn; Mathews, Carol A; Knowles, James A; Cook, Edwin H; Pauls, David L; Wang, Kai; Scharf, Jeremiah M
OBJECTIVE: Obsessive-compulsive disorder (OCD) and Tourette syndrome (TS) are heritable neurodevelopmental disorders with a partially shared genetic etiology. This study represents the first genome-wide investigation of large (>500 kb), rare (<1%) copy number variants (CNVs) in OCD and the largest g
L.M. McGrath; D. Yu (D.); C.R. Marshall (Christian); L.K. Davis (Lea); B. Thiruvahindrapuram (Bhooma); B. Li (Bingbin); C. Cappi (Carolina); G. Gerber (Gloria); A. de Wolf (Anneke); F.A. Schroeder (Frederick); L. Osiecki (Lisa); C. O'Dushlaine (Colm); A. Kirby (Andrew); C. Illmann (Cornelia); S. Haddad (Stephen); P. Gallagher (Patience); J. Fagerness (Jesen); C.L. Barr; L. Bellodi (Laura); F. Benarroch (Fortu); O.J. Bienvenu (Oscar); D.W. Black (Donald W); J. Bloch (Jocelyne); R.D. Bruun (Ruth); C.L. Budman (Cathy); B. Camarena (Beatriz); D. Cath (Daniëlle); M.C. Cavallini (Maria); S. Chouinard; V. Coric (Vladimir); C. Cullen; R. Delorme (Richard); D.A.J.P. Denys (Damiaan); E.M. Derks (Eske); Y. Dion (Yves); M.C. Rosário (Maria); C.E. Eapen (Chundamannil Eapen); P. Evans; P. Falkai (Peter); T.V. Fernandez (Thomas); H. Garrido (Helena); D. Geller (Daniel); H.J. Grabe (Hans Jörgen); M. Grados (Marco); B.D. Greenberg (Benjamin); V. Gross-Tsur (Varda); E. Grünblatt (Edna); M.L. Heiman (Mark); S.M.J. Hemmings (Sian); L.D. Herrera (Luis); A.G. Hounie (Ana); J. Jankovic (Joseph); J.L. Kennedy; R.A. King; R. Kurlan; N. Lanzagorta (Nuria); M. Leboyer (Marion); J.F. Leckman; L. Lennertz (Leonhard); C. Lochner (Christine); T.L. Lowe (Thomas); H.N. Lyon (Helen); F. MacCiardi (Fabio); W. Maier (Wolfgang); J.T. McCracken (James); W.M. McMahon (William); D.L. Murphy (Dennis); A.L. Naarden (Allan); E. Nurmi (Erika); A.J. Pakstis; C. Pato (Carlos); C. Pato (Carlos); J. Piacentini (John); C. Pittenger (Christopher); M.N. Pollak (Michael); V.I. Reus (Victor); M.A. Richter (Margaret); M. Riddle (Mark); M.M. Robertson; D. Rosenberg (David); G.A. Rouleau; S. Ruhrmann (Stephan); A.S. Sampaio (Aline); J. Samuels (Jonathan); P. Sandor (Paul); B. Sheppard (Brooke); H.S. Singer (Harvey); J.H. Smit (Jan); D.J. Stein (Dan); J.A. Tischfield (Jay); H. Vallada (Homero); J. Veenstra-Vanderweele (Jeremy); S. Walitza (Susanne); Y. Wang (Ying); A. Wendland (Annika); Y.Y. Shugart; E.C. Miguel (Euripedes); H. Nicolini (Humberto); B.A. Oostra (Ben); R. Moessner (Rainald); M. Wagner (Michael); A. Ruiz-Linares (Andres); P. Heutink (Peter); G. Nestadt (Gerald); N.B. Freimer (Nelson); T.L. Petryshen (Tracey); D. Posthuma (Danielle); M.A. Jenike (Michael); N.J. Cox (Nancy); G.L. Hanna (Gregory); H. Brentani (Helena); S.W. Scherer (Stephen); P.D. Arnold (Paul); S.E. Stewart; C. Mathews; J.A. Knowles (James A); E.H. Cook (Edwin); D.L. Pauls (David); K. Wang (Kai); J.M. Scharf; B.M. Neale (Benjamin)
textabstractObjective Obsessive-compulsive disorder (OCD) and Tourette syndrome (TS) are heritable neurodevelopmental disorders with a partially shared genetic etiology. This study represents the first genome-wide investigation of large (>500 kb), rare (<1%) copy number variants (CNVs) in OCD and th
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.
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…
Full Text Available Abstract Background Estimates of the annual prevalence for Obsessive Compulsive Disorder (OCD were consistent across the international sites range, 1.9% – 2.5%. The nine population surveys, which used Diagnostic Interview Schedule, estimated a six-month prevalence of OCD ranging from 0.7% to 2.1%. This study performed in order to determine the prevalence of OCD in a population-based study among Iranian adults aged 18 and older and to study the association of them with factors such as sex, marital status, education, type of occupation and residential area. Methods A cross-sectional nationwide epidemiological study of the Iranian population aged 18 and older was designed to estimate the prevalence of psychiatric disorders and their association with the above mentioned factors. 25180 individuals were selected and interviewed through a randomized systematic and cluster sampling method from all Iranian households. Schedule for Affective Disorders and Schizophrenia (SADS and Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV criteria were used in diagnosis of OCD. 250 clinical psychologists interviewed the selected subjects face to face at their homes. Results The prevalence of OCD in Iran is 1.8% (0.7% and 2.8% in males and females; respectively. 50.3% of the survey sample were men, 49.9% women, 29.1% single, 67.45% married, 0.4% separated or divorced, 2.5% widow/widower and 4% undetermined. All of the above-mentioned factors were examined in the univariate and multivariate logistic regression models. Although the data did not fit the models well, but in univariate models, sex, the category "single" of marital status, age, the categories "business" and "housewife" and residential areas showed significant effect adjusting for the factors, but the models didn't fit the data properly. Conclusion The study suggests that the prevalence of OCD is not rare in the community of Iran and is within the range of other countries. Similar to prior
Full Text Available This study investigated the effectiveness of acceptance and commitment therapy in obsessive- compulsive disorder. A single case design used in five patients with obsessive- compulsive disorder. Yale Brown Obsessive Compulsive Scale, Beck Depression Inventory-II, Beck anxiety Inventory and a processing measure was used for assessment of patients. Results suggested the significant decreases in all measures in post test in five patients and these results maintained at 1-month follow up. Process of treatment and results from this study suggest that Acceptance and Commitment Therapy can be effective intervention for difficult thoughts, feelings, and behaviors seen in OCD.
Weidt, Steffi; Rufer, Michael; Brühl, Annette; Baumann-Vogel, Heide; Delsignore, Aba
Obsessive-compulsive disorder (OCD) is common and associated with marked impairment and reduced quality of life. In the general practitioner's office as well as in the specialist's consultation, patients with OCD usually present intrusive thoughts (obsessions) and repetitive behaviours (compulsions). OCD sufferers generally recognize their obsessions and compulsions as irrational. Without treatment, OCD often takes a chronic course. Some basic aspects can help to identify patients suffering from OCD earlier and to initiate sufficient therapy. With evidence-based treatment with cognitive-behavioral therapy and adequate psychopharmacotherapy, many patients can achieve complete symptom remission. Initial treatment can be initiated in the general practitioner's office. PMID:23823684
Nilsson, Björn M; Ekselius, Lisa
We report successful treatment with electroconvulsive therapy of a comorbid condition including severe obsessive-compulsive symptoms and hypochondriacal delusions in a 38-year-old man with Asperger syndrome. His condition deteriorated into a severely disabled chronic state that was refractory to different pharmacological and psychological treatments but was completely reversed after electroconvulsive therapy. Although typical obsessive-compulsive symptoms were predominant, the case also exhibits differences compared with regular obsessive-compulsive disorder regarding onset and course that are discussed in the report.
Anagnostopoulos, D C; Korlou, S; Sakellariou, K; Kondyli, V; Sarafidou, J; Tsakanikos, E; Giannakopoulos, G; Liakopoulou, M
Comorbid psychopathology in children and adolescents with obsessive-compulsive disorder (OCD) has been investigated in a number of studies over the last twenty years. The aim of the present study was to investigate the phenomenology of illness and broader psychopathology in a group of Greek children and adolescents with OCD. The investigation of parental psychopathology in children and adolescents with OCD was a secondary aim of the present study. We studied 31 children and adolescents with OCD (n=31, age range 8-15 years) and their parents (n=62, age range 43-48 years) and compared to children and adolescents with specific reading and written expression learning disorders (n=30, age range 7-16 years) and their parents (n=58, age range 40-46 years). Appropriate testing showed specific reading and learning disorders, which were of mild to moderate severity for the 85% of this latter group. The diagnosis of learning disorder of reading and written expression was made through the use of standardized reading material, appropriate for ages 10-15 years. Reading comprehension and narration were tested. The written expression (spelling, syntax, content) was examined by a written text, in which the subject developed a certain theme from the reading material. Based on their level of education and occupation, the index families were classified as high (29%), average (45%) and low (26%) socioeconomic status, whereas 6.7% of control families belonged to high, 63.3% to average, and 30% to low status. In order to investigate psychopathology, the Schedule for Affective Disorders and Schizophrenia for School Aged Children, Present and Life-time version was administered to children and their parents, as well as the Child Behavior Checklist 4/18 (CBCL) to both parents and adolescents (Youth Self-Report). Also the Yale- Brown Obsessive Compulsive Scale (Y-BOCS) was rated for both children and parents. Moreover, the children were given the Children's Depression Inventory (CDI) and the
Marras, Anna; Fineberg, Naomi; Pallanti, Stefano
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. PMID:27401060
Sesia, Thibaut; Bizup, Brandon; Grace, Anthony A
Obsessive compulsive disorder (OCD) is a psychiatric condition defined by intrusive thoughts (obsessions) associated with compensatory and repetitive behaviour (compulsions). However, advancement in our understanding of this disorder has been hampered by the absence of effective animal models and correspondingly analysis of the physiological changes that may be present in these models. To address this, we have evaluated two current rodent models of OCD; repeated injection of dopamine D2 agonist quinpirole and repeated adolescent injection of the tricyclic agent clomipramine in combination with a behavioural paradigm designed to produce compulsive lever pressing. These results were then compared with their relative impact on the state of activity of the mesolimbic dopaminergic system using extracellular recoding of spontaneously active dopamine neurons in the ventral tegmental area (VTA). The clomipramine model failed to exacerbate compulsive lever pressing and VTA dopamine neurons in clomipramine-treated rats had mildly diminished bursting activity. In contrast, quinpirole-treated animals showed significant increases in compulsive lever pressing, which was concurrent with a substantial diminution of bursting activity of VTA dopamine neurons. Therefore, VTA dopamine activity correlated with the behavioural response in these models. Taken together, these data support the view that compulsive behaviours likely reflect, at least in part, a disruption of the dopaminergic system, more specifically by a decrease in baseline phasic dopamine signalling mediated by burst firing of dopamine neurons. PMID:23360787
Steven Charles Hertler
Full Text Available The present review and critique of extant etiological theories centers on a single finding: Obsessive-compulsive personality is highly heritable (0.78 and not significantly influenced by “common, shared-in-families environmental factors” (Torgersen et al., 2000, p. 424. This finding, though twelve years old, has remained dissociated from existing etiological accounts. Psychoanalytic theories anachronistically maintain that obsessive personality is familially forged. Biological theories, few, unelaborated and weakened by postulating proximate instead of ultimate explanations, fail to seriously reckon with Torgersen’s findings. Truly integrating heritability estimates into a functional etiological account of obsessive character, it is argued in the discussion section, will come from an evolutionary model that understands obsessive personality to be an evolved strategy rather than a dysfunctional disorder.
Bonura Carlo A; Boersma Jonathan T; Tse Wai S; Eckert Michael J; Szechtman Henry; McClelland Jessica Z; Culver Kirsten E; Eilam David
Abstract Background A previous report showed that the open field behavior of rats sensitized to the dopamine agonist quinpirole satisfies 5 performance criteria for compulsive checking behavior. In an effort to extend the parallel between the drug-induced phenomenon and human obsessive-compulsive disorder (OCD), the present study investigated whether the checking behavior of quinpirole rats is subject to interruption, which is an attribute characteristic of OCD compulsions. For this purpose, ...
Gilbert, Andrew R.; Akkal, Dalila; Almeida, Jorge R. C.; Mataix-Cols, David; Kalas, Catherine; Devlin, Bernie; Birmaher, Boris; Phillips, Mary L.
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.
Alonso, Pino; Cuadras, Daniel; Gabriëls, Loes; Denys, D.; Goodman, Wayne; Greenberg, Ben D; Jimenez-Ponce, Fiacro; Kuhn, Jens; Lenartz, Doris; Mallet, Luc; Nuttin, Bart; Real, Eva; Segalas, Cinto; Schuurman, Rick; Tezenas du Montcel, Sophie; Menchon, Jose M
BACKGROUND: Deep brain stimulation (DBS) has been proposed as an alternative to ablative neurosurgery for severe treatment-resistant Obsessive-Compulsive Disorder (OCD), although with partially discrepant results probably related to differences in anatomical targetting and stimulation conditions. We
Obsessive-compulsive disorder(OCD) is characterized by intrusive frightening thoughts, images or impulses (obsessions; e.g., “did I stab my partner while doing the dishes?”) to which patients respond with repetitive behavior (compulsions; e.g., checking the knives and scissors in the house or calling their partner to ensure he or she is alive) to suppress these unwanted thoughts and prevent misfortunes from happening (American Psychiatric Association, 2013). Repeated checking is one of the mo...
Full Text Available Neuroimaging studies of obsessive-compulsive disorder have found abnormalities in orbitofronto-striato-thalamic circuitry, including the orbitofrontal cortex, anterior cingulate cortex, caudate, and thalamus, but few studies have explored abnormal intrinsic or spontaneous brain activity in the resting state. We investigated both intra- and inter-regional synchronized activity in twenty patients with obsessive-compulsive disorder and 20 healthy controls using resting-state functional magnetic resonance imaging. Regional homogeneity (ReHo and functional connectivity methods were used to analyze the intra- and inter-regional synchronized activity, respectively. Compared with healthy controls, patients with obsessive-compulsive disorder showed significantly increased ReHo in the orbitofrontal cortex, cerebellum, and insula, and decreased ReHo in the ventral anterior cingulate cortex, caudate, and inferior occipital cortex. Based on ReHo results, we determined functional connectivity differences between the orbitofrontal cortex and other brain regions in both patients with obsessive-compulsive disorder and controls. We found abnormal functional connectivity between the orbitofrontal cortex and ventral anterior cingulate cortex in patients with obsessive-compulsive disorder compared with healthy controls. Moreover, ReHo in the orbitofrontal cortex was correlated with the duration of obsessive-compulsive disorder. These findings suggest that increased intra- and inter-regional synchronized activity in the orbitofrontal cortex may have a key role in the pathology of obsessive-compulsive disorder. In addition to orbitofronto-striato-thalamic circuitry, brain regions such as the insula and cerebellum may also be involved in the pathophysiology of obsessive-compulsive disorder.
Vidal-Ribas Belil, Pablo; Stringaris, Argyris; Ruck, Christian; Serlachius, Eva; Lichtenstein, Paul; Mataix-Cols, David
Traumatic or stressful life events have long been hypothesized to play a role in causing or precipitating obsessive-compulsive symptoms but the impact of these environmental factors has rarely been investigated using genetically informative designs. We tested whether a wide range of retrospectively-reported stressful life events (SLEs) influence the lifetime presence and severity of obsessive-compulsive symptoms (OCS) in a large Swedish population-based cohort of 22,084 twins. Multiple regres...
de Koning, P P; Figee, M; Endert, E.; Van den Munckhof, P.; Schuurman, P.R.; Storosum, J G; Denys, D; Fliers, E.
Improvement of obsessions and compulsions by deep brain stimulation (DBS) for obsessive-compulsive disorder (OCD) is often preceded by a rapid and transient mood elevation (hypomania). In a previous study we showed that improvement of mood by DBS for OCD is associated with a decreased activity of the hypothalamus-pituitary adrenal axis. The aim of our present study was to evaluate the time course of rapid clinical changes following DBS reactivation in more detail and to assess their associati...
Wetterneck, Chad T; Siev, Jedidiah; Adams, Thomas G; Slimowicz, Joseph C; Smith, Angela H
Sexual obsessions are a common symptom of obsessive-compulsive disorder (OCD), often classified in a broader symptom dimension that includes aggressive and religious obsessions, as well. Indeed, the Dimensional Obsessive-Compulsive Scale (DOCS) Unacceptable Thoughts Scale includes obsessional content relating to sexual, violent, and religious themes associated with rituals that are often covert. However, there is reason to suspect that sexual obsessions differ meaningfully from other types of unacceptable thoughts. We conducted two studies to evaluate the factor structure, initial psychometric characteristics, and associated clinical features of a new DOCS scale for sexually intrusive thoughts (SIT). In the first study, nonclinical participants (N=475) completed the standard DOCS with additional SIT questions and we conducted an exploratory factor analysis on all items and examined clinical and cognitive correlates of the different scales, as well as test-retest reliability. The SIT Scale was distinct from the Unacceptable Thoughts Scale and was predicted by different obsessional cognitions. It had good internal consistency and there was evidence for convergent and divergent validity. In the second study, we examined the relationships among the standard DOCS and SIT scales, as well as types of obsessional cognitions and symptom severity, in a clinical sample of individuals with OCD (N=54). There were indications of both convergence and divergence between the Unacceptable Thoughts and SIT scales, which were strongly correlated with each other. Together, the studies demonstrate the potential utility of assessing sexually intrusive thoughts separately from the broader category of unacceptable thoughts. PMID:26163717
Mas, Sergi; Gassó, Patricia; Morer, Astrid; Calvo, Anna; Bargalló, Nuria; Lafuente, Amalia; Lázaro, Luisa
We propose an integrative approach that combines structural magnetic resonance imaging data (MRI), diffusion tensor imaging data (DTI), neuropsychological data, and genetic data to predict early-onset obsessive compulsive disorder (OCD) severity. From a cohort of 87 patients, 56 with complete information were used in the present analysis. First, we performed a multivariate genetic association analysis of OCD severity with 266 genetic polymorphisms. This association analysis was used to select and prioritize the SNPs that would be included in the model. Second, we split the sample into a training set (N = 38) and a validation set (N = 18). Third, entropy-based measures of information gain were used for feature selection with the training subset. Fourth, the selected features were fed into two supervised methods of class prediction based on machine learning, using the leave-one-out procedure with the training set. Finally, the resulting model was validated with the validation set. Nine variables were used for the creation of the OCD severity predictor, including six genetic polymorphisms and three variables from the neuropsychological data. The developed model classified child and adolescent patients with OCD by disease severity with an accuracy of 0.90 in the testing set and 0.70 in the validation sample. Above its clinical applicability, the combination of particular neuropsychological, neuroimaging, and genetic characteristics could enhance our understanding of the neurobiological basis of the disorder. PMID:27093171
Fergus, Thomas A; Russell, Laurie H
Searching for medical information online is a widespread activity that increases distress for many individuals. Researchers have speculated that this phenomenon, referred to as cyberchondria, overlaps substantially with both health anxiety and obsessive-compulsive symptoms. This study sought to examine: (1) the distinguishability of cyberchondria from health anxiety and obsessive-compulsive symptoms and (2) the components of health anxiety and obsessive-compulsive symptoms that cluster most strongly with cyberchondria. The sample consisted of community adults in the United States with no current reported medical problems (N=375). Results from confirmatory factor analyses (CFAs) support the idea that cyberchondria is distinct from, yet related to, health anxiety and obsessive-compulsive symptoms. Results from zero-order correlations and regression analyses suggest that cyberchondria clusters with the affective (health worry) component of health anxiety. Regression results diverged from prior findings, as obsessive-compulsive symptoms did not share associations with cyberchondria after accounting for negative affect and health anxiety. The present results indicate that cyberchondria is possibly discernible from both health anxiety and obsessive-compulsive symptoms, while also providing insight into areas of potential overlap.
Stein, Dan J; Carey, Paul D; Lochner, Christine;
of OCD symptom dimensions to 12 weeks of treatment with escitalopram or placebo was investigated. METHODS: Data from a randomized, double-blind, placebo-controlled study of escitalopram in 466 adults with OCD were analyzed. Exploratory factor analysis of individual items of the Yale-Brown Obsessive...... of individual Yale-Brown Obsessive-Compulsive Scale items yielded 5 factors (contamination/cleaning, harm/checking, hoarding/symmetry, religious/sexual, and somatic/hypochondriacal). Analyses of covariance including all the subscales demonstrated that escitalopram was more effective than placebo...
Mehri Moradi; Ladan Fata; Ali Ahmadi Abhari; Imaneh Abbasi
Objective Attention is an important factor in information processing; obsessive- compulsive disorder (OCD) and generalized anxiety disorder (GAD) are two main emotional disorders with a chronic course. This research examined the relationship among attentional control and intrusive thoughts (worry, rumination and obsession) in these disorders. It was hypothesized that attentional control is a common factor in OCD and GAD. In addition, we compared worry, rumination and obsession among OCD, GAD ...
Firoozeh Raisi; Marzieh Tavakoli; Abbas Ali Nasehi
Objective: The fact that some antidepressants with strong effects on serotonin reuptake blockade fail to relieve obsessive-compulsive symptoms has caused growing interest in investigating noradrenergic function in obsessive-compulsive disorder (OCD) . In light of the above, we undertook a trial to investigate whether the combination of citalopram with nortriptyline is more effective in treating obsessive-compulsive symptoms than citalopram alone. Method: 40 patients who met the DSM-IV criteri...
A. van Dijk
We see a strong impact of deep brain stimulation (DBS) on several aspects of OCD (obsessive compulsive disorder). DBS in different brain areas affects compulsive behaviour, conditioned and unconditioned anxiety. DBS in the internal capsule (IC) shows the most promising behavioural results by uniquel
Full Text Available 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.
Daros, Alexander Robert; Zakzanis, Konstantine K; Rector, Neil Alexander
Obsessive-Compulsive Disorder (OCD) is characterized by persistent and unwanted obsessions generally accompanied by ritualistic behaviors or compulsions. Previous research proposed specific disgust facial emotion recognition deficits in patients with OCD. This research however, remains largely inconsistent. Therefore, the results of 10 studies contrasting facial emotion recognition accuracy in patients with OCD (n=221) and non-psychiatric controls (n=224) were quantitatively reviewed and synthesized using meta-analytic techniques. Patients with OCD were less accurate than controls in recognizing emotional facial expressions. Patients were also less accurate in recognizing negative emotions as a whole; however, this was largely due to significant differences in disgust and anger recognition specifically. The results of this study suggest that patients with OCD have difficulty recognizing specific negative emotions in faces and may misclassify emotional expressions due to symptom characteristics within the disorder. The contribution of state-related emotion perception biases to these findings requires further clarification. PMID:24411075
Błachno, Magda; Bryńska, Anita
There is constant interest in possible relations between obsessive-compulsive disorder (OCD) and eating disorders, particularly anorexia nervosa (AN). The comorbidity rate for OCD and AN is reported to be between 10% and even 40%. There is also an increased incidence of prior AN in OCD patients and high number of anorectic patients with obsessional premorbid personality. Similarities between AN and OCD lie in the symptoms of the disorders: intrusive, fearful thoughts, a compulsive need to perform rituals aimed at reducing the level of anxiety and obsessions maintaining these rituals. In case of AN, these behaviours revolve around food and thinness, whereas in OCD they are of more general and differential in type. Research on AN-OCD relations provides interesting insights, but also presents some limitations. The purpose of this review is to analyse and discuss the specificity of relations between symptoms of AN and OCD. PMID:23479943
Luyten, L; Hendrickx, S; Raymaekers, S; Gabriëls, L; Nuttin, B
In 1998, we proposed deep brain stimulation as a last-resort treatment option for patients suffering from severe, treatment-resistant obsessive-compulsive disorder (OCD). Here, 24 OCD patients were included in a long-term follow-up study to evaluate the effects of electrical stimulation in the anterior limbs of the internal capsule (ALIC) and bed nucleus of the stria terminalis (BST). We find that electrical stimulation in the ALIC/BST area is safe and significantly decreases obsessions, compulsions, and associated anxiety and depressive symptoms, and improves global functioning in a blinded crossover trial (n=17), after 4 years (n=18), and at last follow-up (up to 171 months, n=24). Moreover, our data indicate that BST may be a better stimulation target compared with ALIC to alleviate OCD symptoms. We conclude that electrical stimulation in BST is a promising therapeutic option for otherwise treatment-resistant OCD patients. PMID:26303665
Santos, Veruska; Nardi, Antonio Egidio; King, Anna Lucia Spear
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.
Full Text Available Background: Emotion regulation and anxiety sensitivity are two psychological components which play important roles in causing anxiety disorders. This study aims at predicting the Obsessive-Compulsive Disorder (OCD based on the emotion regulation and anxiety sensitivity in university students. Materials and Methods: In this descriptive correlation study, a total of 317 students of University of Mohaghegh Ardabili were selected using available sampling method in 2010-2011 academic year and they were asked to fill out the obsessive-compulsive inventories designed for emotion regulation and anxiety sensitivity. Results: The results of regression analysis showed that reappraisal and anxiety sensitivity are the best indicators of OCD in students.Conclusion: The results indicated that the reappraisal and anxiety sensitivity play a significant role in predicting OCD in students.
Objective: Inferential confusion is a reasoning process that has been theoretically and empirically linked to obsessive-compulsiveness in the literature. Little is known about the mechanisms by which some people become more or less inferentially confused and in what contexts. Dissociation has been postulated as a process related to inferential confusion, yet findings to date are limited and have been inconclusive. There is preliminary evidence to support the notion that inferential confusion ...
Morein-Zamir, Sharon; Voon, Valerie; Dodds, Chris; Sule, Akeem; van Niekerk, Jan; Sahakian, Barbara J.; Robbins, Trevor W.
Background: There is evidence of executive function impairment in Obsessive Compulsive Disorder (OCD) that potentially contributes to symptom development and maintenance. Nevertheless, the precise nature of these executive impairments and their neural basis remains to be defined. Methods: We compared stopping and shifting, two key executive functions previously implicated in OCD, in the same task using functional magnetic resonance imaging (fMRI), in patients with virt...
Mattheisen, Manuel; Samuels, Jack F.; Wang, Ying(School of Physics, Shandong University, Jinan, 250100, PR China); 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, Erica; Askland, Kathleen D.
Obsessive-compulsive disorder (OCD) is a psychiatric condition characterized by intrusive thoughts and urges and repetitive, intentional behaviors that cause significant distress and impair functioning. The OCD Collaborative Genetics Association Study (OCGAS) is comprised of comprehensively assessed OCD patients, with an early age of OCD onset. After application of a stringent quality control protocol, a total of 1 065 families (containing 1 406 patients with OCD), combined with population-ba...
Clerkin, Elise M.; Teachman, Bethany A.
The current study tested the causal premise underlying cognitive models of obsessive compulsive disorder (OCD) that negative interpretations of intrusive thoughts lead to the distress and impairment associated with symptoms of OCD. Specifically, we sought to determine: a) whether it was possible to train healthier (defined as more benign/less threatening) interpretations regarding the significance of intrusive thoughts; and b) whether there was a link between modifying negative interpretation...
Rodriguez, Carolyn I; Kegeles, Lawrence S; Levinson, Amanda; Feng, Tianshu; Marcus, Sue M; Vermes, Donna; Flood, Pamela; Simpson, Helen B.
Serotonin reuptake inhibitors (SRIs), the first-line pharmacological treatment for obsessive-compulsive disorder (OCD), have two limitations: incomplete symptom relief and 2–3 months lag time before clinically meaningful improvement. New medications with faster onset are needed. As converging evidence suggests a role for the glutamate system in the pathophysiology of OCD, we tested whether a single dose of ketamine, a non-competitive N-methyl-D-aspartate (NMDA) glutamate receptor antagonist, ...
Richter, Margaret A.; de Jesus, Danilo R.; Hoppenbrouwers, Sylco; Daigle, Melissa; Deluce, Jasna; Lakshmi N Ravindran; Fitzgerald, Paul B; Daskalakis, Zafiris J.
Several lines of evidence suggest that obsessive-compulsive disorder (OCD) is associated with an inability to inhibit unwanted intrusive thoughts. The neurophysiological mechanisms mediating such inhibitory deficits include abnormalities in cortical γ-aminobutyric acid (GABA) inhibitory as well as N-methyl--aspartate (NMDA) receptor-mediated mechanisms. Molecular evidence suggests that both these neurotransmitter systems are involved in OCD. Transcranial magnetic stimulation (TMS) represents ...
Amir, Nader; Cobb, Michelle; Morrison, Amanda S.
Individuals with obsessive-compulsive disorder (OCD) often experience intrusive thoughts. These intrusions may be due to biases in information processing mechanisms, including attention, memory, and learning. To examine this hypothesis, we presented a modified negative priming (NP) paradigm with idiographically-selected words to 19 individuals with OCD (OCs) and 19 matched non-anxious control participants (NACs). The words included OCD-relevant threat, OCD-relevant positive, and neutral words...
Veale, David; Page, Nicholas; Woodward, Elizabeth; Salkovskis, Paul
BACKGROUND AND OBJECTIVES: Some individuals with Obsessive Compulsive Disorder (OCD) may experience recurrent intrusive distressing images, which may be emotionally linked to past aversive memories. Our aim was to investigate whether Imagery Rescripting was an effective intervention for such individuals with OCD.METHOD: Twelve cases who experienced intrusive distressing images are presented in a A1BA2CA3 single case experimental design. After a baseline of symptom monitoring (A1), participant...
Z Khanjani; B Esmaeili Anamage; M Gholamzadeh
Introduction: Parents interaction styles with children or teens have an important impact on shaping their character and mental health and the incidence of some psychiatric symptoms. The aim of this study was to predict anxiety thought and obsessive - compulsive symptoms of the adolescents based on parents' parenting styles. Methods: This was a descriptive study. 180 male students in Marand were selected by cluster random sampling. We used Baumrind parents parenting style questionnaire, Wales ...
Himanshu Tyagi; Rupal Patel; Fabienne Rughooputh; Hannah Abrahams; Watson, Andrew J.; Lynne Drummond
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 comorbi...
Merkel, W T; Pollard, C A; Wiener, R L; Staebler, C R
It has been hypothesized that parents of patients with obsessive compulsive disorder exhibit specific traits. 320 consecutive inpatient admissions who met criteria for OCD, depression, and panic disorder checked a list of adjectives to describe their parents. Patients with OCD were 1) less likely to perceive their mothers as disorganized than depressives, 2) more likely to perceive their mothers as overprotective than depressives and 3) less likely to perceive their fathers as demanding than patients with panic. PMID:8404245
Fábio M. Corregiari
Full Text Available 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.
Jarry, J L; Vaccarino, F J
This paper explores a possible connection between neurochemistry and cognitions in eating disorders (ED). Cognitions play an important role in ED. However, a possible neurochemical origin of these cognitions has not been explored. Obsessive-compulsive disorder (OCD) is known as a disorder of thinking. Extensive neurochemical research conducted on this disorder indicates a connection between serotonin (5-HT) dysregulation and cognitions in OCD. This study used research done on OCD as a templat...
Magee, Joshua C; Teachman, Bethany A.
The current study examined the nature and consequences of attributions about unsuccessful thought suppression. Undergraduate students with either high (N=67) or low (N=59) levels of obsessive-compulsive symptoms rated attributions to explain their unsuccessful thought suppression attempts. We expected that self-blaming attributions and attributions ascribing importance to unwanted thoughts would predict more distress and greater recurrence of thoughts during time spent monitoring or suppressi...
Morein-Zamir, S; Fineberg, N A; Robbins, T. W.; Sahakian, B J
Background Obsessive-compulsive disorder (OCD) has been associated with impairments in stop-signal inhibition, a measure of motor response suppression. The study used a novel paradigm to examine both thought suppression and response inhibition in OCD, where the modulatory effects of stimuli relevant to OCD could also be assessed. Additionally, the study compared inhibitory impairments in OCD patients with and without co-morbid depression, as depression is the major co-morbidity of OCD. Method...
Aelterman, Nathalie; Decuyper, Mieke; De Fruyt, Filip
The validity of the Axis II Obsessive-Compulsive Personality Disorder (OCPD) category and its position within the Cluster C personality disorder (PDs) section of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV, APA, 2000) continues to be a source of much debate. The present study examines the associations between general and maladaptive personality traits and OCPD symptoms, prior to and after controlling for co-occurring PD variance, in a general population sample of 274 Fle...
Mohamadirizi, Soheila; Kordi, Masoumeh; Shakeri, Mohamad Taghi; Modares-Gharavi, Morteza
Background: 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. Materials and Methods: This cross-sectional study was carried on 213 in primigravida women referring to Mashhad health care centers, selected through a two st...
Ciesielski, Kristina T.; Scott L. Rauch; Ahlfors, Seppo P.; Vangel, Mark E.; Wilhelm, Sabine; Rosen, Bruce R.; Hämäläinen, Matti S
Recurrent anticipation of ominous events is central to obsessions, the core symptom of obsessive–compulsive disorder (OCD), yet the neural basis of intrinsic anticipatory processing in OCD is unknown. We studied non-medicated adults with OCD and case matched healthy controls in a visual-spatial working memory task with distractor. Magnetoencephalography was used to examine the medial cortex activity during anticipation of to-be-inhibited distractors and to-be-facilitated retrieval stimuli. In...
Solem, Stian; Hagen, Kristen; Wenaas, Christoffer; Håland, Åshild Tellefsen; Launes, Gunvor; Vogel, Patrick A.; Hansen, Bjarne; Himle, Joseph A.
Background: Research is scarce with regard to the role of psychotic and schizotypal symptoms in treatment of obsessive-compulsive disorder (OCD). The aim of the current study was to investigate the occurrence and specificity of psychotic and schizotypal symptoms among non-psychotic OCD patients, and to examine whether such symptoms was associated with response to exposure and response prevention (ERP), and whether ERP for OCD had an impact on psychotic and schizotypal symptoms. ...
Nergis LAPSEKİLİ; Ak, Mehmet
Introduction: The implementation of effective treatment depends on thorough understanding of disorder and its presentation. Treatment strategies must depend on the individual formulation of the patient. In this paper an Obsessive Compulsive Disorder(OCD) patient treated with Cognitive Behavioral Therapy (CBT) methods is presented. It is discussed that in the therapy, formulation is an ongoing dynamic process and necessarily required for the effectiveness of therapy. Case: Y.B. was...
Dijk, van, G.
We see a strong impact of deep brain stimulation (DBS) on several aspects of OCD (obsessive compulsive disorder). DBS in different brain areas affects compulsive behaviour, conditioned and unconditioned anxiety. DBS in the internal capsule (IC) shows the most promising behavioural results by uniquely reducing conditioned anxiety and by shortening the compulsive grooming bout in the sapap3 mutant mouse. This suggests that the IC is possibly the best target for DBS in relation to OCD. Further r...
Mavrogiorgou, Paraskevi; Bethge, Mareike; Luksnat, Stefanie; Nalato, Fabio; Juckel, Georg; Brüne, Martin
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.
Mavrogiorgou, Paraskevi; Bethge, Mareike; Luksnat, Stefanie; Nalato, Fabio; Juckel, Georg; Brüne, Martin
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. PMID:26810438
Johanna M.P. Baas
Full Text Available Deep brain stimulation (DBS of the ventral internal capsule is effective in treating therapy refractory obsessive-compulsive disorder (OCD. Given the close proximity of the stimulation site to the stria terminalis (BNST, we hypothesized that the striking decrease in anxiety symptoms following DBS could be the result of the modulation of contextual anxiety. However, the effect of DBS in this region on contextual anxiety is as of yet unknown. Thus, the current study investigated the effect of DBS on contextual anxiety in an experimental threat of shock paradigm. Eight patients with DBS treatment for severe OCD were tested in a double-blind crossover design with randomly assigned two-week periods of active and sham stimulation. DBS resulted in significant decrease of obsessive-compulsive symptoms, anxiety and depression. However, even though the threat manipulation resulted in a clear context potentiated startle effect, none of the parameters derived from the startle recordings was modulated by the DBS. This suggests that DBS in the ventral internal capsule is effective in treating anxiety symptoms of obsessive-compulsive disorder without modulating the startle circuitry. We hypothesize that the anxiety symptoms present in OCD are likely distinct from the pathological brain circuits in defensive states of other anxiety disorders.
Wu, Kevin D
The purpose of this research was to investigate the specificity of purported relations between symptoms of eating disorders (ED) and obsessive-compulsive disorder (OCD). Whereas most research has focused on diagnostic comorbidity or between-groups analyses, this study took a dimensional approach to investigate specific relations among symptoms of anorexia, bulimia, and OCD, as well as panic, depression, and general distress in a student sample (N=465). Results were that all symptoms showed significant zero-order correlations, including all ED-OCD pairings. After removing general distress variance, however, none of three OCD scales significantly predicted anorexia; only compulsive washing among OCD scales significantly predicted bulimia. Hierarchical multiple regression demonstrated that panic and depression out-performed OCD in predicting bulimia symptoms. Overall, symptoms of ED and OCD did not show unique relations at the level of core dimensions of each construct. A possible link between bulimia and compulsive washing is worth further study. PMID:18396006
L. Islam; Scarone, S.; O. Gambini
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...
Melli, Gabriele; Moulding, Richard; Gelli, Simona; Chiorri, Carlo; Pinto, Antonio
Sexual Orientation-Obsessive-Compulsive Disorder (SO-OCD) is characterized by intrusive thoughts, images, and urges related to one's sexual orientation, and by consequent avoidance, reassurance seeking, and overt and covert compulsions. Currently there is no short self-report measure that assesses SO-OCD symptoms. The current article describes two studies that develop and evaluate the first version of the Sexual Orientation Obsessive-Compulsive Scale (SO-OCS), a 14-item Italian self-report measure targeted towards heterosexual individuals. In Study 1, the SO-OCS was developed and refined through item analysis and exploratory factor analysis from an initial pool of 33 items administered to 732 Italian nonclinical participants. The SO-OCS showed a unidimensional structure and an acceptable internal consistency. In Study 2, the factor structure, internal consistency, temporal stability, construct and criterion validity, and diagnostic sensitivity of the SO-OCS were investigated in three samples of Italian participants (294 from the general population, 52 OCD patients who reported sexual orientation-related symptoms or concerns as a primary complaint, and 51 OCD patients who did not report these symptoms as primary complaint). The SO-OCS was again found to have a unidimensional structure and good internal consistency, as well as to exhibit strong construct validity. Specifically, the SO-OCS showed an excellent criterion validity and diagnostic sensitivity, as it successfully discriminated between those with SO-OCD and all other groups of participants. Finally, evidence of temporal stability of the SO-OCS in a nonclinical subsample was found. The SO-OCS holds promise as a measure of SO-OCD symptoms in heterosexual individuals. PMID:27423161
Su, Yi-Jen; Carpenter, Joseph K; Zandberg, Laurie J; Simpson, Helen Blair; Foa, Edna B
This study examined cognitive mediators of symptom change during exposure and response prevention (EX/RP) for obsessive-compulsive disorder (OCD). Based on cognitive models of OCD, obsessive beliefs were hypothesized as a mediator of symptom change. Participants were 70 patients with primary OCD receiving EX/RP either as part of a randomized controlled trial (n=38) or in open treatment following nonresponse to risperidone or placebo in the same trial (n=32). Blinded evaluations of OCD severity and self-report assessments of three domains of obsessive beliefs (i.e., responsibility/threat of harm, importance/control of thoughts, and perfectionism/intolerance of uncertainty) were administered during acute (Weeks 0, 4 and 8) and maintenance treatment (Weeks 12 and 24). Study hypotheses were examined using cross-lagged multilevel modeling. Contrary to predictions, the obsessive beliefs domains investigated did not mediate subsequent OCD symptom reduction. In addition, OCD symptoms did not significantly mediate subsequent change in obsessive beliefs. The present study did not find evidence of cognitive mediation during EX/RP for OCD, highlighting the need to investigate other plausible mediators of symptom improvement.
Su, Yi-Jen; Carpenter, Joseph K; Zandberg, Laurie J; Simpson, Helen Blair; Foa, Edna B
This study examined cognitive mediators of symptom change during exposure and response prevention (EX/RP) for obsessive-compulsive disorder (OCD). Based on cognitive models of OCD, obsessive beliefs were hypothesized as a mediator of symptom change. Participants were 70 patients with primary OCD receiving EX/RP either as part of a randomized controlled trial (n=38) or in open treatment following nonresponse to risperidone or placebo in the same trial (n=32). Blinded evaluations of OCD severity and self-report assessments of three domains of obsessive beliefs (i.e., responsibility/threat of harm, importance/control of thoughts, and perfectionism/intolerance of uncertainty) were administered during acute (Weeks 0, 4 and 8) and maintenance treatment (Weeks 12 and 24). Study hypotheses were examined using cross-lagged multilevel modeling. Contrary to predictions, the obsessive beliefs domains investigated did not mediate subsequent OCD symptom reduction. In addition, OCD symptoms did not significantly mediate subsequent change in obsessive beliefs. The present study did not find evidence of cognitive mediation during EX/RP for OCD, highlighting the need to investigate other plausible mediators of symptom improvement. PMID:27423164
Full Text Available Attention is an important factor in information processing; obsessive- compulsive disorder (OCD and generalized anxiety disorder (GAD are two main emotional disorders with a chronic course. This research examined the relationship among attentional control and intrusive thoughts (worry, rumination and obsession in these disorders. It was hypothesized that attentional control is a common factor in OCD and GAD. In addition, we compared worry, rumination and obsession among OCD, GAD and non- clinical participants.The research sample included three groups: OCD (n = 25, GAD (n = 30 and non- clinical samples (n = 56. Data were collected using the Attentional Control Scale (ACS, Rumination Response Scale (RRS, Pennsylvania State Worry Questionnaire (PSWQ, Beck Depression Inventory (BDI, Beck Anxiety Inventory (BAI, Obsessive-Compulsive Inventory-Revised (OCI-R and General Health Questionnaire (GHQ-28. Data were analyzed using MANOVA and MANCOVA by SPSS-17.Multivariate Analysis of Variance revealed that the OCD and GAD groups reported greater deficits in attentional control, higher obsessive-compulsive symptoms, rumination, worry, anxiety and depression compared to the control group.This research indicated a great attentional deficit in obsessive- compulsive disorder and generalized anxiety disorder. However, no significant difference was found between these two disorders.
March John S
Full Text Available Abstract This paper presents the rationale, design, and methods of the Pediatric Obsessive-Compulsive Disorder Treatment Study II (POTS II, which investigates two different cognitive-behavior therapy (CBT augmentation approaches in children and adolescents who have experienced a partial response to pharmacotherapy with a serotonin reuptake inhibitor for OCD. The two CBT approaches test a "single doctor" versus "dual doctor" model of service delivery. A specific goal was to develop and test an easily disseminated protocol whereby child psychiatrists would provide instructions in core CBT procedures recommended for pediatric OCD (e.g., hierarchy development, in vivo exposure homework during routine medical management of OCD (I-CBT. The conventional "dual doctor" CBT protocol consists of 14 visits over 12 weeks involving: (1 psychoeducation, (2, cognitive training, (3 mapping OCD, and (4 exposure with response prevention (EX/RP. I-CBT is a 7-session version of CBT that does not include imaginal exposure or therapist-assisted EX/RP. In this study, we compared 12 weeks of medication management (MM provided by a study psychiatrist (MM only with two types of CBT augmentation: (1 the dual doctor model (MM+CBT; and (2 the single doctor model (MM+I-CBT. The design balanced elements of an efficacy study (e.g., random assignment, independent ratings with effectiveness research aims (e.g., differences in specific SRI medications, dosages, treatment providers. The study is wrapping up recruitment of 140 youth ages 7–17 with a primary diagnosis of OCD. Independent evaluators (IEs rated participants at weeks 0,4,8, and 12 during acute treatment and at 3,6, and 12 month follow-up visits. Trial registration NCT00074815
Although obsessive-compulsive disorder has been reported as one of many anxiety-related sequelae of brain injury, few empirical data of its responsiveness to psychological intervention are available. In this study, a single participant changing criterion experimental design was used to evaluate a neurobehavioural intervention for compulsive behaviour of an adult with severe traumatic brain injury. The participant, a man aged 24 years, had sustained frontal-temporal lobe brain trauma 12 months earlier, and presented with compulsive counting and voiding of bladder. The neurobehavioural intervention consisted of regular in-home consultations, self-regulation procedures including self-recording of compulsive behaviour, stress-coping strategies, errorless remediation, social reinforcement, and gradual fading of intervention. Baseline showed counting occurred on average 80% of daily hourly intervals, and voiding 12 times per day. Intervention produced elimination of compulsive counting, acceptable voiding at 8 times per day, and reports of the participant's satisfaction with intervention methods and outcomes. At 6 months follow-up, counting remained at zero levels, and voiding had decreased further to 7 times per day. PMID:18058389
In the past twenty years functional brain imaging has advanced to the point of tackling the differential diagnosis, prognosis and therapeutic response in Neurology and Psychiatry. Psychiatric disorders were rendered 'functional' a century ago; however nowadays they can be seen by means of brain imaging. Functional images in positron emission tomography (PET) and single photon emission tomography (NEUROSPET) show in non-invasive fashion the state of brain functioning. PET does this assessing glucose metabolism and NEUROSPET by putting cerebral blood flow in images. Prevalence of OCD is clearly low (2 to 3%), but comorbidity with depression, psychoses, bipolar disorder and schizophrenia is high. Furthermore, it is not infrequent with autism, attention disorder, tichotillomany, borderline personality disorders, in pathological compulsive spending, sexual compulsion and in pathological gambling, in tics, and in Gilles de la Tourette disorder, NEUROSPET and PET show hypoperfusion in both frontal lobes, in their prefrontal dorsolateral aspects, in their inferior zone and premotor cortex, with hyperperfusion in the posterior cingulum and hypoperfusion in basal ganglia (caudate nucleus). Cummings states that hyperactivity of the limbic system might be involved in OCD. Thus, brain imaging in OCD is a diagnostic aid, allows us to see clinical imagenological evolution and therapeutic response and, possibly, it is useful predict therapeutic response (Au)
Geller, Daniel A.; Wagner, Karen Dineen; Emslie, Graham; Murphy, Tanya; Carpenter, David J.; Wetherhold, Erica; Perera, Phil; Machin, Andrea; Gardiner, Christel
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…
Full Text Available 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.
Wu, Ke; Hanna, Gregory L; Rosenberg, David R; Arnold, Paul D
Obsessive-compulsive disorder (OCD) is a common and often debilitating neuropsychiatric condition characterized by persistent intrusive thoughts (obsessions), repetitive ritualistic behaviors (compulsions) and excessive anxiety. While the neurobiology and etiology of OCD has not been fully elucidated, there is growing evidence that disrupted neurotransmission of glutamate within corticalstriatal-thalamocortical (CSTC) circuitry plays a role in OCD pathogenesis. This review summarizes the findings from neuroimaging, animal model, candidate gene and treatment studies in the context of glutamate signaling dysfunction in OCD. First, studies using magnetic resonance spectroscopy are reviewed demonstrating altered glutamate concentrations in the caudate and anterior cingulate cortex of patients with OCD. Second, knockout mouse models, particularly the DLGAP3 and Sltrk5 knockout mouse models, display remarkably similar phenotypes of compulsive grooming behavior associated with glutamate signaling dysfunction. Third, candidate gene studies have identified associations between variants in glutamate system genes and OCD, particularly for SLC1A1 which has been shown to be associated with OCD in five independent studies. This converging evidence for a role of glutamate in OCD has led to the development of novel treatment strategies involving glutamatergic compounds, particularly riluzole and memantine. We conclude the review by outlining a glutamate hypothesis for OCD, which we hope will inform further research into etiology and treatment for this severe neuropsychiatric condition. PMID:22024159
Joubert, C E
75 women and 64 men responded to the Coopersmith Self-esteem Inventory, the Manifest Anxiety Scale, and the Maudsley Obsessional-compulsive Inventory in addition to responding to a questionnaire on personal habits. The results indicated that more frequent hair-pullers and nervous twitchers scored lower on self-esteem and higher on anxiety. People who giggled and those who bit their fingernails more often scored higher on obsessive-compulsiveness. Self-reported gigglers were higher on manifest anxiety. If the criterion of self-assessed seriousness of the behavior problem was used, people who bit their nails, picked their noses, pulled their hair, chewed on objects, giggled, ground their teeth, twitched nervously, and picked at scabs scored lower on self-esteem. Higher manifest-anxiety scores were found among the people who regarded their nail-biting, hair-pulling, object-chewing, nervous twitching, or giggling as serious problems. Finally, people who regarded their nail-biting as more serious tended to have higher obsessive-compulsive scores. The results in general suggest that the frequency of several of these behaviors is anxiety-related and that it is the person's assessments of these behaviors as problems rather than simply their frequency that is related to higher anxiety and lower self-esteem. PMID:8234610
Full Text Available Among cognitive models attempting to explain the etiology of Obsessive Compulsive Disorder (OCD, models such as Inflated Responsibility Model, Misinterpretation of Significance Theory and Cognitive Control Model are currently considered to be valid in many aspects in understanding adulthood OCD. Embracing these models that underline various cognitions in adult OCD, the presence of six faulty appraisals and belief domains can be noticed: inflated responsibility; overimportance of thoughts; excessive concern about the importance of controlling one's thoughts, overestimation of threat, intolerance of uncertainty and perfectionism. Previous studies indicated a difference between early onset OCD and late onset OCD with regards to the presence of pure compulsions, insidious onset of symptoms. Examining faulty assessment and belief domains related with OCD reveals that overimportance of thoughts, intolerance of uncertainty and perfectionism is not only limited to adulthood, but also observed during childhood and/or adolescence periods. Nevertheless, inflated responsibility, excessive concern about the importance of controlling one's thoughts and overestimation of threat found in childhood and adolescence period is not as pronounced and striking as observed with adults. Considering the facts that OCD symptoms and related areas of faulty appraisals and belief domains differ amongst various age groups, early diagnosis and intervention will be critical in terms of the course of treatment for obsessive compulsive disorder. The purpose of this review is to briefly examine three current cognitive models proposed for OCD and evaluate six faulty appraisals and belief domains considered to play a role in the understanding of OCD with respect to developmental periods.
陈彦华; 刘婷婷; 李辉
目的对比强迫症和伴强迫症状的精神分裂症状不同的临床特点。方法选取我院在2012年1月~12月收治的80例强迫症患者作为强迫症组，选取80例伴强迫症患者作为分裂症组。结果分裂症组的强迫行为比率(63.8%)明显高于强迫症组(53.8%)(P<0.05)。结论强迫症患者承受的痛苦及功能障碍比伴强迫症者明显，但强迫行为没有伴强迫症者明显，临床在进行治疗时，要注意区分，做好鉴别，以便于采取对症的治疗方案。%Objective To compare the symptoms of obsessive-compulsive disorder and with forced schizophrenic symptoms of dif erent clinical characteristics.Methods Our hospital in January 2012 to December 2012,admit ed during the period of 80 patients with obsessive-compulsive disorder ocd group,80 patients with obsessive-compulsive disorder as schizophrenia group.Results The ratio of compulsive behavior schizophrenia group (63.8%)was obviously higher than ocd group (53.8%)( <0.05).Conclusion OCD patients suf er pain and dysfunction than with obsessive-compulsive disorder, but not compulsive behavior associated with obsessive-compulsive disorder,obvious clinical treatment,at ention should be paid to distinguish,completes the identification,in order to adopt the symptomatic treatment.
Haynes, W I A; Millet, B; Mallet, L
Deep brain stimulation was first developed for movement disorders but is now being offered as a therapeutic alternative in severe psychiatric disorders after the failure of conventional therapies. One of such pathologies is obsessive-compulsive disorder. This disorder which associates intrusive thoughts (obsessions) and repetitive irrepressible rituals (compulsions) is characterized by a dysfunction of a cortico-subcortical loop. After having reviewed the pathophysiological evidence to show why deep brain stimulation was an interesting path to take for severe and resistant cases of obsessive-compulsive disorder, we will present the results of the different clinical trials. Finally, we will provide possible mechanisms for the effects of deep brain stimulation in this pathology. PMID:22898561
Full Text Available Álvaro Frías,1,2 Carol Palma,1,2 Núria Farriols,1,2 Laura González2 1FPCEE Blanquerna, Universitat Ramon Llull, Barcelona, 2Adult Outpatient Mental Health Center, Hospital de Mataró – CSdM, Mataró, Spain 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
Hegde, Aditya; Kalyani, Bangalore G; Arumugham, Shyam Sundar; Narayanaswamy, Janardhanan C; Math, Suresh Bada; Reddy, Y C Janardhan
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 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. PMID:27219093
The symptoms of obsessive-compulsive disorder (OCD)--repetitive troublesome intrusive thoughts and/or compulsions--may indicate a reduction in the efficiency of inhibitory control over thought and action. A number of neuropsychological studies using various indices of inhibitory activity were aimed at verifying the hypothesis of deficient inhibition in OCD. The paper critically reviews the studies that relate to three kinds of inhibition-related phenomena --i.e. negative priming, thought suppression, and directed forgetting--and summarises the results of other research addressing the inhibitory processes in OCD subjects. All in all, the results do not support the hypothesis of general inhibitory deficit in OCD, although some studies suggest an impairment in the ability to suppress specific mental contents in this clinical group. In the discussion some general problems related to neuropsychological diagnosis of inhibitory processes in psychopathology are indicated. PMID:17444286
Kim, Kwanguk; Roh, Daeyoung; Kim, Sun I; Kim, Chan-Hyung
The current study aims to explore the effectiveness of virtual environment (VE) in producing anxiety variations to arrangement in order to treat obsessive-compulsive disorder. Twenty-four participants completed and performed the virtual arrangement tasks three times with three-day intervals. The results showed that the levels of participants' anxiety decreased significantly from the first to the last day, but the levels of decrement were different depending on the type of tasks: the time limit task was most effective among the three tasks in evoking arrangement anxiety. Also, only the Symmetry, Ordering, and Arrangement Questionnaire (SOAQ) revealed significant positive correlations with anxieties. These VE profiles can serve as an adjunct for better diagnosis and treatment for people with arranging compulsion symptoms.
Celik, Gonca; Tas, Didem Arslan; Varmıs, Dilek Altun; Tahiroglu, Aysegul; Avci, Ayse
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. PMID:27388777
Frías Á; Palma C; Farriols N; González L
Álvaro Frías,1,2 Carol Palma,1,2 Núria Farriols,1,2 Laura González2 1FPCEE Blanquerna, Universitat Ramon Llull, Barcelona, 2Adult Outpatient Mental Health Center, Hospital de Mataró – CSdM, Mataró, Spain 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 disorde...
Full Text Available Jing Xia,1 Yanqiu Du,2 Jiyang Han,1 Guo Liu,1 Xumei Wang11Department of Psychiatry, Shengjing Hospital of China Medical University, Heping District Shenyang, Liaoning, People’s Republic of China; 2Department of Medicine, Shenyang Ninth People’s Hospital, Tiexi District, Shenyang, Liaoning, People’s Republic of ChinaObjective: To evaluate the overall effect of D-cycloserine (DCS augmentation on exposure and response prevention (ERP therapy for obsessive-compulsive disorder (OCD.Methods: Clinical studies on the effect of DCS augmentation on ERP therapy for OCD compared to placebo were included for meta analysis. The primary outcome was the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS. Meta-analyses were performed with a random-effect model or a fixed-effect model using the Cochrane Review Manager (RevMan, version 5.2 to calculate the odds ratio and the mean difference, with their corresponding 95% confidence intervals.Results: A total of six studies was included in the current meta-analyses, and their data were extracted. Among them, four were for analyses of DCS and Y-BOCS at midtreatment, six for analysis at posttreatment, and four at 3-month follow-up. Besides, three of the six eligible studies were included in the meta-analysis of the DCS and Clinical Global Impression – Severity Scale at posttreatment, and three in the meta-analysis of DCS and proportions of treatment responders and of subjects attaining clinical remission status criteria at posttreatment. Our meta-analyses do not reveal a significant effect of DCS augmentation in ERP therapy for OCD patients, except when measured at midtreatment. Compared to the placebo group, DCS augmentation did show a trend toward significantly lower/decreased Y-BOCS; when measured at posttreatment and in the subpopulation of DCS taken before some of the ERP sessions, DCS augmentation showed a trend toward significantly lower/decreased Y-BOCS.Conclusion: Our result suggested that with the careful
Bhikram, Tracy P; Farb, Norman A S; Ravindran, Lakshmi N; Papadopoulos, Yousef G; Conn, David K; Pollock, Bruce G; Ravindran, Arun V
This study investigated the effect of an intravenous serotonin reuptake inhibitor on the neural substrates of obsessive-compulsive disorder (OCD), as intravenous agents may be more effective in treating OCD than conventional oral pharmacotherapy. Eight OCD subjects and eight control subjects received alternate infusions of citalopram and placebo during functional magnetic resonance imaging, in a randomized, symptom-provocation, crossover design. Compared with baseline, OCD subjects displayed significant changes in prefrontal neural activity after the citalopram infusion relative to placebo, and these changes correlated with reductions in subjective anxiety. PMID:27019066
Objective To investigate association between tumor necrosis factor alpha (TNF-α) and obsessive compulsive disorder (OCD) in Chinese Han population.Methods Plasma concentrations of TNF-α were measured in 61 drug-free patients who fulfilled DSM-Ⅳ criteria for OCD and 93 healthy controls.TNF-α concentrations in blood were determined by enzyme-linked immunosorbent assay (ELISA).Two polymorphisms of TNF-α gene were investigated in the same patients and healthy controls:-308 G/A and-238 G/A.The allelic and genoty...
Maia Alex S. S. Freire
Full Text Available Obsessive-compulsive disorder (OCD has been reported in association with some neurological diseases that affect the basal ganglia such as Tourette's syndrome, Sydenham's chorea, Parkinson's disease, and Huntington's disease. Furthermore, studies such as neuroimaging, suggest a role of the basal ganglia in the pathophysiology of OCD. The aim of this paper is to describe the association of OCD and several neurologic disorders affecting the basal ganglia, report the existing evidences of the role of the basal ganglia in the pathophysiology of OCD, and analyze the mechanisms probably involved in this pathophysiology.
Feldmann, Robert E; Kranz, Gottfried; Praschak-Rieder, Nicole; Kasper, Siegfried
The authors report the case of a 32-year-old man who had been treated for anxiety and obsessive-compulsive disorder and had received 800 mg methylphenobarbital (MPB). After switching to a barbiturate-free schedule, his condition continued to be unstable for more than 21 MPB half-lives (approx. 30 days) and did not stabilize until MPB-metabolites dropped below their urinary detection limit. Considering that this article provides findings from a single patient, the authors use this experience to discuss and emphasize the importance of clinical control of barbiturates in psychiatry. PMID:19630487
de Leeuw, Aart S; Oranje, Bob; van Megen, Harold J G M;
Obsessive-compulsive disorder (OCD) is associated with deficits in inhibition mechanisms. This is reflected in reports showing impaired sensorimotor and sensory gating in OCD patients, as measured with prepulse inhibition (PPI) of the startle reflex and P50 suppression paradigms. However, most of...... sensorimotor and sensory gating is not impaired in drug-free OCD patients, taking into account the menstrual cycle effects in women. These results do not support hypotheses linking deficits in these inhibition paradigms and the pathogenesis of OCD. The finding of an increased P50 suppression in the subgroup of...
Chen, Yunhui; Juhas, Michal; Greenshaw, Andrew J; Hu, Qiang; Meng, Xin; Cui, Hongsheng; Ding, Yongzhuo; Kang, Lu; Zhang, Yubo; Wang, Yuhua; Cui, Guangcheng; Li, Ping
The data provided here related to our research article (Chen et al., 2016) . We provide whole-brain intrinsic functional connectivity patterns in obsessive-compulsive disorder at resting-state . This article also provides supplementary information to our research article, i.e., between - group comparisons of the effect of selective serotonin reuptake inhibitors (SSRIs) and combined depression symptoms on resting-state neural activities in obsessive-compulsive disorder. The data presented here provide novel insights into the effect of SSRIs and combined depression symptoms on the neural activities at rest. PMID:27504477
Rotge, J Y; Aouizerate, B; Amestoy, V; Lambrecq, V; Langbour, N; Nguyen, T.H.; Dovero, S; Cardoit, L; Tignol, J; Bioulac, B; Burbaud, P; Guehl, D
Obsessive-compulsive disorder (OCD) is a frequent psychiatric disorder characterized by repetitive intrusive thoughts and severe anxiety, leading to compulsive behaviors. Although medical treatment is effective in most cases, resistance is observed in about 30% of patients. In this context, deep brain stimulation (DBS) of the caudate or subthalamic nuclei has been recently proposed with encouraging results. However, some patients were unimproved or exhibited awkward side effects. Therefore, e...
Pedro eMorgado; Daniela eFreitas; João M Bessa; Nuno eSousa; Cerqueira, João J.
Obsessive–compulsive disorder (OCD) is achronic psychiatric disorder characterized by recurrent intrusive thoughts and/or repetitive compulsory behaviors. This psychiatric disorder is known to be stress responsive, as symptoms increase during periods of stress but also because stressful events may precede the onset of OCD. However, only a few and inconsistent reports have been published about the stress perception and the stress-response in these patients. Herein, we have characterized the co...
Wolmarans, De Wet; Stein, Dan J; Harvey, Brian H
Obsessive-compulsive disorder (OCD) is a phenotypically heterogeneous condition characterised by time-consuming intrusive thoughts and/or compulsions. Irrespective of the symptom type diagnosed, the severity of OCD is characterised by heterogeneity in symptom presentation that complicates diagnosis and treatment. Heterogeneity of symptoms would be invaluable in an animal model. Nest building behaviour forms part of the normal behavioural repertoire of rodents and demonstrates profound between-species differences. However, it has been proposed that within-species differences in nest building behaviour (i.e. aberrant vs. normal nest building) may resemble obsessive-compulsive-like symptoms. In an attempt to investigate whether other obsessive-compulsive-like behaviours are present in an animal model of OCD, or if aberrant nest building behaviour may represent a unique obsessive-compulsive phenotype in such a model, the current study assessed nest building behaviour in high (H, viz obsessive-compulsive) and non (N, viz normal) stereotypical deer mice. Subsequently, 12 N and H animals, respectively, were provided with an excess of cotton wool daily for one week prior to and following four weeks of high-dose oral escitalopram treatment (50 mg/kg/day). Data from the current investigation demonstrate daily nesting activity to be highly variable in deer mice, with stereotypy and nest building being independent behaviours. However, we identified unique aberrant large nest building behaviour in 30% of animals from both cohorts that was attenuated by escitalopram to pre-treatment nesting scores of the larger group. In summary, behavioural and drug-treatment evidence confirms that deer mouse behaviour does indeed resemble symptom heterogeneity related to OCD, and as such expands its face and predictive validity for the disorder. PMID:27154874
Full Text Available Insight into the biological pathomechanism of a clinical syndrome facilitates the development of effective interventions. This paper applies this perspective to the important clinical problem of obsessive-compulsive symptoms (OCS occurring during the lifetime diagnosis of schizophrenia. Up to 25% of schizophrenia patients suffer from OCS and about 12% fulfil the diagnostic criteria of obsessive-compulsive disorder (OCD. This is accompanied by marked subjective burden of disease, high levels of anxiety, depression and suicidality, increased neurocognitive impairment, less favourable levels of social and vocational functioning, and greater service utilization. Comorbid patients can be assigned to heterogeneous subgroups. It is assumed that second generation antipsychotics (SGAs, most importantly clozapine, might aggravate or even induce second-onset OCS. Several epidemiological and pharmacological arguments support this assumption. Specific genetic risk factors seem to dispose patients with schizophrenia to develop OCS and risk-conferring polymorphisms has been defined in SLC1A1, BDNF, DLGAP3, and GRIN2B and in interactions between these individual genes. Further research is needed with detailed characterization of large samples. In particular interactions between genetic risk constellations, pharmacological and psychosocial factors should be analysed. Results will further define homogeneous subgroups, which are in need for differential causative interventions. In clinical practise, schizophrenia patients should be carefully monitored for OCS, starting with at-risk mental states of psychosis and longitudinal follow-ups, hopefully leading to the development of multimodal therapeutic interventions.
Bhanu PS Kaurav; Manish M Wanjari; Amol Chandekar; Nagendra Singh Chauhan; Neeraj Upmanyu
ABSTRACT Objective:To study the influence of methanolic and aqueous extract ofWithania somnifera (W. somnifera) root on the marble-burying behavior of mice a well-accepted model of obsessive compulsive behavior.Methods:Mice were divided in different groups(n=6).Fluoxetine(5,10,15 mg/kg), (10,25,50,100 mg/kg) and methanolic extractW. somnifera(MEWS)(10,25,50,100 mg/kg) were administered i.p.30 min. prior to the assessment of marble burying behavior and locomotor activity.The control group received vehicle of the extract.Results:Administration of aqueous extractsW. somnifera(AEWS) andMEWS(50 mg/kg) successively decreaesed the marble burying behavior activity without affecting motor activity.This effect ofAEWS andMEWS was comparable to standard fluoxetine, ritanserin and parachlorophenylalanine.Conclusions:W. somnifera extract is effective in treating obsessive compulsive disorder.
Oren, Ela; Friedmann, Naama; Dar, Reuven
The study examined the prediction that obsessive-compulsive tendencies are related to an attenuated sense of agency (SoA). As most explicit agency judgments are likely to reflect also motivation for and expectation of control, we examined agency in sentence production. Reduced agency can be expressed linguistically by omitting the agent or by using grammatical framings that detach the event from the entity that caused it. We examined the use of agentic language of participants with high vs. low scores on a measure of obsessive-compulsive (OC) symptoms, using structured linguistic tasks in which sentences are elicited in a conversation-like setting. As predicted, high OC individuals produced significantly more non-agentic sentences than low OC individuals, using various linguistic strategies. The results suggest that OC tendencies are related to attenuated SoA. We discuss the implications of these findings for explicating the SoA in OCD and the potential contribution of language analysis for understanding psychopathology. PMID:27003263
Franklin, Martin E; Kratz, Hilary E; Freeman, Jennifer B; Ivarsson, Tord; Heyman, Isobel; Sookman, Debbie; McKay, Dean; Storch, Eric A; March, John
The efficacy of cognitive-behavioral therapy (CBT) for pediatric obsessive-compulsive disorder (OCD) has been the subject of much study over the past fifteen years. Building on a foundation of case studies and open clinical trials, the literature now contains many methodologically sound studies that have compared full CBT protocols to waitlist controls, pill placebo, psychosocial comparison conditions, active medication, combined treatments, and brief CBT. This review is part of a series commissioned by The Canadian Institute for Obsessive Compulsive Disorders (CIOCD) in an effort to publish in one place what is known about the efficacy of treatments for OCD. A total of fourteen studies were identified; collectively their findings support the efficacy of CBT for youth with OCD. CBT protocols that emphasized either strictly behavioral or cognitive conceptualizations have each been found efficacious relative to waitlist controls. Efforts to enhance CBT׳s efficacy and reach have been undertaken. These trials provide guidance regarding next steps to be taken to maximize efficacy and treatment availability. Findings from studies in community clinics suggest that significant treatment benefits can be realized and are not reported only from within academic contexts. These findings bode well for broader dissemination efforts. Recommendations for future research directions are provided.
Fullana, Miquel Angel; Mataix-Cols, David; Caseras, Xavier; Alonso, Pino; Manuel Menchón, Josep; Vallejo, Julio; Torrubia, Rafael
Recent factor-analytic studies involving over 2000 patients have reduced the symptoms of obsessive-compulsive disorder (OCD) into a few dimensions or potentially overlapping syndromes. Hoarding consistently emerged as a separate factor in all these studies. This study investigated the relationship between OCD symptom dimensions and normal personality traits in a sample of 56 OCD patients. They were administered the Sensitivity to Punishment and Sensitivity to Reward Questionnaire and the Eysenck Personality Questionnaire, derived from Gray's and Eysenck's personality models, respectively. The personality scores were correlated with previously identified symptom dimensions from the Yale-Brown Obsessive-Compulsive Scale Symptom Checklist (Y-BOCS-SC), controlling for overall illness severity. High scores on the hoarding dimension of the Y-BOCS-SC were positively correlated with scores on the Sensitivity to Punishment scale and negatively with Eysenck's Psychoticism scale. While high sensitivity to punishment is a personality feature common to many OCD patients, it is more strongly pronounced in patients with hoarding symptoms. These patients also appear to be less impulsive or novelty seeking as reflected by low scores on Eysenck's Psychoticism scale. High sensitivity to punishment and low novelty seeking in OCD hoarders might explain their poor compliance and response to conventional treatments, but this question needs to be explored further in a prospective treatment study.
García-Soriano, Gemma; Rosell-Clari, Vicent; Serrano, Miguel Ángel
Different variables have been associated with the development/ maintenance of contamination-related obsessive-compulsive disorder (OCD), although the relevance of these factors has not been clearly established. The present study aimed to analyze the relevance and specificity of these variables. Forty-five women with high scores on obsessive-compulsive contamination symptoms (n = 16) or checking symptoms (n = 15), or non-clinical scores (n = 14) participated in a behavioral approach/avoidance task (BAT) with a contamination-OCD stimulus. Vulnerability variables and participants' emotional, cognitive, physiological and behavioral responses to the BAT were appraised. Results show that fear of illness was a relevant vulnerability variable specific to contamination participants (p = .001; η2 p = .291). Contamination participants responded with significantly higher subjective disgust (p =.001; η2 p = .269), anxiety (p = .001; η2 p = .297), urge to wash (p contamination severity (p = .002; η2 p = .260) appraisals, and with lower behavioral approach (p = .008; η2 p = .208) than the other two groups. Moreover, contamination participants showed lower heart rate acceleration (p = .046; η2 p = .170) and higher contamination likelihood appraisals (p contamination symptoms.
Bulli, Francesco; Melli, Gabriele; Cavalletti, Veronica; Stopani, Eleonora; Carraresi, Claudia
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.
Stein, D J; Liu, Y; Shapira, N A; Goodman, W K
Psychobiologic models of obsessive-compulsive disorder (OCD) have focused on cortico-striatal-thalamic-cortical (CTSC) circuits, noting normal function in cognitive and motoric procedural strategies. Such models have relied on the classification of OCD as an anxiety disorder, seldom exploring other relevant emotions. Based on the hypothesis that a central emotion in OCD is disgust, the authors review the literature on its psychobiology and its relevance to current models of OCD. There are important parallels between the psychobiology of OCD and that of disgust. Obsessive- compulsive disorder may be conceptualized in terms of a false contamination alarm in which disgust plays a crucial organizing or embodying role, not only at a basic brain level, but also in terms of the psychosocial aspects of the disorder. Just as psychobiologic models of panic disorder and post- traumatic stress disorder have been strengthened by the inclusion of preclinical work on amygdala-mediated fear conditioning, so findings on disgust and its mediating CSTC circuits may generate useful hypotheses for OCD research.
Full Text Available Introduction Social physique anxiety (SPA and Obsessive-compulsive disorders (OCD are highly correlated and have been considered to be important in understanding eating problems. HoweverSPA and OCD have not been directly studied with respect to eating problems. Thus, the aim of this study was to examine the relationship between SPA and OCD and measures of eating problems.Materials and Methods This cross-sectional analytical study was done on 100 adolescent girls in Isfahan-Iran. The girls completed questionnaires measuring Social physique anxiety scale (SPAS, 17-item, Obsessive-Compulsive Disorders (30- item and Eating problems (31-item. Data were analyzed by the statistical tests of Pearson correlation coefficient, Student’s t-test, one-way analysis of variance (ANOVA, and regression through SPSS version 14.Results The mean age of students was 15.1+ 2.3, 53% had normal Body mass index (BMI and 83% of them had moderate economical status. There was a positive correlation between the rate of eating problems symptoms with OCD (P
Full Text Available Introduction. The obsessive compulsive disorder (OCD is one of psychiatric disorder that has correlation to factors such as sex, marriage, job, IQ and socieconomic state. There is not any documented information about the OCD and correlated faceors in our community. In this study the prevalence and severity of four patterns of OCD in medical and engineers student were estimated. Methods. One hundred and sixty medical students (from IUMSHS and 160 engineer students (from Isfahan University were selected, randomly. Four patterns of OCD that was studied include checking, cleaning, doubting and slowness. The study was performed by application of moudsley obsessive compulsive inventory (MOCL that include 30 items about symptoms of OCD. Results. Estimated frequncies were 45 percent for cleaning, 42.8 percent for checking 20.3 percent for slowness and 41.2 percent for doubting. Discussion. It seems that there is no relation between study course and ineidence of subtype of OCD. The checking subtype in males and washing subtype in females had greater frequency and severity than other subtypes. But there was no relation between sexuality and two other subtypes (slowness and doubting. The frequency of checking subtype was greater in single student than married stuedents.
Gezginç, Kazim; Uguz, Faruk; Karatayli, Savaş; Zeytinci, Esra; Aşkin, Rüstem; Güler, Ozkan; Sahin, Figen; Murat Emül, H; Ozbulut, Omer; Geçici, Omer
Aim. To examine the effects of obsessive-compulsive disorder (OCD) on quality of life in pregnant women. Material and method. Twenty-five pregnant women diagnosed as OCD in two university outpatient clinics were included for the study. Twenty-five pregnant women with no mental disorders and the same sociodemographic properties were taken as the control group. The diagnosis of OCD was confirmed with the DSM-IV Axis-I Disorders Structured Clinic Interview Diagnosis/Clinic Version (SCID-I/CV). In order to measure the severity of OCD Yale-Brown Obsession and Compulsion Scale was performed. Quality of life was evaluated by WHO (World Health Organisation) Life Quality Scale - Short Form (WHOQOL-Brief). Results. The whole subgroup of points of WHOQOL-Brief was significantly lower in OCD patients compared to control group (in all subgroups Penviromental areas. Besides, there was a negative correlation between the duration of OCD and WHOQOL-Brief psychological health subarea (P <0.05). Conclusion. OCD negatively effects the quality of life in pregnant women and is correlated with the severity of the disorder. PMID:24916624
Ana Cristina Pedron
Full Text Available There is no consensus in the literature as to neuropsychological functioning, the severity of obsessive-compulsive symptoms (OCS and the definitions of the OCS dimensions. We conducted a cross-sectional study investigating the relationship between executive function and OCS severity in the various dimensions, according to the Dimensional Yale-Brown Obsessive-Compulsive Scale criteria. We evaluated 28 patients with OCS, using eight neuropsychological instruments to evaluate executive function. We found that OCS severity in the contamination/cleaning dimension correlates negatively with executive function, inhibitory control and attentional control. Severity in the hoarding dimension correlated positively with cognitive flexibility, visual processing and logical reasoning, whereas it correlated negatively with the capacity to develop efficient complex problem-solving strategies. There was also a positive correlation between severity in the symmetry/ordering dimension and attentional control. Our findings suggest that the profile of executive function in OCD is defined by the severity of the various OCS dimensions.
Goods, N A R; Rees, C S; Egan, S J; Kane, R T
Inferential confusion is an under-researched faulty reasoning process in obsessive-compulsive disorder (OCD). Based on an overreliance on imagined possibilities, it shares similarities with the extensively researched construct of thought-action fusion (TAF). While TAF has been proposed as a specific subset of the broader construct of magical thinking, the relationship between inferential confusion and magical thinking is unexplored. The present study investigated this relationship, and hypothesised that magical thinking would partially mediate the relationship between inferential confusion and obsessive-compulsive symptoms. A non-clinical sample of 201 participants (M = 34.94, SD = 15.88) were recruited via convenience sampling. Regression analyses found the hypothesised mediating relationship was supported, as magical thinking did partially mediate the relationship between inferential confusion and OC symptoms. Interestingly, inferential confusion had the stronger relationship with OC symptoms in comparison to the other predictor variables. Results suggest that inferential confusion can both directly and indirectly (via magical thinking) impact on OC symptoms. Future studies with clinical samples should further investigate these constructs to determine whether similar patterns emerge, as this may eventually inform which cognitive errors to target in treatment of OCD. PMID:25265223
Atalay, Hakan; Atalay, Figen; Karahan, Dilara; Caliskan, Mecit
Aim. The aim of the present article is to investigate the activation patterns of early maladaptive schemas (EMSs) in patients with obsessive-compulsive disorder (OCD). Method. During the time between 1 January 2006 and 1 April 2006, 45 consecutive patients from an outpatient facility of a general hospital and 45 age- and gender-matched healthy control subjects from the hospital staff were included in the study. They were administered the Structured Clinical Interview for Diagnosis of DSM-IV Mental Disorders (SCID-1), the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-2), the Young Schema Questionnaire-Short Form (YSQ-SF), the Young Parenting Inventory (YPI) and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). The results were assessed using GraphPad Prisma V.3 statistical program. Results. The YSQ total score of the OCD group was significantly higher than the control group (t=3.62, Pschemas were significantly higher than the average scores of the control group, although the others did not make any difference between the OCD and control groups. Conclusion. The study demonstrates that, in the patients with OCD, most of the early maladaptive schemas including social isolation, vulnerability and pessimism, are prominently activated. PMID:24937713
Kim, Ji Eun; Lee, Sang Won; Lee, Seung Jae
The aims of this study were to evaluate early maladaptive schemas (EMSs) of patients with obsessive-compulsive disorder (OCD) and to clarify relationships between particular EMSs and the five factor-analyzed symptom dimensions and other clinical variables. Fifty-seven patients with OCD and 70 normal controls completed the Young Schema Questionnaire, the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Y-BOCS symptom checklist, and the Beck Depression Inventory. Patients with OCD had significantly higher scores for schema related to defectiveness/shame, social isolation/alienation, and failure than did normal controls. Among the five OCD symptom dimensions, the sexual/religious dimension was only significantly correlated with two schemas of vulnerability to harm or illness and enmeshment/undeveloped self. These two schemas were significant predictors of the sexual/religious dimension, accounting for 33% of the total variance in this dimension. Any EMSs in patients with OCD were not related to clinical variables such as severity of OCD and duration of illness. These findings may constitute evidence to improve our understandings of OCD from a perspective of schema theory. PMID:23962740
Coffey, B J; Miguel, E C; Biederman, J; Baer, L; Rauch, S L; O'Sullivan, R L; Savage, C R; Phillips, K; Borgman, A; Green-Leibovitz, M I; Moore, E; Park, K S; Jenike, M A
Clinical research has documented a bidirectional overlap between Tourette's disorder (TD) and obsessive-compulsive disorder (OCD) from familial-genetic, phenomenological, comorbidity, and natural history perspectives. Patients with Tourette's disorder plus obsessive-compulsive disorder (TD + OCD), a putative subtype, share features of both. The purpose of this exploratory study was to evaluate correlates of patients with TD, OCD, and TD + OCD to determine whether TD + OCD is a subtype of TD, OCD, or an additive form of both. Sixty-one subjects with TD, OCD, or TD + OCD were evaluated with the Structured Clinical Interview for DSM-III-R supplemented with additional modules. The three groups differed in the rates of bipolar disorder (p < .04), social phobia (p < .02), body dysmorphic disorder (p < .002), attention deficit hyperactivity disorder (p < .03), and substance use disorders (p < .04). These findings were accounted for by the elevated rates of the disorders in the TD + OCD group compared with the TD and OCD groups. These finding are most consistent with the hypothesis that TD + OCD is a more severe disorder than TD and OCD and may be more etiologically linked to TD than to OCD. These findings highlight the importance of assessment of the full spectrum of psychiatric comorbidity in patients with TD and OCD.
Wetterneck, Chad T; Little, Tannah E; Chasson, Gregory S; Smith, Angela H; Hart, John M; Stanley, Melinda A; Björgvinsson, Thröstur
Previous research has demonstrated that comorbid obsessive-compulsive personality disorder (OCPD) in patients with obsessive-compulsive disorder (OCD) is associated with greater overall OCD severity, functional impairment, and poorer treatment outcomes (Coles et al., 2008; Lochner et al., 2010; Pinto, 2009). However, research has only examined the effects of OCPD categorically and has yet to thoroughly examine the impact of individual OCPD characteristics dimensionally. Thus, the present study sought to investigate the relationships between various OCPD-related dimensions (e.g., perfectionism, rigidity) and OCD symptomology and severity. The study recruited a sample of OCD patients (n=51) in the OCD units of two residential treatment facilities. Findings yielded significant relationships between OCD severity and the following OCPD dimensions: flexibility, doubts about actions (a dimension of perfectionism), and hoarding. Interpretations of these results and the implications for diagnosis, prognosis, and treatment outcome are discussed. Furthermore, the current study provides insight into a unique perspective which leaves room for more symptom overlap and variability between OCD and OCPD.
de Koning, Pelle P; Figee, Martijn; Endert, Erik; Storosum, Jitschak G; Fliers, Eric; Denys, Damiaan
Deep brain stimulation (DBS) is an effective treatment for obsessive-compulsive disorder (OCD), but its mechanism of action is largely unknown. Since DBS may induce rapid symptomatic changes and the pathophysiology of OCD has been linked to the hypothalamic-pituitary-adrenal (HPA) axis, we set out to study whether DBS affects the HPA axis in OCD patients. We compared a stimulation ON and OFF condition with a one-week interval in 16 therapy-refractory OCD patients, treated with DBS for at least one year, targeted at the nucleus accumbens (NAc). We measured changes in 24-h urinary excretion of free cortisol (UFC), adrenaline and noradrenaline and changes in obsessive-compulsive (Y-BOCS), depressive (HAM-D) and anxiety (HAM-A) symptom scores. Median UFC levels increased with 53% in the OFF condition (from 93 to 143nmol/24h, p=0.12). There were no changes in urinary adrenaline or noradrenaline excretion. The increase in Y-BOCS (39%), and HAM-D (78%) scores correlated strongly with increased UFC levels in the OFF condition. Our findings indicate that symptom changes following DBS for OCD patients are associated with changes in UFC levels. PMID:23333254
Baas, Johanna M P; Klumpers, Floris; Mantione, Mariska H; Figee, Martijn; Vulink, Nienke C; Schuurman, P Richard; Mazaheri, Ali; Denys, Damiaan
Deep brain stimulation (DBS) of the ventral internal capsule is effective in treating therapy refractory obsessive-compulsive disorder (OCD). Given the close proximity of the stimulation site to the stria terminalis (BNST), we hypothesized that the striking decrease in anxiety symptoms following DBS could be the result of the modulation of contextual anxiety. However, the effect of DBS in this region on contextual anxiety is as of yet unknown. Thus, the current study investigated the effect of DBS on contextual anxiety in an experimental threat of shock paradigm. Eight patients with DBS treatment for severe OCD were tested in a double-blind crossover design with randomly assigned 2-week periods of active and sham stimulation. DBS resulted in significant decrease of obsessive-compulsive symptoms, anxiety, and depression. However, even though the threat manipulation resulted in a clear context-potentiated startle effect, none of the parameters derived from the startle recordings was modulated by the DBS. This suggests that DBS in the ventral internal capsule is effective in treating anxiety symptoms of OCD without modulating the startle circuitry. We hypothesize that the anxiety symptoms present in OCD are likely distinct from the pathological brain circuits in defensive states of other anxiety disorders. PMID:25249953
Tierney, Travis S; Abd-El-Barr, Muhammad M; Stanford, Arielle D; Foote, Kelly D; Okun, Michael S
Surgical therapy for treatment-resistant obsessive compulsive disorder (OCD) remains an effective option for well-selected patients managed within a multidisciplinary setting. Historically, lesions within the limbic system have been used to control both obsessive thoughts and repetitive compulsions associated with this disease. We discuss classical targets as well as contemporary neuromodulatory approaches that have been shown to provide symptomatic relief. Recently, deep brain stimulation (DBS) of the anterior limb of the internal capsule/ventral striatum received Conformité Européene (CE) mark and Food and Drug Administration (FDA) approvals for treatment of intractable OCD. Remarkably, this is the first such approval for neurosurgical intervention in a strictly psychiatric indication in modern times. This target is discussed in detail along with alternative targets currently being proposed. We close with a discussion of gamma knife capsulotomy, a modality with deep historical roots. Further directions in the surgical treatment of OCD will require better preoperative predictors of postoperative responses, optimal selection of individualized targets, and rigorous reporting of adverse events and standardized outcomes. To meet these challenges, centers must be equipped with a multidisciplinary team and patient-centered approach to ensure adequate screening and follow up of patients with this difficult-to-treat condition. PMID:24099662
Lipsman, Nir; Giacobbe, Peter; Lozano, Andres M
The last decade has seen a significant rise in interest in the use of deep brain stimulation (DBS) for the management of obsessive-compulsive disorder (OCD), one of psychiatry's most challenging conditions. The prominent role of both thought (obsessions) and motor (compulsions) dysfunction in OCD place the condition at the border between the neurological and the psychiatric. This is supported by a growing body of literature that implicates structures in decision-making, reward, and action-selection circuits in the disorder. Here, we provide an overview of the neurocircuitry of OCD while reviewing the DBS literature to date for the condition. Results of DBS trials in treatment- resistant OCD have been remarkably similar, with clinical response rates in the range of 40-60%, despite the use of a diverse range of targets. These results imply that a common underlying circuit is being modulated, and moreover that there is room for improvement, and debate, in the development of an evidence-driven DBS treatment for this chronic, debilitating illness. PMID:24112898
Atalay, Hakan; Atalay, Figen; Karahan, Dilara; Caliskan, Mecit
Aim. The aim of the present article is to investigate the activation patterns of early maladaptive schemas (EMSs) in patients with obsessive-compulsive disorder (OCD). Method. During the time between 1 January 2006 and 1 April 2006, 45 consecutive patients from an outpatient facility of a general hospital and 45 age- and gender-matched healthy control subjects from the hospital staff were included in the study. They were administered the Structured Clinical Interview for Diagnosis of DSM-IV Mental Disorders (SCID-1), the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-2), the Young Schema Questionnaire-Short Form (YSQ-SF), the Young Parenting Inventory (YPI) and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). The results were assessed using GraphPad Prisma V.3 statistical program. Results. The YSQ total score of the OCD group was significantly higher than the control group (t=3.62, Pschemas were significantly higher than the average scores of the control group, although the others did not make any difference between the OCD and control groups. Conclusion. The study demonstrates that, in the patients with OCD, most of the early maladaptive schemas including social isolation, vulnerability and pessimism, are prominently activated.
Full Text Available Abstract Background Cognitive behavior therapy (CBT is widely regarded as an effective treatment for obsessive compulsive disorder (OCD, but access to CBT therapists is limited. Internet-based CBT (ICBT with therapist support is a way to increase access to CBT but has not been developed or tested for OCD. The aim of this study was to evaluate ICBT for OCD. Method An open trial where patients (N = 23 received a 15-week ICBT program with therapist support consisting of psychoeducation, cognitive restructuring and exposure with response prevention. The primary outcome was the Yale-Brown Obsessive Compulsive Scale (Y-BOCS, which was assessed by a psychiatrist before and immediately after treatment. Secondary outcomes were self-rated measures of OCD symptoms, depressive symptoms, general functioning, anxiety and quality of life. All assessments were made at baseline and post-treatment. Results All participants completed the primary outcome measure at all assessment points. There were reductions in OCD symptoms with a large within-group effect size (Cohen's d = 1.56. At post-treatment, 61% of participants had a clinically significant improvement and 43% no longer fulfilled the diagnostic criteria of OCD. The treatment also resulted in statistically significant improvements in self-rated OCD symptoms, general functioning and depression. Conclusions ICBT with therapist support reduces OCD symptoms, depressive symptoms and improves general functioning. Randomized trials are needed to confirm the effectiveness of this new treatment format. Trial Registration ClinicalTrials.gov: NCT01348529
Rodriguez, Carolyn I; Kegeles, Lawrence S; Levinson, Amanda; Feng, Tianshu; Marcus, Sue M; Vermes, Donna; Flood, Pamela; Simpson, Helen B
Serotonin reuptake inhibitors (SRIs), the first-line pharmacological treatment for obsessive-compulsive disorder (OCD), have two limitations: incomplete symptom relief and 2-3 months lag time before clinically meaningful improvement. New medications with faster onset are needed. As converging evidence suggests a role for the glutamate system in the pathophysiology of OCD, we tested whether a single dose of ketamine, a non-competitive N-methyl-D-aspartate (NMDA) glutamate receptor antagonist, could achieve rapid anti-obsessional effects. In a randomized, double-blind, placebo-controlled, crossover design, drug-free OCD adults (n=15) with near-constant obsessions received two 40-min intravenous infusions, one of saline and one of ketamine (0.5 mg/kg), spaced at least 1-week apart. The OCD visual analog scale (OCD-VAS) and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) were used to assess OCD symptoms. Unexpectedly, ketamine's effects within the crossover design showed significant (pobsessions (measured by OCD-VAS) during the infusion compared with subjects receiving placebo (n=7). One-week post-infusion, 50% of those receiving ketamine (n=8) met criteria for treatment response (≥35% Y-BOCS reduction) vs 0% of those receiving placebo (n=7). Rapid anti-OCD effects from a single intravenous dose of ketamine can persist for at least 1 week in some OCD patients with constant intrusive thoughts. This is the first randomized, controlled trial to demonstrate that a drug affecting glutamate neurotransmission can reduce OCD symptoms without the presence of an SRI and is consistent with a glutamatergic hypothesis of OCD. PMID:23783065
Bourne, Sarah K; Eckhardt, Christine A; Sheth, Sameer A; Eskandar, Emad N
Deep brain stimulation (DBS) has emerged as a safe, effective, and reversible treatment for a number of movement disorders. This has prompted investigation of its use for other applications including psychiatric disorders. In recent years, DBS has been introduced for the treatment of obsessive compulsive disorder (OCD), which is characterized by recurrent unwanted thoughts or ideas (obsessions) and repetitive behaviors or mental acts performed in order to relieve these obsessions (compulsions). Abnormal activity in cortico-striato-thalamo-cortical (CSTC) circuits including the orbitofrontal cortex (OFC), anterior cingulate cortex (ACC), ventral striatum, and mediodorsal (MD) thalamus has been implicated in OCD. To this end a number of DBS targets including the anterior limb of the internal capsule (ALIC), ventral capsule/ventral striatum (VC/VS), ventral caudate nucleus, subthalamic nucleus (STN), and nucleus accumbens (NAc) have been investigated for the treatment of OCD. Despite its efficacy and widespread use in movement disorders, the mechanism of DBS is not fully understood, especially as it relates to psychiatric disorders. While initially thought to create a functional lesion akin to ablative procedures, it is increasingly clear that DBS may induce clinical benefit through activation of axonal fibers spanning the CSTC circuits, alteration of oscillatory activity within this network, and/or release of critical neurotransmitters. In this article we review how the use of DBS for OCD informs our understanding of both the mechanisms of DBS and the circuitry of OCD. We review the literature on DBS for OCD and discuss potential mechanisms of action at the neuronal level as well as the broader circuit level. PMID:22712007
Sarah Kathleen Bourne
Full Text Available Deep brain stimulation (DBS has emerged as a safe, effective, and reversible treatment for a number of movement disorders. This has prompted investigation of its use for other applications including psychiatric disorders. In recent years, DBS has been introduced for the treatment of obsessive-compulsive disorder (OCD, which is characterized by recurrent unwanted thoughts or ideas (obsessions and repetitive behaviors or mental acts performed in order to relieve these obsessions (compulsions. Abnormal activity in cortico-striato-thalamo-cortical (CSTC circuits including the orbitofrontal cortex, anterior cingulate cortex, ventral striatum, and mediodorsal thalamus has been implicated in OCD. To this end a number of DBS targets including the anterior limb of the internal capsule, ventral capsule/ventral striatum, ventral caudate nucleus, subthalamic nucleus, nucleus accumbens, and the inferior thalamic peduncle have been investigated for the treatment of OCD. Despite its efficacy and widespread use in movement disorders, the mechanism of DBS is not fully understood, especially as it relates to psychiatric disorders. While initially thought to create a functional lesion akin to ablative procedures, it is increasingly clear that DBS may induce clinical benefit through activation of axonal fibers spanning the CSTC circuits, alteration of oscillatory activity within this network, and/or release of critical neurotransmitters. In this article we review how the use of DBS for OCD informs our understanding of both the mechanisms of DBS and the circuitry of OCD. We review the literature on DBS for OCD and discuss potential mechanisms of action at the neuronal level as well as the broader circuit level.
Toffolo, Marieke B J; van den Hout, Marcel A; Engelhard, Iris M; Hooge, Ignace T C; Cath, Daniëlle C
Patients with obsessive-compulsive disorder (OCD) not only respond to obsessions with perseverative checking, but also engage in more general checking, irrespective of their obsessive concerns. This study investigated whether general checking is specific to OCD and exacerbated when only mild uncertainty is induced. Thirty-one patients with OCD, 26 anxiety- and 31 healthy controls performed a visual search task with eye-tracking and indicated in 50 search displays whether a target was "present" or "absent". Target-present trials were unambiguous, whereas target-absent trials induced mild uncertainty, because participants had to rely on not overlooking the target. Checking behavior was measured by assessing search time and the number of fixations, measured with an eye-tracker. Results showed that in both target-present and target-absent trials patients with OCD searched longer and made more fixations than healthy and anxiety controls. However, the difference in checking behavior between patients with OCD and the control groups was larger in target-absent trials (where mild uncertainty was induced). Anxiety and healthy controls did not differ in checking behavior. Thus, mild uncertainty appears to specifically promote checking in patients with OCD, which has implications for treatment. PMID:27423170
Woody, Erik Z.; Szechtman, Henry
In response to commentary by S. Taylor, D. McKay, and J. S. Abramowitz, the authors discuss the distinctive features of their theory of obsessive-compulsive disorder outlined in their original article, which explains the disorder as a dysfunction of a security-motivation system. The authors address issues of the interrelation of emotion,…
Speckens, A.E.M.; Hackmann, A.; Ehlers, A.; Cuthbert, B.
Mental imagery is increasingly considered to be an important feature in anxiety disorders. The aim of this study was to investigate the prevalence and characteristics of mental images in obsessive compulsive disorder (OCD) and their possible association with earlier adverse events. A consecutive sam
Olatunji, Bunmi O.; Rosenfield, David; Tart, Candyce D.; Cottraux, Jean; Powers, Mark B.; Smits, Jasper A. J.
Objective: To examine symptom change over time, the effect of attrition on treatment outcome, and the putative mediators of cognitive therapy (CT) versus behavior therapy (BT) for obsessive-compulsive disorder (OCD) using archival data. Method: Sixty-two adults with OCD were randomized to 20 sessions of CT (N = 30) or BT (N = 32) that consisted of…
Krebs, Georgina; Bolhuis, Koen; Heyman, Isobel; Mataix-Cols, David; Turner, Cynthia; Stringaris, Argyris
Background: Temper outbursts in youth with obsessive-compulsive disorder (OCD) are a common source of concern, but remain poorly understood. This study examined a set of hypotheses related to: (a) the prevalence of temper outbursts in paediatric OCD, (b) the associations of temper outbursts with OCD severity and depressive symptoms; and (c) the…
Huyser, Chaim; Veltman, Dick J.; Wolters, Lidewij H.; de Haan, Else; Boer, Frits
Objective: Pediatric obsessive compulsive disorder (OCD) has been associated with cognitive abnormalities, in particular executive impairments, and dysfunction of frontal-striatal-thalamic circuitry. The aim of this study was to investigate if planning as an executive function is compromised in pediatric OCD and is associated with…
Lin, Haiqun; Katsovich, Liliya; Ghebremichael, Musie; Findley, Diane B.; Grantz, Heidi; Lombroso, Paul J.; King, Robert A.; Zhang, Heping; Leckman, James F.
Background: The goals of this prospective longitudinal study were to monitor levels of psychosocial stress in children and adolescents with Tourette syndrome (TS) and/or obsessive-compulsive disorder (OCD) compared to healthy control subjects and to examine the relationship between measures of psychosocial stress and fluctuations in tic,…
Guglielmi, Valeria; Vulink, Nienke C C; Denys, D.; Wang, Ying; Samuels, Jack F; Nestadt, Gerald
BACKGROUND: Women with obsessive-compulsive disorder (OCD) often report that symptoms first appear or exacerbate during reproductive cycle events; however, little is known about these relationships. The goals of this study were to examine, in a US and a European female OCD sample, onset and exacerba
Faragian, Sarit; Kurs, Rena; Poyurovsky, Michael
A substantial proportion of adolescent schizophrenia patients also has obsessive-compulsive disorder (OCD). As the reliability of OCD identification in schizophrenia has been challenged, we evaluated insight into OCD symptoms and awareness of schizophrenia, using the Brown Assessment of Beliefs Scale and the Scale to Assess Unawareness of Mental…
Steinhausen, Hans-Christoph; Bisgaard, Charlotte; Munk-Jørgensen, Povl;
This nationwide register-based study investigates how often obsessive-compulsive disorders (OCD) with different age at diagnosis occur in affected families compared to control families. Furthermore, the study addresses the impact of certain risk factors, that is, sex, degree of urbanization, year...
Gul Eryilmaz; Sermin Kesebir; Işil Göğcegöz Gül; Eylem Özten; Kayihan Oğuz Karamustafalioğlu
Objective The aim of this study is to investigate the presence of dissociative symptoms and whether they are related to childhood trauma and obsessive-compulsive symptoms in bipolar disorder type II (BD-II). Methods Thirty-three euthymic patients (HDRS
Ota, Toyosaku; Iida, Junzo; Sawada, Masayuki; Suehiro, Yuko; Yamamuro, Kazuhiko; Matsuura, Hiroki; Tanaka, Shohei; Kishimoto, Naoko; Negoro, Hideki; Kishimoto, Toshifumi
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.…
J.F. Leckman; D. Denys; H.B. Simpson; D. Mataix-Cols; E. Hollander; S. Saxena; E.C. Miguel; S.L. Rauch; W.K. Goodman; K.A. Phillips; D.J. Stein
BACKGROUND: Since the publication of the DSM-IV in 1994, research on obsessive-compulsive disorder (OCD) has continued to expand. It is timely to reconsider the nosology of this disorder, assessing whether changes to diagnostic criteria as well as subtypes and specifiers may improve diagnostic valid
P.P. de Koning; M. Figee; P. van den Munckhof; P.R. Schuurman; D. Denys
Obsessive-compulsive disorder (OCD) is a chronic psychiatric disorder that affects 2% of the general population. Despite optimal cognitive-behavioral and pharmacologic therapy, approximately 10% of patients remain treatment resistant. Currently, deep brain stimulation (DBS) is being investigated as
Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder with an estimated life-time prevalence of 2%. Severe OCD leads to pronounced suffering and has a major impact on family relationships, social life and the capacity to function at work. At present, clinical management of OCD consists
Twohig, Michael P.; Hayes, Steven C.; Plumb, Jennifer C.; Pruitt, Larry D.; Collins, Angela B.; Hazlett-Stevens, Holly; Woidneck, Michelle R.
Objective: Effective treatments for obsessive-compulsive disorder (OCD) exist, but additional treatment options are needed. The effectiveness of 8 sessions of acceptance and commitment therapy (ACT) for adult OCD was compared with progressive relaxation training (PRT). Method: Seventy-nine adults (61% female) diagnosed with OCD (mean age = 37…
Huang, Li-Chung; Tsai, Kuen-Jer; Wang, Hao-Kuang; Sung, Pi-Shan; Wu, Ming-Hsiu; Hung, Kuo-Wei; Lin, Sheng-Hsiang
Obsessive-compulsive disorder (OCD) is a chronic debilitating anxiety disorder significant in intrusive thoughts and compensation repetitive behaviors. Few studies have reported on this condition Asia. This study estimated the prevalence, incidence and psychiatric comorbidities of OCD in Taiwan. We identified study subjects for 2000-2008 with a principal diagnosis of OCD according to the International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) diagnostic criteria by using National Health Research Institute database. These patients received either outpatient or inpatient care for their condition. Rates were directly age- and sex-adjusted to the 2004 Taiwan population distribution. The estimated mean annual incidence was 27.57 per 10(5) inhabitants and the one year prevalence was 65.05 per 10(5) inhabitants. Incidence and prevalence increased with age, peaking at age 18-24 years in males and at 35-44 years in females. About 53% of adults (≥18 years) and 48% of child and adolescent patients (6-17 years) had one or more comorbid psychiatric conditions. The most common comorbid diagnosis was depressive disorders for both adult and child-adolescent patients. We found a lower prevalence and incidence of clinically diagnosed OCD than that of community studies. Many Asian patients with OCD also had various psychiatric comorbidities, a clinically relevant finding. PMID:25169892
Juliana Belo Diniz
Full Text Available INTRODUCTION: In obsessive-compulsive disorder, early treatment discontinuation can hamper the effectiveness of first-line treatments. OBJECTIVE: This study aimed to investigate the clinical correlates of early treatment discontinuation among obsessive-compulsive disorder patients. METHODS: A group of patients who stopped taking selective serotonin reuptake inhibitors (SSRIs or stopped participating in cognitive behavioral therapy before completion of the first twelve weeks (total n = 41; n = 16 for cognitive behavioral therapy and n = 25 for SSRIs were compared with a paired sample of compliant patients (n = 41. Demographic and clinical characteristics were obtained at baseline using structured clinical interviews. Chisquare and Mann-Whitney tests were used when indicated. Variables presenting a p value <0.15 for the difference between groups were selected for inclusion in a logistic regression analysis that used an interaction model with treatment dropout as the response variable. RESULTS: Agoraphobia was only present in one (2.4% patient who completed the twelve-week therapy, whereas it was present in six (15.0% patients who dropped out (p = 0.044. Social phobia was present in eight (19.5% patients who completed the twelve-week therapy and eighteen (45% patients who dropped out (p = 0.014. Generalized anxiety disorder was present in eight (19.5% patients who completed the twelve-week therapy and twenty (50% dropouts (p = 0.004, and somatization disorder was not present in any of the patients who completed the twelveweek therapy; however, it was present in six (15% dropouts (p = 0.010. According to the logistic regression model, treatment modality (p = 0.05, agoraphobia, the Brown Assessment of Beliefs Scale scores (p = 0.03 and the Beck Anxiety Inventory (p = 0.02 scores were significantly associated with the probability of treatment discontinuation irrespective of interactions with other variables. DISCUSSION AND CONCLUSION: Early treatment
E. Salemink; L. Wolters; E. de Haan
BACKGROUND AND OBJECTIVES: Cognitive Behavioral Therapy for children and adolescents with Obsessive Compulsive Disorder (OCD) is effective. However, since almost half of patients remain symptomatic after treatment, there remains room for improvement. Cognitive Bias Modification training of Interpret
de Haan, Sanneke; Rietveld, Erik; Stokhof, Martin; Denys, D.
Deep Brain Stimulation (DBS) is a relatively new, experimental treatment for patients suffering from treatment-refractory Obsessive Compulsive Disorder (OCD). The effects of treatment are typically assessed with psychopathological scales that measure the amount of symptoms. However, clinical experie
Zai, Gwyneth; Brandl, Eva J; Müller, Daniel J; Richter, Margaret A; Kennedy, James L
Obsessive-compulsive disorder (OCD) is a chronic neuropsychiatric disorder with high genetic influence. Antidepressants such as serotonin reuptake inhibitors, are widely accepted as the first-line medications for OCD; however, approximately 50% of OCD patients show poor response. Personalized medicine utilizing genetic testing has recently received much attention because the variability of antidepressant response and tolerability are partly due to an individual's genetic variations. This has led to researchers investigating the role of specific genetic factors on antidepressant response and utility of testing in the clinical realm. Genetic test panels are showing promise for guiding antidepressant treatment to improve outcomes in depression. This article will review the most recent findings in the pharmacogenetics of OCD and its related disorders. Promising results have been reported for several serotonergic and glutamatergic system genes and the cytochrome CYP450 liver enzyme genes, which appear to play an important role in OCD and antidepressant response.
Brooks, Catherine Francis
This autoethnography offers an account of my experience with mental illness and provides an analysis of the performative aspects of obsessive-compulsive disorder (OCD). OCD is a genetic disorder triggered by environmental stressors involving a chemical imbalance in the brain. The resulting biologically altered state leaves individuals to steer themselves among and between "appropriate" performance and secret rituals. Analyzing my own communication practices through a performance lens highlights the importance of image management for people struggling with disability. In telling my own story, this article provides readers an in-depth look at OCD as a traumatic brain disorder whose sufferers rely on communicative performance to maintain their public and private identities, and as a disease that impedes social life for its sufferers. Implications of this account for those struggling with mental disability and for practitioners aiming to help them are discussed. PMID:20739588
Aghukwa, N C
The objective was to report a case of obsessive-compulsive disorder (OCD) with comorbid somatic symptoms that was complicated by movement disorders. A literature search on related issues was done online with Google Scholar, followed by a chronological report of the index case. This case presents a 52-year-old man who presented with intrusive, disturbing, and unreasonable thoughts at the mid adolescent time. Following these were complaints of multiple somatic symptoms which the patient labeled with different disease terms. The illness affected his academic, occupational, social, and marital role obligations. And lately, in the illness due to underlying predispositions, developed drug-related movement problems that worsened his state of handicap. This case attempts to point out the importance of early detection and cautious use of medications in patients, who present with OCDs with or without other psychiatric co-morbidities. PMID:26755234
Felipe Filardi da Rocha
Full Text Available OBJECTIVE: This study aims to evaluate the process of decision-making in patients with obsessive-compulsive disorder (OCD using the Iowa Gambling Task (IGT. In addition, we intend to expand the understanding of clinical and demographic characteristics that influence decision-making. METHOD: Our sample consisted of 214 subjects (107 diagnosed with OCD and 107 healthy controls who were evaluated on their clinical, demographic and neuropsychological features. Moreover, the Iowa Gambling Task (IGT, a task that detects and measures decision-making impairments, was used. RESULTS: We found that OCD patients performed significantly worse on the IGT. Furthermore, features such as symptoms of anxiety did not influence IGT performance. CONCLUSION: Impaired decision-making seems to be a key feature of OCD. Given that OCD is a complex heterogeneous disorder, homogeneous groups are necessary for an accurate characterization of our findings.
Full Text Available Obsessive Compulsive Disorder (OCD is a chronic and debilitating disorder that can cause significant distress and interference with daily functioning and impairment in quality of life, social and familial relationship. Selective serotonin reuptake inhibitors and cognitive-behavioral therapy are currently viewed as the first line treatments of choice for OCD. Approximately 30-40% OCD patients fail to respond to these treatments. Anterior capsulotomy, cingulotomy, limbic leucotomy, subcaudate tractotomy are used for the treatment of refractory OCD. The studies suggested that gamma knife capsulotomy caused improvements in 55-70% refractory OCD patients. Many studies suggest that psychosurgery is a beneficial, well tolerated and safe method. This study aimed to report efficacy, adverse effects and long term effects of surgery techniques especially gamma knife and deep brain stimulation in refractory OCD patients . [Archives Medical Review Journal 2015; 24(2.000: 239-250
Rodman, Alexandra M; Milad, Mohammed R; Deckersbach, Thilo; Im, Jamie; Chou, Tina; Dougherty, Darin D
Research in predictor studies has largely been limited to disorders such as obsessive-compulsive disorder (OCD), as it has a fairly well-established pathophysiology in the literature, and patients with OCD are more likely to receive neurotherapeutic treatment. As neurosurgical procedures are often invasive and involve standard risks associated with neurosurgery, along with a high cost, there is a major impetus to distinguish potential responders to treatment using neuroimaging techniques. This could not only assist in patient selection and improve response rates, but could also potentially be implemented to tailor a treatment avenue to an individual patient. Here we review studies that elucidate the pathophysiology of OCD, illustrate modern neurosurgical treatments and investigate predictive correlates of treatment outcome. PMID:22288677
Longley, Susan L; Calamari, John E; Wu, Kevin; Wade, Michael
In the context of the integrative model of anxiety and depression, we examined whether the essential problem of hypochondriasis is one of anxiety. When analyzed, data from a large nonclinical sample corresponded to the integrative model's characterization of anxiety as composed of both broad, shared and specific, unique symptom factors. The unique hypochondriasis, obsessive-compulsive, and panic attack symptom factors all had correlational patterns expected of anxiety with the shared, broad factors of negative emotionality and positive emotionality. A confirmatory factor analysis showed a higher-order, bifactor model was the best fit to our data; the shared and the unique hypochondriasis and anxiety symptom factors both contributed substantial variance. This study provides refinements to an empirically based taxonomy and clarifies what hypochondriasis is and, importantly, what it is not. PMID:21035611
Brooks, Catherine Francis
This autoethnography offers an account of my experience with mental illness and provides an analysis of the performative aspects of obsessive-compulsive disorder (OCD). OCD is a genetic disorder triggered by environmental stressors involving a chemical imbalance in the brain. The resulting biologically altered state leaves individuals to steer themselves among and between "appropriate" performance and secret rituals. Analyzing my own communication practices through a performance lens highlights the importance of image management for people struggling with disability. In telling my own story, this article provides readers an in-depth look at OCD as a traumatic brain disorder whose sufferers rely on communicative performance to maintain their public and private identities, and as a disease that impedes social life for its sufferers. Implications of this account for those struggling with mental disability and for practitioners aiming to help them are discussed.
Full Text Available 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.
Full Text Available Obsessive-compulsive disorder (OCD is a prevalent psychiatric disorder of unknown etiology. However, there is some evidence that the immune system may play an important role in its pathogenesis. In the present study, two polymorphisms (rs1800795 and rs361525 in the promoter region of the cytokine tumor necrosis factor-alpha (TNFA gene were genotyped in 183 OCD patients and in 249 healthy controls. The statistical tests were performed using the PLINK® software. We found that the A allele of the TNFA rs361525 polymorphism was significantly associated with OCD subjects, according to the allelic χ² association test (p=0.007. The presence of genetic markers, such as inflammatory cytokines genes linked to OCD, may represent additional evidence supporting the role of the immune system in its pathogenesis.
Frydman, Ilana; de Salles Andrade, Juliana B; Vigne, Paula; Fontenelle, Leonardo F
In this integrative review, we discuss findings supporting the use neuroimaging biomarkers in the diagnosis and treatment of obsessive-compulsive disorder (OCD). To do so, we have selected the most recent studies that attempted to identify the underlying pathogenic process associated with OCD and whether they provide useful information to predict clinical features, natural history or treatment responses. Studies using functional magnetic resonance (fMRI), voxel-based morphometry (VBM), diffusion tensor imaging (DTI) and proton magnetic resonance spectroscopy (1H MRS) in OCD patients are generally supportive of an expanded version of the earlier cortico-striatal-thalamus-cortical (CSTC) model of OCD. Although it is still unclear whether this information will be incorporated into the daily clinical practice (due to current conceptual approaches to mental illness), statistical techniques, such as pattern recognition methods, appear promising in identifying OCD patients and predicting their outcomes. PMID:27549605
Swedo, S.E.; Schapiro, M.B.; Grady, C.L.; Cheslow, D.L.; Leonard, H.L.; Kumar, A.; Friedland, R.; Rapoport, S.I.; Rapoport, J.L.
The cerebral metabolic rate for glucose was studied in 18 adults with childhood-onset obsessive-compulsive disorder (OCD) and in age- and sex-matched controls using positron emission tomography and fludeoxyglucose F 18. Both groups were scanned during rest, with reduced auditory and visual stimulation. The group with OCD showed an increased glucose metabolism in the left orbital frontal, right sensorimotor, and bilateral prefrontal and anterior cingulate regions as compared with controls. Ratios of regional activity to mean cortical gray matter metabolism were increased for the right prefrontal and left anterior cingulate regions in the group with OCD as a whole. Correlations between glucose metabolism and clinical assessment measures showed a significant relationship between metabolic activity and both state and trait measurements of OCD and anxiety as well as the response to clomipramine hydrochloride therapy. These results are consistent with the suggestion that OCD may result from a functional disturbance in the frontal-limbic-basal ganglia system.
Full Text Available Objective: To explore the relationship between regional cerebral blood flow (CBF and cognitive function in obsessive-compulsive disorder (OCD. Method: Single-photon emission computed tomography (SPECT was performed for 139 OCD patients and 139 controls, and the radioactivity rate (RAR was calculated. Cognitive function was assessed by the Wisconsin Card Sorting Test (WCST. Results: The RARs of the prefrontal, anterior temporal, and right occipital lobes were higher in patients than controls. For the WCST, correct and classification numbers were significantly lower, and errors and persistent errors were significantly higher in OCD patients. Right prefrontal lobe RAR was negatively correlated with correct numbers, right anterior temporal lobe RAR was positively correlated with errors, and the RARs of the right prefrontal lobe and left thalamus were positively correlated with persistent errors. Conclusion: OCD patients showed higher CBF in the prefrontal and anterior temporal lobes, suggesting that these areas may be related with cognitive impairment.
Qing FAN; Zeping XIAO
Obsessive-compulsive disorder (OCD) is a common mental disorder of uncertain etiology.Neuroimaging studies of patients with OCD in China started to appear in the late 1990s,identifying structural abnormalities in the gray matter and white matter of the prefrontal lobe,the corpus striatum,and the thalamus.Studies using positron emission tomography (PET),functional magnetic resonance imaging (fMRI),and magnetic resonance spectroscopy (MRS) have found increased metabolism and activation in these brain regions that are correlated with the duration,severity and cognitive symptoms of OCD.After surgery for OCD the activation in these target areas decreases.These results in China are similar to those presented in previous neuroimaging studies,including several meta-analyses from other countries.
Although selective serotonin reuptake inhibitors (SSRIs) and cognitive behavioral therapy (CBT) are first-line treatments for obsessive-compulsive disorder (OCD), response rates to these therapies are 40-60%. There may be many treatment-refractory patients who do not respond to several SSRIs and intensive CBT treatment. The current treatment guidelines suggest various strategies for treatment-refractory cases, but there is no established evidence for most of them. Augmentation therapies with antipsychotics and glutamate modulator drugs have yielded some supporting evidence. When all drugs and CBT are ineffective, non-pharmacological treatment including deep brain stimulation (DBS) should be applied. However, it is necessary to establish criteria for treatment-refractory patients and standardize conventional treatment before neuromodulation treatment is applied in Japan. PMID:24228478
Nair, Girish; Evans, Andrew; Bear, Renee E; Velakoulis, Dennis; Bittar, Richard G
Deep brain stimulation (DBS) is now well established in the treatment of intractable movement disorders. Over the past decade the clinical applications have expanded into the realm of psychosurgery, including depression and obsessive compulsive disorder (OCD). The optimal targets for electrode placement in psychosurgery remain unclear, with numerous anatomical targets reported for the treatment of OCD. We present four patients with Tourette's syndrome and prominent features of OCD who underwent DBS of the anteromedial globus pallidus internus (GPi) to treat their movement disorder. Their pre-operative and post-operative OCD symptoms were compared, and responded dramatically to surgery. On the basis of these results, we propose the anteromedial (limbic) GPi as a potential surgical target for the treatment of OCD, and furnish data supporting its further investigation as a DBS target for the treatment of psychiatric conditions. PMID:24524950
Mairwen K. Jones
Full Text Available Obsessive compulsive disorder (OCD is one of the most frequently occurring psychiatric conditions in older adults. While exposure and response prevention (ERP is considered the most effective psychological treatment for children and adults with OCD, research investigating its effectiveness for older adults is scarce. This clinical case study investigates the effectiveness of ERP in an 80-year-old man with a 65-year history of OCD. The client received 14 individual, 50-minute ERP treatment sessions. Clinician-based Y-BOCS scores reduced by 65% from 20 (moderate at pretreatment to 7 (subclinical at 7-month posttreatment followup. OCI-R total scores reduced by 45% from 38 at baseline to 21 at 7-month follow-up. Despite his long history of the disorder, ERP was effective and well tolerated. The application of ERP for older adults with OCD, including age-specific modifications that may be required for this treatment approach, is discussed.
The cerebral metabolic rate for glucose was studied in 18 adults with childhood-onset obsessive-compulsive disorder (OCD) and in age- and sex-matched controls using positron emission tomography and fludeoxyglucose F 18. Both groups were scanned during rest, with reduced auditory and visual stimulation. The group with OCD showed an increased glucose metabolism in the left orbital frontal, right sensorimotor, and bilateral prefrontal and anterior cingulate regions as compared with controls. Ratios of regional activity to mean cortical gray matter metabolism were increased for the right prefrontal and left anterior cingulate regions in the group with OCD as a whole. Correlations between glucose metabolism and clinical assessment measures showed a significant relationship between metabolic activity and both state and trait measurements of OCD and anxiety as well as the response to clomipramine hydrochloride therapy. These results are consistent with the suggestion that OCD may result from a functional disturbance in the frontal-limbic-basal ganglia system
Full Text Available Abstract Background H. Szechtman and E. Woody (2004 hypothesized that obsessive-compulsive disorder results from a deficit in the feeling of knowing that normally terminates thoughts or actions elicited by security motivation. To test the plausibility of this proposed mechanism, an experiment was conducted to produce an analog of washing in obsessive-compulsive disorder by eliciting a scenario of potential harm and using hypnosis to block changes in internally generated feelings that would normally occur during washing. Results Participants reacted with increased disgust, anxiety, and heart rate to their mental images of contamination and potential danger. As predicted, high but not low hypnotizable participants showed a significant prolongation of washing when change in feelings during washing was blocked hypnotically. Conclusion Results show that blocking the affective signal that is normally generated during security-related behaviors, such as washing, leads to prolonged performance of these behaviors. This finding lends support to the plausibility of the proposed model of obsessive-compulsive disorder.
Full Text Available A large subgroup of around 25% of schizophrenia patients suffers from obsessive-compulsive symptoms (OCS and about 12% fulfil the diagnostic criteria of obsessive-compulsive disorder (OCD. The additional occurrence of OCS is associated with high subjective burden of disease, additional neurocognitive impairment, poorer social and vocational functioning, greater service utilization and high levels of anxiety and depression. Comorbid patients can be assigned to heterogeneous subgroups. One hypothesis assumes that second generation antipsychotics (SGAs, most importantly clozapine, might aggravate or even induce second-onset OCS. Several arguments support this assumption, most importantly the observed chronological order of first psychotic manifestation, start of treatment with clozapine and onset of OCS. In addition, correlations between OCS-severity and dose and serum levels and duration of clozapine treatment hint towards a dose-dependent side effect. It has been hypothesized that genetic risk-factors dispose patients with schizophrenia to develop OCS. One study in a South Korean sample reported associations with polymorphisms in the gene SLC1A1 (solute carrier family 1A1 and SGA-induced OCS. However, this finding could not be replicated in European patients. Preliminary results also suggest an involvement of polymorphisms in the BDNF gene (brain-derived neurotrophic factor and an interaction between markers of SLC1A1 and the gene DLGAP3 (disc large associated protein 3 as well as GRIN2B (N-methyl-D-aspartate receptor subunit 2B. Further research of well-defined samples, in particular studies investigating possible interactions of genetic risk-constellations and pharmacodynamic properties, are needed to clarify the assumed development of SGA-induced OCS. Results might improve pathogenic concepts and facilitate the definition of at risk populations, early detection and monitoring of OCS as well as multimodal therapeutic interventions.
Full Text Available Introduction: The implementation of effective treatment depends on thorough understanding of disorder and its presentation. Treatment strategies must depend on the individual formulation of the patient. In this paper an Obsessive Compulsive Disorder(OCD patient treated with Cognitive Behavioral Therapy (CBT methods is presented. It is discussed that in the therapy, formulation is an ongoing dynamic process and necessarily required for the effectiveness of therapy. Case: Y.B. was 32 years old, single male patient graduated from university. He applied because of his obsessions and compulsions. He was diagnosed OCD after the psychiatric evaluation according to Diagnostic and Statistical Manual of Mental Disorders-IV(DSM-IV. In treatment following strategies were applied: 1 Cognitive restructuring of the thoughtaction- fusion, anxiety intolerance, overestimated threat appraisals, 2 exposure and response prevention techniques aimed to test if catastrophic expectations would occur. Discussion: When planning CBT for the treatment of OCD, the first and most important step is a good formulation created with the data obtained from a good evaluation process. Treatment planning in our case was planned on using cognitive restructing techniques for thought-action-fusion, anxiety intolerance and overestimated threat appraisals but the formulation was completed in the course of treatment when the patient could talk about his early experiences. As a result, the formulation is a roadmap that should be taken into consideration at every stage of therapy. Its presence is essential to reach the correct destination and it is a dynamic process needed to be updated according to the information from the patient
Full Text Available Abstract Objective The study aimed to investigate phenomenology, psychiatric comorbidity, and family history of obsessive-compulsive disorder (OCD in a clinical sample of normally developing preschool children with OCD. Method Subjects in this study were recruited from a clinical sample of preschool children (under 72 months of age who were referred to a university clinic. Subjects with a normal developmental history and significant impairment related to OCD symptoms were included in the study. Children’s Yale-Brown Obsessive-Compulsive Scale was used to assess OCD symptoms. Each subject was assessed for comorbid DSM-IV psychiatric disorders using a semi-structured interview. Parents were evaluated for lifetime history of OCD in individual sessions. Results Fifteen boys and ten girls (age range: 28 to 69 months; 54.12±9.08 months were included. Mean age of onset of OCD was 35.64±13.42 months. All subjects received at least one comorbid diagnosis. The most frequent comorbid disorders were non-OCD anxiety disorders (n=17; 68.0%, attention-deficit hyperactivity disorder (ADHD (n=15; 60.0%, oppositional defiant disorder (ODD (n=12; 48.0%, and tic disorders (n=6; 24.0%. Mean number of comorbid disorders was 3.65 and 2.35 for boys and girls, respectively. At least one parent received lifetime OCD diagnosis in 68 percent of the subjects. Conclusions The results indicated that OCD in referred preschool children is more common in males, highly comorbid with other psychiatric disorders, and associated with high rates of family history of OCD. Given the high rates of comorbidity and family history, OCD should be considered in referred preschool children with disruptive behavior disorders and/or with family history of OCD.
Pepper, Joshua; Hariz, Marwan; Zrinzo, Ludvic
Obsessive-compulsive disorder (OCD) is a chronic and debilitating psychiatric condition. Traditionally, anterior capsulotomy (AC) was an established procedure for treatment of patients with refractory OCD. Over recent decades, deep brain stimulation (DBS) has gained popularity. In this paper the authors review the published literature and compare the outcome of AC and DBS targeting of the area of the ventral capsule/ventral striatum (VC/VS) and nucleus accumbens (NAcc). Patients in published cases were grouped according to whether they received AC or DBS and according to their preoperative scores on the Yale-Brown Obsessive-Compulsive Scale (YBOCS), and then separated according to outcome measures: remission (YBOCS score DBS of the VC/VS or the NAcc (mean age 38 years, follow-up 19 months, baseline YBOCS score of 33), and 108 patients underwent AC (mean age 36 years, follow-up 61 months, baseline YBOCS score of 30). In patients treated with DBS there was a 40% decrease in YBOCS score, compared with a 51% decrease for those who underwent AC (p = 0.004). Patients who underwent AC were 9% more likely to go into remission than patients treated with DBS (p = 0.02). No difference in complication rates was noted. Anterior capsulotomy is an efficient procedure for refractory OCD. Deep brain stimulation in the VC/VS and NAcc area is an emerging and promising therapy. The current popularity of DBS over ablative surgery for OCD is not due to nonefficacy of AC, but possibly because DBS is perceived as more acceptable by clinicians and patients. PMID:25635480
Full Text Available Objective The aim of this study is to investigate the presence of dissociative symptoms and whether they are related to childhood trauma and obsessive-compulsive symptoms in bipolar disorder type II (BD-II. Methods Thirty-three euthymic patients (HDRS<8, YMRS<5 and 50 healthy subjects were evaluated by SCID-I and SCID-NP. We excluded all first and second-axis comorbidities. All patients and healthy subjects were examined with the Dissociative Experiences Scale (DES, Childhood Trauma Questionnaire (CTQ-53, and Yale-Brown Obsessive-Compulsive Disorder scale (Y-BOCS. Results In pairwise comparisons between the BD-II and control groups, the total CTQ, emotional abuse, emotional neglect, DES, and total Y-BOCS scores in the BD-II group were significantly higher than those in the control group (p < 0.05. There were five cases with DES scores over 30 (15.2% and one case (2% in the control group. DES was weakly correlated with total CTQ and Y-BOCS in patients diagnosed with BD-II (r = 0.278, p < 0.05 and r = 0.217, p < 0.05, respectively. While there was no correlation between total CTQ and Y-BOCS, the CTQ sexual abuse subscale was found to be related to Y-BOCS (r = 0.330, p < 0.05. Discussion These results suggest that there is a relation between childhood traumas and obsessive-compulsive symptoms, or that dissociative symptoms are more associated with anxiety than obsessive symptoms, which prevents the increase of obsessive-compulsive symptoms in BD-II.
... or working on a craft. Reward and praise self-control . For example, allow your little girl to use ... Aid: Nosebleeds Obsessive-Compulsive Disorder Teaching Your Child Self-Control Temper Tantrums How Can I Stop My Child ...
Full Text Available Objective: The study aimed to evaluate the correlation of maladjusted schema and locus of control with OCD, with the emphasis on cognitive approach to OCD. Method: In this study, 273 Iranian participants were selected; of whom,30% were male and 70% were female. Participants’age ranged from 19 to 34 and the mean age for the sample was 23.42(SD=2.46. Participants completed questionnaire batteries including measure of Levenson Locus of Control, Young Schema Scale and Y –bocsOCD Scale. One sample consisted of patients with a primary OCD according to DSM-IV criteria. The other sample selected for this cross-sectional study was university students.Result: Regression statistics item and reliability analysis were calculated with SPSS and LISREL software. Obsessive compulsive disorder was significantly predicted with both schema and powerful others’ locus of control, as these relations were large but association schema with OCDwas larger than the correlation OCD with powerful others (OCD with schema p.v<0.001 β=.47 and OCD with powerful others p.v<0.001 β=.15.Conclusion: The findings of the present study showed that schema and powerful others type of locus of control, were significantly related to both total OCD symptom severity and also to other sub scale of OCD. It is important to mention that schema can significantly predict all symptoms dimension of OCD. Furthermore, the analyses showed that schema was a strong predictor for obsessive thinking.
Full Text Available The aim of this review is to describe the main theoretical findings and research conclusions about obsessive-compulsive disorder (OCD in the perinatal period. On one hand, epidemiological studies show that the risk of OCD onset and/or exacerbation could increase in this period, particularly in the puerperium. Phenomenologically, in this stage aggressive and contamination obsessions are very common and are related to the fetus or newborn. On the other hand, regarding OCD pathogenesis in this period, there is indirect evidence to suggest the participation of neuroendocrine (e.g. female gonadal steroids and oxytocin and cognitive behavioural variables (e.g. hyper-responsibility, threat overestimation, and mental control. In terms of research, more empirical studies are needed to contrast these specific vulnerability factors. Moreover, no empirically validated psychotherapeutic treatments (controlled trials adapted to this OCD sub-group were found, although some studies highlight the role of cognitive behavioural therapy (CBT as an effective intervention in the context of selective primary prevention.
Full Text Available Aim: the aim of the study is to evaluate the socio-demographic and clinical features with prognostic value in predicting evolution in severe OCD.Materials and methods: patients with a main diagnosis of OCD were recruited according to DSM-IV criteria. Socio-demographic and clinical features were assessed by mean of a semi-structured interview and clinical rating scales (Y-BOCS, HAM-A, HAM-D and SCID-II. Two subgroups were compared according to the severity of symptoms (severe vs mild-moderate.Results: the total sample was made up of 450 OCD subjects aged 34.5±12.1, with a mean age of onset 22.3±9.1; 215 subjects (47.8% were females. Patients with severe OCD (Y-BOCS ≥ 32 showed a more insidious onset and a more chronic course compared to patients with mild-moderate symptoms. Other predictors of increased OCD severity were washing and hoarding compulsions. Lastly, the severity of the obsessive-compulsive condition was higher when it was associated either with mood disorders or with Axis II disorders (particularly Cluster A.Discussion: our study shows a correlation between severe OCD and severity predictors such as functional impairment and mood disorders. Furthermore washing and hoarding symptoms, lifetime comorbity with mood disorders and Cluster A personality disorders seem to predict OCD severity.
Thorsen, Anders Lillevik; van den Heuvel, Odile A; Hansen, Bjarne; Kvale, Gerd
The symptoms of obsessive-compulsive disorder (OCD) include intrusive thoughts, compulsive behavior, anxiety, and cognitive inflexibility, which are associated with dysfunction in dorsal and ventral corticostriato-thalamocortical (CSTC) circuits. Psychotherapy involving exposure and response prevention has been established as an effective treatment for the affective symptoms, but the impact on the underlying neural circuits is not clear. This systematic review used the Medline, Embase, and PsychINFO databases to investigate how successful therapy may affect neural substrates of OCD. Sixteen studies measuring neural changes after therapy were included in the review. The studies indicate that dysfunctions in neural function and structure are partly reversible and state-dependent for affective symptoms, which may also apply to cognitive symptoms. This is supported by post-treatment decreases of symptoms and activity in the ventral circuits during symptom provocation, as well as mainly increased activity in dorsal circuits during cognitive processing. These effects appear to be common to both psychotherapy and medication approaches. Although neural findings were not consistent across all studies, these findings indicate that people with OCD may experience functional, symptomatic, and neural recovery after successful treatment. PMID:26228566
Sung Yun Sohn
Full Text Available OBJECTIVE: Although the relationship between obsessive compulsive disorder (OCD and impulsivity has long been debated, impulsivity has not been systematically examined in clinical samples of OCD. Meanwhile, recent findings suggest that impulsivity is multi-dimensional construct that can be examined through several constructs. Therefore, this study is aimed to evaluate multiple facets of impulsivity in OCD. METHOD: The recruitment includes 80 OCD and 76 healthy control participants. Participants completed a test battery comprising three behavioral tasks of stop signal task (SST, delay discounting task (DDT and balloon analog risk test (BART, and one self-report measure of the Barratt Impulsiveness scale (BIS-11. RESULTS: OCD subjects showed significantly lower stop signal reaction time of SST reflecting higher action impulsivity and higher delay discounting parameter of DDT suggesting increased choice impulsivity but significantly lower adjusted mean pump of BART implying lower risk taking propensity of BART than healthy control. CONCLUSION: Increased Action and choice impulsivity, and decreased risk taking propensities were found in OCD. These findings seem to be consistent with clinical characteristics of OCD such as greater preference for or avoid risky situations (avoidance, inability to wait tension relief may provoke safety behaviors (compulsion and inability to stop already started behaviors (repetition.
Segar, David J; Chodakiewitz, Yosef G; Torabi, Radmehr; Cosgrove, G Rees
Deep brain stimulation (DBS) has been reported to have beneficial effects in severe, treatment-refractory cases of obsessive-compulsive disorder (OCD) and Tourette syndrome (TS). In this report, the authors present the first case in which DBS was used to treat the neuropsychiatric symptoms of Kleefstra syndrome, a rare genetic disorder characterized by childhood hypotonia, intellectual disability, distinctive facial features, and myriad psychiatric and behavioral disturbances. A 24-year-old female patient with childhood hypotonia, developmental delay, and diagnoses of autism spectrum disorder, OCD, and TS refractory to medical management underwent the placement of bilateral ventral capsule/ventral striatum (VC/VS) DBS leads, with clinical improvement. Medical providers and family observed gradual and progressive improvement in the patient's compulsive behaviors, coprolalia, speech, and social interaction. Symptoms recurred when both DBS electrodes failed because of lead fracture and dislodgement, although the clinical benefits were restored by lead replacement. The symptomatic and functional improvements observed in this case of VC/VS DBS for Kleefstra syndrome suggest a novel indication for DBS worthy of further investigation. PMID:26030700
Full Text Available BackgroundPatients with obsessive-compulsive disorder (OCD have highly idiosyncratic triggers. To fully understand which role this idiosyncrasy plays in the neurobiological mechanisms behind OCD, it is necessary to elucidate the impact of individualization regarding the applied investigation methods.This functional magnetic resonance imaging (fMRI study explores the neural correlates of contamination/washing-related OCD with a highly individualized symptom provocation paradigm. Additionally, it is the first study to directly compare individualized and standardized symptom provocation. MethodsNineteen patients with washing compulsions created individual OCD hierarchies, which later served as instructions to photograph their own individualized stimulus sets. The patients and 19 case-by-case matched healthy controls participated in a symptom provocation fMRI experiment with individualized and standardized stimulus sets created for each patient. ResultsOCD patients compared to healthy controls displayed stronger activation in the basal ganglia (nucleus accumbens, nucleus caudatus, pallidum for individualized symptom provocation. Using standardized symptom provocation, this group comparison led to stronger activation in the nucleus caudatus. The direct comparison of between-group effects for both symptom provocation approaches revealed stronger activation of the orbitofronto-striatal network for individualized symptom provocation.ConclusionsThe present study provides insight into the differential impact of individualized and standardized symptom provocation on the orbitofronto-striatal network of OCD washers. Behavioral and neural responses imply a higher symptom-specificity of individualized symptom provocation.
Yahghoubi, Hassan; Mohammadzadeh, Ali
Background: Psychopathological perfectionism is often correlated with obsessive compulsive eating disorders. Objectives: The purpose of this study was to investigate perfectionism in people with high traits of obsessive compulsive and eating disorder characteristics. Materials and Methods: This study was an expo fact research. The statistical population of the research comprised of male and female undergraduate students at Tabriz and Sarab branches of Payam- e- Noor University, Tabriz Islamic University and Azarbaijan Shahid Madani university in the academic year 2012 - 2013. A group of 640 university students, using the stratified random sampling method were screened by the obsessive compulsive inventory and the eating attitude test, then a group of 143 participants with high obsessive compulsive traits with another 137 participants with high eating disorder characteristics were selected and assessed with the Perfectionism Inventory. Data were analyzed using one way analysis of variance. Results: The results showed that perfectionism and related negative dimension are more commonly found in people with high obsessive-compulsive traits than eating disorder characteristics (P eating attitude. Also, no difference was found between the two groups in terms of negative perfectionism. Conclusions: The greater association of perfectionism with symptoms of obsessive-compulsive is consistent with its phenomenological feature. Fear of failure may motivate the behavioral components of perfectionism that aim to focus on careful checking, reassurance seeking and excessive consideration before making a decision. PMID:26576174
陆茜; 肖泽萍; 张天宏
强迫型人格障碍(OCPD)的诊断经常与其他精神障碍特别是强迫症(OCD)的诊断存在着界限上的争议.本文通过对OCPD和OCD在产生的历史背景、临床表现、流行病学特征、共病、神经生物学及对药物治疗的预后上的特殊关系进行文献复习,进而讨论OCPD和OPD是否存在一种谱性关系.%The definition of obsessive-compulsive personality disorder (OCPD) and its relationship with other mental disorders especially obsessive-compulsive disorder has always been controversial. Focusing on backgrounds, phenomenology, epidemiology, comorbidity, neurobiology, and treatment response, this article examines related papers and discusses the relationship between the two disorders.
Objective To investigate the obsessive-compulsive symptoms by Yale -Brown Obsessive Compulsive Scale Symptoms Checklist.Methods Yale-Brown Obsessive Compulsive Scale Symptoms Checklist was administered to 78 outpatients with Obsessive Compulsive disorder(OCD).Results In 78 OCD patients,obsessions average was(9.6 ±6.8),compulsions was(4.7 ±4.2);Top three obsessions were contamination(42.8%),aggressive(35.9%)and symmetry(17.9%).Top three compulsions were cleaning(39.8%), checking(38.4%)and repeating(28.2%).Sexual obsessions in male patients was higher than that in female (u=2.38,P<0.05). Cleaning compulsions in employed patients was higher than that in unemployed (u=2.22,P<0.05).Conclusion Yale-Brown Ob-sessive Compulsive Scale Symptoms Checklist can effectively describe the symptoms of OCD patients .OCD symptoms are associated with demography data .%目的：初步使用耶鲁-布朗强迫症状清单调查我国强迫症的症状类型。方法采用耶鲁-布朗强迫症状清单调查78例强迫症患者的症状及出现的频率，分析症状类型与人口学资料的相关性。结果78例强迫症患者，强迫思维的症状数量（9．6±6．8）个，强迫行为的症状数量（4．7±4．2）个；排在前3位的强迫思维依次为怕污染的强迫思维（42．3％）、怕冲动的强迫思维（35．9％）、要求对称或精确的强迫思维（17．9％）。强迫行为前3位依次为强迫洗涤行为（39．8％）、强迫检查行为（38．4％）、强迫重复行为（28．2％）。男性患者20．9％存在有关性的强迫思维高于女性2．9％，差异有统计学意义（ U＝2．38，P＝0．0172）。无职业者50．0％存在强迫洗涤行为高于有职业者25．0％，差异有统计学意义（U＝2．22，P＝0．0265）。结论耶鲁-布朗强迫症状清单能够有效涵盖所有强迫症状，初步应用成功。强迫症状类型与人口学资料存在相关性。
Full Text Available BACKGROUND: Pathological gambling (PG and obsessive-compulsive disorder (OCD are conceptualized as a behavioral addiction, with a dependency on repetitive gambling behavior and rewarding effects following compulsive behavior, respectively. However, no neuroimaging studies to date have examined reward circuitry during the anticipation phase of reward in PG compared with in OCD while considering repetitive gambling and compulsion as addictive behaviors. METHODS/PRINCIPAL FINDINGS: To elucidate the neural activities specific to the anticipation phase of reward, we performed event-related functional magnetic resonance imaging (fMRI in young adults with PG and compared them with those in patients with OCD and healthy controls. Fifteen male patients with PG, 13 patients with OCD, and 15 healthy controls, group-matched for age, gender, and IQ, participated in a monetary incentive delay task during fMRI scanning. Neural activation in the ventromedial caudate nucleus during anticipation of both gain and loss decreased in patients with PG compared with that in patients with OCD and healthy controls. Additionally, reduced activation in the anterior insula during anticipation of loss was observed in patients with PG compared with that in patients with OCD which was intermediate between that in OCD and healthy controls (healthy controls < PG < OCD, and a significant positive correlation between activity in the anterior insula and South Oaks Gambling Screen score was found in patients with PG. CONCLUSIONS: Decreased neural activity in the ventromedial caudate nucleus during anticipation may be a specific neurobiological feature for the pathophysiology of PG, distinguishing it from OCD and healthy controls. Correlation of anterior insular activity during loss anticipation with PG symptoms suggests that patients with PG fit the features of OCD associated with harm avoidance as PG symptoms deteriorate. Our findings have identified functional disparities and
Privitera, Anna P; Distefano, Rosario; Wefer, Hugo A; Ferro, Alfredo; Pulvirenti, Alfredo; Giugno, Rosalba
Obsessive-compulsive disorder (OCD) is a psychiatric condition characterized by intrusive and unwilling thoughts (obsessions) giving rise to anxiety. The patients feel obliged to perform a behavior (compulsions) induced by the obsessions. The World Health Organization ranks OCD as one of the 10 most disabling medical conditions. In the class of Anxiety Disorders, OCD is a pathology that shows an hereditary component. Consequently, an online resource collecting and integrating scientific discoveries and genetic evidence about OCD would be helpful to improve the current knowledge on this disorder. We have developed a manually curated database, OCD Database (OCDB), collecting the relations between candidate genes in OCD, microRNAs (miRNAs) involved in the pathophysiology of OCD and drugs used in its treatments. We have screened articles from PubMed and MEDLINE. For each gene, the bibliographic references with a brief description of the gene and the experimental conditions are shown. The database also lists the polymorphisms within genes and its chromosomal regions. OCDB data is enriched with both validated and predicted miRNA-target and drug-target information. The transcription factors regulations, which are also included, are taken from David and TransmiR. Moreover, a scoring function ranks the relevance of data in the OCDB context. The database is also integrated with the main online resources (PubMed, Entrez-gene, HGNC, dbSNP, DrugBank, miRBase, PubChem, Kegg, Disease-ontology and ChEBI). The web interface has been developed using phpMyAdmin and Bootstrap software. This allows (i) to browse data by category and (ii) to navigate in the database by searching genes, miRNAs, drugs, SNPs, regions, drug targets and articles. The data can be exported in textual format as well as the whole database in.sql or tabular format. OCDB is an essential resource to support genome-wide analysis, genetic and pharmacological studies. It also facilitates the evaluation of genetic data
Privitera, Anna P; Distefano, Rosario; Wefer, Hugo A; Ferro, Alfredo; Pulvirenti, Alfredo; Giugno, Rosalba
Obsessive-compulsive disorder (OCD) is a psychiatric condition characterized by intrusive and unwilling thoughts (obsessions) giving rise to anxiety. The patients feel obliged to perform a behavior (compulsions) induced by the obsessions. The World Health Organization ranks OCD as one of the 10 most disabling medical conditions. In the class of Anxiety Disorders, OCD is a pathology that shows an hereditary component. Consequently, an online resource collecting and integrating scientific discoveries and genetic evidence about OCD would be helpful to improve the current knowledge on this disorder. We have developed a manually curated database, OCD Database (OCDB), collecting the relations between candidate genes in OCD, microRNAs (miRNAs) involved in the pathophysiology of OCD and drugs used in its treatments. We have screened articles from PubMed and MEDLINE. For each gene, the bibliographic references with a brief description of the gene and the experimental conditions are shown. The database also lists the polymorphisms within genes and its chromosomal regions. OCDB data is enriched with both validated and predicted miRNA-target and drug-target information. The transcription factors regulations, which are also included, are taken from David and TransmiR. Moreover, a scoring function ranks the relevance of data in the OCDB context. The database is also integrated with the main online resources (PubMed, Entrez-gene, HGNC, dbSNP, DrugBank, miRBase, PubChem, Kegg, Disease-ontology and ChEBI). The web interface has been developed using phpMyAdmin and Bootstrap software. This allows (i) to browse data by category and (ii) to navigate in the database by searching genes, miRNAs, drugs, SNPs, regions, drug targets and articles. The data can be exported in textual format as well as the whole database in.sql or tabular format. OCDB is an essential resource to support genome-wide analysis, genetic and pharmacological studies. It also facilitates the evaluation of genetic data
Cilly Klüger Issler; José Antonio de Mello Siqueira Amaral; Renata Sayuri Tamada; Angela Maria Schwartzmann; Roseli Gedanke Shavitt; Eurípedes Constantino Miguel; Beny Lafer
OBJECTIVE: To study clinical and psychopathological features of obsessive-compulsive disorder (OCD) in women with bipolar disorder (BD). METHODS: Fifteen outpatients with concurrent bipolar disorder I (80.0%) or II (20.0%) and obsessive-compulsive disorder were studied. Most of them (80.0%) sought treatment for bipolar disorder. They were ascertained by means of the Structured Clinical Interview for DSM-IV (SCID/P), semi-structured interviews to investigate obsessions, compulsions and sensory...
Full Text Available Anxienty is closely related to sexual disorders, being their source, preserver, and consequence. Therefore, it represents an important obstacle in the course of a therapy. The role of anxiety in sexual disorders has already been widely investigated, but the question whether the above mentioned connection exists at a micro level remains unanswered. The present study focused on two specific anxiety disorders: agoraphobia and obsessive compulsive disorder. Two translated questionnaries were used: Mobility Inventory for Agoraphobia MIA (Chambless, Caputo, Jasin, & Gracely, 1985 and Padua Inventory PI (Sanavio, 1988. Participants were patients with sexual disorders who sought psychiatric help, and a group of students represented a control group. Results demonstrated a strong connection between agoraphobic and obsessive compulsive symptoms on one side and sexual disorders on the other. Among the possible explanations for this connection the circular model seems to be the most appropriate.
Turner, Jo; DRUMMOND, LYNNE M; Mukhopadhyay, Suman; Ghodse, Hamid; White, Sarah; PILLAY, ANUSHA; Fineberg, Naomi A.
There have been relatively few studies examining sleep in patients with obsessive-compulsive disorder (OCD) and these have produced contradictory findings. A recent retrospective study identified a possible association between OCD and a circadian rhythm sleep disorder known as delayed sleep phase syndrome (DSPS). Patients with this pattern of sleeping go to bed and get up much later than normal. They are unable to shift their sleep to an earlier time and, as a result, suffer...
Mostafa Toobaei; Mohamad Reza Shairi; Giti Shams; Gholamhosein Ghaedi
Background: This research seeks to make a comparison between executive functions of the obsessive compulsive disorder (OCD) patients, with poor and high insight levels and normal people. Patients and Methods: In this casual comparative study, 22 OCD patients with high insight level, 5 OCD patients with poor insight level (based on YBOCS’ 11th item score) and 23 normal subjects were selected using convenience sampling technique. The subjects were evaluated using two groups of clinical and n...
Gail Steketee; Barbara Van Noppen
This article reviews the family constellation of patients with obsessive compulsive disorder (OCD), the presence of OCD symptoms among family members, and familial aspects including parental attachment, expressed emotion (EE), and family accommodation. Some evidence supports a negative effect of hostility, emotional over-involvement, and criticism perceived by the patient on behavioral treatment outcome. However, actual criticism observed by the relative during an interview was associated wit...
Schirmbeck, Frederike; Rausch, Franziska; Englisch, Susanne; Eifler, Sarah; Esslinger, Christine; Meyer-Lindenberg, Andreas; Zink, Mathias
Background: Amongst schizophrenia patients, a large subgroup of up to 25% also suffers from comorbid obsessive-compulsive symptoms (OCSs). The association between comorbid OCSs in these patients and neuropsychological impairment remains unclear and somewhat contradictory. Longitudinal approaches investigating the stability of OCS-associated cognitive deficits are missing. Methods: Thirty-seven patients with schizophrenia and comorbid OCSs and 43 schizophrenia patients without OCS were assesse...
Clementz, B A; Farber, R H; Lam, M N; Swerdlow, N. R.
This study was conducted to evaluate the smooth pursuit system functioning of patients with obsessive-compulsive disorder (OCD). For Study 1, 12 subjects with OCD and 12 nonpsychiatric subjects were administered 9-deg-per-sec ramp stimuli to elicit smooth pursuit eye movements. Consistent with a previous report, patients with OCD did not significantly differ from nonpsychiatric subjects on pursuit gain, or frequency of corrective and intrusive saccades. Patients with OCD, however, had smaller...
Margherita eMelloni; Claudia eUrbistondo; Lucas eSedeño; Carlos eGelormini; Rafael eKichic; Agustin eIbanez
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, su...
Challop, Roger S.; Rashid A. Fawwaz; DeLaPaz, Robert L.; W. Louis Cleveland
This paper describes an individual who was diagnosed with obsessive-compulsive disorder (OCD) and body dysmorphic disorder (BDD) at age 17 when education was discontinued. By age 19, he was housebound without social contacts except for parents. Adequate trials of three selective serotonin reuptake inhibitors, two with atypical neuroleptics, were ineffective. Major exacerbations following ear infections involving Group A -hemolytic streptococcus at ages 19 and 20 led to intravenous immune gl...
Full Text Available Obsessive-Compulsive Disease (OCD incidence rate in children and adolescents is about 1-2 percent; males develop the disease more than females and it clearly is associated with attentiondeficithyperactivity disorder (ADHD, depression and body dysmorphic disorder. Regarding the fact that initial diagnosis and treatment of disorders with OCD in children can protect them from further problems in their life, in this study, the premature OCD with motor tic disorder in an 8-year-old boy is reported.
Hammer, Anke; Kordon, Andreas; Heldmann, Marcus; Zurowski, Bartosz; Münte, Thomas F.
Background The anterior cingulate cortex (ACC) is thought to be overacting in patients with Obsessive Compulsive Disorder (OCD) reflecting an enhanced action monitoring system. However, influences of conflict and error-likelihood have not been explored. Here, the error-related negativity (ERN) originating in ACC served as a measure of conflict and error-likelihood during memory recognition following different learning modes. Errorless learning prevents the generation of false memory candidate...
Michele FornaroDepartment of Neuroscience, Section of Psychiatry, University of Genoa, Genoa, ItalyAbstract: Isotretinoin, a drug used for moderate to severe acne, has been repeatedly associated with various psychiatric complications, although a definitive causal relationship has not been established to date. This case report describes a 25-year-old male who developed obsessive-compulsive disorder at the age of 23 years following isotretinoin treatment for acne (10–20 mg/day) since ...
Bipeta, Rajshekhar; Yerramilli, Srinivasa SRR; Karredla, Ashok Reddy; Gopinath, Srinath
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 compa...
Cohen, L J; Hollander, E; DeCaria, C M; Stein, D J; Simeon, D; Liebowitz, M R; Aronowitz, B R
Specificity of neuropsychological dysfunction in obsessive-compulsive disorder (OCD) was assessed by comparing neuropsychological performance in 65 OCD patients, 17 social phobic patients, and 32 normal control subjects. Although both patient groups showed visual constructional impairment relative to normal subjects, only patients with social phobia showed executive dysfunction. Nonconcurrent state anxiety did not correlate with neuropsychological performance. Among anxiety disorders, neuropsychological dysfunction may not be specific to OCD, but the functions implicated may differ across patient groups.
Sayyah, Mehdi; Eslami, Kaveh; AlaiShehni, Shabnam; Kouti, Leila
Objectives. Identification of adverse effects of selective serotonin reuptake inhibitors (SSRIs) is of great importance due to their extensive use in medicine. Some studies have reported the effects of SSRIs on cognitive functions, but the results are conflicting. This study was designed to assess the effect of these drugs on cognition of patients with depression or obsessive-compulsive disorder (OCD). Methods. Patients with depression or OCD, naïve to therapy, and candidates of receiving one...
Denys, D.A.J.P.; Nieman, D.H.; Mantione, M.H.M.
Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder with an estimated life-time prevalence of 2%. Severe OCD leads to pronounced suffering and has a major impact on family relationships, social life and the capacity to function at work. At present, clinical management of OCD consists of pharmacological treatment and cognitive behavioural therapy (CBT). Although both treatments are often effective, approximately 10% of patients remain severely affected and suffer from treatment-...
Zai, Gwyneth; Zai, Clement C; Arnold, Paul D; Freeman, Natalie; Burroughs, Eliza; Kennedy, James L; Richter, Margaret A
Obsessive-compulsive disorder (OCD) is a severe psychiatric condition with a clear genetic component (Nicolini et al., 2009) in which neurodevelopmental mechanisms may be etiologically important. Brain-derived neurotrophic factor (BDNF) is an interesting candidate for molecular analysis in OCD on the basis of potential functional relevance, positive association studies, and reported interaction between this gene and other neurotransmitters implicated in this disorder.
Haaland, Aashild Tellefsen; Vogel, Patrick A; Launes, Gunvor; Haaland, Vegard Øksendal; Hansen, Bjarne; Solem, Stian; Himle, Joseph A
This is the first study that explores whether early maladaptive schemas are related to treatment outcome for patients with obsessive-compulsive disorder (OCD). The sample consisted of 88 outpatients with a diagnosis of OCD who completed exposure and response prevention treatment. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Beck Depression Inventory and Young Schema Questionnaire - Short Form were administered before and after treatment. Regression analyses using post-treatment Y-BOCS as the dependent variable indicated that higher scores on the abandonment schema at pre-treatment were related to poor outcome and explained 7% of the variance in symptoms at post-treatment. Higher scores on the self-sacrifice schema at pre-treatment were related to good outcome and explained 6% of the variance in obsessive-compulsive symptoms at post-treatment. During treatment, only changes in the failure schema were significantly related to good outcome and explained 18% of the variance in symptoms at post-treatment.
Zambrano-Vazquez, Laura; Allen, John J B
Obsessive-Compulsive Disorder (OCD) is characterized by intrusive thoughts (i.e. obsessions) and future-oriented worrisome cognitions that are associated with behavioral ritualistic compensations (i.e. compulsions) and anxious arousal. Research has found an enhanced error-related negativity (ERN) among those with OCD in choice response tasks such as the flankers task, but not in probabilistic learning tasks. To date, research has not directly investigated whether the ERN effect observed in individuals with OCD is specific to the central features of OCD (obsessions and compulsions), or is related more closely to the worry or anxiety observed in this disorder. This study compared groups with relatively pure symptom profiles on OC, worry, and anxiety symptoms (e.g. high on OC, low on worry and anxiety) relative to a "typical" OC presentation group (e.g. high OC, mild to high worry and anxiety) and a non-anxious non-worry Control group, in both flankers and probabilistic learning tasks. For the flankers task, only the Worry group had a significantly enhanced ERN relative to controls. For the probabilistic learning task, the OC typical group had significantly enhanced ERN amplitude on suboptimal choices relative to controls. Across tasks, the experimental groups had significantly enhanced activity on error/suboptimal choices relative to the OC specific group. The results highlight the role of worry across both tasks, and to a lesser extent anxiety and OC symptoms, in performance-monitoring processes. PMID:24971709
Degortes, Daniela; Zanetti, Tatiana; Tenconi, Elena; Santonastaso, Paolo; Favaro, Angela
Although there is evidence that childhood perfectionistic traits predate the onset of eating disorders, few studies to date have examined the prevalence and clinical correlates of these traits in patients with anorexia nervosa (AN) and their unaffected sisters. The aim of this work was to study the prevalence of childhood obsessive-compulsive traits in patients with lifetime AN, their unaffected sisters and healthy women. A total of 116 AN patients, 32 healthy sisters and 119 controls were assessed by the EATATE Interview to assess traits such as perfectionism, inflexibility, rule-bound traits, drive for order and symmetry, and excessive doubt and cautiousness. Both self-report and maternal reports were collected. AN patients reported more childhood obsessive-compulsive traits than their healthy sisters and controls. In contrast, no differences between healthy controls and unaffected sisters emerged. In patients with AN, a dose-response relationship was found between the number of childhood obsessive-compulsive traits and psychopathology, including body image distortion, thus indicating that these traits are an important feature to be considered in assessing and treating eating disorders. PMID:24851802
Haaland, Aashild Tellefsen; Vogel, Patrick A; Launes, Gunvor; Haaland, Vegard Øksendal; Hansen, Bjarne; Solem, Stian; Himle, Joseph A
This is the first study that explores whether early maladaptive schemas are related to treatment outcome for patients with obsessive-compulsive disorder (OCD). The sample consisted of 88 outpatients with a diagnosis of OCD who completed exposure and response prevention treatment. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Beck Depression Inventory and Young Schema Questionnaire - Short Form were administered before and after treatment. Regression analyses using post-treatment Y-BOCS as the dependent variable indicated that higher scores on the abandonment schema at pre-treatment were related to poor outcome and explained 7% of the variance in symptoms at post-treatment. Higher scores on the self-sacrifice schema at pre-treatment were related to good outcome and explained 6% of the variance in obsessive-compulsive symptoms at post-treatment. During treatment, only changes in the failure schema were significantly related to good outcome and explained 18% of the variance in symptoms at post-treatment. PMID:21920500
Joel, D; Avisar, A
This study aimed at developing a rat model of obsessive compulsive disorder based on the hypothesis that a deficient response feedback mechanism underlies obsessions and compulsions. Rats were trained to lever press for food, whose delivery was signaled by the presentation of a compound stimulus (light+tone). Subsequently, the classical contingency between the stimulus and food was extinguished (signal attenuation). Experiment 1 showed that this manipulation resulted in increased lever pressing during a subsequent extinction test, which was highly correlated with an increase in the number of trials on which the rat did not attempt to collect the food reward. This behavioral pattern was not evident in an extinction test not preceded by signal attenuation (Experiment 2), suggesting that the latter is a crucial factor in the development of this behavioral pattern. Excessive lever pressing was attenuated by the selective serotonin re-uptake inhibitor, fluoxetine (10 mg/kg; Experiment 3), but not by the anxiolytic drug, diazepam (2 mg/kg; Experiment 4). Based on these results we propose that post-training signal attenuation may provide a rat model of obsessive compulsive disorder. PMID:11377731
Obsessive-compulsive disorder is a group of obsessive-compulsive symptoms (including obsessions and compul-sions) as the main clinical manifestations of neurosis. In this case, the main use of Morita therapy and behavior modification method (shaping law, punitive law), so that visitors gradually overcome compulsive behavior, successful escape forced bath-ing problems.%强迫症是一组以强迫症状（主要包括强迫观念和强迫行为）为主要临床表现的神经症。在本案例中，主要采用森田疗法和行为矫正法（塑造法、惩罚法），使来访者逐步克服强迫行为，成功的摆脱强迫洗澡的困扰。
Fan, Jie; Liu, Wanting; Lei, Hui; Cai, Lin; Zhong, Mingtian; Dong, Jiaojiao; Zhou, Cheng; Zhu, Xiongzhao
Obsessive-compulsive disorder (OCD) is characterized by unwanted, intrusive thoughts (obsessions) and/or repetitive, ritualistic behaviors (compulsions). Findings related to the two components of inhibition, namely interference control and behavioral inhibition, among OCD patients have been inconsistent. It might be that this inconsistency is due to the heterogeneity among OCD cases representing multiple subtypes of OCD, such as autogenous obsessions and reactive obsessions types (AOs vs. ROs). AOs and ROs are distinguished by the category of their most disturbing obsessions. The purpose of this study was to systematically examine whether inhibition functions differ between AO and RO patients. We assessed interference control and behavioral inhibition with the emotional Stroop task (EST) and stop-signal task (SST), respectively, in 42 AOs, 55 ROs and 62 healthy controls (HCs) and event-related potentials (ERPs) were recorded in a random subset of these subjects (25 AOs, 25 ROs, and 31HCs). Results showed that in the EST, AOs exhibited longer reaction times (RTs) for color-naming positive-, negative-, and neutral-valence word stimulus than both ROs and HCs, and demonstrated larger P2 and less negative N450 amplitudes than HCs and larger P3 amplitudes than ROs and HCs. In the SST, both AOs and ROs showed lengthened stop signal reaction time (SSRT) and reduced Stop-P3 amplitudes in successful inhibition (SI) trials compared to the HC group. These present findings suggest that behavioral inhibition impairment may reflect a common pathology in both the autogenous- and reactive-type OCD patients, whereas interference inhibition impairment appears to be specific to patients with autogenous obsessions. These findings strengthened the insight into the clinical heterogeneity and pathophysiology of OCD. PMID:26995786
Full Text Available BACKGROUND Obsessive-compulsive disorder (OCD is the 10th leading cause of disability of all medical conditions in the industrialized world and the ‘Quality of Life’ has emerged as a valid parameter to measure the outcome of illness and effectiveness of treatment. OBJECTIVE To see the quality of life, functioning and clinical variables between the OCD patient and the ‘Patient control’ group MATERIAL AND METHODS A total of 120 probands were assessed, of which 60 subjects were OCD patients and 60 stable schizophrenia patients were used as patient control group. Yale-Brown Obsessive-Compulsive Rating Scale, Positive and Negative Symptom Scale for Schizophrenia, Hamilton Rating Scale for Depression, Hamilton Rating Scale for Anxiety, The Brown Assessment of Beliefs Scale, WHOQOL-BREF, Global Assessment of Functioning Scale were applied as per the protocol. The data was analysed using descriptive statistics with the help of SPSS version 16.0 for Windows. RESULTS The cost of medication was significantly higher in OCD group as compared to Schizophrenia Group. Depression and anxiety scores were significantly higher in OCD group. Global functioning was significantly better in schizophrenia group but quality of life better in OCD group on Physical Health domain and Environment domain of WHOQOL-BREF. CONCLUSION The Psychopathology of OCD spared satisfaction with sleep, ability to perform daily living activities, capacity to work, ability to get around, energy for everyday life, physical pain and need for any medical treatment to function in daily life, satisfaction with the conditions of your living places, access to health services, transport, opportunities for leisure activities, money to meet the needs, availability of the required information, and safety in daily life; when compared to stable schizophrenia patients The Psychopathology of OCD had as severe an impact as Schizophrenia on ‘enjoying life, finding it meaningful, level of negative
Full Text Available Abstract Background In spite of advances in psychotherapy and pharmacotherapy, there are still a significant number of patients with depression and obsessive-compulsive disorder that are not aided by either intervention. Although still in the experimental stage, deep brain stimulation (DBS offers many advantages over other physically-invasive procedures as a treatment for these psychiatric disorders. The purpose of this study is to systematically review reports on clinical trials of DBS for obsessive-compulsive disorder (OCD and treatment-resistant depression (TRD. Locations for stimulation, success rates and effects of the stimulation on brain metabolism are noted when available. The first observation of the effects of DBS on OCD and TRD came in the course of using DBS to treat movement disorders. Reports of changes in OCD and depression during such studies are reviewed with particular attention to electrode locations and associated adverse events; although these reports were adventitious observations rather than planned. Subsequent studies have been guided by more precise theories of structures involved in DBS and OICD. This study suggests stimulation sites and prognostic indicators for DBS. We also briefly review tractography, a relatively new procedure that holds great promise for the further development of DBS. Methods Articles were retrieved from MEDLINE via PubMed. Relevant references in retrieved articles were followed up. We included all articles reporting on studies of patients selected for having OCD or TRD. Adequacy of the selected studies was evaluated by the Jadad scale. Evaluation criteria included: number of patients, use of recognized psychiatric rating scales, and use of brain blood flow measurements. Success rates classified as "improved" or "recovered" were recorded. Studies of DBS for movement disorders were included if they reported coincidental relief of depression or reduction in OCD. Most of the studies involved small
Debes, Nanette; Hjalgrim, Helle; Skov, Liselotte
We assessed the psychosocial and educational consequences of Tourette syndrome using a structured interview and child behavior checklist in 314 children with Tourette syndrome and 81 healthy controls. Of the children with Tourette syndrome, 59.0% needed some kind of educational support, 44.7% had...... been teased, and 61.8% withheld themselves from taking part in social activities because of Tourette syndrome-related problems. There were significantly more psychosocial and educational problems in children with Tourette syndrome compared with healthy controls. A higher rate of these problems was also...... seen if the comorbidities attention-deficit hyperactivity disorder (ADHD) and/or obsessive compulsive disorder were present. It is very important for the physicians, teachers, and other professionals to be aware of the high prevalence of these social and educational problems to be able to deal...
Debes, Nanette; Hjalgrim, Helle; Skov, Liselotte
been teased, and 61.8% withheld themselves from taking part in social activities because of Tourette syndrome-related problems. There were significantly more psychosocial and educational problems in children with Tourette syndrome compared with healthy controls. A higher rate of these problems was also...... seen if the comorbidities attention-deficit hyperactivity disorder (ADHD) and/or obsessive compulsive disorder were present. It is very important for the physicians, teachers, and other professionals to be aware of the high prevalence of these social and educational problems to be able to deal......We assessed the psychosocial and educational consequences of Tourette syndrome using a structured interview and child behavior checklist in 314 children with Tourette syndrome and 81 healthy controls. Of the children with Tourette syndrome, 59.0% needed some kind of educational support, 44.7% had...
Full Text Available Clinical Philosophy (CP can be understood as an approach to the treatment of mental disorders. The goal of the present study is to put this CP approach to a first empirical testing. I present Arnold, a comorbid case with an insufficient treatment response to conventional, standard cognitive-behavioral therapy (CBT. Using a single case pre-test/post-test design a CP approach was developed drawing heavily on existentialist and philosophy-oriented writers. The client responded well to this novel treatment approach. Above all, levels of intolerance of uncertainty improved greatly from pre- to post-treatment. Also, a decrease in overall illness severity as well as specific psychopathological variables such as obsessive-compulsive symptoms, depression, and anxiety could be observed. Results are discussed in terms of the underlying mechanism of the CP approach. An account of the underlying mechanism of efficacy, understood as a tripartite function, is introduced. CP as a philosophy-oriented method within the broader framework of third wave CBT and existential analysis is considered.
Williams, Monnica T; Proetto, Dante; Casiano, Delane; Franklin, Martin E
Obsessive-compulsive disorder (OCD) is a leading cause of disability worldwide, however for reasons that are poorly understood ethnic minority groups are not well represented in clinical research studies. Thus, although African Americans experience equivalent rates of OCD according to epidemiological surveys, the generalizability of findings from clinical trials remains unknown. Research designed to improve identification, assessment and treatment of OCD is an important public health priority. The purpose of this study is to report outreach methods used to recruit African American adults for participation in an OCD research study. A variety of methods were employed, including radio advertisements, public transportation advertising, community outreach, and online advertising. A total of 83 African American adult participants were recruited over a 9.5 month period at the University of Pennsylvania in Philadelphia, and given comprehensive psychiatric assessments. African Americans with OCD symptoms were reliably identified and assessed, for a total of 75 with lifetime OCD (4 past and 71 current diagnoses). There was variability in the success and cost effectiveness of study recruitment methods. Radio ads were the most expensive means of recruitment, newspaper ads accounted for the largest number of eligible participants, and no cost methods such as Craig's List and word of mouth were also effective. The authors conclude that, with focused efforts, there are many effective methods for recruiting African Americans with OCD. Guidelines for recruitment are discussed, with a focus on cultural considerations. PMID:21983626
Kwak, Kyung-Hwa; Lee, Seung Jae
Schema theory and therapy may be an additional therapeutic approach to identify and treat chronic psychological problems, namely early maladaptive schemas (EMSs), in patients with obsessive-compulsive disorder (OCD) and panic disorder (PAD). In the current study, we investigated the characteristics in EMSs between patients with OCD and PAD. Fifty-one patients with OCD, 46 patients with PAD, and 70 normal controls participated in this study. EMSs and depressive symptoms were measured using the Young Schema Questionnaire and the Beck Depression Inventory (BDI), respectively. Analysis of covariance was conducted with age, sex, BDI score, and education level as covariates to assess group differences. Direct comparisons among the three groups revealed that the defectiveness/shame and social isolation/alienation schemas were prominently activated in patients with OCD, whereas the vulnerability to harm or illness and self-sacrifice were activated in patients with PAD. In subgroup analysis, these differences were observed between subgroups with lower BDI scores, but not between the patient subgroups with higher BDI scores. However, the differences between the patient groups in the defectiveness/shame and vulnerability to harm or illness schemas almost reached significance. Patients with OCD and PAD differed in particular EMS characteristics, which could have potential therapeutic implications.
Full text: Obsessive-Compulsive Disorder (OCD) is an anxiety disorder which is increasingly being recognised as a neurobiological disorder. While serotonergic mechanisms have been proposed, the major competing theory in the pathophysiology of OCD involves the neurotransmitter dopamine. The Dopamine D1 receptor is implicated in OCD following the finding of specific spatial working memory abnormalities in a series of neuropsychological studies. Spatial working memory is known to depend on the integrity of D1 receptor function in the Dorso-lateral Prefrontal Cortex (DLPFC) of primates. This study aims to examine the role of dopamine in patients with OCD and in particular to test the hypothesis that there is an upregulation of dopamine D1 receptors in the DLPFC which correlates with spatial working memory deficits in OCD. Three OCD patients and three normal controls underwent Positron Emission Tomography (PET) following intravenous injection of the D1 antagonist PET ligand SCH23390. Reconstructed PET images were co registered with subject Magnetic Resonance Images (MRI) and regions of interest drawn manually. We will present the analysis of the Binding Potentials of SCH23390 in the regions of interest of the first three OCD patients and compare them with three normal control patients. In conclusion Dopamine-Serotonergic interactions are involved in the pathophysiology of OCD. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc
Moritz, Steffen; Hottenrott, Birgit; Jelinek, Lena; Brooks, Amanda M; Scheurich, Armin
Theoretical models of obsessive-compulsive disorder (OCD) implicate neurocognitive dysfunction, particularly deficits in nonverbal memory and executive functioning, in the pathogenesis of the disorder. The opposite hypothesis (poor performance in neuropsychological test as an epiphenomenon of OCD symptoms) has rarely been contemplated although checking behavior, obsessional doubt, lack of motivation, and slowness as well as preoccupation with touching objects may result in secondary test impairment and mimic manifestations of neural dysfunction. A total of 60 patients with OCD and 30 healthy controls were tested with a multi-functional neuropsychological battery. At the end of the testing participants were asked about their effort and the severity of OCD symptoms during task execution. Up to one fourth of the OCD patients affirmed OCD-related worries and motivational problems during task execution. Poor motivation and checking were significantly associated with enhanced objective performance deficits. Whereas the present study does not negate a role of neurocognitive deficits in the formation of OCD, in our view the reverse relationship should be contemplated as well. We advise researchers to pay closer attention to possible confounds that may mediate the relationship between OCD and neurocognition. Limitations of the study are discussed. PMID:22166079
Richter, Margaret A; de Jesus, Danilo R; Hoppenbrouwers, Sylco; Daigle, Melissa; Deluce, Jasna; Ravindran, Lakshmi N; Fitzgerald, Paul B; Daskalakis, Zafiris J
Several lines of evidence suggest that obsessive-compulsive disorder (OCD) is associated with an inability to inhibit unwanted intrusive thoughts. The neurophysiological mechanisms mediating such inhibitory deficits include abnormalities in cortical γ-aminobutyric acid (GABA) inhibitory as well as N-methyl-D-aspartate (NMDA) receptor-mediated mechanisms. Molecular evidence suggests that both these neurotransmitter systems are involved in OCD. Transcranial magnetic stimulation (TMS) represents a noninvasive technique to ascertain neurophysiological indices of inhibitory GABA and facilitatory NMDA receptor-mediated mechanisms. In this study, both mechanisms were indexed in 34 patients with OCD (23 unmedicated and 11 medicated) and compared with 34 healthy subjects. Cortical inhibitory and facilitatory neurotransmission was measured using TMS paradigms known as short-interval cortical inhibition (SICI), cortical silent period (CSP), and intracortical facilitation (ICF). Patients with OCD demonstrated significantly shortened CSP (pdisorder (MDD) from the analysis, these differences remained significant. Our findings suggest that OCD is associated with dysregulation in cortical inhibitory and facilitatory neurotransmission. Specifically, these findings suggest impairments in GABA(B) receptor-mediated and NMDA receptor-mediated neurotransmission. These findings are consistent with previously published genetic studies implicating GABA(B), and NMDA transporter and receptor genes in OCD. It is posited that dysregulation of such mechanisms may lead to the generation and persistence of intrusive thoughts that form the basis for this disorder. PMID:22169948
Schubert, Jessica R; Coles, Meredith E
Research has demonstrated a relationship between circadian disruption and severe obsessive-compulsive disorder (OCD). Misalignment of sleep timing/endogenous biological rhythms with the 24-hour light/dark cycle may result in difficulty dismissing intrusive thoughts, thus increasing vulnerability to disorders characterized by intrusive thoughts, such as OCD. Deficits in inhibition of intrusive thoughts are posited to play a role in OCD. The current study investigated whether individuals with delayed sleep phase disorder (DSPD) report elevated symptoms of OCD and have greater difficulty inhibiting intrusive thoughts than do individuals without DSPD. Community participants with and without DSPD completed questionnaires and performed behavioral tasks designed to elicit intrusive thoughts. The participants with DSPD (n = 27) had elevated OCD symptoms and greater rates of disorders characterized by intrusive thoughts on a structured interview, as compared with the participants without DSPD (n = 19). These results support a link between the timing of sleep and symptoms of OCD. Implications and future directions are discussed. PMID:24080675
Lind, Christian; Boschen, Mark J; Morrissey, Shirley
Obsessive compulsive disorder (OCD) is a prevalent and costly condition that causes significant functional impairment and reduced quality of life. Although treatments with demonstrated efficacy for OCD, such as cognitive behavior therapy and antidepressants, have existed for over three decades, many patients remain inadequately treated or untreated. Challenges encountered in the treatment of OCD include problems with homework compliance, frequent relapse, difficulties in simulating the spontaneous nature of intrusive thoughts, and infrequent treatment sessions. Accumulated research now indicates that computerized assessment and therapy tools can significantly improve the cost/time-effectiveness of conventional psychotherapeutic interventions for anxiety disorders such as OCD without impairing therapeutic progress and outcome. In this paper we examine the potential of such technology, address current challenges in the assessment and treatment of OCD, and provide a rationale for future research in the field. We outline the general utility of computer technology in psychotherapeutic interventions, critically evaluate the existing literature on computer-assisted assessment and treatment specific to OCD, as well as discuss potential implications of portable technology for OCD treatment delivery and outcomes. PMID:23247201