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Sample records for depression obsessive-compulsive disorder

  1. Response Inhibition Function of Obsessive-Compulsive Patients with Obsessive-Compulsive Personality Disorder

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    Hui Lei

    2017-06-01

    Full Text Available Objective: To explore the effect of comorbid obsessive-compulsive personality disorder (OCPD on response inhibition functions in patients with obsessive-compulsive disorder (OCD. Methods: Forty-five obsessive-compulsive patients with obsessive-compulsive personality disorder (OCD + OCPD, 42 obsessive-compulsive patients without obsessive-compulsive personality disorder (OCD - OCPD and 54 healthy volunteers were selected for the stop-signal task. Results: Obsessive-compulsive patients with obsessive-compulsive personality disorder had a higher score of depression and anxiety and more severe obsessive-compulsive symptoms than that of obsessive-compulsive patients without obsessive-compulsive personality disorder. The two groups of obsessive-compulsive patients of had a greater stop-signal reaction time (SSRT during the inhibition process than the healthy volunteers of the control group (OCD + OCPD: 221.45 ± 31.78; OCD - OCPD: 218.36 ± 31.78; Controls: 199.29 ± 22.80; p < 0.05. However, no significant difference was found between the two groups of obsessive-compulsive patients. Conclusion: The findings show that the comorbid obsessive-compulsive personality disorder has no effect on response inhibition function of obsessive-compulsive patients.

  2. Major Depressive Disorder, Obsessive-Compulsive Disorder, and Generalized Anxiety Disorder: Do the Sexual Dysfunctions Differ?

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    Kendurkar, Arvind; Kaur, Brinder

    2008-01-01

    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.

  3. Obsessive Compulsive Disorder among Adults

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    ... Adults Data Sources Share Obsessive-Compulsive Disorder (OCD) Definition Obsessive-compulsive disorder (OCD) is often a long- ... MSC 9663 Bethesda, MD 20892-9663 Follow Us Facebook Twitter YouTube Google Plus NIMH Newsletter NIMH RSS ...

  4. Perceived parental characteristics of patients with obsessive compulsive disorder, depression, and panic disorder.

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    Merkel, W T; Pollard, C A; Wiener, R L; Staebler, C R

    1993-01-01

    It has been hypothesized that parents of patients with obsessive compulsive disorder exhibit specific traits. 320 consecutive inpatient admissions who met criteria for OCD, depression, and panic disorder checked a list of adjectives to describe their parents. Patients with OCD were 1) less likely to perceive their mothers as disorganized than depressives, 2) more likely to perceive their mothers as overprotective than depressives and 3) less likely to perceive their fathers as demanding than patients with panic.

  5. Disentangling depressive personality disorder from avoidant, borderline, and obsessive-compulsive personality disorders.

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    Huprich, Steven K; Zimmerman, Mark; Chelminski, Iwona

    2006-01-01

    Several studies have found that 3 personality disorders (PDs) tend to share moderate rates of comorbidity with depressive PD: avoidant, borderline, and obsessive-compulsive. This study sought to evaluate the diagnostic criteria of each disorder in an effort to understand where areas of overlap may occur and to modify criteria sets where reasonable to reduce any degree of overlap. One thousand two hundred psychiatric outpatients were interviewed with the Structured Interview for DSM-IV Personality Disorders. The highest degree of comorbidity was observed between avoidant PD and depressive PD. Logistic regression analyses indicated that 2 criteria-avoidant criterion 5 and depressive criterion 2-could be removed from the diagnostic criteria sets and reduce the rates of overlap by as much as 15%. A factor analysis of the criteria of all 4 PDs indicated that there is a common clustering of many of the symptoms of avoidant, borderline, depressive, and obsessive-compulsive PDs and that borderline symptoms tend to cluster together most consistently. Avoidant and obsessive-compulsive personality symptoms clustered in ways that may reflect a problem of how to engage with others, suggestive of an approach-avoidance conflict. Depressive PD symptoms clustered in a way suggestive of problems with anger that is directed toward oneself and others. The factor analysis results suggest that an organization of symptoms around themes of conflict may provide useful ways of understanding the personality patterns of these 4 disorders.

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

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

    2012-08-01

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

  7. Anger attacks in obsessive compulsive disorder

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    Nitesh Prakash Painuly

    2011-01-01

    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.

  8. SUCCESSFUL TREATMENT OF OBSESSIVE-COMPULSIVE DISORDER WITH ELECTROCONVULSIVE THERAPY

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    Kishimoto, Toshifumi; Ikawa, Genro

    1995-01-01

    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.

  9. Anxiety and Shame as Risk Factors for Depression, Suicidality, and Functional Impairment in Body Dysmorphic Disorder and Obsessive Compulsive Disorder.

    Science.gov (United States)

    Weingarden, Hilary; Renshaw, Keith D; Wilhelm, Sabine; Tangney, June P; DiMauro, Jennifer

    2016-11-01

    Body dysmorphic disorder (BDD) and obsessive compulsive disorder (OCD) are associated with elevated depression, suicidality, functional impairment, and days housebound, yet little research has identified risk factors for these outcomes. Using path analysis, the present study examined anxiety and shame as risk factors for these outcomes across Internet-recruited self-report groups (BDD [n = 114], OCD [n = 114], and healthy control [HC; n = 133]). Paths from anxiety and shame to outcomes were similar and mostly significant across BDD and OCD, compared to non-significant paths for HCs, with one exception: the path from shame to depression was significant in the BDD group (b = 0.32) but non-significant in the OCD group (b = 0.07). Findings underscore similarities in BDD and OCD, supporting their reclassification into the same Obsessive Compulsive Related Disorders category. Results emphasize the importance of targeting shame, in addition to anxiety, in treatments for BDD and OCD.

  10. Bipolar Disorder and Obsessive Compulsive Disorder Comorbidity

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    Necla Keskin

    2014-08-01

    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

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

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

    2005-10-01

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

  12. Psilocybin and Obsessive Compulsive Disorder.

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    Wilcox, James Allen

    2014-01-01

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

  13. Paediatric Obsessive-Compulsive Disorder and Depressive Symptoms: Clinical Correlates and CBT Treatment Outcomes.

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    Brown, H M; Lester, K J; Jassi, A; Heyman, I; Krebs, G

    2015-07-01

    Depression frequently co-occurs with paediatric obsessive-compulsive disorder (OCD), yet the clinical correlates and impact of depression on CBT outcomes remain unclear. The prevalence and clinical correlates of depression were examined in a paediatric specialist OCD-clinic sample (N = 295; Mean = 15 [7 - 18] years, 42 % female), using both dimensional (Beck Depression Inventory-youth; n = 261) and diagnostic (Development and Wellbeing Assessment; n = 127) measures of depression. The impact of depressive symptoms and suspected disorders on post-treatment OCD severity was examined in a sub-sample who received CBT, with or without SSRI medication (N = 100). Fifty-one per-cent of patients reported moderately or extremely elevated depressive symptoms and 26 % (95 % CI: 18 - 34) met criteria for a suspected depressive disorder. Depressive symptoms and depressive disorders were associated with worse OCD symptom severity and global functioning prior to CBT. Individuals with depression were more likely to be female, have had a psychiatric inpatient admission and less likely to be attending school (ps depressive symptom severity significantly decreased after CBT. Depressive symptoms and depressive disorders predicted worse post-treatment OCD severity (βs = 0.19 and 0.26, ps Depression is common in paediatric OCD and is associated with more severe OCD and poorer functioning. However, depression severity decreases over the course of CBT for OCD and is not independently associated with worse outcomes, supporting the recommendation for treatment as usual in the presence of depressive symptoms.

  14. Investigation of attentional bias in obsessive compulsive disorder with and without depression in visual search.

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    Sharon Morein-Zamir

    Full Text Available Whether Obsessive Compulsive Disorder (OCD is associated with an increased attentional bias to emotive stimuli remains controversial. Additionally, it is unclear whether comorbid depression modulates abnormal emotional processing in OCD. This study examined attentional bias to OC-relevant scenes using a visual search task. Controls, non-depressed and depressed OCD patients searched for their personally selected positive images amongst their negative distractors, and vice versa. Whilst the OCD groups were slower than healthy individuals in rating the images, there were no group differences in the magnitude of negative bias to concern-related scenes. A second experiment employing a common set of images replicated the results on an additional sample of OCD patients. Although there was a larger bias to negative OC-related images without pre-exposure overall, no group differences in attentional bias were observed. However, OCD patients subsequently rated the images more slowly and more negatively, again suggesting post-attentional processing abnormalities. The results argue against a robust attentional bias in OCD patients, regardless of their depression status and speak to generalized difficulties disengaging from negative valence stimuli. Rather, post-attentional processing abnormalities may account for differences in emotional processing in OCD.

  15. A review on quality of life and depression in obsessive-compulsive disorder.

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    Moritz, Steffen

    2008-09-01

    Quality of life (QoL) is increasingly recognized as a pivotal outcome parameter in research on obsessive-compulsive disorder (OCD). While the concept remains somewhat ill-defined, there is now little dispute that the patients' personal goals deserve foremost consideration during the course of treatment as the primary aim of treatment should be relief from individual despair, which is related but by no means synonymous to symptom reduction. Studies using generic (ie, illness-unspecific) instruments have confirmed poor QoL in OCD patients across a wide range of domains, especially with respect to social, work role functioning, and mental health aspects. Scores are sometimes as low as those obtained by patients with schizophrenia. Depression and obsessions are the symptom clusters that most strongly contribute to low QoL. Findings from a novel survey of 105 OCD participants point to multiple daily life problems, poor work status, and tense social networks in these patients. In order to achieve therapeutic success and improve QoL, functional problems at work and comorbid disorders such as secondary depression and physical impairments should be targeted. While successful treatment sometimes positively impacts well-being, in some studies symptom decline did not translate into improved QoL.

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

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    Haraldsson, Magnús

    2015-02-01

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

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

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

    1997-01-01

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

  18. Determinants of obsessive compulsive disorder

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    Sateesh Rangarao Koujalgi

    2015-01-01

    Full Text Available Background: The family has a significant role both in the genesis and prognosis of obsessive-compulsive disorder (OCD. Early identification, treatment and prevention of relapse in patients with OCD have important therapeutic and psychosocial implications. Hence, to study and determine family factors like high expressed emotion (EE and family dysfunction are essential. These two factors play a significant role in the relapse and course of OCD. Aim: The aim was to study the relationship between family function, EE and OCD. Materials and Methods: The sample included 30 patients who were diagnosed with OCD using International Classification of Diseases-10 Diagnostic Criteria for Research criteria. Yale-Brown obsessive compulsive scale was used to assess the severity of OCD. EE was assessed in cases using Family Emotional Involvement and Criticism Scale and family function was assessed in cases using the family interaction pattern scale (FIPS. Statistical analysis was performed using Statistical Packages for Social Science. Patient and caregivers of the patients were assessed on self-developed socio-demographic proforma. Pearson co-relation co-efficient test was used to study the correlation between OCD, high EE and family dysfunction. Results: The result showed that there are significant correlations between high EE, family dysfunction and OCD. The Pearson correlation co-efficient between OCD and EE shows a significant correlation between the high EE of the caregiver and OCD with P < 0.01. The Pearson correlation co-efficient between OCD and Family Interaction Pattern Scale shows a significant correlation between the family dysfunction of the caregiver and OCD. Conclusion: Impaired family function and high EE in caregivers associated with OCD. Thus clinical interventions may improve the functional abilities of the caregivers.

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

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

    2007-06-01

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

  20. Obsessive-compulsive personality disorder and suicidal behavior: evidence for a positive association in a sample of depressed patients.

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    Diaconu, Gabriel; Turecki, Gustavo

    2009-11-01

    To explore the association between obsessive-compulsive personality disorder (OCPD) and suicidal behavior. Subjects referred for a psychiatric consultation were evaluated with structured interviews for mood and personality disorders (the Structured Clinical Interview for DSM-III-R and the Structured Clinical Interview for DSM-III-R Axis II Disorders), a history of suicidal behavior, and levels of coping. A total of 311 subjects were investigated using a 3-group design to test the association between OCPD and suicidal behavior, controlling for the presence of depression. Subjects with OCPD and a history of depression were compared to depressed subjects without any Axis II diagnosis and to subjects without depression or personality disorders. The study was conducted at Verdun Community Psychiatric Clinic, Douglas Hospital, McGill University, in Montreal, Quebec, Canada, and subjects were recruited from 2003 until 2005. Subjects in the comorbid OCPD-depression group presented increased current and lifetime suicide ideation compared to the groups with depression alone or without depression or personality disorders (P = .004); they also had increased history of suicide attempts (P = .04), which were often multiple attempts (P = .01). They also scored lower on the Reasons for Living Inventory (RFL) and the Death Anxiety Questionnaire. Interestingly, comorbid OCPD-depression patients differed from patients with depression alone on the Moral Objections items of the RFL, on which individuals with OCPD-depression scored lowest. Limitations of this study were its cross-sectional design, retrospective sample, and limited generalizability to the population at large. Obsessive-compulsive personality disorder is a factor increasing risk for nonfatal suicidal behavior independently of risk conferred by depressive disorders. Copyright 2009 Physicians Postgraduate Press, Inc.

  1. Fusion or confusion in obsessive compulsive disorder.

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    O'Connor, Kieron; Aardema, Frederick

    2003-08-01

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

  2. Diagnosis of obsessive-compulsive disorder in the course of bipolar disorder

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    Maciej Żerdziński

    2016-06-01

    Full Text Available Aim: The aim of this study was to evaluate the coexistence of obsessive-compulsive symptoms with bipolar disorder (during the manic phase, depressive phase and remission. Method: The subjects were 70 patients previously diagnosed with and treated for bipolar disorder. For the purposes of this study, three subgroups were created: patients in the manic phase, depressive phase and in remission. The Hamilton Depression Rating Scale, Young Mania Rating Scale and Yale-Brown Obsessive Compulsive Scale were diagnostic tools used for the evaluation of patients’ mental health. Results: The data indicate high likelihood of co-occurrence of obsessive-compulsive disorder (28.6% and obsessive-compulsive syndromes (32.8% with bipolar disorder. Obsessions and compulsions were observed irrespectively of the type of bipolar disorder (type 1 and 2 and phase of the illness (depression, mania, remission. The results in the three subgroups were similar. The severity of anankastic symptoms depended both on the severity of depression and mania. The subjects confirmed the presence of obsessive-compulsive symptoms in the interview, although they were usually undiagnosed and untreated. Conclusions: Obsessive-compulsive disorder symptoms often coexist with bipolar disorder, both in its two phases and in remission. The severity of obsessive-compulsive symptoms in the course of bipolar condition varies, ranging from mild to extremely severe forms. The obsessive-compulsive disorder presentation in the course of bipolar disorder increases with the severity of depressive and manic symptoms. Obsessive-compulsive disorder can be primary to bipolar disorder. Obsessive-compulsive disorder coexisting with bipolar disorder is not diagnosed or treated properly.

  3. Clarifying the convergence between obsessive compulsive personality disorder criteria and obsessive compulsive disorder.

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    Eisen, Jane L; Coles, Meredith E; Shea, M Tracie; Pagano, Maria E; Stout, Robert L; Yen, Shirley; Grilo, Carlos M; Rasmussen, Steven A

    2006-06-01

    In this study we examined the convergence between obsessive-compulsive personality disorder (OCPD) criteria and obsessive-compulsive disorder (OCD). Baseline assessments of 629 participants of the Collaborative Longitudinal Personality Disorders Study were used to examine the associations between OCPD criteria and diagnoses of OCD. Three of the eight OCPD criteria--hoarding, perfectionism, and preoccupation with details--were significantly more frequent in subjects with OCD (n = 89) than in subjects without OCD (n = 540). Logistic regressions were used to predict the probability of each OCPD criterion as a function of Axis I diagnoses (OCD, additional anxiety disorders, and major depressive disorder). Associations between OCD and these three OCPD criteria remained significant in the logistic regressions, showing unique associations with OCD and odds ratios ranging from 2.71 to 2.99. In addition, other anxiety disorders and major depressive disorder showed few associations with specific OCPD criteria. This study suggests variability in the strength of the relationships between specific OCPD criteria and OCD. The findings also support a unique relationship between OCPD symptoms and OCD, compared to other anxiety disorders or major depression. Future efforts to explore the link between Axis I and Axis II disorders may be enriched by conducting analyses at the symptom level.

  4. CLARIFYING THE CONVERGENCE BETWEEN OBSESSIVE COMPULSIVE PERSONALITY DISORDER CRITERIA AND OBSESSIVE COMPULSIVE DISORDER

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    Eisen, Jane L.; Coles, Meredith E.; Shea, M. Tracie; Pagano, Maria E.; Stout, Robert L.; Yen, Shirley; Grilo, Carlos M.; Rasmussen, Steven A.

    2006-01-01

    In this study we examined the convergence between obsessive-compulsive personality disorder (OCPD) criteria and obsessive-compulsive disorder (OCD). Baseline assessments of 629 participants of the Collaborative Longitudinal Personality Disorders Study were used to examine the associations between OCPD criteria and diagnoses of OCD. Three of the eight OCPD criteria—hoarding, perfectionism, and preoccupation with details—were significantly more frequent in subjects with OCD (n = 89) than in sub...

  5. Obsessive compulsive disorder- prevalence in Xhosaspeaking ...

    African Journals Online (AJOL)

    Obsessive compulsive disorder- prevalence in Xhosaspeaking schizophrenia patients. ... No concordance for OCD was noted in the sibship group. Our findings differ from those in other parts of the world, and if replicated, might suggest unique protective environmental or genetic factors for OCD in certain ethnic groups.

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

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

    2015-06-01

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

  7. Obsessive compulsive symptoms in patients with schizophrenia on clozapine and with obsessive compulsive disorder: a comparison study.

    LENUS (Irish Health Repository)

    Doyle, Mairead

    2014-01-01

    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

  8. Associations in the longitudinal course of body dysmorphic disorder with major depression, obsessive-compulsive disorder, and social phobia.

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    Phillips, Katharine A; Stout, Robert L

    2006-06-01

    Body dysmorphic disorder (BDD) is an impairing and relatively common disorder that has high comorbidity with certain Axis I disorders. However, the longitudinal associations between BDD and comorbid disorders have not previously been examined. Such information may shed light on the nature of BDD's relationship to putative "near-neighbor" disorders, such as major depression, obsessive-compulsive disorder (OCD), and social phobia. This study examined time-varying associations between BDD and these comorbid disorders in 161 participants over 1-3 years of follow-up in the first prospective longitudinal study of the course of BDD. We found that BDD had significant longitudinal associations with major depression--that is, change in the status of BDD and major depression was closely linked in time, with improvement in major depression predicting BDD remission, and, conversely, improvement in BDD predicting depression remission. We also found that improvement in OCD predicted BDD remission, but that BDD improvement did not predict OCD remission. No significant longitudinal associations were found for BDD and social phobia (although the results for analyses of OCD and social phobia were less numerically stable). These findings suggest (but do not prove) that BDD may be etiologically linked to major depression and OCD, i.e., that BDD may be a member of both the putative OCD spectrum and the affective spectrum. However, BDD does not appear to simply be a symptom of these comorbid disorders, as BDD symptoms persisted in a sizable proportion of subjects who remitted from these comorbid disorders. Additional studies are needed to elucidate the nature of BDD's relationship to commonly co-occurring disorders, as this issue has important theoretical and clinical implications.

  9. Depression and risk of suicide in patients with obsessive-compulsive disorder: A hospital-based study

    Directory of Open Access Journals (Sweden)

    Rupesh Kumar Chaudhary

    2016-01-01

    Full Text Available Background: Obsessive Compulsive Disorder (OCD is a chronic, distressing, anxiety disorder associated with significant functional impairment. Patient with OCD often suffer from one or more co-morbid disorders. Major depression has been the most common co-morbid syndrome. Comorbid Axis I disorders along with increased severity of comorbid depressive and anxiety symptoms, increased severity of obsessions, feelings of hopelessness and past history of suicide attempts have been associated with worsening levels of suicidality in OCD (Angelakis I, Gooding P., 2015. As per data Thirty-six percent of the patients of OCD report lifetime suicidal thoughts and 11% have a history of attempted suicide(Torres AR, Ramos-Cerqueira AT, et al, 2011. There is a reasonable probability that the patient of OCD have suicidal thoughts, plans or actually attempt suicide. Aim: To assess depression and suicidality in OCD patients. Method: This study was conducted on 50 patients diagnosed with OCD as per ICD 10 criteria, both outpatient & indoor, from department of psychiatry, Dayanand Medical College & Hospital, Ludhiana, Punjab, India. A socio-demographic proforma (containing demographic details, Hamilton Depression Rating & Scale, Columbia suicide severity rating scale (CSSRS & Yale Brown Obsessive Compulsive Scale Symptom Checklist (YBOCS were administered. Results: Mild depression was found out to be 40% whereas 16% were suffering from moderate depression and 10% and 14% had severe and very severe depression respectively. Suicidal ideation was found in 52 % of patients.16% of patients had history of actual attempt. Data showed that 70% of females had suicidal ideations. It was also found that in cases of severe and very severe depression associated with OCD all the patients had suicidal ideations as compared to 35% in mild and 87.5% in moderate depressive patients. It was found that 40% of severe depressive and 28.57% of very severe depressive patients had attempted

  10. Conscientiousness and Obsessive-Compulsive Personality Disorder

    OpenAIRE

    Samuel, Douglas B; Widiger, Thomas A

    2011-01-01

    A dimensional perspective on personality disorder hypothesizes that the current diagnostic categories represent maladaptive variants of general personality traits. However, a fundamental foundation of this viewpoint is that dimensional models can adequately account for the pathology currently described by these categories. While most of the personality disorders have well established links to dimensional models that buttress this hypothesis, obsessive-compulsive personality disorder (OCPD) ha...

  11. Explanation of obsessive-compulsive disorder and major depressive disorder on the basis of thought-action fusion.

    Science.gov (United States)

    Ghamari Kivi, Hossein; Mohammadipour Rik, Ne'mat; Sadeghi Movahhed, Fariba

    2013-01-01

    Thought-action fusion (TAF) refers to the tendency to assume incorrect causal relationship between one's own thoughts and external reality, in which, thoughts and actions are treated as equivalents. This construct is present to development and maintenance of many psychological disorders. The aim of the present study was to predict obsessive-compulsive disorder (OCD) and its types, and major depressive disorder (MDD) with TAF and its levels. Two groups, included 50 persons with OCD and MDD, respectively, were selected by convenience sampling method in private and governmental psychiatric centers in Ardabil, Iran. Then, they responded to Beck Depression Inventory, Padua Inventory and TAF scale. Data were analysed using multiple regressions analysis by stepwise method. TAF or its subtypes (moral TAF, likelihood-self TAF and likelihood-others TAF) can explain 14% of MDD variance (p < 0.01), 15% of OCD variance (p < 0.01), and 8-21% of OCD types variance (p < 0.05). Moral TAF had high levels in OCD and MDD. The construct of TAF is not specific factor for OCD, and it is present in MDD, too. None.

  12. Obsessive compulsive personality disorder and Parkinson's disease.

    Science.gov (United States)

    Nicoletti, Alessandra; Luca, Antonina; Raciti, Loredana; Contrafatto, Donatella; Bruno, Elisa; Dibilio, Valeria; Sciacca, Giorgia; Mostile, Giovanni; Petralia, Antonio; Zappia, Mario

    2013-01-01

    To evaluate the frequency of personality disorders in Parkinson's disease (PD) patients and in a group of healthy controls. Patients affected by PD diagnosed according to the United Kingdom Parkinson's disease Society Brain Bank diagnostic criteria and a group of healthy controls were enrolled in the study. PD patients with cognitive impairment were excluded from the study. Structured Clinical Interview for Personality Disorders-II (SCID-II) has been performed to evaluate the presence of personality disorders. Presence of personality disorders, diagnosed according to the DSM-IV, was confirmed by a psychiatric interview. Clinical and pharmacological data were also recorded using a standardized questionnaire. 100 PD patients (57 men; mean age 59.0 ± 10.2 years) and 100 healthy subjects (52 men; mean age 58.1 ± 11.4 years) were enrolled in the study. The most common personality disorder was the obsessive-compulsive personality disorder diagnosed in 40 PD patients and in 10 controls subjects (p-valuepersonality disorder recorded in 14 PD patients and 4 control subjects (p-value 0.02). Obsessive-compulsive personality disorder was also found in 8 out of 16 de novo PD patients with a short disease duration. PD patients presented a high frequency of obsessive-compulsive personality disorder that does not seem to be related with both disease duration and dopaminergic therapy.

  13. Understanding Obsessive-Compulsive Personality Disorder

    OpenAIRE

    Steven C. Hertler

    2013-01-01

    With the ultimate goal of better understanding Obsessive-Compulsive Personality Disorder (OCPD), the present work is a review and critique of Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV) diagnostic criteria at the end of their 18 years of use. Problems of specificity (polythetic criteria and failure to employ a hallmark feature) make OCPD an indistinct diagnostic category that consequently co...

  14. The role of avoidant and obsessive-compulsive personality disorder traits in matching patients with major depression to cognitive behavioral and psychodynamic therapy: A replication study.

    Science.gov (United States)

    Kikkert, Martijn J; Driessen, Ellen; Peen, Jaap; Barber, Jacques P; Bockting, Claudi; Schalkwijk, Frans; Dekker, Jeff; Dekker, Jack J M

    2016-11-15

    Barber and Muenz (1996) reported that cognitive behavior therapy (CBT) was more effective than interpersonal therapy (IPT) for depressed patients with elevated levels of avoidant personality disorder, while IPT was more effective than CBT in patients with elevated levels of obsessive-compulsive personality disorder. These findings may have important clinical implications, but have not yet been replicated. We conducted a study using data from a randomized clinical trial comparing the efficacy of CBT and short-term psychodynamic supportive psychotherapy in the outpatient treatment of depression. We found no evidence indicating that avoidant patients may benefit more from CBT compared to short-term psychodynamic supportive therapy (SPSP). Our results indicate that treatment effect does not depend on the level of avoidance, or obsessive-compulsiveness personality disorders further examine the influence of personality disorders on the effectiveness of CBT or psychodynamic therapy in the treatment of depression. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Metacognitive Model of Obsessive Compulsive Disorder

    Directory of Open Access Journals (Sweden)

    Mehmet Zihni Sungur

    2012-09-01

    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.

  16. Self-esteem and obsessive compulsive disorder.

    Science.gov (United States)

    Husain, Nusrat; Chaudhry, Imran; Raza-ur-Rehman; Ahmed, Ghazal Riaz

    2014-01-01

    To explore the association between self-esteem and obsessive compulsive disorder in a low-income country, and to conduct an in-depth analysis into the said relationship by identifying any confounding variables that might exist. The cross-sectional study was conducted at the psychiatry out-patient clinic of Civil Hospital, Karachi, from January to March 2008, and comprised 65 patients diagnosed with obsessive compulsive disorder and 30 healthy controls. The participatnts completed the Janis and Field Social Adequacy scale and the Rosenberg Self-esteem scale. SPSS 15 was used for statistical analysis. Significantly different scores were reported on both measures of self-esteem between the patients and the controls (pself-esteem in the patients compared to the controls. Data replicated earlier findings from populations in high-income countries.

  17. Thought Action Fusion in Obsessive Compulsive Disorder

    OpenAIRE

    Þahin ÇÝFTÇÝ; Tacettin KURU

    2013-01-01

    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 includi...

  18. Obsessive-Compulsive Disorder in the Elderly

    Directory of Open Access Journals (Sweden)

    Michael P. Philpot

    1998-01-01

    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.

  19. Memory Functioning in Obsessive-Compulsive Disorder

    Directory of Open Access Journals (Sweden)

    M. Abbruzzese

    1993-01-01

    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.

  20. Prevalence of Childhood Obsessive-Compulsive Personality Traits in Adults with Obsessive Compulsive Disorder versus Obsessive Compulsive Personality Disorder

    OpenAIRE

    Pinto, Anthony; Greene, Ashley L.; Storch, Eric A.; Simpson, H. Blair

    2014-01-01

    Identifying risk factors of psychopathology has been an important research challenge. Prior studies examining the impact of childhood temperament on adult disorder have largely focused on undercontrolled and inhibited presentations, with little study of overcontrolled traits such as obsessive-compulsive personality traits (OCPTs). We compared rates of childhood OCPTs in adults with OCD (without OCPD) (n = 28) to adults with OCPD (without OCD) (n = 27), adults with both OCD and OCPD (n = 28), ...

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

    Science.gov (United States)

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

    2013-12-01

    Obsessive-compulsive disorder (OCD) is a chronic mental illness that can have a debilitating effect on daily functioning. A body of research reveals altered sleep behaviour in OCD sufferers; however, findings are inconsistent and there is no consensus on the nature of this relationship. Understanding sleep disturbance in OCD is of critical importance given the known negative consequences of disturbed sleep for mood and emotional wellbeing. A systematic literature search was conducted of five databases for studies assessing sleep in adults diagnosed with OCD. Fourteen studies met inclusion criteria and qualitative data analysis methods were used to identify common themes. There was some evidence of reduced total sleep time and sleep efficiency in OCD patients. Many of the sleep disturbances noted were characteristic of depression. However, some OCD sufferers displayed delayed sleep onset and offset and an increased prevalence of delayed sleep phase disorder (DSPD). Severe OCD symptoms were consistently associated with greater sleep disturbance. While the sleep of OCD patients has not been a major focus to date, the existing literature suggests that addressing sleep disturbance in OCD patients may ensure a holistic approach to treatment, enhance treatment efficacy, mitigate relapse and protect against the onset of co-morbid psychiatric illnesses. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

  2. Eating Disorders in Obsessive-Compulsive Disorder: Prevalence and Effect on Treatment Outcome

    OpenAIRE

    Tobiassen, Linn Graham

    2013-01-01

    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...

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

    OpenAIRE

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

    2011-01-01

    Despite elevated rates of obsessive compulsive personality disorder (OCPD) in patients with obsessive compulsive disorder (OCD), no study has specifically examined comorbid OCPD as a predictor of exposure and ritual prevention (EX/RP) outcome. Participants were adult outpatients (n = 49) with primary OCD and a Yale-Brown Obsessive Compulsive Scale (YBOCS) total score ≥ 16 despite a therapeutic serotonin reuptake inhibitor dose for at least 12 weeks prior to entry. Participants received 17 ses...

  4. Cognitive neuroscience of obsessive-compulsive disorder.

    Science.gov (United States)

    Stern, Emily R; Taylor, Stephan F

    2014-09-01

    Cognitive neuroscience investigates neural responses to cognitive and emotional probes, an approach that has yielded critical insights into the neurobiological mechanisms of psychiatric disorders. This article reviews some of the major findings from neuroimaging studies using a cognitive neuroscience approach to investigate obsessive-compulsive disorder (OCD). It evaluates the consistency of results and interprets findings within the context of OCD symptoms, and proposes a model of OCD involving inflexibility of internally focused cognition. Although further research is needed, this body of work probing cognitive-emotional processes in OCD has already shed considerable light on the underlying mechanisms of the disorder. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Plasma fluoxetine concentrations and clinical improvement in an adolescent sample diagnosed with major depressive disorder, obsessive-compulsive disorder, or generalized anxiety disorder.

    Science.gov (United States)

    Blázquez, Ana; Mas, Sergi; Plana, Maria Teresa; Gassó, Patricia; Méndez, Iria; Torra, Mercè; Arnaiz, Joan Albert; Lafuente, Amàlia; Lázaro, Luisa

    2014-06-01

    Fluoxetine (FLX) has been one of the most widely studied selective serotonin reuptake inhibitors in adolescents. Despite its efficacy, however, 30% to 40% of patients do not respond to treatment. The aim of this study was to evaluate whether clinical improvement or adverse events are related to the corrected dose of FLX at 8 and 12 weeks after starting treatment in a sample of adolescents diagnosed with major depressive disorder, obsessive-compulsive disorder, or generalized anxiety disorder. Seventy-four subjects aged between 10 and 17 years participated in the study. Clinical improvement was measured with the Clinical Global Impression-Improvement Scale, whereas the UKU (Udvalg for Klinske Undersogelser) scale was administered to assess adverse effects of treatment. Fluoxetine per kilograms of body weight was related to serum concentration of FLX, NORFLX (norfluoxetine), FLX + NORFLX, and FLX/NORFLX. No relationship was found between dose-corrected FLX levels and therapeutic or adverse effects. No differences in serum concentrations were found between responders and nonresponders to treatment. Sex differences were observed in relation to dose and FLX serum concentration. The analysis by diagnosis revealed differences in FLX dose between obsessive-compulsive disorder patients and both generalized anxiety disorder and major depressive disorder patients. Fluoxetine response seems to be influenced by factors such as sex, diagnosis, or certain genes that might be involved in the drug's pharmacokinetics and pharmacodynamics. Clinical and pharmacogenetic studies are needed to elucidate further the differences between treatment responders and nonresponders.

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

    Science.gov (United States)

    Ecker, Willi; Kupfer, Jochen; Gönner, Sascha

    2014-01-01

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

  7. Obsessive Compulsive Disorder Case Following Cerebral Ischemia

    Directory of Open Access Journals (Sweden)

    Semra Bilge

    2011-09-01

    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.

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

    Science.gov (United States)

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

    2011-03-01

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

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

    OpenAIRE

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

    2015-01-01

    This study examined the frequency and sociodemographic and clinical correlates of suicidal ideation in a sample of children and adolescents with obsessive-compulsive disorder (OCD). Fifty-four youth with OCD and their parent(s) were administered the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime, Children’s Yale-Brown Obsessive Compulsive Scale, and Children’s Depression Rating Scale-Revised. Children completed the Suicidal Ideation Questionnai...

  10. Relationship between severity of obsessive-compulsive symptoms and schizotypy in obsessive-compulsive disorder

    Directory of Open Access Journals (Sweden)

    Yamamoto H

    2012-12-01

    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

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

    Science.gov (United States)

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

    2005-01-01

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

  12. Obsessive-Compulsive-Bipolar Disorder Comorbidity: A Case Report

    Directory of Open Access Journals (Sweden)

    João Pedro Ribeiro

    2013-12-01

    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.

  13. Understanding Obsessive-Compulsive Personality Disorder

    Directory of Open Access Journals (Sweden)

    Steven C. Hertler

    2013-08-01

    Full Text Available With the ultimate goal of better understanding Obsessive-Compulsive Personality Disorder (OCPD, the present work is a review and critique of Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV diagnostic criteria at the end of their 18 years of use. Problems of specificity (polythetic criteria and failure to employ a hallmark feature make OCPD an indistinct diagnostic category that consequently contains a plurality of types. Problems of sensitivity (missing elements and concrete expression of signs make it more difficult to cull OCPD persons from the population at large. Collectively, these problems of specificity and sensitivity have undermined the efficiency of the DSM-IV criteria set; but more importantly, these problems continue to distort the clinical understanding of OCPD generally.

  14. Common Dermatoses in Patients with Obsessive Compulsive Disorders

    Directory of Open Access Journals (Sweden)

    Mircea Tampa

    2015-10-01

    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.

  15. Thought Action Fusion in Obsessive Compulsive Disorder

    Directory of Open Access Journals (Sweden)

    Þahin ÇÝFTÇÝ

    2013-12-01

    Full Text Available 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 including a certain level also in the normal population, was seen in the relationship with the inflated responsability in OCD, thought suppression and neutralising, was tried to explain the direction of this relationship in the mediationel model framework. [JCBPR 2013; 2(3.000: 138-146

  16. Thought Action Fusion in Obsessive Compulsive Disorder

    Directory of Open Access Journals (Sweden)

    Sahin CIFTCI

    2013-11-01

    Full Text Available 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 including a certain level also in the normal population, was seen in the relationship with the inflated responsability in OCD, thought suppression and neutralising, was tried to explain the direction of this relationship in the mediationel model framework.

  17. Obsessive compulsive disorder in dental setting

    Directory of Open Access Journals (Sweden)

    Preetika Chandna

    2014-01-01

    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.

  18. Sleep in Children and Adolescents with Obsessive-Compulsive Disorder.

    Science.gov (United States)

    Reynolds, Katharine C; Gradisar, Michael; Alfano, Candice A

    2015-06-01

    Sleep problems are not a core feature of obsessive-compulsive disorder (OCD), but emerging empirical data indicate some form of sleep disruption to be highly common. Available research in both adult and child patients is limited in several important ways, including the use of subjective reports (particularly in children), high rates of comorbid depression, and concurrent use of psychotropic medication. The presence of sleep disruption in OCD patients may compound severity and impairment of the disorder. More research is needed to fully understand the nature and consequences of sleep-wake disruption in children with OCD. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. The association between obsessive compulsive disorder and obsessive compulsive personality disorder: prevalence and clinical presentation.

    Science.gov (United States)

    Gordon, Olivia M; Salkovskis, Paul M; Oldfield, Victoria B; Carter, Natalie

    2013-09-01

    The relationship between Obsessive Compulsive Disorder (OCD) and Obsessive Compulsive Personality Disorder (OCPD) has been the subject of interest for some time due to the historical assumption that OCPD causes OCD. This study systematically examined the association between OCD and OCPD in terms of prevalence and clinical presentation. The specificity of the association between OCD and OCPD was investigated relative to another axis I anxiety disorder (Panic disorder). Data for this study were drawn from measures taken at initial assessment at a specialist treatment centre for anxiety disorders. Of the 359 participants included in this study, 189 had a principal diagnosis of OCD, while 170 had a principal diagnosis of Panic disorder. Measures included SCID I and II interview modules and self-report measures of anxiety, depression, and OCD syptomatology. Significantly elevated rates of OCPD were found in OCD relative to Panic disorder. Regardless of axis I disorder, individuals with comorbid OCPD reported more severe depression relative to those without. Participants with both OCD and OCPD had greater self-reported OCD symptom severity, doubting, ordering, and hoarding symptoms at assessment relative to those without OCPD. Participants with OCD and comorbid OCPD also reported significantly higher levels of alcohol consumption. There appears to be a significant and specific association between OCD and OCPD. Co-occurring OCD and OCPD is associated with greater severity of impairment in terms of certain OCD symptoms. The significant and specific association between OCD and OCPD suggests that OCPD occurs more frequently with OCD than previously suggested. A comorbid OCPD diagnosis is associated with a greater degree of depression, regardless of axis I disorder, either OCD or Panic disorder. This is an important consideration, as depression can interfere with therapeutic progress (Foa, 1979). Participants with OCD and OCPD had greater self-reported OCD severity, along

  20. Brain Imaging in Pediatric Obsessive-Compulsive Disorder

    Science.gov (United States)

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

    2008-01-01

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

  1. Somatic delusions and obsessive-compulsive disorder in ...

    African Journals Online (AJOL)

    2009-10-12

    Oct 12, 2009 ... Case Study: Somatic delusions and obsessive-compulsive disorder in schizophrenia. 527. Vol 52 No 6 ... liver function, and urea and electrolytes), including an ... neurotransmitter systems (such as serotonin and dopamine).

  2. Phenomenology of obsessive-compulsive disorder in Taiwan.

    Science.gov (United States)

    Juang, Y Y; Liu, C Y

    2001-12-01

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

  3. Interpersonal Functioning in Obsessive-Compulsive Personality Disorder

    OpenAIRE

    Cain, Nicole M.; Ansell, Emily B.; Simpson, H. Blair; Pinto, Anthony

    2014-01-01

    The core symptoms of obsessive-compulsive personality disorder (OCPD) often lead to interpersonal difficulties. However, little research has explored interpersonal functioning in OCPD. The current study examined interpersonal problems, interpersonal sensitivities, empathy, and systemizing, the drive to analyze and derive underlying rules for systems, in a sample of 25 OCPD individuals, 25 individuals with comorbid OCPD and obsessive-compulsive disorder (OCD), and 25 healthy controls. We found...

  4. Relationships that compulsive buying has with addiction, obsessive-compulsiveness, hoarding, and depression.

    Science.gov (United States)

    Lawrence, Lee Matthew; Ciorciari, Joseph; Kyrios, Michael

    2014-07-01

    Compulsive buying has been associated with addiction, depression, and obsessive-compulsive disorder, as well as hoarding. The present study investigated the relationship that compulsive buying (CB) has with 'addictive' (i.e., sensitivity to reward), obsessive-compulsive, and depressive phenomena, after controlling for hoarding, substance dependence, manic, and Borderline Personality Disorder symptoms. 87 participants from a community population completed the online questionnaires for the study, however 70 participants (M=29.19, SD=10.45; 70% were female) were used in the analyses because of exclusion criteria. As expected, CB measures correlated with hoarding, depression, sensitivity to reward, and, but less so, obsessive-compulsive measures. Sensitivity to reward was the most important predictor of CB severity, compared to obsessive-compulsive and depression symptoms. Hoarding was also an important predictor of CB severity. Small sample size meant gender comparisons could not be made, and the use of a novel, communicated questionnaire meant that interpretation should be considered conservatively. Overall, findings suggest that CB may be most closely related to the phenomena associated with addiction (an increased sensitivity to reward), rather than obsessive-compulsive or depression symptoms. Hoarding and reward sensitivity perhaps might separate compulsive buying from ordinary and recreational shopping. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Obsessive-compulsive symptoms and obsessive-compulsive disorder in adolescents: a population-based study

    Directory of Open Access Journals (Sweden)

    Analise de Souza Vivan

    2014-05-01

    Full Text Available Objectives: To estimate the prevalence of obsessive-compulsive symptoms (OCS and disorder (OCD among adolescents and to describe OCD characteristics according to gender. Methods: Participants were selected by cluster sampling at seven high-schools in southern Brazil. In the first stage, 2,323 students were screened for OCS; in the second stage, adolescents scoring ≥ 21 on the OCI-R scale were individually interviewed. OCD diagnosis was established using a semi-structured interview (Schedule for Affective Disorders and Schizophrenia for School Aged Children: Present and Lifetime Version - K-SADS-PL. Results: The past-month estimated prevalence of OCS was 18.3%, and the point estimated prevalence of OCD, 3.3%. Girls showed higher scores (OCS: 24.8 vs. 14.4%; OCD: 4.9 vs. 1.4%; p < 0.001. Only 9.3% of OCD adolescents had been diagnosed and 6.7% received treatment. The most frequent/severe DY-BOCS dimensions were miscellaneous (86.7%; mean score 6.3±3.8 and symmetry (85.3%; 5.9±3.8. Female OCD adolescents predominantly showed depression (p = 0.032, and male adolescents, tic disorders (p = 0.006. Conclusions: OCD is underdiagnosed in adolescents, and few are treated. Future studies should investigate the relationship between OCS and the onset of OCD.

  6. The Impact of Obsessive Compulsive Personality Disorder on Cognitive Behaviour Therapy for Obsessive Compulsive Disorder.

    Science.gov (United States)

    Gordon, Olivia M; Salkovskis, Paul M; Bream, Victoria

    2016-07-01

    It is often suggested that, in general, co-morbid personality disorders are likely to interfere with CBT based treatment of Axis I disorders, given that personality disorders are regarded as dispositional and are therefore considered less amenable to change than axis I psychiatric disorders. The present study aimed to investigate the impact of co-occurring obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) on cognitive-behavioural treatment for OCD. 92 individuals with a diagnosis of OCD participated in this study. Data were drawn from measures taken at initial assessment and following cognitive-behavioural treatment at a specialist treatment centre for anxiety disorders. At assessment, participants with OCD and OCPD had greater overall OCD symptom severity, as well as doubting, ordering and hoarding symptoms relative to those without OCPD; however, participants with co-morbid OCD and OCPD demonstrated greater treatment gains in terms of OCD severity, checking and ordering than those without OCPD. Individuals with OCD and OCPD had higher levels of checking, ordering and overall OCD severity at initial assessment; however, at post-treatment they had similar scores to those without OCPD. The implications of these findings are discussed in the light of research on axis I and II co-morbidity and the impact of axis II disorders on treatment for axis I disorders.

  7. Music therapy as an adjunct to standard treatment for obsessive compulsive disorder and co-morbid anxiety and depression: A randomized clinical trial.

    Science.gov (United States)

    Shiranibidabadi, Shahrzad; Mehryar, Amirhooshang

    2015-09-15

    Previous studies have highlighted the potential therapeutic benefits of music therapy as an adjunct to standard care, in a variety of psychiatric ailments including mood and anxiety disorders. However, the role of music in the treatment of obsessive-compulsive disorder (OCD) have not been investigated to date. In a single-center, parallel-group, randomized clinical trial (NCT02314195) 30 patients with OCD were randomly assigned to standard treatment (pharmacotherapy and cognitive-behavior therapy) plus 12 sessions of individual music therapy (n = 15) or standard treatment only (n = 15) for one month. Maudsley Obsessive-Compulsive Inventory, Beck Anxiety Inventory, and Beck Depression Inventory-Short Form were administered baseline and after one month. Thirty patients completed the study. Music therapy resulted in a greater decrease in total obsessive score (post-intervention score: music therapy+standard treatment: 12.4 ± 1.9 vs standard treatment only: 15.1 ± 1.7, p Music therapy was significantly more effective in reducing anxiety (post-intervention score: music therapy + standard treatment: 16.9 ± 7.4 vs standard treatment only: 22.9 ± 4.6, p music therapy + standard treatment: 10.8 ± 3.8 vs standard treatment: 17.1 ± 3.7, p music therapy, as an adjunct to standard care, seems to be effective in reducing obsessions, as well as co-morbid anxiety and depressive symptoms. Copyright © 2015. Published by Elsevier B.V.

  8. Conscientiousness and obsessive-compulsive personality disorder.

    Science.gov (United States)

    Samuel, Douglas B; Widiger, Thomas A

    2011-07-01

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

  9. Obsessive-Compulsive Disorder: Diagnosis and Management.

    Science.gov (United States)

    Fenske, Jill N; Petersen, Ketti

    2015-11-15

    Obsessive-compulsive disorder (OCD) is a chronic illness that can cause marked distress and disability. It is a complex disorder with a variety of manifestations and symptom dimensions, some of which are underrecognized. Early recognition and treatment with OCD-specific therapies may improve outcomes, but there is often a delay in diagnosis. Patients can experience significant improvement with treatment, and some may achieve remission. Recommended first-line therapies are cognitive behavior therapy, specifically exposure and response prevention, and/or a selective serotonin reuptake inhibitor (SSRI). Patients with OCD require higher SSRI dosages than for other indications, and the treatment response time is typically longer. When effective, long-term treatment with an SSRI is a reasonable option to prevent relapse. Patients with severe symptoms or lack of response to first-line therapies should be referred to a psychiatrist. There are a variety of options for treatment-resistant OCD, including clomipramine or augmenting an SSRI with an atypical antipsychotic. Patients with OCD should be closely monitored for psychiatric comorbidities and suicidal ideation.

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

    Science.gov (United States)

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

    2013-01-01

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

  11. Tic disorders and obsessive-compulsive disorder : Is autoimmunity involved?

    NARCIS (Netherlands)

    Hoekstra, PJ; Minderaa, RB

    The precise cause of tic disorders and paediatric obsessive-compulsive disorder (OCD) is unknown. In addition to genetic factors, autoimmunity may play a role, possibly as a sequela of preceding streptococcal throat infections in susceptible children. Here we review the most recent findings, from

  12. Behavioral inhibition and obsessive-compulsive disorder.

    Science.gov (United States)

    Coles, Meredith E; Schofield, Casey A; Pietrefesa, Ashley S

    2006-01-01

    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.

  13. Latent class analysis of the Yale-Brown Obsessive-Compulsive Scale symptoms in obsessive-compulsive disorder

    NARCIS (Netherlands)

    Delucchi, K.L.; Katerberg, H.; Stewart, S.E.; Denys, D.A.; Lochner, C.; Stack, D.E.; den Boer, J.A.; van Balkom, A.J.L.M.; Jenike, M.A.; Stein, D.J.; Cath, D.C.; Mathews, C.A.

    2011-01-01

    Objective: Obsessive-compulsive disorder (OCD) is phenomenologically heterogeneous, and findings of underlying structure classification based on symptom grouping have been ambiguous to date. Variable-centered approaches, primarily factor analysis, have been used to identify homogeneous groups of

  14. Comorbid obsessive-compulsive personality disorder in obsessive-compulsive disorder (OCD): a marker of severity.

    Science.gov (United States)

    Lochner, Christine; Serebro, Paul; van der Merwe, Lize; Hemmings, Sian; Kinnear, Craig; Seedat, Soraya; Stein, Dan J

    2011-06-01

    Comorbid obsessive-compulsive personality disorder (OCPD) is well-described in obsessive-compulsive disorder (OCD). It remains unclear, however, whether OCPD in OCD represents a distinct subtype of OCD or whether it is simply a marker of severity in OCD. The aim of this study was to compare a large sample of OCD subjects (n=403) with and without OCPD on a range of demographic, clinical and genetic characteristics to evaluate whether comorbid OCPD in OCD represents a distinct subtype of OCD, or is a marker of severity. Our findings suggest that OCD with and without OCPD are similar in terms of gender distribution and age at onset of OC symptoms. Compared to OCD-OCPD (n=267, 66%), those with OCD+OCPD (n=136, 34%) are more likely to present with the OC symptom dimensions which reflect the diagnostic criteria for OCPD (e.g., hoarding), and have significantly greater OCD severity, comorbidity, functional impairment, and poorer insight. Furthermore there are no differences in distribution of gene variants, or response to treatment in the two groups. The majority of our findings suggest that in OCD, patients with OCPD do not have a highly distinctive phenomenological or genetic profile, but rather that OCPD represents a marker of severity. Copyright © 2011 Elsevier Inc. All rights reserved.

  15. Abnormal Sexual Behavior in an Adult Male with Obsessive Compulsive Disorder

    OpenAIRE

    Raguraman, Janakiraman; Priyadharshini, Kothai R.; Chandrasekaran, R.; Vijaysagar, John

    2004-01-01

    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.

  16. Prevalence of Childhood Obsessive-Compulsive Personality Traits in Adults with Obsessive Compulsive Disorder versus Obsessive Compulsive Personality Disorder.

    Science.gov (United States)

    Pinto, Anthony; Greene, Ashley L; Storch, Eric A; Simpson, H Blair

    2015-01-01

    Identifying risk factors of psychopathology has been an important research challenge. Prior studies examining the impact of childhood temperament on adult disorder have largely focused on undercontrolled and inhibited presentations, with little study of overcontrolled traits such as obsessive-compulsive personality traits (OCPTs). We compared rates of childhood OCPTs in adults with OCD (without OCPD) (n = 28) to adults with OCPD (without OCD) (n = 27), adults with both OCD and OCPD (n = 28), and healthy controls (HC) (n= 28), using the Childhood Retrospective Perfectionism Questionnaire, a validated measure of perfectionism, inflexibility, and drive for order. Adults with OCPD (both with and without comorbid OCD) reported higher rates of all three childhood OCPTs relative to HC. Individuals with OCD (without OCPD) reported higher rates of inflexibility and drive for order relative to HC, suggesting that these traits may presage the development of OCD, independent of OCPD. Childhood OCPTs were associated with particular OCD symptom dimensions in adulthood (contamination/cleaning, doubt/checking, and symmetry/ordering), independent of OCD onset age and OCPD diagnosis. Longitudinal prospective studies evaluating OCPTs in children are needed to better understand the progression of these traits from childhood to adulthood and their ability to predict future psychopathology.

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

    Science.gov (United States)

    Denys, Damiaan

    2011-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Denys Damiaan

    2011-02-01

    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.

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

    Science.gov (United States)

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

    2005-12-01

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

  20. Hypochondriasis and its relationship to obsessive-compulsive disorder.

    Science.gov (United States)

    Fallon, B A; Qureshi, A I; Laje, G; Klein, B

    2000-09-01

    Hypochondriasis is a heterogeneous disorder. This was well demonstrated in the study by Kellner et al, which showed that patients with high levels of disease fear tended to be more anxious or phobic, whereas patients with high levels of disease conviction tended to have more and more severe somatic symptoms. Little comorbidity exists to support the statement that hypochondriasis is an obsessive-compulsive spectrum disorder. Although patients exist whose hypochondriac concerns are identical in quality to the intrusive thoughts of patients with OCD, as a group, patients with hypochondriasis do not share a comorbidity profile comparable with that of patients with OCD. The data support a closer relationship between hypochondriasis and somatization disorder than between hypochondriasis and OCD. The family history data is limited by the lack of adequate studies. Using comparable methods of the family history approach, Black's study reported a higher frequency of GAD but not OCD among the relatives of OCD patients--a finding similar to what Noyes found among the relatives of hypochondriac patients; however, using the direct interview method, somatization disorder was the only statistically more common disorder, among relatives of female hypochondriac patients. Therefore, although the parallel in overlap with GAD is suggestive of a commonality between OCD, GAD, and hypochondriasis, the finding of a greater frequency of somatization disorder leans against the hypothesis that hypochondriasis is best considered an OCD spectrum disorder. The pharmacologic treatment data are the one type of biologic evidence that supports a bridge to OCD. The pharmacologic studies suggest that for patients with general hypochondriasis, TCAs are not effective and that higher dosages and longer trials of the SRIs are needed. These pharmacologic observations are comparable with the ones made for patients with OCD but dissimilar to the observations made for depression. The benefit of imipramine

  1. Cognitive inflexibility in Obsessive-Compulsive Disorder.

    Science.gov (United States)

    Gruner, Patricia; Pittenger, Christopher

    2017-03-14

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

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

    Science.gov (United States)

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

    2014-01-01

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

  3. Interpersonal ambivalence in obsessive-compulsive disorder.

    Science.gov (United States)

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

    2013-10-01

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

  4. Brain Regions and Neuropsychological Deficits in Obsessive-Compulsive Disorder

    Directory of Open Access Journals (Sweden)

    Murat Erdem

    2013-09-01

    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

  5. The presence of magical thinking in obsessive compulsive disorder.

    Science.gov (United States)

    Einstein, Danielle A; Menzies, Ross G

    2004-05-01

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

  6. Dream content and intrusive thoughts in Obsessive-Compulsive Disorder.

    Science.gov (United States)

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

    2016-10-30

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

  7. A meta-analysis of the relation of intolerance of uncertainty to symptoms of generalized anxiety disorder, major depressive disorder, and obsessive-compulsive disorder.

    Science.gov (United States)

    Gentes, Emily L; Ruscio, Ayelet Meron

    2011-08-01

    Intolerance of uncertainty (IU) has been suggested to reflect a specific risk factor for generalized anxiety disorder (GAD), but there have been no systematic attempts to evaluate the specificity of IU to GAD. This meta-analysis examined the cross-sectional association of IU with symptoms of GAD, major depressive disorder (MDD), and obsessive-compulsive disorder (OCD). Random effects analyses were conducted for two common definitions of IU, one that has predominated in studies of GAD (56 effect sizes) and another that has been favored in studies of OCD (29 effect sizes). Using the definition of IU developed for GAD, IU shared a mean correlation of .57 with GAD, .53 with MDD, and .50 with OCD. Using the alternate definition developed for OCD, IU shared a mean correlation of .46 with MDD and .42 with OCD, with no studies available for GAD. Post-hoc significance tests revealed that IU was more strongly related to GAD than to OCD when the GAD-specific definition of IU was used. No other differences were found in the magnitude of associations between IU and the three syndromes. We discuss implications of these findings for models of shared and specific features of emotional disorders and for future research efforts. Copyright © 2011 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2014-04-15

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

  9. Internet cognitive behavioural treatment for obsessive compulsive disorder : A randomised controlled trial

    NARCIS (Netherlands)

    Mahoney, Alison E J; Mackenzie, Anna; Williams, Alishia D; Smith, Jessica; Andrews, Gavin

    2014-01-01

    Internet-based cognitive behaviour therapy (iCBT) is becoming increasing accepted as an efficacious and effective treatment for the anxiety and depressive disorders. However few studies have examined the efficacy of iCBT for obsessive compulsive disorder (OCD). This randomised controlled trial

  10. THE SENSITIVITY TO CHANGE OF MEASURES FOR OBSESSIVE-COMPULSIVE DISORDER

    NARCIS (Netherlands)

    VANOPPEN, P; EMMELKAMP, PMG; VANBALKOM, AJLM; VANDYCK, R

    1995-01-01

    This study presents data on the sensitivity to change of the Padua Inventory-Revised (PI-R), the Yale Brown Obsessive Compulsive Scale (Y-BOCS), and the Anxiety Discomfort Scale (ADS) for obsessive-compulsive disorder. In a sample of obsessive-compulsives (n = 63) who received either behaviour

  11. Stability of the pregnancy obsessive compulsive personality disorder symptoms checklist

    NARCIS (Netherlands)

    van Broekhoven, K.E.M.; Karreman, A.; Hartman, E.E.; Pop, V.J.M.

    2018-01-01

    Because stability over time is central to the definition of personality disorder, aim of the current study was to determine the stability of the Pregnancy Obsessive-Compulsive Personality Disorder (OCPD) Symptoms Checklist (N = 199 women). Strong positive correlations between assessments at 32 weeks

  12. Late-Onset Startle Syndrome and Obsessive Compulsive Disorder

    Directory of Open Access Journals (Sweden)

    Alejandro Gonzalez

    1998-01-01

    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.

  13. Relationship between movement disorders and obsessive-compulsive disorder : beyond the obsessive-compulsive-tic phenotype. A systematic review

    NARCIS (Netherlands)

    Fibbe, Lieneke A.; Cath, Danielle C.; van den Heuvel, Odile A.; Veltman, Dick J.; Tijssen, Marina A. J.; Van Balkom, Anton J. L. M.

    Background Obsessive-compulsive disorder (OCD) and symptoms (OC symptoms) are associated with tic disorders and share an aetiological relationship. The extent to which OCD/OC symptoms are correlated with other hyperkinetic movement disorders is unclear. The aim of this review was to investigate this

  14. Relationship between movement disorders and obsessive-compulsive disorder: beyond the obsessive-compulsive-tic phenotype. A systematic review

    NARCIS (Netherlands)

    Fibbe, L.A.; Cath, D.C.; van den Heuvel, O.A.; Veltman, D.J.; Tijssen, M.A.J.; van Balkom, A.J.L.M.

    2012-01-01

    Background: Obsessive-compulsive disorder (OCD) and symptoms (OC symptoms) are associated with tic disorders and share an aetiological relationship. The extent to which OCD/OC symptoms are correlated with other hyperkinetic movement disorders is unclear. The aim of this review was to investigate

  15. Deontological guilt and obsessive compulsive disorder.

    Science.gov (United States)

    Mancini, Francesco; Gangemi, Amelia

    2015-12-01

    The emotion of guilt plays a pivotal role in the genesis and maintenance of Obsessive-Compulsive Disorder (OCD). But what kind of guilt do OC patients want to prevent? Several studies suggest the existence of two different types of guilt emotions, namely deontological and altruistic guilt. This research suggests that the former, more than the latter, is involved in OCD. Studies in which people must hypothetically choose between killing one person to save a few (consequentialist choice) or take no action and allow things to take their course (omission choice), have found that the latter is consistent with the "Do not play God" moral principle whereas the former is consistent with altruistic motivations. This paper is aimed at verifying whether both OC patients, with no induction, and nonclinical participants, after the induction of deontological guilt prefer omission more often than a consequentialist option. It is hypothesized that people with OCD will be motivated to avoid feeling deontological guilt and thus will be more likely to opt for omission. Similarly, nonclinical participants who receive a deontological guilt induction will also be more likely to choose omission. In two studies participants were given seven scenarios (four moral dilemmas, three control scenarios). Twenty patients with OCD, 20 anxious controls, and 20 healthy participants took part in study 1. In study 2, we recruited 70 healthy participants who were randomly assigned to receive a deontological guilt or a control induction. Consistent with hypotheses, in Study 1 OC patients preferred omission, instead of the consequentialist option, moreso than did the clinical and nonclinical controls. In Study 2, the group receiving the deontological guilt induction preferred omission to a greater extent than did the altruistic group. The present study cannot establish that the goal of preventing or neutralizing deontological guilt actually drives obsessions and compulsions. These results provide further

  16. Relations of mindfulness facets with psychological symptoms among individuals with a diagnosis of obsessive-compulsive disorder, major depressive disorder, or borderline personality disorder.

    Science.gov (United States)

    Didonna, Fabrizio; Rossi, Roberta; Ferrari, Clarissa; Iani, Luca; Pedrini, Laura; Rossi, Nicoletta; Xodo, Erica; Lanfredi, Mariangela

    2018-03-25

    To explore differences in mindfulness facets among patients with a diagnosis of either obsessive-compulsive disorder (OCD), major depressive disorder (MDD), or borderline personality disorder (BPD), and healthy controls (HC), and their associations with clinical features. One hundred and fifty-three patients and 50 HC underwent a clinical assessment including measures of mindfulness (Five Facets Mindfulness Questionnaire - FFMQ), psychopathological symptoms (Symptom Check List-90-R), dissociation (Dissociative Experience Scale), alexithymia (Alexithymia Scale 20), and depression (Beck Depression Inventory-II). Analysis of variance (ANOVA) and analysis of covariance (ANCOVA) were performed to assess differences in mindfulness scores and their associations with clinical features. The three diagnostic groups scored lower on all mindfulness facets (apart from FFMQobserving) compared to the HC group. OCD group had a significant higher FFMQ total score (FFMQ-TS) and FFMQacting with awareness compared to the BPD group, and scored higher on FFMQdescribing compared to BPD and MDD groups. The scores in non-judging facet were significantly lower in all the three diagnostic groups compared to the HC group. Interestingly, higher FFMQ-TS was inversely related to all psychological measures, regardless of diagnostic group. Deficits in mindfulness skills were present in all diagnostic groups. Furthermore, we found disease-specific relationships between some mindfulness facets and specific psychological variables. Clinical implications are discussed. The study showed deficits in mindfulness scores in all diagnostic groups compared to a healthy control group. Overall, mindfulness construct has a significantly negative association with indexes of global distress, dissociative symptoms, alexithymia, and depression. Mindfulness-based interventions in clinical settings should take into account different patterns of mindfulness skills and their impact on disease-specific maladaptive

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

    Science.gov (United States)

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

    2010-01-01

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

  18. Attention and cognition in patients with obsessive-compulsive disorder

    NARCIS (Netherlands)

    de Geus, Femke; Denys, Damiaan A. J. P.; Sitskoorn, Margriet M.; Westenberg, Herman G. M.

    2007-01-01

    Although a dysfunctional prefrontal-striatal system is presupposed in obsessive-compulsive disorder (OCD), this is not sustained by neuropsychological studies. The aim of this study was twofold: (i) to investigate the cognitive deficits in patients with OCD compared to matched healthy controls; and

  19. New pharmacotherapeutic approaches to obsessive-compulsive disorder

    NARCIS (Netherlands)

    Figee, Martijn; Denys, Damiaan

    2009-01-01

    This article summarizes results of all pharmacotherapy trials for obsessive-compulsive disorder (OCD) published from 2006 to 2008 as well as studies on markers for predicting response to treatment and neurobiological changes induced by pharmacotherapy. Results show that recent developments in the

  20. The Pregnancy Obsession-Compulsion-Personality Disorder Symptom Checklist

    NARCIS (Netherlands)

    van Broekhoven, K.; Hartman, E.; Spek, V.; Bergink, V.; van Son, M.J.M.; Karreman, A.; Pop, V.

    2016-01-01

    Background: Up until now, very little research has been undertaken on the possible role of personality traits, such as perfectionism and obsessive compulsive personality disorder (OCPD), on pregnancy distress. This is possibly due to the fact that no appropriate instruments are available for use

  1. The pregnancy obsession-compulsion-personality disorder symptom checklist

    NARCIS (Netherlands)

    van Broekhoven, K.; Hartman, E.E.; Spek, V.R.M.; Bergink, V.; van Son, M.; Karreman, A.; Pop, V.J.M.

    Background: Up until now, very little research has been undertaken on the possible role of personality traits, such as perfectionism and obsessive compulsive personality disorder (OCPD), on pregnancy distress. This is possibly due to the fact that no appropriate instruments are available for use

  2. Intensive cognitive behavioural therapy for obsessive-compulsive disorder

    DEFF Research Database (Denmark)

    Jonsson, H.; Kristensen, M.; Arendt, M.

    2015-01-01

    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...

  3. co-occurrence of schizophrenia and obsessive compulsive disorder

    African Journals Online (AJOL)

    McGlashan' found that 21 (12.9%) of 163 DSM-III-diagnosed .... Abbruzzese M, Ferri 5, Scarone S. The selecti~ebreakdown of frontal functions in patients ... Obsessive-compulsive disorder: its conceptual history in France during the 19th.

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

    Science.gov (United States)

    Murphy, Dennis L; Timpano, Kiara R; Wheaton, Michael G; Greenberg, Benjamin D; Miguel, Euripedes C

    2010-01-01

    Obsessive-compulsive disorder (OCD) is a clinical syndrome whose hallmarks are excessive, anxiety-evoking thoughts and compulsive behaviors that are generally recognized as unreasonable, but which cause significant distress and impairment. When these are the exclusive symptoms, they constitute uncomplicated OCD. OCD may also occur in the context of other neuropsychiatric disorders, most commonly other anxiety and mood disorders. The question remains as to whether these combinations of disorders should be regarded as independent, cooccurring disorders or as different manifestations of an incompletely understood constellation of OCD spectrum disorders with a common etiology. Additional considerations are given here to two potential etiology-based subgroups: (i) an environmentally based group in which OCD occurs following apparent causal events such as streptococcal infections, brain injury, or atypical neuroleptic treatment; and (ii) a genomically based group in which OCD is related to chromosomal anomalies or specific genes. Considering the status of current research, the concept of OCD and OCD-related spectrum conditions seems fluid in 2010, and in need of ongoing reappraisal.

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

    Science.gov (United States)

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

    2017-09-01

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

  6. Seasonal mood changes in patients with obsessive-compulsive disorder.

    Science.gov (United States)

    Tan, Oğuz; Metin, Barış; Ünsalver, Barış Önen; Sayar, Gökben Hızlı

    2017-12-01

    Obsessive-compulsive disorder (OCD) is frequently associated with mood disorders. However, to date, the co-occurrence of OCD with seasonal affective disorder (SAD) has not been investigated. We have aimed to estimate the prevalence of seasonal mood changes in patients with OCD and explore the contribution of seasonality in mood to the severity of OCD. The Seasonal Pattern Assessment Questionnaire (SPAQ), the Yale-Brown Obsession and Compulsion Scale (Y-BOCS), the Hamilton Depression Rating Scale-17 Items (HDRS-17), and the Beck Anxiety Inventory (BAI) were administered to patients with OCD (n=104) and controls (n=125). The degree of seasonality was measured by the Global Seasonality Score (GSS) calculated from the SPAQ. SAD and subsyndromal seasonal affective disorder (S-SAD) were significantly more prevalent in patients with OCD (53%, n=55) than controls (25%, n=31). When patients were assessed in the season in which SAD occurs, depression and compulsions (but not obsessions, OCD or anxiety) were more severe than those assessed in a season during which SAD does not occur. SAD frequently co-occurs with OCD and, given this co-occurrence, depression symptoms in some patients with OCD might be expected to vary on a seasonal basis. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Obsessive-compulsive disorder spectrum as a scientific "metaphor".

    Science.gov (United States)

    Pallanti, Stefano; Hollander, Eric

    2008-09-01

    As a result of clinical, epidemiological, neuroimaging, and therapy studies that took place in the late 1980s, obsessive-compulsive disorder (OCD) has been well-characterized in the field of anxiety disorders. Other disorders attracted attention for their similarities to OCD, and were located in the orbit of the disorder. OCD has become known as the "primary domain" of a scientific "metaphor" comprising the putative cluster of OCD-related disorders (OCRDs). It is a "paradigm" with which to explore basal ganglia dysfunction. The OCRDs share common phenomenology, comorbidities, lifetime course, demographics, possible genetics, and frontostriatal dysfunction (particularly caudate hyperactivity.) The adoption of this metaphor analogy has proven useful. However, 15 years since its emergence, the spectrum of obsessive-compulsive disorders remains controversial. Questions under debate include whether OCD is a unitary or split condition, whether it is an anxiety disorder, and whether there exists only one spectrum or several possible spectrums. Further work is needed to clarify obsessive-compulsive symptoms, subtypes, and endophenotypes. There is need to integrate existing databases, better define associated symptom domains, and create a more comprehensive endophenotyping protocol for OCRDs. There is also a need to integrate biological and psychological perspectives, concepts, and data to drive this evolution. By increasing research in this field, the OCD spectrum may evolve from a fragmented level of conceptualization as a "metaphor" to one that is more comprehensive and structured.

  8. Gilles de la Tourette's syndrome with and without obsessive-compulsive disorder compared with obsessive-compulsive disorder without tics: Which symptoms discriminate?

    NARCIS (Netherlands)

    Cath, D.C.; Spinhoven, P.; Woerkom, T.C.A.M. van; Wetering, B.J.M. van de; Hoogduin, C.A.L.; Landman, A.D.; Roos, R.A.C.; Rooijmans, H.G.M.

    2001-01-01

    Stereotyped repetitive behaviors occur in Gilles de la Tourette's Syndrome (GTS) and obsessive-compulsive disorder (OCD). The present study was undertaken to compare the distribution of obsessive-compulsive and Tourette-related impulsive behaviors in GTS with (+) OCD, GTS without (-) OCD, tic-free

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

    Science.gov (United States)

    Murphy, Yolanda E; Flessner, Christopher A

    2015-11-01

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

  10. Interpersonal functioning in obsessive-compulsive personality disorder.

    Science.gov (United States)

    Cain, Nicole M; Ansell, Emily B; Simpson, H Blair; Pinto, Anthony

    2015-01-01

    The core symptoms of obsessive-compulsive personality disorder (OCPD) often lead to interpersonal difficulties. However, little research has explored interpersonal functioning in OCPD. This study examined interpersonal problems, interpersonal sensitivities, empathy, and systemizing, the drive to analyze and derive underlying rules for systems, in a sample of 25 OCPD individuals, 25 individuals with comorbid OCPD and obsessive-compulsive disorder (OCD), and 25 healthy controls. We found that OCPD individuals reported hostile-dominant interpersonal problems and sensitivities with warm-dominant behavior by others, whereas OCPD+OCD individuals reported submissive interpersonal problems and sensitivities with warm-submissive behavior by others. Individuals with OCPD, with and without OCD, reported less empathic perspective taking relative to healthy controls. Finally, we found that OCPD males reported a higher drive to analyze and derive rules for systems than OCPD females. Overall, results suggest that there are interpersonal deficits associated with OCPD and the clinical implications of these deficits are discussed.

  11. Interpersonal Functioning in Obsessive-Compulsive Personality Disorder

    Science.gov (United States)

    Cain, Nicole M.; Ansell, Emily B.; Simpson, H. Blair; Pinto, Anthony

    2014-01-01

    The core symptoms of obsessive-compulsive personality disorder (OCPD) often lead to interpersonal difficulties. However, little research has explored interpersonal functioning in OCPD. The current study examined interpersonal problems, interpersonal sensitivities, empathy, and systemizing, the drive to analyze and derive underlying rules for systems, in a sample of 25 OCPD individuals, 25 individuals with comorbid OCPD and obsessive-compulsive disorder (OCD), and 25 healthy controls. We found that OCPD individuals reported hostile-dominant interpersonal problems and sensitivities with warm-dominant behavior by others while OCPD+OCD individuals reported submissive interpersonal problems and sensitivities with warm-submissive behavior by others. Individuals with OCPD, with and without OCD, reported less empathic perspective taking relative to healthy controls. Finally, we found that OCPD males reported a higher drive to analyze and derive rules for systems than OCPD females. Overall, results suggest that there are interpersonal deficits associated with OCPD and the clinical implications of these deficits are discussed. PMID:25046040

  12. Early onset obsessive-compulsive disorder with and without tics.

    Science.gov (United States)

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

    2009-07-01

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

  13. Latent class analysis of the Yale-Brown Obsessive-Compulsive Scale symptoms in obsessive-compulsive disorder.

    Science.gov (United States)

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

    2011-01-01

    Obsessive-compulsive disorder (OCD) is phenomenologically heterogeneous, and findings of underlying structure classification based on symptom grouping have been ambiguous to date. Variable-centered approaches, primarily factor analysis, have been used to identify homogeneous groups of symptoms; but person-centered latent methods have seen little use. This study was designed to uncover sets of homogeneous groupings within 1611 individuals with OCD based on symptoms. Latent class analysis models using 61 obsessive-compulsive symptoms collected from the Yale-Brown Obsessive-Compulsive Scale were fit. Relationships between latent class membership and treatment response, sex, symptom severity, and comorbid tic disorders were tested for relationship to class membership. Latent class analysis models of best fit yielded 3 classes. Classes differed only in frequency of symptom endorsement. Classes with higher symptom endorsement were associated with earlier age of onset, being male, higher Yale-Brown Obsessive-Compulsive Scale symptom severity scores, and comorbid tic disorders. There were no differences in treatment response between classes. These results provide support for the validity of a single underlying latent OCD construct, in addition to the distinct symptom factors identified previously via factor analyses. Copyright © 2011 Elsevier Inc. All rights reserved.

  14. Hoarding behavior among young children with obsessive-compulsive disorder

    OpenAIRE

    Frank, Hannah; Stewart, Elyse; Walther, Michael; Benito, Kristen; Freeman, Jennifer; Conelea, Christ; Garci, Abbe

    2013-01-01

    Previous research has shown that among the various subtypes of obsessive-compulsive disorder (OCD), adults (e.g. Frost, Krause & Steketee, 1996) and older children and adolescents (Bloch et al., 2009; Storch et al., 2007) with problematic hoarding have distinct features and a poor treatment prognosis. However, there is limited information on the phenomenology and prevalence of hoarding behaviors in young children. The present study characterizes children ages 10 and under who present with OCD...

  15. Functional Neuroimaging of Avoidance Habits in Obsessive-Compulsive Disorder

    OpenAIRE

    Gillan, Claire Marie; Apergis-Schoute, Annemieke Margaretha; Morein-Zamir, Sharon; Urcelay, Gonzalo P; Sule, Akeem; Fineberg, Naomi A; Sahakian, Barbara Jacquelyn; Robbins, Trevor William

    2015-01-01

    Objective: The goal of this study was to determine the neural correlates of excessive habit formation in obsessive-compulsive disorder (OCD). We aimed to (i) test for neurobiological convergence with the known pathophysiology of OCD and (ii) infer, based on abnormalities in brain activation, whether these habits arise from dysfunction in the goal-directed or habit system. Method: Thirty-seven OCD patients and 33 controls learned to avoid shocks while undergoing a functional Magnetic Resona...

  16. Functional Neurosurgery in the Treatment of Severe Obsessive Compulsive Disorder and Major Depression: Overview of Disease Circuits and Therapeutic Targeting for the Clinician

    Science.gov (United States)

    Shah, Dhwani B.; Pesiridou, Angeliki; Baltuch, Gordon H.; Malone, Donald A.; O’Reardon, John P.

    2008-01-01

    Over the past 20 years, there has been a concerted effort to expand our understanding of the neural circuitry involved in the pathogenesis of psychiatric disorders. Distinct neuronal circuits and networks have been implicated in obsessive compulsive disorder (OCD) and major depressive disorder (MDD) involving feedback loops between the cortex, striatum, and thalamus. When neurosurgery is used as a therapeutic tool in severe OCD and MDD, the goal is to modulate specific targets or nodes within these networks in an effort to produce symptom relief. Currently, four lesioning neurosurgical procedures are utilized for treatment refractory OCD and MDD: cingulotomy, capsulotomy, subcaudate tractotomy, and limbic leucotomy. Deep brain stimulation (DBS) is a novel neurosurgical approach that has some distinct advantages over lesioning procedures. With DBS, the desired clinical effect can be achieved by reversible, high frequency stimulation in a nucleus or at a node in the circuit without the need to produce an irreversible lesion. Recent trials of deep brain stimulation in both OCD and MDD at several neuroanatomical targets have reported promising early results in highly refractory patients and with a good safety profile. Future definitive trials in MDD and OCD are envisaged. PMID:19727257

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

    Science.gov (United States)

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

    2017-09-01

    Deep brain stimulation can be of benefit in carefully selected patients with severe intractable obsessive-compulsive disorder. The aim of this paper is to describe the outcomes of the first seven deep brain stimulation procedures for obsessive-compulsive disorder undertaken at the Neuropsychiatry Unit, Royal Melbourne Hospital. The primary objective was to assess the response to deep brain stimulation treatment utilising the Yale-Brown Obsessive Compulsive Scale as a measure of symptom severity. Secondary objectives include assessment of depression and anxiety, as well as socio-occupational functioning. Patients with severe obsessive-compulsive disorder were referred by their treating psychiatrist for assessment of their suitability for deep brain stimulation. Following successful application to the Psychosurgery Review Board, patients proceeded to have deep brain stimulation electrodes implanted in either bilateral nucleus accumbens or bed nucleus of stria terminalis. Clinical assessment and symptom rating scales were undertaken pre- and post-operatively at 6- to 8-week intervals. Rating scales used included the Yale-Brown Obsessive Compulsive Scale, Obsessive Compulsive Inventory, Depression Anxiety Stress Scale and Social and Occupational Functioning Assessment Scale. Seven patients referred from four states across Australia underwent deep brain stimulation surgery and were followed for a mean of 31 months (range, 8-54 months). The sample included four females and three males, with a mean age of 46 years (range, 37-59 years) and mean duration of obsessive-compulsive disorder of 25 years (range, 15-38 years) at the time of surgery. The time from first assessment to surgery was on average 18 months. All patients showed improvement on symptom severity rating scales. Three patients showed a full response, defined as greater than 35% improvement in Yale-Brown Obsessive Compulsive Scale score, with the remaining showing responses between 7% and 20%. Deep

  18. Screening for Obsessive-Compulsive Disorder (OCD)

    Science.gov (United States)

    ... Print this form Follow Us Facebook Twitter RSS YouTube Advertisement Find A Therapist Search our directory of ADAA mental health professional members who specialize in anxiety, depression and co-occurring disorders. Understand the Facts Anxiety ...

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

    Directory of Open Access Journals (Sweden)

    Maria S Signorelli

    2014-12-01

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

  20. Preliminary evidence for an association between a dopamine D3 receptor gene variant and obsessive-compulsive personality disorder in patients with major depression.

    Science.gov (United States)

    Light, Katrina J; Joyce, Peter R; Luty, Suzanne E; Mulder, Roger T; Frampton, Christropher M A; Joyce, Laura R M; Miller, Allison L; Kennedy, Martin A

    2006-06-05

    We have previously reported that the Ser9Gly dopamine D3 receptor (DRD3) polymorphism was associated with increased rates of obsessive-compulsive personality disorder (OCPD) symptomology. We tested the replicability of this association within a further two independent groups of individuals with a history of depression, from a clinical sample (n = 149) and a family study (n = 213). The data from the replication samples and the original sample, within which the association was found, were compiled within a meta-analysis. Although the independent samples did not replicate the original finding, the meta-analysis elucidated significant evidence supporting the association. An individual with Gly/Gly genotype is 2.4 (P = 0.017) times more likely to be diagnosed with OCPD. Male gender was also found to be a significant predictor of OCPD diagnosis (OR = 2.82, P = 0.001). An exploration of an association of DRD3 with Axis I anxiety disorder diagnoses and Temperament and Character Inventory (TCI) traits, in particular persistence, revealed no support for an association. We conclude that DRD3 may contribute to the development of OCPD.

  1. Relapse prevention and residual symptoms: a closer analysis of placebo-controlled continuation studies with escitalopram in major depressive disorder, generalized anxiety disorder, social anxiety disorder, and obsessive-compulsive disorder

    DEFF Research Database (Denmark)

    Bech, Per; Lönn, Sara L; Overø, Kerstin F

    2010-01-01

    -Asberg Depression Rating Scale (MADRS) scores on items 1, 3, and 7 at randomization. RESULTS: All studies showed a statistically significant (P ...-Severity of Illness scores and relapse status in 4 studies published from 2005 to 2007, 1 each in major depressive disorder (MDD), generalized anxiety disorder, social anxiety disorder, and obsessive-compulsive disorder (OCD), were analyzed using mixed-effects model repeated measures as a function of Montgomery...... > 0) and without residual symptoms (MADRS score = 0) at the start of continuation treatment were defined by how patients scored on 3 core items of the MADRS: depressed mood (observed), inner or psychic tension, and lassitude. At randomization, patients with a residual symptom were globally more ill...

  2. Relapse prevention and residual symptoms: a closer analysis of placebo-controlled continuation studies with escitalopram in major depressive disorder, generalized anxiety disorder, social anxiety disorder, and obsessive-compulsive disorder

    DEFF Research Database (Denmark)

    Bech, Per; Lönn, Sara L; Overø, Kerstin F

    2010-01-01

    -Severity of Illness scores and relapse status in 4 studies published from 2005 to 2007, 1 each in major depressive disorder (MDD), generalized anxiety disorder, social anxiety disorder, and obsessive-compulsive disorder (OCD), were analyzed using mixed-effects model repeated measures as a function of Montgomery......-Asberg Depression Rating Scale (MADRS) scores on items 1, 3, and 7 at randomization. RESULTS: All studies showed a statistically significant (P ... > 0) and without residual symptoms (MADRS score = 0) at the start of continuation treatment were defined by how patients scored on 3 core items of the MADRS: depressed mood (observed), inner or psychic tension, and lassitude. At randomization, patients with a residual symptom were globally more ill...

  3. Comorbidity of obsessive-compulsive disorder with obsessive-compulsive personality disorder: Does it imply a specific subtype of obsessive-compulsive disorder?

    Science.gov (United States)

    Garyfallos, George; Katsigiannopoulos, Konstantinos; Adamopoulou, Aravela; Papazisis, Georgios; Karastergiou, Anastasia; Bozikas, Vasilios P

    2010-05-15

    The present study examined whether the comorbidity of obsessive-compulsive personality disorder (OCPD) and obsessive-compulsive disorder (OCD) constitute a specific subtype of OCD. The study sample consisted of 146 consecutive outpatients with a DSM-IV diagnosis of OCD. Diagnoses were established using MINI, IPDE, YBOCS and YBOCS-SC. OCD patients with comorbid OCPD were compared with OCD patients without OCPD on various sociodemographic and clinical variables. Almost one third of the OCD subjects met criteria for comorbid OCPD. OCD+OCPD patients had a significantly earlier age at onset of initial OC symptoms, earlier age at onset of OCD and more obsessions and compulsions than pure obsessions compared to the patients with OCDOCPD. OCD+OCPD patients also had a higher rate of comorbidity with avoidant personality disorder and showed more impairment in global functioning. There were not differences between the two sub-groups on severity of OCD symptoms and also on type of OCD onset. Our results indicate that the comorbidity of OCD with OCPD is associated with a number of specific clinical characteristics of OCD. These findings in conjunction with of current clinical, family and genetic studies provide some initial evidence that OCD comorbid with OCPD constitute a specific subtype of OCD. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2011-08-01

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

  5. The prevalence and structure of obsessive-compulsive personality disorder in Hispanic psychiatric outpatients

    OpenAIRE

    Ansell, Emily B.; Pinto, Anthony; Crosby, Ross D.; Becker, Daniel F.; Añez, Luis M.; Paris, Manuel; Grilo, Carlos M.

    2010-01-01

    This study sought to confirm a multi-factor model of Obsessive-compulsive personality disorder (OCPD) in a Hispanic outpatient sample and to explore associations of the OCPD factors with aggression, depression, and suicidal thoughts. One hundred and thirty monolingual, Spanish-speaking participants were recruited from a community mental health center and were assessed by bilingual doctoral level clinicians. OCPD was highly prevalent (26%) in this sample. Multi-factor models of OCPD were teste...

  6. Obsessive-compulsive disorder: an overview.

    Science.gov (United States)

    Simpson, H B; Fallon, B A

    2000-01-01

    In this article, which is the first in a three-part series, the authors provide an overview of the current state of our knowledge of the phenomenology, etiology, and diagnosis of OCD. The DSM-IV criteria for OCD are presented and explicated. Disorders that are commonly comorbid with OCD (e.g., major depressive disorder, other anxiety dis-orders, Tourette's disorder) are described. The authors also discuss disorders such as body dysmorphic disorder that may be related to OCD and are often termed OCD spectrum disorders. OCD is likely to have multiple causes and the authors discuss behavioral, neuroanatomical, and neurochemical theories of OCD. Two treatments have demonstrated efficacy in OCD, cognitive-behavioral therapy and pharmacotherapy with serotonergic reuptake inhibitors, and the authors discuss how these treatments may work in light of what is known about the etiology of the disorder. The different subtypes of OCD that have been proposed are described along with their implications for treatment. The article concludes with a discussion of diagnosis that provides specific guidance for the clinician on how to assess a patient for possible OCD. The next two articles in this series will cover cognitive-behavioral and medication treatment in detail.

  7. Longitudinal course of pharmacotherapy in obsessive-compulsive disorder

    DEFF Research Database (Denmark)

    Grant, Jon E; Mancebo, Maria C; Weinhandl, Eric

    2013-01-01

    -term course of SRI utilization among individuals with OCD. METHODS: A total of 252 adult outpatients with Diagnostic and Statistical Manual of Mental Disorders, 4th ed. OCD, treated with medication in the community, were examined for discontinuation and resumption of SRIs. Data on weekly OCD symptoms......BACKGROUND: Although data fully support the use of serotonin reuptake inhibitors (SRIs) in the treatment of obsessive-compulsive disorder (OCD), investigations on pharmacotherapy discontinuation during the course of OCD are lacking. This 5-year prospective study sought to better understand the long...

  8. Tic disorders and obsessive compulsive disorder: where is the link?

    Science.gov (United States)

    Roessner, V; Becker, A; Banaschewski, T; Rothenberger, A

    2005-01-01

    Over the last years evidence on the overlap between tic-disorders (TD) and obsessive compulsive behavior/disorder (OCB/OCD) has increased. The main focus of research have been the phenomenological and epidemiological similarities and differences in samples of different age, primary diagnosis (TD vs. OCD) including the co-occurrence of both. Unfortunately, only a minority of studies included all three groups (TD, TD + OCD, OCD). Nevertheless, new insight concerning possible subtypes for both TD and OCD has been gained. While some authors concentrated on OCD with/without tics we will summarize the field of TD and OCB/OCD from the viewpoint of tics, since OCB plays an important role in patients with TD. Thereby we will not only sharpen the clinicans' awareness of known differences in phenomenology, epidemiology, genetics and neurobiology, aimed to improve their diagnoses and treatment but also highlight the gaps of knowledge and discuss possibilities for further research in this field.

  9. Comparing attentional control and intrusive thoughts in obsessive-compulsive disorder, generalized anxiety disorder and non clinical population.

    Directory of Open Access Journals (Sweden)

    Mehri Moradi

    2014-06-01

    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.

  10. Obsessive-compulsive personality disorder and behavioral disinhibition.

    Science.gov (United States)

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

    2004-01-01

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

  11. Comparison of cognitive flexibility and planning ability in patients with obsessive compulsive disorder, patients with obsessive compulsive personality disorder, and healthy controls

    OpenAIRE

    PAAST, Negin; KHOSRAVI, Zohreh; MEMARI, Amir Hossein; SHAYESTEHFAR, Monir; ARBABI, Mohammad

    2016-01-01

    Background Cognitive functioning in individuals with Obsessive Compulsive Disorder (OCD) and with Obsessive Compulsive Personality Disorder (OCPD) has not been adequately studied. Aim Examine the cognitive flexibility and planning ability of individuals with OCD and OCPD. Methods Twenty patients with OCD and 25 patients with OCPD who had not taken medication in the previous two weeks were identified in an outpatient psychology clinic in Tehran, and 25 healthy control subjects were identified ...

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2014-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Frías Á

    2015-08-01

    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

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

    Science.gov (United States)

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

    2013-01-01

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

  16. OBSESSIVE-COMPULSIVE PERSONALITY DISORDER: EVIDENCE FOR TWO DIMENSIONS.

    Science.gov (United States)

    Riddle, Mark A; Maher, Brion S; Wang, Ying; Grados, Marco; Bienvenu, O Joseph; Goes, Fernando S; Cullen, Bernadette; Murphy, Dennis L; Rauch, Scott L; Greenberg, Benjamin D; Knowles, James A; McCracken, James T; Pinto, Anthony; Piacentini, John; Pauls, David L; Rasmussen, Steven A; Shugart, Yin Yao; Nestadt, Gerald; Samuels, Jack

    2016-02-01

    To determine possible dimensions that underlie obsessive-compulsive personality disorder (OCPD) and to investigate their clinical correlates, familiality, and genetic linkage. Participants were selected from 844 adults assessed with the Structured Instrument for the Diagnosis of DSM-IV Personality Disorders (SIDP) in the OCD Collaborative Genetics Study (OCGS) that targeted families with obsessive-compulsive disorder (OCD) affected sibling pairs. We conducted an exploratory factor analysis, which included the eight SIDP-derived DSM-IV OCPD traits and the indecision trait from the DSM-III, assessed clinical correlates, and estimated sib-sib correlations to evaluate familiality of the factors. Using MERLIN and MINX, we performed genome-wide quantitative trait locus (QTL) linkage analysis to test for allele sharing among individuals. Two factors were identified: Factor 1: order/control (perfectionism, excessive devotion to work, overconscientiousness, reluctance to delegate, and rigidity); and Factor 2: hoarding/indecision (inability to discard and indecisiveness). Factor 1 score was associated with poor insight, whereas Factor 2 score was associated with task incompletion. A significant sib-sib correlation was found for Factor 2 (rICC = .354, P OCPD, order/control and hoarding/indecision. The hoarding/indecision factor is familial and shows modest linkage to a region on chromosome 10. © 2015 Wiley Periodicals, Inc.

  17. The suicidality continuum in a large sample of obsessive-compulsive disorder (OCD) patients.

    Science.gov (United States)

    Velloso, P; Piccinato, C; Ferrão, Y; Aliende Perin, E; Cesar, R; Fontenelle, L; Hounie, A G; do Rosário, M C

    2016-10-01

    Obsessive-compulsive disorder (OCD) has a chronic course leading to huge impact in the patient's functioning. Suicidal thoughts and attempts are much more frequent in OCD subjects than once thought before. To empirically investigate whether the suicidal phenomena could be analyzed as a suicidality severity continuum and its association with obsessive-compulsive (OC) symptom dimensions and quality of life (QoL), in a large OCD sample. Cross-sectional study with 548 patients diagnosed with OCD according to the DSM-IV criteria, interviewed in the Brazilian OCD Consortium (C-TOC) sites. Patients were evaluated by OCD experts using standardized instruments including: Yale-Brown Obsessive-Compulsive Scale (YBOCS); Dimensional Yale-Brown Obsessive-Compulsive Scale (DYBOCS); Beck Depression and Anxiety Inventories; Structured Clinical Interview for DSM-IV (SCID); and the SF-36 QoL Health Survey. There were extremely high correlations between all the suicidal phenomena. OCD patients with suicidality had significantly lower QoL, higher severity in the "sexual/religious", "aggression" and "symmetry/ordering" OC symptom dimensions, higher BDI and BA scores and a higher frequency of suicide attempts in a family member. In the regression analysis, the factors that most impacted suicidality were the sexual dimension severity, the SF-36 QoL Mental Health domain, the severity of depressive symptoms and a relative with an attempted suicide history. Suicidality could be analyzed as a severity continuum and patients should be carefully monitored since they present with suicidal ideation. Lower QoL scores, higher scores on the sexual dimension and a family history of suicide attempts should be considered as risk factors for suicidality among OCD patients. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

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

    Science.gov (United States)

    García-Soriano, Gemma; Belloch, Amparo

    2012-06-30

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

  19. Humor appreciation of captionless cartoons in obsessive-compulsive disorder

    Science.gov (United States)

    2011-01-01

    Background It seems that the core neural regions and cognitive processes implicated in obsessive-compulsive disorder (OCD) pathophysiology may overlap with those involved in humor appreciation. However, to date, there have been no studies that have explored humor appreciation in OCD. The purpose of the present work was to investigate humor appreciation in a group of patients with OCD. Methods We examined 25 patients with OCD and 25 healthy controls, matched by age, education, and gender. We administered Penn's Humor Appreciation Test (PHAT), a computerized test comprising captionless cartoons by Mordillo. Each set of stimuli consisted of two almost identical drawings, one of which was funny due to the alteration of a detail in the cartoon, whereas the other was not funny. Severity of psychopathology was evaluated with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Results No significant effect for group, gender or group × gender interaction was found on the PHAT scores. In OCD patients, humor appreciation was not significantly associated with age of onset, duration of illness, and obsessions, but correlated significantly with compulsions. Conclusions Humor appreciation, based on captionless cartoons in OCD, does not seem to be deficient compared to healthy subjects but may be related to illness characteristics. PMID:22103926

  20. Social cognition and metacognition in obsessive-compulsive disorder: an explorative pilot study.

    Science.gov (United States)

    Mavrogiorgou, Paraskevi; Bethge, Mareike; Luksnat, Stefanie; Nalato, Fabio; Juckel, Georg; Brüne, Martin

    2016-04-01

    Obsessive-compulsive disorder (OCD) is a severe psychiatric condition that is, among other features, characterized by marked impairment in social functioning. Although theoretically plausible with regard to neurobiological underpinnings of OCD, there is little research about possible impairments in social cognitive and meta-cognitive abilities and their connections with social functioning in patients with OCD. Accordingly, we sought to examine social cognitive skills and metacognition in OCD. Twenty OCD patients and age-, sex-, and education-matched 20 healthy controls were assessed using neurocognitive and diverse social cognitive skills including the Ekman 60 Faces test, the Hinting Task, the faux pas test, and a proverb test. In addition, the Metacognition Questionnaire-30 was administered to both the OCD and the control groups. Social functioning was measured using the Personal and Social Performance Scale. Symptom severity in patients was determined by the Yale-Brown Obsessive-Compulsive Scale and the Maudsley Obsessive-Compulsive Inventory. No group differences emerged in basic social cognitive abilities. In contrast, compared to controls, OCD patients scored higher on all MCQ dimensions, particularly negative beliefs about worry, uncontrollability, and danger; beliefs about need to control thoughts; and cognitive self-consciousness. There were no significant correlations between social or metacognitive parameters and OCD symptom severity. However, in the patient group, depression and metacognition predicted social functioning. OCD patients show normal basal social cognitive abilities, but dysfunctional metacognitive profiles, which may contribute to their psychosocial impairment.

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

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

    2017-01-01

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

  2. Sexual dysfunction in Obsessive-Compulsive disorder

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    Firoozeh Raisi

    2015-05-01

    Conclusion: High prevalence of sexual dysfunction in OCD women and significant correlation between male sexual dysfunction and OCD (r= -481.0 between total score of OCI-R with erectile dysfunction and r= -458.0 between total score of OCI-R and sexual satisfaction could confirm a relation between OCD and sexual disorders. So, evaluation of sexual function in all patients with OCD is recommended.

  3. Obsessive-compulsive disorder comorbidity: clinical assessment and therapeutic implications

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    Stefano ePallanti

    2011-12-01

    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.

  4. Cluster analysis of obsessive-compulsive spectrum disorders in patients with obsessive-compulsive disorder: clinical and genetic correlates.

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    Lochner, Christine; Hemmings, Sian M J; Kinnear, Craig J; Niehaus, Dana J H; Nel, Daniel G; Corfield, Valerie A; Moolman-Smook, Johanna C; Seedat, Soraya; Stein, Dan J

    2005-01-01

    Comorbidity of certain obsessive-compulsive spectrum disorders (OCSDs; such as Tourette's disorder) in obsessive-compulsive disorder (OCD) may serve to define important OCD subtypes characterized by differing phenomenology and neurobiological mechanisms. Comorbidity of the putative OCSDs in OCD has, however, not often been systematically investigated. The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition , Axis I Disorders-Patient Version as well as a Structured Clinical Interview for Putative OCSDs (SCID-OCSD) were administered to 210 adult patients with OCD (N = 210, 102 men and 108 women; mean age, 35.7 +/- 13.3). A subset of Caucasian subjects (with OCD, n = 171; control subjects, n = 168), including subjects from the genetically homogeneous Afrikaner population (with OCD, n = 77; control subjects, n = 144), was genotyped for polymorphisms in genes involved in monoamine function. Because the items of the SCID-OCSD are binary (present/absent), a cluster analysis (Ward's method) using the items of SCID-OCSD was conducted. The association of identified clusters with demographic variables (age, gender), clinical variables (age of onset, obsessive-compulsive symptom severity and dimensions, level of insight, temperament/character, treatment response), and monoaminergic genotypes was examined. Cluster analysis of the OCSDs in our sample of patients with OCD identified 3 separate clusters at a 1.1 linkage distance level. The 3 clusters were named as follows: (1) "reward deficiency" (including trichotillomania, Tourette's disorder, pathological gambling, and hypersexual disorder), (2) "impulsivity" (including compulsive shopping, kleptomania, eating disorders, self-injury, and intermittent explosive disorder), and (3) "somatic" (including body dysmorphic disorder and hypochondriasis). Several significant associations were found between cluster scores and other variables; for example, cluster I scores were associated

  5. Obsessive-compulsive disorder in children and adolescents.

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    Krebs, Georgina; Heyman, Isobel

    2015-05-01

    Obsessive-compulsive disorder (OCD) in childhood and adolescence is an impairing condition, associated with a specific set of distressing symptoms incorporating repetitive, intrusive thoughts (obsessions) and distressing, time-consuming rituals (compulsions). This review considers current knowledge of causes and mechanisms underlying OCD, as well as assessment and treatment. Issues relating to differential diagnosis are summarised, including the challenges of distinguishing OCD from autism spectrum disorders and tic disorders in youth. The recommended treatments, namely cognitive behaviour therapy and serotonin reuptake inhibiting/selective serotonin reuptake inhibitor medications, are outlined along with the existing evidence-based and factors associated with treatment resistance. Finally, novel clinical developments that are emerging in the field and future directions for research are discussed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  6. Co-morbid anxiety disorders in bipolar disorder and major depression: familial aggregation and clinical characteristics of co-morbid panic disorder, social phobia, specific phobia and obsessive-compulsive disorder.

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    Goes, F S; McCusker, M G; Bienvenu, O J; Mackinnon, D F; Mondimore, F M; Schweizer, B; Depaulo, J R; Potash, J B

    2012-07-01

    Co-morbidity of mood and anxiety disorders is common and often associated with greater illness severity. This study investigates clinical correlates and familiality of four anxiety disorders in a large sample of bipolar disorder (BP) and major depressive disorder (MDD) pedigrees. The sample comprised 566 BP families with 1416 affected subjects and 675 MDD families with 1726 affected subjects. Clinical characteristics and familiality of panic disorder, social phobia, specific phobia and obsessive-compulsive disorder (OCD) were examined in BP and MDD pedigrees with multivariate modeling using generalized estimating equations. Co-morbidity between mood and anxiety disorders was associated with several markers of clinical severity, including earlier age of onset, greater number of depressive episodes and higher prevalence of attempted suicide, when compared with mood disorder without co-morbid anxiety. Familial aggregation was found with co-morbid panic and OCD in both BP and MDD pedigrees. Specific phobia showed familial aggregation in both MDD and BP families, although the findings in BP were just short of statistical significance after adjusting for other anxiety co-morbidities. We found no evidence for familiality of social phobia. Our findings suggest that co-morbidity of MDD and BP with specific anxiety disorders (OCD, panic disorder and specific phobia) is at least partly due to familial factors, which may be of relevance to both phenotypic and genetic studies of co-morbidity.

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

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

    2017-10-01

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

  8. Early childhood experiences shaping vulnerability to Obsessive-Compulsive Disorder

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    Barbara Barcaccia

    2015-12-01

    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.

  9. Heterogeneity of obsessive-compulsive disorder: a literature review.

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    Lochner, Christine; Stein, Dan J

    2003-01-01

    Significant advances have been made in characterizing the phenomenology and psychobiology of obsessive-compulsive disorder (OCD) in recent years. In many ways, such advances suggest a conceptualization of OCD as a relatively homogeneous neuropsychiatric entity, underpinned by particular mechanisms that manifest in universal symptoms. Nevertheless, some data have pointed to the heterogeneity of this disorder. A computerized literature search (MEDLINE: 1964-2001) was used to collect studies addressing the heterogeneity of OCD. In addition, reviews of the phenomenology, psychobiology, family studies, and treatment of OCD were examined in an attempt to collate data addressing this issue. There is a growing consensus that some subtypes of OCD are valid and provide a useful means of integrating data on its symptomatology, neurobiology, and treatment response; for example, OCD with comorbid tics is characterized by earlier onset, a particular range of OCD symptoms, and worse response to selective serotonin reuptake inhibitors. The heterogeneity of OCD has important clinical and research implications.

  10. Sex differences in the phenotypic expression of obsessive-compulsive disorder: an exploratory study from Brazil.

    Science.gov (United States)

    Torresan, Ricardo Cezar; Ramos-Cerqueira, Ana Teresa de Abreu; de Mathis, Maria Alice; Diniz, Juliana Belo; Ferrão, Ygor Arzeno; Miguel, Euripedes Constantino; Torres, Albina Rodrigues

    2009-01-01

    Previous studies have shown differences in clinical features of obsessive-compulsive disorder (OCD) between men and women, including mean age at onset of obsessive-compulsive symptoms (OCS), types of OCS, comorbid disorders, course, and prognosis. The aim of this study was to compare male and female Brazilian patients with OCD on several demographic and clinical characteristics. Three hundred thirty outpatients with OCD (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [DSM-IV], criteria) who sought treatment at 3 Brazilian public universities and at 2 private practice clinics in the city of São Paulo were evaluated. The assessment instruments used were the Yale-Brown Obsessive-Compulsive Scale to evaluate OCD severity and symptoms, the Beck Depression and Anxiety Inventories, the Yale Global Tic Severity Scale, and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Axis I Disorders to assess psychiatric comorbidity. Fifty-five percent of the patients (n = 182) were men who were significantly more likely than women to be single and to present sexual, religious, and symmetry obsessions and mental rituals. They also presented earlier onset of OCS and earlier symptom interference in functioning, and significantly more comorbid tic disorders and posttraumatic stress disorder. Women, besides showing significantly higher mean scores in the Beck Depression and Anxiety Inventories, were more likely to present comorbid simple phobias, eating disorders in general and anorexia in particular, impulse control disorders in general, and compulsive buying and skin picking in particular. No significant differences were observed between sexes concerning family history of OCS or OCD, and global symptoms severity, either in obsession or compulsive subscale. The present study confirms the presence of sex-related differences described in other countries and cultures. The fact that the OCS start earlier and

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

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

    2017-01-01

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

  12. Sexual Functions in Obsessive Compulsive Disorder Patients: A Case Report

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    Nergis LAPSEKİLİ

    2012-11-01

    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.

  13. Electroconvulsive therapy for obsessive-compulsive disorder: a systematic review.

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    Fontenelle, Leonardo F; Coutinho, Evandro S F; Lins-Martins, Natália M; Fitzgerald, Paul B; Fujiwara, Hironobo; Yücel, Murat

    2015-07-01

    Surgical therapies for treatment-refractory obsessive-compulsive disorder (OCD), such as deep brain stimulation or psychosurgery, remain unattainable for many patients. Despite the long-held view that electroconvulsive therapy (ECT) is an ineffective treatment for OCD, there is no systematic review to support or refute this claim, which is the basis of the current review. A systematic search of MEDLINE, Web of Science, Scopus, and LILACS databases was conducted on December 22, 2013, using the terms obsessive-compulsive disorder and electroconvulsive therapy. Reference lists, specific journals, and clinical trial registries were also scrutinized. No date or language limitation was imposed on the search. After irrelevant and redundant records from the 500 identified titles were excluded, the 50 articles reporting the acute treatment effects of ECT in OCD and related constructs (involving a total of 279 patients) were analyzed for this study. The relevant sociodemographic, clinical, and outcome data of individual cases were extracted. Data from individual cases were used to compare the characteristics of responders versus nonresponders to ECT. Most selected records were case reports/series; there were no randomized controlled trials. A positive response was reported in 60.4% of the 265 cases in which individual responses to ECT were available. ECT responders exhibited a significantly later onset of OCD symptoms (P = .003), were more frequently nondepressed (P = .009), more commonly reported being treated with ECT for severe OCD (P = .01), and received a fewer number of ECT sessions (P = .03). ECT responders were also less frequently previously treated with adequate trials of serotonin reuptake inhibitors (P = .05) and cognitive-behavioral therapy (P = .005). Although 60% of the reported cases reviewed exhibited some form of a positive response to ECT, it cannot be stated that this provides evidence that ECT is indeed effective for OCD. © Copyright 2015 Physicians

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

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

    2016-07-01

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

  15. Family Factors Predict Treatment Outcome for Pediatric Obsessive Compulsive Disorder

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

    2012-01-01

    Objective To examine family conflict, parental blame, and poor family cohesion as predictors of treatment outcome for youth receiving family-focused cognitive behavioral therapy (FCBT) for obsessive compulsive disorder (OCD). Methods We analyzed data from a sample of youth who were randomized to FCBT (n = 49; 59% male; mean age = 12.43 years) as part of a larger randomized clinical trial. Youngsters and their families were assessed by an independent evaluator (IE) pre- and post- FCBT using a standardized battery of measures evaluating family functioning and OCD symptom severity. Family conflict and cohesion were measured via parent self-report on the Family Environment Scale (FES; Moos & Moos, 1994) and parental blame was measured using parent self-report on the Parental Attitudes and Behaviors Scale (PABS; Peris, 2008b). Symptom severity was rated by IE’s using the Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS; Scahill et al., 1997). Results Families with lower levels of parental blame and family conflict and higher levels of family cohesion at baseline were more likely to have a child who responded to FCBT treatment even after adjusting for baseline symptom severity compared to families who endorsed higher levels of dysfunction prior to treatment. In analyses using both categorical and continuous outcome measures, higher levels of family dysfunction and difficulty in higher number of domains of family functioning were associated with lower rates of treatment response. In addition, changes in family cohesion predicted response to FCBT controlling for baseline symptom severity. Conclusions Findings speak to the role of the family in treatment for childhood OCD and highlight potential targets for future family interventions. PMID:22309471

  16. A double blind comparison of venlafaxine and paroxetine in obsessive-compulsive disorder

    NARCIS (Netherlands)

    Denys, Damiaan; van der Wee, Nic; van Megen, Harold J. G. M.; Westenberg, Herman G. M.

    2003-01-01

    SUMMARY: While the usefulness of clomipramine and selective serotonin reuptake inhibitors (SSRIs) in obsessive-compulsive disorder (OCD) has been established, the efficacy of serotonin-norepinephrine reuptake inhibitors remains to be determined. This report describes the first randomized

  17. Neuroimaging of psychotherapy for obsessive-compulsive disorder: A systematic review

    NARCIS (Netherlands)

    Thorsen, A.L.; van den Heuvel, O.A.; Hansen, B.; Kvale, G.

    2015-01-01

    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

  18. Comments on: “Transcranial Direct Current Stimulation for Obsessive-Compulsive Disorder: A Systematic Review”

    Directory of Open Access Journals (Sweden)

    Mohammad Alwardat

    2018-03-01

    Full Text Available Dear Editor, Brunelin et al. [1] recently conducted a systematic review that evaluated the effect of applied transcranial direct current stimulation (tDCS on patients with obsessive compulsive disorder (OCD.[...

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

    Science.gov (United States)

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

    2000-11-01

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

  20. Symptom dimensions, clinical course and comorbidity in men and women with obsessive-compulsive disorder.

    Science.gov (United States)

    Torresan, Ricardo C; Ramos-Cerqueira, Ana Teresa A; Shavitt, Roseli G; do Rosário, Maria Conceição; de Mathis, Maria Alice; Miguel, Euripedes C; Torres, Albina R

    2013-09-30

    The study aimed to compare male and female patients with obsessive-compulsive disorder (OCD) across symptom dimensions, clinical course and comorbidity. A cross-sectional study was undertaken with 858 adult OCD patients (DSM-IV) from the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders. Patients were evaluated using structured interviews, including the Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS) and the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I). The sample was composed of 504 women (58.7%) and 354 men (41.3%) with a mean age of 35.4 years-old (range: 18-77). Men were younger, more frequently single and presented more tics, social phobia and alcohol use disorders. Among men, symptom interference occurred earlier and symptoms of the sexual/religious dimension were more common and more severe. Conversely, women were more likely to present symptoms of the aggressive, contamination/cleaning and hoarding dimension and comorbidity with specific phobias, anorexia nervosa, bulimia, trichotillomania, skin picking and "compulsive" buying. In the logistic regression, female gender remained independently associated with the aggressive and contamination/cleaning dimensions. In both genders the aggressive dimension remained associated with comorbid post-traumatic stress disorder, the sexual/religious dimension with major depression and the hoarding dimension with tic disorders. Gender seems to be relevant in the determination of OCD clinical presentation and course and should be considered an important aspect when defining more homogeneous OCD subgroups. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  1. Dissociative symptoms and dissociative disorders comorbidity in obsessive compulsive disorder: Symptom screening, diagnostic tools and reflections on treatment

    OpenAIRE

    Belli, Hasan

    2014-01-01

    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...

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

    Science.gov (United States)

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

    2008-09-01

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

  3. Aripiprazole augmentation in poor insight obsessive-compulsive disorder: a case report

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    Vinciguerra Valentina

    2008-12-01

    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.

  4. What’s left feels right : Studies in obsessive-compulsive disorder (OCD) and body integrity identity disorder (BIID)

    NARCIS (Netherlands)

    Blom, R.M.

    2017-01-01

    Over the last decade the nosology status of obsessive-compulsive and related disorders has been topic of debate. Whereas in DSM-IV (Diagnostic and Statistical Manual of Mental Disorders IV) obsessive-compulsive disorder (OCD) was classified as an anxiety disorder, in DSM-V it is classified as a

  5. Clinical features of obsessive-compulsive disorder with hoarding symptoms: a multicenter study.

    Science.gov (United States)

    Torres, Albina R; Fontenelle, Leonardo F; Ferrão, Ygor A; do Rosário, Maria Conceição; Torresan, Ricardo C; Miguel, Eurípedes C; Shavitt, Roseli G

    2012-06-01

    Factor analyses indicate that hoarding symptoms constitute a distinctive dimension of obsessive-compulsive disorder (OCD), usually associated with higher severity and limited insight. The aim was to compare demographic and clinical features of OCD patients with and without hoarding symptoms. A cross sectional study was conducted with 1001 DSM-IV OCD patients from the Brazilian Research Consortium of Obsessive-Compulsive Spectrum Disorders (CTOC), using several instruments. The presence and severity of hoarding symptoms were determined using the Dimensional Yale-Brown Obsessive-Compulsive Scale. Statistical univariate analyses comparing factors possibly associated with hoarding symptoms were conducted, followed by logistic regression to adjust the results for possible confounders. Approximately half of the sample (52.7%, n = 528) presented hoarding symptoms, but only four patients presented solely the hoarding dimension. Hoarding was the least severe dimension in the total sample (mean score: 3.89). The most common lifetime hoarding symptom was the obsessive thought of needing to collect and keep things for the future (44.0%, n = 440). After logistic regression, the following variables remained independently associated with hoarding symptoms: being older, living alone, earlier age of symptoms onset, insidious onset of obsessions, higher anxiety scores, poorer insight and higher frequency of the symmetry-ordering symptom dimension. Concerning comorbidities, major depressive, posttraumatic stress and attention deficit/hyperactivity disorders, compulsive buying and tic disorders remained associated with the hoarding dimension. OCD hoarding patients are more likely to present certain clinical features, but further studies are needed to determine whether OCD patients with hoarding symptoms constitute an etiologically discrete subgroup. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Co-Morbidity of Obsessive-Compulsive Disorder with Motor Tics in an Eight Year–Old Boy

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    Mina Zarei

    2013-02-01

    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.

  7. Electroconvulsive therapy for manic state with mixed and psychotic features in a teenager with bipolar disorder and comorbid episodic obsessive-compulsive disorder: a case report.

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    Rask, Olof; Suneson, Klara; Holmström, Eva; Bäckström, Beata; Johansson, Björn Axel

    2017-12-12

    Comorbidity of bipolar disorder and obsessive-compulsive disorder is common in adolescence. Obsessive-compulsive disorder symptoms may be episodic and secondary to alterations in mood, and display specific features. Management of pediatric bipolar disorder-obsessive-compulsive disorder is challenging, as pharmacotherapy of obsessive-compulsive disorder may induce or exacerbate manic episodes and there is limited evidence of treatment efficacy. Electroconvulsive therapy is sparsely used in children and adolescents, but is documented to be a safe and efficacious intervention in adults with bipolar disorder. In view of the severity of symptoms in juvenile mania, studies on treatment strategies are warranted. We report a case of an adolescent with bipolar disorder-obsessive-compulsive disorder who was successfully treated with electroconvulsive therapy during an episode of severe mania. A 16-year-old girl of Middle East origin first presented to us with depressed mood, irritability, and increased obsessive-compulsive disorder symptoms, which were initially interpreted in the context of acute stress secondary to migration. She had been diagnosed with bipolar disorder and obsessive-compulsive disorder in her previous home country, but had difficulties in accounting for earlier psychiatric history. During hospitalization her mood switched to a manic state with mixed and psychotic features, at times showing aggression toward others. Interruption in her lithium treatment for a short period and possibly the introduction of an atypical antipsychotic could in part have been triggering factors. After 8 weeks of in-patient care and psychotropic drug trials, electroconvulsive therapy was initiated and administered every second or third day for 4 weeks, with marked positive response. No apparent side effects were reported. This case demonstrates the need for a detailed medical history, taking special note of periodicity and character of obsessive-compulsive disorder symptoms, in

  8. New diagnostic perspectives on obsessive-compulsive personality disorder and its links with other conditions.

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    Starcevic, Vladan; Brakoulias, Vlasios

    2014-01-01

    This review examines the conceptualization of obsessive-compulsive personality disorder (OCPD), its epidemiology and efforts to better understand the relationships between OCPD and other conditions. The alternative Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders conceptualization of OCPD is radically different in that it combines categorical and dimensional diagnostic approaches and introduces a hierarchy of diagnostic criteria. OCPD is one of the most common personality disorders in the general population. The relationship between OCPD and obsessive-compulsive disorder (OCD) is important, but to a large extent obfuscated by the overlap between their diagnostic criteria. Frequent changes in the OCPD diagnostic criteria make it difficult to ascertain the 'true' relationship between OCPD and OCD. It is not uncommon for OCPD to occur with anorexia nervosa, depression, hypochondriasis, certain other personality disorders and Parkinson's disease, but further research is necessary to understand the implications of these links. OCPD is yet to be conceptualized consistently and in the manner that would make a clear and well supported distinction between its core and peripheral features. Future studies need to separate a genuine from overlap-driven co-occurrence of OCPD and other conditions, as that would give a better insight into the way in which OCPD relates to other disorders.

  9. Obsessive-compulsive disorder and trichotillomania: a phenomenological comparison

    Directory of Open Access Journals (Sweden)

    Sandler Robin

    2005-01-01

    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.

  10. Obsessive-compulsive disorder and trichotillomania: a phenomenological comparison

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    Lochner, Christine; Seedat, Soraya; du Toit, Pieter L; Nel, Daniel G; Niehaus, Dana JH; Sandler, Robin; Stein, Dan J

    2005-01-01

    Background Similarities between obsessive-compulsive disorder (OCD) and trichotillomania (TTM) have been widely recognized. Nevertheless, there is evidence of important differences between these two disorders. Some authors have conceptualized the disorders as lying on an OCD spectrum of conditions. Methods Two hundred and seventy eight OCD patients (n = 278: 148 male; 130 female) and 54 TTM patients (n = 54; 5 male; 49 female) of all ages were interviewed. Female patients were compared on select demographic and clinical variables, including comorbid axis I and II disorders, and temperament/character profiles. Results OCD patients reported significantly more lifetime disability, but fewer TTM patients reported response to treatment. OCD patients reported higher comorbidity, more harm avoidance and less novelty seeking, more maladaptive beliefs, and more sexual abuse. OCD and TTM symptoms were equally likely to worsen during menstruation, but OCD onset or worsening was more likely associated with pregnancy/puerperium. Conclusions These findings support previous work demonstrating significant differences between OCD and TTM. The classification of TTM as an impulse control disorder is also problematic, and TTM may have more in common with conditions characterized by stereotypical self-injurious symptoms, such as skin-picking. Differences between OCD and TTM may reflect differences in underlying psychobiology, and may necessitate contrasting treatment approaches. PMID:15649315

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

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

    2014-11-01

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

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

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

    2015-04-01

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

  13. Psychotherapy and medication management strategies for obsessive-compulsive disorder

    Directory of Open Access Journals (Sweden)

    McDougle CJ

    2011-08-01

    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

  14. Glutamate abnormalities in obsessive compulsive disorder: neurobiology, pathophysiology, and treatment.

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

    2011-12-01

    Obsessive compulsive disorder is prevalent, disabling, incompletely understood, and often resistant to current therapies. Established treatments consist of specialized cognitive-behavioral psychotherapy and pharmacotherapy with medications targeting serotonergic and dopaminergic neurotransmission. However, remission is rare, and more than a quarter of OCD sufferers receive little or no benefit from these approaches, even when they are optimally delivered. New insights into the disorder, and new treatment strategies, are urgently needed. Recent evidence suggests that the ubiquitous excitatory neurotransmitter glutamate is dysregulated in OCD, and that this dysregulation may contribute to the pathophysiology of the disorder. Here we review the current state of this evidence, including neuroimaging studies, genetics, neurochemical investigations, and insights from animal models. Finally, we review recent findings from small clinical trials of glutamate-modulating medications in treatment-refractory OCD. The precise role of glutamate dysregulation in OCD remains unclear, and we lack blinded, well-controlled studies demonstrating therapeutic benefit from glutamate-modulating agents. Nevertheless, the evidence supporting some important perturbation of glutamate in the disorder is increasingly strong. This new perspective on the pathophysiology of OCD, which complements the older focus on monoaminergic neurotransmission, constitutes an important focus of current research and a promising area for the ongoing development of new therapeutics. Copyright © 2011 Elsevier Inc. All rights reserved.

  15. The relationship between types and severity of repetitive behaviors in Gilles de la Tourette's disorder and obsessive-compulsive disorder

    NARCIS (Netherlands)

    Cath, D.C.; Spinhoven, P.; Wetering, B.J.M. van de; Hoogduin, C.A.L.; Landman, A.D.; Woerkom, T.C.A.M. van; Roos, R.A.C.; Rooijmans, H.G.M.

    2000-01-01

    BACKGROUND: This study investigated which categories of obsessive-compulsive and Tourette-related behaviors in Gilles de la Tourette's disorder and obsessive-compulsive disorder (OCD) without tics are experienced as most severe across the study groups and what the differences are in symptom

  16. Comorbidity, age of onset and suicidality in obsessive-compulsive disorder (OCD): An international collaboration.

    Science.gov (United States)

    Brakoulias, V; Starcevic, V; Belloch, A; Brown, C; Ferrao, Y A; Fontenelle, L F; Lochner, C; Marazziti, D; Matsunaga, H; Miguel, E C; Reddy, Y C J; do Rosario, M C; Shavitt, R G; Shyam Sundar, A; Stein, D J; Torres, A R; Viswasam, K

    2017-07-01

    To collate data from multiple obsessive-compulsive disorder (OCD) treatment centers across seven countries and five continents, and to report findings in relation to OCD comorbidity, age of onset of OCD and comorbid disorders, and suicidality, in a large clinical and ethnically diverse sample, with the aim of investigating cultural variation and the utility of the psychiatric diagnostic classification of obsessive-compulsive and related disorders. Researchers in the field of OCD were invited to contribute summary statistics on current and lifetime psychiatric comorbidity, age of onset of OCD and comorbid disorders and suicidality in their patients with OCD. Data from 3711 adult patients with primary OCD came from Brazil (n=955), India (n=802), Italy (n=750), South Africa (n=565), Japan (n=322), Australia (n=219), and Spain (n=98). The most common current comorbid disorders were major depressive disorder (28.4%; n=1055), obsessive-compulsive personality disorder (24.5%, n=478), generalized anxiety disorder (19.3%, n=716), specific phobia (19.2%, n=714) and social phobia (18.5%, n=686). Major depression was also the most commonly co-occurring lifetime diagnosis, with a rate of 50.5% (n=1874). OCD generally had an age of onset in late adolescence (mean=17.9years, SD=1.9). Social phobia, specific phobia and body dysmorphic disorder also had an early age of onset. Co-occurring major depressive disorder, generalized anxiety disorder and psychotic disorders tended to have a later age of onset than OCD. Suicidal ideation within the last month was reported by 6.4% (n=200) of patients with OCD and 9.0% (n=314) reported a lifetime history of suicide attempt. In this large cross-continental study, comorbidity in OCD was common. The high rates of comorbid major depression and anxiety disorders emphasize the need for clinicians to assess and monitor for these disorders. Earlier ages of onset of OCD, specific phobia and social phobia may indicate some relatedness between these

  17. Parental bonding and hoarding in obsessive-compulsive disorder

    Science.gov (United States)

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

    2017-01-01

    Background Hoarding behavior may indicate a clinically and possibly etiologically distinct subtype of obsessive compulsive disorder (OCD). Empirical evidence supports a relationship between hoarding and emotional over-attachment to objects. However, little is known about the relationship between hoarding and parental attachment in OCD. Method The study sample included 894 adults diagnosed with DSM-IV OCD who had participated in family and genetic studies of OCD. Participants were assessed for Axis I disorders, personality disorders, and general personality dimensions. The Parental Bonding Instrument (PBI) was used to assess dimensions of perceived parental rearing (care, overprotection, and control). We compared parental PBI scores in the 334 hoarding and 560 non-hoarding participants, separately in men and women. We used logistic regression to evaluate the relationship between parenting scores and hoarding in women, adjusting for other clinical features associated with hoarding. Results In men, there were no significant differences between hoarding and non-hoarding groups in maternal or paternal parenting scores. In women, the hoarding group had a lower mean score on maternal care (23.4 vs. 25.7, poverprotection, and maternal overcontrol are associated with hoarding in women with OCD. Parenting dimensions are not related to hoarding in men. These findings provide further support for a hoarding subtype of OCD and for sex-specific differences in etiologic pathways for hoarding in OCD. PMID:27915218

  18. A comparison of obsessive-compulsive personality disorder scales.

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    Samuel, Douglas B; Widiger, Thomas A

    2010-05-01

    In this study, we utilized a large undergraduate sample (N = 536), oversampled for the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision [DSM-IV-TR]; American Psychiatric Association, 2000) obsessive-compulsive personality disorder (OCPD) pathology, to compare 8 self-report measures of OCPD. No prior study has compared more than 3 measures, and the results indicate that the scales had only moderate convergent validity. We also went beyond the existing literature to compare these scales to 2 external reference points: their relationships with a well-established measure of the five-factor model of personality (FFM) and clinicians' ratings of their coverage of the DSM-IV-TR criterion set. When the FFM was used as a point of comparison, the results suggest important differences among the measures with respect to their divergent representation of conscientiousness, neuroticism, and agreeableness. Additionally, an analysis of the construct coverage indicated that the measures also varied in terms of their representation of particular diagnostic criteria. For example, whereas some scales contained items distributed across the diagnostic criteria, others were concentrated more heavily on particular features of the DSM-IV-TR disorder.

  19. Obsessive-compulsive personality disorder: a current review.

    Science.gov (United States)

    Diedrich, Alice; Voderholzer, Ulrich

    2015-02-01

    This review provides a current overview on the diagnostics, epidemiology, co-occurrences, aetiology and treatment of obsessive-compulsive personality disorder (OCPD). The diagnostic criteria for OCPD according to the recently published Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) include an official set of criteria for clinical practice and a new, alternative set of criteria for research purposes. OCPD is a personality disorder prevalent in the general population (3-8 %) that is more common in older and less educated individuals. Findings on sex distribution and course of OCPD are inconsistent. OCPD is comorbid with several other medical and psychological conditions. As for causes of OCPD, most empirical evidence provides support for disturbed attachment as well as the heritability of OCPD. So far, cognitive (behavioural) therapy is the best validated treatment of OCPD. Self-esteem variability, stronger early alliances as well as the distress level seem to predict cognitive (behavioural) therapy outcome. Future research is needed to further advance knowledge in OCPD and to resolve inconsistencies.

  20. Compulsivity in obsessive-compulsive disorder and addictions.

    Science.gov (United States)

    Figee, Martijn; Pattij, Tommy; Willuhn, Ingo; Luigjes, Judy; van den Brink, Wim; Goudriaan, Anneke; Potenza, Marc N; Robbins, Trevor W; Denys, Damiaan

    2016-05-01

    Compulsive behaviors are driven by repetitive urges and typically involve the experience of limited voluntary control over these urges, a diminished ability to delay or inhibit these behaviors, and a tendency to perform repetitive acts in a habitual or stereotyped manner. Compulsivity is not only a central characteristic of obsessive-compulsive disorder (OCD) but is also crucial to addiction. Based on this analogy, OCD has been proposed to be part of the concept of behavioral addiction along with other non-drug-related disorders that share compulsivity, such as pathological gambling, skin-picking, trichotillomania and compulsive eating. In this review, we investigate the neurobiological overlap between compulsivity in substance-use disorders, OCD and behavioral addictions as a validation for the construct of compulsivity that could be adopted in the Research Domain Criteria (RDoC). The reviewed data suggest that compulsivity in OCD and addictions is related to impaired reward and punishment processing with attenuated dopamine release in the ventral striatum, negative reinforcement in limbic systems, cognitive and behavioral inflexibility with diminished serotonergic prefrontal control, and habitual responding with imbalances between ventral and dorsal frontostriatal recruitment. Frontostriatal abnormalities of compulsivity are promising targets for neuromodulation and other interventions for OCD and addictions. We conclude that compulsivity encompasses many of the RDoC constructs in a trans-diagnostic fashion with a common brain circuit dysfunction that can help identifying appropriate prevention and treatment targets. Copyright © 2016. Published by Elsevier B.V.

  1. Deductive and inductive reasoning in obsessive-compulsive disorder.

    Science.gov (United States)

    Pélissier, Marie-Claude; O'Connor, Kieron P

    2002-03-01

    This study tested the hypothesis that people with obsessive-compulsive disorder (OCD) show an inductive reasoning style distinct from people with generalized anxiety disorder (GAD) and from participants in a non-anxious (NA) control group. The experimental procedure consisted of administering a range of six deductive and inductive tasks and a probabilistic task in order to compare reasoning processes between groups. Recruitment was in the Montreal area within a French-speaking population. The participants were 12 people with OCD, 12 NA controls and 10 people with GAD. Participants completed a series of written and oral reasoning tasks including the Wason Selection Task, a Bayesian probability task and other inductive tasks, designed by the authors. There were no differences between groups in deductive reasoning. On an inductive "bridging task", the participants with OCD always took longer than the NA control and GAD groups to infer a link between two statements and to elaborate on this possible link. The OCD group alone showed a significant decrease in their degree of conviction about an arbitrary statement after inductively generating reasons to support this statement. Differences in probabilistic reasoning replicated those of previous authors. The results pinpoint the importance of examining inference processes in people with OCD in order to further refine the clinical applications of behavioural-cognitive therapy for this disorder.

  2. Selective attention deficits in obsessive-compulsive disorder: the role of metacognitive processes.

    Science.gov (United States)

    Koch, Julia; Exner, Cornelia

    2015-02-28

    While initial studies supported the hypothesis that cognitive characteristics that capture cognitive resources act as underlying mechanisms in memory deficits in obsessive-compulsive disorder (OCD), the influence of those characteristics on selective attention has not been studied, yet. In this study, we examined the influence of cognitive self-consciousness (CSC), rumination and worrying on performance in selective attention in OCD and compared the results to a depressive and a healthy control group. We found that 36 OCD and 36 depressive participants were impaired in selective attention in comparison to 36 healthy controls. In all groups, hierarchical regression analyses demonstrated that age, intelligence and years in school significantly predicted performance in selective attention. But only in OCD, the predictive power of the regression model was improved when CSC, rumination and worrying were implemented as predictor variables. In contrast, in none of the three groups the predictive power improved when indicators of severity of obsessive-compulsive (OC) and depressive symptoms and trait anxiety were introduced as predictor variables. Thus, our results support the assumption that mental characteristics that bind cognitive resources play an important role in the understanding of selective attention deficits in OCD and that this mechanism is especially relevant for OCD. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. Internet-based cognitive behavior therapy for obsessive compulsive disorder: A pilot study

    Directory of Open Access Journals (Sweden)

    Andersson Gerhard

    2011-08-01

    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

  4. Psychiatric, behavioral, and attitudinal correlates of avoidant and obsessive-compulsive personality pathology in patients with binge-eating disorder.

    Science.gov (United States)

    Becker, Daniel F; Masheb, Robin M; White, Marney A; Grilo, Carlos M

    2010-01-01

    We examined correlates of avoidant and obsessive-compulsive personality pathology--with respect to psychiatric comorbidity, eating disorder psychopathology, and associated psychologic factors--in patients with binge-eating disorder (BED). Three hundred forty-seven treatment-seeking patients who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), research criteria for BED were reliably assessed with semistructured interviews to evaluate DSM-IV Axis I disorders, personality disorders, and behavioral and attitudinal features of eating disorder psychopathology. Fifteen percent of subjects had avoidant personality disorder features, 12% had obsessive-compulsive personality disorder features, 8% had features of both disorders, and 66% had features of neither. These groups differed significantly in the frequencies of depressive and anxiety disorders, as well as on measures of psychologic functioning (negative/depressive affect and self-esteem) and eating disorder attitudes (shape and weight concerns). There were no group differences on measures of eating behaviors. The avoidant and obsessive-compulsive groups had more psychiatric comorbidity than the group without these personality features but less than the combined group. The group without these features scored significantly lower than all other groups on negative/depressive affect and significantly higher than the avoidant and combined groups on self-esteem. The combined group had the greatest severity on shape and weight concerns. Avoidant and obsessive-compulsive personality features are common in patients with BED. Among BED patients, these forms of personality psychopathology--separately and in combination--are associated with clinically meaningful diagnostic, psychologic, and attitudinal differences. These findings have implications for the psychopathologic relationship between BED and personality psychopathology and may also have implications for assessment and treatment. Copyright

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

    Science.gov (United States)

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

    2015-01-01

    Background With the advent of the fifth edition of Diagnostic and Statistical Manual of Mental Disorders, body dysmorphic disorder (BDD) has been subsumed into the obsessive-compulsive disorders and related disorders (OCDRD) category. Objective We aimed to determine the empirical evidence regarding the potential relationship between BDD and obsessive-compulsive disorder (OCD) based on the prevalence data, etiopathogenic pathways, and clinical characterization of patients with both disorders. Method A comprehensive search of databases (PubMed and PsycINFO) was performed. Published manuscripts between 1985 and May 2015 were identified. Overall, 53 studies fulfilled inclusion criteria. Results Lifetime comorbidity rates of BDD–OCD are almost three times higher in samples with a primary diagnosis of BDD than those with primary OCD (27.5% vs 10.4%). However, other mental disorders, such as social phobia or major mood depression, are more likely among both types of psychiatric samples. Empirical evidence regarding the etiopathogenic pathways for BDD–OCD comorbidity is still inconclusive, whether concerning common shared features or one disorder as a risk factor for the other. Specifically, current findings concerning third variables show more divergences than similarities when comparing both disorders. Preliminary data on the clinical characterization of the patients with BDD and OCD indicate that the deleterious clinical impact of BDD in OCD patients is greater than vice versa. Conclusion Despite the recent inclusion of BDD within the OCDRD, data from comparative studies between BDD and OCD need further evidence for supporting this nosological approach. To better define this issue, comparative studies between BDD, OCD, and social phobia should be carried out. PMID:26345330

  6. Prevalence of irritable bowel syndrome in obsessive-compulsive disorder.

    Science.gov (United States)

    Masand, Prakash S; Keuthen, Nancy J; Gupta, Sanjay; Virk, Subhdeep; Yu-Siao, Barbara; Kaplan, David

    2006-01-01

    Irritable bowel syndrome (IBS) occurs more frequently in psychiatric patients, especially those with anxiety and mood disorders. We sought to determine the prevalence and phenomenology of IBS in patients diagnosed with obsessive-compulsive disorder (OCD). A semi-structured diagnostic interview was administered to patients seeking treatment for OCD in outpatient settings. Structured questions regarding gastrointestinal functioning and IBS symptoms were administered. IBS was diagnosed by a gastroenterologist using Rome I criteria. Thirty-seven patients (35.1%) with OCD met criteria for IBS. Of these, 53.8% had IBS with both diarrhea and constipation, 30.8% had diarrhea-predominant IBS, and 15.4% had constipation-predominant IBS. The prevalence rate of IBS in an age- and sex-matched control group (n=40) of medical patients in a family practice was 2.5%. IBS prevalence rates were significantly higher for OCD patients than control subjects (P=.0002). IBS and psychiatric illness have high rates of bi-directional comorbidity. This study shows that 35.1% of patients with OCD satisfied criteria for IBS in contrast to 2.5% of the controlled subjects. In most patients the IBS was characterized by both diarrhea and constipation. While taking the initial history clinicians should inquire about bowel symptoms in patients presenting with psychiatric illnesses, including OCD. SSRIs could potentially worsen such symptoms and lead to non-adherence.

  7. Visuospatial memory in patients with obsessive-compulsive disorder

    Directory of Open Access Journals (Sweden)

    Anamika Sahu

    2017-01-01

    Full Text Available Background: Obsessive-compulsive disorder (OCD is a clinically heterogeneous disorder. The previous studies have been conducted to elucidate visuospatial and nonverbal memory deficits in OCD patients. However, they did not reach equivocal results which need to be replicated. Objectives: The current study examines the visuospatial memory in male patients with OCD as compared to normal healthy controls. Materials and Methods: It is a cross-sectional hospital-based study, in which 15 OCD patients and 15 age-, sex-, and education-matched normal healthy controls were chosen by purposive sampling technique. All the participants underwent the Extended Complex Figure Test (ECFT for the assessment of visuospatial memory. Results: Significant difference was found between OCD patients and normal healthy controls on various domains of ECFT. OCD patients performed poorly on copy condition (t = −4.46; P< 0.001, immediate recall (t = −5.20; P< 0.001, delayed recall (t = −5.18; P< 0.001, recognition task (P < 0.001, and matching task (P < 0.001 than the controls. Conclusion: Visuospatial memory was significantly impaired in OCD that included disturbed encoding and impaired visuospatial functioning. Hence, it is important to understand the significance of visuospatial memory in the pathophysiology for OCD diagnosis and therapeutic decision.

  8. Enhanced visual performance in obsessive compulsive personality disorder.

    Science.gov (United States)

    Ansari, Zohreh; Fadardi, Javad Salehi

    2016-12-01

    Visual performance is considered as commanding modality in human perception. We tested whether Obsessive-compulsive personality disorder (OCPD) people do differently in visual performance tasks than people without OCPD. One hundred ten students of Ferdowsi University of Mashhad and non-student participants were tested by Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II), among whom 18 (mean age = 29.55; SD = 5.26; 84% female) met the criteria for OCPD classification; controls were 20 persons (mean age = 27.85; SD = 5.26; female = 84%), who did not met the OCPD criteria. Both groups were tested on a modified Flicker task for two dimensions of visual performance (i.e., visual acuity: detecting the location of change, complexity, and size; and visual contrast sensitivity). The OCPD group had responded more accurately on pairs related to size, complexity, and contrast, but spent more time to detect a change on pairs related to complexity and contrast. The OCPD individuals seem to have more accurate visual performance than non-OCPD controls. The findings support the relationship between personality characteristics and visual performance within the framework of top-down processing model. © 2016 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

  9. Obsessive compulsive disorder and psychopathic behaviour in Babylon.

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    Reynolds, Edward H; Kinnier Wilson, James V

    2012-02-01

    The history of obsessive compulsive, phobic and psychopathic behaviour can be traced to the 17th century AD. We draw attention to these behaviours in a Babylonian cuneiform medical text known as Shurpu. These three categories were united in the Babylonian mind around the concept of the māmīt 'oath' idea, the behaviour habits being so unbreakable it appeared that the subject had sworn an oath to do or not to do the action involved. The behavioural accounts were entirely objective, including what we would call immature, antisocial and criminal behaviour, and obsessional categories of contamination, aggression, orderliness of objects, sex and religion. They do not include subjective descriptions of obsessional thoughts, ruminations or the subject's attitude to their own behaviour, which are more modern fields of enquiry. The Babylonians had no understanding of brain or psychological function but they were remarkable describers of medical disease and behaviour. Although they had both physical and supernatural theories of many medical disorders and behaviours, they had an open mind on these particular behaviours which they regarded as a 'mystery' yet to be 'resolved'. We are not aware of comparable accounts of these behaviours in ancient Egyptian or classical medicine. These Babylonian descriptions extend the history of these disorders to the first half of the second millennium BC.

  10. White Matter Features Associated With Autistic Traits in Obsessive-Compulsive Disorder

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    Masaru Kuno

    2018-05-01

    Full Text Available Obsessive-compulsive disorder (OCD is among the most debilitating psychiatric disorders. Comorbid autism spectrum disorder (ASD or autistic traits may impair treatment response in OCD. To identify possible neurostructural deficits underlying autistic traits, we performed white matter tractography on diffusion tensor images (DTI and assessed autistic trait severity using the Autism-Spectrum Quotient (AQ in 33 OCD patients. Correlations between AQ and the DTI parameters, fractional anisotropy (FA, mean diffusivity (MD, axial diffusivity (AD, and radial diffusivity (RD were examined in major white matter tracts that were suggested to be altered in previous OCD studies. We found a negative correlation between AQ and FA and positive correlations between AQ and MD, AD and RD in the left uncinate fasciculus using age, Beck Depression Inventory, Yale-Brown Obsessive-Compulsive Scale, intelligence quotient and medication as covariates. However, we could not detect the significant results between AQ and all DTI parameters when adding gender as a covariate. In addition, in the ASD comorbid group, FA in the left uncinate fasciculus was significantly lower than in the non-ASD comorbid group and MD and RD were significantly higher than in the non-ASD group. These results did not survive correction for multiple comparisons. In ASD, the socio-emotional dysfunction is suggested to be related to the alteration of white matter microstructure in uncinate fasciculus. Our results suggest that variations in white matter features of the left uncinate fasciculus might be partly explained by autistic traits encountered in OCD patients.

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

    NARCIS (Netherlands)

    Rodrigues Zilhao Nogueira, Nuno; Smit, Dirk J; Boomsma, Dorret I; Cath, Danielle C

    2016-01-01

    Hoarding, obsessive-compulsive disorder (OCD), and Tourette's disorder (TD) are psychiatric disorders that share symptom overlap, which might partly be the result of shared genetic variation. Population-based twin studies have found significant genetic correlations between hoarding and OCD symptoms,

  12. Hoarding behavior among young children with obsessive-compulsive disorder.

    Science.gov (United States)

    Frank, Hannah; Stewart, Elyse; Walther, Michael; Benito, Kristen; Freeman, Jennifer; Conelea, Christ; Garci, Abbe

    2014-01-01

    Previous research has shown that among the various subtypes of obsessive-compulsive disorder (OCD), adults (e.g. Frost, Krause & Steketee, 1996) and older children and adolescents (Bloch et al., 2009; Storch et al., 2007) with problematic hoarding have distinct features and a poor treatment prognosis. However, there is limited information on the phenomenology and prevalence of hoarding behaviors in young children. The present study characterizes children ages 10 and under who present with OCD and hoarding behaviors. Sixty-eight children received a structured interview-determined diagnosis of OCD. Clinician administered, parent-report, and child-report measures on demographic, symptomatic, and diagnostic variables were completed. Clinician ratings of hoarding symptoms and parent and child endorsement of the hoarding item on the CY-BOCS checklist (Scahill, Riddle, McSwiggin-Hardin, & Ort, 1997) determined inclusion in the hoarding group ( n =33). Compared to children without hoarding symptoms ( n =35), the presence of hoarding symptoms was associated with an earlier age of primary diagnosis onset and a higher proportion of ADHD and provisional anxiety diagnoses. These results are partially consistent with the adult literature and with findings in older children (Storch et al., 2007). Additional data on clinical presentation and phenomenology of hoarding are needed to form a developmentally appropriate definition of the behavior.

  13. Social context modulates cognitive markers in Obsessive-Compulsive Disorder.

    Science.gov (United States)

    Santamaría-García, Hernando; Soriano-Mas, Carles; Burgaleta, Miguel; Ayneto, Alba; Alonso, Pino; Menchón, José M; Cardoner, Narcis; Sebastián-Gallés, Nuria

    2017-08-03

    Error monitoring, cognitive control and motor inhibition control are proposed as cognitive alterations disrupted in obsessive-compulsive disorder (OCD). OCD has also been associated with an increased sensitivity to social evaluations. The effect of a social simulation over electrophysiological indices of cognitive alterations in OCD was examined. A case-control cross-sectional study measuring event-related potentials (ERP) for error monitoring (Error-Related Negativity), cognitive control (N2) and motor control (LRP) was conducted. We analyzed twenty OCD patients and twenty control participants. ERP were recorded during a social game consisting of a visual discrimination task, which was performed in the presence of a simulated superior or an inferior player. Significant social effects (different ERP amplitudes in Superior vs. Inferior player conditions) were found for OCD patients, but not for controls, in all ERP components. Performing the task against a simulated inferior player reduced abnormal ERP responses in OCD to levels observed in controls. The hierarchy-induced ERP effects were accompanied effects over reaction times in OCD patients. Social context modulates signatures of abnormal cognitive functioning in OCD, therefore experiencing a social superiority position impacts over cognitive processes in OCD such as error monitoring mechanisms. These results open the door for the research of new therapeutic choices.

  14. Inverse reasoning processes in obsessive-compulsive disorder.

    Science.gov (United States)

    Wong, Shiu F; Grisham, Jessica R

    2017-04-01

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

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

    Science.gov (United States)

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

    2013-01-01

    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. 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. 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. 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. 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.

  16. A Virtual Reality Game to Assess Obsessive-Compulsive Disorder.

    Science.gov (United States)

    van Bennekom, Martine J; Kasanmoentalib, M Soemiati; de Koning, Pelle P; Denys, Damiaan

    2017-11-01

    The retrospective and subjective nature of clinical interviews is an important shortcoming of current psychiatric diagnosis. Consequently, there is a clear need for objective and standardized tools. Virtual reality (VR) can be used to achieve controlled symptom provocation, which allows direct assessment for the clinician. We developed a video VR game to provoke and assess obsessive-compulsive disorder (OCD) symptoms in a standardized and controlled environment. The first objective was to evaluate if the VR game is capable of provoking symptoms in OCD patients as opposed to healthy controls. The second objective was to evaluate the tolerability of the VR game in OCD patients. The VR game was created using a first-person perspective and confronted patients with 15 OCD-specific items, while simultaneously measuring OCD symptoms, including the number of compulsions, anxiety, tension, uncertainty, and urge to control. In this pilot study, eight patients and eight healthy controls performed the VR game. OCD patients performed significantly more compulsions (U = 5, p = 0.003) during the VR game. The anxiety, tension, uncertainty, and urge to control in response to the specific items were also higher for OCD patients, although significance was not yet reached because of the small sample. There were no substantial adverse effects. The results of this pilot study indicate that the VR game is capable of provoking a variety of OCD symptoms in OCD patients, as opposed to healthy controls, and is a potential valuable tool to objectify and standardize an OCD diagnosis.

  17. Reasoning in people with obsessive-compulsive disorder.

    Science.gov (United States)

    Simpson, Jane; Cove, Jennifer; Fineberg, Naomi; Msetfi, Rachel M; J Ball, Linden

    2007-11-01

    The aim of this study was to investigate the inductive and deductive reasoning abilities of people with obsessive-compulsive disorder (OCD). Following previous research, it was predicted that people with OCD would show different abilities on inductive reasoning tasks but similar abilities to controls on deductive reasoning tasks. A two-group comparison was used with both groups matched on a range of demographic variables. Where appropriate, unmatched variables were entered into the analyses as covariates. Twenty-three people with OCD and 25 control participants were assessed on two tasks: an inductive reasoning task (the 20-questions task) and a deductive reasoning task (a syllogistic reasoning task with a content-neutral and content-emotional manipulation). While no group differences emerged on several of the parameters of the inductive reasoning task, the OCD group did differ on one, and arguably the most important, parameter by asking fewer correct direct-hypothesis questions. The syllogistic reasoning task results were analysed using both correct response and conclusion acceptance data. While no main effects of group were evident, significant interactions indicated important differences in the way the OCD group reasoned with content neutral and emotional syllogisms. It was argued that the OCD group's patterns of response on both tasks were characterized by the need for more information, states of uncertainty, and doubt and postponement of a final decision.

  18. [Neuroimaging and the neurobiology of obsessive-compulsive disorder].

    Science.gov (United States)

    Schiepek, Günter; Tominschek, Igor; Karch, Susanne; Mulert, Christoph; Pogarell, Oliver

    2007-01-01

    The following review is focusing on results of functional neuroimaging. After some introductory remarks on the phenomenology, epidemiology, and psychotherapy approaches of obsessive-compulsive disorders (OCD) the most important OCD-related brain regions are presented. Obviously, not only the prominent cortico-striato-thalamo-cortical feedback loops are involved, as functional brain imaging studies tell us, but also other regions as the inferior parietal lobe, the anterior and posterior cingulate gyrus, insula, amygdala, cerebellum, and others. Subclassifications using factor-analysis methods support the hypothesis, that most important subtypes ("washing/contamination fear", "obsessions/checking", "symmetry/ordering", "hoarding") involve different, but partially overlapping brain areas. Stimulation paradigms in fMRI-research are commonly based on symptom provocation by visual or tactile stimuli, or on action-monitoring and error-monitoring tasks. Deficits in action-monitoring and planning are discussed to be one of the basic dysfunctions of OCD. Finally, results of psychotherapeutic induced variations of brain activations in OCD are presented.

  19. Inductive and deductive reasoning in obsessive-compulsive disorder.

    Science.gov (United States)

    Liew, Janice; Grisham, Jessica R; Hayes, Brett K

    2018-06-01

    This study examined the hypothesis that participants diagnosed with obsessive-compulsive disorder (OCD) show a selective deficit in inductive reasoning but are equivalent to controls in deductive reasoning. Twenty-five participants with OCD and 25 non-clinical controls made inductive and deductive judgments about a common set of arguments that varied in logical validity and the amount of positive evidence provided (premise sample size). A second inductive reasoning task required participants to make forced-choice decisions and rate the usefulness of diverse evidence or non-diverse evidence for evaluating arguments. No differences in deductive reasoning were found between participants diagnosed with OCD and control participants. Both groups saw that the amount of positive evidence supporting a conclusion was an important guide for evaluating inductive arguments. However, those with OCD showed less sensitivity to premise diversity in inductive reasoning than controls. The findings were similar for both emotionally neutral and OCD-relevant stimuli. The absence of a clinical control group means that it is difficult to know whether the deficit in diversity-based reasoning is specific to those with OCD. People with OCD are impaired in some forms of inductive reasoning (using diverse evidence) but not others (use of sample size). Deductive reasoning appears intact in those with OCD. Difficulties using evidence diversity when reasoning inductively may maintain OCD symptoms through reduced generalization of learned safety information. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Inductive reasoning and doubt in obsessive compulsive disorder.

    Science.gov (United States)

    O'Connor, Kieron; Wilson, Samantha; Taillon, Annie; Pélissier, Marie-Claude; Audet, Jean-Sebastien

    2018-06-01

    Previous studies show that individuals with obsessive compulsive disorder (OCD) accord more importance than healthy controls (HC) to alternative conclusions, resulting in increased doubt regarding an initial conclusion. The goal of the present study was to replicate and extend this finding. Eighteen participants diagnosed with OCD and 16 HC completed the Reasoning with Inductive Arguments Task (RIAT), which operationalizes doubt as change in confidence towards a conclusion after alternative conclusions are presented. To examine conditions that facilitate doubt, the impact of alternative conclusions that both supported and contradicted the initial conclusion was compared, as well as the effect of neutral and OCD-relevant item content. Both the OCD and HC groups decreased confidence after contradicting conclusions, but only the HC group increased confidence when presented with supporting conclusions. Furthermore, decrease in confidence in the OCD group correlated with OCD symptom severity. The RIAT could be adapted to better take into account of OCD subtypes. Doubt generation may contribute to obsessional doubting. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Functional neuroimaging of avoidance habits in obsessive-compulsive disorder.

    Science.gov (United States)

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

    2015-03-01

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

  2. Examining procedural working memory processing in obsessive-compulsive disorder.

    Science.gov (United States)

    Shahar, Nitzan; Teodorescu, Andrei R; Anholt, Gideon E; Karmon-Presser, Anat; Meiran, Nachshon

    2017-07-01

    Previous research has suggested that a deficit in working memory might underlie the difficulty of obsessive-compulsive disorder (OCD) patients to control their thoughts and actions. However, a recent meta-analyses found only small effect sizes for working memory deficits in OCD. Recently, a distinction has been made between declarative and procedural working memory. Working memory in OCD was tested mostly using declarative measurements. However, OCD symptoms typically concerns actions, making procedural working-memory more relevant. Here, we tested the operation of procedural working memory in OCD. Participants with OCD and healthy controls performed a battery of choice reaction tasks under high and low procedural working memory demands. Reaction-times (RT) were estimated using ex-Gaussian distribution fitting, revealing no group differences in the size of the RT distribution tail (i.e., τ parameter), known to be sensitive to procedural working memory manipulations. Group differences, unrelated to working memory manipulations, were found in the leading-edge of the RT distribution and analyzed using a two-stage evidence accumulation model. Modeling results suggested that perceptual difficulties might underlie the current group differences. In conclusion, our results suggest that procedural working-memory processing is most likely intact in OCD, and raise a novel, yet untested assumption regarding perceptual deficits in OCD. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  3. Relapse prevention and residual symptoms: a closer analysis of placebo-controlled continuation studies with escitalopram in major depressive disorder, generalized anxiety disorder, social anxiety disorder, and obsessive-compulsive disorder.

    Science.gov (United States)

    Bech, Per; Lönn, Sara L; Overø, Kerstin F

    2010-02-01

    Analyses of data from 4 relapse-prevention studies with escitalopram were conducted in order to compare patients with and without residual symptoms with regard to relapse rates and global illness during double-blind, 24-week continuation periods. Clinical Global Impressions-Severity of Illness scores and relapse status in 4 studies published from 2005 to 2007, 1 each in major depressive disorder (MDD), generalized anxiety disorder, social anxiety disorder, and obsessive-compulsive disorder (OCD), were analyzed using mixed-effects model repeated measures as a function of Montgomery-Asberg Depression Rating Scale (MADRS) scores on items 1, 3, and 7 at randomization. All studies showed a statistically significant (P 0) and without residual symptoms (MADRS score = 0) at the start of continuation treatment were defined by how patients scored on 3 core items of the MADRS: depressed mood (observed), inner or psychic tension, and lassitude. At randomization, patients with a residual symptom were globally more ill than patients without such a symptom. Patients who did not continue active treatment worsened, even if they were initially free of a residual symptom. In contrast, patients who continued receiving escitalopram remained stable or further improved, regardless of residual symptoms or diagnosis. No clear picture emerged regarding whether patients with residual symptoms had a higher relapse rate. The presence of residual symptoms is associated with significantly worse overall illness severity in all 4 diagnostic groups and with a higher (although not significantly) risk of relapse for patients with MDD or OCD. The greatest difference in all of the studies was between patients treated with escitalopram (relapse rates ~ 20%) and placebo (relapse rates of about 50%). Copyright 2010 Physicians Postgraduate Press, Inc.

  4. The relationship between theory of mind and insight in obsessive-compulsive disorder.

    Science.gov (United States)

    Tulacı, Rıza Gökçer; Cankurtaran, Eylem Şahin; Özdel, Kadir; Öztürk, Nefise; Kuru, Erkan; Özdemir, İlker

    2018-02-09

    It is known that obsessive-compulsive disorder (OCD) patients with poor insight display more severe neuropsychological impairments than other patients with OCD. There are limited studies of OCD and theory of mind (ToM). To investigate ToM skills in patients with OCD and the relationship between insight and ToM skills by comparing OCD patients with good and poor insight. Eighty patients with OCD and 80 healthy controls completed the structured clinical interview for DSM-IV axis I disorders, the Yale Brown Obsessive-Compulsive Scale, the Beck Anxiety and Beck Depression Inventories, and the Brown Assessment of Beliefs Scale. To assess ToM skills, first- and second-order false-belief tests, a hinting test, a faux pas test, a reading the mind in the eyes test, and a double-bluff test were administered. Patients with OCD had poorer ToM abilities than healthy controls. All ToM scores were significantly lower in the poor insight group than in the good insight group (p insight than in OCD with good insight may contribute to the idea of OCD with poor insight being a subtype with different clinical and neuropsychological characteristics.

  5. Copy number variation in obsessive-compulsive disorder and tourette syndrome : a cross-disorder study

    NARCIS (Netherlands)

    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

  6. Copy number variation in obsessive-compulsive disorder and tourette syndrome: a cross-disorder study

    NARCIS (Netherlands)

    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, Damiaan; 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.

    2014-01-01

    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 genome-wide

  7. Copy number variation in obsessive-compulsive disorder and tourette syndrome: A cross-disorder study

    NARCIS (Netherlands)

    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 (Cathy); L. Bellodi (Laura); F. Benarroch (Fortu); O.J. Bienvenu (Oscar); D.W. Black (Donald); 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)

    2014-01-01

    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

  8. Copy number variation in obsessive-compulsive disorder and tourette syndrome: a cross-disorder study.

    NARCIS (Netherlands)

    McGrath, L.M.; Yu, D.; Marshall, C.; Davis, L.K.; Thiruvahindrapuram, B.; Li, B.; Cappi, C.; Gerber, G.; Wolf, A.; Schroeder, F.A.; Osiecki, L.; O'Dushlaine, C.; Kirby, A.; Illmann, C.; Haddad, S.; Gallagher, P.; Fagerness, J.A.; Barr, C.L.; Bellodi, L.; Benarroch, F.; Bienvenu, O.J.; Black, D. W.; Bloch, M.H.; Bruun, R.D.; Budman, C.L.; Camarena, B.; Cath, D.C.; Cavallini, M.C.; Chouinard, S.; Coric, V.; Cullen, B.; Delorme, R.; Denys, D.; Derks, E.M.; Dion, Y.; Rosário, M.C.; Eapen, V.; Evans, P.; Falkai, P.; Fernandez, T.V.; Garrido, H.; Geller, D.; Grabe, H.J.; Grados, M.A.; Greenberg, B.D.; Gross-Tsur, V.; Grünblatt, E.; Heiman, G.A.; Hemmings, S.M.; Herrera, L.D.; Hounie, A.G.; Jankovic, J.; Kennedy, J.L.; King, R.A.; Kurlan, R.; Lanzagorta, N.; Leboyer, M.; Leckman, J.F.; Lennertz, L.; Lochner, C.; Lowe, T.L.; Lyon, G.J.; Macciardi, F.; Maier, W.; McCracken, J.T.; McMahon, W.; Murphy, D.L.; Naarden, A.L.; Neale, B. M.; Nurmi, E.; Pakstis, A.J.; Pato, M. T.; Piacentini, J.; Pittenger, C.; Pollak, Y.; Reus, V.I.; Richter, M.A.; Riddle, M.; Robertson, M.M.; Rosenberg, D.; Rouleau, G.A.; Ruhrmann, S.; Sampaio, A.S.; Samuels, J.; Sandor, P.; Sheppard, B.; Singer, H.S.; Smit, J.H.; Stein, D.J.; Tischfield, J.A.; Vallada, H.; Veenstra-Vanderweele, J.; Walitza, S.; Wang, Y.; Wendland, J.R.; Shugart, Y.Y.; Miguel, E.C.; Nicolini, H.; Oostra, B.A.; Moessner, R.; Wagner, M.; Ruiz-Linares, A.; Heutink, P.; Nestadt, G.; Freimer, N.; Petryshen, T.; Posthuma, D.; Jenike, M.A.; Cox, N.J.; Hanna, G.L.; Brentani, H.; Scherer, S.W.; Arnold, P.D.; Stewart, S.E.; Mathews, C.A.; Knowles, J.A.; Cook, E.H.; Pauls, D.L.; Wang, K.; Scharf, J.M.

    2014-01-01

    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

  9. Prevalence of psychotic disorders in patients with obsessive-compulsive disorder

    NARCIS (Netherlands)

    de Haan, Lieuwe; Dudek-Hodge, Christine; Verhoeven, Yolanda; Denys, Damiaan

    2009-01-01

    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

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

    Science.gov (United States)

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

    2017-06-01

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

  11. Dopaminergic activity in Tourette syndrome and obsessive-compulsive disorder.

    Science.gov (United States)

    Denys, Damiaan; de Vries, Froukje; Cath, Danielle; Figee, Martijn; Vulink, Nienke; Veltman, Dick J; van der Doef, Thalia F; Boellaard, Ronald; Westenberg, Herman; van Balkom, Anton; Lammertsma, Adriaan A; van Berckel, Bart N M

    2013-11-01

    Tourette syndrome (TS) and obsessive-compulsive disorder (OCD) both are neuropsychiatric disorders associated with abnormalities in dopamine neurotransmission. Aims of this study were to quantify striatal D2/3 receptor availability in TS and OCD, and to examine dopamine release and symptom severity changes in both disorders following amphetamine challenge. Changes in [(11)C]raclopride binding potential (BP(ND)) were assessed using positron emission tomography before and after administration of d-amphetamine (0.3 mg kg(-1)) in 12 TS patients without comorbid OCD, 12 OCD patients without comorbid tics, and 12 healthy controls. Main outcome measures were baseline striatal D2/3 receptor BP(ND) and change in BP(ND) following amphetamine as a measure of dopamine release. Voxel-based analysis revealed significantly decreased baseline [(11)C]raclopride BP(ND) in bilateral putamen of both patient groups vs. healthy controls, differences being more pronounced in the TS than in the OCD group. Changes in BP(ND) following amphetamine were not significantly different between groups. Following amphetamine administration, tic severity increased in the TS group, which correlated with BP(ND) changes in right ventral striatum. Symptom severity in the OCD group did not change significantly following amphetamine challenge and was not associated with changes in BP(ND). This study provides evidence for decreased striatal D2/3 receptor availability in TS and OCD, presumably reflecting higher endogenous dopamine levels in both disorders. In addition, it provides the first direct evidence that ventral striatal dopamine release is related to the pathophysiology of tics. Copyright © 2013 Elsevier B.V. and ECNP. All rights reserved.

  12. Pindolol augmentation in treatment-resistant obsessive compulsive disorder: a double-blind placebo controlled trial.

    Science.gov (United States)

    Dannon, P N; Sasson, Y; Hirschmann, S; Iancu, I; Grunhaus, L J; Zohar, J

    2000-05-01

    To evaluate the efficacy of pindolol augmentation in treatment-resistant obsessive compulsive disorder (OCD) patients who were unsuccessfully treated with serotonin reuptake inhibitors. Fourteen treatment-resistant OCD patients were treated with paroxetine for 17.4+/-2.1 weeks up to 60 mg/d after they failed at least two other serotonin reuptake inhibitor trials. The patients, who did not respond to open-label paroxetine treatment, were assigned to a double-blind, placebo-controlled pindolol (2.5 mgx3/d) augmentation. All the subjects were evaluated biweekly for a six-week period with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Hamilton Anxiety Scale (HAM-Anx), and Montgomery Asberg Depression Rating Scale (MADRS). Data was analyzed by paired t-test, and ANOVA with repeated measures. Pindolol augmentation to paroxetine (n=8) as compared to placebo augmentation (n=6), was associated with a significant (P<0.01) improvement in Y-BOCS as measured by paired t-test after the fourth week of the treatment and by ANOVA with repeated measures (df: 4.9, f: 3,3, P<0.006). Although no significant differences were found between placebo and pindolol groups on HAM-Anx and MADRS, a trend for improvement in the pindolol group was noted. The results of our study demonstrated that pindolol may augment the therapeutic effect of paroxetine in treatment-resistant OCD patients.

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

    Science.gov (United States)

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

    2009-04-01

    To compare patterns of temperament and character and the prevalence of Obsessive-Compulsive Personality Disorder (OCPD) and OCPD traits in parents of children with OCD and parents of healthy controls. TCI and SCID-II were administered to 63 parents of 32 children with OCD and 63 parents of age- and sex-matched controls with no psychiatric diagnosis. Interviewers were not blind to proband status. Personality dimension scores and frequencies of OCPD criteria in both groups were compared after excluding parents with a diagnosis of OCD. Relationships between TCI dimensions and OCPD symptoms in parents and the clinical characteristics of OCD children were also studied. Parents of OCD children presented significantly higher scores in harm avoidance and lower scores in self-directedness, cooperativeness and reward dependence than parents of healthy children. A higher incidence of OCPD was found in parents of probands (pOCPD criteria in these parents in comparison to parents of healthy children highlight the importance of the role of personality factors in familial OCD.

  14. Relationship between movement disorders and obsessive-compulsive disorder: beyond the obsessive-compulsive-tic phenotype. A systematic review.

    Science.gov (United States)

    Fibbe, Lieneke A; Cath, Danielle C; van den Heuvel, Odile A; Veltman, Dick J; Tijssen, Marina A J; van Balkom, Anton J L M

    2012-06-01

    Obsessive-compulsive disorder (OCD) and symptoms (OC symptoms) are associated with tic disorders and share an aetiological relationship. The extent to which OCD/OC symptoms are correlated with other hyperkinetic movement disorders is unclear. The aim of this review was to investigate this co-occurrence and the extent to which OCD/OC symptoms and hyperkinetic movement disorders share a neurobiological basis. A systematic review was performed, specifically searching for OCD/OC symptom comorbidity in hyperkinetic movement disorders using case control studies, longitudinal studies and family based studies. The literature search was conducted using PubMed and PsycINFO databases. Heterogeneity of measurement instruments to detect OCD diagnosis and OC symptoms decreased comparability between studies. The most convincing evidence for a relationship was found between the choreas (Huntington's disease and Sydenham's chorea) and OCD/OC symptoms. Furthermore, elevated frequencies of OC symptoms were found in small case control series of dystonias. Small family based studies in dystonia subtypes modestly suggest shared familial/genetic relationships between OC symptoms and dystonia. Current data indicate a relationship between OCD/OC symptoms and the choreas. As OCD and the choreas have been associated with dysfunctional frontal-striatal circuits, the observed relationships might converge at the level of dysfunctions of these circuits. However, paucity of longitudinal and family studies hampers strong conclusions on the nature of the relationship. The relationship between OCD and movement disorders needs further elaboration using larger family based longitudinal studies and sound instruments to characterise OC symptomatology. This could lead to better understanding of the shared pathology between OCD and hyperkinetic movement disorders.

  15. Socio-demographic study of obsessive compulsive disorder in Qatar.

    Science.gov (United States)

    Gad, Ehsane M; Shaltout, Taher E

    2004-10-01

    We dedicated our work to study the socio-demographic aspect of obsessive compulsive disorder (OCD) patients seeking psychiatric treatment in the outpatient clinic of Hamad General Hospital for a duration of approximately 5 years of continuous follow-up. Out of 8878 individual patients who attended the psychiatric outpatient clinic of Hamad General Hospital in Qatar, during the period from August 1996 to December 2001, we reviewed a total number of 348 patients with the diagnosis of OCD (according to International Classification of Diseases-10 diagnostic criteria). We divided them according to their age, sex, nationality, duration of illness, occupation and marital status. Each patient was interviewed using a structured interview technique and evaluated by a psychiatrist in one session at the psychiatric outpatient clinic. We found that the disorder is more prevalent among non-Qatari people (52%) (Arabs 36.2%, non-Arabs 15.8%) than Qatari people (48%); more common at the age groups of 31-45 years (44.8%); more frequent in the category that visited the outpatient clinic for a period of 1-4 years (60%). We found that the married females (34.5%) are affected more than the married male patients (24.7%). It was also found that in the diagnosis of OCD predominantly obsessional thoughts were 54.9%; more frequent in the sample than the other diagnosis. In the State of Qatar, where expatriates usually outnumber Qatari patients, we discovered that non-Qatari patients are affected more with OCD than the natives. Sex, marital status and occupation also proved to be important factors. From our study, in the female married group, being a housewife seems to pose a greater risk in developing OCD. Predominantly obsessional thought was the most common sub-type of OCD affecting the patients in Qatar.

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

    Directory of Open Access Journals (Sweden)

    Klila H

    2013-11-01

    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

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

    Science.gov (United States)

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

    2014-10-01

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

  18. Abnormal processing of deontological guilt in obsessive-compulsive disorder.

    Science.gov (United States)

    Basile, Barbara; Mancini, Francesco; Macaluso, Emiliano; Caltagirone, Carlo; Bozzali, Marco

    2014-07-01

    Guilt plays a significant role in the occurrence and maintenance of obsessive-compulsive disorder (OCD). Two major types of guilt have been identified: one deriving from the transgression of a moral rule (deontological guilt DG), another (altruistic guilt AG), relying on the assumption of having compromised a personal altruistic goal. Clinical evidence suggests that OCD patients are particularly sensitive to DG, but not AG. In this functional magnetic resonance imaging (fMRI) study, we investigated brain response of OCD patients while processing DG and AG stimuli. A previously validated fMRI paradigm was used to selectively evoke DG and AG, and anger and sadness, as control emotions in 13 OCD patients and 19 healthy controls. Patients' behavioral results showed a prominent attitude to experience guilt, compared to controls, while accomplishing task. fMRI results revealed that patients have reduced activation in the anterior cingulate (ACC) and frontal gyrus when experiencing guilt, regardless of its specific type (DG or AG). When separately considering each type of guilt (against each of its control), patients showed decreased activation in the ACC, the insula and the precuneus, for DG. No significant differences were observed between groups when processing AG, anger or sad stimuli. This study provides evidence for an abnormal processing of guilt, and specifically DG, in OCD patients. We suggest that decreased activation may reflect patients' cerebral efficiency, which derives from their frequent exposure to guilty feelings ("neural efficiency hypothesis"). In conclusion, our study confirms a selective abnormal processing of guilt, and specifically DG, in OCD.

  19. The prevalence and structure of obsessive-compulsive personality disorder in Hispanic psychiatric outpatients.

    Science.gov (United States)

    Ansell, Emily B; Pinto, Anthony; Crosby, Ross D; Becker, Daniel F; Añez, Luis M; Paris, Manuel; Grilo, Carlos M

    2010-09-01

    This study sought to confirm a multi-factor model of Obsessive-compulsive personality disorder (OCPD) in a Hispanic outpatient sample and to explore associations of the OCPD factors with aggression, depression, and suicidal thoughts. One hundred and thirty monolingual, Spanish-speaking participants were recruited from a community mental health center and were assessed by bilingual doctoral-level clinicians. OCPD was highly prevalent (26%) in this sample. Multi-factor models of OCPD were tested and the two factors - perfectionism and interpersonal rigidity - provided the best model fit. Interpersonal rigidity was associated with aggression and anger while perfectionism was associated with depression and suicidal thoughts. (c) 2010 Elsevier Ltd. All rights reserved.

  20. Response of symptom dimensions in obsessive-compulsive disorder to treatment with citalopram or placebo

    DEFF Research Database (Denmark)

    Stein, Dan J; Andersen, Elisabeth Anne Wreford; Overo, Kerstin Fredricson

    2007-01-01

    -Brown Obsessive-Compulsive Scale Checklist individual items yielded 5 factors (contamination/cleaning, harm/checking, aggressive/sexual/religious, hoarding/symmetry, and somatic/hypochondriacal). Hoarding/symmetry was associated with male gender, longer duration of obsessive-compulsive disorder and early onset......, whereas contamination/cleaning was associated with female gender. Citalopram was more effective than placebo, but high scores on the symmetry/hoarding and contamination/cleaning subscales predicted worse outcome at the end of study while high scores on the aggressive/religious/sexual subscale predicted...... dimension is mediated by the dopamine system. There may be associations between symmetry/hoarding, male gender, early onset, tics, and particular genetic variants; further work is, however, needed to delineate fully obsessive-compulsive disorder subtypes and their underlying neurobiology....

  1. Processes of Change in Cognitive-Behavioural Treatment of Obsessive-Compulsive Disorder : Current Status and Some Future Directions

    NARCIS (Netherlands)

    Polman, Annemiek; Bouman, Theo K.; van Hout, Wiljo J. P. J.; de Jong, Peter J.; den Boer, Johan A.

    2010-01-01

    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

  2. Maintenance electroconvulsive therapy for comorbid pharmacotherapy-refractory obsessive-compulsive and schizoaffective disorder

    Directory of Open Access Journals (Sweden)

    Hanisch F

    2009-08-01

    Full Text Available Abstract Objective There is a high comorbidity of schizophrenia and obsessive-compulsory disorder (OCD associated with more severe symptoms. Standard pharmacotherapy achieve symptom improvement in approximately 60% only. Results We report about a 48-old women treated for depression which developed successively psychotic symptoms (ideas of reference, psychotic worries, negative symptoms (blunted affect, impoverished thinking, difficulties in planning, and obsessive-compulsive symptoms (mainly repeating rituals, avoidance behaviour, collecting and hoarding. She did not respond to combined treatment with neuroleptics and high dose selective serotonin re-uptake inhibitors. She acutely improved during a course of electroconvulsive therapy (ECT and was maintained on outpatient ECTs fortnightly together with 12 mg sertindol and 45 mg mirtazapine for 42 weeks. Conclusion Maintenance ECT is not an approved therapy in OCD but might be an option in pharmacotherapy refractory cases of comorbid OCD and schizophrenic/schizoaffective disorder.

  3. Obsessive-compulsive personality disorder: a review of current empirical findings

    NARCIS (Netherlands)

    de Reus, R.J.M.; Emmelkamp, P.M.G.

    2012-01-01

    The aim of this article is to review the literature on aetiology, epidemiology and course, assessment and treatment of the obsessive-compulsive personality disorder (OCPD). OCPD is a rather prevalent personality disorder, being one of the most prevalent personality disorders in the general

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

    OpenAIRE

    Ritter, McKenzie L.; Guo, Wei; Samuels, Jack F.; Wang, Ying; Nestadt, Paul S.; Krasnow, Janice; Greenberg, Benjamin D.; Fyer, Abby J.; McCracken, James T.; Geller, Daniel A.; Murphy, Dennis L.; Knowles, James A.; Grados, Marco A.; Riddle, Mark A.; Rasmussen, Steven A.

    2017-01-01

    Objective: The aim of this study was to identify any potential genetic overlap between attention deficit hyperactivity disorder (ADHD) and obsessive compulsive disorder (OCD). We hypothesized that since these disorders share a sub-phenotype, they may share common risk alleles. In this manuscript, we report the overlap found between these two disorders. Methods: A meta-analysis was conducted between ADHD and OCD, and polygenic risk scores (PRS) were calculated for both disorders. In addition, ...

  5. Prevalence of obsessive-compulsive disorder in Iran

    Directory of Open Access Journals (Sweden)

    Akhondzadeh Shahin

    2004-02-01

    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

  6. Comorbidity variation in patients with obsessive-compulsive disorder according to symptom dimensions: Results from a large multicentre clinical sample.

    Science.gov (United States)

    Torres, Albina R; Fontenelle, Leonardo F; Shavitt, Roseli G; Ferrão, Ygor A; do Rosário, Maria Conceição; Storch, Eric A; Miguel, Euripedes C

    2016-01-15

    Obsessive-compulsive disorder (OCD) has a heterogeneous and complex phenomenological picture, characterized by different symptom dimensions and comorbid psychiatric disorders, which frequently co-occur or are replaced by others over the illness course. To date, very few studies have investigated the associations between specific OCD symptom dimensions and comorbid disorders. Cross-sectional, multicenter clinical study with 1001 well-characterized OCD patients recruited within the Brazilian Research Consortium on Obsessive-Compulsive and Related Disorders. The primary instruments were the Dimensional Yale-Brown Obsessive Compulsive Scale (DY-BOCS) and the Structured Clinical Interview for DSM-IV Axis I Disorders. Bivariate analyses between symptom dimensions and comorbidities were followed by logistic regression. The most common comorbidities among participants (56.8% females) were major depression (56.4%), social phobia (34.6%), generalized anxiety disorder (34.3%), and specific phobia (31.4%). The aggressive dimension was independently associated with posttraumatic stress disorder (PTSD), separation anxiety disorder, any impulse-control disorder and skin picking; the sexual-religious dimension was associated with mood disorders, panic disorder/agoraphobia, social phobia, separation anxiety disorder, non-paraphilic sexual disorder, any somatoform disorder, body dysmorphic disorder and tic disorders; the contamination-cleaning dimension was related to hypochondriasis; and the hoarding dimension was associated with depressive disorders, specific phobia, PTSD, impulse control disorders (compulsive buying, skin picking, internet use), ADHD and tic disorders. The symmetry-ordering dimension was not independently associated with any comorbidity. Cross-sectional design; participants from only tertiary mental health services; personality disorders not investigated. Different OCD dimensions presented some specific associations with comorbid disorders, which may influence

  7. What's left feels right: Studies in obsessive-compulsive disorder (OCD) and body integrity identity disorder (BIID).

    OpenAIRE

    Blom, R.M.

    2017-01-01

    Over the last decade the nosology status of obsessive-compulsive and related disorders has been topic of debate. Whereas in DSM-IV (Diagnostic and Statistical Manual of Mental Disorders IV) obsessive-compulsive disorder (OCD) was classified as an anxiety disorder, in DSM-V it is classified as a separate entity with compulsivity as the main symptom. The first part of this thesis consists of studies that contributed to this debate, investigating the prevalence of obsessions in the general popul...

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

    Directory of Open Access Journals (Sweden)

    Saiz-Ruiz Jeronimo

    2006-05-01

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

  9. Relations between childhood traumatic experiences, dissociation, and cognitive models in obsessive compulsive disorder.

    Science.gov (United States)

    Selvi, Yavuz; Besiroglu, Lutfullah; Aydin, Adem; Gulec, Mustafa; Atli, Abdullah; Boysan, Murat; Celik, Cihat

    2012-03-01

    Previous studies have indicated that obsessive compulsive disorder (OCD) is associated with childhood traumatic experiences and higher levels of dissociation. Dissociative tendency may arise when individual attempt to incorporate adverse experiences into cognitive schema. We investigated the possible links among childhood trauma, dissociation, and cognitive processes. We evaluated 95 patients with OCD using the Beck Depression Inventory (BDI), Thought-Action Fusion Scale (TAFS), Metacognitions Questionnaire (MCQ-30), White Bear Suppression Inventory (WBSI), Dissociative Experiences Scale (DES), and Childhood Trauma Questionnaire (CTQ-28). The CTQ-28 total scores were not associated with Y-BOCS total, Y-BOCS insight, BDI, TAFS, MCQ-30, and WBSI scores. The TAFS Total, MCQ-30, WBSI, and BDI scores were significantly associated with DES scores. Regression analysis revealed that MCQ-30 and WBSI scores significantly predicted the DES scores. These results suggest that in spite of pathological connotation of dissociative experiences, dissociation may primarily constitute a cognitive trait which is strongly associated with cognitive processes.

  10. Predictors of course in obsessive-compulsive disorder: logistic regression versus Cox regression for recurrent events.

    Science.gov (United States)

    Kempe, P T; van Oppen, P; de Haan, E; Twisk, J W R; Sluis, A; Smit, J H; van Dyck, R; van Balkom, A J L M

    2007-09-01

    Two methods for predicting remissions in obsessive-compulsive disorder (OCD) treatment are evaluated. Y-BOCS measurements of 88 patients with a primary OCD (DSM-III-R) diagnosis were performed over a 16-week treatment period, and during three follow-ups. Remission at any measurement was defined as a Y-BOCS score lower than thirteen combined with a reduction of seven points when compared with baseline. Logistic regression models were compared with a Cox regression for recurrent events model. Logistic regression yielded different models at different evaluation times. The recurrent events model remained stable when fewer measurements were used. Higher baseline levels of neuroticism and more severe OCD symptoms were associated with a lower chance of remission, early age of onset and more depressive symptoms with a higher chance. Choice of outcome time affects logistic regression prediction models. Recurrent events analysis uses all information on remissions and relapses. Short- and long-term predictors for OCD remission show overlap.

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

    Science.gov (United States)

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

    2009-01-01

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

  12. Integrating play therapy in the treatment of children with obsessive-compulsive disorder.

    Science.gov (United States)

    Gold-Steinberg, S; Logan, D

    1999-10-01

    While behavioral and psychopharmacological approaches are the most effective interventions for treating obsessive-compulsive disorder (OCD), psychodynamically oriented play therapy can enhance the treatment of children with this disorder. Play therapy techniques are useful in addressing treatment resistance, feelings of shame around OCD symptoms, negative self-concept, and issues of psychosocial adjustment. A case study illustrates this integrated approach to treatment.

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2006-01-01

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

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

    Science.gov (United States)

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

    2005-01-01

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

  16. Moving the brain: Neuroimaging motivational changes of deep brain stimulation in obsessive-compulsive disorder

    NARCIS (Netherlands)

    Figee, M.

    2013-01-01

    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

  17. Comparison of Child Behavior Checklist subscales in screening for obsessive-compulsive disorder

    DEFF Research Database (Denmark)

    Andersen, Pia Aaron Skovby; Bilenberg, Niels

    2012-01-01

    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....

  18. A systematic review of evidence for fitness-to-drive among people with the mental health conditions of schizophrenia, stress/anxiety disorder, depression, personality disorder and obsessive compulsive disorder.

    Science.gov (United States)

    Unsworth, Carolyn A; Baker, Anne M; So, Man H; Harries, Priscilla; O'Neill, Desmond

    2017-08-31

    Limited evidence exists regarding fitness-to-drive for people with the mental health conditions of schizophrenia, stress/anxiety disorder, depression, personality disorder and obsessive compulsive disorder (herein simply referred to as 'mental health conditions'). The aim of this paper was to systematically search and classify all published studies regarding driving for this population, and then critically appraise papers addressing assessment of fitness-to-drive where the focus was not on the impact of medication on driving. A systematic search of three databases (CINAHL, PSYCHINFO, EMBASE) was completed from inception to May 2016 to identify all articles on driving and mental health conditions. Papers meeting the eligibility criteria of including data relating to assessment of fitness-to-drive were critically appraised using the American Academy of Neurology and Centre for Evidence-Based Medicine protocols. A total of 58 articles met the inclusion criteria of driving among people with mental health conditions studied, and of these, 16 contained data and an explicit focus on assessment of fitness-to-drive. Assessment of fitness-to-drive was reported in three ways: 1) factors impacting on the ability to drive safely among people with mental health conditions, 2) capability and perception of health professionals assessing fitness-to-drive of people with mental health conditions, and 3) crash rates. The level of evidence of the published studies was low due to the absence of controls, and the inability to pool data from different diagnostic groups. Evidence supporting fitness-to-drive is conflicting. There is a relatively small literature in the area of driving with mental health conditions, and the overall quality of studies examining fitness-to-drive is low. Large-scale longitudinal studies with age-matched controls are urgently needed in order to determine the effects of different conditions on fitness-to-drive.

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

    Science.gov (United States)

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

    2015-01-01

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

  20. Comparison of cognitive flexibility and planning ability in patients with obsessive compulsive disorder, patients with obsessive compulsive personality disorder, and healthy controls.

    Science.gov (United States)

    Paast, Negin; Khosravi, Zohreh; Memari, Amir Hossein; Shayestehfar, Monir; Arbabi, Mohammad

    2016-02-25

    Cognitive functioning in individuals with Obsessive Compulsive Disorder (OCD) and with Obsessive Compulsive Personality Disorder (OCPD) has not been adequately studied. Examine the cognitive flexibility and planning ability of individuals with OCD and OCPD. Twenty patients with OCD and 25 patients with OCPD who had not taken medication in the previous two weeks were identified in an outpatient psychology clinic in Tehran, and 25 healthy control subjects were identified from the university staff and local community residents. All participants were administered the 28-item version of the General Health Questionnaire (GHQ-28), the Wisconsin Card Sorting Test (WCST), and the Tower of London (TOL) test. Two measures of the WCTS (number of perseverative errors and number of categories completed) were used to assess cognitive flexibility and three measures of the TOL (total number of moves in 12 trials, total response time, and planning time) were used to assess planning ability. The level of current psychological distress in the two patient groups was significantly greater than that in the control group. After adjusting for demographic variables and the level of psychological distress, both OCD patients and OCPD patients made more perseverative errors on the WCST than control subjects, and the OCD patients (but not the OCPD patients) completed significantly fewer categories than the control subjects. Both the OCD patients and OCPD patients required significantly more moves than control subjects to complete the 12 TOL tasks and OCD patients took significantly longer than both OCPD patients and control subjects to complete the tasks. Individuals with OCD and OCPD have impaired cognitive flexibility and planning ability compared to healthy controls, and there are some differences in these measures of cognitive functioning between OCD and OCPD. Long term follow-up studies of OCD and OCPD that assess changes in cognitive measures as the severity of obsessive compulsive

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

    Science.gov (United States)

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

    2010-06-01

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

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

    Science.gov (United States)

    2014-09-01

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

  3. Personality disorders and normal personality dimensions in obsessive-compulsive disorder.

    Science.gov (United States)

    Samuels, J; Nestadt, G; Bienvenu, O J; Costa, P T; Riddle, M A; Liang, K Y; Hoehn-Saric, R; Grados, M A; Cullen, B A

    2000-11-01

    Little is known about personality disorders and normal personality dimensions in relatives of patients with obsessive-compulsive disorder (OCD). To determine whether specific personality characteristics are part of a familial spectrum of OCD. Clinicians evaluated personality disorders in 72 OCD case and 72 control probands and 198 case and 207 control first-degree relatives. The selfcompleted Revised NEO Personality Inventory was used for assessment of normal personality dimensions. The prevalence of personality disorders and scores on normal personality dimensions were compared between case and control probands and between case and control relatives. Case probands and case relatives had a high prevalence of obsessive-compulsive personality disorder (OCPD) and high neuroticism scores. Neuroticism was associated with OCPD in case but not control relatives. Neuroticism and OCPD may share a common familial aetiology with OCD.

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

    Science.gov (United States)

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

    2014-10-01

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

  5. Correlates of comorbid anxiety and externalizing disorders in childhood obsessive compulsive disorder.

    Science.gov (United States)

    Langley, Audra K; Lewin, Adam B; Bergman, R Lindsey; Lee, Joyce C; Piacentini, John

    2010-08-01

    The present study examines the influence of diagnostic comorbidity on the demographic, psychiatric, and functional status of youth with a primary diagnosis of obsessive compulsive disorder (OCD). Two hundred and fifteen children (ages 5-17) referred to a university-based OCD specialty clinic were compared based on DSM-IV diagnostic profile: OCD without comorbid anxiety or externalizing disorder, OCD plus anxiety disorder, and OCD plus externalizing disorder. No age or gender differences were found across groups. Higher OCD severity was found for the OCD + ANX group, while the OCD + EXT group reported greater functional impairment than the other two groups. Lower family cohesion was reported by the OCD + EXT group compared to the OCD group and the OCD + ANX group reported higher family conflict compared to the OCD + EXT group. The OCD + ANX group had significantly lower rates of tic disorders while rates of depressive disorders did not differ among the three groups. The presence of comorbid anxiety and externalizing psychopathology are associated with greater symptom severity and functional and family impairment and underscores the importance of a better understanding of the relationship of OCD characteristics and associated disorders. Results and clinical implications are further discussed.

  6. A double-blind switch study of paroxetine and venlafaxine in obsessive-compulsive disorder

    NARCIS (Netherlands)

    Denys, Damiaan; van Megen, Harold J. G. M.; van der Wee, Nic; Westenberg, Herman G. M.

    2004-01-01

    BACKGROUND: The treatment guidelines for obsessive-compulsive disorder (OCD) propose to switch serotonin reuptake inhibitors (SRIs) in case of refractoriness. However, no controlled research has been published yet that prospectively examined the effects of changing SRIs. This article describes the

  7. Effects of paroxetine and venlafaxine on immune parameters in patients with obsessive compulsive disorder

    NARCIS (Netherlands)

    Denys, Damiaan; Fluitman, Sjoerd; Kavelaars, Annemieke; Heijnen, Cobi; Westenberg, Herman G. M.

    2006-01-01

    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

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2006-01-01

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

  10. Effects of quetiapine on cognitive functioning in obsessive-compulsive disorder

    NARCIS (Netherlands)

    de Geus, Femke; Denys, Damiaan; Westenberg, Herman G. M.

    2007-01-01

    In recent years, growing evidence supports the efficacy of antipsychotic addition to serotonin reuptake inhibitors in patients with treatment-refractory obsessive-compulsive disorder. This study is the first to investigate the effects of antipsychotic addition on cognitive functioning in

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

    Science.gov (United States)

    Lewin, Adam B.; Piacentini, John

    2010-01-01

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

  12. Family Factors Predict Treatment Outcome for Pediatric Obsessive-Compulsive Disorder

    Science.gov (United States)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2008-01-01

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

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

    Science.gov (United States)

    Rees, Clare S.; Anderson, Rebecca A.

    2013-01-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

  17. Predictors of course in obsessive-compulsive disorder: logistic regression versus Cox regression for recurrent events

    NARCIS (Netherlands)

    Kempe, P. T.; van Oppen, P.; de Haan, E.; Twisk, J. W. R.; Sluis, A.; Smit, J. H.; van Dyck, R.; van Balkom, A. J. L. M.

    2007-01-01

    Two methods for predicting remissions in obsessive-compulsive disorder (OCD) treatment are evaluated. Y-BOCS measurements of 88 patients with a primary OCD (DSM-III-R) diagnosis were performed over a 16-week treatment period, and during three follow-ups. Remission at any measurement was defined as a

  18. Multimodal Voxel-Based Meta-Analysis of White Matter Abnormalities in Obsessive-Compulsive Disorder

    NARCIS (Netherlands)

    Radua, J.; Grau, M.; van den Heuvel, O.A.; Thiebaut de Schotten, M.; Stein, D.J.; Canales-Rodriguez, E.J.; Catani, M.; Mataix-Cols, D.

    2014-01-01

    White matter (WM) abnormalities have long been suspected in obsessive-compulsive disorder (OCD) but the available evidence has been inconsistent. We conducted the first multimodal meta-analysis of WM volume (WMV) and fractional anisotropy (FA) studies in OCD. All voxel-wise studies comparing WMV or

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

    Science.gov (United States)

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

    2004-01-01

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

  20. Implicit self- and other-associations in obsessive-compulsive personality disorder traits

    NARCIS (Netherlands)

    Weertman, A.; Arntz, A.R.; Jong, P.J. de; Rinck, M.

    2008-01-01

    This study investigated automatic associations with the self and with others in the context of obsessive-compulsive personality disorder (OCPD). Participants scoring high (n=20) or low (n=20) on DSM-IV OCPD traits performed three irrelevant-feature tasks in which language of the words (Dutch vs.

  1. Think twice: Impulsivity and decision making in obsessive-compulsive disorder

    NARCIS (Netherlands)

    Grassi, Giacomo; Pallanti, Stefano; Righi, Lorenzo; Figee, Martijn; Mantione, Mariska; Denys, Damiaan; Piccagliani, Daniele; Rossi, Alessandro; Stratta, Paolo

    2015-01-01

    Recent studies have challenged the anxiety-avoidance model of obsessive-compulsive disorder (OCD), linking OCD to impulsivity, risky-decision-making and reward-system dysfunction, which can also be found in addiction and might support the conceptualization of OCD as a behavioral addiction. Here, we

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

    Science.gov (United States)

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

    2012-01-01

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

  3. Nicotine augmentation for refractory obsessive-compulsive disorder. A case report.

    Science.gov (United States)

    Pasquini, Massimo; Garavini, Alessandra; Biondi, Massimo

    2005-01-01

    The authors present a case of obsessive-compulsive disorder (OCD) resistant to conventional treatments, which improved following nicotine augmentation administered as 4 mg chewing gum. The role of acetylcholine in the pathophysiology of OCD is not clear. The authors discuss the effect of nicotine on memory for actions.

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Science.gov (United States)

    Simpson, Helen Blair; Zuckoff, Allan

    2011-01-01

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

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

    Science.gov (United States)

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

    2009-01-01

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

  7. Patients with obsessive-compulsive disorder are impaired in associative learning based on external feedback

    NARCIS (Netherlands)

    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

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

    Science.gov (United States)

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

    2017-12-01

    Serotonergic antidepressants are first-line medication therapies for obsessive-compulsive disorder, however it is not known if synaptic serotonin availability is important for selective serotonin reuptake inhibitor efficacy. The present study tested the hypothesis that temporary reduction in central serotonin transmission, through acute tryptophan depletion, would result in an increase in anxiety in selective serotonin reuptake inhibitor-remitted obsessive-compulsive disorder patients. Eight patients (four males) with obsessive-compulsive disorder who showed sustained clinical improvement with selective serotonin reuptake inhibitor treatment underwent acute tryptophan depletion in a randomized, double-blind, placebo-controlled, within-subjects design, over two days one week apart. Five hours after consumption of the depleting/sham drink the participants performed a personalized obsessive-compulsive disorder symptom exposure task. Psychological responses were measured using the Spielberger State Anxiety Inventory, Yale-Brown Obsessive Compulsive Scale and Visual Analogue Scales. Free plasma tryptophan to large neutral amino acid ratio decreased by 93% on the depletion day and decreased by 1% on the sham day, as anticipated. Psychological rating scores as measured by Visual Analogue Scale showed a significant decrease in perceived control and increase in interfering thoughts at the time of provocation on the depletion day but not on the sham day. A measure of convergent validity, namely Visual Analogue Scale Similar to past, was significantly higher at the time of provocation on both the depletion and sham days. Both the depletion and time of provocation scores for Visual Analogue Scale Anxiety, Spielberger State Anxiety Inventory, Yale-Brown Obsessive Compulsive Scale and blood pressure were not significant. Acute tryptophan depletion caused a significant decrease in perceived control and increase in interfering thoughts at the time of provocation. Acute tryptophan

  9. Cognitive-behavioral group therapy in obsessive-compulsive disorder: a clinical trial

    Directory of Open Access Journals (Sweden)

    Cordioli Aristides V

    2002-01-01

    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.

  10. Treatment of obsessive-compulsive disorder in the context of an avoidant personality disorder

    DEFF Research Database (Denmark)

    Reich, James; Simonsen, Erik

    2008-01-01

    Presents a case study of a 66-year old single white male who presented for treatment of his obsessive-compulsive disorder (OCD), which had become progressively worse since his retirement four years prior. He described a secondary social isolation, which did not appear to be his major concern. He ...... with the personality traits they have. (PsycINFO Database Record (c) 2012 APA, all rights reserved)...

  11. Comorbid obsessive-compulsive disorder with bipolar disorder: A distinct form?

    Science.gov (United States)

    Ozdemiroglu, Filiz; Sevincok, Levent; Sen, Gulnur; Mersin, Sanem; Kocabas, Oktay; Karakus, Kadir; Vahapoglu, Fatih

    2015-12-30

    We examined whether the patients with Bipolar Disorder (BD) and Obsessive-Compulsive Disorder (OCD) comorbidity may represent a distinct form of BD. The subjects diagnosed with BD (n=48), OCD (n=61), and BD with OCD (n=32) were compared in terms of several socio-demographic and clinical characteristics. Previous history of suicidal attempts was more likely to be higher in BD-OCD group compared to the other two groups. A more episodic course of OCD, higher rates of rapid cycling, and the seasonality were found in BD-OCD patients. The frequency of bipolar II and NOS subtypes was more prevalent in patients with BD-OCD than in OCD patients. The first diagnosed illness was BD in the majority of BD-OCD cases. It was found that first affective episode was major depression in half of BD-OCD patients. Age at onset of BD was found to be earlier in BD-OCD group compared to pure BD patients. Bipolarity may not have a specific effect on the phenomenology of OC symptoms. The episodic course of OCD, seasonality, rapid cycling, earlier onset of BD, and impulsivity in BD-OCD patients may be indicative for a distinct form of BD. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Family functioning in patients with obsessive compulsive disorder: A case - control study

    OpenAIRE

    Sateesh R Koujalgi; Raghavendra B Nayak; Adithya A Pandurangi; Nanasahed M Patil

    2015-01-01

    Background: Psychological disorders can have a direct impact on family functioning. Family dysfunction is an indirect factor leading to the relapse of psychological disorders. Literature on family dysfunction in anxiety disorder is limited. Role of family and its functioning in obsessive-compulsive disorder (OCD) may help in better understanding of the role of social factors in OCD. Aim: The aim was to compare family functions in patients with OCD and compare with controls. Materials and Meth...

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

    Science.gov (United States)

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

  15. Clinical features of tic-related obsessive-compulsive disorder: results from a large multicenter study.

    Science.gov (United States)

    Gomes de Alvarenga, Pedro; de Mathis, Maria Alice; Dominguez Alves, Anna Claudia; do Rosário, Maria Conceição; Fossaluza, Victor; Hounie, Ana Gabriela; Miguel, Euripedes Constantino; Rodrigues Torres, Albina

    2012-06-01

    To evaluate the clinical features of obsessive-compulsive disorder (OCD) patients with comorbid tic disorders (TD) in a large, multicenter, clinical sample. A cross-sectional study was conducted that included 813 consecutive OCD outpatients from the Brazilian OCD Research Consortium and used several instruments of assessment, including the Yale-Brown Obsessive-Compulsive Scale, the Dimensional Yale-Brown Obsessive-Compulsive Scale, the Yale Global Tic Severity Scale (YGTSS), the USP Sensory Phenomena Scale, and the Structured Clinical Interview for DSM-IV Axis I Disorders. The sample mean current age was 34.9 years old (SE 0.54), and the mean age at obsessive-compulsive symptoms (OCS) onset was 12.8 years old (SE 0.27). Sensory phenomena were reported by 585 individuals (72% of the sample). The general lifetime prevalence of TD was 29.0% (n = 236), with 8.9% (n = 72) presenting Tourette syndrome, 17.3% (n = 141) chronic motor tic disorder, and 2.8% (n = 23) chronic vocal tic disorder. The mean tic severity score, according to the YGTSS, was 27.2 (SE 1.4) in the OCD + TD group. Compared to OCD patients without comorbid TD, those with TD (OCD + TD group, n = 236) were more likely to be males (49.2% vs. 38.5%, p disorders in general: separation anxiety disorder, social phobia, specific phobia, generalized anxiety disorder, post-traumatic stress disorder, attention-deficit hyperactivity disorder, impulse control disorders in general, and skin picking. Also, the "aggressive," "sexual/religious," and "hoarding" symptom dimensions were more severe in the OCD + TD group. Tic-related OCD may constitute a particular subgroup of the disorder with specific phenotypical characteristics, but its neurobiological underpinnings remain to be fully disentangled.

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

    Science.gov (United States)

    Marras, Anna; Fineberg, Naomi; Pallanti, Stefano

    2016-08-01

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

  17. Abnormal Spontaneous Neural Activity in Obsessive-Compulsive Disorder: A Resting-State Functional Magnetic Resonance Imaging Study.

    Science.gov (United States)

    Ping, Li; Su-Fang, Li; Hai-Ying, Han; Zhang-Ye, Dong; Jia, Luo; Zhi-Hua, Guo; Hong-Fang, Xiong; Yu-Feng, Zang; Zhan-Jiang, Li

    2013-01-01

    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.

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

    Science.gov (United States)

    Boland, Elaine M; Ross, Richard J

    2015-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Naomi A. Fineberg

    2014-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  1. Personality Disorders in Obsessive-Compulsive Disorder: A Comparative Study versus Other Anxiety Disorders

    Directory of Open Access Journals (Sweden)

    Josep Pena-Garijo

    2013-01-01

    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.

  2. Personality Disorders in Obsessive-Compulsive Disorder: A Comparative Study versus Other Anxiety Disorders

    Science.gov (United States)

    Pena-Garijo, Josep; Edo Villamón, Silvia; Ruipérez, M. Ángeles

    2013-01-01

    Objective. The purpose of this paper is to provide evidence for the relationship between personality disorders (PDs), obsessive compulsive disorder (OCD), and other anxiety disorders different from OCD (non-OCD) symptomatology. Method. The sample consisted of a group of 122 individuals divided into three groups (41 OCD; 40 non-OCD, and 41 controls) matched by sex, age, and educational level. All the individuals answered the IPDE questionnaire and were evaluated by means of the SCID-I and SCID-II interviews. Results. Patients with OCD and non-OCD present a higher presence of PD. There was an increase in cluster C diagnoses in both groups, with no statistically significant differences between them. Conclusions. Presenting anxiety disorder seems to cause a specific vulnerability for PD. Most of the PDs that were presented belonged to cluster C. Obsessive Compulsive Personality Disorder (OCPD) is the most common among OCD. However, it does not occur more frequently among OCD patients than among other anxious patients, which does not confirm the continuum between obsessive personality and OCD. Implications for categorical and dimensional diagnoses are discussed. PMID:24453917

  3. Obsessive-compulsive disorder and Tourette Syndrome: is there a relationship?

    Directory of Open Access Journals (Sweden)

    Maria Conceição do Rosário

    Full Text Available The authors describe the main characteristics of Obsessive-Compulsive Disorder, the fourth most frequent psychiatric disease, and Tourette Syndrome. Considered completely separate disorders, there is growing scientific evidence that there is a connection between them. The authors present clinical, genetic and neuroimaging data reinforcing this idea, and call attention to the importance of research in this area, as they believe that the definition of more homogenous subgroups will facilitate the identification of biological markers and predictors of treatment response.

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

    OpenAIRE

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

    2017-01-01

    Background: Internet use is pervasive in many cultures. Little is known about the impact of Obsessive-Compulsive Personality Disorder (OCPD) symptoms on impulsive and compulsive psychopathologies in people who use the Internet. Method: 1323 adult Internet users completed an online questionnaire quantifying OCPD symptoms, likely occurrence of select mental disorders (OCD, ADHD, problematic Internet use, anxiety), and personality questionnaires of impulsivity (Barratt) and compulsivity (Pad...

  5. Virtual exhibition as a tool for the treatment of obsessive compulsive disorder

    OpenAIRE

    Cardenas L., Gergina; Muñoz, Sandra; Oviedo L., Paola

    2014-01-01

    In Mexico City 2.6% of population have Obsessive Compulsive Disorder, this is a that impact the quality of life in the persons who presents, it was classified by WHO like tenth disability cause in the world, it´s for this reason that needs closer attention about mental health professionals, there are several studies about treatment for this disorder, between these we can find the exposure and response prevention treatment and cognitive treatment. The treatment could be perceived like aversive...

  6. Relations between Obsessive-Compulsive Disorder and personality: beyond Axis I-Axis II comorbidity.

    Science.gov (United States)

    Wu, Kevin D; Clark, Lee Anna; Watson, David

    2006-01-01

    Most research on relations between Obsessive-Compulsive Disorder (OCD) and personality addresses only comorbidity rates between OCD and Obsessive-Compulsive Personality Disorder (OCPD). We first investigated empirical OCD-OCPD relations, but then also examined patterns of dimensional traits in OCD patients versus students and general outpatients. Results did not support a specific OCD-OCPD relation and the implications of this conclusion are discussed. Regarding traits, OCD patients shared with other patients elevated negative affectivity and lower positive affectivity. Differences on several lower order dimensions, including lower scores on manipulativeness, mistrust, and disinhibition distinguished the personality profile of OCD patients from others. Also noteworthy was a pattern of very low self-image for OCD patients, as suggested by the combination of low self-esteem and low entitlement scores. Overall, OCD patients showed a more specific pattern of personality pathology than did general outpatients, who were elevated more generally across personality disorders and negative affectivity scales.

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

    Science.gov (United States)

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

    2012-10-01

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

  8. Treatment outcomes for inpatients with obsessive-compulsive personality disorder: An open comparison trial.

    Science.gov (United States)

    Smith, Ryan; Shepard, Christopher; Wiltgen, Anika; Rufino, Katrina; Fowler, J Christopher

    2017-02-01

    The current case-control study compared rates of clinically significant and reliable change in psychopathology and global functioning, prevalence of clinical deterioration, and rates of symptom remission among adult patients with obsessive compulsive personality disorder OCPD (n=52) and well-matched inpatients with any other personality disorder (n=56) and no personality disorder (n=53). Propensity score matching (PSM) was utilized to select patients matched on specific criteria present in the OCPD group. Multivariate analysis of variance models measured differences in admission functioning and RCI change across depression and anxiety severity, emotion dysregulation and suicidal ideation. Patients diagnosed with OCPD admit to treatment with higher rates of depression, anxiety, difficulty with emotion regulation and non-acceptance of emotional experience than inpatient controls. Furthermore, OCPD patients respond to treatment at a similar rate to inpatient controls, but experience lower rates of anxiety remission upon discharge. Post-hoc analyses indicate individuals meeting stubbornness and rigidity (OCPD Criteria 8) were nine times more likely to report moderate to severe anxiety at point of discharge. Limitations include a predominantly Caucasian, inpatient sample, use of self-report measures and a non-manualized treatment approach. Overall, OCPD inpatients benefit from an intensive multimodal psychiatric treatment, but experience more anxiety than non-PD patients upon discharge. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Family functioning in patients with obsessive compulsive disorder: A case - control study

    Directory of Open Access Journals (Sweden)

    Sateesh R Koujalgi

    2015-01-01

    Full Text Available Background: Psychological disorders can have a direct impact on family functioning. Family dysfunction is an indirect factor leading to the relapse of psychological disorders. Literature on family dysfunction in anxiety disorder is limited. Role of family and its functioning in obsessive-compulsive disorder (OCD may help in better understanding of the role of social factors in OCD. Aim: The aim was to compare family functions in patients with OCD and compare with controls. Materials and Methods: The sample included 30 cases and 30 age and sex-matched controls. The patients were diagnosed as having OCD using ICD-10 DCR criteria. Yale-Brown Obsessive Compulsive Scale was used to assess the severity of OCD among patients. General Health Questionnaire was used as screening instruments for psychiatric disorder among the control population. Family function was assessed in cases and control using the Family Interaction Patterns Schedule (FIPS. Statistical analysis was performed using SPSS software. Results: Obsessive compulsive disorder patients in comparison controls had significantly increased total FIPS score (P = 0.001. Conclusion: Families with OCD are more significantly impaired in multiple domains of family dynamics than families without member suffering from OCD. It is, therefore, essential that family-based structure effective assessment be sought in the psychosocial management of OCD.

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

    Directory of Open Access Journals (Sweden)

    Himanshu Tyagi

    2015-01-01

    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.

  11. Perseveration induces dissociative uncertainty in obsessive-compulsive disorder.

    Science.gov (United States)

    Giele, Catharina L; van den Hout, Marcel A; Engelhard, Iris M; Dek, Eliane C P; Toffolo, Marieke B J; Cath, Danielle C

    2016-09-01

    Obsessive compulsive (OC)-like perseveration paradoxically increases feelings of uncertainty. We studied whether the underlying mechanism between perseveration and uncertainty is a reduced accessibility of meaning ('semantic satiation'). OCD patients (n = 24) and matched non-clinical controls (n = 24) repeated words 2 (non-perseveration) or 20 times (perseveration). They decided whether this word was related to another target word. Speed of relatedness judgments and feelings of dissociative uncertainty were measured. The effects of real-life perseveration on dissociative uncertainty were tested in a smaller subsample of the OCD group (n = 9). Speed of relatedness judgments was not affected by perseveration. However, both groups reported more dissociative uncertainty after perseveration compared to non-perseveration, which was higher in OCD patients. Patients reported more dissociative uncertainty after 'clinical' perseveration compared to non-perseveration.. Both parts of this study are limited by some methodological issues and a small sample size. Although the mechanism behind 'perseveration → uncertainty' is still unclear, results suggest that the effects of perseveration are counterproductive. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Symptoms of hypochondriasis in Obsessive-Compulsive Disorder: Prevalence, Treatment Outcome, and Relationship with Metacognition

    OpenAIRE

    Borgejordet, Synne

    2014-01-01

    The study aimed to examine symptoms of hypochondriasis in relation to obsessive-compulsive disorder (OCD), by investigating the prevalence of hypochondriacal symptoms in OCD, the effect hypochondriacal symptoms has on OCD treatment outcome, and how OCD treatment affects hypochondriacal symptoms. Another objective of the study was to explore the role of metacognition in symptoms of hypochondria. A sample of 313 patients with a primary diagnosis of OCD and 382 community controls were compared o...

  13. Recruitment of a Hidden Population: African Americans with Obsessive-Compulsive Disorder

    OpenAIRE

    Williams, Monnica T.; Proetto, Dante; Casiano, Delane; Franklin, Martin

    2011-01-01

    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...

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

    OpenAIRE

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

    2017-01-01

    Background The goal of the present study was to determine the relationships between attachment styles and resiliency in obsessive-compulsive personality disorder. Methods A random sample of 260 subjects was obtained from the population of undergraduate students of the Nour Branch of Islamic Azad University, which is located in Mazandaran, and these subjects were enrolled in this descriptive and correlational study. The collected data included the subjects' responses to an adult attachment sty...

  15. Dysfunctional beliefs in group and individual cognitive behavioral therapy for obsessive compulsive disorder

    DEFF Research Database (Denmark)

    Jónsson, Hjalti; Hougaard, Esben; Bennedsen, Birgit

    2011-01-01

    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...... of the study with pre-and post-therapy measurements only does not allow for a causal mediator analysis...

  16. Symptom Dimensions in Obsessive-Compulsive Disorder: Phenomenology and Treatment Outcomes with Exposure and Ritual Prevention

    OpenAIRE

    Williams, Monnica T.; Mugno, Beth; Franklin, Martin; Faber, Sonya

    2013-01-01

    Obsessive-compulsive disorder (OCD) is a severe condition with varied symptom presentations. The cognitive-behavioral treatment with the most empirical support is currently exposure and ritual prevention (EX/RP); however, clinical impression and some empirical data suggest that certain OCD symptoms are more responsive to treatment than others. Prior work identifying symptom dimensions within OCD is discussed, including epidemiological findings, factor analytic studies, and biological findings...

  17. Prevalence and severity of obsessive-compulsive disorder and their relationships with dermatological diseases.

    OpenAIRE

    Fatemeh Sheikhmoonesi; Zohreh Hajheidari; Abbas Masoudzadeh; Reza Ali Mohammadpour; Mahbubeh Mozaffari

    2014-01-01

    Most obsessive-compulsive disorder (OCD) patients meet psychiatrists 5 to 10 years after onset of OCD .Its relatively high prevalence ratio and the delay in seeking help suggest that patients with OCD may seek help at non-psychiatric clinics. The present study was undertaken to provide some epidemiological data on the prevalence and severity of OCD in dermatological patients. The participants included 265 consecutive patients with primary dermatologic chief complaint. They were visited by a d...

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

    Science.gov (United States)

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

    2017-11-01

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

  19. Mindfulness-based cognitive therapy as an augmentation treatment for obsessive-compulsive disorder.

    Science.gov (United States)

    Key, Brenda L; Rowa, Karen; Bieling, Peter; McCabe, Randi; Pawluk, Elizabeth J

    2017-09-01

    A significant number of obsessive-compulsive disorder (OCD) patients continue to experience symptoms that interfere with their functioning following cognitive behavioural therapy (CBT). Providing an additional augmentation treatment following CBT could help reduce these residual symptoms. Mindfulness interventions that facilitate less reactivity to thoughts and feelings may be helpful for patients suffering from residual OCD symptoms. The purpose of the current randomized waitlist control trial was to evaluate the feasibility and impact of providing an 8-week mindfulness-based cognitive therapy (MBCT) intervention following completion of a CBT intervention to OCD patients who continued to suffer from significant symptoms. Results indicated that compared to the waitlist control group, MBCT participants reported decreases in OCD symptoms (d = 1.38), depression symptoms (d = 1.25), anxiety symptoms (d = 1.02), and obsessive beliefs (d = 1.20) along with increases in self-compassion (d = 0.77) and mindfulness skills (d = 0.77). Additionally, participants reported high levels of satisfaction with the MBCT intervention. The results suggest that the use of MBCT for OCD as an augmentation therapy is acceptable to patients who continue to suffer from OCD symptoms after completing CBT and provides some additional relief from residual symptoms. Mindfulness interventions teach skills that facilitate disengaging from cognitive routines and accepting internal experience, and these skills may be valuable in treating obsessive-compulsive disorder (OCD), as individuals describe getting "stuck" in repetitive thoughts and consequent rituals. The results of this study suggest that teaching mindfulness skills using an 8-week mindfulness-based cognitive therapy (MBCT) intervention provides an added benefit (decreases in OCD, depression, and anxiety symptoms) for patients with OCD who have completed a cognitive behavioural therapy intervention and continued to suffer from

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

    Science.gov (United States)

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

    2017-10-01

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

  1. Treatment outcome of schizophrenia co-morbid with obsessive-compulsive disorder

    International Nuclear Information System (INIS)

    Khan, M.N.S.; Arshad, N.; Naeem Ullah

    2004-01-01

    Objective: To evaluate the pharmacological treatment outcome of schizophrenia, co-morbid with obsessive-compulsive disorder by comparing the effects of typical neuroleptic, atypical neuroleptic and a combination of typical with anti-obsessional drugs on positive and negative symptoms of schizophrenia and obsessional symptoms. Subjects and Methods: The sample consisted of 39 patients suffering from schizophrenia co-morbid with obsessive- compulsive disorder. They were divided in three groups according to the pharmacological treatment given by the treating psychiatrists. Sample was assessed at the start of treatment and twelve weeks later. Results: Patients receiving typical neuroleptics and anti-obsessional drugs showed better outcome (p < .05) both in psychotic (pre-intervention mean scores of positive scale of PANSS 26.90 as compared to postinterventional mean scores 19.00) and obsessional symptoms (pre-intervention mean scores on Padua Inventory 165.00 compared to 84.00 postinterventional mean scores) than those receiving typical and atypical neuroleptics alone. Conclusion: Treatment outcome of schizophrenia co-morbid with obsessive-compulsive disorder shows better results if anti-obsessional drugs are added to the neuroleptics. (author)

  2. Escitalopram in obsessive-compulsive disorder: response of symptom dimensions to pharmacotherapy

    DEFF Research Database (Denmark)

    Stein, Dan J; Carey, Paul D; Lochner, Christine

    2008-01-01

    INTRODUCTION: There is a substantial body of evidence that obsessive-compulsive disorder (OCD) symptoms can be grouped into a series of discrete dimensions, and some evidence that not all OCD symptom dimensions respond equally well to pharmacologic or psychotherapeutic intervention. The response...... 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....... There was a significant interaction for the hoarding/symmetry factor, which was associated with a poor treatment response. CONCLUSION: Escitalopram shows good efficacy across the range of OCD symptom dimensions. Nevertheless, hoarding/symmetry was associated with a poorer treatment response. Hoarding/symmetry may...

  3. Deficits of organizational strategy and visual memory in obsessive-compulsive disorder.

    Science.gov (United States)

    Shin, M S; Park, S J; Kim, M S; Lee, Y H; Ha, T H; Kwon, J S

    2004-10-01

    This study was conducted to investigate the deficits of organizational strategy and visual memory in obsessive-compulsive disorder (OCD). Thirty OCD patients and 30 healthy controls aged 20-35 years participated. The Maudsley Obsessive-Compulsive Inventory, Beck Anxiety Inventory, Wechsler Adult Intelligence Scale, and Rey-Osterrieth Complex Figure (ROCF) test were administered to participants. The authors scored ROCF performances using the Boston Qualitative Scoring System. The OCD patients showed poorer planning ability and higher fragmentation than did healthy controls when copying the ROCF, and they showed even poorer performances in the immediate and delayed recall conditions. The authors found that the Organization score in the copy condition mediated the difference between the OCD group and the healthy group in immediate recall. The direct effect of diagnosis (OCD or healthy) on the immediate recall condition of the ROCF was also significant. This study indicates that people with OCD have poor memory function and organizational deficits.

  4. The relationship between obsessive-compulsive personality disorder traits, obsessive-compulsive disorder and excessive exercise in patients with anorexia nervosa: a systematic review.

    Science.gov (United States)

    Young, Sarah; Rhodes, Paul; Touyz, Stephen; Hay, Phillipa

    2013-01-01

    Obsessive-compulsive personality disorder (OCPD) traits and obsessive-compulsive disorder (OCD) are commonly associated with patients with Anorexia Nervosa (AN). The aim of this review was to systematically search the literature to examine whether OCPD and OCD are positively associated with excessive exercise in patients with AN. A systematic electronic search of the literature (using PsycInfo, Medline and Web of Knowledge) was undertaken to identify relevant publications until May 2012. A total of ten studies met criteria for inclusion in the review. The design of the studies varied from cross-sectional to retrospective and quasi-experimental. Seven out of the ten studies reviewed demonstrated a positive relationship between OCPD and/or OCD in AN patients who exercise excessively, whilst three studies found a lack of relationship, or a negative relationship, between these constructs. There is evidence from the literature to suggest that there is a positive relationship between OCPD and excessive exercise in patients with AN. However, the relationship between OCD and excessive exercise is less clear and further research is required to qualify the strength of such relationships. Future research should utilise the most comprehensive and reliable clinical assessment tools, and address prognostic factors, treatment factors and specific interventions for patients with OCPD and/or OCD and excessive exercise.

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

    Science.gov (United States)

    Wheaton, Michael G; Pinto, Anthony

    2017-10-01

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

  6. Surgical neuroanatomy and programming in deep brain stimulation for obsessive compulsive disorder.

    Science.gov (United States)

    Morishita, Takashi; Fayad, Sarah M; Goodman, Wayne K; Foote, Kelly D; Chen, Dennis; Peace, David A; Rhoton, Albert L; Okun, Michael S

    2014-06-01

    Deep brain stimulation (DBS) has been established as a safe, effective therapy for movement disorders (Parkinson's disease, essential tremor, etc.), and its application is expanding to the treatment of other intractable neuropsychiatric disorders including depression and obsessive-compulsive disorder (OCD). Several published studies have supported the efficacy of DBS for severely debilitating OCD. However, questions remain regarding the optimal anatomic target and the lack of a bedside programming paradigm for OCD DBS. Management of OCD DBS can be highly variable and is typically guided by each center's individual expertise. In this paper, we review the various approaches to targeting and programming for OCD DBS. We also review the clinical experience for each proposed target and discuss the relevant neuroanatomy. A PubMed review was performed searching for literature on OCD DBS and included all articles published before March 2012. We included all available studies with a clear description of the anatomic targets, programming details, and the outcomes. Six different DBS approaches were identified. High-frequency stimulation with high voltage was applied in most cases, and predictive factors for favorable outcomes were discussed in the literature. DBS remains an experimental treatment for medication refractory OCD. Target selection and programming paradigms are not yet standardized, though an improved understanding of the relationship between the DBS lead and the surrounding neuroanatomic structures will aid in the selection of targets and the approach to programming. We propose to form a registry to track OCD DBS cases for future clinical study design. © 2013 International Neuromodulation Society.

  7. Cigarette smoking in obsessive-compulsive disorder and unaffected parents of OCD patients.

    Science.gov (United States)

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

    2015-01-01

    Cigarette smoking is more prevalent among individuals with psychiatric disorders than the general population. Obsessive-compulsive disorder (OCD) may be an intriguing exception, although no recent study has investigated this hypothesis in OCD patients. Moreover, it is unknown whether reduced smoking rates are present in unaffected first-degree relatives of OCD patients. We assessed smoking prevalence in adults with OCD and unaffected parents of youth with OCD (PYOCD). To this end, 113 adults with OCD completed online questionnaires assessing symptom severity and smoking status. Smoking status was obtained from an independent sample of 210 PYOCD assessed for psychiatric diagnoses. Smoking prevalence rates in adults with OCD (13.3%; n=15) and PYOCD (9.5%; n=20) samples were significantly lower than those found in representative samples of the general population (19-24%, all POCD subset without clinically significant depressive symptoms (n=54). Low prevalence of smoking in OCD may be familial and unique among psychiatric disorders, and might represent a possible state-independent OCD marker. Hypotheses concerning the uncharacteristically low prevalence rates are discussed with relation to OCD phenomenology and pathophysiology. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  8. IMPACT OF PSYCHOPATHOLOGY OF ADULT OBSESSIVE COMPULSIVE DISORDER ON QUALITY OF LIFE: A PATIENT CONTROLLED STUDY

    Directory of Open Access Journals (Sweden)

    Mohd. Aleem

    2015-12-01

    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

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

    Science.gov (United States)

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

    2010-12-30

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

  10. Sleep, arousal, and circadian rhythms in adults with obsessive-compulsive disorder: a meta-analysis.

    Science.gov (United States)

    Nota, Jacob A; Sharkey, Katherine M; Coles, Meredith E

    2015-04-01

    Findings of this meta-analysis show that obsessive-compulsive disorder (OCD) is related to disruptions in both the duration and timing of sleep. PsycINFO and Google Scholar database searches identified 12 relevant studies that compared measures of sleep in individuals with OCD to those of either a healthy control group or published norms. Sleep measures included sleep onset latency, sleep duration, awakening after sleep onset, percentage of rapid eye movement (REM) sleep, percentage of slow wave sleep, and prevalence of delayed sleep phase disorder (DSPD). Individual effect sizes were pooled using a random effects model. Sleep duration was found to be shorter, and the prevalence of DSPD higher, in individuals with OCD compared to controls. Further, excluding samples with comorbid depression did not meaningfully reduce the magnitude of these effects (although the results were no longer statistically significant) and medication use by participants is unlikely to have systematically altered sleep timing. Overall, available data suggest that sleep disruption is associated with OCD but further research on both sleep duration and sleep timing in individuals with OCD is needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. The overlap of obsessive-compulsive disorder and social phobia and its treatment.

    Science.gov (United States)

    Baldwin, David S; Brandish, Emma K; Meron, Daniel

    2008-09-01

    Both obsessive-compulsive disorder (OCD) and social phobia are common in community and clinical settings, and it should be expected that a proportion of patients with one of these conditions will also fulfill either current or lifetime criteria for the other condition. However, comorbid social phobia is more common among patients with a primary diagnosis of OCD than is comorbid OCD in patients with a primary diagnosis of social phobia. This article explores the extent of the association of OCD and social phobia in epidemiological studies, and examines the possible role of underlying depression and other disorders in mediating the appearance of the comorbid condition. Although there have been no published randomized controlled trials in patients with this particular pattern of co-morbidity, it seems sensible to adopt pharmacologic and psychologic treatment approaches which have been found efficacious in both OCD and social phobia. Pharmacologic management therefore centers on first-line treatment with a selective serotonin reuptake inhibitor. Psychologic intervention should draw on the range of cognitive and behavioral approaches required for optimal outcomes in OCD and social phobia, as discrete conditions.

  12. Clinical Profile and Comorbidity of Obsessive-Compulsive Disorder among Children and Adolescents: A Cross-Sectional Observation in Bangladesh

    Directory of Open Access Journals (Sweden)

    Md. Hafizur Rahman Chowdhury

    2016-01-01

    Full Text Available Obsessive compulsive disorder (OCD is a common disorder characterised by persistent and unwanted intrusive thoughts, images, and urges and repetitive behaviours or mental acts and can cause pervasive impairments. In Bangladesh, the prevalence of OCD among children is 2% which is higher than in previous reporting. This study was aimed at looking into the type, frequency, and severity of symptoms of OCD and comorbidity among children and adolescents. A consecutive 60 OCD cases from a child mental health service with age range of 5–18 years were recruited and divided into below and above 12 years of age group. The assessment was carried out using standardized Bangla version of Development and Wellbeing Assessment and Children’s Yale-Brown Obsessive Compulsive Scale was administered. Of the obsession, contamination was the highest followed by doubt, and of the compulsion, washing/cleaning was the highest followed by checking, repeating, and ordering rituals. More than half of the subjects had severe OCD and comorbidity was present in 58% subjects. Specific phobia, social phobia, major depressive disorder, and tic disorder were more prevalent. These symptoms and comorbidity profile can serve the baseline data for a country like Bangladesh and further large scale study would better generalize the study results.

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

    Science.gov (United States)

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

    2018-01-01

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

  14. DSM-IV obsessive-compulsive personality disorder: prevalence in patients with anxiety disorders and in healthy comparison subjects.

    Science.gov (United States)

    Albert, Umberto; Maina, Giuseppe; Forner, Federica; Bogetto, Filippo

    2004-01-01

    The relationship between obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) has not yet been fully clarified. The aim of the present study was to analyze DSM-IV OCPD prevalence rates in OCD and panic disorder (PD) patients to test for the specificity of the OCPD-OCD link, and to compare them to OCPD prevalence in a control group of subjects without any psychiatric disorder. A total of 109 patients with a principal diagnosis of DSM-IV (SCID-I) OCD and 82 with PD were interviewed using the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II) in order to assess the prevalence of OCPD. All patients with a coexisting axis I diagnosis were excluded from the study to eliminate confounding factors when evaluating the association between prevalence rates of OCPD and anxiety disorder diagnoses. An exclusion criteria was also a Hamilton Depression Rating Scale (HAM-D) score >/=16. A sample of comparison subjects (age 18 to 65 years) without any psychiatric disorder was recruited from people registered with two general practitioners (GPs), whether or not they consulted the doctor, in order to evaluate OCPD prevalence rate in the community. A significant difference was found between the prevalence of OCPD in OCD (22.9%) and in PD (17.1%) on one hand, and that in the comparison sample (3.0%) on the other. No differences were found between the two psychiatric groups, even when splitting the samples according to gender. Our study failed to support the hypothesis of a specific relationship between OCPD and OCD; we confirmed the higher prevalence rate of this personality disorder in OCD subjects with regard to the general population, but we also confirmed the higher rate of OCPD in another anxiety disorder which is phenomenologically well characterized and different from OCD, such as PD.

  15. Uncertainty increases neural indices of attention in obsessive-compulsive disorder.

    Science.gov (United States)

    Dieterich, Raoul; Endrass, Tanja; Kathmann, Norbert

    2017-11-01

    Patients with obsessive-compulsive disorder (OCD) experience abnormally high levels of uncertainty, and unpredictability is evaluated negatively and not well tolerated. The current study examined neural correlates of attentional processing in response to experimentally induced uncertainty in OCD. Twenty-four OCD patients and 24 healthy controls performed a task where neutral and negative pictures were preceded by a cue, either being predictive (certain condition) or nonpredictive (uncertain condition) of subsequent picture valence. We examined prepicture anticipatory attention through α (∼8-12 Hz) suppression, and attentional allocation during picture presentation with the P1, N1, P2, N2, and late positive potential (LPP) of the event-related potential. Additionally, we tested how clinical measures related to these attentional markers. Subjectively, patients overestimated the frequency of negative pictures after nonpredictive cues. Patients, but not controls, showed upper α(10-12 Hz) suppression after nonpredictive and predictive negative cues relative to predictive neutral cues. Only patients showed increased P2 and decreased N2 amplitudes for pictures after nonpredictive cues, and, whereas both groups showed increased LPP amplitudes for pictures after nonpredictive cues, this modulation was more pronounced in OCD during the early LPP (pictures were associated positively with anxiety and negatively with depression. These results suggest that OCD patients process anticipation of inevitable and potential threat similarly and highlight the substantial motivational impact of uncertain events to OCD patients. Finally, the correlation with anxiety implies that anxiety represents the source of hypervigilance during uncertainty resolution. © 2017 Wiley Periodicals, Inc.

  16. Dysfunctional beliefs in group and individual cognitive behavioral therapy for obsessive compulsive disorder.

    Science.gov (United States)

    Jónsson, Hjalti; Hougaard, Esben; Bennedsen, Birgit E

    2011-05-01

    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). IR and TAF declined significantly during CBT, and the decline was positively associated with change in OCD symptoms. However, when controlling for change in depressive symptoms, only change in IR remained significantly associated with OCD symptom change. The moral subtype of TAF predicted poorer treatment outcome, but only in group CBT. Both treatments produced a similar amount of change in the dysfunctional beliefs. The results provide some, preliminary evidence that IR, but not TAF, may be specifically involved in the change mechanisms of both individual and group CBT for OCD, although the design of the study with pre- and post-therapy measurements only does not allow for a causal mediator analysis. Copyright © 2010 Elsevier Ltd. All rights reserved.

  17. Quality of Life and its Correlates in Patients With Obsessive-compulsive Disorder

    Directory of Open Access Journals (Sweden)

    Shu-Ying Hou

    2010-08-01

    Full Text Available The care of patients with obsessive-compulsive disorder (OCD has raised quality of life (QOL issues. The purpose of this study was to compare the level of QOL between patients with and without OCD, and to examine the associations between QOL and sociodemographic data, course of illness, psychopathology, perceived social support, and treatment characteristics. The QOL levels measured with the Taiwan version of the Short Form of the World Health Organization Questionnaire on Quality of Life were compared between 57 subjects with OCD and 106 subjects without OCD. The correlates of QOL were examined among subjects with OCD. The analysis revealed that QOL scores for the general, physical, psychological and social relationship domains were lower in the OCD group than in the control group; however, no difference in the environmental domain was found. Multiple factors were associated with poor QOL in subjects with OCD, including comorbid depression, severe obsession symptoms, perceived low social support, severe adverse effects of medication, combined use of mood stabilizers, and low social status. Different domains of QOL are differently affected by OCD. The QOL of subjects with OCD was correlated to multiple factors that were specific to individual subjects and influenced by interactions with treatment and the social environment.

  18. [Neuroimaging data of ADHD, tic-disorder and obsessive-compulsive-disorder in children and adolescents].

    Science.gov (United States)

    Vloet, Timo D; Neufang, Susanne; Herpertz-Dahlmann, Beate; Konrad, Kerstin

    2006-09-01

    ADHD, Tic Disorder, Tourette's Syndrome, and Obsessive-Compulsive Disorder are all characterised by an impairment of executive functioning and often occur together. There are thus indications of a similar neurobiological basis. This review presents an overview of neuroimaging studies of these disorders in childhood and adolescence, focusing thereby on magnet resonance imaging data. Studies provide concurring data about structural changes in the basal ganglia and the prefrontal cortex, and abnormal activation in the fronto-striatal circuitry in patients as compared to healthy controls. ADHD and Tourette's Syndrome are both associated with prefrontal aberrations. However, variances in Tourette's Syndrome are less pronounced, which might be due to compensation mechanisms. ADHD children show small, but more global, morphological alterations in the cortex and cerebellum, while Tourette's Syndrome seems to be linked additionally to differences in the occipital cortex. Furthermore, structural and functional data for obsessive-compulsive disorder indicate aberrations in the amygdala and thalamus, and functional changes in the orbito-frontal cortex. By comparison, findings in children with ADHD point towards abnormal activity in the ventral prefrontal cortex. To summarise, the data display an impairment of cortico-striato-thalamic circuits which appears to be associated with dysfunctioning motor inhibition, and impulsive behaviour and objectionable thoughts. Since the majority of the studies reviewed are characterised by small and heterogeneous samples, and since the studies differ in their methods, comparability is limited and general conclusions can not be drawn.

  19. Evaluation of the reported association of obsessive-compulsive symptoms or disorder with Tourette's disorder.

    Science.gov (United States)

    Shapiro, A K; Shapiro, E

    1992-01-01

    This review evaluates the evidence reporting an association of obsessive-compulsive symptoms (OCS) and obsessive-compulsive disorder (OCD) with Tourette's syndrome or disorder (TS). Published reports in the literature describing a relationship between OCS-OCD and TS provided the data for the review. The methodological adequacy of the studies are discussed and rated on five criteria: adequacy of the experimental sample, presence and adequacy of the control sample, whether tics are defined as OCS-OCD, whether blind procedures are used to diagnose OCS-OCD in subjects and controls, and evidence for the reliability and validity of OCS-OCD measures. Although there are considerable clinical indications suggesting an association of OCS-OCD with TS and chronic motor tic disorder (CMT), and a possible overlap between OSC-OCD and TS, our evaluation of the evidence does not provide adequate support for an association between these disorders. To meaningfully evaluate the possible relationship between OCS-OCD and TS requires development of specific criteria for classification of OCS-OCD-TS symptoms, use of adequate experimental and control samples, blind evaluation, reliable and valid measures of OCS-OCD-TS, and appropriate statistical analysis. If such studies are performed, it is possible that the strong relationship reported between OCS-OCD and TS is more likely to be artifact than fact, and recent bandwagon effect rather than the latest breakthrough.

  20. The role of avoidant and obsessive-compulsive personality disorder traits in matching patients with major depression to cognitive behavioral and psychodynamic therapy : A replication study

    NARCIS (Netherlands)

    Kikkert, M. J.; Driessen, E.; Peen, J.; Barber, J. P.; Bockting, C. L. H.; Schalkwijk, F.; Dekker, J.; Dekker, J. J. M.

    2016-01-01

    BACKGROUND: Barber and Muenz (1996) reported that cognitive behavior therapy (CBT) was more effective than interpersonal therapy (IPT) for depressed patients with elevated levels of avoidant personality disorder, while IPT was more effective than CBT in patients with elevated levels of

  1. Is thought-action fusion specific to obsessive-compulsive disorder?: a mediating role of negative affect.

    Science.gov (United States)

    Abramowitz, J S; Whiteside, S; Lynam, D; Kalsy, S

    2003-09-01

    Thought-action fusion (TAF) is a cognitive bias presumed to underlie the development of obsessional problems (i.e. obsessive-compulsive disorder; OCD). Previous studies have found that TAF is related to not only OCD, but also to other anxiety disorders. In the present study we compared levels of TAF in OCD patients and in patients with other anxiety disorders, depression, and healthy controls to examine whether TAF is characteristic of individuals with emotional distress in general, as opposed to anxiety disorders per se. We also examined whether negative affect (i.e. anxiety and depression) mediates the relationship between OCD and TAF. Results indicated that OCD patients were characterized by higher scores on likelihood-self and likelihood-other TAF, but that this difference was predominately due to differences in negative affect. These findings support a model in which negative affect mediates the relationship between OCD and TAF.

  2. Study of compulsive buying in patients presenting obsessive-compulsive disorder.

    Science.gov (United States)

    Lejoyeux, Michel; Bailly, Florence; Moula, Hervé; Loi, Sabrina; Adès, Jean

    2005-01-01

    The authors assessed the prevalence of compulsive buying (CB) among patients presenting an obsessive-compulsive disorder (OCD). They compared the buying style of patients with and without CB. One thousand five hundred consecutive patients were assessed by a general practitioner in Paris (France). Sixty patients presenting with OCD were included. Patients with CB associated with OCD (n = 14) were compared with those with "pure" OCD (n = 46). Sixty patients paired for sex and age and free from OCD, depression, and anxiety were also recruited among the clients of the same general practitioner. We compared 3 groups: controls, patients with OCD, and patients with OCD + CB. Prevalence of CB was 23% (14 cases) among patients with OCD and 6% (4 cases) in controls (chi(2)(1) = 5.3, P = .02). Patients presenting with OCD + CB had a higher number of Diagnostic and Statistical Manual of Mental Disorders, Revised Fourth Edition diagnostic criteria for OCD than patients with pure OCD (6.1 and 5.4, respectively, P = .001). Depression was more frequent in the OCD + CB group (78%) than in the OCD group (42%) and in controls (10%) (P = .02). Patients from the OCD + CB group had higher score at the CAGE questionnaire than those of the OCD group (2 vs 0.7, P = .003). Patients with OCD + CB considered 42% of their purchases as occasions not to be passed up compared with 15.4% in the OCD group and 8.6% in controls. OCD+CD patients used the items they bought after a longer delay than controls and patients with pure OCD (8.2 vs 3 and 3.1 days, respectively). Compulsive buying is more frequent in OCD than in controls. Patients presenting with OCD + CB show more depressive disorders and drink more alcohol. They are more highly implicated in the items they buy and they are more often disappointed by the items once they possess them.

  3. Autism spectrum disorders in adult outpatients with obsessive compulsive disorder in the UK.

    Science.gov (United States)

    Wikramanayake, Waduge Nishani Maheshi; Mandy, William; Shahper, Sonia; Kaur, Sukhwinder; Kolli, Sangeetha; Osman, Selma; Reid, Jemma; Jefferies-Sewell, Kiri; Fineberg, Naomi Anne

    2018-03-01

    Patients with obsessive compulsive disorder (OCD) frequently show traits of autism spectrum disorders (ASD). This is one of the first studies to explore the clinical impact of the overlap between OCD and ASD as a categorical diagnosis. A cross-sectional survey in 73 adult outpatients with DSM-IV OCD. Autistic traits were measured using the Autism-Spectrum Quotient (AQ). A clinical estimate ASD diagnosis was made by interview using DSM-IV-TR criteria. OCD patients with and without autistic traits or ASD were compared on demographic and clinical parameters and level of OCD treatment-resistance based on treatment history. Thirty-four (47%) patients scored above the clinical threshold on the AQ (≥26) and 21 (27.8%) met diagnostic criteria for ASD. These diagnoses had not been made before. Patients with autistic traits showed a borderline significant increase in OCD symptom-severity (Yale-Brown Obsessive Compulsive Scale (Y-BOCS); p = .054) and significantly increased impairment of insight (Brown Assessment of Beliefs Scale; p = .01). There was a positive correlation between AQ and Y-BOCS scores (p = .04), but not with OCD treatment resistance. There is a high prevalence of previously undiagnosed ASD in patients with OCD. ASD traits are associated with greater OCD symptom-severity and poor insight.

  4. Prevalence of Obsessive-Compulsive Disorder and its relationship with anxiety symptoms in students of Zanjan universities (2009

    Directory of Open Access Journals (Sweden)

    Seyed Abolfazl Ghoreishi

    2014-08-01

    Full Text Available Background: Obsessive-Compulsive Disorder (OCD is the fourth most common mental disorder that can adversely affect the people’s life. University education is a stressful time for almost all students and many newly-accepted students are at the risk of periodical OCD. In this study, the prevalence of Obsessive-Compulsive Disorder and its relationship with anxiety symptoms was investigated in students of Zanjan universities. Method: The students were analyzed by a questionnaire, including the demographic information, Yale-Brown Obsessive-Compulsive Scale and Hamilton Anxiety Rating Scale.The acquired data were analyzed by SPSS software using Chi-square Test. Results: 61.2% of the students (738 were affected by Obsessive-Compulsive Disorder (OCD symptoms and 25.1% of them (302 were affected by anxiety symptoms (mild to severe. Prevalence of Clinical OCD among the students was estimated 22.2 % (268 .The results of statistical analysis showed significant correlations between Obsessive-Compulsive Disorder (OCD and anxiety symptoms (P=0.0005, sex (P=0.0005 , age (P=0.005 and university (P= 0.002 Conclusion: This study demonstrated a higher prevalence of OCD among the study sample compared to the similar studies performed in Iran as well as other countries

  5. Harm avoidance and childhood adversities in patients with obsessive-compulsive disorder and their unaffected first-degree relatives.

    Science.gov (United States)

    Bey, K; Lennertz, L; Riesel, A; Klawohn, J; Kaufmann, C; Heinzel, S; Grützmann, R; Kathmann, N; Wagner, M

    2017-04-01

    The etiology of obsessive-compulsive disorder (OCD) is assumed to involve interactions between genetically determined vulnerability factors and significant environmental features. Here, we aim to investigate how the personality trait harm avoidance and the experience of childhood adversities contribute to OCD. A total of 169 patients with OCD, 157 healthy comparison subjects, and 57 unaffected first-degree relatives of patients with OCD participated in the study. Harm avoidance was assessed using the Temperament and Character Inventory, and the severity of childhood adversities was measured with the Childhood Trauma Questionnaire. Both patients with OCD and relatives showed elevated levels of harm avoidance compared to controls. Furthermore, patients exhibited significantly higher scores than relatives. This linear pattern was observed throughout all subscales of harm avoidance, and remained stable after controlling for the severity of depressive and obsessive-compulsive symptoms. With regard to childhood adversities, patients with OCD reported higher levels than relatives and controls. Our results provide further evidence for a diathesis-stress model of OCD. While patients and unaffected relatives share elevated levels of harm avoidance, supporting the role of harm avoidance as an endophenotype of OCD, a heightened severity of childhood adversity was only observed in patients. The assumed biological underpinnings of these findings are discussed. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Striatal structure and its association with N-Acetylaspartate and glutamate in autism spectrum disorder and obsessive compulsive disorder

    NARCIS (Netherlands)

    Naaijen, Jilly; Zwiers, Marcel P.; Forde, Natalie J.; Williams, Steven C. R.; Durston, Sarah; Brandeis, Daniel; Glennon, Jeffrey C.; Franke, Barbara; Lythgoe, David J.; Buitelaar, Jan K.

    Autism spectrum disorders (ASD) and obsessive compulsive disorder (OCD) are often comorbid and are associated with changes in striatal volumes and N-Acetylaspartate (NAA) and glutamate levels. Here, we investigated the relation between dorsal striatal volume and NAA and glutamate levels. We

  7. Cool and Hot Aspects of Executive Function in Childhood Obsessive-Compulsive Disorder

    DEFF Research Database (Denmark)

    Hybel, Katja Anna; Mortensen, Erik Lykke; Lambek, Rikke

    2017-01-01

    Aspects of executive functioning (EF) have been put forward as endophenotypes in obsessive- compulsive disorder (OCD) and meta-analyses support EF underperformance in adult samples. Childhood-onset OCD has been suggested to constitute a separate neurodevelopmental subtype of the disorder......-17 years of which 70% were female, 50 pairwise age and gender matched non-psychiatric controls (NP) and 38 children and adolescents with mixed anxiety disorders (MA). Participants underwent structured diagnostic interviews and assessment with a battery encompassing cool EF tasks of working memory, set...

  8. Mental health literacy and obsessive--compulsive personality disorder.

    Science.gov (United States)

    Koutoufa, Iakovina; Furnham, Adrian

    2014-01-30

    An opportunistic sample of 342 participants completed a vignette identification task that required them to name the possible psychological problem of an individual described in vignettes describing people with depression, schizophrenia, OCD and OCPD. Participants rated the degree to which they believed the individual experienced distress, they felt sympathetic towards the described individual, and the degree to which they believed the individual was well-adjusted in the community. There were very low recognition rates of OCPD, with participants more likely to identify depression, schizophrenia and OCD. Analysis of distress, sympathy and adjustment ratings also revealed significant differences between the disorders. The findings highlight the necessity of greater mental health awareness and the importance of psycho-education in order to increase successful treatment seeking of OCPD patients. © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. Obsessive-compulsive disorder: advances in brain imaging

    International Nuclear Information System (INIS)

    Galli, Enrique

    2000-01-01

    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)

  10. Depression, anxiety and obsessive-compulsive symptoms in relation to nutritional status and outcome in severe anorexia nervosa.

    Science.gov (United States)

    Mattar, Lama; Thiébaud, Marie-Raphaele; Huas, Caroline; Cebula, Christelle; Godart, Nathalie

    2012-12-30

    Depression, anxiety and obsessive-compulsive disorder are frequently reported to co-occur with anorexia nervosa (AN). There is clinical consensus that depressive symptoms and anxiety may in part be sequelae of malnutrition in AN. However, evidence-based data are still very rare. The present study among severe AN patients investigates links between these psychological variants and nutritional status at admission and subsequent to nutritional rehabilitation. Twenty-four women with AN diagnosed according to the Diagnostic and Statistical Manual IV (DSM-IV) were included prospectively and consecutively at hospitalisation. Nutritional status was assessed by body mass index (BMI). Several psychological aspects were assessed using various scales for depression, anxiety, social phobia, obsessive and eating behaviour symptoms. Follow-up weights and heights at 4-12 years after hospital discharge were measured in 18 patients. BMI and all the scores except the Yale-Brown obsessive-compulsive scale (Y-BOCS) showed significant improvement between admission and discharge. This study highlights the fact that some of the depressive and anxiety symptoms at least partially decrease with nutrition rehabilitation. The improvement in the scores on the psychometric scales between admission and discharge was not correlated with BMI improvement. Psychometric scores at admission and at discharge were not correlated with BMI at follow-up. BMI at follow-up was correlated with minimum lifetime BMI (r=0.486, P=0.04). Future studies should use a better indicator for nutritional status than BMI alone, and should also consider the initial degree of weight loss and the rate at which weight was lost. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  11. Stability of the Pregnancy Obsessive-Compulsive Personality Disorder Symptoms Checklist.

    Science.gov (United States)

    van Broekhoven, Kiki E M; Karreman, Annemiek; Hartman, Esther E; Pop, Victor J M

    2018-02-01

    Because stability over time is central to the definition of personality disorder, aim of the current study was to determine the stability of the Pregnancy Obsessive-Compulsive Personality Disorder (OCPD) Symptoms Checklist (N = 199 women). Strong positive correlations between assessments at 32 weeks of pregnancy and 2 and 3-3.5 years after childbirth were found (r between .62-.72), and the group mean score did not change over time. The Pregnancy OCPD Symptoms Checklist assesses stable, trait-like symptoms of OCPD.

  12. Developmental aspects of error and high-conflict-related brain activity in pediatric obsessive-compulsive disorder: a fMRI study with a Flanker task before and after CBT

    NARCIS (Netherlands)

    Huyser, C.; Veltman, D.J.; Wolters, L.H.; de Haan, E.; de Boer, F.

    2011-01-01

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

  13. Deep brain stimulation and treatment-resistant obsessive-compulsive disorder: A systematic review.

    Science.gov (United States)

    Vázquez-Bourgon, Javier; Martino, Juan; Sierra Peña, María; Infante Ceberio, Jon; Martínez Martínez, M Ángeles; Ocón, Roberto; Menchón, José Manuel; Crespo Facorro, Benedicto; Vázquez-Barquero, Alfonso

    2017-07-01

    At least 10% of patients with Obsessive-compulsive Disorder (OCD) are refractory to psychopharmacological treatment. The emergence of new technologies for the modulation of altered neuronal activity in Neurosurgery, deep brain stimulation (DBS), has enabled its use in severe and refractory OCD cases. The objective of this article is to review the current scientific evidence on the effectiveness and applicability of this technique to refractory OCD. We systematically reviewed the literature to identify the main characteristics of deep brain stimulation, its use and applicability as treatment for obsessive-compulsive disorder. Therefore, we reviewed PubMed/Medline, Embase and PsycINFO databases, combining the key-words 'Deep brain stimulation', 'DBS' and 'Obsessive-compulsive disorder' 'OCS'. The articles were selected by two of the authors independently, based on the abstracts, and if they described any of the main characteristics of the therapy referring to OCD: applicability; mechanism of action; brain therapeutic targets; efficacy; side-effects; co-therapies. All the information was subsequently extracted and analysed. The critical analysis of the evidence shows that the use of DBS in treatment-resistant OCD is providing satisfactory results regarding efficacy, with assumable side-effects. However, there is insufficient evidence to support the use of any single brain target over another. Patient selection has to be done following analyses of risks/benefits, being advisable to individualize the decision of continuing with concomitant psychopharmacological and psychological treatments. The use of DBS is still considered to be in the field of research, although it is increasingly used in refractory-OCD, producing in the majority of studies significant improvements in symptomatology, and in functionality and quality of life. It is essential to implement random and controlled studies regarding its long-term efficacy, cost-risk analyses and cost/benefit. Copyright

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

    Science.gov (United States)

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

    2017-08-01

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

  15. Perfectionism in obsessive-compulsive and eating disorders Perfeccionismo no transtorno obsessivo-compulsivo e nos transtornos alimentares

    Directory of Open Access Journals (Sweden)

    Berta Rodrigues Maia

    2009-12-01

    Full Text Available OBJECTIVE: The main aims of this article are twofold. First, to assess perfectionism dimensions in obsessive-compulsive disorder and eating disorders in comparison with psychiatric control (depression/anxiety and non-clinical control groups. Second, to examine if perfectionism is specifically related to these different clinical conditions. METHOD: Thirty-nine outpatients with obsessive-compulsive disorder, 24 outpatients with eating disorders, 65 outpatients with a diagnosis of depression and/or anxiety, and 70 non-clinical participants completed the Portuguese version of the Multidimensional Perfectionism Scale. RESULTS: Compared to non-clinical subjects, individuals of all clinical samples had significantly higher scores on Multidimensional Perfectionism Scale total score, Self-Oriented and Socially-Prescribed Perfectionism. There were no significantly differences in Self-Oriented Perfectionism and Multidimensional Perfectionism Scale total score in all the three clinical samples. Subjects from the eating disorders sample had significantly higher scores of Socially-Prescribed Perfectionism in comparison to obsessive-compulsive disorder and psychiatric control samples. CONCLUSION: Perfectionism showed to be related with this broad range of psychopathologies. However, the differences between eating disorders versus obsessive-compulsive disorder and psychiatric control on Socially-Prescribed Perfectionism warrant further investigation in order to clarify the specificity of this perfectionism dimension in eating disorders.OBJETIVO: Este estudo tem dois objetivos principais. Primeiro, avaliar as dimensões do perfeccionismo no transtorno obsessivo-compulsivo e nos transtornos alimentares em comparação com duas amostras controle: psiquiátrica (depressão/ansiedade e não clínica. Segundo, avaliar se o perfeccionismo é um traço de personalidade especificamente relacionado com estas diferentes condições clínicas. MÉTODO: 39 pacientes com

  16. Evidence-Based Pharmacotherapy for Pediatric Obsessive-Compulsive Disorder and Chronic Tic Disorders

    Directory of Open Access Journals (Sweden)

    Alessandro S. De Nadai

    2011-01-01

    Full Text Available In recent years, much progress has been made in pharmacotherapy for pediatric obsessive-compulsive disorder (OCD and chronic tic disorders (CTDs. What were previously considered relatively intractable conditions now have an array of efficacious medicinal (and psychosocial interventions available at clinicians' disposal, including selective serotonin reuptake inhibitors, atypical antipsychotics, and alpha-2 agonists. The purpose of this review is to discuss the evidence base for pharmacotherapy with pediatric OCD and CTDs with regard to efficacy, tolerability, and safety, and to put this evidence in the context of clinical management in integrated behavioral healthcare. While there is no single panacea for these disorders, there are a variety of medications that provide considerable relief for children with these disabling conditions.

  17. Evidence-Based Pharmacotherapy for Pediatric Obsessive-Compulsive Disorder and Chronic Tic Disorders

    Science.gov (United States)

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

    2011-01-01

    In recent years, much progress has been made in pharmacotherapy for pediatric obsessive-compulsive disorder (OCD) and chronic tic disorders (CTDs). What were previously considered relatively intractable conditions now have an array of efficacious medicinal (and psychosocial) interventions available at clinicians’ disposal, including selective serotonin reuptake inhibitors, atypical antipsychotics, and alpha-2 agonists. The purpose of this review is to discuss the evidence base for pharmacotherapy with pediatric OCD and CTDs with regard to efficacy, tolerability, and safety, and to put this evidence in the context of clinical management in integrated behavioral healthcare. While there is no single panacea for these disorders, there are a variety of medications that provide considerable relief for children with these disabling conditions. PMID:23861643

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

    Science.gov (United States)

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

    2017-06-01

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

  19. Towards a post-traumatic subtype of obsessive-compulsive disorder.

    Science.gov (United States)

    Fontenelle, Leonardo F; Cocchi, Luca; Harrison, Ben J; Shavitt, Roseli G; do Rosário, Maria Conceição; Ferrão, Ygor A; de Mathis, Maria Alice; Cordioli, Aristides V; Yücel, Murat; Pantelis, Christos; Mari, Jair de Jesus; Miguel, Euripedes C; Torres, Albina R

    2012-03-01

    We evaluated whether traumatic events are associated with a distinctive pattern of socio-demographic and clinical features of obsessive-compulsive disorder (OCD). We compared socio-demographic and clinical features of 106 patients developing OCD after post-traumatic stress disorder (PTSD; termed post-traumatic OCD), 41 patients developing OCD before PTSD (pre-traumatic OCD), and 810 OCD patients without any history of PTSD (non-traumatic OCD) using multinomial logistic regression analysis. A later age at onset of OCD, self-mutilation disorder, history of suicide plans, panic disorder with agoraphobia, and compulsive buying disorder were independently related to post-traumatic OCD. In contrast, earlier age at OCD onset, alcohol-related disorders, contamination-washing symptoms, and self-mutilation disorder were all independently associated with pre-traumatic OCD. In addition, patients with post-traumatic OCD without a previous history of obsessive-compulsive symptoms (OCS) showed lower educational levels, greater rates of contamination-washing symptoms, and more severe miscellaneous symptoms as compared to post-traumatic OCD patients with a history of OCS. Copyright © 2011 Elsevier Ltd. All rights reserved.

  20. Cross MFF—analysis in studying the obsessive-compulsive disorder

    International Nuclear Information System (INIS)

    Demin, S A; Panischev, O Yu; Demina, N Yu

    2016-01-01

    There were demonstrated capabilities of the Memory Function Formalism (MFF) in analyzing cross correlations in human brain bioelectric activity at obsessive-compulsive disorder (OCD). To extract the information about collective phenomena in (electroencephalogram) EEG brain activity we use the power spectra of memory functions and the memory quantifiers. We discover the pairs of the electrodes with the greatest differences in dynamic and stochastic parameters for patients with the different condition. The high OCD condition is characterized by the influence of the memory effects. The MFF cross correlation analysis allow to describe the collective phenomena in EEG dynamics at OCD including the dynamic, spectral and stochastic behavior. (paper)

  1. Change Factors in the Process of Cognitive-Behavioural Therapy for Obsessive-Compulsive Disorder.

    Science.gov (United States)

    Schwartz, C; Hilbert, S; Schubert, C; Schlegl, S; Freyer, T; Löwe, B; Osen, B; Voderholzer, U

    2017-05-01

    While there is a plethora of evidence for the efficacy of cognitive-behavioural therapy (CBT) in obsessive-compulsive disorder (OCD), studies on change factors of the therapeutic process that account for this success are scarce. In the present study, 155 participants with primary OCD were investigated during CBT inpatient treatment. The Yale-Brown Obsessive-Compulsive Scale-SR served as a measure of symptom severity. In addition, the following process change factors were measured: therapeutic relationship, experience of self-esteem during therapy, experience of mastery, problem actualization and clarification. All variables were assessed on a weekly basis for seven weeks. Linear mixed growth curve analyses were conducted to model the decrease of symptoms over time and to analyse whether the change factors predicted symptom reduction. The analyses revealed a linear decrease of symptoms with high inter-individual variation. Results further showed that increase in self-esteem and mastery experiences as well as the initial score on mastery experience and clarification predicted decrease on the Y-BOCS. We conclude that CBT therapists should focus on clarification in the very first sessions, and try to boost self-esteem and self-efficacy, which is related to mastery, throughout the treatment of OCD. Copyright © 2016 John Wiley & Sons, Ltd. Increase in mastery and self-esteem experiences are associated with symptom decrease in obsessive-compulsive disorder (OCD) during cognitive-behavioural therapy (CBT). Initial score of mastery experiences and problem clarification predict symptom decrease in OCD during CBT. CBT therapists should focus on problem clarification in the very first sessions and try to boost self-esteem and self-efficacy throughout the treatment of OCD. Copyright © 2016 John Wiley & Sons, Ltd.

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

    Science.gov (United States)

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

    2011-01-01

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

  3. Emotional Functioning in Obsessive-Compulsive Personality Disorder: Comparison to Borderline Personality Disorder and Healthy Controls.

    Science.gov (United States)

    Steenkamp, Maria M; Suvak, Michael K; Dickstein, Benjamin D; Shea, M Tracie; Litz, Brett T

    2015-12-01

    Few studies have investigated emotional functioning in obsessive-compulsive personality disorder (OCPD). To explore the nature and extent of emotion difficulties in OCPD, the authors examined four domains of self-reported emotional functioning--negative affectivity, anger, emotion regulation, and emotion expressivity--in women with OCPD and compared them to a borderline personality disorder (BPD) group and a healthy control group. Data were collected as part of a larger psychophysiological experimental study on emotion regulation and personality. Compared to healthy controls, participants with OCPD reported significantly higher levels of negative affectivity, trait anger, emotional intensity, and emotion regulation difficulties. Emotion regulation difficulties included lack of emotional clarity, nonacceptance of emotional responses, and limited access to effective emotion regulation strategies. Participants with OCPD scored similarly to participants with BPD on only one variable, namely, problems engaging in goal-directed behavior when upset. Results suggest that OCPD may be characterized by notable difficulties in several emotional domains.

  4. Acute obsessive compulsive disorder (OCD) in veterans with posttraumatic stress disorder (PTSD).

    Science.gov (United States)

    Fostick, Leah; Nacasch, Nitsa; Zohar, Joseph

    2012-04-01

    Posttraumatic obsessions have been reported in a few studies and case series. However, as the patients described were chronic, and the onset of their posttraumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD) symptoms was dated some time previously, this hampers interpretation of the temporal, biological and psychological relationship of OCD following traumatic events. In the current paper we describe the emergence of posttraumatic obsessions a short time following the exposure to a traumatic event. The emergence of posttraumatic obsessions, a few months after exposure to trauma, is described for five veterans. All the veterans participated in combat during the summer of 2006 (in the Second Lebanon War). For all cases, OCD symptoms were initially related to the trauma but later became generalized and independent. The course of the symptoms suggests a potential environmental role in the development of OCD following an exposure to a traumatic event. These observations suggest a biological linkage between exposure to trauma and OCD.

  5. The neuropsychology of obsessive-compulsive personality disorder: a new analysis.

    Science.gov (United States)

    Fineberg, Naomi A; Day, Grace A; de Koenigswarter, Nica; Reghunandanan, Samar; Kolli, Sangeetha; Jefferies-Sewell, Kiri; Hranov, Georgi; Laws, Keith R

    2015-10-01

    Obsessive compulsive personality disorder (OCPD) is characterized by perfectionism, need for control, and cognitive rigidity. Currently, little neuropsychological data exist on this condition, though emerging evidence does suggest that disorders marked by compulsivity, including obsessive-compulsive disorder (OCD), are associated with impairment in cognitive flexibility and executive planning on neurocognitive tasks. The current study investigated the neurocognitive profile in a nonclinical community-based sample of people fulfilling diagnostic criteria for OCPD in the absence of major psychiatric comorbidity. Twenty-one nonclinical subjects who fulfilled Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for OCPD were compared with 15 healthy controls on selected clinical and neurocognitive tasks. OCPD was measured using the Compulsive Personality Assessment Scale (CPAS). Participants completed tests from the Cambridge Automated Neuropsychological Test Battery including tests of set shifting (Intra-Extra Dimensional [IED] Set Shifting) executive planning (Stockings of Cambridge [SOC]), and decision making (Cambridge Gamble Task [CGT]). The OCPD group made significantly more IED-ED shift errors and total shift errors, and also showed longer mean initial thinking time on the SOC at moderate levels of difficulty. No differences emerged on the CGT. Nonclinical cases of OCPD showed significant cognitive inflexibility coupled with executive planning deficits, whereas decision-making remained intact. This profile of impairment overlaps with that of OCD and implies that common neuropsychological changes affect individuals with these disorders.

  6. Insight, Cognitive Insight and Sociodemographic Features in Obsessive Compulsive Disorder Presenting with Reactive and Autogeneus Features

    Directory of Open Access Journals (Sweden)

    Katre ÇAMLI

    2012-03-01

    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.

  7. D-cycloserine augmentation in behavioral therapy for obsessive-compulsive disorder: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Xia J

    2015-04-01

    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

  8. Comparing family accommodation in pediatric obsessive-compulsive disorder, anxiety disorders, and nonanxious children.

    Science.gov (United States)

    Lebowitz, Eli R; Scharfstein, Lindsay A; Jones, Johnna

    2014-12-01

    Family accommodation describes ways in which parents modify their behavior to help a child avoid or alleviate distress caused by emotional disorders. Accommodation is associated with increased symptom severity, lower functioning, and poorer treatment outcomes. Accommodation is prevalent in childhood obsessive-compulsive disorder (OCD) and anxiety disorders (ADs) but no studies have compared accommodation in these groups or compared them to healthy controls to ascertain if accommodation is prevalent in the general population. This study addresses these gaps by comparing patterns of accommodation, factors that maintain accommodation, and its relation to symptom severity in OCD and AD, relative to healthy controls. We directly compared reports of accommodation to childhood OCD (N = 26) and AD (N = 31), and a comparison group of nonanxious (NA) children (N = 30). Mothers completed measures of accommodation (Family Accommodation Scale (FAS)/Family Accommodation Scale-Anxiety (FASA)), anxiety (Screen for Childhood Anxiety Related Emotional Disorders-Parent Report (SCARED-PR)), and OCD (Children's Yale-Brown Obsessive Compulsive Scale (CYBOCS)). Family accommodation is prevalent among mothers of children with OCD and AD. Few differences were found between the two clinical groups who reported more accommodation (F[2,84] = 23.411, P anxiety in AD (r = .426, P = .017) and OCD (r = .465, P = .017), but not in the NA group. Findings highlight family accommodation as a phenomenon that applies broadly and in a similar manner to children with AD and OCD. Evaluating accommodation provides useful information for clinical care and is an important part of the assessment of children with AD and OCD. © 2014 Wiley Periodicals, Inc.

  9. Do autistic traits play a role in the bullying of obsessive-compulsive disorder and social phobia sufferers?

    Science.gov (United States)

    Bejerot, S; Mörtberg, E

    2009-01-01

    Social phobia and obsessive-compulsive disorder (OCD) share several similarities: both are categorized as anxiety disorders, avoidant personality disorder and depression are common in both, they have a similar age of onset and course, and both disorders respond to treatments with serotonin reuptake inhibitors and cognitive behavioural therapy. However, OCD and social phobia differ in respect to their relation to autism spectrum disorders (ASD; i.e. Asperger's syndrome, autism, pervasive disorder not otherwise specified). Findings that suggest a link between OCD and ASD have no parallel in social phobia. Moreover, obsessive-compulsive, paranoid and schizotypal personality disorders are prevalent in OCD and in ASD, but not in social phobia. Individuals with ASD are known to be frequent targets of bullying. We hypothesised that individuals with autistic traits would have been frequent targets for bullies during their childhood, as opposed to people without such traits. Adult patients with social phobia (n = 63) or OCD (n = 65) were assessed regarding autistic traits, and interviewed about being bullied at school. A reference group (n = 551) responded to questions about being bullied. There was a significant difference in the prevalence of being bullied between OCD (50%), social phobia patients (20%) and the reference group (27%). Autistic traits were more common in OCD than in social phobia. A history of being bullied was related to autistic traits among patients. Falling victim to bullying is not a random event. Autistic traits, i.e. low social skills, may be a predictor of being bullied in school. The high rate of bullying victims in persons who later develop OCD is suggested to be related to the overlap between OCD and ASD. Copyright 2009 S. Karger AG, Basel.

  10. Neither bipolar nor obsessive-compulsive disorder: compulsive buyers are impulsive acquirers.

    Science.gov (United States)

    Filomensky, Tatiana Zambrano; Almeida, Karla Mathias; Castro Nogueira, Marcelo Campos; Diniz, Juliana Belo; Lafer, Beny; Borcato, Sonia; Tavares, Hermano

    2012-07-01

    Compulsive buying (CB) is currently classified as an impulse control disorder (ICD) not otherwise classified. Compulsive buying prevalence is estimated at around 5% of the general population. There is controversy about whether CB should be classified as an ICD, a subsyndromal bipolar disorder (BD), or an obsessive-compulsive disorder (OCD) akin to a hoarding syndrome. To further investigate the appropriate classification of CB, we compared patients with CB, BD, and OCD for impulsivity, affective instability, hoarding, and other OCD symptoms. Eighty outpatients (24 CB, 21 BD, and 35 OCD) who were neither manic nor hypomanic were asked to fill out self-report questionnaires. Compulsive buying patients scored significantly higher on all impulsivity measures and on acquisition but not on the hoarding subdimensions of clutter and "difficulty discarding." Patients with BD scored higher on the mania dimension from the Structured Clinical Interview for Mood Spectrum scale. Patients with OCD scored higher on obsessive-compulsive symptoms and, particularly, higher on the contamination/washing and checking dimensions from the Padua Inventory; however, they did not score higher on any hoarding dimension. A discriminant model built with these variables correctly classified patients with CB (79%), BD (71%), and OCD (77%). Patients with CB came out as impulsive acquirers, resembling ICD- rather than BD- or OCD-related disorders. Manic symptoms were distinctive of patients with BD. Hoarding symptoms other than acquisition were not particularly associated with any diagnostic group. Copyright © 2012 Elsevier Inc. All rights reserved.

  11. Parsing the phenotype of obsessive-compulsive tic disorder (OCTD): a multidisciplinary consensus.

    Science.gov (United States)

    Dell'Osso, Bernardo; Marazziti, Donatella; Albert, Umberto; Pallanti, Stefano; Gambini, Orsola; Tundo, Antonio; Zanaboni, Carlotta; Servello, Domenico; Rizzo, Renata; Scalone, Luciana; Benatti, Beatrice; Altamura, A Carlo; Porta, Mauro

    2017-06-01

    Obsessive-Compulsive Disorder (OCD) and Tic Disorder (TD) are highly disabling and often comorbid conditions. Of note, the DSM-5 acknowledged a new 'tic-related' specifier for OCD, which might be referred to as Obsessive-Compulsive Tic Disorder (OCTD), raising new interest toward a better clinical characterisation of affected patients. Available literature indicates that early onset, male gender, sensory phenomena and obsessions of symmetry, aggressiveness, hoarding, exactness and sounds as well as comorbidity with Attention Deficit Hyperactivity Disorder (ADHD) may be of more frequent observation in patients with OCTD. In order to share expertise in the field from different perspectives, a multidisciplinary panel of Italian clinicians, specifically involved in the clinical care of OCD and TD patients, participated into a consensus initiative, aimed to produce a shared document. As a result, after having examined the most relevant literature, authors sought to critically identify and discuss main epidemiologic, socio-demographic and clinical features characterising OCTD patients, along with other specific aspects including Health-Related Quality-of-Life (HRQoL), economic consequences related with the condition and its management, as well as treatment-related issues, that need to be further investigated.

  12. Using direct-to-consumer marketing strategies with obsessive-compulsive disorder in the nonprofit sector.

    Science.gov (United States)

    Szymanski, Jeff

    2012-06-01

    Three to four million individuals struggle with obsessive-compulsive disorder (OCD) in the United States at any given time. OCD can be a debilitating disorder associated with significant quality-of-life and occupational impairment. First-line treatments for OCD (selective serotonin reuptake inhibitors and exposure and response prevention therapy) have been shown to be effective; yet, many individuals suffering from OCD experience multiple barriers to accessing these treatments. In fact, it can take as many as 17 years from onset of symptoms to effective treatment. Given the need to increase access to and utilization of effective treatments, direct-to-consumer marketing in the context of OCD appears crucial. The International OCD Foundation (formerly the Obsessive Compulsive Foundation) was established as a nonprofit organization with a mission to educate the public and mental health professionals about appropriate practice guidelines, raise awareness of the disorder, and ensure that individuals looking for treatment find the necessary resources. This paper reviews the obstacles those struggling with OCD face in their attempts to alleviate suffering, as well as the direct-to-consumer strategies and tactics used by the International OCD Foundation to improve access to empirically supported, effective treatment. Copyright © 2011. Published by Elsevier Ltd.

  13. Similarities and differences between children and adolescents with autism spectrum disorder and those with obsessive compulsive disorder: executive functioning and repetitive behaviour.

    NARCIS (Netherlands)

    Scheeren, Anke M; Begeer, Sander; Banerjee, Robin; Meerum Terwogt, Mark; Koot, Hans M

    2010-01-01

    In order to examine hypothesized underlying neurocognitive processes in repetitive behaviour, children and adolescents (7-16 years) with autism spectrum disorder (ASD) and obsessive compulsive disorder (OCD) were compared on a range of executive function (EF) measures. Performance on

  14. Obsessive-compulsive disorder: a review of the diagnostic criteria and possible subtypes and dimensional specifiers for DSM-V

    NARCIS (Netherlands)

    Leckman, James F.; Denys, Damiaan; Simpson, H. Blair; Mataix-Cols, David; Hollander, Eric; Saxena, Sanjaya; Miguel, Euripedes C.; Rauch, Scott L.; Goodman, Wayne K.; Phillips, Katharine A.; Stein, Dan J.

    2010-01-01

    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

  15. Intact short-term memory and impaired executive functions in obsessive compulsive disorder.

    Science.gov (United States)

    Demeter, Gyula; Racsmány, Mihály; Csigó, Katalin; Harsányi, András; Németh, Attila; Döme, László

    2013-01-30

    Previous neuropsychological studies produced inconsistent results with tasks tapping short-term verbal and visual-spatial memory and executive functions in obsessive compulsive disorder (OCD). The aim of this study was to investigate the presence of deficits in these cognitive domains. A further goal was to describe the distribution of patients in different impairment ranges for all functions, and clarify the relationship between symptom severity and cognitive impairments. Thirty patients with OCD (DSM-IV) and 30 healthy volunteers were compared using well-known neuropsychological tasks. We assessed short-term verbal memory with the Digit Span Forward and Digit Span Backward Tasks, short-term visual-spatial memory with the Corsi Block Tapping Task, while we measured the level of executive functions with the StroopTask and the Wisconsin Card Sorting Test (WCST). Compared with a matched healthy control group, the performance of OCD patients was in the impaired range only in the two executive tasks. We find a significant positive correlations between the Y-BOCS (Yale-Brown Obsessive Compulsive Scale) total scores and the number of perseverative responses (r(28) = 0.409, p short-term memory is intact in OCD. This is in line with neuropsychological model of OCD that the deficit of cognitive and behavioral inhibition are responsible for the main cognitive findings of this disorder, most prevalently the deficit in set shifting and prepotent response inhibition.

  16. Successful anterior capsulotomy in comorbid anorexia nervosa and obsessive-compulsive disorder: case report.

    Science.gov (United States)

    Barbier, Johan; Gabriëls, Loes; van Laere, Koen; Nuttin, Bart

    2011-09-01

    State-of-the-art treatment of anorexia nervosa (AN) and obsessive-compulsive disorder (OCD) often proves ineffective. Both disorders have common features, and anterior capsulotomy is a last-resort treatment for OCD. We document the effect of bilateral anterior capsulotomy in a patient with comorbid AN and OCD. A 38-year-old woman with life-threatening, chronic, treatment-refractory AN and OCD underwent anterior capsulotomy. Psychiatric and neuropsychological evaluations at baseline and at follow-up document the severity and progress of the case. Bilateral anterior capsulotomy resulted in normalization of eating pattern and weight and a significant decrease of food-related and overall obsessive-compulsive symptoms. Psychiatric evaluations and exposure to food cues confirmed the clinical improvement that was evident immediately after surgery and sustained at 3-month follow-up. This case report suggests that bilateral anterior capsulotomy can be a therapeutic option for patients with comorbid AN and OCD. However, a well-controlled study is warranted.

  17. Childhood-onset obsessive-compulsive disorder: a tic-related subtype of OCD?

    Science.gov (United States)

    Eichstedt, J A; Arnold, S L

    2001-02-01

    Obsessive-compulsive disorder (OCD) is a psychiatric condition characterized by recurrent obsessions or compulsions that cause significant impairment or distress. Although OCD was once perceived to be relatively rare in childhood, current estimates suggest that as many as half of all adult OCD cases may have their onset in childhood or adolescence. In general, there appears to be a great deal of continuity between the clinical presentation of OCD in children and that in adults. Yet, numerous differences have also been found between child and adult OCD, including differences in sex distribution, patterns of comorbidity, and degree of familial loading. These differences raise the issue of whether obsessive-compulsive symptoms that have their onset in childhood, but perhaps persist into adult life, are meaningfully different from those that emerge de novo in adulthood. In this article, current research on child- and adult-onset OCD is critically reviewed. It is proposed that child-onset OCD represents a phenomenologically and etiologically distinct subtype of OCD, bearing a close genetic relationship to tic-disorders and possibly sharing a common or similar pathogenesis. Clinical implications of the child- versus adult-onset OCD distinction are discussed.

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

    NARCIS (Netherlands)

    Denys, Damiaan

    2011-01-01

    Progress in psychiatry depends on accurate definitions of disorders. As long as there are no known biologic markers available that are highly specific for a particular psychiatric disorder, clinical practice as well as scientific research is forced to appeal to clinical symptoms. Currently, the

  19. A Preliminary Investigation of Pathways to Inflated Responsibility Beliefs in Children with Obsessive Compulsive Disorder.

    Science.gov (United States)

    Collins, Lindsey M; Coles, Meredith E

    2018-05-01

    Cognitive theorists posit that inflated responsibility beliefs contribute to the development of obsessive compulsive disorder (OCD). Salkovskis et al. (1999) proposed that experiencing heightened responsibility, overprotective parents and rigid rules, and thinking one influenced or caused a negative life event act as 'pathways' to the development of inflated responsibility beliefs, thereby increasing risk for OCD. Studies in adults with OCD and non-clinical adolescents support the link between these experiences and responsibility beliefs (Coles et al., 2015; Halvaiepour and Nosratabadi, 2015), but the theory has never been tested in youth with current OCD. We provided an initial test of the theory by Salkovskis et al. (1999) in youth with OCD. We predicted that childhood experiences proposed by Salkovskis et al. (1999) would correlate positively with responsibility and harm beliefs and OCD symptom severity. Twenty youth with OCD (age 9‒16 years) completed a new child-report measure of the experiences hypothesized by Salkovskis et al. (1999), the Pathways to Inflated Responsibility Beliefs Scale-Child Version (PIRBS-CV). Youth also completed the Obsessive Beliefs Questionnaire-Child Version (Coles et al., 2010) and the Obsessive Compulsive Inventory-Child Version (Foa et al., 2010). Consistent with hypotheses, the PIRBS-CV was significantly related to responsibility and harm beliefs and OCD symptom severity. Results provide initial support for the theory proposed by Salkovskis et al. (1999) as applied to youth with OCD. Future studies are needed to further assess the model in early-onset OCD.

  20. Morphometric brain characterization of refractory obsessive-compulsive disorder: diffeomorphic anatomic registration using exponentiated Lie algebra.

    Science.gov (United States)

    Tang, Wanjie; Li, Bin; Huang, Xiaoqi; Jiang, Xiaoyu; Li, Fei; Wang, Lijuan; Chen, Taolin; Wang, Jinhui; Gong, Qiyong; Yang, Yanchun

    2013-10-01

    Few studies have used neuroimaging to characterize treatment-refractory obsessive-compulsive disorder (OCD). This study sought to explore gray matter structure in patients with treatment-refractory OCD and compare it with that of healthy controls. A total of 18 subjects with treatment-refractory OCD and 26 healthy volunteers were analyzed by MRI using a 3.0-T scanner and voxel-based morphometry (VBM). Diffeomorphic anatomical registration using exponentiated Lie algebra (DARTEL) was used to identify structural changes in gray matter associated with treatment-refractory OCD. A partial correlation model was used to analyze whether morphometric changes were associated with Yale-Brown Obsessive-Compulsive Scale scores and illness duration. Gray matter volume did not differ significantly between the two groups. Treatment-refractory OCD patients showed significantly lower gray matter density than healthy subjects in the left posterior cingulate cortex (PCC) and mediodorsal thalamus (MD) and significantly higher gray matter density in the left dorsal striatum (putamen). These changes did not correlate with symptom severity or illness duration. Our findings provide new evidence of deficits in gray matter density in treatment-refractory OCD patients. These patients may show characteristic density abnormalities in the left PCC, MD and dorsal striatum (putamen), which should be verified in longitudinal studies. © 2013. Published by Elsevier Inc. All rights reserved.

  1. Family Accommodation in Obsessive-Compulsive Disorder: A Study on Associated Variables

    Directory of Open Access Journals (Sweden)

    Teresa Cosentino

    2015-10-01

    Full Text Available The present study aimed to examine family accommodation in relatives of obsessive-compulsive disease (OCD patients. Accommodation was assessed in a sample of 31 relatives of OCD patients by means of the Family Accommodation Scale. Other variables measured as predictors of accommodation were the tendency of a family member to feel guilty, sensitivity to guilt, anxiety sensitivity and the prevalence of a passive communication style. Accommodation was found to be rather widespread in the family members who took part in our study, and they tended to show more accommodation the greater their sensitivity to guilt and the stable tendency to experience this emotion as well as anxiety sensitivity and a passive communication style. Multiple linear regression analyses showed that, among the variables considered, the family member’s sensitivity to guilt is the only factor which can predict accommodation with regard to the patient’s demands for involvement. On the other hand, the small number of family members in the sample and the lack of clinical data on patients (such as the severity, typology and duration of their obsessive-compulsive disorder pose limits to the generalizability of the results and point to the need for further research.

  2. A Voxel Based Morphometry Study of Brain Gray Matter Volumes in Juvenile Obsessive Compulsive Disorder.

    Science.gov (United States)

    Jayarajan, Rajan Nishanth; Agarwal, Sri Mahavir; Viswanath, Biju; Kalmady, Sunil V; Venkatasubramanian, Ganesan; Srinath, Shoba; Chandrashekar, C R; Janardhan Reddy, Y C

    2015-01-01

    Adult patients with Obsessive Compulsive Disorder (OCD) have been shown to have gray matter (GM) volume differences from healthy controls in multiple regions - the orbitofrontal cortex (OFC), anterior cingulate cortex (ACC), medial frontal gyri (MFG), striatum, thalamus, and superior parietal lobule. However, there is paucity of data with regard to juvenile OCD. Hence, we examined GM volume differences between juvenile OCD patients and matched healthy controls using voxel based morphometry (VBM) with the above apriori regions of interest. Fifteen right handed juvenile patients with OCD and age- sex- handedness- matched healthy controls were recruited after administering the Mini International Neuropsychiatric Interview-KID and the Children's Yale-Brown Obsessive Compulsive Scale, and scanned using a 3 Tesla magnetic resonance imaging scanner. VBM methodology was followed. In comparison with healthy controls, patients had significantly smaller GM volumes in left ACC. YBOCS total score (current) showed significant negative correlation with GM volumes in bilateral OFC, and left superior parietal lobule. These findings while reiterating the important role of the orbito-fronto-striatal circuitry, also implicate in the parietal lobe - especially the superior parietal lobule as an important structure involved in the pathogenesis of OCD.

  3. Designing and validation of a yoga-based intervention for obsessive compulsive disorder.

    Science.gov (United States)

    Bhat, Shubha; Varambally, Shivarama; Karmani, Sneha; Govindaraj, Ramajayam; Gangadhar, B N

    2016-06-01

    Some yoga-based practices have been found to be useful for patients with obsessive compulsive disorder (OCD). The authors could not find a validated yoga therapy module available for OCD. This study attempted to formulate a generic yoga-based intervention module for OCD. A yoga module was designed based on traditional and contemporary yoga literature. The module was sent to 10 yoga experts for content validation. The experts rated the usefulness of the practices on a scale of 1-5 (5 = extremely useful). The final version of the module was pilot-tested on patients with OCD (n = 17) for both feasibility and effect on symptoms. Eighty-eight per cent (22 out of 25) of the items in the initial module were retained, with modifications in the module as suggested by the experts along with patients' inputs and authors' experience. The module was found to be feasible and showed an improvement in symptoms of OCD on total Yale-Brown Obsessive-Compulsive Scale (YBOCS) score (p = 0.001). A generic yoga therapy module for OCD was validated by experts in the field and found feasible to practice in patients. A decrease in the symptom scores was also found following yoga practice of 2 weeks. Further clinical validation is warranted to confirm efficacy.

  4. The role of anxiety in sexual disorders: The connection between agoraphobic and obsessive compulsive simptoms and sexual disorders

    Directory of Open Access Journals (Sweden)

    Ana Krevh

    2006-08-01

    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.

  5. Somatic delusions and obsessive-compulsive disorder in ...

    African Journals Online (AJOL)

    The patient was later referred to the psychiatry department of the same hospital and diagnosed with schizophrenia with somatic delusions and OCS according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. He was screened for schizophrenia, OCS and olfactory and somatic delusions by ...

  6. Family aggregation and risk factors of obsessive-compulsive disorders in a nationwide three-generation study

    DEFF Research Database (Denmark)

    Steinhausen, Hans-Christoph; Bisgaard, Charlotte; Munk-Jørgensen, Povl

    2013-01-01

    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...

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

    Science.gov (United States)

    Grados, Marco A.

    2010-01-01

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

  8. Response to Cognitive impulsivity and the behavioral addiction model of obsessive-compulsive disorder: Abramovitch and McKay

    NARCIS (Netherlands)

    Grassi, Giacomo; Figee, Martjin; Stratta, Paolo; Rossi, Alessandro; Pallanti, Stefano

    2016-01-01

    In our recently published article, we investigated the behavioral addiction model of obsessive-compulsive disorder (OCD), by assessing three core dimensions of addiction in patients with OCD healthy participants. Similar to the common findings in addiction, OCD patients demonstrated increased

  9. Better super safe than slightly sorry? : Reciprocal relationships between checking behavior and cognitive symptoms in obsessive-compulsive disorder

    NARCIS (Netherlands)

    Toffolo, M.B.J.

    2015-01-01

    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

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

    Science.gov (United States)

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

    2007-01-01

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

  11. Tic-Related Versus Tic-Free Obsessive-Compulsive Disorder : Clinical Picture and 2-Year Natural Course

    NARCIS (Netherlands)

    de Vries, Froukje E; Cath, Danielle C; Hoogendoorn, Adriaan W; van Oppen, Patricia; Glas, Gerrit; Veltman, Dick J; van den Heuvel, Odile A; van Balkom, Anton J L M

    2016-01-01

    OBJECTIVE: The tic-related subtype of obsessive-compulsive disorder (OCD) has a distinct clinical profile. The course of tic-related OCD has previously been investigated in treatment studies, with inconclusive results. This study aimed to compare clinical profiles between tic-related and tic-free

  12. Obsessive-compulsive disorder and female reproductive cycle events: results from the OCD and reproduction collaborative study

    NARCIS (Netherlands)

    Guglielmi, Valeria; Vulink, Nienke C. C.; Denys, Damiaan; Wang, Ying; Samuels, Jack F.; Nestadt, Gerald

    2014-01-01

    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 exacerbation of OCD

  13. Phenomenology, psychiatric comorbidity and family history in referred preschool children with obsessive-compulsive disorder

    Directory of Open Access Journals (Sweden)

    Coskun Murat

    2012-11-01

    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.

  14. Cortisol and Brain-Derived Neurotrophic Factor Levels Prior to Treatment in Children With Obsessive-Compulsive Disorder.

    Science.gov (United States)

    Şimşek, Şeref; Gençoğlan, Salih; Yüksel, Tuğba; Kaplan, İbrahim; Alaca, Rümeysa

    2016-07-01

    In this study, we investigated serum brain-derived neurotrophic factor (BDNF), adrenocorticotropic hormone (ACTH), and cortisol levels between children with obsessive-compulsive disorder (OCD) prior to treatment and healthy controls. In addition, the study aimed to assess any correlations between OCD symptom severity and BDNF, ACTH, and cortisol levels. Twenty-nine children, aged from 7 to 17 years (male/female: 21/8) and diagnosed with OCD according to DSM-IV prior to treatment, were compared with 25 healthy control subjects (male/female: 16/9). The study was conducted between December 2012 and December 2013. The Kiddie Schedule for Affective Disorders and Schizophrenia, Present and Lifetime Version (K-SADS-PL), Children's Yale-Brown Obsessive Compulsive Scale, and Children's Depression Inventory (CDI) were administered to the children. BDNF, ACTH, and cortisol levels were detected using a prepared kit with the enzyme-linked immunosorbent assay method. BDNF, ACTH, and cortisol levels in the OCD group were significantly higher when compared with the control group (P = .02, P = .03, and P = .046, respectively). No association was detected between the severity and duration of OCD symptoms and BDNF, ACTH, and cortisol levels. CDI scores in both groups were similar. The mean (SD) duration of OCD symptoms was 17.9 (18.5) months. Our findings suggest that BDNF levels adaptively increase as a result of the damaging effects of the hypothalamic-pituitary-adrenal (HPA) axis hyperactivity on brain tissue in the early stages of OCD. HPA axis abnormalities and BDNF may play a role in the pathogenesis of the disease. © Copyright 2016 Physicians Postgraduate Press, Inc.

  15. A critical review of PANDAS research in the context of obsessive compulsive disorder

    Directory of Open Access Journals (Sweden)

    Jonathan E. Harvey

    2017-10-01

    Full Text Available The discovery and elaboration of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS is emerging from a polemical status and gaining wide recognition. Current research has proposed a specific neurological pathogenesis for the disorder. This paper connects the dominant neurobiological model of obsessive compulsive disorder (OCD with the proposed pathogenesis and treatment of PANDAS. PANDAS presentation is described and an important early debate regarding anti-neuronal antibodies in the brain of PANDAS patients is outlined. Recent research on a specific immunological trigger for antibodies that cause a blood brain barrier breakdown will be discussed along with treatment for the disorder. Future avenues of research are discussed including a critique of the seminal studies in PANDAS pathology and treatment from the focal point of the dominant OCD model.

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

    DEFF Research Database (Denmark)

    Meier, Sandra M; Mattheisen, Manuel; Mors, Ole

    2016-01-01

    .7 years. The risk of death by natural or unnatural causes was significantly higher among persons with OCD (MRR, 1.68 [95% CI, 1.31-2.12] for natural causes; MRR, 2.61 [95% CI, 1.91-3.47] for unnatural causes) than among the general population. After the exclusion of persons with comorbid anxiety disorders...... risk of death. DESIGN, SETTING, AND PARTICIPANTS: Using data from Danish registers, we conducted a nationwide prospective cohort study with 30 million person-years of follow-up. The data were collected from Danish longitudinal registers. A total of 3 million people born between 1955 and 2006 were...... followed up from January 1, 2002, through December 31, 2011. During this period, 27,236 people died. The data were analyzed primarily in June 2015. MAIN OUTCOMES AND MEASURES: We estimated mortality rate ratios (MRRs), adjusted for calendar year, age, sex, maternal and paternal age, place of residence...

  17. Risk factors for early treatment discontinuation in patients with obsessive-compulsive disorder

    Directory of Open Access Journals (Sweden)

    Juliana Belo Diniz

    2011-01-01

    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

  18. Streptococcal upper respiratory tract infections and psychosocial stress predict future tic and obsessive-compulsive symptom severity in children and adolescents with Tourette syndrome and obsessive-compulsive disorder.

    Science.gov (United States)

    Lin, Haiqun; Williams, Kyle A; Katsovich, Liliya; Findley, Diane B; Grantz, Heidi; Lombroso, Paul J; King, Robert A; Bessen, Debra E; Johnson, Dwight; Kaplan, Edward L; Landeros-Weisenberger, Angeli; Zhang, Heping; Leckman, James F

    2010-04-01

    One goal of this prospective longitudinal study was to identify new group A beta-hemolytic streptococcal infections (GABHS) in children and adolescents with Tourette syndrome (TS) and/or obsessive-compulsive disorder (OCD) compared with healthy control subjects. We then examined the power of GABHS infections and measures of psychosocial stress to predict future tic, obsessive-compulsive (OC), and depressive symptom severity. Consecutive ratings of tic, OC, and depressive symptom severity were obtained for 45 cases and 41 matched control subjects over a 2-year period. Clinical raters were blinded to the results of laboratory tests. Laboratory personnel were blinded to case or control status and clinical ratings. Structural equation modeling for unbalanced repeated measures was used to assess the sequence of new GABHS infections and psychosocial stress and their impact on future symptom severity. Increases in tic and OC symptom severity did not occur after every new GABHS infection. However, the structural equation model found that these newly diagnosed infections were predictive of modest increases in future tic and OC symptom severity but did not predict future depressive symptom severity. In addition, the inclusion of new infections in the model greatly enhanced, by a factor of three, the power of psychosocial stress in predicting future tic and OC symptom severity. Our data suggest that a minority of children with TS and early-onset OCD were sensitive to antecedent GABHS infections. These infections also enhanced the predictive power of current psychosocial stress on future tic and OC symptom severity. Copyright 2010 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  19. [Therapeutic response to plasmapheresis in four cases with obsessive-compulsive disorder and tic disorder triggered by streptococcal infections].

    Science.gov (United States)

    Beşiroğlu, Lütfullah; Ağargün, Mehmet Yücel; Ozbebit, Ozgür; Sözen, Mehmet; Dilek, Imdat; Güleç, Mustafa

    2007-01-01

    The acronym PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections) has been assigned to a subgroup of patients experiencing pediatric onset obsessive-compulsive symptoms and tics as a result of autoimmune response to group A beta-hemolytic streptococcal infection. It has been hypothesized that an immune process initiated by infection affects the basal ganglia and causes neuropsychiatric symptoms. In cases with severe neuropsychiatric symptoms, the use of treatment strategies that interrupt the autoimmune process responsible for the pathogenesis of PANDAS, such as therapeutic plasmapheresis or intravenous immunoglobulin, has been proposed. In this paper, we discuss the effect of plasmapheresis treatment in 4 adult cases of obsessive-compulsive disorder and tic disorder triggered by streptococcal infections.

  20. Responsibility, thought-action fusion, and thought suppression in Turkish patients with obsessive-compulsive disorder.

    Science.gov (United States)

    Yorulmaz, O; Karanci, A N; Bastug, B; Kisa, C; Goka, E

    2008-03-01

    Although an inflated sense of responsibility, thought-action fusion, and thought suppression are influential factors in cognitive models of obsessive-compulsive disorder (OCD), their impact on OCD has generally been demonstrated in samples from Western countries. The aim of the present study is to evaluate these cognitive factors in Turkish patients with OCD, other anxiety disorders, and community controls. Group comparisons showed that responsibility based on self-dangerousness and thought suppression significantly distinguished OCD patients from patients with other anxiety disorders and controls. Moreover, correlation and discriminant function analyses indicated that thought-action fusion in morality and likelihood was also associated with OCD symptoms. The present findings provide support for the international validity and specificity of cognitive factors and model for OCD.

  1. Early-onset obsessive-compulsive disorder and personality disorders in adulthood.

    Science.gov (United States)

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

    2008-03-15

    Obsessive-compulsive disorder (OCD) often emerges in childhood or adolescence. The aim of the present study was to evaluate whether adult patients with prepuberal onset differ from subjects with later onset in terms of personality disorder comorbidity. The Structured Clinical Interview for DSM-IV Axis II Disorders was used to assess 148 patients with a principal diagnosis of OCD according to the Structured Clinical Interview for DSM-IV Axis I Disorders. The following two subgroups of subjects were selected according to the age at onset of symptomatology: patients with an early-onset ( or =17 years). Of the 148 patients screened for the present study, 33 (22.3%) had an early onset and 1369 (46.6%) had a later onset. With regard to personality disorders, early-onset patients showed more OC personality disorders (OCPD) than later onset patients. Our finding suggests that OCD in childhood increases the risk for developing OCPD in adulthood, or that early-onset OCD and OCPD share a common pathogenesis.

  2. 'Impulsive compulsivity' in obsessive-compulsive disorder: a phenotypic marker of patients with poor clinical outcome.

    Science.gov (United States)

    Kashyap, Himani; Fontenelle, Leonardo F; Miguel, Euripedes C; Ferrão, Ygor A; Torres, Albina R; Shavitt, Roseli G; Ferreira-Garcia, Rafael; do Rosário, Maria C; Yücel, Murat

    2012-09-01

    Although traditionally obsessive-compulsive disorder (OCD) and impulse control disorders (ICD) have represented opposing ends of a continuum, recent research has demonstrated a frequent co-occurrence of impulsive and compulsive behaviours, which may contribute to a worse clinical picture of some psychiatric disorders. We hypothesize that individuals with 'impulsive' OCD as characterized by poor insight, low resistance, and reduced control towards their compulsions will have a deteriorative course, greater severity of hoarding and/or symmetry/ordering symptoms, and comorbid ICD and/or substance use disorders (SUD). The sample consisted of 869 individuals with a minimum score of 16 on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Of these, 65 had poor insight, low resistance, and reduced control towards compulsions ('poor IRC') and 444 had preserved insight, greater resistance and better control over compulsions ('good IRC'). These two groups were compared on a number of clinical and demographic variables. Individuals with poor IRC were significantly more likely to have a deteriorative course (p disorder (p = 0.026), trichotillomania (p = 0.014) and compulsive buying (p = 0.040). Regression analysis revealed that duration of obsessions (p = 0.037) and hoarding severity (p = 0.005) were significant predictors of poor IRC. In the absence of specific measures for impulsivity in OCD, the study highlights the utility of simple measures such as insight, resistance and control over compulsions as a phenotypic marker of a subgroup of OCD with impulsive features demonstrating poor clinical outcome. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Pediatric obsessive-compulsive disorder with tic symptoms: clinical presentation and treatment outcome.

    Science.gov (United States)

    Højgaard, Davíð R M A; Skarphedinsson, Gudmundur; Nissen, Judith Becker; Hybel, Katja A; Ivarsson, Tord; Thomsen, Per Hove

    2017-06-01

    Some studies have shown that children and adolescents with obsessive-compulsive disorder (OCD) and co-morbid tics differ from those without co-morbid tics in terms of several demographic and clinical characteristics. However, not all studies have confirmed these differences. This study examined children and adolescents with OCD and with possible or definite tic specifiers according to the DSM-5 in order to see whether they differ from patients without any tic symptoms regarding clinical presentation and outcome of cognitive behavioral therapy (CBT). The full sample included 269 patients (aged 7-17) with primary DSM-IV OCD who had participated in the Nordic Long-term Treatment Study (NordLOTS). Symptoms of tics were assessed using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-PL). One or more tic symptoms were found in 29.9% of participants. Those with OCD and co-morbid tic symptoms were more likely male, more likely to have onset of OCD at an earlier age, and differed in terms of OCD symptom presentation. More specifically, such participants also showed more symptoms of OCD-related impairment, externalization, autism spectrum disorder (ASD), social anxiety, and attention-deficit/hyperactivity disorder (ADHD). However, the two groups showed no difference in terms of OCD severity or outcome of CBT. Children and adolescents with OCD and co-morbid tic symptoms differ from those without tic symptoms in several aspects of clinical presentation, but not in their response to CBT. Our results underscore the effectiveness of CBT for tic-related OCD. Nordic Long-term Obsessive-Compulsive Disorder (OCD) Treatment Study; www.controlled-trials.com ; ISRCTN66385119.

  4. Virtual reality for obsessive-compulsive disorder: past and the future.

    Science.gov (United States)

    Kim, Kwanguk; Kim, Chan-Hyung; Kim, So-Yeon; Roh, Daeyoung; Kim, Sun I

    2009-09-01

    The use of computers, especially for virtual reality (VR), to understand, assess, and treat various mental health problems has been developed for the last decade, including application for phobia, post-traumatic stress disorder, attention deficits, and schizophrenia. However, the number of VR tools addressing obsessive-compulsive disorder (OCD) is still lacking due to the heterogeneous symptoms of OCD and poor understanding of the relationship between VR and OCD. This article reviews the empirical literatures for VR tools in the future, which involve applications for both clinical work and experimental research in this area, including examining symptoms using VR according to OCD patients' individual symptoms, extending OCD research in the VR setting to also study behavioral and physiological correlations of the symptoms, and expanding the use of VR for OCD to cognitive-behavioral intervention.

  5. Decision-making impairment in obsessive-compulsive disorder as measured by the Iowa Gambling Task

    Directory of Open Access Journals (Sweden)

    Felipe Filardi da Rocha

    2011-08-01

    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.

  6. Association study between functional polymorphisms in the TNF-alpha gene and obsessive-compulsive disorder

    Directory of Open Access Journals (Sweden)

    Carolina Cappi

    2012-02-01

    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.

  7. An Integrative Approach to Treatment-Resistant Obsessive-Compulsive Disorder.

    Science.gov (United States)

    Woon, Luke Sy-Cherng; Kanapathy, Anita; Zakaria, Hazli; Alfonso, César A

    2017-01-01

    Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder that often runs a chronic unremitting course. Treatment outcomes can be unsatisfactory despite the availability of various somatic and psychological therapies. Psychodynamic psychotherapy in combination with cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) could help patients with treatment-resistant OCD achieve better outcomes. An integrative approach can help patients gain insight, strengthen the therapeutic alliance, improve treatment adherence, and provide symptomatic relief when other treatments seem insufficient or have failed. We describe the treatment process of a person with treatment-resistant OCD who received pharmacotherapy, concurrent CBT/ERP, and a brief course of psychodynamic psychotherapy. Case formulations from cognitive behavioral and psychodynamic perspectives are presented. The authors discuss the advantages of doing a psychodynamic assessment and formulation in treatment refractory cases and the wisdom of integrating psychotherapy interventions for OCD, as well as the unique clinical features of cases that warrant a multimodal treatment approach.

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

    Science.gov (United States)

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

    2017-12-01

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

  9. Safety, tolerability, and efficacy of psilocybin in 9 patients with obsessive-compulsive disorder.

    Science.gov (United States)

    Moreno, Francisco A; Wiegand, Christopher B; Taitano, E Keolani; Delgado, Pedro L

    2006-11-01

    Anecdotal reports suggest that psychedelic agents may relieve symptoms of obsessive-compulsive disorder (OCD). This modified double-blind study investigated the safety, tolerability, and clinical effects of psilocybin, a potent 5-HT(1A) and 5-HT(2A/2C) agonist, in patients with OCD. Nine subjects with DSM-IV-defined OCD and no other current major psychiatric disorder participated in up to 4 single-dose exposures to psilocybin in doses ranging from sub-hallucinogenic to frankly hallucinogenic. Low (100 microg/kg), medium (200 microg/kg), and high (300 microg/kg) doses were assigned in that order, and a very low dose (25 microg/kg) was inserted randomly and in double-blind fashion at any time after the first dose. Testing days were separated by at least 1 week. Each session was conducted over an 8-hour period in a controlled environment in an outpatient clinic; subjects were then transferred to a psychiatric inpatient unit for overnight observation. The Yale-Brown Obsessive Compulsive Scale (YBOCS) and a visual analog scale measuring overall obsessive-compulsive symptom severity were administered at 0, 4, 8, and 24 hours post-ingestion. The Hallucinogen Rating Scale was administered at 8 hours, and vital signs were recorded at 0, 1, 4, 8, and 24 hours after ingestion. The study was conducted from November 2001 to November 2004. Nine subjects were administered a total of 29 psilocybin doses. One subject experienced transient hypertension without relation to anxiety or somatic symptoms, but no other significant adverse effects were observed. Marked decreases in OCD symptoms of variable degrees were observed in all subjects during 1 or more of the testing sessions (23%-100% decrease in YBOCS score). Repeated-measures analysis of variance for all YBOCS values revealed a significant main effect of time on Wilks lambda (F = 9.86, df = 3,3; p = .046), but no significant effect of dose (F = 2.25, df = 3,3; p = .261) or interaction of time and dose (F = 0.923, df = 9,45; p

  10. Randomized controlled trial of yogic meditation techniques for patients with obsessive-compulsive disorder.

    Science.gov (United States)

    Shannahoff-Khalsa, D S; Ray, L E; Levine, S; Gallen, C C; Schwartz, B J; Sidorowich, J J

    1999-12-01

    The objective of this study was to compare efficacy of two meditation protocols for treating patients with obsessive-compulsive disorder (OCD). Patients were randomized to two groups-matched for sex, age, and medication status-and blinded to the comparison protocol. They were told the trial would last for 12 months, unless one protocol proved to be more efficacious. If so, groups would merge, and the group that received the less efficacious treatment would also be afforded 12 months of the more effective one. The study was conducted at Children's Hospital, San Diego, Calif. Patients were selected according to Diagnostic and Statistical Manual of Mental Disorders, Third Edition-Revised (DSM-III-R) criteria and recruited by advertisements and referral. At baseline, Group 1 included 11 adults and 1 adolescent, and Group 2 included 10 adults. Group 1 employed a kundalini yoga meditation protocol and Group 2 employed the Relaxation Response plus Mindfulness Meditation technique. Baseline and 3-month interval testing was conducted using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Symptoms Checklist-90-Revised Obsessive Compulsive (SCL-90-R OC) and Global Severity Index (SCL-90-R GSI) scales, Profile of Moods scale (POMS), Perceived Stress Scale (PSS), and Purpose in Life (PIL) test. Seven adults in each group completed 3 months of therapy. At 3 months, Group 1 demonstrated greater improvements (Student's independent groups t-test) on the Y-BOCS, SCL-90-R OC and GSI scales, and POMS, and greater but nonsignificant improvements on the PSS and PIL test. An intent-to-treat analysis (Y-BOCS) for the baseline and 3-month tests showed that only Group 1 improved. Within-group statistics (Student's paired t-tests) showed that Group 1 significantly improved on all six scales, but Group 2 had no improvements. Groups were merged for an additional year using Group 1 techniques. At 15 months, the final group (N=11) improved 71%, 62%, 66%, 74%, 39%, and 23%, respectively, on

  11. A review of self-management interventions for panic disorders, phobias and obsessive-compulsive disorders.

    Science.gov (United States)

    Barlow, J H; Ellard, D R; Hainsworth, J M; Jones, F R; Fisher, A

    2005-04-01

    To review current evidence for the clinical and cost-effectiveness of self-management interventions for panic disorder, phobias and obsessive-compulsive disorder (OCD). Papers were identified through computerized searches of databases for the years between 1995 and 2003, manual searches and personal contacts. Only randomized-controlled trials were reviewed. Ten studies were identified (one OCD, five panic disorder, four phobias). Effective self-management interventions included cognitive-behavioural therapy (CBT) and exposure to the trigger stimuli for phobias and panic disorders. All involved homework. There was evidence of effectiveness in terms of improved symptoms and psychological wellbeing when compared with standard care, waiting list or relaxation. Brief interventions and computer-based interventions were effective for most participants. In terms of quality, studies were mainly based on small samples, lacked long-term follow-up, and failed to address cost-effectiveness. Despite the limitations of reviewed studies, there appears to be sufficient evidence to warrant greater exploration of self-management in these disorders. Copyright 2005 Blackwell Munksgaard.

  12. Brain 99Tcm-ECD SPECT imaging in patients with obsessive-compulsive disorder

    International Nuclear Information System (INIS)

    Sun Da; Zhan Hongwei; Ye Xiaojuan; He Gangqiang

    2010-01-01

    Purpose Obsessive-compulsive disorder (OCD) is a chronic anxiety disorder of unknown aetiology. The purpose of the study is to evaluate the changes of brain function in patients with OCD. Methods: Regional cerebral perfusion was investigated using SPECT in 25 patients with OCD. The mean ages of the patients were 29.04 (1 8-46) years old. The clinical symptom consists of repeating thinking (suspect, worry, nervous) and repeating action (checking, washing, counting, making telephone calls) principally. After administration of 740-925 MBq (20-25 mCi) 99mTc-ECD a single photon emission tomography study was performed and then transaxial, sagittal and coronal slices were obtained. For the semiquantitative analysis of the data Results: 92 per cent of patients (23125) had relative hypoperfusions in some cerebral regions. The patients had a significant decrease of rCBF in the frontal lobes, temporal lobes, basal ganglia, thalamus, and cingulate gyrus. There were no correlation between the change of rCBF and age of age or course of disease. But there were some correlation with clinical symptom. Conclusion: Obsessive-compulsive disorder (OCD) has been linked to a dysfunction of brain orbitofrontal-striatum-pallidum-thalamus networks that were confirmed by PET SPECT functional imaging studies. These study indicated hypoperfusion in frontal lobes, basal ganglion, thalamus in OCD patients, and suggests a reduced serotonergic input into the fronto-subcortical circuits in OCD, thereby diminishing the inhibitory regulation of serotonin on these circuits. According to our results, patients with OCD had profound dysfunction of the frontal and temporal cortices, and basal ganglia. These may reflect a fundamental feature of clinical neuropathophysiology in OCD, and support previous findings about dysfunction of frontal-subcortical circuits in this disorder. (authors)

  13. Structural covariance of neostriatal and limbic regions in patients with obsessive-compulsive disorder.

    Science.gov (United States)

    Subirà, Marta; Cano, Marta; de Wit, Stella J; Alonso, Pino; Cardoner, Narcís; Hoexter, Marcelo Q; Kwon, Jun Soo; Nakamae, Takashi; Lochner, Christine; Sato, João R; Jung, Wi Hoon; Narumoto, Jin; Stein, Dan J; Pujol, Jesus; Mataix-Cols, David; Veltman, Dick J; Menchón, José M; van den Heuvel, Odile A; Soriano-Mas, Carles

    2016-03-01

    Frontostriatal and frontoamygdalar connectivity alterations in patients with obsessive-compulsive disorder (OCD) have been typically described in functional neuroimaging studies. However, structural covariance, or volumetric correlations across distant brain regions, also provides network-level information. Altered structural covariance has been described in patients with different psychiatric disorders, including OCD, but to our knowledge, alterations within frontostriatal and frontoamygdalar circuits have not been explored. We performed a mega-analysis pooling structural MRI scans from the Obsessive-compulsive Brain Imaging Consortium and assessed whole-brain voxel-wise structural covariance of 4 striatal regions (dorsal and ventral caudate nucleus, and dorsal-caudal and ventral-rostral putamen) and 2 amygdalar nuclei (basolateral and centromedial-superficial). Images were preprocessed with the standard pipeline of voxel-based morphometry studies using Statistical Parametric Mapping software. Our analyses involved 329 patients with OCD and 316 healthy controls. Patients showed increased structural covariance between the left ventral-rostral putamen and the left inferior frontal gyrus/frontal operculum region. This finding had a significant interaction with age; the association held only in the subgroup of older participants. Patients with OCD also showed increased structural covariance between the right centromedial-superficial amygdala and the ventromedial prefrontal cortex. This was a cross-sectional study. Because this is a multisite data set analysis, participant recruitment and image acquisition were performed in different centres. Most patients were taking medication, and treatment protocols differed across centres. Our results provide evidence for structural network-level alterations in patients with OCD involving 2 frontosubcortical circuits of relevance for the disorder and indicate that structural covariance contributes to fully characterizing brain

  14. A cross-sectional study of insight and family accommodation in pediatric obsessive-compulsive disorder

    Science.gov (United States)

    2013-01-01

    Background Factors predicting treatment outcome in pediatric patients with obsessive-compulsive disorder (OCD) include disease severity, functional impairment, comorbid disorders, insight, and family accommodation (FA). Treatment of pediatric OCD is often only partly successful as some of these predictors are not targeted with conventional therapy. Among these, insight and FA were identified to be modifiable predictors of special relevance to pediatric OCD. Despite their clinical relevance, insight and FA remain understudied in youth with OCD. This study examined the clinical correlates of insight and FA and determined whether FA mediates the relationship between symptom severity and functional impairment in pediatric OCD. Methods This was a cross-sectional, outpatient study. Thirty-five treatment-naive children and adolescentswith DSM-IV diagnosis of OCD (mean age: 13.11 ± 3.16; 54.3% males) were included. Standard questionnaires were administered for assessing the study variables. Insight and comorbidities were assessed based on clinician’s interview. Subjects were categorized as belonging to a high insight or a low insight group, and the differences between these two groups were analyzed using ANOVA. Pearson’s correlation coefficients were calculated for the remaining variables of interest. Mediation analysis was carried out using structural equation modeling. Results Relative to those in the high insight group, subjects in the low insight group were younger, had more severe disease and symptoms, and were accommodated to a greater extent by their families. In addition, comorbid depression was more frequent in subjects belonging to the low insight group. Family accommodation was positively related to disease severity, symptom severity, and functional impairment. Family accommodation totally mediated the relationship between symptom severity and functional impairment. Conclusions Results support the differences in the diagnostic criteria between adult and

  15. Influence of Culture in Obsessive-compulsive Disorder and Its Treatment.

    Science.gov (United States)

    Nicolini, Humberto; Salin-Pascual, Rafael; Cabrera, Brenda; Lanzagorta, Nuria

    2017-12-01

    The aspects of cultural identity and its impact on obsessive-compulsive disorder (OCD) have been un-derstudied. There are different opinions, ranging from the idea that culture does not affect the symptoms of this condition to the idea that cultures with high religiosity may have more severity of OCD. Also, the concept of OCD has considerably var-ied across history and cultures, from being considered an issue related to lack of control of blasphemous ideas, and a part of anxious issues, to the description of complex neurobiological systems in its causation. The aim of this review was to address OCD as a well-characterized disorder with a proposed neurobiological ba-sis which may or may not have variations depending on cultural diversity. The question that was asked in this review is whether or not there are cultural differences in the manifestations of the OCD symptomatology and which factors of cultural diversity have a major influence on such manifestations along with the differences among some cultures regarding OCD is-sues, where the difference among countries has also been highlighted. A review of the literature was conducted that includes the following words: obsessive-compulsive disorder, cul-ture, cultural identity and religion in a period of 10 years. Cultural variations do not seem to differ from symptomatic clusters of OCD, which may be indicating that a se-ries of adaptive behaviors is evolutionarily evolving to be constantly altered, perhaps by well-determined pathophysiological mechanisms. Some aspects that have been related to some dimensions of OCD symptomatology are religion and religiosity, affecting the content of obsessions and the severity of manifestations. Properly evaluating the education background, access to health services, food, and the genetic structure of populations, using investigational instruments sensitive to these cultural elements, will increase our understanding of the importance of culture on OCD and its treatment.

  16. A Review and Critique of Obsessive-Compulsive Personality Disorder Etiologies

    Directory of Open Access Journals (Sweden)

    Steven Charles Hertler

    2014-02-01

    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.

  17. Executive function predicts cognitive-behavioral therapy response in childhood obsessive-compulsive disorder

    DEFF Research Database (Denmark)

    Hybel, Katja Anna; Mortensen, Erik Lykke; Lambek, Rikke

    2017-01-01

    Cognitive-behavioral therapy (CBT) is considered first-line treatment for childhood obsessive-compulsive disorder (OCD). Despite CBT's efficacy, too many children and adolescents do not fully respond to treatment, making the identification of predictors of treatment response highly relevant...... in CBT for childhood OCD and denotes a possible need for development of enhanced treatments for children and adolescents with OCD and superior EF performance........ Daily life EF behavior in OCD probands improved after treatment relative to controls. The findings suggest that EF performance impacts CBT outcome, and that exposure-based CBT is well-suited for children and adolescents with OCD and poorer EF test performance. This study supports the relevance of EF...

  18. The case of rat man: A psychoanalytic understanding of obsessive-compulsive disorder

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    Suresh Thapaliya

    2017-01-01

    Full Text Available This article discusses case of Mr. Ernst Lanzer known as the “Rat Man” in the history of psychoanalysis. He was diagnosed as a case of obsessive-compulsive disorder by Sigmund Freud known as obsessional neurosis that time. The patient presented to Freud with number of distressing obsessions of which the main one was fear of a corporal punishment to his loved ones using rats. The patient underwent psychoanalytic treatment for his symptoms for 6 months following which he was declared cured. Freud has discussed the case in a published case note. Over the subsequent years, the case received wider attention from the psychoanalytic community and continues to be interpreted and discussed from different perspectives after nearly one century of his clinical interaction with Freud.

  19. Regional cerebral blood flow and cognitive function in patients with obsessive-compulsive disorder

    Directory of Open Access Journals (Sweden)

    Huirong Guo

    2014-01-01

    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.

  20. [Twiddler's syndrome in a patient with obsessive-compulsive disorder treated with deep brain stimulation].

    Science.gov (United States)

    Moliz, Nicolás; Katati, Majed J; Iañez, Benjamín; García, Asunción; Yagui, Eskandar; Horcajadas, Ángel

    2015-01-01

    Twiddler's syndrome is a rare complication associated with implantable electrical stimulation devices. First described in a patient with a pacemaker, it is a known complication in the field of cardiology. However, it is not so recognised in the world of neurosurgery, in which it has been described in relation to deep brain stimulation (DBS) devices. Characterised by manipulating either consciously or unconsciously the generator of such devices, which causes it to rotate on itself, the syndrome causes the coiling of the wiring of these systems and can lead to their rupture or the displacement of intracranial electrodes. We describe a case of twiddler's syndrome in a patient treated with DBS for obsessive-compulsive disorder, in which clinical deterioration presented after a good initial response. Control radiographs revealed rotation of the wiring system and displacement of the intracranial electrodes. Copyright © 2013 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  1. 18F-FDG PET study after bilateral capsulotomy in obsessive-compulsive disorder

    International Nuclear Information System (INIS)

    Zuo Chuantao; Lin Xiangtong; Guan Yihui; Zhao Jun; Li Dianyou; Sun Bomin

    2003-01-01

    Objective: To assess the changes in regional glucose metabolism following bilateral capsulotomy in patients with medically intractable obsessive-compulsive disorder (OCD). Methods: Eight OCD patients underwent bilateral anterior capsulotomy. 18 F-fluorodeoxyglucose (FDG) PET data obtained before and after operation were subjected to statistical parameter mapping (SPM) . Results: The glucose metabolism decrease was found in the left cingulategyrus, caudatum, left and right thalamic nucleus medialis dorsalis nuclei, bilateral medial and inferior frontal white matter. Conclusion: SPM analysis showed the significant change of cingulate-striatum-thalamic circuits in OCD patients after operation, and the findings implicate that the decreased cerebral metabolism in cingulate gyrus, striatum, and thalamus could be related to bilateral capsulotomy which blocks the abnormal functional connection of corticolimbic loop

  2. Brain anatomy and chemistry may predict treatment response in paediatric obsessive--compulsive disorder.

    Science.gov (United States)

    Rosenberg, D R; MacMillan, S N; Moore, G J

    2001-06-01

    Obsessive--compulsive disorder (OCD) is a severe, highly prevalent and often chronically disabling illness with frequent onset in childhood and adolescence. This underscores the importance of studying the illness during childhood near the onset of illness to minimize potential confounds of long-term illness duration and treatment intervention as well as to examine the developmental underpinnings of the illness. In this review, the authors focus on an integrated series of brain-imaging studies in paediatric OCD suggesting a reversible glutamatergically mediated thalamo-cortical--striatal dysfunction in OCD and their relevance for improved diagnosis and treatment of the condition. Developmental neurobiological models for OCD are presented and particular attention is devoted to evaluating neuroimaging studies designed to test these models and how they may help predict treatment response in paediatric OCD.

  3. Treating refractory obsessive-compulsive disorder: what to do when conventional treatment fails?

    Science.gov (United States)

    Franz, Adelar Pedro; Paim, Mariana; Araújo, Rafael Moreno de; Rosa, Virgínia de Oliveira; Barbosa, Ísis Mendes; Blaya, Carolina; Ferrão, Ygor Arzeno

    2013-01-01

    Obsessive-compulsive disorder (OCD) is a chronic and impairing condition. A very small percentage of patients become asymptomatic after treatment. The purpose of this paper was to review the alternative therapies available for OCD when conventional treatment fails. Data were extracted from controlled clinical studies (evidence-based medicine) published on the MEDLINE and Science Citation Index/Web of Science databases between 1975 and 2012. Findings are discussed and suggest that clinicians dealing with refractory OCD patients should: 1) review intrinsic phenomenological aspects of OCD, which could lead to different interpretations and treatment choices; 2) review extrinsic phenomenological aspects of OCD, especially family accommodation, which may be a risk factor for non-response; 3) consider non-conventional pharmacological approaches; 4) consider non-conventional psychotherapeutic approaches; and 5) consider neurobiological approaches.

  4. Treating refractory obsessive-compulsive disorder: what to do when conventional treatment fails?

    Directory of Open Access Journals (Sweden)

    Adelar Pedro Franz

    2013-01-01

    Full Text Available Obsessive-compulsive disorder (OCD is a chronic and impairing condition. A very small percentage of patients become asymptomatic after treatment. The purpose of this paper was to review the alternative therapies available for OCD when conventional treatment fails. Data were extracted from controlled clinical studies (evidence-based medicine published on the MEDLINE and Science Citation Index/Web of Science databases between 1975 and 2012. Findings are discussed and suggest that clinicians dealing with refractory OCD patients should: 1 review intrinsic phenomenological aspects of OCD, which could lead to different interpretations and treatment choices; 2 review extrinsic phenomenological aspects of OCD, especially family accommodation, which may be a risk factor for non-response; 3 consider non-conventional pharmacological approaches; 4 consider non-conventional psychotherapeutic approaches; and 5 consider neurobiological approaches.

  5. Evaluation of Relationship between Obsessive-compulsive Disorder and Dissociative Experiences.

    Science.gov (United States)

    Tatlı, Mustafa; Cetinkaya, Ozlem; Maner, Fulya

    2018-05-31

    The aim of the study is to evaluate the relationship between obsessive-compulsive disorder (OCD) symptoms and dissociative experiences and the effect of childhood traumatic experiences on this relationship in OCD patients. Fifty consecutive OCD patients and 50 healthy controls are enrolled for this study. Sociodemographic and Clinical Data Form, Dissociative Experiences Scale (DES), Padua Inventory (PI) and Childhood Trauma Questionnaire (CTQ) are applied to participants. Average DES total score in the patient group is 20.58 and in the control group it is 4.87. In the patient group, when we evaluate the relation strengths of DES total and subscale scores with PI total score, we found out that amnesia subscale has r=0.361 ( p controls. Among dissociative experiences, absorption has stronger relation with OCD symptoms. The relation between OCD and dissociation is independent from and stronger than the relation between childhood traumatic experiences and OCD.

  6. Obsessive-compulsive disorder and family accommodation: A 3-year follow-up.

    Science.gov (United States)

    Gomes, Juliana Braga; Cordioli, Aristides Volpato; Heldt, Elizeth

    2017-07-01

    The present study assessed 3-year maintenance of family accommodation (FA) reduction in a sample from a randomized clinical trial that assessed the impact of 12 sessions of cognitive-behavioral group therapy (CBGT) for obsessive-compulsive disorder (OCD), with the involvement of family members in two sessions. Of the 46 original pairs of patients/family members, 35 were assessed at 3 years. Demographic and clinical characteristics remained similar. Post-CBGT improvement of OCD symptoms remained significant; FA reduced 39% after the therapy and 51% at follow-up. FA reduction remained over time, underscoring the importance of permanently assessing FA and involving family members when treating OCD. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  7. Cerebral glucose metabolism in childhood-onset obsessive-compulsive disorder

    International Nuclear Information System (INIS)

    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.

    1989-01-01

    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

  8. Break in volition: a virtual reality study in patients with obsessive-compulsive disorder.

    Science.gov (United States)

    Cipresso, Pietro; La Paglia, Filippo; Paglia, F L; La Cascia, Caterina; Cascia, C L; Riva, Giuseppe; Albani, Giovanni; La Barbera, Daniele

    2013-09-01

    Research in obsessive-compulsive disorder (OCD) produced inconsistent results in demonstrating an association between patients' symptom severity and their cognitive impairments. The process involved in volition aspects of behavioral syndromes can be extensively analyzed using specific tests developed in virtual environments, more suitable to manipulate rules and possible breaks of the normal task execution with different, confusing or stopping instructions. The study involved thirty participants (15 OCD patients and 15 controls) during task execution and the relative interferences. At this purpose, the virtual version of Multiple Errands Test was used. Virtual reality setting, with a higher ecological validity respect to a classic neuropsychological battery, allowed us to take into account deficits of volition and the relative dysexecutive functions associated with OCD patients. The proposed paradigm also allows the development of innovative prototypes of coevolving technologies based on new theories and models and deeper understanding of human behavior.

  9. Sintomas obsessivo-compulsivos na depressão pós-parto: relatos de casos Obsessive-compulsive symptoms in postpartum depression: case reports

    Directory of Open Access Journals (Sweden)

    Carla Fonseca Zambaldi

    2008-08-01

    Full Text Available A depressão pós-parto é o transtorno afetivo mais prevalente no puerpério. O seu quadro clínico apresenta algumas peculiaridades sintomatológicas, podendo uma delas ser a presença mais freqüente de obsessões e compulsões. Relatamos seis casos identificados pela análise de prontuários de puérperas atendidas no Programa de Saúde Mental da Mulher do Hospital das Clínicas da Universidade Federal de Pernambuco. Todas elas tinham diagnóstico de depressão através do Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I e apresentavam concomitantemente sintomas obsessivo-compulsivos. Nos relatos, abordamos o período de aparecimento desses sintomas nas mulheres deprimidas, assim como o seu conteúdo, duração e resposta ao tratamento. Em duas mulheres, os sintomas obsessivo-compulsivos precederam os depressivos, e em outras duas, deu-se o inverso. Houve exacerbação de obsessões e compulsões preexistentes em duas puérperas. O conteúdo mais freqüente foi de pensamentos agressivos contra o bebê. Os sintomas tenderam a diminuir juntamente com a melhora da depressão.Postpartum depression is the most common affective disorder in the puerperium. There are some particular symptoms in its clinical presentation, and one might be the higher frequency of obsessions and compulsions. We report six cases identified from the analysis of medical charts of puerperal women receiving care at the Women's Mental Health Program, Hospital das Clínicas, Universidade Federal de Pernambuco, Brazil. All the women were diagnosed with postpartum depression using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I and had associated obsessive-compulsive symptoms. We report time of onset, topics, course and treatment response of these symptoms. Obsessive-compulsive symptoms preceded depressive symptoms in two women, and were succeeded in two other women. There was exacerbation of preexisting obsessions and compulsions in two

  10. Intrusive thoughts in obsessive-compulsive disorder and eating disorder patients: a differential analysis.

    Science.gov (United States)

    García-Soriano, Gemma; Roncero, Maria; Perpiñá, Conxa; Belloch, Amparo

    2014-05-01

    The present study aims to compare the unwanted intrusions experienced by obsessive-compulsive (OCD) and eating disorder (ED) patients, their appraisals, and their control strategies and analyse which variables predict the intrusions' disruption and emotional disturbance in each group. Seventy-nine OCD and 177 ED patients completed two equivalent self-reports designed to assess OCD-related and ED-related intrusions, their dysfunctional appraisals, and associated control strategies. OCD and ED patients experienced intrusions with comparable frequency and emotional disturbance, but OCD patients experienced greater disruption. Differences appeared between groups on some appraisals and control strategies. Intolerance to uncertainty (OCD group) and thought importance (ED group) predicted their respective emotional disturbance and disruption. Additionally, control importance (OCD group) and thought-action fusion moral (OCD and ED groups) predicted their emotional disturbance. OCD and ED share the presence of intrusions; however, different variables explain why they are disruptive and emotionally disturbing. Cognitive intrusions require further investigation as a transdiagnostic variable. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.

  11. Relationship of quality of life with disability grade in obsessive compulsive disorder and dysthymic disorder

    Directory of Open Access Journals (Sweden)

    N V Roopesh Gopal

    2014-01-01

    Full Text Available Background: There is paucity of information on the relationship of quality of life (QOL in obsessive compulsive disorder (OCD and dysthymic disorder (DD with disability grade in India. Aim: To assess the relation of QOL with disability level in OCD and DD. Materials and Methods: This hospital based study was conducted in a medical institution in Davanagere, Karnataka, India. Data was collected by using Diagnostic and Statistical Manual IV Text Revision (DSM IV TR criteria, WHO QOL BREF and IDEAS. Relationship between disability grade and QOL was assessed by independent sample t test. Results: Mild disabled OCD patients had a significantly better QOL in the Q1 domain i.e. perception on quality of life as compared to moderately disabled patients ( P 0.05. But, QOL score in physical domain showed significant difference across disability grades (56.00, SD = 6.89; 48.50, SD = 12.28 in DD, but not in other domains. Conclusion: Perception of QOL is better in those with mild disability in OCD, but in DD, physical domain of QOL score is more in mild disability compared to moderate disability.

  12. A study of cognitive function in treatment-refractory obsessive-compulsive disorder treated with capsulotomy.

    Science.gov (United States)

    Gong, Feilong; Li, Peng; Li, Bin; Zhang, Shizhen; Zhang, Xinjie; Yang, Sen; Liu, Hongbin; Wang, Wei

    2018-02-01

    OBJECTIVE Anterior capsulotomy (AC) is sometimes used as a last resort for treatment-refractory obsessive-compulsive disorder (OCD). Previous studies assessing neuropsychological outcomes in patients with OCD have identified several forms of cognitive dysfunction that are associated with the disease, but few have focused on changes in cognitive function in OCD patients who have undergone surgery. In the present study, the authors investigated the effects of AC on the cognitive function of patients with treatment-refractory OCD. METHODS The authors selected 14 patients with treatment-refractory OCD who had undergone bilateral AC between 2007 and 2013, 14 nonsurgically treated OCD patients, and 14 healthy control subjects for this study. The 3 groups were matched for sex, age, and education. Several neuropsychological tests, including Similarities and Block Design, which are subsets of the Wechsler Abbreviated Scale of Intelligence; Immediate and Delayed Logical Memory and Immediate and Delayed Visual Reproduction, which are subsets of the Wechsler Memory Scale-Revised; and Corrects, Categories, Perseverative Errors, Nonperseverative Errors, and Errors, subtests of the Wisconsin Card Sorting Test, were conducted in all 42 subjects at baseline and after AC, after nonsurgical treatment, or at 6-month intervals, as appropriate. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was used to measure OCD symptoms in all 28 OCD patients. RESULTS The Y-BOCS scores decreased significantly in both OCD groups during the 12-month follow-up period. Surgical patients showed higher levels of improvement in verbal memory, visual memory, visuospatial skills, and executive function than the nonsurgically treated OCD patients. CONCLUSIONS The findings of this study suggest that AC not only reduces OCD symptoms but also attenuates moderate cognitive deficits.

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

    Science.gov (United States)

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

    2016-01-01

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

  14. Evaluating effect of symptoms heterogeneity on decision-making ability in obsessive-compulsive disorder.

    Science.gov (United States)

    Martoni, Riccardo Maria; Brombin, Chiara; Nonis, Alessandro; Salgari, Giulia Carlotta; Buongiorno, Angela; Cavallini, Maria Cristina; Galimberti, Elisa; Bellodi, Laura

    2015-07-01

    Despite having a univocal definition, obsessive-compulsive disorder (OCD) shows a remarkably phenotypic heterogeneity. The published reports show impaired decision-making in OCD patients, using tasks such as the Iowa Gambling Task (IGT). We wanted to verify the hypothesis of an IGT worse performance in a large sample of OCD patients and healthy control (HC) subjects and to examine the relation between neuropsychological performance in IGT and the OCD symptoms heterogeneity. Binary data from the Yale-Brown Obsessive Compulsive Scale collected on a large sample of OCD patients were analyzed using a multidimensional item response theory model to explore the underlying structure of data, thus revealing latent factors. Factor scores were categorized into quartiles. Then, for each factor, we identified patients respectively with the highest versus lowest score. We evaluated whether symptom dimensions affect the probability of a correct answer over time generalized, during IGT performance, fitting a generalized linear mixed model. We found a general deficit in ambiguous decision-making in OCD compared to HC. Moreover, our findings suggested that OCD symptoms heterogeneity affects decision-making learning abilities during IGT. In fact, while 'Symmetry' and 'Washing' patients showed a learning curve during the task, other subgroups did not. Our study confirmed previous findings suggesting that OCD is characterized by a deficit in decision-making under uncertainty. Moreover, our study gave evidence about biological specificity for each symptom dimension in OCD. Data were discussed in the context of the somatic marker hypothesis, which was hypothesized to be reduced in OCD patients. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

  15. Internet-delivered cognitive behavior therapy for adolescents with obsessive-compulsive disorder: an open trial.

    Directory of Open Access Journals (Sweden)

    Fabian Lenhard

    Full Text Available BACKGROUND: International guidelines recommend Cognitive Behavior Therapy (CBT as the first line treatment for pediatric obsessive-compulsive disorder (OCD. However, a substantial proportion of patients do not have access to such treatment. We developed and tested the feasibility, efficacy and acceptability of a novel therapist-guided, Internet-delivered CBT (ICBT platform for adolescents with OCD. METHODS: An interactive, age-appropriate ICBT platform ("BiP OCD" was developed. Twenty-one adolescents (12-17 years with a DSM-IV diagnosis of OCD and their parents were enrolled in the study. All participants received 12 weeks of ICBT with therapist support. The primary outcome measure was the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS. Acceptability was assessed at post-treatment. RESULTS: Participants completed on average 8.29 (SD = 3.0 of the 12 treatment chapters. Treatment yielded significant improvements on all clinician-, parent- and most self-administered outcome measures, with a large effect size of d = 2.29 (95% CI 1.5-3.07 on the CY-BOCS. Patients continued to improve at follow-up. At 6-month follow-up, 71% were classified as responders (≥35% decrease on the CY-BOCS and 76% as being in remission (CY-BOCS score ≤12. Average clinician support time was less than 20 minutes per patient per week. The majority of participants felt that BiP OCD was age-appropriate and rated the treatment as good or very good. CONCLUSIONS: ICBT could be efficacious, acceptable, and cost-effective for adolescents with OCD. More rigorously controlled studies are needed to further evaluate the treatment. TRIAL REGISTRATION: ClinicalTrials.gov; NCT01809990.

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  18. Frontostriatal Dysfunction During Decision Making in Attention-Deficit/Hyperactivity Disorder and Obsessive-Compulsive Disorder.

    Science.gov (United States)

    Norman, Luke J; Carlisi, Christina O; Christakou, Anastasia; Murphy, Clodagh M; Chantiluke, Kaylita; Giampietro, Vincent; Simmons, Andrew; Brammer, Michael; Mataix-Cols, David; Rubia, Katya

    2018-03-24

    The aim of the current paper is to provide the first comparison of computational mechanisms and neurofunctional substrates in adolescents with attention-deficit/hyperactivity disorder (ADHD) and adolescents with obsessive-compulsive disorder (OCD) during decision making under ambiguity. Sixteen boys with ADHD, 20 boys with OCD, and 20 matched control subjects (12-18 years of age) completed a functional magnetic resonance imaging version of the Iowa Gambling Task. Brain activation was compared between groups using three-way analysis of covariance. Hierarchical Bayesian analysis was used to compare computational modeling parameters between groups. Patient groups shared reduced choice consistency and relied less on reinforcement learning during decision making relative to control subjects, while adolescents with ADHD alone demonstrated increased reward sensitivity. During advantageous choices, both disorders shared underactivation in ventral striatum, while OCD patients showed disorder-specific underactivation in the ventromedial orbitofrontal cortex. During outcome evaluation, shared underactivation to losses in patients relative to control subjects was found in the medial prefrontal cortex and shared underactivation to wins was found in the left putamen/caudate. ADHD boys showed disorder-specific dysfunction in the right putamen/caudate, which was activated more to losses in patients with ADHD but more to wins in control subjects. The findings suggest shared deficits in using learned reward expectancies to guide decision making, as well as shared dysfunction in medio-fronto-striato-limbic brain regions. However, findings of unique dysfunction in the ventromedial orbitofrontal cortex in OCD and in the right putamen in ADHD indicate additional, disorder-specific abnormalities and extend similar findings from inhibitory control tasks in the disorders to the domain of decision making under ambiguity. Copyright © 2018 Society of Biological Psychiatry. Published by

  19. Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders

    Science.gov (United States)

    2014-01-01

    Background Anxiety and related disorders are among the most common mental disorders, with lifetime prevalence reportedly as high as 31%. Unfortunately, anxiety disorders are under-diagnosed and under-treated. Methods These guidelines were developed by Canadian experts in anxiety and related disorders through a consensus process. Data on the epidemiology, diagnosis, and treatment (psychological and pharmacological) were obtained through MEDLINE, PsycINFO, and manual searches (1980–2012). Treatment strategies were rated on strength of evidence, and a clinical recommendation for each intervention was made, based on global impression of efficacy, effectiveness, and side effects, using a modified version of the periodic health examination guidelines. Results These guidelines are presented in 10 sections, including an introduction, principles of diagnosis and management, six sections (Sections 3 through 8) on the specific anxiety-related disorders (panic disorder, agoraphobia, specific phobia, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder), and two additional sections on special populations (children/adolescents, pregnant/lactating women, and the elderly) and clinical issues in patients with comorbid conditions. Conclusions Anxiety and related disorders are very common in clinical practice, and frequently comorbid with other psychiatric and medical conditions. Optimal management requires a good understanding of the efficacy and side effect profiles of pharmacological and psychological treatments. PMID:25081580

  20. Where emotion meets cognition : studies on executive function in obsessive-compulsive disorder

    NARCIS (Netherlands)

    Nielen, Maria Margaretha Anna

    2003-01-01

    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

  1. Study protocol for a randomised controlled trial of internet-based cognitive-behavioural therapy for obsessive-compulsive disorder

    OpenAIRE

    Kyrios, Michael; Nedeljkovic, Maja; Moulding, Richard; Klein, Britt; Austin, David; Meyer, Denny; Ahern, Claire

    2014-01-01

    Background Obsessive-Compulsive Disorder (OCD) is a common chronic psychiatric disorder that constitutes a leading cause of disability. Although Cognitive-Behaviour Therapy (CBT) has been shown to be an effective treatment for OCD, this specialised treatment is unavailable to many due to access issues and the social stigma associated with seeing a mental health specialist. Internet-based psychological treatments have shown to provide effective, accessible and affordable treatment for a range ...

  2. Copy Number Variation in Obsessive-Compulsive Disorder and Tourette Syndrome: A Cross-Disorder Study

    Science.gov (United States)

    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, Damiaan; Derks, Eske M.; Dion, Yves; Rosário, Maria C.; Eapen, Valsama; Evans, Patrick; Falkai, Peter; Fernandez, Thomas; 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.

    2014-01-01

    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 (>500kb), rare (<1%) copy number variants (CNVs) in OCD and the largest genome-wide CNV analysis in TS to date. Method The primary analyses utilized a cross-disorder design for 2,699 patients (1,613 ascertained for OCD, 1,086 ascertained for TS) and 1,789 controls. Parental data facilitated a de novo analysis in 348 OCD trios. Results Although no global CNV burden was detected in the cross-disorder analysis or in secondary, disease-specific analyses, there was a 3.3-fold increased burden of large deletions previously associated with other neurodevelopmental disorders (p=.09). Half of these neurodevelopmental deletions were located in a single locus, 16p13.11 (5 patient deletions: 0 control deletions, p=0.08 in current study, p=0.025 compared to published controls). Three 16p13.11 deletions were confirmed de novo, providing further support to the etiological significance of this region. The overall OCD de novo rate was 1.4%, which is intermediate between published rates in controls (0.7%) and in autism or schizophrenia (2–4%). Conclusion Several converging lines of evidence implicate 16p13.11 deletions in OCD, with weaker evidence for a role in TS. The trend toward increased overall neurodevelopmental CNV burden in TS and OCD suggests that deletions previously associated with other neurodevelopmental disorders may also contribute to these phenotypes. PMID:25062598

  3. Response inhibition and interference control in obsessive-compulsive spectrum disorders

    Directory of Open Access Journals (Sweden)

    Laura S van Velzen

    2014-06-01

    Full Text Available Over the past twenty years, motor response inhibition and interference control have received considerable scientific effort and attention, due to their important role in behavior and the development of neuropsychiatric disorders. Results of neuroimaging studies indicate that motor response inhibition and interference control are dependent on cortical-striatal-thalamic-cortical (CSTC circuits. Structural and functional abnormalities within the CSTC circuits have been reported for many neuropsychiatric disorders, including obsessive-compulsive disorder (OCD and related disorders, such as attention deficit hyperactivity disorder (ADHD, Tourette’s syndrome (TS and trichotillomania. These disorders also share impairments in motor response inhibition and interference control, which may underlie some of their behavioral and cognitive symptoms. Results of task-related neuroimaging studies on inhibitory functions in these disorders show that impaired task performance is related to altered recruitment of the CSTC circuits. Previous research has shown that inhibitory performance is dependent upon dopamine, noradrenaline and serotonin signaling, neurotransmitters that have been implicated in the pathophysiology of these disorders. In this review we discuss the common and disorder-specific pathophysiological mechanisms of inhibition-related dysfunction in OCD and related disorders.

  4. Relations Between Executive Functions and Different Symptomatic Dimensions in Obsessive Compulsive Disorder

    OpenAIRE

    Pedron, Ana Cristina; Ferrão, Ygor Arzeno; Gurgel, Léia Gonçalves; Reppold, Caroline Tozzi

    2015-01-01

    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...

  5. THE STRUCTURE OF OBSESSIVE-COMPULSIVE SYMPTOMS

    NARCIS (Netherlands)

    VANOPPEN, P; HOEKSTRA, RJ; EMMELKAMP, PMG

    In the present study, the structure of obsessive-compulsive symptoms was investigated by means of the Padua Inventory (PI). Simultaneous Components Analysis on data from obsessive-compulsives (n = 206), patients with other anxiety disorders (n = 222), and a non clinical sample (n = 430) revealed a

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

    Science.gov (United States)

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

    2016-05-01

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

  7. Tic Severity and Treatment in Children: The Effect of Comorbid Attention Deficit Hyperactivity Disorder and Obsessive Compulsive Behaviors.

    Science.gov (United States)

    Pringsheim, Tamara

    2017-12-01

    While attention deficit hyperactivity disorder (ADHD) and obsessive compulsive disorder have been shown to have major impacts on quality of life in individuals with Tourette syndrome, there is comparatively little data on how the presence of these comorbidities influence tic severity and treatment. 114 children (mean age 10.25 years) were extensively clinically phenotyped at a single specialty clinic. While there was no difference in Yale Global Tic Severity Scale (YGTSS) scores in children with versus without ADHD, children with obsessive compulsive behaviors had significantly higher YGTSS scores (p = 0.008). There was a significant correlation between YGTSS scores and age (r = 0.344, p tics within the first two years of diagnosis (OR 3.51, p = 0.009). As tic severity does not appear to be greater in children with ADHD, this association may relate to greater overall psychosocial impairment in children with this comorbidity.

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

    Science.gov (United States)

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

    2016-01-01

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

  9. The link between autoimmune diseases and obsessive-compulsive and tic disorders: A systematic review.

    Science.gov (United States)

    Pérez-Vigil, Ana; Fernández de la Cruz, Lorena; Brander, Gustaf; Isomura, Kayoko; Gromark, Caroline; Mataix-Cols, David

    2016-12-01

    Immunological factors are increasingly recognized as being important in a range of neuropsychiatric disorders. We aimed to summarize the disperse and often conflicting literature on the potential association between autoimmune diseases (ADs) and obsessive-compulsive disorder (OCD) and tic disorders. We searched PubMed, EMBASE, and PsycINFO for original studies evaluating the relationship between ADs and OCD/tic disorders until July, 13th 2016. Seventy-four studies met inclusion criteria. Overall, the studies were of limited methodological quality. Rates of OCD were higher in rheumatic fever patients who were also affected by its neurological manifestation, Sydenham's chorea. The literature on other ADs was scarce and the findings inconclusive. Few studies examined the association between ADs and tic disorders. A handful of family studies reported elevated rates of ADs in first-degree relatives of individuals with OCD/tic disorders, and vice versa, potentially suggesting shared genetic and/or environmental mechanisms. In conclusion, at present, there is modest evidence for a possible association and familial co-aggregation between ADs and OCD/tic disorders. We offer some suggestions for future research. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2017-07-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

  12. Strategic memory in adults with anorexia nervosa: are there similarities to obsessive compulsive spectrum disorders?

    Science.gov (United States)

    Sherman, Bonnie J; Savage, Cary R; Eddy, Kamryn T; Blais, Mark A; Deckersbach, Thilo; Jackson, Safia C; Franko, Debra L; Rauch, Scott L; Herzog, David B

    2006-09-01

    There is growing interest in the relationship between anorexia nervosa (AN) and obsessive-compulsive (OC) spectrum disorders (e.g., OCD, body dysmorphic disorder [BDD]). Previous neuropsychological investigations of OC spectrum disorders have identified problems with the efficient use of strategy on complex measures of learning and memory. This study evaluated nonverbal strategic memory in AN outpatients using an approach previously applied to OC spectrum disorders. Eighteen patients with AN and 19 healthy control participants completed the Rey-Osterrieth Complex Figure Test (RCFT), a widely used measure of nonverbal strategic planning, learning, and memory. Individuals with AN differed significantly from healthy controls in the organizational strategies used to copy the RCFT figure, and they recalled significantly less information on both immediate and delayed testing. Multiple regression analyses indicated that group differences in learning were mediated by copy organizational strategies. These results are identical to study findings in OCD and BDD, indicating important shared neuropsychological features among AN and these OC spectrum disorders. As in OCD and BDD, the essential cognitive deficit in AN was impaired use of organizational strategies, which may inform our understanding of the pathophysiology of AN and potentially offer treatment implications. Copyright (c) 2006 by Wiley Periodicals, Inc.

  13. The putative catalytic role of higher serotonin bioavailability in the clinical response to exposure and response prevention in obsessive-compulsive disorder

    Directory of Open Access Journals (Sweden)

    Thiago Sampaio

    Full Text Available Objective: Exposure and response prevention (ERP is effective to treat obsessive-compulsive disorder (OCD, but the lack of tolerance to the aversion nature of exposure techniques results in a high drop-out rate. There have been reports of a generic stress endurance effect of serotonin (5-HT in the central nervous system (CNS which might be explained by suppression of defensive fixed action patterns. Previous studies have proposed that higher baseline 5-HT concentration and slow decrease in concentration during drug treatment of OCD were predictors of good clinical response to 5-HT reuptake inhibitors. The objective of this study was to investigate whether pre-treatment platelet rich plasma (PRP 5-HT concentration is associated with latency of treatment response and final response to an ERP protocol for obsessive-compulsive disorder (OCD. Methods: Thirty adult and treatment-free OCD patients were included in an 8-week, 16-session ERP protocol. 5-HT concentration was determined at baseline and after treatment. Patients with a reduction ≥30% on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS at the end of ERP were defined as responders. Results: A positive correlation between baseline 5-HT concentration and reduction of symptoms on the Y-BOCS was observed after 4 weeks. Baseline 5-HT concentration was not correlated with clinical response after 8 weeks of ERP, possibly due to the similar though delayed clinical response of patients with lower (compared to those with higher baseline 5-HT concentration. Patients with higher 5-HT baseline concentration also showed more improvement in depressive symptoms with treatment. Conclusion: The present results partially support the hypothesis of a stress endurance effect of 5-HT in OCD patients. According to the literature, fast onset responders possibly have more or larger 5-HT containing neurons, higher endogenous 5-HT synthesis or lower monoamine oxidase activity; all these hypotheses remain to be

  14. Real-time functional magnetic resonance imaging in obsessive-compulsive disorder

    Directory of Open Access Journals (Sweden)

    Gonçalves ÓF

    2017-07-01

    Full Text Available Óscar F Gonçalves,1–3 Marcelo C Batistuzzo,4 João R Sato5 1Neuropsychophysiology Lab, CIPsi, School of Psychology, University of Minho, Braga, Portugal; 2Spaulding Neuromodulation Center, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; 3Social and Cognitive Neuroscience Laboratory, Center for Health and Biological Sciences, Mackenzie Presbyterian University, 4Department and Institute of Psychiatry, University of São Paulo Medical School (FMUSP, 5Mathematics, Computing, and Cognition Center, Universidade Federal do ABC – UFABC, São Paulo, Brazil Abstract: The current literature provides substantial evidence of brain alterations associated with obsessive-compulsive disorder (OCD symptoms (eg, checking, cleaning/decontamination, counting compulsions; harm or sexual, symmetry/exactness obsessions, and emotional problems (eg, defensive/appetitive emotional imbalance, disgust, guilt, shame, and fear learning/extinction and cognitive impairments associated with this disorder (eg, inhibitory control, working memory, cognitive flexibility. Building on this evidence, new clinical trials can now target specific brain regions/networks. Real-time functional magnetic resonance imaging (rtfMRI was introduced as a new therapeutic tool for the self-regulation of brain–mind. In this review, we describe initial trials testing the use of rtfMRI to target brain regions associated with specific OCD symptoms (eg, contamination, and other mind–brain processes (eg, cognitive – working memory, inhibitory control, emotional – defensive, appetitive systems, fear reduction through counter-conditioning found impaired in OCD patients. While this is a novel topic of research, initial evidence shows the promise of using rtfMRI in training the self-regulation of brain regions and mental processes associated with OCD. Additionally, studies with

  15. Amygdala activation in response to facial expressions in pediatric obsessive-compulsive disorder

    Science.gov (United States)

    Britton, Jennifer C.; Stewart, S. Evelyn; Killgore, William D.S.; Rosso, Isabelle M.; Price, Lauren M.; Gold, Andrea L.; Pine, Daniel S.; Wilhelm, Sabine; Jenike, Michael A.; Rauch, Scott L.

    2010-01-01

    Background Exaggerated amygdala activation to threatening faces has been detected in adults and children with anxiety disorders, compared to healthy comparison subjects. However, the profile of amygdala activation in response to facial expressions in obsessive-compulsive disorder (OCD) may be a distinguishing feature; a prior study found that compared with healthy adults, adults with OCD exhibited less amygdala activation to emotional and neutral faces, relative to fixation (Cannistraro et al., 2004). Methods In the current event-related functional magnetic resonance imaging (fMRI) study, a pediatric OCD sample (N=12) and a healthy comparison sample (HC, N=17) performed a gender discrimination task while viewing emotional faces (happy, fear, disgust) and neutral faces. Results Compared to the HC group, the OCD group showed less amygdala/hippocampus activation in all emotion and neutral conditions relative to fixation. Conclusions Like previous reports in adult OCD, pediatric OCD may have a distinct neural profile from other anxiety disorders, with respect to amygdala activation in response to emotional stimuli that are not disorder-specific. PMID:20602430

  16. The impact of obsessive-compulsive disorder in pregnancy on quality of life.

    Science.gov (United States)

    Gezginç, Kazim; Uguz, Faruk; Karatayli, Savaş; Zeytinci, Esra; Aşkin, Rüstem; Güler, Ozkan; Sahin, Figen; Murat Emül, H; Ozbulut, Omer; Geçici, Omer

    2008-01-01

    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.

  17. Dissociative experiences in bipolar disorder II: Are they related to childhood trauma and obsessive-compulsive symptoms?

    Directory of Open Access Journals (Sweden)

    Gul Eryilmaz

    2015-04-01

    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.

  18. No deficits in nonverbal memory, metamemory and internal as well as external source memory in obsessive-compulsive disorder (OCD).

    Science.gov (United States)

    Moritz, Steffen; Ruhe, Claudia; Jelinek, Lena; Naber, Dieter

    2009-04-01

    A large body of literature suggests that some symptoms of obsessive-compulsive disorder (OCD) result from mnemonic dysfunctions. The present study tested various formulations of the memory deficit hypothesis considering important moderators, such as depression and response slowing. Thirty-two OCD patients and 32 healthy controls were presented verbal or nonverbal instructions for actions (e.g. simple gestures). These actions should either be performed or imagined. For recognition, previously presented as well as novel actions were displayed. Decisions had to be made whether an action was previously displayed (verbally vs. nonverbally) or not and whether an action was performed or imagined (internal source memory). Moreover, both judgments required confidence ratings. Groups did not differ in memory accuracy and metamemory for verbally presented material. Patients displayed some impairment for nonverbally presented material and imagined instructions, which, however, could be fully accounted for by response slowing and depressive symptoms. The study challenges the view that primary memory deficits underlie OCD or any of its subtypes. We claim that research should move forward from the mere study of objective impairment to the assessment of cognitive performance in conjunction with personality traits such as inflated responsibility.

  19. Diagnostic efficiency of DSM-IV criteria for obsessive compulsive personality disorder in patients with binge eating disorder.

    Science.gov (United States)

    Grilo, C M

    2004-01-01

    This study examined the diagnostic efficiency of the DSM-IV criteria for obsessive compulsive personality disorder (OCPD) in patients with binge eating disorder (BED). Two hundred and eleven consecutive adult patients with axis I diagnoses of BED were reliably assessed with semi-structured diagnostic interviews. Conditional probabilities-sensitivity, specificity, positive predictive power (PPP), and negative predictive power (NPP)-were calculated for each of the eight criteria for OCPD, using the 'best-estimate' OCPD diagnosis as the standard. The diagnostic efficiencies of the OCPD criteria were variable, with three criteria failing to have predictive value (PPPOCPD based on performance and call into question the utility of some criteria.

  20. Neurological soft signs, dissociation and alexithymia in patients with obsessive-compulsive disorder (OCD) and healthy subjects.

    Science.gov (United States)

    Tapancı, Zafer; Yıldırım, Abdullah; Boysan, Murat

    2017-11-21

    A body of evidence has supported that patients with obsessive-compulsive disorder (OCD) have increased rates of various neurological soft signs (NSS) compared to controls. Various lines of research has documented robust relationships between OCD and dissociative symptomatology. The study aimed to examine the associations between obsessive-compulsive symptoms, dissociative experiences alexithymia, and NSS. The study included thirty OCD patients and thirty healthy controls, matched for age, marital status, education, and income. The Neurological Evaluation Scale (NES), Padua Inventory-Revised (PI-R), Dissociative Experiences Scale (DES) and Toronto Alexithymia Scale (TAS-20) were administered. In comparison to healthy controls, patients with OCD had difficulty sequencing for complex motor acts and greater absorption/ imaginative involvement. Using latent class analysis, the study sample was classified into two homogenous subsets as mild NSS (n = 45) and severe NSS (n = 15). Majority of the participants who were grouped into severe NSS latent class were OCD patient (n = 14, 93.3%). Furthermore, those with severe NSS reported greater levels of alexithymia and more severe obsessive-compulsive symptoms, particularly precision. We concluded that relationships between OCD severity and NSS appear to be of crucial importance. Our data along with accumulated evidence suggest that OCD associated with pronounced NSS may represent a specific subtype of the disorder. Copyright © 2017 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2003-01-01

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

  2. Should OCD leave the anxiety disorders in DSM-V? The case for obsessive compulsive-related disorders.

    Science.gov (United States)

    Hollander, Eric; Braun, Ashley; Simeon, Daphne

    2008-01-01

    Recently in 2006, a group of experts in obsessive compulsive disorder (OCD) and obsessive compulsive-related disorders (OCRDs) convened in Washington, DC, to review existing data on the relationships between these various disorders, and to suggest approaches to address the gaps in our knowledge, in preparation for the upcoming Diagnostic and Statistical Manual (Fifth Edition) (DSM-V). As a result of this meeting, the Research Planning Agenda for DSM-V: OCRD Work Group suggested removing OCD from the anxiety disorders, where it is currently found. This proposal is in accordance with the current International Classification of Mental Disorders (ICD-10) classification of OCD as a separate category from the anxiety disorders. Although the ICD-10 places both OCD and the anxiety disorders under the umbrella category of "neurotic, stress-related, and somatoform disorders," they are two separate categories, distinct from one another. As OCD and other putative OCRDs share aspects of phenomenology, comorbidity, neurotransmitter/peptide systems, neurocircuitry, familial and genetic factors, and treatment response, it was proposed to create a new category in DSM-V entitled OCRDs. Alternatively, the OCRDs might be conceptualized as a new category within the broader category of anxiety disorders. Future studies are needed to better define the relationships among these disorders, and to study boundary issues for this proposed category. There are both advantages and disadvantages in creating a new diagnostic category in DSM-V, and these are discussed in this article.

  3. Differentiating among singular and comorbid obsessive-compulsive disorder and social phobia symptomology.

    Science.gov (United States)

    Rudy, Brittany M; May, Anna C; Whiting, Sara E; Davis, Thompson E; Jenkins, Whitney S; Reuther, Erin T

    2014-01-01

    Social phobia is a frequent co-occurring diagnosis with obsessive-compulsive disorder (OCD); however, co-occurring OCD in those with social phobia is less common. Genetic, environmental, and cognitive traits are common risk factors for anxiety disorders broadly. It is plausible that shared variables related to OCD and/or social phobia could provide insight into the co-occurrence of these two disorders. The current study explored differences in fear of negative evaluation (FNE) and perfectionism among four groups: those with (1) elevated social phobia symptoms, (2) elevated OCD symptoms, (3) elevated symptoms of OCD and social phobia, and those who were (4) asymptomatic as a control group. A non-clinical sample of 196 participants completed several online questionnaires about social phobia and OCD symptomology. Results identified three cognitive variables (i.e., FNE, total perfectionism, and concern over mistakes) as differential variables in comorbid symptom presentation of OCD and social phobia. A fourth variable (i.e., doubts about actions) was identified as a potential dual risk factor, and four subsequent variables (i.e., parental criticism, personal standards, parental expectations, and organization) were not implicated in differential symptom presentation. Given the different rates of OCD and social phobia co-occurrence, identification of differentiating variables could aid in better understanding of potential risk factors, which may enhance preventative and therapeutic techniques. Study implications, limitations, and future recommendations are discussed.

  4. Alterations of the default mode network connectivity in obsessive-compulsive personality disorder: A pilot study.

    Science.gov (United States)

    Coutinho, Joana; Goncalves, Oscar Filipe; Soares, José Miguel; Marques, Paulo; Sampaio, Adriana

    2016-10-30

    Obsessive-compulsive personality (OCPD) disorder is characterized by a pattern of excessive self-control, perfectionism and behavioral and cognitive rigidity. Despite the fact that OCPD is the most common personality disorder in the general population, published studies looking at the brain correlates of this disorder are practically nonexistent. The main goal of this study was to analyze the presence of brain alterations in OCPD when compared to healthy controls, specifically at the level of the Default Mode Network (DMN). The DMN is a well-established resting state network which was found to be associated with psychological processes that may play a key role in OCPD (e.g., self-awareness, episodic future thinking and mental simulation). Ten individuals diagnosed with OCPD and ten healthy controls underwent a clinical assessment interview and a resting-state functional magnetic resonance imaging (fMRI) acquisition. The results show that OCPD patients presented an increased functional connectivity in the precuneus (i.e., a posterior node of the DMN), known to be involved in the retrieval manipulation of past events in order to solve current problems and develop plans for the future. These results suggest that this key node of the DMN may play an important role in the pathophysiology of OCPD. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Facial discrimination in body dysmorphic, obsessive-compulsive and social anxiety disorders.

    Science.gov (United States)

    Hübner, Claudia; Wiesendahl, Wiebke; Kleinstäuber, Maria; Stangier, Ulrich; Kathmann, Norbert; Buhlmann, Ulrike

    2016-02-28

    Body dysmorphic disorder (BDD) is characterized by preoccupation with perceived flaws in one's own appearance. Several risk factors such as aesthetic perceptual sensitivity have been proposed to explain BDD's unique symptomatology. Although research on facial discrimination is limited so far, the few existing studies have produced mixed results. Thus, the purpose of this study was to further examine facial discrimination in BDD. We administered a facial discrimination paradigm, which allows to assess the ability to identify slight to strong facial changes (e.g., hair loss, acne) when presented with an original (unmodified) facial image, relative to a changed (modified) facial image. The experiment was administered in individuals with BDD, social anxiety disorder, obsessive-compulsive disorder, and mentally healthy controls (32 per group, respectively). Overall, groups did not differ with respect to their ability to correctly identify facial aberrations when presented with other people's faces. Our findings do not support the hypothesis of enhanced general aesthetic perceptual sensitivity in individuals with (vs. without) BDD. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. ODD irritability is associated with obsessive-compulsive behavior and not ADHD in chronic tic disorders.

    Science.gov (United States)

    Thériault, Marie-Claude G; Lespérance, Paul; Achim, André; Tellier, Geneviève; Diab, Sabrina; Rouleau, Guy A; Chouinard, Sylvain; Richer, Francois

    2014-12-15

    Gilles de la Tourette syndrome (TS) and chronic tic disorder (CT) are often associated with a variety of behavioral comorbidities including attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive behavior (OCB), oppositional-defiant disorder (ODD) and temper outbursts. ODD is often associated with ADHD but its links to other symptoms of TS/CT is not as clear. This study examined whether the various symptoms of ODD were differentially linked to the various comorbidities in TS. A clinical sample of 135 children diagnosed with TS was evaluated through parent questionnaires and semi-structured interviews. Regressions and structural equation modeling confirmed that ODD is multidimensional in a TS/CT sample and showed that OCB was associated with the irritability symptoms of ODD whereas ADHD was associated with the Headstrong symptoms of ODD. Results suggest that increased attention to the different facets of ODD may help improve our understanding of emotional symptoms in TS/CT. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  7. Frontal-subcortical circuits in obsessive-compulsive disorder: role of the dopamine D1 receptor

    International Nuclear Information System (INIS)

    Olver, J.S.; Reutens, D.C.; Maruff, P.; Burrows, G.D.; Norman, T.R.; Ellen, S.R.; Pantelis, C.; Tochon-Danguy, H.; Ackermann, U.; Stekelenberg, N.

    2000-01-01

    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

  8. OCD? Not Me! Protocol for the development and evaluation of a web-based self-guided treatment for youth with obsessive-compulsive disorder.

    Science.gov (United States)

    Rees, Clare S; Anderson, Rebecca A; Finlay-Jones, Amy

    2015-04-29

    OCD? Not Me! is a novel, web-based, self-guided intervention designed to treat obsessive-compulsive disorder (OCD) in young people aged 12-18, using the principles of exposure and response prevention. The current paper presents the protocol for the development of the programme and for an open trial that will evaluate the effectiveness of this programme for OCD in young people, and associated distress and symptom accommodation in their parents and caregivers. We will measure the impact of the OCD? Not Me! programme on OCD symptoms using the Children's Florida Obsessive Compulsive Inventory (C-FOCI), and both the self-report and parent report of the Children's Obsessional Compulsive Inventory-Revised (ChOCI-R). The impact of the programme on OCD-related functional impairment will be measured using the parent report of the Child Obsessive-Compulsive Impact Scale-Revised (COIS-R). Secondary outcome measures include the Rosenberg Self-Esteem Scale and the Youth Quality of Life-Short Form (YQoL-SF). The 21-item Depression Anxiety Stress Scales (DASS-21) will be used to measure the impact of the programme on parent/caregiver distress, while the Family Accommodation Scale (FAS) will be used to measure change in family accommodation of OCD symptoms. Multilevel mixed effects linear regression will be used to analyse the impact of the intervention on the outcome measures. This study has been approved by the Curtin University Human Research Ethics Committee. The results of the study will be reported in international peer-reviewed journals. Australian New Zealand Clinical Trials Registry: ACTRN12613000152729. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

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

    Science.gov (United States)

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

    2017-01-01

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

  10. Evolution of gamma knife capsulotomy for intractable obsessive-compulsive disorder.

    Science.gov (United States)

    Miguel, Euripedes C; Lopes, Antonio C; McLaughlin, Nicole C R; Norén, Georg; Gentil, André F; Hamani, Clement; Shavitt, Roseli G; Batistuzzo, Marcelo C; Vattimo, Edoardo F Q; Canteras, Miguel; De Salles, Antonio; Gorgulho, Alessandra; Salvajoli, João Victor; Fonoff, Erich Talamoni; Paddick, Ian; Hoexter, Marcelo Q; Lindquist, Christer; Haber, Suzanne N; Greenberg, Benjamin D; Sheth, Sameer A

    2018-05-09

    For more than half a century, stereotactic neurosurgical procedures have been available to treat patients with severe, debilitating symptoms of obsessive-compulsive disorder (OCD) that have proven refractory to extensive, appropriate pharmacological, and psychological treatment. Although reliable predictors of outcome remain elusive, the establishment of narrower selection criteria for neurosurgical candidacy, together with a better understanding of the functional neuroanatomy implicated in OCD, has resulted in improved clinical efficacy for an array of ablative and non-ablative intervention techniques targeting the cingulum, internal capsule, and other limbic regions. It was against this backdrop that gamma knife capsulotomy (GKC) for OCD was developed. In this paper, we review the history of this stereotactic radiosurgical procedure, from its inception to recent advances. We perform a systematic review of the existing literature and also provide a narrative account of the evolution of the procedure, detailing how the procedure has changed over time, and has been shaped by forces of evidence and innovation. As the procedure has evolved and adverse events have decreased considerably, favorable response rates have remained attainable for approximately one-half to two-thirds of individuals treated at experienced centers. A reduction in obsessive-compulsive symptom severity may result not only from direct modulation of OCD neural pathways but also from enhanced efficacy of pharmacological and psychological therapies working in a synergistic fashion with GKC. Possible complications include frontal lobe edema and even the rare formation of delayed radionecrotic cysts. These adverse events have become much less common with new radiation dose and targeting strategies. Detailed neuropsychological assessments from recent studies suggest that cognitive function is not impaired, and in some domains may even improve following treatment. We conclude this review with

  11. Meta-Analysis of Intelligence Quotient (IQ) in Obsessive-Compulsive Disorder.

    Science.gov (United States)

    Abramovitch, Amitai; Anholt, Gideon; Raveh-Gottfried, Sagi; Hamo, Naama; Abramowitz, Jonathan S

    2018-03-01

    Obsessive compulsive disorder (OCD) is associated with a moderate degree of underperformance on cognitive tests, including deficient processing speed. However, despite little research focusing on Intelligence Quotient (IQ) in OCD, it has long been speculated that the disorder is associated with elevated intellectual capacity. The present meta-analytic study was, therefore, conducted to quantitatively summarize the literature on IQ in OCD systematically. We identified 98 studies containing IQ data among individuals with OCD and non-psychiatric comparison groups, and computed 108 effect sizes for Verbal IQ (VIQ, n = 55), Performance IQ (PIQ, n = 13), and Full Scale IQ (FSIQ, n = 40). Across studies, small effect sizes were found for FSIQ and VIQ, and a moderate effect size for PIQ, exemplifying reduced IQ in OCD. However, mean IQ scores across OCD samples were in the normative range. Moderator analyses revealed no significant moderating effect across clinical and demographic indices. We conclude that, although lower than controls, OCD is associated with normative FSIQ and VIQ, and relatively lowered PIQ. These results are discussed in light of neuropsychological research in OCD, and particularly the putative impact of reduced processing speed in this population. Recommendations for utilization of IQ tests in OCD, and directions for future studies are offered.

  12. Obsessive-compulsive disorder in African American children and adolescents: Risks, resiliency, and barriers to treatment.

    Science.gov (United States)

    Williams, Monnica T; Jahn, Matthew E

    2017-01-01

    Obsessive-compulsive disorder (OCD) is a serious condition that remains understudied in ethnoracial minority populations. The presence of OCD and the individual, familial, and cultural factors that influence this condition can interfere with healthy development and cause lifelong disability. To date, there has not been a single published research article focused on OCD in African American youth. Ethnic and racial minorities with OCD are underrepresented or altogether absent from treatment centers and research studies, although evidence suggests that OCD may be particularly persistent in these populations. This article reviews risk factors, protective factors, and barriers to treatment in African American children and adolescents with OCD. This review conceptualizes cultural differences in symptomology, low income, reduced access to care, racism, and mental health stigma, as risk factors. Also discussed are the roles of family factors in the development and maintenance of the disorder, including family accommodations, conflictual family communication, and parenting styles. Potential protective factors are also examined, including a positive ethnic identity, social support, present-centered time orientation, and religious communities. Implications of findings are discussed. There is an urgent need for research to understand the needs of African American children and adolescents with OCD. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  13. Is There A Role For Lifestyle Interventions In Obsessive-Compulsive And Related Disorders?

    Science.gov (United States)

    Fontenelle, Leonardo F; Quintas, Julliana N; Yücel, Murat

    2018-01-04

    Many of the currently available treatments for obsessive-compulsive and related disorders (OCRDs) such as pharmacotherapy augmentation strategies, partial hospitalization programs, deep brain stimulation, and neurosurgery are efficacious for individuals suffering from more severe forms of these conditions. Unfortunately, the application of these treatments in milder forms of illness and subclinical samples, which affect a substantial portion of the population, is not justifiable by their costs (e.g. cognitive-behavioral therapy) and/or potential for side effects (serotonin-reuptake inhibitors associated sexual side effects). As such, there is an urgent need to develop simple yet effective treatments, such as modifiable lifestyle interventions, that can be employed on a broader scale. Here, we review the current state of evidence that supports or refutes the efficacy of lifestyle approaches for OCRDs. We focus on dimensions of lifestyle that are deemed important for cardiovascular diseases; namely, physical activity, stress, sleep, diet and eating behaviors, alcohol consumption, and smoking. Despite the relative scarcity of well-designed randomized controlled trials targeting unhealthy life styles in OCRDs, we found meditation-based therapies and interventions focusing on eliminating sedentarism to be promising approaches. In the future, these strategies may represent valid alternative for subjects with subthreshold symptoms or at risk for OCRDs or other "compulsive" disorders. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  14. Memory and executive functioning in obsessive-compulsive disorder: a selective review.

    Science.gov (United States)

    Olley, Amanda; Malhi, Gin; Sachdev, Perminder

    2007-12-01

    The neurocognitive deficits that underlie the unique features of obsessive-compulsive disorder (OCD) are not yet completely understood. This paper reviews the main neuropsychological findings in memory and executive functioning in this disorder, and examines a number of challenges facing this area of research. A selective review of the neuropsychological literature on OCD was conducted using MEDLINE and drawing on literature known to the authors. The neuropsychological profile of OCD appears to be one of primary executive dysfunction. Although memory functioning may be affected, these deficits appear secondary to an executive failure of organizational strategies during encoding. On tasks of executive functioning patients with OCD demonstrate increased response latencies, perseveration of responses, and difficulties utilizing feedback to adapt to change. A statistical meta-analysis was not performed and only the cognitive domains of memory and executive functioning were examined. Given the prominence of chronic doubt and indecision in clinical settings, it is surprising that decision making as a cognitive construct as related to OCD has not received greater attention in the neuropsychological literature. On the basis of emerging literature we suggest that it is a potential area of dysfunction and one that warrants further investigation as it may assist in enhancing our understanding of the pathophysiology of OCD.

  15. An empirical investigation of incompleteness in a large clinical sample of obsessive compulsive disorder.

    Science.gov (United States)

    Sibrava, Nicholas J; Boisseau, Christina L; Eisen, Jane L; Mancebo, Maria C; Rasmussen, Steven A

    2016-08-01

    Obsessive Compulsive Disorder (OCD) is a disorder with heterogeneous clinical presentations. To advance our understanding of this heterogeneity we investigated the prevalence and clinical features associated with incompleteness (INC), a putative underlying core feature of OCD. We predicted INC would be prominent in individuals with OCD and associated with greater severity and impairment. We examined the impact of INC in 307 adults with primary OCD. Participants with clinically significant INC (22.8% of the sample) had significantly greater OCD severity, greater rates of comorbidity, poorer ratings of functioning, lower quality of life, and higher rates of unemployment and disability. Participants with clinically significant INC were also more likely to be diagnosed with OCPD and to endorse symmetry/exactness obsessions and ordering/arranging compulsions than those who reported low INC. Our findings provide evidence that INC is associated with greater severity, comorbidity, and impairment, highlighting the need for improved assessment and treatment of INC in OCD. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Abnormal white matter structural connectivity in adults with obsessive-compulsive disorder.

    Science.gov (United States)

    Gan, J; Zhong, M; Fan, J; Liu, W; Niu, C; Cai, S; Zou, L; Wang, Ya; Wang, Yi; Tan, C; Chan, R C K; Zhu, X

    2017-03-14

    Obsessive-compulsive disorder (OCD) is a complex and severe psychiatric disorder whose pathogenesis is not fully understood. Recent studies have shown white matter (WM) alterations in adults with OCD, but the results have been inconsistent. The present study investigated WM structure in OCD patients with the hypothesis that large-scale brain networks may be disrupted in OCD. A total of 24 patients with OCD and 23 healthy controls (HCs) were scanned with diffusion tensor imaging. A tract-based spatial statistics (TBSS) approach was used to detect differences across the whole brain in patients with OCD vs HCs; post hoc fiber tractography was applied to characterize developmental differences between the two groups. Relative to HCs, patients with OCD had lower fractional anisotropy (FA) values in the corpus callosum (CC), left anterior corona radiata (ACR), left superior corona radiata (SCR) and left superior longitudinal fasciculus (SLF), and higher radial diffusivity in the genu and body of CC. Among the TBSS de-projected region of interest results, compared with HCs, patients with OCD showed lower of the mean FA values of fiber bundles passing though the SLF, and shorter lengths of ACR, SCR and CC. In conclusion, this study provides novel evidence of widespread microstructural alterations in OCD and suggests that OCD may involve abnormalities affecting a broader network of regions than commonly believed.

  17. Adverse childhood experiences and gender influence treatment seeking behaviors in obsessive-compulsive disorder.

    Science.gov (United States)

    Benedetti, Francesco; Poletti, Sara; Radaelli, Daniele; Pozzi, Elena; Giacosa, Chiara; Smeraldi, Enrico

    2014-02-01

    Exposure to adverse childhood experiences (ACE) increases the risk of adult physical and mental health disorders, including obsessive-compulsive disorder (OCD), and influences adult brain structure and function. ACE could influence the use of psychotropic drugs in adulthood, and treatment seeking behaviors. We assessed the severity of ACE in a sample of 31 healthy controls and 66 patients with OCD who were consecutively referred for hospitalization and were either drug-naïve or drug-treated. In addition, we explored the possible clinical relevance of ACE with two additional analyses: (a) a discriminant function analysis with sex and ACE as factors, and (b) a logistic regression with use of medication as dependent variable and ACE as factor. Despite comparable age, years at school, age at onset of illness, duration of illness, and severity of illness (Y-BOCS), adult drug-naïve patients reported lower exposure to ACE and later contacts with mental health professionals than drug-treated. This effect was particularly evident in female patients compared to males. The interaction of gender with factors linked with the early familial environment biased access to psychiatric care and use of medication, independent of OCD-associated factors such as severity of symptoms or duration of illness. The need for medications of patients could be higher in families where OCD symptomatology is associated with ACE. © 2014.

  18. S1-3: Perception of Biological Motion in Schizophrenia and Obsessive-Compulsive Disorder

    Directory of Open Access Journals (Sweden)

    Jejoong Kim

    2012-10-01

    Full Text Available Major mental disorders including schizophrenia, autism, and obsessive-compulsive disorder (OCD are characterized by impaired social functioning regardless of wide range of clinical symptoms. Past studies also revealed that people with these mental illness exhibit perceptual problems with altered neural activation. For example, schizophrenia patients are deficient in processing rapid and dynamic visual stimuli. As well documented, people are very sensitive to motion signals generated by others (i.e., biological motion even when those motions are portrayed by point-light display. Therefore, ability to perceive biological motion is important for both visual perception and social functioning. Nevertheless, there have been no systematic attempts to investigate biological motion perception in people with mental illness associated with impaired social functioning until a decade ago. Recently, a series of studies newly revealed abnormal patterns of biological motion perception and associated neural activations in schizophrenia and OCD. These new achievements will be reviewed focusing on perceptual and neural difference between patients with schizophrenia/OCD and healthy individuals. Then implications and possible future research will be discussed in this talk.

  19. Dissociative symptoms and dissociative disorders comorbidity in obsessive compulsive disorder: Symptom screening, diagnostic tools and reflections on treatment.

    Science.gov (United States)

    Belli, Hasan

    2014-08-16

    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 experiences scale can be used for screening dissociative symptoms and detecting dissociative disorders in patients with OCD. However, a history of neglect and abuse during childhood is linked to a risk factor in the pathogenesis of dissociative psychopathology in adults. The childhood trauma questionnaire-53 and childhood trauma questionnaire-40 can be used for this purpose. Clinicians should not fail to notice the hidden dissociative symptoms and childhood traumatic experiences in OCD cases with severe symptoms that are resistant to treatment. Symptom screening and diagnostic tools used for this purpose should be known. Knowing how to treat these pathologies in patients who are diagnosed with OCD can be crucial.

  20. [Obsessive compulsive disorder and the internet. An evaluation of Dutch-language websites and quality indicators].

    Science.gov (United States)

    Serdobbel, Y; Pieters, G; Joos, S

    2006-01-01

    The Internet is an important source of information about health matters. The quality of the information about Obsessive Compulsive Disorder (OCD) has not been investigated. Possible indicators of quality are the DISCERN rating tool, Google PageRank and cooperation from health care professionals. To investigate the quality of the information given on Dutch-language websites relating to OCD and to determine whether the quality of the contents is correlated with site characteristics, scores on DISCERN and Google PageRank. We selected 27 Dutch-language websites via Google and Ixquick and investigated the correlation between the quality of the contents measured by 4 parameters and the presence of incorrect information, site characteristics, the DISCERN score and Google PageRank. The quality of the information was generally poor. The only investigated site characteristic that was found to be associated with basic criteria relating to symptoms and diagnosis was the size of the site. The DISCERN score was significantly correlated with the quality of the information. The occurrence of incorrect information was independent of the quality of the content, site characteristics, Google PageRank and DISCERN scores. The quality of Dutch-language websites on the subject of OCD is inadequate. Site characteristics and Google PageRank are not good predictors of the quality of information. The DISCERN rating tool is a potentially valuable indicator of content quality with regard to treatment options.

  1. A Selective Impairment in Attentional Disengagement from Erotica in Obsessive-Compulsive Disorder

    Science.gov (United States)

    Olatunji, Bunmi O.; Ciesielski, Bethany G.; Zald, David H.

    2011-01-01

    Although an attentional bias for threat has been implicated in obsessive-compulsive disorder (OCD), evidence supporting such a bias has been inconsistent. Furthermore, few studies have made distinctions between attentional capture vs. attentional disengagement and the extent to which different emotional content modulates attention in OCD also remains unclear. To address these issues, we examined patients with OCD (n = 30) and controls (n = 30) during an emotional attentional blink paradigm in which participants searched for a target embedded within a series of rapidly presented images. Critically, an erotic, fear, disgust, or neutral distracter image appeared 200 ms or 800 ms before the target. Impaired target detection was observed among OCD patients relative to controls following erotic distracters, but only when presented 800 ms, and not 200 ms, prior to the target, indicating difficulty with attentional disengagement. Difficulty disengaging from erotic images was significantly correlated with OCD symptoms in the full sample but not with symptoms of trait anxiety. These data delineate a specific information processing abnormality in OCD. PMID:21801779

  2. Assessment of executive functions in patients with obsessive compulsive disorder by NeuroVR.

    Science.gov (United States)

    La Paglia, Filippo; La Cascia, Caterina; Rizzo, Rosalinda; Riva, Giuseppe; La Barbera, Daniele

    2012-01-01

    Executive functions are often impaired in obsessive-compulsive disorder (OCD). We used a Virtual Reality version of the Multiple Errand Test (VMET) - developed dusing the free NeuroVR software (http://www.neurovr.org) - to evaluate the executive functions in daily life in 10 OCD patients and 10 controls. It is performed in a shopping setting where there are items to be bought and information to be obtained. The execution time for the whole task was higher in patients with OCD compared to controls, suggesting that patients with OCD need more time in planning than controls. The same difference was found in the partial errors during the task. Furthermore, the mean rank for and for interpretation failures is higher for controls, while the values of divided attention and the of self correction seems to be lower in controls. We think that obsessive patients tend to work with greater diligence and observance of rules than controls. In conclusion, these results provide initial support for the feasibility of VMET as assessment tool of executive functions. Specifically, the significant correlation found between the VMET and the neuropsychological battery support the ecological validity of VMET as an instrument for the evaluation of executive functions in patients with OCD.

  3. Neurological Soft Signs in Obsessive Compulsive Disorder: Standardised Assessment and Comparison with Schizophrenia

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    D. Bolton

    1999-01-01

    Full Text Available While several studies have detected raised levels of neurological soft signs in patients with obsessive compulsive disorder (OCD, the specificity of these abnormalities remains uncertain. This study used a new standardised measure, the Cambridge Neurological Inventory (CNI, to assess soft signs in 51 subjects with OCD. Comparison was made with data on patients with schizophrenia and a non-clinical control group from a previously reported study. Individuals with OCD showed raised levels of soft signs compared with non-clinical controls in many categories of the CNI: Motor Coordination, Sensory Integration, Primitive Reflexes, Extrapyramidal Signs, and Failure of Suppression. Compared with patients with schizophrenia, the OCD group had lower levels of neurological signs in some CNI categories: Hard Signs, Motor Co-ordination, Tardive Dyskinesia, Catatonic Signs, and Extrapyramidal Signs. However, levels of soft signs in the OCD group did not significantly differ from those in the schizophrenia group in other CNI categories: Sensory Integration, Primitive Reflexes and Failure of Suppression. The significance of these patterns of findings is discussed.

  4. Reduced prefrontal activation in pediatric patients with obsessive-compulsive disorder during verbal episodic memory encoding.

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    Batistuzzo, Marcelo Camargo; Balardin, Joana Bisol; Martin, Maria da Graça Morais; Hoexter, Marcelo Queiroz; Bernardes, Elisa Teixeira; Borcato, Sonia; Souza, Marina de Marco E; Querido, Cicero Nardini; Morais, Rosa Magaly; de Alvarenga, Pedro Gomes; Lopes, Antonio Carlos; Shavitt, Roseli Gedanke; Savage, Cary R; Amaro, Edson; Miguel, Euripedes C; Polanczyk, Guilherme V; Miotto, Eliane C

    2015-10-01

    Patients with obsessive-compulsive disorder (OCD) often present with deficits in episodic memory, and there is evidence that these difficulties may be secondary to executive dysfunction, that is, impaired selection and/or application of memory-encoding strategies (mediation hypothesis). Semantic clustering is an effective strategy to enhance encoding of verbal episodic memory (VEM) when word lists are semantically related. Self-initiated mobilization of this strategy has been associated with increased activity in the prefrontal cortex, particularly the orbitofrontal cortex, a key region in the pathophysiology of OCD. We therefore studied children and adolescents with OCD during uncued semantic clustering strategy application in a VEM functional magnetic resonance imaging (fMRI)-encoding paradigm. A total of 25 pediatric patients with OCD (aged 8.1-17.5 years) and 25 healthy controls (HC, aged 8.1-16.9) matched for age, gender, handedness, and IQ were evaluated using a block design VEM paradigm that manipulated semantically related and unrelated words. The semantic clustering strategy score (SCS) predicted VEM performance in HC (p semantic clustering in OCD. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

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

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

    2008-04-01

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

  6. Recruitment of a hidden population: African Americans with obsessive-compulsive disorder.

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    Williams, Monnica T; Proetto, Dante; Casiano, Delane; Franklin, Martin E

    2012-01-01

    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. Copyright © 2011 Elsevier Inc. All rights reserved.

  7. Obsessive-compulsive disorder in the perinatal period: epidemiology, phenomenology, pathogenesis, and treatment

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    Álvaro Frías

    2015-01-01

    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.

  8. Anxiety provocation and measurement using virtual reality in patients with obsessive-compulsive disorder.

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    Kim, Kwanguk; Kim, Chan-Hyung; Cha, Kyung Ryeol; Park, Junyoung; Han, Kiwan; Kim, Yun Ki; Kim, Jae-Jin; Kim, In Young; Kim, Sun I

    2008-12-01

    The current study is a preliminary test of a virtual reality (VR) anxiety-provoking tool using a sample of participants with obsessive-compulsive disorder (OCD). The tasks were administrated to 33 participants with OCD and 30 healthy control participants. In the VR task, participants navigated through a virtual environment using a joystick and head-mounted display. The virtual environment consisted of three phases: training, distraction, and the main task. After the training and distraction phases, participants were allowed to check (a common OCD behavior) freely, as they would in the real world, and a visual analogy scale of anxiety was recorded during VR. Participants' anxiety in the virtual environment was measured with a validated measure of psychiatric symptoms and functions and analyzed with a VR questionnaire. Results revealed that those with OCD had significantly higher anxiety in the virtual environment than did healthy controls, and the decreased ratio of anxiety in participants with OCD was also higher than that of healthy controls. Moreover, the degree of anxiety of an individual with OCD was positively correlated with a his or her symptom score and immersive tendency score. These results suggest the possibility that VR technology has a value as an anxiety-provoking or treatment tool for OCD.

  9. Default network connectivity as a vulnerability marker for obsessive compulsive disorder.

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    Peng, Z W; Xu, T; He, Q H; Shi, C Z; Wei, Z; Miao, G D; Jing, J; Lim, K O; Zuo, X N; Chan, R C K

    2014-05-01

    Aberrant functional connectivity within the default network is generally assumed to be involved in the pathophysiology of obsessive compulsive disorder (OCD); however, the genetic risk of default network connectivity in OCD remains largely unknown. Here, we systematically investigated default network connectivity in 15 OCD patients, 15 paired unaffected siblings and 28 healthy controls. We sought to examine the profiles of default network connectivity in OCD patients and their siblings, exploring the correlation between abnormal default network connectivity and genetic risk for this population. Compared with healthy controls, OCD patients exhibited reduced strength of default network functional connectivity with the posterior cingulate cortex (PCC), and increased functional connectivity in the right inferior frontal lobe, insula, superior parietal cortex and superior temporal cortex, while their unaffected first-degree siblings only showed reduced local connectivity in the PCC. These findings suggest that the disruptions of default network functional connectivity might be associated with family history of OCD. The decreased default network connectivity in both OCD patients and their unaffected siblings may serve as a potential marker of OCD.

  10. Obsessive compulsive disorder networks: positron emission tomography and neuropsychology provide new insights.

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    Bruno Millet

    Full Text Available BACKGROUND: Deep brain stimulation has shed new light on the central role of the prefrontal cortex (PFC in obsessive compulsive disorder (OCD. We explored this structure from a functional perspective, synchronizing neuroimaging and cognitive measures. METHODS AND FINDINGS: This case-control cross-sectional study compared 15 OCD patients without comorbidities and not currently on serotonin reuptake inhibitors or cognitive behavioural therapy with 15 healthy controls (matched for age, sex and education level on resting-state (18FDG-PET scans and a neuropsychological battery assessing executive functions. We looked for correlations between metabolic modifications and impaired neuropsychological scores. Modifications in glucose metabolism were found in frontal regions (orbitofrontal cortex and dorsolateral cortices, the cingulate gyrus, insula and parietal gyrus. Neuropsychological differences between patients and controls, which were subtle, were correlated with the metabolism of the prefrontal, parietal, and temporal cortices. CONCLUSION: As expected, we confirmed previous reports of a PFC dysfunction in OCD patients, and established a correlation with cognitive deficits. Other regions outside the prefrontal cortex, including the dorsoparietal cortex and the insula, also appeared to be implicated in the pathophysiology of OCD, providing fresh insights on the complexity of OCD syndromes.

  11. Obsessive Compulsive Disorder Networks: Positron Emission Tomography and Neuropsychology Provide New Insights

    Science.gov (United States)

    Millet, Bruno; Dondaine, Thibaut; Reymann, Jean-Michel; Bourguignon, Aurélie; Naudet, Florian; Jaafari, Nematollah; Drapier, Dominique; Turmel, Valérie; Mesbah, Habiba; Vérin, Marc; Le Jeune, Florence

    2013-01-01

    Background Deep brain stimulation has shed new light on the central role of the prefrontal cortex (PFC) in obsessive compulsive disorder (OCD). We explored this structure from a functional perspective, synchronizing neuroimaging and cognitive measures. Methods and Findings This case-control cross-sectional study compared 15 OCD patients without comorbidities and not currently on serotonin reuptake inhibitors or cognitive behavioural therapy with 15 healthy controls (matched for age, sex and education level) on resting-state 18FDG-PET scans and a neuropsychological battery assessing executive functions. We looked for correlations between metabolic modifications and impaired neuropsychological scores. Modifications in glucose metabolism were found in frontal regions (orbitofrontal cortex and dorsolateral cortices), the cingulate gyrus, insula and parietal gyrus. Neuropsychological differences between patients and controls, which were subtle, were correlated with the metabolism of the prefrontal, parietal, and temporal cortices. Conclusion As expected, we confirmed previous reports of a PFC dysfunction in OCD patients, and established a correlation with cognitive deficits. Other regions outside the prefrontal cortex, including the dorsoparietal cortex and the insula, also appeared to be implicated in the pathophysiology of OCD, providing fresh insights on the complexity of OCD syndromes. PMID:23326403

  12. Think twice: Impulsivity and decision making in obsessive-compulsive disorder.

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    Grassi, Giacomo; Pallanti, Stefano; Righi, Lorenzo; Figee, Martijn; Mantione, Mariska; Denys, Damiaan; Piccagliani, Daniele; Rossi, Alessandro; Stratta, Paolo

    2015-12-01

    Recent studies have challenged the anxiety-avoidance model of obsessive-compulsive disorder (OCD), linking OCD to impulsivity, risky-decision-making and reward-system dysfunction, which can also be found in addiction and might support the conceptualization of OCD as a behavioral addiction. Here, we conducted an exploratory investigation of the behavioral addiction model of OCD by assessing whether OCD patients are more impulsive, have impaired decision-making, and biased probabilistic reasoning, three core dimensions of addiction, in a sample of OCD patients and healthy controls. We assessed these dimensions on 38 OCD patients and 39 healthy controls with the Barratt Impulsiveness Scale (BIS-11), the Iowa Gambling Task (IGT) and the Beads Task. OCD patients had significantly higher BIS-11 scores than controls, in particular on the cognitive subscales. They performed significantly worse than controls on the IGT preferring immediate reward despite negative future consequences, and did not learn from losses. Finally, OCD patients demonstrated biased probabilistic reasoning as reflected by significantly fewer draws to decision than controls on the Beads Task. OCD patients are more impulsive than controls and demonstrate risky decision-making and biased probabilistic reasoning. These results might suggest that other conceptualizations of OCD, such as the behavioral addiction model, may be more suitable than the anxiety-avoidance one. However, further studies directly comparing OCD and behavioral addiction patients are needed in order to scrutinize this model.

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

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

    2017-08-01

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

  14. Brain structural alterations in obsessive-compulsive disorder patients with autogenous and reactive obsessions.

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    Marta Subirà

    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.

  15. Abnormal small-world brain functional networks in obsessive-compulsive disorder patients with poor insight.

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    Lei, Hui; Cui, Yan; Fan, Jie; Zhang, Xiaocui; Zhong, Mingtian; Yi, Jinyao; Cai, Lin; Yao, Dezhong; Zhu, Xiongzhao

    2017-09-01

    There are limited data on neurobiological correlates of poor insight in obsessive-compulsive disorder (OCD). This study explored whether specific changes occur in small-world network (SWN) properties in the brain functional network of OCD patients with poor insight. Resting-state electroencephalograms (EEGs) were recorded for 12 medication-free OCD patients with poor insight, 50 medication-free OCD patients with good insight, and 36 healthy controls. Both of the OCD groups exhibited topological alterations in the brain functional network characterized by abnormal small-world parameters at the beta band. However, the alterations at the theta band only existed in the OCD patients with poor insight. A relatively small sample size. Subjects were naïve to medications and those with Axis I comorbidity were excluded, perhaps limiting generalizability. Disrupted functional integrity at the beta bands of the brain functional network may be related to OCD, while disrupted functional integrity at the theta band may be associated with poor insight in OCD patients, thus this study might provide novel insight into our understanding of the pathophysiology of OCD. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Abnormal resting-state functional connectivity of the left caudate nucleus in obsessive-compulsive disorder.

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    Chen, Yunhui; Juhás, Michal; Greenshaw, Andrew J; Hu, Qiang; Meng, Xin; Cui, Hongsheng; Ding, Yongzhuo; Kang, Lu; Zhang, Yubo; Wang, Yuhua; Cui, Guangcheng; Li, Ping

    2016-06-03

    Altered brain activities in the cortico-striato-thalamocortical (CSTC) circuitry are implicated in the pathophysiology of obsessive-compulsive disorder (OCD). However, whether the underlying changes occur only within this circuitry or in large-scale networks is still not thoroughly understood. This study performed voxel-based functional connectivity analysis on resting-state functional magnetic resonance imaging (fMRI) data from thirty OCD patients and thirty healthy controls to investigate whole-brain intrinsic functional connectivity patterns in OCD. Relative to the healthy controls, OCD patients showed decreased functional connectivity within the CSTC circuitry but increased functional connectivity in other brain regions. Furthermore, decreased left caudate nucleus-thalamus connectivity within the CSTC circuitry was positively correlated with the illness duration of OCD. This study provides additional evidence that CSTC circuitry may play an essential role and alteration of large-scale brain networks may be involved in the pathophysiology of OCD. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Organizational strategies mediate nonverbal memory impairment in obsessive-compulsive disorder.

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    Savage, C R; Baer, L; Keuthen, N J; Brown, H D; Rauch, S L; Jenike, M A

    1999-04-01

    Previous neuropsychological studies of obsessive-compulsive disorder (OCD) have indicated impaired executive functioning and nonverbal memory. The extent to which impaired executive functioning impacts nonverbal memory has not been established. The current study investigated the mediating effects of organizational strategies used when copying a figure on subsequent nonverbal memory for that figure. We examined neuropsychological performance in 20 unmedicated subjects with OCD and 20 matched normal control subjects. Subjects were administered the Rey-Osterrieth Complex Figure Test (RCFT) and neuropsychological tests assessing various aspects of executive function. OCD subjects differed significantly from healthy control subjects in the organizational strategies used to copy the RCFT figure, and they recalled significantly less information on both immediate and delayed testing. Multiple regression analyses indicated that group differences in immediate percent recall were significantly mediated by copy organizational strategies. Further exploratory analyses indicated that organizational problems in OCD may be related to difficulties shifting mental and/or spatial set. Immediate nonverbal memory problems in OCD subjects were mediated by impaired organizational strategies used during the initial copy of the RCFT figure. Thus, the primary deficit was one affecting executive function, which then had a secondary effect on immediate memory. These findings are consistent with current theories proposing frontal-striatal system dysfunction in OCD.

  18. Training interpretation biases among individuals with symptoms of obsessive compulsive disorder.

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    Clerkin, Elise M; Teachman, Bethany A

    2011-09-01

    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 interpretations and subsequent emotional vulnerability to an OC stressor. A nonclinical sample of students high in OC symptoms completed either a Positive (n = 50) or Neutral (n = 50) interpretation training procedure designed to alter OC-relevant interpretations and beliefs. As expected, participants in the Positive (versus Neutral) training condition endorsed healthier OC-relevant interpretations and beliefs following training. Additionally, when controlling for baseline affect, participants in the Positive (versus Neutral) training condition reported less negative affect during the OC-stressor task (at the level of a non-significant trend) and reported less desire to perform neutralizing activities. In general, results provide some support for cognitive models of obsessions and suggest that negative interpretations of intrusive thoughts may be causally related to symptoms of OCD. Published by Elsevier Ltd.

  19. Symptom dimensions in obsessive-compulsive disorder: phenomenology and treatment outcomes with exposure and ritual prevention.

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    Williams, Monnica T; Mugno, Beth; Franklin, Martin; Faber, Sonya

    2013-01-01

    Obsessive-compulsive disorder (OCD) is a severe condition with varied symptom presentations. Currently, the cognitive-behavioral treatment with the most empirical support is exposure and ritual prevention (EX/RP); however, clinical impression and some empirical data suggest that certain OCD symptoms are more responsive to treatment than others. Prior work identifying symptom dimensions within OCD is discussed, including epidemiological findings, factor analytic studies, and biological findings. Symptom dimensions most reliably identified include contamination/cleaning, doubt about harm/checking, symmetry/ordering, and unacceptable thoughts/mental rituals. The phenomenology of each of these subtypes is described and research literature is summarized, emphasizing the differential effects of EX/RP and its variants on each of these primary symptom dimensions. To date it appears that EX/RP is an effective treatment for the various OCD dimensions, although not all dimensions have been adequately studied (i.e. symmetry and ordering). Modifications to treatment may be warranted for some types of symptoms. Clinical implications and directions for future research are discussed. Copyright © 2013 S. Karger AG, Basel.

  20. Performance monitoring and error significance in patients with obsessive-compulsive disorder.

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    Endrass, Tanja; Schuermann, Beate; Kaufmann, Christan; Spielberg, Rüdiger; Kniesche, Rainer; Kathmann, Norbert

    2010-05-01

    Performance monitoring has been consistently found to be overactive in obsessive-compulsive disorder (OCD). The present study examines whether performance monitoring in OCD is adjusted with error significance. Therefore, errors in a flanker task were followed by neutral (standard condition) or punishment feedbacks (punishment condition). In the standard condition patients had significantly larger error-related negativity (ERN) and correct-related negativity (CRN) ampliudes than controls. But, in the punishment condition groups did not differ in ERN and CRN amplitudes. While healthy controls showed an amplitude enhancement between standard and punishment condition, OCD patients showed no variation. In contrast, group differences were not found for the error positivity (Pe): both groups had larger Pe amplitudes in the punishment condition. Results confirm earlier findings of overactive error monitoring in OCD. The absence of a variation with error significance might indicate that OCD patients are unable to down-regulate their monitoring activity according to external requirements. Copyright 2010 Elsevier B.V. All rights reserved.

  1. Neurocognitive deficits in obsessive compulsive disorder: A state or trait phenomenon?

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    Sachin Sharma

    2014-01-01

    Full Text Available Background: Studies have shown that in obsessive-compulsive disorder (OCD, there is impairment of neurocognitive functioning during the symptomatic phase. However, studies that explore the "state or trait" dependent nature of these neurocognitive deficits are largely lacking. By comparing the neuropsychological functions of the clinical and subclinical group of OCD patients and healthy controls; we tried to establish whether neuropsychological deficits in OCD were "state" dependent or independent. Materials and Methods: Twenty "mild to moderate" OCD patients, 15 subclinical (remitted OCD patients, and 20 matched healthy controls were compared and assessed on computerized battery of neuropsychological tests including Wisconsin card sorting test, continuous performance test, and spatial working memory test. The observations were statistically analyzed. Results: Executive functions in both the subclinical and clinical groups performed poorly when compared to healthy controls. The patient groups made significantly more wrong responses, more missed responses and took more time to respond. On the test of spatial working memory, the mild to moderate OCD patients showed significant impairment, but not the subclinical patients group. Conclusion: Thus, we conclude that cognitive dysfunctions are core and enduring deficits of OCD, they seem to continue into the subclinical- well state. Certain cognitive deficits, depending on their presence or absence in subclinical cases, may be identified as "state" or "trait" markers of OCD.

  2. Efficacy of cognitive-behavioral therapy for obsessive-compulsive disorder.

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    McKay, Dean; Sookman, Debbie; Neziroglu, Fugen; Wilhelm, Sabine; Stein, Dan J; Kyrios, Michael; Matthews, Keith; Veale, David

    2015-05-30

    Cognitive-behavioral therapy (CBT), which encompasses exposure with response prevention (ERP) and cognitive therapy (CT), has demonstrated efficacy in the treatment of obsessive-compulsive disorder (OCD). However, the samples studied (reflecting the heterogeneity of OCD), the interventions examined (reflecting the heterogeneity of CBT), and the definitions of treatment response vary considerably across studies. This review examined the meta-analyses conducted on ERP and cognitive therapy (CT) for OCD. Also examined was the available research on long-term outcome associated with ERP and CT. The available research indicates that ERP is the first line evidence based psychotherapeutic treatment for OCD and that concurrent administration of cognitive therapy that targets specific symptom-related difficulties characteristic of OCD may improve tolerance of distress, symptom-related dysfunctional beliefs, adherence to treatment, and reduce drop out. Recommendations are provided for treatment delivery for OCD in general practice and other service delivery settings. The literature suggests that ERP and CT may be delivered in a wide range of clinical settings. Although the data are not extensive, the available research suggests that treatment gains following ERP are durable. Suggestions for future research to refine therapeutic outcome are also considered. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Plasma Levels of Tumor Necrosis Factor-Alpha and Interleukin-6 in Obsessive Compulsive Disorder

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    N. Konuk

    2007-01-01

    Full Text Available Aim. Recent research implicated place of an immune mechanism in the pathophysiology of obsessive-compulsive disorder (OCD. Despite increasing evidence involvement of cytokine release in OCD, results of the studies are inconsistent. The aim of this study was to evaluate the plasma levels of the cytokines; tumor necrosis factor-alpha (TNF-α and interleukin-6 (IL-6 in OCD patients. Methods. Plasma concentrations of TNF-α and IL-6 were measured in 31 drug-free outpatients with OCD, and 31-year age and sex-matched healthy controls. TNF-α and IL-6 concentrations in blood were determined by enzyme-linked immunosorbent assay (ELISA. Results. Both TNF-α and IL-6 levels showed statistically significant increases in OCD patients compared to controls (P<.000, P<.001, resp.. In addition, the age of onset was negatively correlated with TNF-α level (r=−.402, P=.025 and duration of illness was weakly correlated with IL-6 levels (r:.357; P:.048 in patients group. Conclusion. OCD patients showed increases in TNF-α and IL-6 levels compared to the healthy controls. This study provides evidence for alterations in the proinflamatory cytokines which suggest the involvement of the immune system in the pathophysiology of OCD.

  4. Study of regional cerebral blood flow in obsessive compulsive disorder patients with SPM and ROI method

    International Nuclear Information System (INIS)

    Li Peiyong; Jiang Xufeng; Zhang Liying; Guo Wanhua; Zhu Chengmo

    2002-01-01

    Objective: To investigate the alternations in regional cerebral blood flow (rCBF) in obsessive compulsive disorder (OCD) patients using statistical parametric mapping (SPM). Methods: rCBF measurements using 99 Tc m -ethyl cysteinate dimer (ECD) SPECT was performed on 14 OCD patients and 23 age-matched healthy volunteers. The rCBF distribution was compared between these two groups with SPM under the conditions of increased and decreased perfusion, and with regions of interest (ROIs) using cerebral template. P value was set at 0.01 level. Results: SPM analysis showed that rCBF decreased in cerebral areas including bilateral putamen, superior temporal gyrus and precuneus, and right orbital gyrus, superior and middle frontal gyrus, and left temporo-occipital lobule and superior parietal gyrus, and vermis. rCBF was also increased in left inferior frontal gyrus and posterior cingulate gyrus. With ROIs method, rCBF was decreased in right anterior frontal, temporo-parietal lobule and left temporo-occipital lobule. Conclusions: The study supports the viewpoint that rCBF abnormality of fronto-striatal circuits is involved in OCD patients. SPM method is a forceful tool in analyzing cerebral regional characters