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Liu J, Wang J, Song Y, Becker B, Ming X, Lei Y. Enhanced disgust generalization in obsessive-compulsive disorder is related to insula and putamen hyperactivity. Psychol Med 2025; 55:e116. [PMID: 40223574 DOI: 10.1017/s0033291725000728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/15/2025]
Abstract
BACKGROUND Compulsive cleaning is a characteristic symptom of a particular subtype of obsessive-compulsive disorder (OCD) and is often accompanied by intense disgust. While overgeneralization of threat is a key factor in the development of obsessive-compulsive symptoms, previous studies have primarily focused on fear generalization and have rarely examined disgust generalization. A systematic determination of the behavioral and neural mechanisms underlying disgust generalization in individuals with contamination concern is crucial for enhancing our understanding of OCD. METHOD In this study, we recruited 27 individuals with high contamination concerns and 30 individuals with low contamination concerns. Both groups performed a disgust generalization task while undergoing functional magnetic resonance imaging (fMRI). RESULTS The results revealed that individuals with high contamination concern had higher disgust expectancy scores for the generalization stimulus GS4 (the stimulus most similar to CS+) and exhibited higher levels of activation in the left insula and left putamen. Moreover, the activation of the left insula and putamen were positively correlated with a questionnaire core of the ratings of disgust and also positively correlated with the expectancy rating of CS+ during the generalization stage. CONCLUSION Hyperactivation of the insula and putamen during disgust generalization neutrally mediates the higher degree of disgust generalization in subclinical OCD individuals. This study indicates that altered disgust generalization plays an important role in individuals with high contamination concerns and provides evidence of the neural mechanisms involved. These insights may serve as a basis for further exploration of the pathogenesis of OCD in the future.
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Affiliation(s)
- Juntong Liu
- College of Psychology, Shenzhen University, Shenzhen, China
- Center for Neurogenetics, Shenzhen Institute of Neuroscience, Shenzhen, China
| | - Jinxia Wang
- Institution for Brain and Psychological Science, Sichuan Normal University, Chengdu, China
- Center for Neurogenetics, Shenzhen Institute of Neuroscience, Shenzhen, China
- Faculty of Education and Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Yuchen Song
- Institution for Brain and Psychological Science, Sichuan Normal University, Chengdu, China
| | - Benjamin Becker
- State Key Laboratory of Brain and Cognitive Sciences, Department of Psychology, The University of Hong Kong, Hong Kong, China
| | - Xianchao Ming
- School of Psychology, South China Normal University, Guangzhou, China
| | - Yi Lei
- Institution for Brain and Psychological Science, Sichuan Normal University, Chengdu, China
- Center for Neurogenetics, Shenzhen Institute of Neuroscience, Shenzhen, China
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Singh R, Sharma M, Sahu S, Adhvaryu A. Breaking New Ground With Endoxifen: Augmentation Strategies in OCD Management-A Case Series. Case Rep Psychiatry 2025; 2025:2908673. [PMID: 40177005 PMCID: PMC11964704 DOI: 10.1155/crps/2908673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2024] [Accepted: 02/28/2025] [Indexed: 04/05/2025] Open
Abstract
Obsessive-compulsive (OC) disorder (OCD) is a common and potentially disabling illness with a waxing and waning course. OCD significantly disrupts the quality of life. Selective serotonin reuptake inhibitors (SSRIs) are first-line pharmacological treatments for OCD and benefit up to half of the patients. Augmentation with low-dose antipsychotics is an evidence-based second-line strategy. Psychotherapy, including cognitive behavior therapy (CBT), is used both as first and second-line treatment. A significant portion of patients, however, do not respond to conventional treatments. We present a case series on the use of Endoxifen as an augmenting agent in patients with OCD and multiple psychiatric comorbidities who did not respond well to conventional pharmacotherapy.
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Affiliation(s)
- Rishabh Singh
- Department of Psychiatry, Command Hospital (Eastern Command), Kolkata, West Bengal, India
| | - Markanday Sharma
- Department of Psychiatry, Military Hospital, Jhansi, Uttar Pradesh, India
| | - Samiksha Sahu
- Department of Psychiatry, Gandhi Medical College, Bhopal, Madhya Pradesh, India
| | - Arka Adhvaryu
- Department of Psychiatry, RG Kar Medical College, Kolkata, West Bengal, India
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Gökçen O, Akkuş M. How Does the Normalization Process After the COVID-19 Pandemic Affect Patients With Obsessive-Compulsive Disorder? A Longitudinal Study. J Nerv Ment Dis 2025; 213:50-57. [PMID: 39760450 DOI: 10.1097/nmd.0000000000001821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2025]
Abstract
ABSTRACT This study aims to investigate the effect of the normalization process after the pandemic on obsessive-compulsive disorder (OCD) patients. During the pandemic period, the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Padua Inventory-Washington State University Revision, the Fear of COVID-19 Scale (FCV-19S), and an interview form inquiring sociodemographic characteristics were applied to the participant patients with OCD. During the normalization process, the patients were reevaluated after about 1 year. A significant decrease was found in the patients' FCV-19S and PE-WSUR total scores along with all subscale scores as well as the Y-BOCS scores. The FCV-19S was associated with OCD symptoms both during the pandemic and the normalization period. The final FCV-19S scores of patients with a Y-BOCS score of 12 and under were found to be statistically significantly lower than the others. This study shows that OCD symptom severity and fear of COVID-19 decreased with the normalization process. A decrease in pandemic-related stress and fear of COVID-19 with the normalization process may have positively affected OCD patients.
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Affiliation(s)
- Onur Gökçen
- Department of Psychiatry, Kutahya Health Sciences University, Kütahya, Türkiye
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4
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Zisler EM, Meule A, Endres D, Schennach R, Jelinek L, Voderholzer U. Effects of inpatient, residential, and day-patient treatment on obsessive-compulsive symptoms in persons with obsessive-compulsive disorder: A systematic review and meta-analysis. J Psychiatr Res 2024; 176:182-197. [PMID: 38875774 DOI: 10.1016/j.jpsychires.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 05/08/2024] [Accepted: 06/04/2024] [Indexed: 06/16/2024]
Abstract
INTRODUCTION Patients with severe or treatment-refractory obsessive-compulsive disorder (OCD) often need an extensive treatment which cannot be provided by outpatient care. Therefore, we aimed to estimate the effects and their moderators of inpatient, residential, or day-patient treatment on obsessive-compulsive symptoms in patients with OCD. METHODS PubMed, PsycINFO, and Web of Science were systematically screened according to the PRISMA guidelines. Studies were selected if they were conducted in an inpatient, residential, or day-patient treatment setting, were using a number of pre-defined instruments for assessing OCD symptom severity, and had a sample size of at least 20 patients. RESULTS We identified 43 eligible studies in which inpatient, residential, or day-patient treatment was administered. The means and standard deviations at admission, discharge, and-if available-at follow-up were extracted. All treatment programs included cognitive-behavioral treatment with exposure and response prevention. Only one study reported to not have used psychopharmacological medication. Obsessive-compulsive symptoms decreased from admission to discharge with large effect sizes (g = -1.59, 95%CI [-1.76; -1.41]) and did not change from discharge to follow-up (g = 0.06, 95%CI [-0.09; 0.21]). Length of stay, age, sex, and region did not explain heterogeneity across the studies but instrument used did: effects were larger for clinician-rated interviews than for self-report measures. CONCLUSIONS Persons with OCD can achieve considerable symptom reductions when undertaking inpatient, residential, or day-patient treatment and effects are-on average-maintained after discharge.
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Affiliation(s)
- Eva M Zisler
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany; Schoen Clinic Roseneck, Prien am Chiemsee, Germany.
| | - Adrian Meule
- Department of Psychology, University of Regensburg, Regensburg, Germany
| | - Dominique Endres
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | | | - Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Germany
| | - Ulrich Voderholzer
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany; Schoen Clinic Roseneck, Prien am Chiemsee, Germany; Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
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5
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Merrill RM, Ashton MK. How Do Mental Disorders and Combinations of Disorders Affect the Odds of Injuries and Poisoning? J Nerv Ment Dis 2024; 212:303-311. [PMID: 38704650 DOI: 10.1097/nmd.0000000000001771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/06/2024]
Abstract
ABSTRACT Injuries and poisoning are associated with mental disorders. The association may be stronger if comorbid mental illness is involved. This study explores whether selected mental disorders (stress, anxiety, depression, attention deficit hyperactivity disorder [ADHD], bipolar, obsessive-compulsive disorder [OCD], schizophrenia) are associated with injuries and poisoning and if the presence and frequency of comorbid mental illness affect these associations. Analyses utilize medical claims data for adult employees of a large corporation during 2017-2021. Approximately half or more of the index mental disorders experience comorbid mental illness. Odds of injury and poisoning are significantly greater for each mental disorder and tend to be significantly greater when comorbid mental illness exists ( vs . the mental disorder alone), especially for the associations involving poisoning. Schizophrenia alone and in combination with other mental illness has the strongest associations with injury and poisoning. OCD is only associated with injury and poisoning, and ADHD is only associated with poisoning, if accompanied by comorbid mental illness.
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Affiliation(s)
- Ray M Merrill
- Department of Public Health, College of Life Sciences, Brigham Young University, Provo, Utah
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Zisler EM, Meule A, Koch S, Schennach R, Voderholzer U. Duration of daily life activities in persons with and without obsessive-compulsive disorder. J Psychiatr Res 2024; 173:6-13. [PMID: 38460475 DOI: 10.1016/j.jpsychires.2024.02.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 02/08/2024] [Accepted: 02/24/2024] [Indexed: 03/11/2024]
Abstract
Persons with obsessive-compulsive disorder (OCD) are often impaired in their daily level of functioning due to their time-consuming obsessions and/or compulsions. To date, however, studies are lacking that quantify how much time persons with OCD actually spend on activities of daily living. Therefore, the current study assessed 13 daily life activities (in minutes) with a self-report questionnaire in 299 persons with OCD at admission to inpatient treatment and 300 age- and sex-matched persons without OCD. A majority of persons with OCD indicated that they experienced obsessions and/or compulsions when leaving (84%) and cleaning (70%) the apartment, grocery shopping (66%), changing clothes (66%), and showering with (62%) and without (63%) shampooing. Persons with OCD who experienced obsessions and/or compulsions during a given daily life activity-but not those who did not experience obsessions and/or compulsions during these activities-reported longer durations for performing 10 of the 13 activities than persons without OCD. For most activities, longer durations related weakly but significantly to higher OCD symptom severity. Results indicate that the duration of daily life activities seems to depend more on whether persons with OCD experience obsessions and/or compulsions during a specific activity and less on whether a person is diagnosed with OCD in general. Future studies may use other assessment methods that allow for tracking the duration in daily life in real time.
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Affiliation(s)
- Eva M Zisler
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany; Schoen Clinic Roseneck, Prien am Chiemsee, Germany.
| | - Adrian Meule
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany; Schoen Clinic Roseneck, Prien am Chiemsee, Germany; Institute of Medical Psychology, Faculty of Medicine, LMU Munich, Germany
| | - Stefan Koch
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
| | | | - Ulrich Voderholzer
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany; Schoen Clinic Roseneck, Prien am Chiemsee, Germany; Medical Center, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Algin S, Banik D, Rahman SA, Mahmud Tusher S, Tuj Johora F, Akter A, Ahmed T, Biswas MAM, Sinha S, Haque M. Ketamine Infusion in a Resistant Obsessive-Compulsive Disorder Patient in Bangladesh with Severe Suicidal Ideation: A Case Report. Cureus 2024; 16:e57877. [PMID: 38596207 PMCID: PMC11002706 DOI: 10.7759/cureus.57877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2024] [Indexed: 04/11/2024] Open
Abstract
Treatment of resistant obsessive-compulsive disorder (OCD) typically results in insufficient symptom alleviation, and even long-term medication often fails to have the intended effect. Ketamine is a potent non-competitive antagonist of the N-methyl-D-aspartate (NMDA) receptor. Studies have shown that low-dose ketamine infusion results in a considerable reduction in obsessive-compulsive symptoms and a rapid resolution of suicidal ideation. This is a case report on the effect of intravenous ketamine infusion on a patient with resistant OCD and severe suicidal ideation. Intravenous (IV) ketamine was given once a week over consecutive three weeks with necessary precautions. Psychometric tools such as the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Clinical Global Impressions Scale (CGI-S), the Beck Scale for Suicidal Ideations (BSSI), and Depression Anxiety and Stress Scale 21 (DASS-21) were applied before and after infusions. Obsessive-compulsive symptoms and suicidal severity started to decrease rapidly after the first infusion. However, after a transient improvement, these symptoms again began to increase after a stressful incident on the second day of the first infusion. All the symptoms measured by validated rating scales showed continued improvement after the following two infusions. The improvement was sustained until discharge (one week after the last infusion) and subsequent follow-up in the sixth and 12th weeks. The role of ketamine in reducing suicidal thoughts and behavior is already established. Very few studies emphasized its effectiveness in improving severe/resistant obsessive-compulsive symptoms. This pioneering work may offer scope for similar research in the relevant field.
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Affiliation(s)
- Sultana Algin
- Psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | - Debasish Banik
- Anesthesia, Analgesia, and Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | - Sm Atikur Rahman
- Psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | - Saiful Mahmud Tusher
- Anesthesia, Analgesia, and Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | - Fatema Tuj Johora
- Child and Adolescent Psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | - Asha Akter
- Psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | - Tanbir Ahmed
- Child and Adolescent Psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka, BGD
| | | | - Susmita Sinha
- Physiology, Khulna City Medical College and Hospital, Khulna, BGD
| | - Mainul Haque
- Karnavati Scientific Research Center (KSRC), School of Dentistry, Karnavati University, Gandhinagar, IND
- Pharmacology and Therapeutics, National Defence University of Malaysia, Kuala Lumpur, MYS
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8
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Shobeiri P, Hosseini Shabanan S, Haghshomar M, Khanmohammadi S, Fazeli S, Sotoudeh H, Kamali A. Cerebellar Microstructural Abnormalities in Obsessive-Compulsive Disorder (OCD): a Systematic Review of Diffusion Tensor Imaging Studies. CEREBELLUM (LONDON, ENGLAND) 2024; 23:778-801. [PMID: 37291229 DOI: 10.1007/s12311-023-01573-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/22/2023] [Indexed: 06/10/2023]
Abstract
Previous neuroimaging studies have suggested that obsessive-compulsive disorder (OCD) is associated with altered resting-state functional connectivity of the cerebellum. In this study, we aimed to describe the most significant and reproducible microstructural abnormalities and cerebellar changes associated with obsessive-compulsive disorder (OCD) using diffusion tensor imaging (DTI) investigations. PubMed and EMBASE were searched for relevant studies using the PRISMA 2020 protocol. A total of 17 publications were chosen for data synthesis after screening titles and abstracts, full-text examination, and executing the inclusion criteria. The patterns of cerebellar white matter (WM) integrity loss, determined by fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) metrics, varied across studies and symptoms. Changes in fractional anisotropy (FA) values were described in six publications, which were decreased in four and increased in two studies. An increase in diffusivity parameters of the cerebellum (i.e., MD, RD, and AD) in OCD patients was reported in four studies. Alterations of the cerebellar connectivity with other brain areas were also detected in three studies. Heterogenous results were found in studies that investigated cerebellar microstructural abnormalities in correlation with symptom dimension or severity. OCD's complex phenomenology may be characterized by changes in cerebellar WM connectivity across wide networks, as shown by DTI studies on OCD patients in both children and adults. Classification features in machine learning and clinical tools for diagnosing OCD and determining the prognosis of the disorder might both benefit from using cerebellar DTI data.
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Affiliation(s)
- Parnian Shobeiri
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
- NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | | | - Maryam Haghshomar
- NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Department of Radiology, Northwestern University, Chicago, IL, USA
| | - Shaghayegh Khanmohammadi
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Soudabeh Fazeli
- Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Houman Sotoudeh
- Department of Radiology and Neurology, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
| | - Arash Kamali
- Department of Diagnostic and Interventional Radiology, University of Texas McGovern Medical School, Houston, TX, USA
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Sarker R, Qusar MMAS, Islam SMA, Bhuiyan MA, Islam MR. Association of granulocyte macrophage colony-stimulating factor and interleukin-17 levels with obsessive-compulsive disorder: a case-control study findings. Sci Rep 2023; 13:18976. [PMID: 37923827 PMCID: PMC10624891 DOI: 10.1038/s41598-023-46401-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/31/2023] [Indexed: 11/06/2023] Open
Abstract
Obsessive-compulsive disorder (OCD) is a mental condition that affects many people and is characterized by recurring obsessions and compulsions. It significantly impacts individuals' ability to function ordinarily daily, affecting people of all ages. This study aimed to investigate whether or not the cytokines granulocyte macrophage colony-stimulating factor (GM-CSF) and interleukin-17 (IL-17) are involved in the pathophysiology of OCD. A case-control study with 50 OCD patients and 38 healthy volunteers served as the controls for this investigation. The levels of GM-CSF and IL-17 in the serum of both groups were measured with enzyme-linked immunosorbent assay (ELISA) kits. In addition, the sociodemographic characteristics of the population under study were studied. Based on the findings of this study, OCD patients had significantly elevated levels of IL-17 than the controls, it appears that there may be a function for IL-17 in the pathophysiology of OCD. It was also discovered that the severity of OCD and IL-17 levels had a significant positive correlation. On the other hand, when comparing the levels of GM-CSF, there was no significant difference between the patients and the controls. This study provides evidence supporting the involvement of cytokine IL-17 in the pathophysiology of OCD. This study suggests IL-17 as a diagnostic biomarker for OCD and adds to our knowledge of the function that the immune system plays in this condition.
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Affiliation(s)
- Rapty Sarker
- Department of Pharmacy, University of Asia Pacific, 74/A Green Road, Farmgate, Dhaka, 1205, Bangladesh
| | - M M A Shalahuddin Qusar
- Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Shahabagh, Dhaka, 1000, Bangladesh
| | | | - Mohiuddin Ahmed Bhuiyan
- Department of Pharmacy, University of Asia Pacific, 74/A Green Road, Farmgate, Dhaka, 1205, Bangladesh
| | - Md Rabiul Islam
- School of Pharmacy, BRAC University, 66 Mohakhali, Dhaka, 1212, Bangladesh.
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Bendriss G, MacDonald R, McVeigh C. Microbial Reprogramming in Obsessive-Compulsive Disorders: A Review of Gut-Brain Communication and Emerging Evidence. Int J Mol Sci 2023; 24:11978. [PMID: 37569349 PMCID: PMC10419219 DOI: 10.3390/ijms241511978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 08/13/2023] Open
Abstract
Obsessive-compulsive disorder (OCD) is a debilitating mental health disorder characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions). Dysbiosis, an imbalance in the gut microbial composition, has been associated with various health conditions, including mental health disorders, autism, and inflammatory diseases. While the exact mechanisms underlying OCD remain unclear, this review presents a growing body of evidence suggesting a potential link between dysbiosis and the multifaceted etiology of OCD, interacting with genetic, neurobiological, immunological, and environmental factors. This review highlights the emerging evidence implicating the gut microbiota in the pathophysiology of OCD and its potential as a target for novel therapeutic approaches. We propose a model that positions dysbiosis as the central unifying element in the neurochemical, immunological, genetic, and environmental factors leading to OCD. The potential and challenges of microbial reprogramming strategies, such as probiotics and fecal transplants in OCD therapeutics, are discussed. This review raises awareness of the importance of adopting a holistic approach that considers the interplay between the gut and the brain to develop interventions that account for the multifaceted nature of OCD and contribute to the advancement of more personalized approaches.
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Ferguson AA, Khan AI, Abuzainah B, Chaudhuri D, Khan KI, Al Shouli R, Allakky A, Hamdan JA. Clinical Effectiveness of N-Methyl-D-Aspartate (NMDA) Receptor Antagonists in Adult Obsessive-Compulsive Disorder (OCD) Treatment: A Systematic Review. Cureus 2023; 15:e37833. [PMID: 37213965 PMCID: PMC10198239 DOI: 10.7759/cureus.37833] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 04/13/2023] [Indexed: 05/23/2023] Open
Abstract
Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder that affects approximately 2% of the human population. Traditional treatment of OCD includes selective serotonin reuptake inhibitor (SSRI) or serotonin reuptake inhibitor (SRI) treatment along with cognitive behavioral therapy (CBT). Nearly 25%-30% of OCD patients do not respond to SSRIs. Glutamatergic agents are currently being studied for the treatment of OCD due to the glutamatergic pathway in the brain, related to OCD, and the role of the cortico-striato-thalamic circuit (CSTC). This review assesses the clinical effectiveness of N-methyl-D-aspartate (NMDA) antagonists, ketamine/esketamine, memantine, and amantadine, for adult patients with OCD. Inclusion criteria include human studies published within the last 15 years, with patients diagnosed with OCD, aged over 18 years, with only psychiatric comorbidities, and full-text articles. Papers that included interventions other than CBT, exposure with response prevention (ERP), and SSRI/SRI were excluded. Articles were searched for using PubMed, PubMed Central, Medical Literature Analysis and Retrieval System Online, GeorgiA LIbrary LEarning Online, EBSCO Information Services, OpenAthens, Multidisciplinary Digital Publishing Institute, and Google Scholar databases, last searched on December 2, 2022. The risk of bias was assessed using Cochrane Risk of Bias tools, the Scale for the Assessment of Narrative Review Articles (SANRA) checklist for literature reviews, and the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for quasi-experimental studies. Results were presented and synthesized by Excel spreadsheet analysis. The database search yielded 4,221 articles, which was cut down to 18 articles by inclusion/exclusion criteria, including duplications. 80% of the ketamine studies resulted in a significant reduction of obsessions and compulsions based on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), and each of the memantine and amantadine studies displayed clinical effectiveness, also. Limitations include the small number of amantadine studies and the limited availability of other NMDA receptor (NMDAR) antagonist-focused studies. This systematic review shows that ketamine is an effective drug for the treatment of non-refractory, mild to moderate OCD, and memantine and amantadine are effective augmentation agents for the treatment of mild to severe OCD.
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Affiliation(s)
- Asila A Ferguson
- Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Aujala Irfan Khan
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Baraa Abuzainah
- General Practice, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Dipabali Chaudhuri
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Kokab Irfan Khan
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Roba Al Shouli
- Pediatric, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Akhil Allakky
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Jaafar A Hamdan
- Medicine, American University of Antigua, St. John, ATG
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Heinen A, Varghese S, Krayem A, Molodynski A. Understanding health anxiety in the COVID-19 pandemic. Int J Soc Psychiatry 2022; 68:1756-1763. [PMID: 34823387 DOI: 10.1177/00207640211057794] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The COVID-19 pandemic continues to be one of the greatest public health challenges faced by the UK. Reported rates of psychiatric difficulties have increased and the mechanisms by which the pandemic has affected mental health requires investigation. AIMS The aim of the study was to understand the psychological impact of the COVID-19 pandemic on health anxiety in the general population, with a focus on Oxford Health NHS Foundation Trust, which provides specialist mental health care within Oxfordshire and Buckinghamshire. METHODS We invited participants aged 18+ across Oxfordshire and Buckinghamshire to complete an online questionnaire consisting of standardised questionnaires measuring psychological wellbeing, non-standardised questions to provide demographic information, and information about social circumstances and behaviour during the COVID-19 pandemic. Participants were then invited via email to complete a 3-month follow-up questionnaire. RESULTS About 324 participants completed the baseline survey while 199 completed the follow-up. Our analysis demonstrated that higher scores on a health anxiety inventory were related to reports of depression, anxiety, loneliness, poor quality of life and obsessive-compulsive symptoms and panic. We also identified several predictors of health anxiety such as being female, having a pre-existing physical or mental health condition, and poor tolerance of uncertainty. Lifestyle and demographic factors such as changes in financial situation, changes in employment status, having a close relative or friend with COVID-19, being able to do grocery shopping, being a key worker, and ethnicity were not found to predict health anxiety. CONCLUSIONS Awareness of the impact of health anxiety on people needs to be consistently high among healthcare professionals, especially in the continuing fallout from the COVID-19 pandemic. The relationship between health anxiety and fatigue, sleep quality, gender and co-morbid mental and physical health difficulties needs to be investigated further to determine areas of intervention.
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Zhu Y, Li Y, Xu X. Suicidal ideation and suicide attempts in psychiatric patients during the COVID-19: A systematic review and meta-analysis. Psychiatry Res 2022; 317:114837. [PMID: 36113254 PMCID: PMC9472469 DOI: 10.1016/j.psychres.2022.114837] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/25/2022] [Accepted: 09/04/2022] [Indexed: 01/04/2023]
Abstract
Current suicidal ideation and suicide attempts among psychiatric patients during the COVID-19 pandemic were studied through systematic review and meta-analysis. We searched the following electronic databases using the relevant search terms: Medline, Embase, PubMed and Web of Science, with the search time as of January 31,2022. Forest plots were obtained using Stata statistical software and a random-effects model was used to conduct a meta-analysis of the prevalence of suicidal ideation. We found 21 eligible studies, 11 of which provided suitable data for meta-analysis. 10 studies explored current suicidal ideation and reported a pooled prevalence of 20.4% (95%CI 14.0-26.8). Six studies examined suicide attempts, with a pooled prevalence of 11.4% (95%CI 6.2-16.6). The prevalence of suicidal ideation and suicide attempts varied by the study method used and by the study sites. This work highlights the need for real-time monitoring of suicidal ideation and suicide in psychiatric patients during the covid-19 pandemic r to inform clinical practice and help identify research questions for future epidemiological studies.
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Affiliation(s)
- Yingqian Zhu
- Medical College, Nantong University,19th Qixiu Road, Nantong, 226001, China
| | - Yanqing Li
- Medical College, Nantong University,19th Qixiu Road, Nantong, 226001, China
| | - Xiuqun Xu
- Department of Nursing, Affiliated Hospital of Nantong University, 20th Xisi Road, Nantong, 226001, China.
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Schizo-obsessive disorder - case study. CURRENT PROBLEMS OF PSYCHIATRY 2022. [DOI: 10.2478/cpp-2022-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Introduction: Schizo-obsessive disorder is a term that includes a dual diagnosis: schizophrenia and obsessive-compulsive disorder (OCD). The schizo-obsessive disorder definition was made at the end of the 19th century and is still valid today. Nowadays, the coexistence of schizophrenia with obsessive-compulsive syndromes becomes more commonly observed, therefore the recognition and number of the described cases has increased.
Material and methods: The aim of this article is to present a clinical case of a patient with a diagnostically and therapeutically difficult disorder, including the comorbidity of schizophrenia and OCD. The analysis of the clinical case and the medical records of a patient and a review of the literature including schizophrenia, OCD, and schizo-obsessive disorder, was performed.
Case study: A male patient, 20 years old, single, high school student, who lives with his family. In November 2019 a mental deterioration occurred. Simultaneously, obsessional ideas and behaviors appeared. An ambulatory treatment was introduced, however without adequate response, which was the cause of the first psychiatric hospitalization in 2020.
Discussion: Comorbidity between obsessive-compulsive disorder and schizophrenia may cause a particular problem for physicians. Without appropriate diagnosis, there is no possibility to implement proper management and treatment. Obsessive-compulsive symptoms should be treated as relatively common in patients with schizophrenia, which will prevent a mistake in the assessment of the patient’s condition.
Conclusions: Due to specific character of the disease, difficulties in diagnosis and treatment, there is a special need for individual therapeutic measures. Appropriate and targeted approach to the patient may be a chance for success in therapy.
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Mitra S, Bult-Ito A. Bidirectional Behavioral Selection in Mice: A Novel Pre-clinical Approach to Examining Compulsivity. Front Psychiatry 2021; 12:716619. [PMID: 34566718 PMCID: PMC8458042 DOI: 10.3389/fpsyt.2021.716619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/16/2021] [Indexed: 11/17/2022] Open
Abstract
Obsessive-compulsive disorder (OCD) and related disorders (OCRD) is one of the most prevalent neuropsychiatric disorders with no definitive etiology. The pathophysiological attributes of OCD are driven by a multitude of factors that involve polygenic mechanisms, gender, neurochemistry, physiological status, environmental exposures and complex interactions among these factors. Such complex intertwining of contributing factors imparts clinical heterogeneity to the disorder making it challenging for therapeutic intervention. Mouse strains selected for excessive levels of nest- building behavior exhibit a spontaneous, stable and predictable compulsive-like behavioral phenotype. These compulsive-like mice exhibit heterogeneity in expression of compulsive-like and other adjunct behaviors that might serve as a valuable animal equivalent for examining the interactions of genetics, sex and environmental factors in influencing the pathophysiology of OCD. The current review summarizes the existing findings on the compulsive-like mice that bolster their face, construct and predictive validity for studying various dimensions of compulsive and associated behaviors often reported in clinical OCD and OCRD.
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Affiliation(s)
- Swarup Mitra
- Department of Pharmacology and Toxicology, State University of New York at Buffalo, Buffalo, NY, United States
| | - Abel Bult-Ito
- Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks, AK, United States
- OCRD Biomed LLC, Fairbanks, AK, United States
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Liu W, Zhang H, He Y. Variation in Obsessive-Compulsive Disorder Symptoms and Treatments: A Side Effect of COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7420. [PMID: 34299871 PMCID: PMC8304611 DOI: 10.3390/ijerph18147420] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 06/30/2021] [Accepted: 07/03/2021] [Indexed: 12/23/2022]
Abstract
The Coronavirus Disease 2019 (COVID-19) exerts variable impact on patients with obsessive compulsive disorders (OCD). There remains a challenge to determine the extent to which OCD is exacerbated due to the pandemic. Therefore, our aim is to explicate the latest researching progress of OCD under COVID-19 based on a review of 15 existing articles. Our review confirms the prevalence of OCD exacerbation in different age groups and particular symptoms. However, it also reveals nonconformity among research, lack of investigation in OCD treatment, and imbalance in OCD symptoms research. Further, we discuss the probable reasons of the exacerbation and current situation of OCD treatments. Finally, based on our discussion, we offer suggestions on how to manage OCD under the new circumstance, including the introduction of new policies, the use of communications technology, the improvement of researching methods, and possible angles for further research.
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Affiliation(s)
- Wuqianhui Liu
- The First School of Clinical Medicine, Nanjing Medical University, Nanjing 211166, China;
| | - Haitao Zhang
- The Research Center for Medical Security, China Pharmaceutic University, Nanjing 211166, China;
- The Institute of National Governance and National Audit, Nanjing Audit University, Nanjing 211815, China
| | - Yuan He
- The Institute of Medical Humanities, Nanjing Medical University, Nanjing 211166, China
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Plunkett R, Costello S, McGovern M, McDonald C, Hallahan B. Impact of the COVID-19 pandemic on patients with pre-existing anxiety disorders attending secondary care. Ir J Psychol Med 2021; 38:123-131. [PMID: 32507119 PMCID: PMC7324660 DOI: 10.1017/ipm.2020.75] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 05/26/2020] [Accepted: 06/04/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To examine the psychological and social impact of the COVID-19 pandemic on patients with established anxiety disorders during a period of stringent mandated social restrictions. METHODS Semi-structured interviews were conducted with 30 individuals attending the Galway-Roscommon Mental Health Services with an International Classification of Diseases diagnosis of an anxiety disorder to determine the impact of the COVID-19 restrictions on anxiety and mood symptoms, social and occupational functioning and quality of life. RESULTS Twelve (40.0%) participants described COVID-19 restrictions as having a deleterious impact on their anxiety symptoms. Likert scale measurements noted that the greatest impact of COVID-19 related to social functioning (mean = 4.5, SD = 2.9), with a modest deleterious effect on anxiety symptoms noted (mean = 3.8, SD = 2.9). Clinician rated data noted that 8 (26.7%) participants had disimproved and 14 (46.7%) participants had improved since their previous clinical review, prior to commencement of COVID-19 restrictions. Conditions associated with no 'trigger', such as generalised anxiety disorder, demonstrated a non-significant increase in anxiety symptoms compared to conditions with a 'trigger', such as obsessive compulsive disorder. Psychiatric or physical comorbidity did not substantially impact on symptomatology secondary to COVID-19 mandated restrictions. CONCLUSIONS The psychological and social impact of COVID-19 restrictions on individuals with pre-existing anxiety disorders has been modest with only minimal increases in symptomatology or social impairment noted.
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Affiliation(s)
- R. Plunkett
- Galway-Roscommon Mental Health Services, University Hospital Galway, Galway, Ireland
| | - S. Costello
- Galway-Roscommon Mental Health Services, University Hospital Galway, Galway, Ireland
- School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - M. McGovern
- Galway-Roscommon Mental Health Services, University Hospital Galway, Galway, Ireland
| | - C. McDonald
- Galway-Roscommon Mental Health Services, University Hospital Galway, Galway, Ireland
- School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - B Hallahan
- Galway-Roscommon Mental Health Services, University Hospital Galway, Galway, Ireland
- School of Medicine, National University of Ireland Galway, Galway, Ireland
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18
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Dennis D, Radnitz C, Wheaton MG. A Perfect Storm? Health Anxiety, Contamination Fears, and COVID-19: Lessons Learned from Past Pandemics and Current Challenges. Int J Cogn Ther 2021; 14:497-513. [PMID: 33907592 PMCID: PMC8061445 DOI: 10.1007/s41811-021-00109-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/15/2021] [Indexed: 12/31/2022]
Abstract
The novel coronavirus disease 2019 (COVID-19) rapidly spread, becoming a global pandemic with significant health, economic, and social impacts. COVID-19 has caused widespread anxiety, which at healthy levels leads to adaptive, protective behavioral changes. For some individuals, a pandemic outbreak can lead to excessive, maladaptive levels of anxiety, particularly among those with obsessive-compulsive disorder (OCD) and health anxiety. In the present paper, we review past research studies that examined anxiety in response to other disease outbreaks (including Swine Flu, Zika, and Ebola) to serve as a guide for expectable responses to COVID-19. Our review focused on the role of belief-based cognitive variables (obsessive beliefs, contamination cognitions), transdiagnostic processes (disgust sensitivity, anxiety sensitivity, an intolerance of uncertainty), social factors, and environmental/situational variables as contributing factors to excessive concerns about past pandemics. These factors in combination with unique characteristics of the virus (disease, behavioral, social and economic factors) and media consumption might enhance vulnerability to excessive anxiety about COVID-19, in line with a diathesis-stress model. COVID-19 is also unique from past pandemics due to its severity, easy transmissibility, and the nature of prescribed behavioral responses (i.e., hand washing and social distancing). We therefore discuss the ways in which COVID-19 may disproportionately affect individuals with OCD and health anxiety. We conclude with important topics for clinical and research attention to help mental health professionals respond in this time of crisis.
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Affiliation(s)
- Danielle Dennis
- Fairleigh Dickinson University, Teaneck, NJ USA.,Barnard College of Columbia University, New York City, NY USA
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19
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Tibi L, Asher S, van Oppen P, van Balkom AJLM, Eikelenboom M, Visser HA, Penninx BW, Anholt GE. The correlates of social phobia in OCD: Findings from a large clinical sample. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2021; 60:312-332. [PMID: 33870535 DOI: 10.1111/bjc.12292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 03/18/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder, often complicated with comorbidities. Social phobia (SP) is the most frequent co-occurring anxiety disorder in OCD, associated with increased clinical severity. However, no study had examined the relevance of interpersonal processes in this comorbidity, which are at the core of SP. This study characterized the clinical (i.e., symptom profile, age of onset, chronicity, and comorbidity), vulnerability (i.e., childhood trauma, negative life events), and interpersonal (attachment style, expressed emotion, and social support) correlates of comorbid SP in a large sample of OCD patients. METHODS We analysed the data of 382 OCD patients participating in the Netherlands Obsessive Compulsive Disorder Association (NOCDA) study. We examined the correlates of SP in OCD using self-report questionnaires and structured clinical interviews. In addition, data of 312 non-OCD SP patients were drawn from the Netherlands Study of Depression and Anxiety (NESDA), to compare the age of onset of SP between groups. Descriptive univariate analyses were followed by backward stepwise logistic regression analyses. RESULTS Social phobia was present among approximately 20% of OCD patients. Social phobia in OCD was associated with increased depression severity and decreased ratings of secure attachment style. Among OCD patients, SP had a significantly earlier age onset as compared to SP in non-OCD patients. CONCLUSION Social phobia in OCD might render a vulnerable clinical picture, characterized with early onset of SP symptoms, insecure attachment style, and increased depressive symptoms. Future studies should use prospective designs to better understand the nature of comorbid SP in OCD. PRACTITIONER POINTS Approximately one fifth of OCD patients were diagnosed with comorbid social phobia in a large representative clinical sample. OCD patients with comorbid social phobia presented with a vulnerable clinical picture, characterized with increased depression severity and decreased ratings of secure attachment style. Social phobia in OCD was associated with an earlier AOO as compared to the AOO of social phobia without OCD. The findings are limited by a cross-sectional design; thus, causality could not be assessed. Research is needed to further examine the mechanisms of comorbid social phobia in OCD.
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Affiliation(s)
- Lee Tibi
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Sapir Asher
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Patricia van Oppen
- Amsterdam UMC, Location VUmc, Department of Psychiatry, Amsterdam Public Health research institute and GGZ inGeest Specialized Mental Health Care, the Netherlands
| | - Anton J L M van Balkom
- Amsterdam UMC, Location VUmc, Department of Psychiatry, Amsterdam Public Health research institute and GGZ inGeest Specialized Mental Health Care, the Netherlands
| | - Merijn Eikelenboom
- Amsterdam UMC, Location VUmc, Department of Psychiatry, Amsterdam Public Health research institute and GGZ inGeest Specialized Mental Health Care, the Netherlands
| | - Henny A Visser
- Innova Research Centre, Mental Health Care Institute GGZ Centraal, Ermelo, The Netherlands
| | - Brenda W Penninx
- Amsterdam UMC, Location VUmc, Department of Psychiatry, Amsterdam Public Health research institute and GGZ inGeest Specialized Mental Health Care, the Netherlands
| | - Gideon E Anholt
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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20
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Abstract
Objectives: To examine if the COVID-19 pandemic is associated with a differential effect over time in relation to its psychological and social impact on patients with established anxiety disorders. Methods: Semi-structured interviews were conducted with 24 individuals attending the Galway–Roscommon Mental Health Services with an International Classification of Diseases (ICD)-10 diagnosis of an anxiety disorder at two time points (six months apart) to determine the impact of the COVID-19 restrictions on anxiety and depressive symptoms, social and occupational functioning and quality of life. Results: No statistical difference in symptomatology was noted between the two time points in relation to anxiety symptoms as measured by utilising psychometric rating scales (BAI and HARS) or utilising a Likert scale. The greatest impact of COVID-19 at both time points is related to social functioning and quality of life. Significant variability was noted for individual participants. Qualitative analysis noted social isolation, concern for the participants’ future and increased difficulty managing anxiety with ongoing restrictions. Conclusions: No significant overall change in symptomatology or functioning over time was noted for individuals with pre-existing anxiety disorders. Variability was, however, demonstrated between individuals, with some individuals describing ongoing anxiety, social isolation and concern for their future. Identifying those with ongoing symptoms or distress and providing multidisciplinary support to this cohort is suggested.
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21
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Wheaton MG, Messner GR, Marks JB. Intolerance of uncertainty as a factor linking obsessive-compulsive symptoms, health anxiety and concerns about the spread of the novel coronavirus (COVID-19) in the United States. J Obsessive Compuls Relat Disord 2021; 28:100605. [PMID: 33251098 PMCID: PMC7681070 DOI: 10.1016/j.jocrd.2020.100605] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/19/2020] [Accepted: 11/18/2020] [Indexed: 12/29/2022]
Abstract
The novel coronavirus disease (COVID-19) has had a significant impact on public health, economic activity, and mental health as it spread across the globe. Research from past pandemics links excessive anxiety about illness-related threats with symptoms of health anxiety and obsessive-compulsive disorder (OCD). In the present study, we investigated whether intolerance of uncertainty (IU), a psychological vulnerability factor involved in both OCD and health anxiety, accounts for a portion of the relationship between these symptoms and fear of COVID-19 during the early stages of the outbreak in the Unites States. We administered measures of concern about the spread of COVID-19 (Coronavirus Threat Scale; CTS), health anxiety, and OCD symptoms to a large sample of community adults in the United States (n = 738) recruited through Amazon MTurk. Results revealed that concern about COVID-19 was moderately and positively correlated with both OCD and health anxiety symptoms, as well as IU. Moreover, regression analyses found that IU partially accounted for the connections between concern about the spread of COVID-19 and OCD and health anxiety symptoms. These results highlight IU as a potential mechanism connecting OCD and health anxiety to anxiety about pandemic threats. Clinical implications, limitations, and future directions for research are discussed.
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22
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Rajkumar RP. A Biopsychosocial Approach to Understanding Panic Buying: Integrating Neurobiological, Attachment-Based, and Social-Anthropological Perspectives. Front Psychiatry 2021; 12:652353. [PMID: 33716838 PMCID: PMC7943846 DOI: 10.3389/fpsyt.2021.652353] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 02/02/2021] [Indexed: 01/07/2023] Open
Abstract
The global COVID-19 pandemic has focused the attention of researchers, civil authority and the general public on the phenomenon of "panic buying," characterized by the excessive purchase of specific materials-particularly food and hygiene-related products-in anticipation of an expected shortage. This phenomenon has been well-documented in response to several natural and man-made disasters, but its global scope and severity in the context of COVID-19 are unprecedented. This response can negatively impact health, food security, and disease prevention efforts. Attempts to modify such behaviors are more likely to succeed if they are based on insights from both the biomedical and the social sciences. From a biological perspective, the phenomenological overlap between panic buying and psychological disorders such as hoarding disorder and compulsive buying raises the possibility of a shared neurobiological underpinning. Evolutionary models suggest that these behaviors represent an attempt to enhance individual and group survival in the face of a threatened scarcity of resources. These phenomena may be influenced by specific genetic variants which are also implicated in hoarding-related psychological disorders. From a psychological perspective, attachment theory provides a conceptual framework that serves as a bridge between prior life adversity, current deprivation, and an increased attachment to material objects. Such a framework is of relevance when considering panic buying during the COVID-19 pandemic, which has been associated with significant disruptions in attachment bonds. From a social-anthropological perspective, hoarding and related behaviors have been associated with social exclusion and rejection, as well a lack of social support. These risk factors have affected large sections of the general population in the context of the COVID-19 pandemic and the governmental responses to it. This perspective also emphasizes the symbolic significance of the hoarded objects themselves. In this paper, an attempt is made to integrate these three perspectives and thereby formulate a biopsychosocial model of panic buying in response to this global health crisis. The existing scientific literature on panic buying is examined in the light of this model. Finally, suggestions are proposed as to how this model might inform social strategies aimed at preventing or reducing panic buying.
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Affiliation(s)
- Ravi Philip Rajkumar
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
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23
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Capuzzi E, Di Brita C, Caldiroli A, Colmegna F, Nava R, Buoli M, Clerici M. Psychiatric emergency care during Coronavirus 2019 (COVID 19) pandemic lockdown: results from a Department of Mental Health and Addiction of northern Italy. Psychiatry Res 2020; 293:113463. [PMID: 32977050 PMCID: PMC7499069 DOI: 10.1016/j.psychres.2020.113463] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 09/06/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND The current COVID-19 pandemic and the consequent containment measures are leading to increasing mental health issues both in psychiatric patients and general population. OBJECTIVE We aimed to compare the number and characteristics of emergency psychiatric consultations during the phase 1 of lockdown with respect to the same period in 2019 in a Department of Mental Health and Addiction (DMHA) located in Lombardy region. METHODS We conducted a cross-sectional study including subjects consecutively admitted to two psychiatric emergency rooms of DMHA in Monza, Lombardy, Italy. Sociodemographic data, clinical characteristics, referred symptoms, diagnosis and information on patients' illness course following the emergency consultations were collected. No subjects were excluded for the purposes of the study. RESULTS Between February 21st and May 3rd 2020, there was a marked reduction in the number of psychiatric emergency consultations, if compared to the same period of 2019. Subjects who were living in psychiatric residential treatment facilities, had cannabis addiction and a diagnosis of obsessive-compulsive disorder were significantly more likely to present to emergency psychiatric consultations during lockdown. CONCLUSIONS COVID-19 epidemic may have a negative impact on more vulnerable individuals. Strategies to enhance relapse prevention and the use of alternative approaches as e-health technologies should be promoted.
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Affiliation(s)
- Enrico Capuzzi
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy.
| | - Carmen Di Brita
- Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 38, 20900 Monza (MB), Italy
| | - Alice Caldiroli
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Fabrizia Colmegna
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Roberto Nava
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Massimo Clerici
- Psychiatric Department, Azienda Socio Sanitaria Territoriale Monza, Monza, Italy; Department of Medicine and Surgery, University of Milano Bicocca, via Cadore 38, 20900 Monza (MB), Italy
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Muhlbauer JE, Ferrão YA, Eppingstall J, Albertella L, do Rosário MC, Miguel EC, Fontenelle LF. Predicting marriage and divorce in obsessive-compulsive disorder. JOURNAL OF SEX & MARITAL THERAPY 2020; 47:90-98. [PMID: 32783604 DOI: 10.1080/0092623x.2020.1804021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Single (N = 472, 51.7%), married or living in stable cohabitation (N = 375, 41.1%) and divorced or separated (N = 66, 7.2%) patients with obsessive-compulsive disorder (OCD) were compared in terms of their sociodemographic features, OCD phenotypes, and comorbidity profile. Using single status as a reference group, a multinominal regression analysis found increased age, lower severity of hoarding, increased rates of panic disorder without agoraphobia, and lower rates of dysthymic disorder to be associated with married or stable cohabitation status. Concomitantly, increased age, higher severity of symmetry symptoms, and increased rates of skin picking disorder were found to be associated with divorced status. These findings suggest that there is a relationship between marital status and different OCD phenotypes.
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Affiliation(s)
- Julia E Muhlbauer
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Ygor A Ferrão
- Department of Psychiatry, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Jan Eppingstall
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - Lucy Albertella
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - Maria C do Rosário
- Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Euripedes C Miguel
- Obsessive-Compulsive Spectrum Disorders Program (PROTOC), Department and Institute of Psychiatry, University of São Paulo (USP), São Paulo, Brazil
| | - Leonardo F Fontenelle
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
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25
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Abstract
The emergence of COVID-19 has recently dominated public discourse given its serious impact on vulnerable patient groups. Advice in relation to reducing risk of contamination has justifiably been circulated widely during the COVID-19 crisis. Contamination fear is a common obsessional theme in patients with obsessive–compulsive disorder (OCD), and there is a need for increased research on how infectious disease epidemics affect patients with OCD. We present the case of a lady in her 30s with a history of well-controlled contamination OCD who presented acutely with a significant exacerbation of OCD symptoms precipitated by media reports of COVID-19. The case highlights the potential psychological impacts of infectious disease epidemics on individuals with mental illness. We also highlight some of the risks posed to such patients in response to epidemics such as the COVID-19 crisis.
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26
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Trait specific modulatory effects of caffeine exposure on compulsive-like behaviors in a spontaneous mouse model of obsessive-compulsive disorder. Behav Pharmacol 2020; 31:622-632. [PMID: 32427622 PMCID: PMC7495980 DOI: 10.1097/fbp.0000000000000570] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Obsessive-compulsive disorder (OCD) is a psychiatric disorder characterized by recurring intrusive thoughts and repetitive compulsive behaviors, ultimately interfering with their quality of life. The complex heterogeneity of symptom dimensions across OCD patient subgroups impedes diagnosis and treatment. The core and comorbid symptomologies of OCD are thought to be modulated by common environmental exposures such as consumption of the psychostimulant caffeine. The effect of caffeine on the expression of obsessions and compulsions are unexplored. The current study utilized mouse strains (HA) with a spontaneous, predictable, and stable compulsive-like phenotype that have face, predictive, and construct validity for OCD. We demonstrate that an acute high dose (25 mg/kg) of caffeine decreased compulsive-like nest-building behavior in the HA strains in the first hour after injection. However, nest-building scores increased in hours 3, 4, and 5 after administration finally decreasing over a 24 h period. In contrast, a high dose of chronic caffeine (25 mg/kg/d) increased nest-building behavior. Interestingly for compulsive-like digging behavior, acute exposure to a high dose of caffeine decreased the number of marbles buried, while chronic exposure had little effect. An acute high dose of caffeine decreased anxiety-like and motor activity in open field behaviors whereas chronic caffeine administration did not have any overall effect on open field activity. The results, therefore, suggest a complex role of caffeine on compulsive-like, anxiety-like, and locomotor behaviors that is dependent on the duration of exposure.
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27
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Jacob L, Haro JM, Koyanagi A. Relationship between living alone and common mental disorders in the 1993, 2000 and 2007 National Psychiatric Morbidity Surveys. PLoS One 2019; 14:e0215182. [PMID: 31042720 PMCID: PMC6493731 DOI: 10.1371/journal.pone.0215182] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 03/27/2019] [Indexed: 12/27/2022] Open
Abstract
Given the high prevalence of common mental disorders (CMDs) and individuals living alone in the United Kingdom, the goal of this study using English nationally representative data was to examine the association between living alone and CMDs, and to identify potential mediating factors of this association. The data were drawn from the 1993, 2000 and 2007 National Psychiatric Morbidity Surveys. CMDs were assessed using the Clinical Interview Schedule-Revised (CIS-R), a questionnaire focusing on past week neurotic symptoms. The presence of CMDs was defined as a CIS-R total score of 12 and above. Multivariable logistic regression and mediation analyses were conducted to analyze the association between living alone and CMDs, and to identify mediators in this association. The prevalence of CMDs was higher in individuals living alone than in those not living alone in all survey years. Multivariable analysis showed a positive association between living alone and CMDs in all survey years (1993: odds ratio [OR] = 1.69; 2000: OR = 1.63; and 2007: OR = 1.88). Overall, loneliness explained 84% of the living alone-CMD association. Living alone was positively associated with CMDs. Interventions addressing loneliness among individuals living alone may be particularly important for the mental wellbeing of this vulnerable population.
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Affiliation(s)
- Louis Jacob
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
- * E-mail:
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
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Wang LY, Chen SF, Chiang JH, Hsu CY, Shen YC. Systemic autoimmune diseases are associated with an increased risk of obsessive-compulsive disorder: a nationwide population-based cohort study. Soc Psychiatry Psychiatr Epidemiol 2019; 54:507-516. [PMID: 30406283 DOI: 10.1007/s00127-018-1622-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 10/30/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE Studies suggested autoimmunity plays a role in the etiology of obsessive-compulsive disorder (OCD). The purpose of this study was to determine if a history of systemic autoimmune diseases (SADs) is associated with an increased risk of subsequent onset of OCD. METHODS Patients with or without SADs were identified in the Taiwan National Health Insurance Program. The SADs cohort consisted of 63,165, while the comparison cohort consisted of 315,825 patients. The incidence rates of OCD with a maximum follow-up period of 10 years between patients with and without SADs were compared using a Cox proportional hazard model to estimate the hazard ratio (HR) and 95% confidence interval (95% CI). RESULTS The major finding was the discovery of a higher incidence of subsequent OCD among patients with SADs (HR: 1.85; 95% CI 1.41-2.43) after adjusted for other demographic characteristics. Specifically, the risk of OCD was observed to be significant increase in systemic lupus erythematosus (1.65, 1.07-2.54) dermatomyositis (3.25, 1.04-10.17), and Sjögren's syndrome (2.38, 1.53-3.72). Also, this study revealed some potential risk factors for developing OCD, including younger age (less than or equal to 50-year-old) and some comorbidities (alcohol use disorder, liver cirrhosis, and malignancies). Conversely, this study found that steroid use was a potential protective factor for the development of OCD. CONCLUSIONS This study confirms that SADs are associated with higher incidence of OCD, suggesting that abnormal autoimmune process is associated with increased expression of psychiatric disturbances.
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Affiliation(s)
- Ling-Yi Wang
- Epidemiology and Biostatistics Consulting Center, Departments of Medical Research and Pharmacy, Tzu Chi General Hospital, Hualien, Taiwan
| | - Shih-Fen Chen
- Center of Medical Genetics, Tzu Chi General Hospital, Hualien, Taiwan
| | - Jen-Huai Chiang
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - Chung-Y Hsu
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
| | - Yu-Chih Shen
- Department of Psychiatry, Tzu Chi General Hospital, 707, Sec. 3, Chung Yang Rd, Hualien, 970, Taiwan. .,School of Medicine, Tzu Chi University, Hualien, Taiwan.
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Barona M, Brown M, Clark C, Frangou S, White T, Micali N. White matter alterations in anorexia nervosa: Evidence from a voxel-based meta-analysis. Neurosci Biobehav Rev 2019; 100:285-295. [PMID: 30851283 DOI: 10.1016/j.neubiorev.2019.03.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 02/08/2019] [Accepted: 03/05/2019] [Indexed: 02/06/2023]
Abstract
Anorexia nervosa (AN) is a severe psychiatric disorder with a complex and poorly understood etiology. Recent studies have sought to investigate differences in white matter microstructure in AN, with significant results in several brain regions. A systematic literature search of Embase, PubMed and Psychinfo databases was conducted in order to identify Diffusion Tensor Imaging (DTI) studies of patients with AN and controls. We performed a meta-analysis of studies that met our inclusion criteria (N = 13) using effect size-signed differential mapping (AES-SDM) to detect differences in Fractional Anisotropy (FA) in patients with AN (N = 227) compared to healthy controls (N = 243). The quantitative meta-analysis of DTI studies identified decreased FA in the posterior areas of the corpus callosum, the left superior longitudinal fasciculus II, and the left precentral gyrus, as well as increased FA in the right cortico-spinal projections, and lingual gyrus in AN vs. controls. Studies of WM architecture are still limited in AN; further studies with longitudinal design are needed to better understand the complexity of abnormalities, and their persistence.
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Affiliation(s)
- Manuela Barona
- UCL Great Ormond Street Institute of Child Health, London, UK
| | - Melanie Brown
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| | | | - Sophia Frangou
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Tonya White
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Nadia Micali
- UCL Great Ormond Street Institute of Child Health, London, UK; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA; Department of Psychiatry, University of Geneva, Geneva, Switzerland.
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30
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Kant R, Pasi S, Surolia A. Auto-Reactive Th17-Cells Trigger Obsessive-Compulsive-Disorder Like Behavior in Mice With Experimental Autoimmune Encephalomyelitis. Front Immunol 2018; 9:2508. [PMID: 30429853 PMCID: PMC6220041 DOI: 10.3389/fimmu.2018.02508] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 10/10/2018] [Indexed: 01/20/2023] Open
Abstract
Th17-lymphocytes are well known for their deleterious role in autoimmunity. But does the notoriety of this repertoire extend beyond autoimmunity? In the present study we employed experimental autoimmune encephalomyelitis as model system to study the role auto-reactive Th17 cells in neuropsychiatric disorders. The mice with experimental autoimmune encephalomyelitis exhibited exaggerated grooming activity. The observed behavioral anomaly resembled obsessive compulsive disorder (OCD) upon analysis of grooming microstructure, induced grooming, marble burying and nestlet shredding. The observed OCD like behavior was relieved upon Th17 cell depletion; alternatively, it could alone be induced by adoptive transfer of myelin oligodendrocyte glycoprotein (35-55) reactive Th17 in B6.Rag1−/− mice. The observed OCD like behavior was also alleviated upon treatment with a selective serotonin reuptake inhibitor, fluoxetine.
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Affiliation(s)
- Ravi Kant
- Molecular Science Laboratory, National Institute of Immunology, New Delhi, India.,Molecular Biophysics Unit, Indian Institute of Science, Bangalore, India
| | - Shweta Pasi
- Molecular Science Laboratory, National Institute of Immunology, New Delhi, India.,Molecular Biophysics Unit, Indian Institute of Science, Bangalore, India
| | - Avadhesha Surolia
- Molecular Science Laboratory, National Institute of Immunology, New Delhi, India.,Molecular Biophysics Unit, Indian Institute of Science, Bangalore, India
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Schirmbeck F, Swets M, Meijer CJ, Zink M, de Haan L. Obsessive-compulsive symptoms and overall psychopathology in psychotic disorders: longitudinal assessment of patients and siblings. Eur Arch Psychiatry Clin Neurosci 2018; 268:279-289. [PMID: 27988852 PMCID: PMC5861177 DOI: 10.1007/s00406-016-0751-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 11/23/2016] [Indexed: 11/26/2022]
Abstract
The course of obsessive-compulsive symptoms (OCS) and its association with alterations in other clinical variables in patients with psychotic disorders is insufficiently known. Patients (n = 602) and unaffected siblings (n = 652) from the Dutch Genetic Risk and Outcome of Psychosis (GROUP) study were investigated at baseline and after 3 years. Participants were assigned to four groups based on the course of OCS over time: no-OCS, persistent OCS, initial OCS and de novo OCS. In addition to cross-sectional comparisons, longitudinal associations between changes in OCS and symptoms of schizophrenia and general functioning were investigated. Patients with co-occurring OCS reported significantly higher severity of psychotic and affective symptoms as well as lower overall functioning compared to patients without OCS. These differences were stable over time for patients reporting persistent OCS. Subsequent repeated measure analysis revealed significant interaction effects for groups reporting changes in their OCS. Whereas the group with remission of initial OCS showed significant improvement in positive symptoms, emotional distress and functioning, the de novo group showed no significant change in these variables, but rather reported stable higher psychopathology. Similar results were found on a subclinical level in siblings. Patients with co-occurring OCS present a more severe clinical picture, especially if symptoms persist over time. The remission of OCS was associated with overall improvement, whereas individuals with de novo OCS already reported higher clinical impairment before OCS onset. More research is needed to elucidate causal pathways and to develop effective interventions for persistent comorbid OCS.
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Affiliation(s)
- Frederike Schirmbeck
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
- Arkin Institute for Mental Health, Amsterdam, The Netherlands.
| | - Marije Swets
- Arkin Institute for Mental Health, Amsterdam, The Netherlands
| | - Carin J Meijer
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Mathias Zink
- Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Arkin Institute for Mental Health, Amsterdam, The Netherlands
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32
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Tapancı Z, Yıldırım A, Boysan M. Neurological soft signs, dissociation and alexithymia in patients with obsessive-compulsive disorder (OCD) and healthy subjects. Psychiatry Res 2018; 260:90-97. [PMID: 29175504 DOI: 10.1016/j.psychres.2017.11.058] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Revised: 11/09/2017] [Accepted: 11/18/2017] [Indexed: 10/18/2022]
Abstract
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.
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Affiliation(s)
- Zafer Tapancı
- Department of Psychiatry, Yüzüncü Yıl University School of Medicine, Van, Turkey.
| | - Abdullah Yıldırım
- Department of Psychiatry, Yüzüncü Yıl University School of Medicine, Van, Turkey.
| | - Murat Boysan
- Department of Psychology, Yüzüncü Yıl University Faculty of Social Sciences, Van, Turkey.
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Sakalli Kani A, Aksoy Poyraz C, Poyraz BC, Bayar MR, Akin E, Kose S. The role of affective temperaments and chronotype in pharmacotherapy response in patients with obsessive-compulsive disorder. PSYCHIAT CLIN PSYCH 2017. [DOI: 10.1080/24750573.2017.1391157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Ayse Sakalli Kani
- Department of Psychiatry, Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Cana Aksoy Poyraz
- Department of Psychiatry, Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey
| | - B. Cağrı Poyraz
- Department of Psychiatry, Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey
| | - M. Reha Bayar
- Department of Psychiatry, Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Ercan Akin
- Department of Psychology, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Samet Kose
- Department of Psychology, Hasan Kalyoncu University, Gaziantep, Turkey
- Department of Psychiatry, University of Texas Medical School of Houston, Houston, TX, USA
- Center for Neurobehavioral Research on Addictions, Houston, TX, USA
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34
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Obsessive-Compulsive Disorder with Suicide Obsessions in a First Responder without Previous Diagnosis of OCD or History of Suicide Attempts. Case Rep Psychiatry 2017; 2017:4808275. [PMID: 29098105 PMCID: PMC5643032 DOI: 10.1155/2017/4808275] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 07/23/2017] [Accepted: 08/24/2017] [Indexed: 11/17/2022] Open
Abstract
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.
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Abstract
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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36
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Bello MS, Pang RD, Chasson GS, Ray LA, Leventhal AM. Obsessive-compulsive symptoms and negative affect during tobacco withdrawal in a non-clinical sample of African American smokers. J Anxiety Disord 2017; 48:78-86. [PMID: 27769664 PMCID: PMC5380588 DOI: 10.1016/j.janxdis.2016.10.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 10/01/2016] [Accepted: 10/03/2016] [Indexed: 10/20/2022]
Abstract
The association between obsessive-compulsive (OC) symptomatology and smoking is poorly understood, particularly in African Americans-a group subject to smoking- and OC-related health disparities. In a non-clinical sample of 253 African American smokers, we tested the negative reinforcement model of OC-smoking comorbidity, purporting that smokers with higher OC symptoms experience greater negative affect (NA) and urge to smoke for NA suppression upon acute tobacco abstinence. Following a baseline visit involving OC assessment, participants completed two counterbalanced experimental visits (non-abstinent vs. 16-h tobacco abstinence) involving affect, smoking urge, and nicotine withdrawal assessment. OC symptom severity predicted larger abstinence-provoked increases in overall NA, anger, anxiety, depression, fatigue, urge to smoke to suppress NA, and composite nicotine withdrawal symptom index. African American smokers with elevated OC symptoms appear to be vulnerable to negative reinforcement-mediated smoking motivation and may benefit from cessation treatments that diminish NA or the urge to quell NA via smoking.
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Affiliation(s)
- Mariel S Bello
- University of Southern California, Department of Psychology, Los Angeles, CA, USA
| | - Raina D Pang
- University of Southern California Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA, USA
| | - Gregory S Chasson
- Illinois Institute of Technology, Department of Psychology, Chicago, IL, USA
| | - Lara A Ray
- University of California Los Angeles, Department of Psychology, Los Angeles, CA, USA
| | - Adam M Leventhal
- University of Southern California, Department of Psychology, Los Angeles, CA, USA; University of Southern California Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA, USA.
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37
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Saraf G, Paul I, Viswanath B, Narayanaswamy JC, Math SB, Reddy YCJ. Bipolar disorder comorbidity in patients with a primary diagnosis of OCD. Int J Psychiatry Clin Pract 2017; 21:70-74. [PMID: 27646489 DOI: 10.1080/13651501.2016.1233344] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Bipolar disorder (BD) is considered to be a common comorbid condition in subjects with obsessive-compulsive disorder (OCD), but there is limited literature on the prevalence of BD and its clinical correlates in those with a primary diagnosis of OCD. METHODS We studied the prevalence of BD in a sample of consecutively registered outpatients attending a specialty OCD clinic in India over a period of 13 months. One hundred and seventy-one patients with a primary diagnosis of OCD were assessed systematically using structured and semi-structured instruments. RESULTS The prevalence of lifetime BD in OCD was 4%. The OCD + BD group had an episodic course of OCD and higher rate of lifetime suicide attempts. CONCLUSIONS BD may not be as highly prevalent in OCD as reported in literature. Those with OCD seem to have only a marginally higher risk for developing BD than the general population. A diagnosis of BD seems to have a pathoplastic effect on the course of OCD. Patients with OCD-BD comorbidity have to be specifically assessed for suicide risk.
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Affiliation(s)
- Gayatri Saraf
- a Department of Psychiatry , National Institute of Mental Health and Neuro Sciences (NIMHANS) , Bangalore , India
| | - Imon Paul
- a Department of Psychiatry , National Institute of Mental Health and Neuro Sciences (NIMHANS) , Bangalore , India
| | - Biju Viswanath
- a Department of Psychiatry , National Institute of Mental Health and Neuro Sciences (NIMHANS) , Bangalore , India
| | - Janardhanan C Narayanaswamy
- a Department of Psychiatry , National Institute of Mental Health and Neuro Sciences (NIMHANS) , Bangalore , India
| | - Suresh Bada Math
- a Department of Psychiatry , National Institute of Mental Health and Neuro Sciences (NIMHANS) , Bangalore , India
| | - Y C Janardhan Reddy
- a Department of Psychiatry , National Institute of Mental Health and Neuro Sciences (NIMHANS) , Bangalore , India
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Zhu TH, Nakamura M, Farahnik B, Abrouk M, Reichenberg J, Bhutani T, Koo J. Obsessive-compulsive skin disorders: a novel classification based on degree of insight. J DERMATOL TREAT 2016; 28:342-346. [DOI: 10.1080/09546634.2016.1240864] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Tian Hao Zhu
- University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Mio Nakamura
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, San Francisco, CA, USA
| | | | - Michael Abrouk
- University of California Irvine School of Medicine, Irvine, CA, USA
| | - Jason Reichenberg
- University of Texas at Austin, Dell Medical School, Austin, TX, USA
- Seton Family of Hospitals, Austin, TX, USA
| | - Tina Bhutani
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, San Francisco, CA, USA
| | - John Koo
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, San Francisco, CA, USA
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Abstract
PURPOSE OF REVIEW The following review provides some description of the movement in cross-disorder psychiatric genomics toward addressing both comorbidity and polygenicity. RECENT FINDINGS We attempt to show how dimensional approaches to the phenotype have led to further addressing the problem of comorbidity of psychiatric diagnoses. And we also attempt to show how a dimensional approach to the genome, with different statistical methods from traditional genome-wide association analyses, has begun to resolve the problem of massive polygenicity. SUMMARY Cross-disorder research, of any area in psychiatry, arguably has the most potential to inform clinical diagnosis, early detection and prevention strategies, and pharmacological treatment research. Future research might leverage what we now know to inform developmental studies of risk and resilience.
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Affiliation(s)
- Anna R Docherty
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Arden A Moscati
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Ayman H Fanous
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA; Washington Veterans Affairs Healthcare System, Washington D.C., USA; Georgetown University School of Medicine, Washington D.C., USA
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Kim H, Lee Y, Kim JE, Han PL. Reversal of an Unconditioned Behavioral Preference for Specific Food Pellets by Intervention of Whisker Sensory Inputs. Exp Neurobiol 2016; 25:79-85. [PMID: 27122994 PMCID: PMC4844566 DOI: 10.5607/en.2016.25.2.79] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Revised: 04/05/2016] [Accepted: 04/05/2016] [Indexed: 11/19/2022] Open
Abstract
Adenylyl cyclase type-5 (AC5) is preferentially expressed in the dorsal striatum. Recently, we reported that AC5 knockout (KO) mice preferred food pellets carrying an olfactory cue produced by AC5 KO mice during food consumption (AC5 KO pellets) over food pellets that had been taken by wildtype (WT) mice. In the present study, we demonstrated that whisker trimming on the right side of the face but not the left in AC5 KO mice blocked the behavioral preference for AC5 KO pellets. Conversely, whisker trimming on the right but not the left in WT mice induced a behavioral preference for AC5 KO pellets. Mice lacking D2 dopamine receptor (D2 KO mice) also showed a behavioral preference for AC5 KO pellets. In D2 mice, whisker trimming on the right side of the face but not the left blocked a behavioral preference for AC5 KO food pellets. AC5 KO mice had increased level of phospho-CaMKIIα in the dorsal striatum, and WT mice with whiskers cut on either side also showed increased p-CaMKIIα level in the dorsal striatum. The siRNA-mediated inhibition of CaMKIIα in the dorsal striatum in either the right or the left hemisphere in AC5 KO mice and D2 KO mice blocked the behavioral preference for AC5 KO pellets. However, behavioral changes induced by this inhibition on each side showed asymmetrical time courses. These results suggest that an unconditioned behavioral preference for specific food pellets can be switched on or off based on the balance of states of neural activity in the dorsal striatum regulated by a signaling pathway centered on AC5 and D2 and the sensory inputs of whiskers from the right side of the face.
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Affiliation(s)
- Hannah Kim
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul 03760, Korea
| | - Yunjin Lee
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul 03760, Korea
| | - Ji-Eun Kim
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul 03760, Korea
| | - Pyung-Lim Han
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul 03760, Korea.; Brain Disease Research Institute, Ewha Womans University, Seoul 03760, Korea.; Department of Chemistry and Nano Science, Ewha Womans University, Seoul 03760, Korea
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Catechol-O-Methyltransferase Gene Polymorphisms in Specific Obsessive–Compulsive Disorder Patients’ Subgroups. J Mol Neurosci 2015; 58:129-36. [DOI: 10.1007/s12031-015-0697-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 12/01/2015] [Indexed: 01/15/2023]
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42
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Kalueff AV, Stewart AM, Song C, Berridge KC, Graybiel AM, Fentress JC. Neurobiology of rodent self-grooming and its value for translational neuroscience. Nat Rev Neurosci 2015; 17:45-59. [PMID: 26675822 DOI: 10.1038/nrn.2015.8] [Citation(s) in RCA: 535] [Impact Index Per Article: 53.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Self-grooming is a complex innate behaviour with an evolutionarily conserved sequencing pattern and is one of the most frequently performed behavioural activities in rodents. In this Review, we discuss the neurobiology of rodent self-grooming, and we highlight studies of rodent models of neuropsychiatric disorders--including models of autism spectrum disorder and obsessive compulsive disorder--that have assessed self-grooming phenotypes. We suggest that rodent self-grooming may be a useful measure of repetitive behaviour in such models, and therefore of value to translational psychiatry. Assessment of rodent self-grooming may also be useful for understanding the neural circuits that are involved in complex sequential patterns of action.
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Affiliation(s)
- Allan V Kalueff
- Research Institute of Marine Drugs and Nutrition, Key Laboratory of Aquatic Product Processing and Safety, College of Food Science and Technology, Guangdong Ocean University, Zhanjiang 524088, China.,Neuroscience Research Laboratory, ZENEREI Research Center, Slidell, Louisiana 70458, USA.,Institute of Translational Biomedicine, St Petersburg State University, St Petersburg 199034, Russia.,Institutes of Chemical Technologies and Natural Sciences, Ural Federal University, Ekaterinburg 620002, Russia
| | - Adam Michael Stewart
- Neuroscience Research Laboratory, ZENEREI Research Center, Slidell, Louisiana 70458, USA
| | - Cai Song
- Research Institute of Marine Drugs and Nutrition, Key Laboratory of Aquatic Product Processing and Safety, College of Food Science and Technology, Guangdong Ocean University, Zhanjiang 524088, China.,Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford St, Life Sciences Centre, Halifax, Nova Scotia B3H4R2, Canada.,Graduate Institute of Neural Cognitive Science, China Medical University, Taichung 000001, Taiwan
| | - Kent C Berridge
- Department of Psychology, University of Michigan, 525E University Str, Ann Arbor, Michigan 48109, USA
| | - Ann M Graybiel
- McGovern Institute for Brain Research and Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, Massachusetts 02139, USA
| | - John C Fentress
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford St, Life Sciences Centre, Halifax, Nova Scotia B3H4R2, Canada
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Abstract
BACKGROUND 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. AIM 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. METHOD 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]). RESULTS 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. CONCLUSIONS 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.
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Rahimi A, Haghighi M, Shamsaei F. Pure Obsessive Compulsive Disorder in Three Generations. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2015; 9:e1116. [PMID: 26288641 PMCID: PMC4539584 DOI: 10.17795/ijpbs1116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Revised: 07/14/2014] [Accepted: 08/22/2014] [Indexed: 01/15/2023]
Abstract
Introduction: Obsessive-compulsive disorder (OCD) is a psychiatric disorder, which has been shown to affect 2 - 3.5% of people, during their lifetimes. Identification of familial more homogenous characteristics of OCD may help to define relevant subtypes and increase the power of genetic and neurobiological studies of OCD. Case Presentation; This case report describes an adult woman suffering from symptoms of energy loss, insomnia, lack of appetite, and depressed mood. The patient history was positive for counting coercion. The patient’s genogram revealed counting coercion in three generations of her family. Conclusions: This case highlights the issue whether counting can be a distinctive feature among inflicted and not inflicted individuals, such as hoarding. Also, it is still unclear what is it really transferred; the vulnerability to disease, which is transferred among three generations, or the symptoms of counting itself, by genes. Further studies are required to answer the debates on this issue.
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Affiliation(s)
- Alireza Rahimi
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Mohammad Haghighi
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Farshid Shamsaei
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical Sciences, Hamadan, IR Iran
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Kim H, Kim TK, Kim JE, Park JY, Lee Y, Kang M, Kim KS, Han PL. Adenylyl cyclase-5 in the dorsal striatum function as a molecular switch for the generation of behavioral preferences for cue-directed food choices. Mol Brain 2014; 7:77. [PMID: 25378213 PMCID: PMC4233066 DOI: 10.1186/s13041-014-0077-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 10/23/2014] [Indexed: 11/10/2022] Open
Abstract
Background Behavioral choices in habits and innate behaviors occur automatically in the absence of conscious selection. These behaviors are not easily modified by learning. Similar types of behaviors also occur in various mental illnesses including drug addiction, obsessive-compulsive disorder, schizophrenia, and autism. However, underlying mechanisms are not clearly understood. In the present study, we investigated the molecular mechanisms regulating unconditioned preferred behaviors in food-choices. Results Mice lacking adenylyl cyclase-5 (AC5 KO mice), which is preferentially expressed in the dorsal striatum, consumed food pellets nearly one after another in cages. AC5 KO mice showed aversive behaviors to bitter tasting quinine, but they compulsively chose quinine-containing AC5 KO-pellets over fresh pellets. The unusual food-choice behaviors in AC5 KO mice were due to the gain of behavioral preferences for food pellets containing an olfactory cue, which wild-type mice normally ignored. Such food-choice behaviors in AC5 KO mice disappeared when whiskers were trimmed. Conversely, whisker trimming in wildtype mice induced behavioral preferences for AC5 KO food pellets, indicating that preferred food-choices were not learned through prior experience. Both AC5 KO mice and wildtype mice with trimmed whiskers had increased glutamatergic input from the barrel cortex into the dorsal striatum, resulting in an increase in the mGluR1-dependent signaling cascade. The siRNA-mediated inhibition of mGluR1 in the dorsal striatum in AC5 KO mice and wildtype mice with trimmed whiskers abolished preferred choices for AC5 KO food pellets, whereas siRNA-mediated inhibition of mGluR3 glutamate receptors in the dorsal striatum in wildtype mice induced behavioral preferences for AC5 KO food pellets, thus mimicking AC5 KO phenotypes. Conclusions Our results show that the gain and loss of behavioral preferences for a specific cue-directed option were regulated by specific cellular factors in the dorsal striatum, such that the preferred food choices were switched on when either the mGluR3-AC5 pathway was inactive or the mGluR1 pathway was active, whereas the preferred food-choices were switched off when mGluR1 or its downstream pathway was suppressed. These results identify the AC5 and mGluR system in the dorsal striatum as molecular on/off switches to direct decisions on behavioral preferences for cue-oriented options.
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Affiliation(s)
- Hannah Kim
- Department of Brain and Cognitive Sciences, Ewha Womans University, 11-1 Daehyun-Dong, Seodaemoon-Gu, Seoul, 120-750, Republic of Korea.
| | - Tae-Kyung Kim
- Department of Brain and Cognitive Sciences, Ewha Womans University, 11-1 Daehyun-Dong, Seodaemoon-Gu, Seoul, 120-750, Republic of Korea.
| | - Ji-Eun Kim
- Department of Brain and Cognitive Sciences, Ewha Womans University, 11-1 Daehyun-Dong, Seodaemoon-Gu, Seoul, 120-750, Republic of Korea.
| | - Jin-Young Park
- Department of Brain and Cognitive Sciences, Ewha Womans University, 11-1 Daehyun-Dong, Seodaemoon-Gu, Seoul, 120-750, Republic of Korea.
| | - Yunjin Lee
- Department of Brain and Cognitive Sciences, Ewha Womans University, 11-1 Daehyun-Dong, Seodaemoon-Gu, Seoul, 120-750, Republic of Korea.
| | - Minkyung Kang
- Department of Brain and Cognitive Sciences, Ewha Womans University, 11-1 Daehyun-Dong, Seodaemoon-Gu, Seoul, 120-750, Republic of Korea.
| | - Kyoung-Shim Kim
- Laboratory Animal Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea.
| | - Pyung-Lim Han
- Department of Brain and Cognitive Sciences, Ewha Womans University, 11-1 Daehyun-Dong, Seodaemoon-Gu, Seoul, 120-750, Republic of Korea. .,Brain Disease Research Institute, Ewha Womans University, 11-1 Daehyun-Dong, Seodaemoon-Gu, Seoul, 120-750, Republic of Korea. .,Department of Chemistry and Nano Science, Ewha Womans University, 11-1 Daehyun-Dong, Seodaemoon-Gu, Seoul, 120-750, Republic of Korea.
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Bejerot S, Edman G, Anckarsäter H, Berglund G, Gillberg C, Hofvander B, Humble MB, Mörtberg E, Råstam M, Ståhlberg O, Frisén L. The Brief Obsessive-Compulsive Scale (BOCS): a self-report scale for OCD and obsessive-compulsive related disorders. Nord J Psychiatry 2014; 68:549-59. [PMID: 24568661 PMCID: PMC4221004 DOI: 10.3109/08039488.2014.884631] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND The Brief Obsessive Compulsive Scale (BOCS), derived from the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the children's version (CY-BOCS), is a short self-report tool used to aid in the assessment of obsessive-compulsive symptoms and diagnosis of obsessive-compulsive disorder (OCD). It is widely used throughout child, adolescent and adult psychiatry settings in Sweden but has not been validated up to date. AIM The aim of the current study was to examine the psychometric properties of the BOCS amongst a psychiatric outpatient population. METHOD The BOCS consists of a 15-item Symptom Checklist including three items (hoarding, dysmorphophobia and self-harm) related to the DSM-5 category "Obsessive-compulsive related disorders", accompanied by a single six-item Severity Scale for obsessions and compulsions combined. It encompasses the revisions made in the Y-BOCS-II severity scale by including obsessive-compulsive free intervals, extent of avoidance and excluding the resistance item. 402 adult psychiatric outpatients with OCD, attention-deficit/hyperactivity disorder, autism spectrum disorder and other psychiatric disorders completed the BOCS. RESULTS Principal component factor analysis produced five subscales titled "Symmetry", "Forbidden thoughts", "Contamination", "Magical thoughts" and "Dysmorphic thoughts". The OCD group scored higher than the other diagnostic groups in all subscales (P < 0.001). Sensitivities, specificities and internal consistency for both the Symptom Checklist and the Severity Scale emerged high (Symptom Checklist: sensitivity = 85%, specificities = 62-70% Cronbach's α = 0.81; Severity Scale: sensitivity = 72%, specificities = 75-84%, Cronbach's α = 0.94). CONCLUSIONS The BOCS has the ability to discriminate OCD from other non-OCD related psychiatric disorders. The current study provides strong support for the utility of the BOCS in the assessment of obsessive-compulsive symptoms in clinical psychiatry.
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Affiliation(s)
- Susanne Bejerot
- Susanne Bejerot, M.D., Ph.D., Associate Professor, Department of Clinical Neuroscience, Karolinska Institutet , Stockholm , Sweden
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Zink M, Schirmbeck F, Rausch F, Eifler S, Elkin H, Solojenkina X, Englisch S, Wagner M, Maier W, Lautenschlager M, Heinz A, Gudlowski Y, Janssen B, Gaebel W, Michel TM, Schneider F, Lambert M, Naber D, Juckel G, Krueger-Oezguerdal S, Wobrock T, Hasan A, Riedel M, Müller H, Klosterkötter J, Bechdolf A. Obsessive-compulsive symptoms in at-risk mental states for psychosis: associations with clinical impairment and cognitive function. Acta Psychiatr Scand 2014; 130:214-26. [PMID: 24571191 DOI: 10.1111/acps.12258] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2014] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Obsessive-compulsive symptoms (OCS) constitute a major comorbidity in schizophrenia. Prevalence estimations of OCS for patients with at-risk mental states (ARMS) for psychosis vary largely. It is unclear how ARMS patients with or without comorbid OCS differ regarding general psychosocial functioning, psychotic and affective symptoms and neurocognitive abilities. METHOD At-risk mental states patients (n = 233) from the interventional trial PREVENT (Secondary Prevention of Schizophrenia) were stratified according to the presence or absence of comorbid OCS and compared on several clinical variables. RESULTS Patients, who fulfilled the criteria for obsessive-compulsive disorder (OCD) or presented with subclinical OCS (ARMSposOCS sample), did not significantly differ from patients without OCS (ARMSnegOCS) with regard to gender, age, premorbid verbal intelligence and levels of education. Furthermore, similar severity of depressive syndromes, basic cognitive, attenuated psychotic and brief limited intermittent psychotic symptoms were found. However, ARMSposOCS patients showed more impairment of psychosocial functioning and higher general psychopathology. In contrast, they scored higher in cognitive tasks measuring working memory and immediate verbal memory. CONCLUSION Findings extend upon previous results due to the multidimensional assessment. Subsequent longitudinal studies might elucidate how comorbid OCS influence differential treatment response, especially to cognitive behavioural interventions and the transition rates to psychosis.
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Affiliation(s)
- M Zink
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Zink M. Comorbid Obsessive-Compulsive Symptoms in Schizophrenia: Insight into Pathomechanisms Facilitates Treatment. Adv Med 2014; 2014:317980. [PMID: 26556409 PMCID: PMC4590963 DOI: 10.1155/2014/317980] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Accepted: 05/19/2014] [Indexed: 12/17/2022] Open
Abstract
Insight into the biological pathomechanism of a clinical syndrome facilitates the development of effective interventions. This paper applies this perspective to the important clinical problem of obsessive-compulsive symptoms (OCS) occurring during the lifetime diagnosis of schizophrenia. Up to 25% of schizophrenia patients suffer from OCS and about 12% fulfil the diagnostic criteria of obsessive-compulsive disorder (OCD). This is accompanied by marked subjective burden of disease, high levels of anxiety, depression and suicidality, increased neurocognitive impairment, less favourable levels of social and vocational functioning, and greater service utilization. Comorbid patients can be assigned to heterogeneous subgroups. It is assumed that second generation antipsychotics (SGAs), most importantly clozapine, might aggravate or even induce second-onset OCS. Several epidemiological and pharmacological arguments support this assumption. Specific genetic risk factors seem to dispose patients with schizophrenia to develop OCS and risk-conferring polymorphisms has been defined in SLC1A1, BDNF, DLGAP3, and GRIN2B and in interactions between these individual genes. Further research is needed with detailed characterization of large samples. In particular interactions between genetic risk constellations, pharmacological and psychosocial factors should be analysed. Results will further define homogeneous subgroups, which are in need for differential causative interventions. In clinical practise, schizophrenia patients should be carefully monitored for OCS, starting with at-risk mental states of psychosis and longitudinal follow-ups, hopefully leading to the development of multimodal therapeutic interventions.
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Affiliation(s)
- Mathias Zink
- Central Institute of Mental Health, Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, P.O. Box 12 21 20, 68072 Mannheim, Germany
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Seo JH, Lee WK, Park SP. Obsessive-compulsive symptoms and their impacts on psychosocial functioning in people with epilepsy. J Clin Neurol 2014; 10:125-32. [PMID: 24829598 PMCID: PMC4017015 DOI: 10.3988/jcn.2014.10.2.125] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Revised: 10/28/2013] [Accepted: 10/30/2013] [Indexed: 11/26/2022] Open
Abstract
Background and Purpose Obsessive-compulsive symptoms (OCS) in people with epilepsy (PWE) have not been studied systematically. We evaluated the severity, predictors, and psychosocial impact of OCS in PWE. Methods We recruited PWE who visited our epilepsy clinic and age-, gender-, and education-matched healthy controls. Both PWE and healthy controls completed the Maudsley Obsessional-Compulsive Inventory (MOCI), which measures OCS. PWE also completed the Beck Depression Inventory (BDI) and the Quality of Life in Epilepsy Inventory-31 (QOLIE-31). We examined the severity of OCS in PWE relative to healthy controls. Predictors of OCS and the QOLIE-31 score were measured by regression analyses. A path analysis model was constructed to verify interrelations between the variables. Results The MOCI total score was significantly higher in PWE than in healthy controls (p=0.002). OCS were found in 20% of eligible patients. The strongest predictor of the MOCI total score was the BDI score (β=0.417, p<0.001), followed by EEG abnormality (β=0.194, p<0.001) and etiology (β=0.107, p=0.031). Epileptic syndrome, the side of the epileptic focus, and action mechanisms of antiepileptic drugs did not affect the MOCI total score. The strongest predictor of the QOLIE-31 overall score was the BDI score (β=-0.569, p<0.001), followed by seizure control (β=-0.163, p<0.001) and the MOCI total score (β=-0.148, p=0.001). The MOCI total score directly affected the QOLIE-31 overall score and also exerted indirect effects on the QOLIE-31 overall score through seizure control and the BDI score. Conclusions OCS are more likely to develop in PWE than in healthy people. The development of OCS appears to elicit psychosocial problems directly or indirectly by provoking depression or uncontrolled seizures.
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Affiliation(s)
- Ji-Hye Seo
- Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Won-Kee Lee
- Center of Biostatics, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Sung-Pa Park
- Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Korea
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Frydman I, do Brasil PE, Torres AR, Shavitt RG, Ferrão YA, Rosário MC, Miguel EC, Fontenelle LF. Late-onset obsessive-compulsive disorder: risk factors and correlates. J Psychiatr Res 2014; 49:68-74. [PMID: 24267559 DOI: 10.1016/j.jpsychires.2013.10.021] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Revised: 10/03/2013] [Accepted: 10/31/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND While a great amount of attention has been paid to early-onset obsessive-compulsive disorder (OCD), there is a dearth of studies on patients showing OCD for the first time at later stages of life. In this study, we aimed at determining possible risk factors/correlates for OCD onset at or after age 40, here termed late-onset OCD. METHOD A series of models including several potential variables associated with late onset OCD were tested using a monolayer neural network. To this regard, data from the Brazilian Research Consortium of Obsessive-Compulsive Spectrum Disorders (CTOC) (n = 1001) was employed. For the purposes of this study, we considered a diagnosis of late onset OCD to be present whenever distress and interference associated with OCD symptoms emerged at or after age 40. Different nested models were compared through the Akaike Criteria keeping the variables with p value ≤0.05. RESULTS Late-onset OCD occurred in 8.6% of the sample. A model including female sex, a history of chronic (>10 years) subclinical obsessive-compulsive symptoms, the co-occurrence of posttraumatic stress disorder (PTSD) after age 40, and a history of recent pregnancy in self or significant others was able to explain a sizeable proportion of late-onset OCD. The general performance of this model, represented by the Maximum Likelihood R2, was 29.4%. CONCLUSION Our results suggest that late-onset OCD is more likely to occur in females, in individuals with long periods of subclinical obsessive-compulsive symptoms, and in association with a major traumatic event occurring after age 40 and a history of recent pregnancy in self or in significant others.
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Affiliation(s)
- Ilana Frydman
- Anxiety and Depression Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil; D'Or Institute for Research and Education, Brazil.
| | | | - Albina R Torres
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, Universidade Estadual Paulista, Brazil
| | - Roseli G Shavitt
- Department of Psychiatry, University of São Paulo Medical School, Brazil
| | - Ygor A Ferrão
- Department of Psychiatry, Health Sciences Federal University of Porto Alegre, Brazil
| | - Maria C Rosário
- Department of Psychiatry, Federal University of São Paulo, Brazil
| | - Euripedes C Miguel
- Department of Psychiatry, University of São Paulo Medical School, Brazil
| | - Leonardo F Fontenelle
- Anxiety and Depression Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil; Department of Psychiatry and Mental Health, Institute of Community Health, Fluminense Federal University, Brazil; D'Or Institute for Research and Education, Brazil
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