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Obsessive
Kinds of Obsessive Terms modified by Obsessive Selected AbstractsObsessive,compulsive disorder: a review of the diagnostic criteria and possible subtypes and dimensional specifiers for DSM-V,DEPRESSION AND ANXIETY, Issue 6 2010James F. Leckman M.D. Abstract Background: Since the publication of the DSM-IV in 1994, research on obsessive,compulsive disorder (OCD) has continued to expand. It is timely to reconsider the nosology of this disorder, assessing whether changes to diagnostic criteria as well as subtypes and specifiers may improve diagnostic validity and clinical utility. Methods: The existing criteria were evaluated. Key issues were identified. Electronic databases of PubMed, ScienceDirect, and PsycINFO were searched for relevant studies. Results: This review presents a number of options and preliminary recommendations to be considered for DSM-V. These include: (1) clarifying and simplifying the definition of obsessions and compulsions (criterion A); (2) possibly deleting the requirement that people recognize that their obsessions or compulsions are excessive or unreasonable (criterion B); (3) rethinking the clinical significance criterion (criterion C) and, in the interim, possibly adjusting what is considered "time-consuming" for OCD; (4) listing additional disorders to help with the differential diagnosis (criterion D); (5) rethinking the medical exclusion criterion (criterion E) and clarifying what is meant by a "general medical condition"; (6) revising the specifiers (i.e., clarifying that OCD can involve a range of insight, in addition to "poor insight," and adding "tic-related OCD"); and (7) highlighting in the DSM-V text important clinical features of OCD that are not currently mentioned in the criteria (e.g., the major symptom dimensions). Conclusions: A number of changes to the existing diagnostic criteria for OCD are proposed. These proposed criteria may change as the DSM-V process progresses. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc. [source] Should an obsessive,compulsive spectrum grouping of disorders be included in DSM-V?,DEPRESSION AND ANXIETY, Issue 6 2010Katharine A. Phillips M.D. Abstract The obsessive,compulsive (OC) spectrum has been discussed in the literature for two decades. Proponents of this concept propose that certain disorders characterized by repetitive thoughts and/or behaviors are related to obsessive,compulsive disorder (OCD), and suggest that such disorders be grouped together in the same category (i.e. grouping, or "chapter") in DSM. This article addresses this topic and presents options and preliminary recommendations to be considered for DSM-V. The article builds upon and extends prior reviews of this topic that were prepared for and discussed at a DSM-V Research Planning Conference on Obsessive,Compulsive Spectrum Disorders held in 2006. Our preliminary recommendation is that an OC-spectrum grouping of disorders be included in DSM-V. Furthermore, we preliminarily recommend that consideration be given to including this group of disorders within a larger supraordinate category of "Anxiety and Obsessive,Compulsive Spectrum Disorders." These preliminary recommendations must be evaluated in light of recommendations for, and constraints upon, the overall structure of DSM-V. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc. [source] Gender differences in obsessive,compulsive symptom dimensionsDEPRESSION AND ANXIETY, Issue 10 2008Javier Labad M.D. Abstract The aim of our study was to assess the role of gender in OCD symptom dimensions with a multivariate analysis while controlling for history of tic disorders and age at onset of OCD. One hundred and eighty-six consecutive outpatients with a DSM-IV diagnosis of OCD were interviewed. Yale-Brown Obsessive,Compulsive Scale (YBOC-S), YBOC-S Symptom Checklist, and Hamilton Depression and Anxiety Scales were administered to all patients. Lifetime history of tic disorders was assessed with the tic inventory section of the Yale Global Tic Severity Scale. Age at onset of OCD was assessed by direct interview. Statistical analysis was carried out through logistic regression to calculate adjusted female:male odds ratios (OR) for each dimension. A relationship was found between gender and two main OCD dimensions: contamination/cleaning (higher in females; female:male OR=2.02, P=0.03) and sexual/religious (lower in females; female:male OR=0.41, P=0.03). We did not find gender differences in the aggressive/checking, symmetry/ordering, or hoarding dimensions. We also found a greater history of tic disorders in those patients with symptoms from the symmetry/ordering, dimension (P<0.01). Both symmetry/ordering and sexual/religious dimensions were associated with an earlier age at onset of OCD (P<0.05). Gender is a variable that plays a role in the expression of OCD, particularly the contamination/cleaning and sexual/religious dimensions. Our results underscore the need to examine the relationship between OCD dimensions and clinical variables such as gender, tics, age at onset and severity of the disorder to improve the identification of OCD subtypes. Depression and Anxiety 2007. © 2007 Wiley-Liss, Inc. [source] Clinical characteristics of inpatient adolescents with severe obsessive,compulsive disorderDEPRESSION AND ANXIETY, Issue 2 2006Gal Shoval M.D. Abstract Obsessive,compulsive disorder (OCD) is a common disorder in adolescents, usually treated in the outpatient setting. Our aim in this study was to evaluate the clinical characteristics of adolescents with severe OCD that required hospitalization. A total of 342 patients consecutively admitted to a psychiatric adolescent inpatient unit and 87 healthy volunteers were assessed by a semistructured interview for clinical diagnosis, suicide risk factors, aggression, ego defense mechanisms, and intelligence. Patients with OCD (n=40) were compared to other four diagnostic patient groups with psychotic, affective, conduct, and eating disorders, as well as to normal controls. Adolescent inpatients with OCD experienced less separation anxiety than all the other psychiatric groups (P < .01) and were less impulsive than controls (P < .001). They differed in aggressive/impulsive traits and hospital-related behaviors from other diagnostic groups. Adolescent inpatients with OCD consist of a unique subgroup in the inpatient unit in terms of their clinical characteristics and risk factors for suicide. These characteristics should be taken into account when developing a treatment plan for these difficult-to-treat inpatients. Depression and Anxiety 23:62,70, 2006. © 2006 Wiley-Liss, Inc. [source] Perceived parental rearing in subjects with obsessive,compulsive disorder and their siblingsACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2010L. Lennertz Lennertz L, Grabe HJ, Ruhrmann S, Rampacher F, Vogeley A, Schulze-Rauschenbach S, Ettelt S, Meyer K, Kraft S, Reck C, Pukrop R, John U, Freyberger HJ, Klosterkötter J, Maier W, Falkai P, Wagner M. Perceived parental rearing in subjects with obsessive,compulsive disorder and their siblings. Objective:, Perceived parenting in patients suffering from obsessive,compulsive disorder (OCD) is examined. We attempted to overcome some methodological limitations of prior studies by taking age of onset, parental OCD and comorbid depression into consideration. In addition, we included data from unaffected siblings to corroborate information on parental rearing. Method:, One hundred and twenty-two cases with OCD and 41 of their siblings as well as 59 healthy controls and 45 of their siblings completed the German short-version of the EMBU (FEE). Results:, Obsessive,compulsive disorder cases reported less parental warmth and more parental rejection and control. Further analyses indicated that parenting is also associated with OCD in cases with late onset and cases without parents affected by OCD. OCD cases with comorbid depression described their parents particularly negatively. Data from siblings indicated good validity of perceived parenting in OCD. Conclusion:, This study provides further evidence for dysfunctional child rearing being relevant to the development of OCD and depression. [source] Pregabalin, tiapride and lorazepam in alcohol withdrawal syndrome: a multi-centre, randomized, single-blind comparison trialADDICTION, Issue 2 2010Giovanni Martinotti ABSTRACT Introduction The aim of this trial was to compare lorazepam with non-benzodiazepine medications such as pregabalin and tiapride in the treatment of alcohol withdrawal syndrome (AWS). These drugs were chosen for their inhibitorial effects on the hypersecretion of neurotransmitters usually observed in AWS. Craving reduction and improvement of psychiatric symptoms were the secondary end-points. Methods One hundred and ninety subjects affected by current alcohol dependence were considered consecutively: 111 were enrolled and divided into three groups of 37 subjects each. Within a treatment duration of 14 days, medication was given up to the following maximum doses (pregabalin 450 mg/day; tiapride 800 mg/day; lorazepam 10 mg/day). Withdrawal (CIWA-Ar), craving [visual analogue scale (VAS); Obsessive and Compulsive Drinking Scale (OCDS)], psychiatric symptoms [Symptom Check List 90 Revised (SCL-90-R)] and quality of life (QL-index) rating scales were applied. Results On the CIWA-Ar score, all the groups showed a significant reduction between times (P < 0.001) with a higher reduction for the pregabalin group (P < 0.01) on items regarding headache and orientation. Retention in treatment was lower in the tiapride group (P < 0.05), while the number of subjects remaining alcohol free was higher in the pregabalin group (P < 0.05). Significant reduction between baseline and the end of the treatment was found in all the groups at the OCDS and the VAS for craving, at the SCL-90-R and QL-index (P < 0.001). Discussion All the medications in the trial showed evidence of safety and efficacy in the treatment of uncomplicated forms of AWS, with some particular differences. The efficacy of pregabalin was superior to that of tiapride, used largely in research trials and, for some measures, to that of the ,gold standard', lorazepam. Accordingly, pregabalin may be considered as a potentially useful new drug for treatment of AWS, deserving further investigation. [source] Concurrent validity of the Yale,Brown Obsessive,Compulsive Scale,Symptom checklist,JOURNAL OF CLINICAL PSYCHOLOGY, Issue 12 2008Michael L. Sulkowski Abstract Despite the frequent use of the Yale,Brown Obsessive,Compulsive Scale,Symptom Checklist (Y-BOCS-SC; Goodman et al., 1989a) and the Obsessive,Compulsive Inventory-Revised (OCI-R; Foa et al., 2002), there are limited data on the psychometric properties of the two instruments. In the present research, clinician ratings on the Y-BOCS-SC for 112 patients with obsessive,compulsive disorder (OCD) were compared to their self-report ratings on the OCI-R. In addition, Y-BOCS-SC and OCI-R scores were compared to measures of OCD symptom severity and self-report measures of anxiety (State,Trait Anxiety Inventory,Trait Subscale [STAI-T]; Spielberger, Gorusch, & Lushene, 1970) and depression (Beck Depression Inventory-II [BDI-II]; Beck, Steer, & Brown, 1996). The six symptom scales of the OCI-R had good internal consistency reliabilities (,s). For the Y-BOCS-SC, three of five scales had good reliabilities (,s >.80), but ,s for symmetry/ordering and sexual/religious symptom scales were inadequate. Total scores for the two instruments were strongly correlated with their corresponding "checking" scales, but no individual symptoms scales were identified as indices of overall OCD symptom presence. Scales assessing washing/contamination, symmetry/ordering, and hoarding from the two OCD instruments correlated well, but lower correlations for the other scales suggested differences in symptom coverage by the two instruments. Most symptom scales from the Y-BOCS-SC and OCI-R had low correlations with the BDI-II and STAI-T, but the OCI-R obsessing scale was well correlated (r=.54) with the STAI-T. These findings reveal some of the strengths and weaknesses of these two OCD instruments, and the results provide guidance for selecting scales that are suitable for measuring OCD symptoms. © 2008 Wiley Periodicals, Inc. J Clin Psychol 64:1,14, 2008. [source] Obsessive,compulsive disorder and romantic functioningJOURNAL OF CLINICAL PSYCHOLOGY, Issue 12 2007Richard D. Abbey The current study examined the romantic relationships of individuals with obsessive,compulsive disorder (OCD). Participants were 64 individuals recruited from a national conference who completed measures of OCD symptoms, depressive symptoms, intimacy, self-disclosure, relationship satisfaction, and relationship worry. Severity of obsessions was negatively correlated with intimacy, relationship satisfaction, and self-disclosure. In contrast, two compulsive behaviors (washing and neutralizing) were positively correlated with several relationship variables. Fears of contamination from sexual activity were positively correlated with the severity of OCD symptoms. The clinical implications of the findings from this study and suggestions for future research are presented. © 2007 Wiley Periodicals, Inc. J Clin Psychol 63: 1181,1192, 2007. [source] Increased Activation of the ACC During a Spatial Working Memory Task in Alcohol-Dependence Versus Heavy Social DrinkingALCOHOLISM, Issue 5 2010Sabine Vollstädt-Klein Background:, Activation of the anterior cingulate cortex (ACC) in a spatial working memory task has been associated with risk factors for alcohol use disorders such as low alcohol effects and positive alcohol expectations in adolescents. To transfer these results into adults, we used the same task in adults. Methods:, During functional magnetic resonance imaging, 12 light social, 7 heavy social, and 11 non-abstinent-dependent alcohol drinkers performed a spatial working memory task and completed measures of automatic alcohol-related thoughts and behavior (Obsessive,Compulsive Drinking Scale,OCDS), alcohol use of the last 90 days, and general intelligence. Results:, Behavioral performance in the spatial working memory task was not significantly different in all 3 groups. Controlling for differences in general intelligence alcohol-dependent participants showed a higher task-related activation of the dorsal ACC (dACC) in comparison with light and heavy social drinkers. Measures of the OCDS were positively correlated with the activation in the left hippocampus and right thalamus in all participants. Conclusions:, Our results support the findings of increased dACC activation during a spatial working memory task as a risk factor for alcohol dependence. Increased task-related activation in the dACC was only observed in alcohol-dependent participants and not in heavy social drinkers with comparable alcohol consumption. Furthermore, the absence of behavioral performance differences between groups as well as an association between dACC activation and working memory performance indicates subtle working memory deficits. Low capacity of working memory has been linked to more automatic and less self-regulated behavior in studies on natural reward processing. Therefore, additional neural activation during performance of the non-alcohol-related working memory task in participants with higher OCDS values in the left hippocampus and the right thalamus may be a consequence of decreased neural capacity because of distracting alcohol-related thoughts. [source] Reduced gray matter volume of dorsal cingulate cortex in patients with obsessive,compulsive disorder: A voxel-based morphometric studyPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2010Ryohei Matsumoto MD Aims:, Previous morphometric studies using magnetic resonance imaging (MRI) have revealed structural brain abnormalities in obsessive,compulsive disorder (OCD). The aim of the present study was to investigate the alterations in brain structure of patients with OCD using a voxel-based morphometry (VBM) method. Methods:, Sixteen patients with OCD free of comorbid major depression, and 32 sex- and age-matched healthy subjects underwent MRI using a 1.5-T MR scanner. OCD severity was assessed with the Yale,Brown Obsessive,Compulsive Scale (mean ± SD: 22 ± 7.6; range: 7,32). MR images were spatially normalized and segmented using the VBM5 package (http://dbm.neuro.uni-jena.de/vbm/). Statistical analysis was performed using statistical parametric mapping software. Results:, Significant reductions in regional gray matter volume were detected in the left caudal anterior cingulate cortex and right dorsal posterior cingulate cortex in the patients with OCD as compared to healthy controls (uncorrected, P < 0.001). No significant differences in white matter volumes were observed in any brain regions of the patients. No significant correlation between Yale,Brown Obsessive,Compulsive Scale score and regional gray matter or white matter volume was observed. Conclusions:, Regional gray matter alteration in the dorsal cingulate cortex, which is suggested to play a role in non-emotional cognitive processes, may be related to the pathophysiology in OCD. [source] Clinical predictors of response to pharmacotherapy with selective serotonin reuptake inhibitors in obsessive,compulsive disorderPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 4 2006IT TÜKEL md Abstract, The objective of this study was to investigate the clinical predictors of response to treatment with selective serotonin reuptake inhibitors (SSRI) in a sample of patients with obsessive,compulsive disorder (OCD). A total of 55 patients diagnosed as OCD according to revised 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders criteria underwent a 12-week standardized SSRI treatment. According to ,treatment response', defined as at least a 35% drop in the Yale,Brown Obsessive,Compulsive Scale total score, OCD patients were divided into two groups. A total of 32 (58.2%) patients who responded to treatment and 23 (41.8%) who did not, were compared in terms of sociodemographic and clinical characteristics. The authors' findings demonstrated that the severity of obsession,compulsions and disability in work, social and family lives at the beginning of treatment were significantly higher in OCD patients who did not respond to treatment in comparison to those who did. Linear regression analysis, however, revealed that Sheehan Disability Scale-work score at baseline was a predictor of response to SSRI treatment. The higher levels of disability at the beginning of treatment in patients with OCD are associated with a poorer response to SSRI. [source] Are the dysfunctional beliefs that predict worry different from those that predict obsessions?CLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 6 2007Amparo Belloch Chronic worry present in Generalized Anxiety Disorder (GAD) and obsessions characteristic of the Obsessive,Compulsive Disorder (OCD) are cognitive phenomena that share some features, but they also differ on others. Based on current cognitive approaches, dysfunctional meta-cognitive beliefs underlie the development and/or maintenance of both GAD and OCD. However, to date, there has been little empirical evidence about the differences between the beliefs that predict the occurrence of obsessions and those that predict worry. This study focuses on the search for these differences and examines to what extent worry and obsessions are associated with a similar or different pattern of dysfunctional cognitive contents. One hundred and seventy-five community subjects completed measures of worry and obsessional intrusive thoughts, as well as questionnaires assessing obsession-related and worry-related meta-cognitive beliefs. Results showed that beliefs about uncontrollability and danger, as well as cognitive self-consciousness, play a central role in predicting worry, whereas the beliefs concerning the importance of thoughts and Thought,Action Fusion probability are relevant in accounting for the frequency of obsessive intrusive thoughts.,Copyright © 2007 John Wiley & Sons, Ltd. [source] Obsessive,compulsive disorder: a review of the diagnostic criteria and possible subtypes and dimensional specifiers for DSM-V,DEPRESSION AND ANXIETY, Issue 6 2010James F. Leckman M.D. Abstract Background: Since the publication of the DSM-IV in 1994, research on obsessive,compulsive disorder (OCD) has continued to expand. It is timely to reconsider the nosology of this disorder, assessing whether changes to diagnostic criteria as well as subtypes and specifiers may improve diagnostic validity and clinical utility. Methods: The existing criteria were evaluated. Key issues were identified. Electronic databases of PubMed, ScienceDirect, and PsycINFO were searched for relevant studies. Results: This review presents a number of options and preliminary recommendations to be considered for DSM-V. These include: (1) clarifying and simplifying the definition of obsessions and compulsions (criterion A); (2) possibly deleting the requirement that people recognize that their obsessions or compulsions are excessive or unreasonable (criterion B); (3) rethinking the clinical significance criterion (criterion C) and, in the interim, possibly adjusting what is considered "time-consuming" for OCD; (4) listing additional disorders to help with the differential diagnosis (criterion D); (5) rethinking the medical exclusion criterion (criterion E) and clarifying what is meant by a "general medical condition"; (6) revising the specifiers (i.e., clarifying that OCD can involve a range of insight, in addition to "poor insight," and adding "tic-related OCD"); and (7) highlighting in the DSM-V text important clinical features of OCD that are not currently mentioned in the criteria (e.g., the major symptom dimensions). Conclusions: A number of changes to the existing diagnostic criteria for OCD are proposed. These proposed criteria may change as the DSM-V process progresses. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc. [source] Should an obsessive,compulsive spectrum grouping of disorders be included in DSM-V?,DEPRESSION AND ANXIETY, Issue 6 2010Katharine A. Phillips M.D. Abstract The obsessive,compulsive (OC) spectrum has been discussed in the literature for two decades. Proponents of this concept propose that certain disorders characterized by repetitive thoughts and/or behaviors are related to obsessive,compulsive disorder (OCD), and suggest that such disorders be grouped together in the same category (i.e. grouping, or "chapter") in DSM. This article addresses this topic and presents options and preliminary recommendations to be considered for DSM-V. The article builds upon and extends prior reviews of this topic that were prepared for and discussed at a DSM-V Research Planning Conference on Obsessive,Compulsive Spectrum Disorders held in 2006. Our preliminary recommendation is that an OC-spectrum grouping of disorders be included in DSM-V. Furthermore, we preliminarily recommend that consideration be given to including this group of disorders within a larger supraordinate category of "Anxiety and Obsessive,Compulsive Spectrum Disorders." These preliminary recommendations must be evaluated in light of recommendations for, and constraints upon, the overall structure of DSM-V. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc. [source] False memory and obsessive,compulsive symptomsDEPRESSION AND ANXIETY, Issue 5 2009Heide Klumpp Ph.D Abstract Background: The memory deficit hypothesis has been used to explain the maintenance of repetitive behavior in individuals with obsessive,compulsive disorder, yet the majority of studies focusing on verbal memory show mixed results. These studies primarily evaluated memory accuracy via the inclusion or omission of previously encountered material, as opposed to false recognition (i.e., the inclusion of erroneous material). We evaluated false memories and memory processes in individuals with obsessive,compulsive washing symptoms (OC), individuals matched on depression and anxiety without OC symptoms (D/A), and in nonanxious individuals (NAC). Methods: Twenty-eight OC, 28 D/A, and 29 NAC individuals read OC-threat relevant, positive, and neutral scenarios and then performed a recognition test. Erroneous recognition of words associated to encoded, but not previously viewed, scenarios were classified as false memories. To evaluate processes underlying memory, participants completed a modified remember/know task to examine whether the OC individuals differed from the other individuals in recollective clarity for false memories of OC-relevant (e.g., germs), positive (e.g., lottery), and neutral (e.g., bread) material. Results: The OC individuals used "know" more than the D/A and NAC individuals for false memories of threat. For veridical memories, the OC individuals used "know" more than the NAC, but not, D/A individuals. Conclusions: The greater reliance on "know" (i.e., feelings of familiarity) in general and false threat memories in particular in individuals with OC symptoms may add to feelings of uncertainty for threat-relevant material, which may contribute to compulsive behavior. Depression and Anxiety, 2009. ©2008 Wiley-Liss, Inc. [source] Gender differences in obsessive,compulsive symptom dimensionsDEPRESSION AND ANXIETY, Issue 10 2008Javier Labad M.D. Abstract The aim of our study was to assess the role of gender in OCD symptom dimensions with a multivariate analysis while controlling for history of tic disorders and age at onset of OCD. One hundred and eighty-six consecutive outpatients with a DSM-IV diagnosis of OCD were interviewed. Yale-Brown Obsessive,Compulsive Scale (YBOC-S), YBOC-S Symptom Checklist, and Hamilton Depression and Anxiety Scales were administered to all patients. Lifetime history of tic disorders was assessed with the tic inventory section of the Yale Global Tic Severity Scale. Age at onset of OCD was assessed by direct interview. Statistical analysis was carried out through logistic regression to calculate adjusted female:male odds ratios (OR) for each dimension. A relationship was found between gender and two main OCD dimensions: contamination/cleaning (higher in females; female:male OR=2.02, P=0.03) and sexual/religious (lower in females; female:male OR=0.41, P=0.03). We did not find gender differences in the aggressive/checking, symmetry/ordering, or hoarding dimensions. We also found a greater history of tic disorders in those patients with symptoms from the symmetry/ordering, dimension (P<0.01). Both symmetry/ordering and sexual/religious dimensions were associated with an earlier age at onset of OCD (P<0.05). Gender is a variable that plays a role in the expression of OCD, particularly the contamination/cleaning and sexual/religious dimensions. Our results underscore the need to examine the relationship between OCD dimensions and clinical variables such as gender, tics, age at onset and severity of the disorder to improve the identification of OCD subtypes. Depression and Anxiety 2007. © 2007 Wiley-Liss, Inc. [source] Striatal dopamine D2 receptor availability in OCD with and without comorbid social anxiety disorder: preliminary findings,DEPRESSION AND ANXIETY, Issue 1 2008Franklin R. Schneier M.D. Abstract Dopamine D2 receptor availability in the striatum has been reported to be low in generalized social anxiety disorder (GSAD) and obsessive,compulsive disorder (OCD), but it has not been studied in persons with comorbid OCD and GSAD (OCD+GSAD). D2 receptor availability was assessed in 7 subjects with OCD+GSAD, 8 with OCD, and 7 matched healthy comparison (HC) subjects, all unmedicated adults. D2 receptor availability was assessed with single-photon emission computerized tomography (SPECT) to measure binding potential (BP) of the D2 receptor radiotracer [123I] iodobenzamide ([123I]IBZM). Mean striatal [123I]IBZM BP was significantly lower in the OCD+GSAD group (72.58 mL/g, SD=18.17) than in the HC group (118.41 mL/g, SD=45.40; P=.025). Mean BP in the OCD group (93.08 mL/g, SD=36.90) did not differ significantly from the HC group (P=.247). Trait detachment, as measured by the Detachment subscale of the Karolinska Scales of Personality, was negatively correlated with D2 availability across all subjects (rs=,.55, P=.013). Comorbid GSAD and OCD may be associated with decreased availability of D2 receptors in the striatum, consistent with prior findings in GSAD. Prior findings of decreased D2 receptor availability in noncomorbid OCD were not confirmed. Decreased D2 receptor availability was also associated with trait detachment, supporting prior findings in samples of healthy subjects. Depression and Anxiety 0:1,7, 2007. Published 2007 Wiley-Liss, Inc. [source] Longitudinal assessment of symptom and subtype categories in obsessive,compulsive disorderDEPRESSION AND ANXIETY, Issue 7 2007Lutfullah Besiroglu M.D. Abstract Although it has been postulated that symptom subtypes are potential predictors of treatment response, few data exist on the longitudinal course of symptom and subtype categories in obsessive,compulsive disorder (OCD). Putative subtypes of OCD have gradually gained more recognition, but as yet there is no generally accepted subtype discrimination. Subtypes, it has been suggested, could perhaps be discriminated based on autogenous versus reactive obsessions stemming from different cognitive processes. In this study, our aim was to assess whether symptom and subtype categories change over time. Using the Yale,Brown Obsessive Compulsive Symptom Checklist (Y-BOCS-SC), we assessed 109 patients who met DSM-IV criteria for OCD to establish baseline values, then reassessed 91 (83%) of the initial group after 36±8.2 months. Upon reassessment, we found significant changes from baseline within aggressive, contamination, religious, symmetry and miscellaneous obsessions and within checking, washing, repeating, counting and ordering compulsion categories. Sexual, hoarding, and somatic obsessions, and hoarding and miscellaneous compulsions, did not change significantly. In accordance with the relevant literature, we also assigned patients to one of three subtypes,autogenous, reactive, or mixed groups. Though some changes in subtype categories were found, no subtype shifts (e.g., autogenous to reactive or reactive to autogenous) were observed during the course of the study. Significantly more patients in the autogenous group did not meet OCD criteria at follow-up than did patients in the other groups. Our results suggest that the discrimination between these two types of obsession might be highly valid, because autogenous and reactive obsessions are quite different, both in the development and maintenance of their cognitive mechanisms, and in their outcome. Depression and Anxiety 24:461,466, 2007. © 2006 Wiley-Liss, Inc. [source] Demographic and clinical characteristics of motor vehicle accident victims in the community general health outpatient clinic: a comparison of PTSD and non-PTSD subjectsDEPRESSION AND ANXIETY, Issue 4 2007Marina Kupchik M.D. Abstract Motor vehicle accidents (MVAs) are the leading cause of posttraumatic stress disorder (PTSD) in the general population, often with enduring symptomatology. This study details epidemiological and clinical features that characterize PTSD among MVA victims living in a nonhospitalized community setting long after the MVA event, and includes exploration of premorbid and peritraumatic factors. MVA victims (n=60; 23 males, 37 females) identified from the registry of a community general health outpatient clinic during a 7-year period were administered an extensive structured battery of epidemiological, diagnostic and clinical ratings. Results indicated that 30 subjects (50%; 12 males, 18 females) had MVA-related PTSD (MVAR-PTSD). Among those with PTSD, 16 individuals exhibited PTSD in partial remission, and six, in full remission. There were no significant demographic or occupational function differences between PTSD and non-PTSD groups. The most common comorbid conditions with MVAR-PTSD were social phobia (20%), generalized anxiety disorder (7.8%) and obsessive,compulsive disorder (0.5%). Previous MVA's were not predictive of PTSD. Subjects with MVAR-PTSD scored worse on the Clinician-Administered Posttraumatic Stress Disorder Scale, Part 2 (CAPS-2), Impact of Event Scale, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Impulsivity Scale, and Toronto Alexithymia Rating Scale. Study observations indicate a relatively high rate of PTSD following an MVA in a community-based sample. The relatively high rate of partially remitted MVAR-PTSD (N=16) underscores the importance of subsyndromal forms of illness. Alexithymia may be an adaptive method of coping with event stress. The development of PTSD appears not to be associated with the severity of MVA-related physical injury. Depression and Anxiety 24:244,250, 2007. © 2006 Wiley,Liss, Inc. [source] Prevalence of social phobia and its comorbidity with psychiatric disorders in IranDEPRESSION AND ANXIETY, Issue 7 2006Mohammad-Reza Mohammadi M.D. Abstract This study explored the prevalence of social phobia (SP) in the general population of Iran, the sociodemographic characteristics of subjects with SP, and its comorbidity with the other lifetime psychiatric disorders. Our study was part of the nationwide study on the prevalence of psychiatric disorders in Iran. Overall, 25,180 Iranian subjects, age 18 years and over, from urban and rural areas of Iran were selected by a clustered random sampling method and interviewed face-to-face by 250 trained clinical psychologists using DSM-IV diagnostic criteria. Out of 12,398,235 households, 7,795 households in the form of 1,559 clusters of five households were selected. The statistical framework was based on the household lists available from the Department of Health in the provinces. The response rate was 90%. The lifetime prevalence of SP was 0.82%. The rate was 0.4% in males and 1.3% in females. The rate was higher in younger age groups and widows/widowers. It was not related to educational level and residential area. Specific phobia (66.7%), obsessive,compulsive disorder (17.4%), major depressive disorder (15%), and panic disorder (12.1%) were the most common lifetime psychiatric disorders among subjects with SP. The rate of SP in Iran is more similar to that in other Asian countries, and it is lower than that in Western countries. The rate of other psychiatric disorders among subjects with SP is more than that in the general population, and the most common psychiatric disorders were the other anxiety disorders and major depressive disorder. Depression and Anxiety 23:405,411, 2006 © 2006 Wiley-Liss, Inc. [source] Cognitive specificity of anxiety disorders: a review of selected key constructsDEPRESSION AND ANXIETY, Issue 2 2006F.R.A.N.Z.C.P., Ph.D., Vladan Starcevic M.D. Abstract Cognitive models of anxiety disorders propose that certain cognitive constructs, that is, underlying beliefs and cognitive processes, may be specific for particular disorders. In this article, we review the specificity of four representative cognitive constructs,anxiety sensitivity, pathological worry, intolerance of uncertainty, and thought,action fusion,for particular disorders. Conceptual overlap, inconsistent definitions, and insufficient consideration of the components of these constructs are limitations of the existing literature. We suggest that the constructs are unlikely to be pathognomonic for any given disorder or to occur in isolation. Rather, the association of each cognitive construct is evident, to varying degrees, with different disorders. Relative to other disorders, anxiety sensitivity is to a certain extent specific for panic disorder, as are pathological worry for generalized anxiety disorder, intolerance of uncertainty for generalized anxiety disorder and obsessive,compulsive disorder, and thought,action fusion for obsessive,compulsive disorder. We discuss the implications of these findings for diagnostic systems and treatment, and suggest areas for further research. Depression and Anxiety 23:51,61, 2006. © 2006 Wiley-Liss, Inc. [source] Clinical characteristics of inpatient adolescents with severe obsessive,compulsive disorderDEPRESSION AND ANXIETY, Issue 2 2006Gal Shoval M.D. Abstract Obsessive,compulsive disorder (OCD) is a common disorder in adolescents, usually treated in the outpatient setting. Our aim in this study was to evaluate the clinical characteristics of adolescents with severe OCD that required hospitalization. A total of 342 patients consecutively admitted to a psychiatric adolescent inpatient unit and 87 healthy volunteers were assessed by a semistructured interview for clinical diagnosis, suicide risk factors, aggression, ego defense mechanisms, and intelligence. Patients with OCD (n=40) were compared to other four diagnostic patient groups with psychotic, affective, conduct, and eating disorders, as well as to normal controls. Adolescent inpatients with OCD experienced less separation anxiety than all the other psychiatric groups (P < .01) and were less impulsive than controls (P < .001). They differed in aggressive/impulsive traits and hospital-related behaviors from other diagnostic groups. Adolescent inpatients with OCD consist of a unique subgroup in the inpatient unit in terms of their clinical characteristics and risk factors for suicide. These characteristics should be taken into account when developing a treatment plan for these difficult-to-treat inpatients. Depression and Anxiety 23:62,70, 2006. © 2006 Wiley-Liss, Inc. [source] The expression of anger and its relationship to symptoms and cognitions in obsessive,compulsive disorderDEPRESSION AND ANXIETY, Issue 3 2005Stephen P. Whiteside Abstract We compared the association between obsessive,compulsive disorder (OCD) and the expression of anger in a sample of 71 patients and 71 college students. Some authors [Rubenstein et al., J Anxiety Disord 1995;9:1,9] have proposed that anger and hostility underlie the symptoms of OCD; however, there has been little empirical study of this relationship. One recent study [Whiteside and Abramowitz, Cog Therapy Res 2004;28:259,268] with college undergraduates found that the association between OCD symptoms and anger was attributable to depressive symptoms. In the present study, we compared the expression of anger in a sample of patients diagnosed with OCD and nonclinical volunteers. Consistent with the previous study, we found increased levels of anger in patients with OCD as compared to control participants; however, these differences could be attributed to between-group differences in general distress. These results were discussed within the framework of the cognitive theory of OCD. © 2005 Wiley-Liss, Inc. [source] Influence of age of onset on clinical features in obsessive,compulsive disorderDEPRESSION AND ANXIETY, Issue 3 2005it Tükel M.D. Abstract We compared early-onset and late-onset obsessive,compulsive disorder (OCD) patients in terms of demographic and clinical features. One hundred sixteen outpatients whose primary diagnosis was OCD according to DSM-IV diagnostic criteria were recruited. Early-onset (n=50) and late-onset (n=66) OCD groups were compared with respect to demographic variables and scores obtained on various scales. A male gender predominance was found in early-onset OCD group. Symmetry/exactness obsessions, religious obsessions, hoarding/saving obsessions, and hoarding/collecting compulsions also were significantly more frequent in the early-onset group than in the late-onset group. The results may suggest a phenotypic difference between the two groups. Further studies are needed to investigate the differences between early-onset and late-onset OCD groups to examine the hypothesis that early-onset OCD is a distinct subtype of the disorder. © 2005 Wiley-Liss, Inc. [source] Perceived parental rearing in subjects with obsessive,compulsive disorder and their siblingsACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2010L. Lennertz Lennertz L, Grabe HJ, Ruhrmann S, Rampacher F, Vogeley A, Schulze-Rauschenbach S, Ettelt S, Meyer K, Kraft S, Reck C, Pukrop R, John U, Freyberger HJ, Klosterkötter J, Maier W, Falkai P, Wagner M. Perceived parental rearing in subjects with obsessive,compulsive disorder and their siblings. Objective:, Perceived parenting in patients suffering from obsessive,compulsive disorder (OCD) is examined. We attempted to overcome some methodological limitations of prior studies by taking age of onset, parental OCD and comorbid depression into consideration. In addition, we included data from unaffected siblings to corroborate information on parental rearing. Method:, One hundred and twenty-two cases with OCD and 41 of their siblings as well as 59 healthy controls and 45 of their siblings completed the German short-version of the EMBU (FEE). Results:, Obsessive,compulsive disorder cases reported less parental warmth and more parental rejection and control. Further analyses indicated that parenting is also associated with OCD in cases with late onset and cases without parents affected by OCD. OCD cases with comorbid depression described their parents particularly negatively. Data from siblings indicated good validity of perceived parenting in OCD. Conclusion:, This study provides further evidence for dysfunctional child rearing being relevant to the development of OCD and depression. [source] Group cognitive behavioural therapy for obsessive,compulsive disorder: a systematic review and meta-analysisACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2009H. Jónsson Objective:, Behaviour therapy with exposure and response prevention (ERP) or cognitive behavioural therapy (CBT) including ERP are considered the psychological treatments of choice for obsessive,compulsive disorder (OCD), but group CBT/ERP has received relatively little research attention in the treatment of OCD. The aim of this study was to provide a meta-analysis of the effectiveness of group CBT/ERP for OCD. Method:, A systematic literature search was conducted and studies were meta-analysed by means of the Cochrane Review Manager Program with measures of i) pre- to post-effect sizes (ES) and ii) between-group ES in comparison with different control conditions. Outcome was primarily measured on the Y-BOCS and ES was calculated in the form of Cohens d. Results:, Thirteen trials were included in the meta-analysis. The overall pre,post-ES of these trials of 1.18 and a between-group ES of 1.12 compared with waiting list control in three randomized controlled studies indicate that group CBT/ERP is an effective treatment for OCD. Group CBT achieved better results than pharmacological treatment in two studies. One study found no significant differences between individual and group CBT. Conclusion:, Group CBT is an effective treatment for OCD, but more studies are needed to compare the effectiveness of group and individual treatment formats. [source] Toward a better understanding of the pathophysiology of OCD SSRI responders: QEEG source localizationACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2007T. G. Bolwig Objective:, To demonstrate the utility of three-dimensional source localization of the scalp-recorded electroencephalogram (EEG) for the identification of the most probable underlying brain dysfunction in patients with obsessive,compulsive disorder (OCD). Method:, Eyes-closed resting EEG data was recorded from the scalp locations of the International 10/20 System. Variable resolution electromagnetic tomography (VARETA) was applied to artifact-free EEG data. This mathematical algorithm estimates the source generators of EEG recorded from the scalp. Results:, An excess in the alpha range was found with sources in the corpus striatum, in the orbito-frontal and temporo-frontal regions in untreated OCD patients. This abnormality was seen to decrease following successful treatment with paroxetine. Conclusion:, The VARETA findings of an activation/deactivation pattern in cortical and subcortical structures in paroxetine-responsive patients are in good accordance with data obtained in previously published positron emission tomography studies related to current hypotheses of a thalamo-striatal-frontal feedback loop being relevant for understanding the pathophysiology of OCD. [source] On phenomenology and classification of hoarding: a reviewACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2004T. Maier Objective:, Hoarding is a behavioural abnormity characterized by the excessive collection of poorly useable objects. It is described mainly in association with obsessive,compulsive disorders (OCDs) and in geriatric populations. Yet the literature on the phenomenon is heterogeneous and the notion obviously lacks a consistent definition. This review attempts to describe the psychopathological and clinical spectrum of hoarding and may contribute to clarify its classification. Method:, Systematic review and discussion of the literature on hoarding. Results:, Hoarding is a complex behavioural phenomenon associated with different mental disorders. The psychopathological structure is variously composed of elements of OCDs, impulse-control disorders, and ritualistic behaviour. Severe self-neglect is a possible consequence of hoarding. Conclusion:, Without further specifications the term hoarding is of limited heuristic value and cannot guide therapeutic interventions satisfactorily. The condition needs to be evaluated carefully in every particular case in relation to the aforementioned psychopathological concepts. [source] Long-term outcome of pediatric obsessive,compulsive disorder: a meta-analysis and qualitative review of the literatureACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2004S. E. Stewart Objective:, To review the extant literature on the long-term outcome of child/adolescent-onset obsessive,compulsive disorder (OCD). Method:, Medline and Psychlit databases were systematically searched for articles regarding long-term outcomes of child/adolescent-onset OCD. Meta-analysis regression was applied to evaluate predictors and persistence of OCD. Results:, Sixteen study samples (n = 6,132; total = 521 participants) in 22 studies had follow-up periods ranging between 1 and 15.6 years. Pooled mean persistence rates were 41% for full OCD and 60% for full or subthreshold OCD. Earlier age of OCD onset (z = ,3.26, P = 0.001), increased OCD duration (z = 2.22, P = 0.027) and in-patient vs. out-patient status (z = 2.94, P = 0.003) predicted greater persistence. Comorbid psychiatric illness and poor initial treatment response were poor prognostic factors. Although psychosocial function was frequently compromised, most studies lacked comprehensive outcome measures. Conclusion:, Long-term persistence of pediatric OCD may be lower than believed. Future studies should include broader measures of outcome including symptomatic persistence and functional impairment in multiple domains. [source] A follow-up study of juvenile obsessive,compulsive disorder from IndiaACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2003Y. C. Janardhan Reddy Objective:, To study the long-term course and outcome of juvenile obsessive,compulsive disorder (OCD). Method:, Two to 9-year follow-up of largely self-referred, drug-naďve subjects (n = 58) by employing catch-up longitudinal design. Results:, The mean follow-up period was 5 years. Nearly three-fourth of the sample was adequately treated with medications. Only 21% of the subjects had clinical OCD at follow-up and 48% were in true remission (no OCD and not on treatment). Earlier age-at-onset was associated with better course and outcome. Conclusion:, Juvenile OCD has favorable outcome. Our findings are applicable to psychiatric hospital settings in India and perhaps to the general psychiatric settings in the Western countries. Whether the better outcome in this sample is the result of differing clinical characteristics or because of true cross-cultural variation in the course needs further exploration. It is speculated that early onset OCD could be a subtype of juvenile OCD with better outcome. [source] | ||||||||||||||||||||||||||||