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Fineberg, Naomi A., Punita Sharma, Thanusha Sivakumaran, Barbara Sahakian, and Sam Chamberlain. "Does Obsessive-Compulsive Personality Disorder Belong Within the Obsessive-Compulsive Spectrum?" CNS Spectrums 12, no. 6 (June 2007): 467–82. http://dx.doi.org/10.1017/s1092852900015340.
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ABSTRACTIt has been proposed that certainDiagnostic and Statistical Manual of Mental Disorders, Fourth EditionAxis 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.
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Hollander, Eric, Suah Kim, Sumant Khanna, and Stefano Pallanti. "Obsessive-Compulsive Disorder and Obsessive-Compulsive Spectrum Disorders: Diagnostic and Dimensional Issues." CNS Spectrums 12, S3 (February 2007): 5–13. http://dx.doi.org/10.1017/s1092852900002467.
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AbstractAlthough obsessive-compulsive disorder (OCD) is classified as an anxiety disorder in the DSM-IV, recent considerations for a reclassification into an obsessive-compulsive spectrum disorders (OCSDs) cluster are gaining prominence. Similarities in symptomatology, course of illness, patient population, and neurocircuitry of OCD and OCSD are supported by comorbidity, family, and neurological studies, which also offer a critical re-evaluation of the relationship between OCD and anxiety disorders. This review examines potential classifications of OCD among the wider spectrum of affective disorders and at the interface between affective disorders and addiction. In addition, it has been suggested that the categorical diagnostic approach would be enhanced by an additional dimensional approach, including parameters such as stability of mood and ability to sustain attention. With further studies, it is ultimately the goal to define OCD and related disorders based on endophenotypes.Despite efforts in this field, there are several fundamental unresolved issues, including the question of which disorders should be grouped together in this category and which characteristics to include as their shared common features. A reclassification of OCD among the OCSDs would allow for better scrutiny of distinct obsessive-compulsive symptoms, as currently this disorder often goes undetected in patients who complain of a broad symptom of anxiety. Advantages and disadvantages of establishing OCSDs and its implications for diagnosis, treatment, and research are discussed.
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Fineberg, Naomi A., Sanjaya Saxena, Joseph Zohar, and Kevin J. Craig. "Obsessive-Compulsive Disorder: Boundary Issues." CNS Spectrums 12, no. 5 (May 2007): 359–75. http://dx.doi.org/10.1017/s1092852900021167.
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ABSTRACTThe boundaries between obsessive-compulsive disorder (OCD) and other neuropsychiatric disorders remain unresolved and may well differ from one disorder to another. Endophenotypes are heritable, quantitative traits hypothesized to more closely represent genetic risk for complex polygenic mental disorders than overt symptoms and behaviors. They may have a role in identifying how closely these disorders are associated with another and with other mental disorders with which they share major comorbidity. This review maps the nosological relationships of OCD to other neuropsychiatric disorders, using OCD as the prototype disorder and endophenotype markers, such as cognitive, imaging, and molecular data as well as results from demographic, comorbidity, family, and treatment studies. Despite high comorbidity rates, emerging evidence suggests substantial endophenotypic differences between OCD and anxiety disorders, depression, schizophrenia, and addictions, though comparative data is lacking and the picture is far from clear. On the other hand, strong relationships between OCD, Tourette syndrome, body dysmorphic disorder, hypochondriasis, grooming disorders, obsessive-compulsive personality disorder, and pediatric autoimmune neuropsychiatric disorders associated with streptococcus are likely. Studies designed to delineate the cause, consequences, and common factors are a challenging but essential goal for future research in this area.
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Ramalho e Silva, F., C. Branco, and A. E. Ribeiro. "Revisiting the Obsessive-compulsive Spectrum." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)70772-2.
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In the DSM IV-TR, Obsessive-Compulsive Disorder (OCD) is categorized as an anxiety disorder. A wide range of psychiatric and medical disorders, not included in this category, has been hypothesized to be related to OCD and to form a family of disorders known as obsessive compulsive spectrum disorders (OCSD). OCSD would include several clinically heterogeneous disorders such as Body Dysmorphic Disorder, Tourette's Syndrome or Pathological Gambling. This construct is based on disorders’ similarities with OCD in a variety of domains such as phenomenology, comorbidity, neurotransmitter or peptide systems, neurocircuitry, family history, genetic factors and treatment response. This presentation provides an overview of the existing literature regarding the concept of the OCD spectrum and the relationships between the disorders included in OCSD. Although there are data supporting the inclusion of some disorders in the OC spectrum, more research is needed to clarify the relationships and the boundaries between these disorders. Ultimately, a better understanding of OC spectrum may have significant implications for clinical practice.
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Gordon, Olivia M., Paul M. Salkovskis, and Victoria Bream. "The Impact of Obsessive Compulsive Personality Disorder on Cognitive Behaviour Therapy for Obsessive Compulsive Disorder." Behavioural and Cognitive Psychotherapy 44, no. 4 (October 13, 2015): 444–59. http://dx.doi.org/10.1017/s1352465815000582.
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Background: 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. Aims: 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. Method: 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. Results: 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. Conclusion: 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.
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Stein, D. J. "Obsessive compulsive disorder." South African Journal of Psychiatry 19, no. 3 (August 30, 2013): 7. http://dx.doi.org/10.4102/sajpsychiatry.v19i3.951.
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This guideline focuses on the pharmacotherapy of obsessive compulsive disorder(OCD). OCD is characterised by obsessions and<div style="left: 70.8662px; top: 364.72px; font-size: 15.45px; font-family: serif; transform: scaleX(0.99966);" data-canvas-width="420.56549999999993">compulsions. A number of other disorders are also characterised by</div><div style="left: 70.8662px; top: 384.72px; font-size: 15.45px; font-family: serif; transform: scaleX(0.97309);" data-canvas-width="419.07749999999993">repetitive thoughts and rituals and may also respond to modifications</div>of standard OCD treatment.
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Black, Donald W. "Obsessive-Compulsive Disorder and Its Potential Subtypes." CNS Spectrums 5, S4 (June 2000): 40–46. http://dx.doi.org/10.1017/s1092852900025037.
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AbstractThis manuscript summarizes presentations by an international panel of experts, representing Brazil, Israel, Italy, Mexico, Portugal, Spain, and the United States, at a symposium on obsessive-compulsive disorder (OCD) and its possible subtypes. Presentations concerned both OCD proper, as well as putative obsessive-compulsive-spectrum disorders (autistic disorders, eating disorders, pathological gambling, and schizo-obsessive disorder). Projects discussed included a study assessing impulsive temperament in eating disorder patients, a study on serotonin receptor sensitivity in autism, a study of sleep EEG abnormalities in OCD, a study of dissociation in pathological gamblers, papers on aspects of schizo-obsessive patients, a study addressing biological alterations in OCD, data from a new family study on OCD, data from a molecular genetic study of OCD, a factor analytic study of Tourette disorder, a study hypothesizing the existence of an OCD continuum, and, finally, a paper on early- vs late-onset OCD. General discussion followed leading to a consensus that 1) OCD is likely heterogeneous with multiple subtypes; 2) division of patients by age-at-onset probably represents a robust and valid subtyping scheme; 3) the presence of schizophrenic features probably identifies a valid subtype; 4) the validation of subtypes in the future will be informed by both family-genetic studies, as well as studies of biological alterations in OCD; and 5) the study of obsessive-compulsive spectrum disorders adds to our understanding of the OCD phenomenon, and helps in our search to identify valid subtypes.
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Zohar, Joseph. "From Obsessive-Compulsive Spectrum to Obsessive-Compulsive Disorders: The Cape Town Consensus Statement." CNS Spectrums 12, S3 (February 2007): 4. http://dx.doi.org/10.1017/s1092852900002455.
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In awareness of recent developments and upcoming future changes in the conceptualization of obsessive-compulsive disorders (OCDs), a group of 14 experts with specific experience in this area decided that a consensus statement on the present and future of OCD is timely. The group, with their long-term interest and productivity in the area of OCD, met with the specific aim of providing a global perspective. Ten countries from four continents were represented in this 2-day consensus meeting.The meeting took place in Cape Town on February 27–28, 2006. The participants were asked to prepare and submit a relevant presentation before the meeting in order to enrich the discussion. Six presentations reviewed the following aspects of OCD: diagnosis, epidemiology, neurobiology, treatment, special populations, and pediatric OCD. A draft consensus was prepared, based on the presentations, recent consensus statements, evidence-based guidelines, and the ensuing discussions.
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Pena-Garijo, Josep, Silvia Edo Villamón, Amanda Meliá de Alba, and M. Ángeles Ruipérez. "Personality Disorders in Obsessive-Compulsive Disorder: A Comparative Study versus Other Anxiety Disorders." Scientific World Journal 2013 (2013): 1–7. http://dx.doi.org/10.1155/2013/856846.
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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.
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Krzyszkowiak, Waldemar, Małgorzata Kuleta-Krzyszkowiak, and Eliza Krzanowska. "Treatment of Obsessive-Compulsive Disorders (OCD) and Obsessive-Compulsive-Related Disorders (OCRD)." Psychiatria Polska 53, no. 4 (August 31, 2019): 825–43. http://dx.doi.org/10.12740/pp/105130.
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Hollander, Eric, and Jennifer Rosen. "OC Spectrum Disorders: The Impulsive and Schizo-Obsessive Clusters." CNS Spectrums 4, S3 (May 1999): 16–21. http://dx.doi.org/10.1017/s1092852900007379.
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AbstractTwo symptom clusters within the obsessive-compulsive (OC) spectrum—the impulsive cluster and the schizo-obsessive cluster—are discussed in this paper. Disorders characterized by impulsivity include disorders of impulse control (eg, intermittent explosive disorder, pyromania, kleptomania, pathologic gambling, trichotillomania); paraphilias, sexual impulsions, and sexual addictions; and impulsive aggression personality disorders (eg, borderline, antisocial, histrionic, and narcissistic personality disorders). The schizo-obsessive cluster includes comorbid symptoms of obsessive-compulsive disorder (OCD) and schizophrenia. Both clusters of disorders have a substantial impact on individuals and society. This article examines the overlap of symptoms between OCD and OC spectrum disorders, along with possible treatment options. Studies on the effectiveness of serotonin reuptake inhibitors in treating pathologic gambling, compulsive buying, and comorbid OCD and schizophrenia are presented. The need for additional large scale, adequately-controlled studies is discussed.
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Bokor, Gyula, and Peter D. Anderson. "Obsessive–Compulsive Disorder." Journal of Pharmacy Practice 27, no. 2 (February 27, 2014): 116–30. http://dx.doi.org/10.1177/0897190014521996.
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Obsessive–compulsive disorder (OCD) is a common heterogeneous psychiatric disorder manifesting with obsessions and compulsions. Obsessions are intrusive, recurrent, and persistent unwanted thoughts. Compulsions are repetitive behaviors or mental acts that an individual feels driven to perform in response to the obsessions. The heterogeneity of OCD includes themes of obsessions, types of rituals, presence or absence of tics, etiology, genetics, and response to pharmacotherapy. Complications of OCD include interpersonal difficulties, unemployment, substance abuse, criminal justice issues, and physical injuries. Areas of the brain involved in the pathophysiology include the orbitofrontal cortex, anterior cingulate gyrus, and basal ganglia. Overall, OCD may be due to a malfunction in the cortico–striato–thalamo–cortical circuit in the brain. Neurotransmitters implicated in OCD include serotonin, dopamine, and glutamate. Numerous drugs such as atypical antipsychotics and dopaminergic agents can cause or exacerbate OCD symptoms. The etiology includes genetics and neurological insults. Treatment of OCD includes psychotherapy, pharmacotherapy, electroconvulsive therapy, transcranial magnetic simulation, and in extreme cases surgery. Exposure and response prevention is the most effective form of psychotherapy. Selective serotonin reuptake inhibitors (SSRIs) are the preferred pharmacotherapy. Higher doses than listed in the package insert and a longer trial are often needed for SSRIs than compared to other psychiatric disorders. Alternatives to SSRIs include clomipramine and serotonin/norepinephrine reuptake inhibitors. Treatment of resistant cases includes augmentation with atypical antipsychotics, pindolol, buspirone, and glutamate-blocking agents.
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Black, Donald W. "Anxiety and the Spectrum of Obsessive-Compulsive Disorder." CNS Spectrums 13, S14 (2008): 4–5. http://dx.doi.org/10.1017/s1092852900026870.
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This supplement to CNS Spectrums focuses on the obsessive-compulsive spectrum of disorders and their relationship to anxiety. Hollander and others pioneered the concept of the obsessive-compulsive spectrum in the early 1990s, and have described its breadth and overlap with other psychiatric disorders. While its place in the psychiatric nomenclature is uncertain, the obsessive-compulsive spectrum is intertwined with the anxiety disorders in both its symptoms and biologic substrates.Obsessive-compulsive disorder (OCD) has an important place at the center of the spectrum. While currently classified in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition as an anxiety disorder, OCD is distinct from these conditions in the International Classification of Diseases. There is a strong rationale for its separation from the anxiety disorders. First, OCD often begins in childhood, whereas other anxiety disorders typically have a later age of onset. OCD has a nearly equal gender distribution, unlike the other anxiety disorders, which are more common in women. Studies of psychiatric comorbidity show that, unlike the other anxiety disorders, persons with OCD generally tend not to have elevated rates of substance misuse. Family studies suggest that first-degree relatives of persons with OCD have an elevated prevalence of OCD-related disorders including body dysmorphic disorder, hypochondriasis, and grooming disorders, but not other anxiety disorders except for generalized anxiety disorder. The brain circuitry that mediates OCD appears to be different from that involved in other anxiety disorders. Lastly, OCD is unique with regard to its specific response to selective serotonin reuptake inhibitors, while noradrenergic medications, effective in the anxiety and mood disorders, are largely ineffective. On the other hand, the benzodiazepines, which have little effect on OCD, are often effective for the other anxiety disorders.
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Rady, A., H. Salama, M. Hamza, and A. Ketat. "Cross sectional study of psychiatric comorbidities among adolescents with obsessive compulsive symptoms." European Psychiatry 26, S2 (March 2011): 566. http://dx.doi.org/10.1016/s0924-9338(11)72273-8.
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BackgroundObsessive symptoms among children and adolescent age groups are increasing, an observation made by mental health professions working with this age group. Our epidemiological study is targeting secondary school students to estimate the prevalence of obsessive symptoms, obsessive compulsive disorder and to evaluate psychiatric comorbidities among students with obsessive compulsive symptoms.Materials and methodsThe study is a cross sectional carried on 1299 secondary school students, the sample size was chosen based on an estimated OCD prevalence of 2% in literature. Equal samples were recruited from the 3 educative zones in Alexandria Governorate. Obsessive compulsive symptoms were assessed by the Arabic version of Lyeton obsessive inventory child version LOI-CV. Students scoring above 35 were subjected to the Mini International Neuropsychiatric Interview for children MINI-KID Arabic version to assess psychiatric comorbidities. OCD patient students detected by MINI-KID were assessed by psychiatric interview to confirm fulfilling criteria of OCD according to DSM IV - TR criteria.ResultsThe sample was equally distributed according to gender with 51.7% and 48.3% of males and females respectively. The prevalence of obsessive compulsive symptoms was 15.5%, while that of obsessive compulsive disorder was 2.2%. Comorbidity with other psychiatric disorders was high for substance abuse 18.9%, Dysthymia 16.4%, social phobia 15.9%, Major depression 13.9%, Generalized anxiety disorder 12.9%.ConclusionThe prevalence of obsessive compulsive symptoms is high among adolescent age group, there is high Comorbidity between obsessive symptoms and psychiatric disorders particularly substance abuse, mood disorders and non OCD Anxiety spectrum disorders.
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Maina, Giuseppe, Umberto Albert, Filippo Bogetto, and Luigi Ravizza. "Onset of Obsessive-Compulsive Disorder: Premorbid Conditions and Prodromal Phase." CNS Spectrums 5, no. 12 (December 2000): 31–43. http://dx.doi.org/10.1017/s1092852900007793.
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AbstractThis article focuses on the clinical onset of obsessive-compulsive disorder (OCD), specifically addressing the of onset, gradual and acute onset, and whether there are some types of premorbid conditions or a prodromal phase that predispose individuals to the onset of OCD. Clinical and epidemiological studies have come to different conclusions regarding age at onset as well as regarding differences between the sexes. Data gleaned from research to date have demonstrated a relationship between OCD and obsessive-compulsive personality disorder (OCPD), although OCPD does not appear to be the more prevalent personality disorder among patients with OCD. Preliminary research has suggested that Axis I disorders may predispose individuals to OCD onset; however, the significance of this relationship remains to be clarified. Evidence of the association between OCD and subthreshold obsessive-compulsive syndrome suggests that these disorders lie on a continuum of severity, with some cases developing OCD while others do not.
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Hollander, Eric, and Stephanie D. Benzaquen. "Is There a Distinct OCD Spectrum?" CNS Spectrums 1, no. 1 (September 1996): 17–26. http://dx.doi.org/10.1017/s1092852900000651.
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The obsessive-compulsive disorders spectrum concept has grown in recent years because of the common clinical features, such as obsessive thinking and compulsive rituals, biological markers, presumed etiology, and treatment response, that these disorders may share with obsessive-compulsive disorder (OCD). This concept has important implications in regard to diagnosis, nosology, neurobiology, and treatment of a wide group of diverse disorders affecting up to 10% of the population. New insights in central nervous system (CNS) mechanisms that drive the repetitive behaviors of the obsessive-compulsive spectrum disorders have heightened interest in the spectrum in researchers, clinicians, and those involved in drug development.An important approach in neuropsychiatry centers on employing a dimensional classification of psychopathology. Psychiatric phenomena often fall on a continuum. A dimensional approach allows for the classification of patients who fall at the border of classical entities or who are otherwise atypical. Diagnostic categories are considered along a spectrum if there is considerable overlap in symptoms and in etiology, as demonstrated by familial linkage biological markers, and pharmacological dissection. Categorical and dimensional approaches to the OCD spectrum could have significant implications for diagnosis, nosology, neurobiology, and treatment of a wide group of disorders affecting a sizable percentage of the population.Recent interest has focused on spectrums in movement disorders, affective disorders, schizophrenia, epileptic and impulsive disorders, and obsessive-compulsive disorders (which we will examine here); in addition, there has been interest in the overlap between these spectrums. Viewing disorders in terms of overlapping spectrums provides researchers and clinicians a framework with which to better understand and treat these disorders.
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Tumkaya, S., F. Karadag, and N. K. Oguzhanoglu. "Neurological soft signs in schizophrenia and obsessive compulsive disorder spectrum." European Psychiatry 27, no. 3 (April 2012): 192–99. http://dx.doi.org/10.1016/j.eurpsy.2010.03.005.
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AbstractObsessive compulsive symptoms are more frequent in patients with schizophrenia compared to normal population. Patients with obsessive compulsive disorder may also exhibit psychosis-like symptoms. Based on these findings, it has been suggested that there is a spectrum of disorders between OCD and schizophrenia. We compared two OCD groups (with good and poor insight) and two schizophrenia groups (with and without OCD) in this recommended spectrum especially in terms of neurological soft signs (NSSs) associated with sensory integration. The schizophrenia with OCD (schizo-obsessive) group exhibited worse performance than the schizophrenia group (p = 0.002) in only graphesthesia tasks. Moreover, schizo-obsessive patients exhibited worse performance compared to OCD patients in terms of graphesthesia (p = 0.001) and audiovisual integration (p = 0.001). Interestingly, OCD patients with poor insight tended to exhibit graphesthesia deficit in a similar manner to schizo-obsessive patients rather than OCD patients. According to our results, graphesthesia disorder is strongly associated both with OCD and schizophrenia. This suggests that neurodevelopmental disorders that lead to graphesthesia disorder overlap in comorbid OCD and schizophrenia patients.
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Gadelkarim, W., S. Shahper, J. Reid, M. Wikramanayake, S. Kaur, S. Kolli, N. Fineberg, and S. Osman. "Obsessive compulsive Personality Disorder and Autism Spectrum Disorder Traits in the Obsessive-compulsive Disorder Clinic." European Psychiatry 41, S1 (April 2017): S135—S136. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1959.
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IntroductionObsessive Compulsive Personality Disorder (OCPD) is a common, highly co-morbid disorder. Subjected to comparatively little research, OCPD shares aspects of phenomenology and neuropsychology with obsessive-compulsive spectrum disorders and neurodevelopmental disorders such as autism spectrum disorder (ASD). A greater understanding of this interrelationship would provide new insights into its diagnostic classification and generate new research and treatment heuristics.AimsTo investigate the distribution of OCPD traits within a cohort of OCD patients. To evaluate the clinical overlap between traits of OCPD, OCD and ASD, as well as level of insight and treatment resistance.MethodWe interviewed 73 consenting patients from a treatment seeking OCD Specialist Service. We evaluated the severity of OCPD traits (Compulsive Personality Assessment Scale; CPAS), OCD symptoms (Yale–Brown Obsessive Compulsive Scale; Y-BOCS), ASD traits (Adult Autism Spectrum Quotient; AQ) and insight (Brown Assessment of Beliefs Scale; BABS).ResultsOut of 67 patients, 24 (36%) met DSM-IV criteria for OCPD, defined using the CPAS. Using Pearson's test, CPAS scores significantly (P < 0.01) correlated with total AQ and selected AQ domains but not with BABS. Borderline significant correlation was observed with Y-BOCS (P = 0.07). OCPD was not over-represented in a highly resistant OCD subgroup.ConclusionDisabling OCPD traits are common in the OCD clinic. They strongly associate with ASD traits, less strongly with OCD severity and do not appear related to poor insight or highly treatment-resistant OCD. The impact of OCPD on OCD treatment outcomes requires further research.Disclosure of interestThis work did not receive funding from external sources. Over the past few years, Dr. Fineberg has received financial support in various forms from the following: Shire, Otsuka, Lundbeck, Glaxo-SmithKline, Servier, Cephalon, Astra Zeneca, Jazz pharmaceuticals, Bristol Myers Squibb, Novartis, Medical Research Council (UK), National Institute for Health Research (UK), Wellcome Foundation, European College of Neuropsychopharmacology, UK College of Mental Health Pharmacists, British Association for Psychopharmacology, International College of Obsessive-Compulsive Spectrum Disorders, International Society for Behavioural Addiction, World Health Organization, Royal College of Psychiatrists.
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Ong, Mian-Li, Lillian Reuman, Eric A. Youngstrom, and Jonathan S. Abramowitz. "Discriminative Validity of the Dimensional Obsessive–Compulsive Scale for Separating Obsessive–Compulsive Disorder From Anxiety Disorders." Assessment 27, no. 4 (July 25, 2018): 810–21. http://dx.doi.org/10.1177/1073191118791039.
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Objective: We investigated the diagnostic efficiency and clinical utility of the Dimensional Obsessive–Compulsive Scale (DOCS) and subscales for distinguishing obsessive–compulsive disorder (OCD) from anxiety disorders (ADs). Method: A total of 369 participants (167 male, Mage = 29.61 years) diagnosed with DSM-IV OCD or AD, recruited from specialty clinics across the United States, completed clinical interviews and self-report questionnaires, including the DOCS. Receiver operating characteristic analyses and diagnostic likelihood ratios (DiLRs) determined discriminative validity and provided clinical utility. Logistic regressions tested for incremental validity in the DOCS-total scale and subscales in predicting OCD status. Results: The DOCS-total scale and Contamination subscale performed best in differentiating between OCD and AD diagnosis (DOCS-total: Area under curve [AUC] = .75, p < .001; Contamination: AUC = .70, p < .001) as compared with the other subscales. At high scores (DOCS-total: 28+, Contamination: 6+), Contamination was more effective than the DOCS-total in differentiating OCD from ADs, with high scores in Contamination quadrupling OCD odds and DOCS-total by about threefold (Contamination DiLR+ = 4.04, DOCS-total DiLR+ = 2.82). At low scores (DOCS-total: 0-9, Contamination: 0-2), the converse was true, with low scores in Contamination cutting OCD odds by half and DOCS-total by one fifths (Contamination DiLR− = 0.52, DOCS-total DiLR− = 0.23). Conclusion: At high scores, the Contamination subscale is the most helpful subscale to differentiate OCD and ADs. For low scores, the DOCS-total scale performs the best among the scales.
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Hohagen, F., and M. Berger. "New perspectives in research and treatment of obsessive–compulsive disorder." British Journal of Psychiatry 173, S35 (August 1998): 1. http://dx.doi.org/10.1192/s0007125000297821.
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In recent years, there has been a renewed interest in obsessive-compulsive disorder (OCD) among psychiatrists due to several factors. OCD is not a rare disease as was believed in former times. New epidemiological studies demonstrate that 1–2% of the adult population suffer from OCD. This result was confirmed by several epidemiological studies among different cultural environments which are summarised by Dr Bebbington in this supplement. Thus, OCD figures among the most common of mental disorders. Lately a unique category of disorders has emerged that share some common key features with OCD. These ‘obsessive-compulsive spectrum disorders’ and their treatments are characterised in Dr Hollander's paper.
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Sookman, Debbie, Gilbert Pinard, and Aaron T. Beck. "Vulnerability Schemas in Obsessive-Compulsive Disorder." Journal of Cognitive Psychotherapy 15, no. 2 (January 2001): 109–30. http://dx.doi.org/10.1891/0889-8391.15.2.109.
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This article elaborates on the construct of dysfunctional vulnerability schemas in Obsessive-Compulsive Disorder (OCD)(Sookman & Pinard, 1995,1999; Sookman, Pinard, & Beauchemin, 1994). These schemas are conceptualized as a central mechanism of excessive threat appraisals proposed to be the predominant cognitive problem in anxiety (Beck, 1996; Beck & Clark, 1997). Four domains of beliefs are hypothesized to comprise vulnerability in OCD: Perceived Vulnerability; View of/Response to Unpredictability, Newness, and Change; View of Strong Affect; and Need for Control. A study carried out with 111 subjects indicated that OCD patients more strongly endorsed these beliefs compared with patients with other anxiety disorders, mood disorders, and normal controls. The discriminant function derived from these four belief domains was effective in classifying OCD patients and other subjects into their respective groups. The results support the inclusion of dysfunctional vulnerability beliefs in cognitive assessment and treatment of OCD.
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Scotti-Muzzi, Estêvão, and Osvaldo Luis Saide. "Schizo-obsessive spectrum disorders: an update." CNS Spectrums 22, no. 3 (September 27, 2016): 258–72. http://dx.doi.org/10.1017/s1092852916000390.
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The presence of obsessive-compulsive symptoms (OCS) and obsessive-compulsive disorders (OCD) in schizophrenia is frequent, and a new clinical entity has been proposed for those who show the dual diagnosis: the schizo-obsessive disorder. This review scrutinizes the literature across the main academic databases, and provides an update on different aspects of schizo-obsessive spectrum disorders, which include schizophrenia, schizotypal personality disorder (SPD) with OCD, OCD with poor insight, schizophrenia with OCS, and schizophrenia with OCD (schizo-obsessive disorder). An epidemiological discussion on the discrepancies observed in the prevalence of OCS and OCD in schizophrenia across time is provided, followed by an overview of the main clinical and phenomenological features of the disorder in comparison to the primary conditions under a spectral perspective. An updated and comparative analysis of the main genetic, neurobiological, neurocognitive, and pharmacological treatment aspects for the schizo-obsessive spectrum is provided, and a discussion on endophenotypic markers is introduced in order to better understand its substrate. There is sufficient evidence in the literature to demonstrate the clinical relevance of the schizo-obsessive spectrum, although little is known about the neurobiology, genetics, and neurocognitive aspects of these groups. The pharmacological treatment of these patients is still challenging, and efforts to search for possible specific endophenotypic markers would open new avenues in the knowledge of schizo-obsessive spectrum.
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Pallanti, Stefano, and Eric Hollander. "Obsessive-Compulsive Disorder Spectrum as a Scientific “Metaphor”." CNS Spectrums 13, S14 (2008): 6–15. http://dx.doi.org/10.1017/s1092852900026882.
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AbstractAs 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.
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Cefalu, Paul. "What's So Funny about Obsessive-Compulsive Disorder?" PMLA/Publications of the Modern Language Association of America 124, no. 1 (January 2009): 44–58. http://dx.doi.org/10.1632/pmla.2009.124.1.44.
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During the past several decades, obsessive-compulsive disorder (OCD) has been widely represented in novels, memoirs, film, television, and other genres and media. What distinguishes representations of OCD from depictions of other mental disorders is the frequency with which OCD is treated with humor and levity. Drawing on genre theory, disability studies, and philosophies of humor, this essay explains why OCD symptomatology evokes laughter and resonates with contemporary popular culture. The essay focuses on the ways in which popular portrayals of OCD distort the actual experience of the disorder.
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Nakata, Ana Cristina Gargano, Juliana B. Diniz, Albina R. Torres, Maria Alice de Mathis, Victor Fossaluza, Carlos Alberto Braganças, Ygor Ferrão, and Euripedes C. Miguel. "Level of Insight and Clinical Features of Obsessive-Compulsive Disorder with and Without Body Dysmorphic Disorder." CNS Spectrums 12, no. 4 (April 2007): 295–303. http://dx.doi.org/10.1017/s1092852900021052.
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ABSTRACTIntroduction: Body dysmorphic disorder (BDD) and obsessive-compulsive disorder (OCD) have several similarities and are included among the obsessive-compulsive spectrum of disorders. However, the content of preoccupations and level of insight of BDD patients differ from OCD patients.Objective: To compare the level of insight regarding obsessive-compulsive symptoms (OCS) and other clinical features in OCD patients with and without comorbid BDD.Methods: We evaluated 103 OCD patients (n=25, comorbid BDD), according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria using the Structured Clinical Interview for DSM-IV, the Yale-Brown Obsessive-Compulsive Scale, the University of São Paulo Sensory Phenomena Scale, the Beck Depression and Anxiety Inventories, and the Brown Assessment of Beliefs Scale.Results: The study groups differed significantly on several clinical features, including level of insight. A worse level of insight regarding OCS was independently associated with the presence of comorbid BDD. Lower educational level, more psychiatric comorbidities, presence of somatic and hoarding obsessions, and presence of intrusive images were associated with BDD comorbidity, even after adjusting for possible confounders.Conclusion: The presence of BDD in OCD patients is associated with poorer insight into obsessional beliefs and higher morbidity, reflected by lower educational levels and higher number of psychiatric comorbid disorders in general.
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de Haan, Lieuwe, Christine Dudek-Hodge, Yolanda Verhoeven, and Damiaan Denys. "Prevalence of Psychotic Disorders in Patients with Obsessive-Compulsive Disorder." CNS Spectrums 14, no. 8 (August 2009): 415–18. http://dx.doi.org/10.1017/s1092852900020381.
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ABSTRACTIntroduction: 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 and Statistical Manual of Mental Disorders, Fourth Edition psychotic disorders was evaluated in 757 subjects consecutively referred to a specialised diagnostic and treatment facility for OCD. Demographic and clinical characteristics were assessed.Results: Thirteen OCD patients (1.7%) also met the DSM-IV criteria for a psychotic disorder. We found no significant differences in clinical characteristic between OCD patients with and without a psychotic disorder, although patients with OCD and a psychotic disorder more likely used illicit substances and more likely were male.Conclusion: Relatively few patients referred to a specialized treatment OCD center suffer from a psychotic disorder.
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de Alvarenga, Pedro Gomes, Maria Alice de Mathis, Anna Claudia Dominguez Alves, Maria Conceição do Rosário, Victor Fossaluza, Ana Gabriela Hounie, Euripedes Constantino Miguel, and Albina Rodrigues Torres. "Clinical features of tic-related obsessive-compulsive disorder: results from a large multicenter study." CNS Spectrums 17, no. 2 (May 4, 2012): 87–93. http://dx.doi.org/10.1017/s1092852912000491.
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ObjectiveTo evaluate the clinical features of obsessive-compulsive disorder (OCD) patients with comorbid tic disorders (TD) in a large, multicenter, clinical sample.MethodA 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.ResultsThe 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 < .005) and to present sensory phenomena and comorbidity with anxiety 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.ConclusionTic-related OCD may constitute a particular subgroup of the disorder with specific phenotypical characteristics, but its neurobiological underpinnings remain to be fully disentangled.
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Russell, Ailsa J., David Mataix-Cols, Martin Anson, and Declan G. M. Murphy. "Obsessions and compulsions in Asperger syndrome and high-functioning autism." British Journal of Psychiatry 186, no. 6 (June 2005): 525–28. http://dx.doi.org/10.1192/bjp.186.6.525.
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BackgroundObsessive–compulsive behaviours are common and disabling in autistic-spectrum disorders (ASD) but little is known about how they compare with those experienced by people with obsessive–compulsive disorder (OCD).AimTo make such a comparison.MethodA group of adults with high-functioning ASD (n=40) were administered the Yale–Brown Obsessive–Compulsive Scale and Symptom Checklist and their symptoms compared with a gender-matched group of adults with a primary diagnosis of OCD (n=45). OCD symptoms were carefully distinguished from stereotypic behaviours and interests usually displayed by those with ASD.ResultsThe two groups had similar frequencies of obsessive–compulsive symptoms, with only somatic obsessions and repeating rituals being more common in the OCD group. The OCD group had higher obsessive–compulsive symptom severity ratings but up to 50% of the ASD group reported at least moderate levels of interference from their symptoms.ConclusionsObsessions and compulsions are both common in adults with high-functioning ASD and are associated with significant levels of distress.
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Giasuddin, Noor Ahmed, and Md Jahangir Hossain. "Understanding Obsessive Compulsive Disorder and Management Options." Faridpur Medical College Journal 15, no. 1 (September 10, 2020): 38–42. http://dx.doi.org/10.3329/fmcj.v15i1.49009.
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Obsessive compulsive disorder is a common mental health problem. It is characterized by obsession and compulsion. Obsession can be defined as unwanted, intrusive, recurrent and persistent thoughts, images or impulses which are not voluntarily produced, but are experienced as events that invade a person's consciousness. Compulsion can be defined as repetitive and seemingly purposeful behavior that is performed according to certain rules or in a stereotyped fashion and is not an end in itself but is usually intended to prevent some event or situation. The obsessions or compulsions interfere significantly with the person's normal routine, occupational functioning, usual social activities, or relationships. Obsessive-compulsive disorder and several related disorders are now put together into separate chapter in Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Literature search was performed with the key words "Obsessive Compulsive Disorder", "Obsession", "Compulsion", "Treatment of Obsessive-Compulsive Disorder". Representative and leading researches from last 25 years were included in the study. Modern concepts of OCD began to evolve in the nineteenth century. Obsessions, in which insight was preserved, were gradually distinguished from delusions, in which it was not. The core features of OCD are remarkably similar from one country to the next, but its manifestations may differ for reasons of culture and experience. OCD is typically a chronic disorder with a waxing and waning course. In classical psychoanalytic theory, OCD was considered a regression from the Oedepal phase to the anal psycho-sexual phase of development. Functional brain imaging studies have produced a model for pathophysiology of OCD which involves hyperactivity in certain subcortical and cortical regions. The idea that abnormality in serotonergic neurotransmission underlies OCD arose from the observation that clomipramine, which inhibits serotonin and norepinephrine reuptake, relieved symptoms, whereas noradrenergic reuptake inhibitors did not. During the last 40 years there has been considerable progress in the pharmacological management of OCD. Behavioral therapy is also considered as an effective way of controlling OCD. Cognitive Behavioral Therapy (CBT) is a well-documented intervention for children, adolescents, and adults with OCD. Other biological approaches for obsessive-compulsive disorder include neurosurgery, deepbrain stimulation, electroconvulsive therapy, and repetitive transcranial magnetic stimulation. The neurosurgical techniques of cingulotomy and capsulotomy may provide clinical improvement among some patients with treatmentrefractory obsessive-compulsive disorder. Overall, stereotactic surgery should be viewed as a last option in treating refractory obsessive-compulsive disorder.
Faridpur Med. Coll. J. Jan 2020;15(1): 38-42
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Bebbington, P. E. "Epidemiology of obsessive-compulsive disorder." British Journal of Psychiatry 173, S35 (August 1998): 2–6. http://dx.doi.org/10.1192/s0007125000297833.
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Background Although the concept of obsessive-compulsive disorder (OCD) has long been established, research diagnostic criteria are relatively recent developments. This is partly because the symptoms of OCD occur in the context of other disorders and it is arguable to what extent they are relatively discrete phenomena.Method Review of the existing epidemiological surveys based on standardised instruments.Results Nine population surveys using the Diagnostic Interview Schedule have given data on OCD, with six-month prevalences ranging from 0.7 to 2.1%. The British National Survey of Psychiatric Morbidity based on the CIS – R gave a one-month prevalence of 1% in males and 1.5% in females. Community surveys show an excess of females and emphasise the early age of onset. Minor obsessional symptoms are considerably more common than OCD itself.Conclusions OCD is fairly rare in the general population, but causes considerable distress to those who suffer from it.
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Castle, David J., and Aaron Groves. "The Internal and External Boundaries of Obsessive–Compulsive Disorder." Australian & New Zealand Journal of Psychiatry 34, no. 2 (April 2000): 249–55. http://dx.doi.org/10.1080/j.1440-1614.2000.00727.x.
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Objective: This study aims to explore the internal and external boundaries of obsessive–compulsive disorder (OCD). Method: Selected literature is reviewed. Results: Prevalence and incidence estimates for OCD vary markedly according to diagnostic criteria applied. External boundaries of the disorder are permeable, with a large degree of overlap with other psychiatric disorders, and an association with certain neurological disorders. Some cases of OCD appear to have a neurodevelopmental origin. Conclusions: Further delineation of disorders characterised by obsessional and compulsive symptoms can inform models of aetiology, pathophysiology and treatment.
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López-Solà, Clara, Leonardo F. Fontenelle, Minh Bui, John L. Hopper, Christos Pantelis, Murat Yücel, José M. Menchón, Pino Alonso, and Ben J. Harrison. "Aetiological overlap between obsessive–compulsive related and anxiety disorder symptoms: Multivariate twin study." British Journal of Psychiatry 208, no. 1 (January 2016): 26–33. http://dx.doi.org/10.1192/bjp.bp.114.156281.
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BackgroundThe aetiological boundary between obsessive–compulsive related disorders (OCRDs) including obsessive–compulsive disorder (OCD) and anxiety disorders is unclear and continues to generate debate.AimsTo determine the genetic overlap and the pattern of causal relationships among OCRDs and anxiety disorders.MethodMultivariate twin modelling methods and a new regression analysis to infer causation were used, involving 2495 male and female twins.ResultsThe amount of common genetic liability observed for OCD symptoms was higher when considering anxiety disorders and OCRDs in the model v. modelling OCRD symptoms alone. OCD symptoms emerged as risk factors for the presence of generalised anxiety, panic and hoarding symptoms, whereas social phobia appeared as a risk factor for OCD symptoms.ConclusionsOCD represents a complex phenotype that includes important shared features with anxiety disorders and OCRDs. The novel patterns of risk identified between OCD and anxiety disorder may help to explain their frequent co-occurrence.
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Rowa, Karen, Martin M. Antony, and Richard P. Swinson. "BEHAVIOURAL TREATMENT OF OBSESSIVE COMPULSIVE DISORDER." Behavioural and Cognitive Psychotherapy 28, no. 4 (October 2000): 353–60. http://dx.doi.org/10.1017/s1352465800004045.
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Until the late 1960s, obsessive compulsive disorder (OCD) was considered to be a relatively untreatable condition. Over the next several years, many advances were made in the psychological treatment of OCD as clinicians and researchers began to realize the value of behavioural treatments for this population. Isaac Marks and his colleagues played an instrumental role in the development and initial validation of exposure-based treatments for OCD. In addition to his other important research in the area of anxiety, Marks continued to study behavioural treatments for OCD, including the processes and predictors of treatment outcome. More recently, his work has focused on self-administered treatments for OCD and other anxiety disorders, including computerized and telephone-based treatments. This paper reviews research on the behavioural treatment of OCD, with an emphasis on the contributions of Isaac Marks.
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Koolwal, Arpit, Supriya Agarwal, Shivanand Manohar, Ghanshyam Das Koolwal, and Anubha Gupta. "Obsessive–Compulsive Disorder and Sexuality: A Narrative Review." Journal of Psychosexual Health 2, no. 1 (January 2020): 37–43. http://dx.doi.org/10.1177/2631831819896171.
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Obsessive–compulsive disorder (OCD) is one of the common psychiatric disorders. Despite being one of the basic aspects of biology, the sexual functioning in OCD patients has not received much attention, with there being very limited research on sexuality in these patients. In this review article, we try to take a look at the research on sexual functioning, sexual dysfunctions, and neurobiology of sexual dysfunctions in the anxiety disorders in general and in OCD specifically. We also take a look at the research on relationship functioning in the patients with OCD, a recently proposed entity, relationship-related obsessive compulsive phenomenon, at the sexual obsessions, and the sexual functioning in patients on active treatment for OCD. The overall research suggests that we should always take into account the sexual life and functioning of patients presenting with OCD.
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Nestadt, G., C. Z. Di, M. A. Riddle, M. A. Grados, B. D. Greenberg, A. J. Fyer, J. T. McCracken, et al. "Obsessive–compulsive disorder: subclassification based on co-morbidity." Psychological Medicine 39, no. 9 (December 2, 2008): 1491–501. http://dx.doi.org/10.1017/s0033291708004753.
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BackgroundObsessive–compulsive disorder (OCD) is probably an etiologically heterogeneous condition. Many patients manifest other psychiatric syndromes. This study investigated the relationship between OCD and co-morbid conditions to identify subtypes.MethodSeven hundred and six individuals with OCD were assessed in the OCD Collaborative Genetics Study (OCGS). Multi-level latent class analysis was conducted based on the presence of eight co-morbid psychiatric conditions [generalized anxiety disorder (GAD), major depression, panic disorder (PD), separation anxiety disorder (SAD), tics, mania, somatization disorders (Som) and grooming disorders (GrD)]. The relationship of the derived classes to specific clinical characteristics was investigated.ResultsTwo and three classes of OCD syndromes emerge from the analyses. The two-class solution describes lesser and greater co-morbidity classes and the more descriptive three-class solution is characterized by: (1) an OCD simplex class, in which major depressive disorder (MDD) is the most frequent additional disorder; (2) an OCD co-morbid tic-related class, in which tics are prominent and affective syndromes are considerably rarer; and (3) an OCD co-morbid affective-related class in which PD and affective syndromes are highly represented. The OCD co-morbid tic-related class is predominantly male and characterized by high conscientiousness. The OCD co-morbid affective-related class is predominantly female, has a young age at onset, obsessive–compulsive personality disorder (OCPD) features, high scores on the ‘taboo’ factor of OCD symptoms, and low conscientiousness.ConclusionsOCD can be classified into three classes based on co-morbidity. Membership within a class is differentially associated with other clinical characteristics. These classes, if replicated, should have important implications for research and clinical endeavors.
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Bogetto, F., S. Venturello, U. Albert, G. Maina, and L. Ravizza. "Gender-related clinical differences in obsessive-compulsive disorder." European Psychiatry 14, no. 8 (December 1999): 434–41. http://dx.doi.org/10.1016/s0924-9338(99)00224-2.
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SummaryThe purpose of the present study was to investigate the gender-related differences of clinical features in a sample of obsessive-compulsive (OCD) patients. One hundred and sixty outpatients with a principal diagnosis of obsessive-compulsive disorder (DSM-IV, Y-BOCS = 16) were admitted. Patients were evaluated with a semi-structured interview covering the following areas: socio-demographic data, Axis I diagnoses (DSM-IV), OCD clinical features (age at onset of OC symptoms and disorder, type of onset, life events and type of course). For statistical analysis the sample was subdivided in two groups according to gender. We found an earlier age at onset of OC symptoms and disorder in males; an insidious onset and a chronic course of illness were also observed in that group of patients. Females more frequently showed an acute onset of OCD and an episodic course of illness; they also reported more frequently a stressful event in the year preceding OCD onset. A history of anxiety disorders with onset preceding OCD and hypomanic episodes occurring after OCD onset was significantly more common among males, while females showed more frequently a history of eating disorders. We found three gender-related features of OCD: males show an earlier age at onset with a lower impact of precipitant events in triggering the disorder; OCD seems to occur in a relative high proportion of males who already have phobias and/or tic disorders; and a surfeit of chronic course of the illness in males in comparison with females.
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Dell’Osso, Bernardo, Humberto Nicolini, Nuria Lanzagorta, Beatrice Benatti, Gregorio Spagnolin, M. Carlotta Palazzo, Donatella Marazziti, et al. "Cigarette smoking in patients with obsessive compulsive disorder: a report from the International College of Obsessive Compulsive Spectrum Disorders (ICOCS)." CNS Spectrums 20, no. 5 (September 9, 2015): 469–73. http://dx.doi.org/10.1017/s1092852915000565.
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Obsessive compulsive disorder (OCD) showed a lower prevalence of cigarette smoking compared to other psychiatric disorders in previous and recent reports. We assessed the prevalence and clinical correlates of the phenomenon in an international sample of 504 OCD patients recruited through the International College of Obsessive Compulsive Spectrum Disorders (ICOCS) network.Cigarette smoking showed a cross-sectional prevalence of 24.4% in the sample, with significant differences across countries. Females were more represented among smoking patients (16% vs 7%; p<.001). Patients with comorbid Tourette’s syndrome (p<.05) and tic disorder (p<.05) were also more represented among smoking subjects. Former smokers reported a higher number of suicide attempts (p<.05).We found a lower cross-sectional prevalence of smoking among OCD patients compared to findings from previous studies in patients with other psychiatric disorders but higher compared to previous and more recent OCD studies. Geographic differences were found and smoking was more common in females and comorbid Tourette’s syndrome/tic disorder.
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Hollander, Eric, Steven Greenwald, David Neville, Jim Johnson, Christopher D. Hornig, and Myrna M. Weissman. "Uncomplicated and Comorbid Obsessive-Compulsive Disorder in an Epidemiologic Sample." CNS Spectrums 3, S1 (May 1998): 10–18. http://dx.doi.org/10.1017/s1092852900007148.
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AbstractThis study investigates lifetime prevalence rates, demographic characteristics, childhood conduct disorder and adult antisocial features, suicide attempts, and cognitive impairment in individuals with obsessive-compulsive disorder (OCD) uncomplicated by or comorbid with any other psychiatric disorder. The data are from the NIMH Epidemiological Catchment Area (ECA) study, and the current analyses compared subjects with uncomplicated OCD (no history of any other lifetime psychiatric disorder) comorbid OCD (with any other lifetime disorder), other lifetime psychiatric disorders, and no lifetime psychiatric disorders across these variables. OCD in its uncomplicated and comorbid form had significantly higher rates of childhood conduct symptoms, adult antisocial personality disorder problems, and of suicide attempts than did no or other disorders. Comorbid OCD subjects had higher rates of mild cognitive impairment on the Mini-Mental Status Exam than did subjects with other disorders. These findings suggest that a subgroup of OCD patients may have impulsive features, including childhood conduct disorder symptoms and an increased rate of suicide attempts; wider clinical attention to these outcomes is needed.
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Matsunaga, Hisato, and Soraya Seedat. "Obsessive-Compulsive Spectrum Disorders: Cross-national and Ethnic Issues." CNS Spectrums 12, no. 5 (May 2007): 392–400. http://dx.doi.org/10.1017/s1092852900021180.
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ABSTRACTEpidemiological and clinical data from a variety of cultural and geographic settings on obsessive-compulsive disorder (OCD), and many of the obsessive-compulsive spectrum disorders, suggest that this is a group of disorders with a good degree of transcultural homogeneity. However, the content and themes that predominate in patients with these disorders, and the course of illness, can be shaped by cultural, ethnic, and religious experiences. Across cultures, OCD is commonly comorbid with mood, anxiety, and impulse-control disorders. However, little is known about the mechanisms by which culture and ethnicity may affect the expression of OCD and related disorders. Cross-national comparative studies exploring culturally influenced differences in clinical course, treatment outcome, including ethnogenetic differences in drug response, and prognosis are needed.
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Rus, O. G., T. J. Reess, G. Wagner, M. Zaudig, C. Zimmer, and K. Koch. "Hypogyrification in obsessive-compulsive disorder." Psychological Medicine 47, no. 6 (December 12, 2016): 1053–61. http://dx.doi.org/10.1017/s0033291716003202.
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BackgroundPrevious studies hypothesized that neurodevelopmental risk factors may play a role in the pathogenesis of obsessive-compulsive disorder (OCD). Cortical folding has been shown to be a reliable indicator for normal and altered neurodevelopment, but in OCD it has barely been investigated up to now. The present study investigates whether alterations in gyrification are detectable in OCD and, if so, how these are associated with clinical characteristics.MethodWe compared the local Gyrification Index (lGI) between 75 OCD patients and 75 matched healthy subjects across the whole brain. In addition, for those regions exhibiting an altered lGI in patients we explored a potential relationship to symptom severity, age of onset, and influence of medication.ResultsOCD patients had a significantly decreased lGI in right parietal, precentral but also insula, temporal, pars triangularis and rostral middle frontal regions compared to healthy subjects. A positive association with age of onset was found but no association with symptom severity. There was no effect of co-morbidity or medication.ConclusionsThe reduced gyrification found in OCD confirms previous findings in other psychiatric disorders and suggests that alterations may already occur during early stages of brain development. Our findings support the idea that altered cortical folding might represent a trait characteristic of the disorder although longitudinal studies are needed to clarify the trajectory of this morphological measure in OCD.
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Dell’Osso, B., B. Benatti, C. I. Rodriguez, C. Arici, C. Palazzo, A. C. Altamura, E. Hollander, et al. "Obsessive-compulsive disorder in the elderly: A report from the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS)." European Psychiatry 45 (September 2017): 36–40. http://dx.doi.org/10.1016/j.eurpsy.2017.06.008.
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AbstractIntroduction:Obsessive-compulsive disorder (OCD) is a highly disabling condition, with frequent early onset. Adult/adolescent OCD has been extensively investigated, but little is known about prevalence and clinical characterization of geriatric patients with OCD (G-OCD = 65 years). The present study aimed to assess prevalence of G-OCD and associated socio-demographic and clinical correlates in a large international sample.Methods:Data from 416 outpatients, participating in the ICOCS network, were assessed and categorized into 2 groups, age < vs = 65 years, and then divided on the basis of the median age of the sample (age < vs = 42 years). Socio-demographic and clinical variables were compared between groups (Pearson Chi-squared and t tests).Results:G-OCD compared with younger patients represented a significant minority of the sample (6% vs 94%, P < .001), showing a significantly later age at onset (29.4 ± 15.1 vs 18.7 ± 9.2 years, P < .001), a more frequent adult onset (75% vs 41.1%, P < .001) and a less frequent use of cognitive-behavioural therapy (CBT) (20.8% vs 41.8%, P < .05). Female gender was more represented in G-OCD patients, though not at a statistically significant level (75% vs 56.4%, P = .07). When the whole sample was divided on the basis of the median age, previous results were confirmed for older patients, including a significantly higher presence of women (52.1% vs 63.1%, P < .05).Conclusions:G-OCD compared with younger patients represented a small minority of the sample and showed later age at onset, more frequent adult onset and lower CBT use. Age at onset may influence course and overall management of OCD, with additional investigation needed.
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Chaturvedi, Amrita, Nikki L. Murdick, and Barbara C. Gartin. "Obsessive Compulsive Disorder: What an Educator Needs to Know." Physical Disabilities: Education and Related Services 33, no. 2 (December 9, 2014): 71–83. http://dx.doi.org/10.14434/pders.v33i2.13134.
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The presence of obsessive compulsive disorder (OCD) impairs social, emotional and academic functioning. Individuals with OCD may have co-morbid disorders including attention deficit hyperactivity disorder, depression, oppositional defiant disorder, or Tourette syndrome. Challenges occur when students with OCD become a part of the general education classroom. This article provides an overview of OCD and presents information to assist teachers and school staff to successfully meet the needs of students with OCD.
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Pomohaibo, V., O. Berezan, and O. Petrushov. "GENETICS OF OBSESSIVE-COMPULSIVE DISORDER." Psychology and Personality, no. 1 (May 20, 2021): 270–80. http://dx.doi.org/10.33989/2226-4078.2021.1.227328.
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Obsessive-compulsive disorder (OCD) is characterized by recurrent episodes of obsessive thoughts, fears, and actions, which, in the opinion of the patient, can defuse frightening events. A patient himself is aware of his condition, but cannot prevent it by a simple effort of will. The prevalence of OCD in the general population varies between 0.7% and 3.0%. Patients with OCD often can have a lifetime diagnosis of other psychopathology – an anxiety disorder, depressive disorder, tic disorder and others. In addition, the OCD symptoms often accompany other mental disorders, such as schizophrenia, bipolar disorder, eating disorder and others.
Family studies in OCD showed that the disorder risk of first-degree relatives of individuals with OCD were approximately 15%, that more likely to develop OCD than its prevalence in the general population. This indicates the presence of a genetic component in the OCD development, that is also confirmed by the significant reliable value of the heritability of OCD (42-53%). Males have an earlier age at onset of OCD than females. Moreover, males more likely to have symptoms in the forbidden thoughts and symmetry dimensions and females more likely to have symptoms in the cleaning dimension. In addition, geographical and cultural factors may shape the content of obsessions and compulsions.
There are four publications that have shown OCD genetic linkage with defined regions of three chromosomes: 9p24, 3q27-28 and 14q23-32. It was also found that the region of chromosome 3q27-28 contains three genes of serotonin receptor subunits – HTR3C (5HT3C), HTR3D (5HT3D) and HTR3E (5HT3E). These genes can be candidate genes for OCD. In addition, the HTR3C gene (3q27.1) is expressed in the brain cells, where it produces the serotonin receptor 3 subunit, which is a very important neurotransmitter. All three genes involved in the pathogenesis of not only OCD, but also of schizophrenia.
Now, according to scientific reviews and «MalaCard: The Human Disease Database» above 40 OCD candidate genes were offered by various researchers. But almost all these studies were conducted on statistically insignificant samples (mostly from several dozens to several hundred individuals), which gave discrepant findings. In addition, not fully used methodological possibilities, for example, case-control samples were used, but family studies were not used. For this reason, the Canadian researcher S. Taylor (2013) conducted a meta-analysis of the findings of 113 studies and obtained high reliable confirmation of an assumption that variants of several genes are involved in the risk of OCD. Two of these genes associated with metabolism of serotonin (SLC6A4 and HTR2A) and two genes, in males only, are involved in catecholamine modulation (COMT and MAOA). Some more three genes have moderate reliability, two of which are associated with the dopamine system (DRD3 and DAT1) and one is associated with the glutamate system (SLC1A1). In addition, in S. Taylor’s opinion, 13 candidate genes attract an attention and merit further investigation.
The results of genetic studies showed that OCD has a polygenic nature, because it is associated with multiple genes, everyone of them makes small contributions to a risk for the disorder. To reveal of these small effects, further studies of fairly large samples are needed. In addition, environmental factors may be involved in the OCD etiology that further exploration of gene–gene and gene–environment interactions is needed. To identify reliable OCD candidate genes all comorbidities must take into account. The OCD picture is extremely various not only in a lifetime of one patient, but between patients within the same family that indicates genetic heterogeneity of the disorder, which complicates the study in addition. These problems induce to study the genetic nature and environmental risk factors of OCD to ensure an earliest and most accurate diagnosis of OCD with due regard for environmental factors.
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Paulson, John. "Exploring the Relationship between Obsessive-compulsive Characteristics and Symptoms of Eating Disorders in a Nonclinical Population." World Journal of Social Science 7, no. 1 (January 19, 2020): 25. http://dx.doi.org/10.5430/wjss.v7n1p25.
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Previous research has documented similarities between symptoms of Obsessive-Compulsive Disorder (OCD), Anorexia Nervosa, and Bulimia Nervosa and elevated comorbidity between these conditions in clinical samples, with the relationship between OCD and Anorexia being stronger than between OCD and Bulimia. Researchers adopting a continuum view of psychopathology have also found that individuals with sub-clinical expressions of obsessive-compulsive symptoms resemble their clinical counterparts in several ways. The goal of the current study was to explore whether or not the observed relationship between obsessive-compulsive symptoms and eating disorder symptoms observed in clinical populations would also be observed in a nonclinical population. 264 participants from a college sample completed self-report measures of these symptoms. A positive correlation was found between scores on obsessive-compulsive, anorexia and bulimia instruments, and reflective of their clinical counterparts the relationship between obsessive-compulsive and anorexia symptoms was more significant than the one between obsessive compulsive symptoms and bulimia symptoms. Implications and limitations for research and clinical practice are discussed.
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Samuels, Jack, Gerald Nestadt, O. Joseph Bienvenu, Paul T. Costa, Mark A. Riddle, Kung-Yee Liang, Rudolf Hoehn-Saric, Marco A. Grados, and Bernadette A. M. Cullen. "Personality disorders and normal personality dimensions in obsessive-compulsive disorder." British Journal of Psychiatry 177, no. 5 (November 2000): 457–62. http://dx.doi.org/10.1192/bjp.177.5.457.
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BackgroundLittle is known about personality disorders and normal personality dimensions in relatives of patients with obsessive-compulsive disorder (OCD).AimsTo determine whether specific personality characteristics are part of a familial spectrum of OCD.MethodClinicians evaluated personality disorders in 72 OCD case and 72 control probands and 198 case and 207 control first-degree relatives. The self-completed 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.ResultsCase 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.ConclusionsNeuroticism and OCPD may share a common familial aetiology with OCD.
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Gillan, Claire M., and Trevor W. Robbins. "Goal-directed learning and obsessive–compulsive disorder." Philosophical Transactions of the Royal Society B: Biological Sciences 369, no. 1655 (November 5, 2014): 20130475. http://dx.doi.org/10.1098/rstb.2013.0475.
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Obsessive–compulsive disorder (OCD) has become a paradigmatic case of goal-directed dysfunction in psychiatry. In this article, we review the neurobiological evidence, historical and recent, that originally led to this supposition and continues to support a habit hypothesis of OCD. We will then discuss a number of recent studies that have directly tested this hypothesis, using behavioural experiments in patient populations. Based on this research evidence, which suggests that rather than goal-directed avoidance behaviours, compulsions in OCD may derive from manifestations of excessive habit formation, we present the details of a novel account of the functional relationship between these habits and the full symptom profile of the disorder. Borrowing from a cognitive dissonance framework, we propose that the irrational threat beliefs (obsessions) characteristic of OCD may be a consequence, rather than an instigator, of compulsive behaviour in these patients. This lays the foundation for a potential shift in both clinical and neuropsychological conceptualization of OCD and related disorders. This model may also prove relevant to other putative disorders of compulsivity, such as substance dependence, where the experience of ‘wanting’ drugs may be better understood as post hoc rationalizations of otherwise goal-insensitive, stimulus-driven behaviour.
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Phillips, Katharine A., and Walter H. Kaye. "The Relationship of Body Dysmorphic Disorder and Eating Disorders to Obsessive-Compulsive Disorder." CNS Spectrums 12, no. 5 (May 2007): 347–58. http://dx.doi.org/10.1017/s1092852900021155.
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ABSTRACTBody dysmorphic disorder (BDD) and eating disorders are body image disorders that have long been hypothesized to be related to obsessive-compulsive disorder (OCD). Available data suggest that BDD and eating disorders are often comorbid with OCD. Data from a variety of domains suggest that both BDD and eating disorders have many similarities with OCD and seem related to OCD. However, these disorders also differ from OCD in some ways. Additional research is needed on the relationship of BDD and eating disorders to OCD, including studies that directly compare them to OCD in a variety of domains, including phenomenology, family history, neurobiology, and etiology.
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Hollander, E. "Treatment of obsessive-compulsive spectrum disorders with SSRIs." British Journal of Psychiatry 173, S35 (August 1998): 7–12. http://dx.doi.org/10.1192/s0007125000297845.
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Background Obsessive-compulsive spectrum disorders (OCSDs) are now recognised as distinct diagnostic entities related to obsessive-compulsive disorder (OCD). The features of OCSDs and OCD overlap in many respects including demographics, repetitive intrusive thoughts or behaviours, comorbidity, aetiology and preferential response to anti-obsessional drugs such as the selective serotonin reuptake inhibitors (SSRIs).Method Literature was reviewed and preliminary data from various studies were re-examined to assess the relationship between compulsivity and impulsivity, and between OCD and OCSDs.Results OCSDs include both compulsive and impulsive disorders and these can be viewed as lying at opposite ends of the dimension of risk avoidance. Compulsiveness is associated with increased frontal lobe activity and increased serotonergic activity, while impulsiveness is associated with reduced activity of these variables. Neural circuits affected by serotonergic pathways have been identified and pharmacological challenge of OCSD patients with serotonin receptor agonists have supported the involvement of serotonergic processes.Conclusions SSRIs such as fluvoxamine have established efficacy in OCD and preliminary studies indicate that they are also effective in OCSDs. The features of three specimen OCSDs –body dysmorphic disorder, pathological gambling and autism – and their treatment with SSRIs are reviewed.
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Krebs, Georgina, and Isobel Heyman. "Obsessive-compulsive disorder in children and adolescents." Archives of Disease in Childhood 100, no. 5 (November 14, 2014): 495–99. http://dx.doi.org/10.1136/archdischild-2014-306934.
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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.
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Hymas, Nigel. "The Neurology of Obsessive-Compulsive Disorder." CNS Spectrums 3, no. 7 (August 1998): 22–28. http://dx.doi.org/10.1017/s1092852900006143.
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AbstractOver the last two decades, there has been a resurgence of interest in cerebral mechanisms underlying many psychiatric disorders. The changes in our understanding of the syndrome called obsessive-compulsive disorder (OCD) reflect this shift of perspective. Although OCD remains a syndrome that is quintessentially psychiatric, it has been increasingly recognized that it also has a neurological dimension that merits study in its own right, using the concepts and tools of clinical neurology.