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PubMed2004

Behavioral differences among subjects with Prader-Willi syndrome and type I or type II deletion and maternal disomy.

OBJECTIVE: To determine whether phenotypic differences exist among individuals with Prader-Willi syndrome with either type I or type II deletions of chromosome 15 or maternal disomy 15 leading to a better understanding of cause and pathophysiology of this classical genetic syndrome. METHODS: We analyzed clinical, anthropometric, and behavioral data in 12 individuals (5 men, 7 women; mean age: 25.9 +/- 8.8 years) with PWS and a type I (TI) deletion, 14 individuals (6 men, 8 women; mean age: 19.6 +/- 6.5 years) with PWS and a type II (TII) deletion, and 21 individuals (10 men, 11 women; mean age: 23.6 +/- 9.2 years) with PWS and maternal disomy 15 (UPD). The deletion type was determined by genotyping of DNA markers between proximal chromosome 15 breakpoints BP1 and BP2. TI deletions are approximately 500 kb larger than TII deletions. Several validated psychological and behavioral tests were used to assess phenotypic characteristics of individuals with PWS representing the 3 genetic subtypes. RESULTS: Significant differences were found between the 2 deletion groups and those with UPD in multiple psychological and behavioral tests, but no differences were observed in other clinical or anthropometric data studied. Adaptive behavior scores were generally worse in individuals with PWS and the TI deletion, and specific obsessive-compulsive behaviors were more evident in the TI individuals compared with those with UPD. Individuals with PWS with TI deletions also had poorer reading and math skills as well as visual-motor integration. CONCLUSIONS: Our study indicates that individuals with TI deletion generally have more behavioral and psychological problems than individuals with the TII deletion or UPD. Four recently identified genes have been identified in the chromosome region between BP1 and BP2 with 1 of the genes (NIPA-1) expressed in mouse brain tissue but not thought to be imprinted. It may be important for brain development or function. These genes are deleted in individuals with TI deletion and are implicated in compulsive behavior and lower intellectual ability in individuals with TI versus TII.

Adult↗
PubMed1987

Asperger's syndrome: a case report.

A case report is presented of an 11-year-old boy who has been diagnosed as having Asperger's syndrome. There follows a review of the clinical features, course, prognosis and management of this condition.

Autistic Disorder↗
PubMed2003

Methylphenidate-induced obsessive-compulsive symptoms in an elderly man.

An 82-year-old man with treatment-resistant depression and early Alzheimer's disease was started on methylphenidate. Significant obsessive-compulsive behavior ensued but diminished over several weeks when methylphenidate was replaced by fluvoxamine. The patient had no prior psychiatric history, but he had a sister with obsessive-compulsive disorder. It appears that methylphenidate precipitated the patient's pathological behavior.

Aged↗
PubMed1993

A comparison of behavioral group therapy and individual behavior therapy in treating obsessive-compulsive disorder.

Outpatients with a primary DSM-III axis I diagnosis of obsessive-compulsive disorder (OCD: N = 93) were randomly assigned to one of three treatment groups: One group (N = 30) received 24 sessions of behavioral group therapy over a 12-week period; a second group (N = 31) received 24 individual behavior therapy sessions over the same treatment interval; and members of a control group (N = 32) received 24 individual sessions of progressive muscle relaxation. The Yale-Brown Obsessive-Compulsive Scale was administered before treatment at 2-week intervals during treatment, and at 6-month follow-up to measure changes in distress caused by OCD symptoms. The Beck Depression Inventory and the Self-Rating Anxiety Scale were also administered at pretreatment, posttreatment, and 6-month follow-up. Both individual and group interventions proved to be equally effective at reducing distress caused by OCD symptoms, general depression, and anxiety by the end of treatment, although patients in the individual behavior therapy condition demonstrated faster reductions in OCD symptom severity. Patients in the group and individual behavioral interventions were able to maintain their gains at 6-month follow-up. Implications of these findings for outpatient treatment are discussed.

Adult↗
PubMed2000

Workaholism and divorce.

This study compared workaholism components and workaholic behaviors of managers currently divorced or currently married. Data were collected using anonymous questionnaires from 530 women and men. 44 divorced and 415 still-married managers indicated similar workaholism and workaholic behaviors.

Adult↗
PubMed2025

Obsessive-compulsive disorder with hoarding behavior: unravelling key differences.

OBJECTIVE: Hoarding disorder remains underexplored and poorly understood despite its significant impact on individuals and communities. While historically linked to obsessive-compulsive disorder (OCD), emerging evidence suggests they may be distinct conditions. This study aims to investigate these differences. METHODS: Adults aged 18-88 years old (M = 39.86, SD = 14.86) were part of the Genomic Psychiatry Cohort study, including 1247 individuals with OCD without presumed hoarding disorder (OCD-pHD) and 663 individuals with OCD and presumed hoarding disorder (OCD+pHD). Sociodemographic data were collected, and participants were screened for other psychiatric conditions. All met DSM-5 criteria for OCD, with severity assessed using the Florida Obsessive-Compulsive Inventory and Y-BOCS. Statistical significance was set at p ≤ 0.0007, adjusted for multiple comparisons. RESULTS: The OCD+pHD group had significantly lower educational attainment, was more likely to live alone or in supervised living, and less likely to be married. This group also had more severe OCD and poorer insight. All types of obsessions and compulsions were more frequent in the OCD+pHD group, except for obsessions related to harming others. Additionally, the OCD+pHD group had higher rates of major depressive disorder, post-traumatic stress disorder, bipolar disorder, schizophrenia, body dysmorphic disorder, trichotillomania and previous diagnosis and/or symptoms of attention deficit and hyperactivity disorder. No significant difference was found for substance use and Tic/Tourette disorders. CONCLUSIONS: Significant clinical differences were observed between the groups, highlighting the need for further research to improve diagnosis, conceptualization, awareness, and support for individuals with hoarding disorder in the context of OCD.

Humans↗
PubMed1999

Psychological factors in nutritional disorders of the elderly: part of the spectrum of eating disorders.

OBJECTIVE: To illustrate common psychogenic factors involved in undereating and undernutrition in the elderly. METHOD: Two cases are described. RESULTS: In the context of age-related physical and social factors, obsessional, phobic, and hypochondriacal anxieties can lead to significant food restrictions and undernutrition. DISCUSSION: Psychogenic factors need to be considered in undernutrition of the elderly and the phenomena considered in the spectrum of eating disorders.

Aged↗
PubMed2006

Lack of evidence for association of the serotonin transporter gene SLC6A4 with autism.

BACKGROUND: The serotonin transporter (5-HTT) has long been considered likely to play a role in autism. Hyperserotonemia has been consistently found in a proportion of autistic patients, and the use of selective serotonin reuptake inhibitors (SSRIs) can have a positive effect in treating some symptoms of autism. Specific variants of the 5-HTT gene, SLC6A4, especially the insertion-deletion 5-HTTLPR promoter locus, have been found to modulate its expression and transporter function. METHODS: We examined the transmission of the short or long allele of 5-HTTLPR locus to affected individuals, using a large cohort of 352 families. In addition, we screened five single nucleotide polymorphisms (SNPs) in the 5' region of SLC6A4 previously reported to be positively associated with autism, as well as 4 additional SNPs also in the 5' region. RESULTS: No association of the 5-HTTLPR locus with autism was found. Furthermore, no evidence for association of any of the nine SNPs covering the SLC6A4 gene, or any of their haplotypes, was observed in our study. Using obsessive-compulsive behaviors (OCB), severe OCBs or rigid-compulsive subsets of our cohort gave the same negative results. CONCLUSIONS: SLC6A4 variants do not appear to be significantly involved in the liability to autism.

Autistic Disorder↗
PubMed1982

Paradoxical communication as interpersonal influence.

This paper is concerned with the strategic uses of paradoxical communication in therapy. Eight more or less distinct uses of paradoxical communication are described, and the proposition is put forward that the paradoxical interventions associated with the Milan group differ from those described by Haley and the Palo Alto group only in that they appear to be designed to influence simultaneously the behavior of several family members. The currently popular idea that such interventions should, or even can, be based on a systemic hypothesis, if "hypothesis" is understood in its usual sense as a statement amenable to empirical testing, is explicitly questioned.

Behavior↗
PubMed1991

Stealing in eating disordered patients.

Previous studies have noted high rates of stealing behavior in patients with eating disorders. To assess the significance of stealing in eating disordered patients, the authors compared the eating and purging behavior, levels of psychologic symptomatology, and alcohol use of 181 eating disordered patients with and without a history of stealing. Overall, the patients with a history of stealing had significantly more dysfunctional eating and purging behavior. Those patients with a history of stealing reported significantly more psychological distress including more depression, interpersonal sensitivity, obsessive compulsive behavior, and hostility. The authors conclude that stealing behavior should be assessed in patients with eating disorders as a history of stealing may define a subgroup of more severely impaired patients.

Adolescent↗
PubMed2005

Obsessive-compulsive disorder in Tourette's syndrome.

A substantial body of scientific evidence suggests that obsessive-compulsive behavior occurs in a large percentage of patients with TS. Reliable estimates suggest that nearly 50% of patients with TS have some degree of obsessive-compulsive features. Most patients with TS have only mild OCB and thus would not meet the DSM-IV diagnostic criteria for OCD. Therefore, OCB is perhaps a more appropriate characterization of this behavioral phenomenon that occurs in TS. OCB in TS appears similar to the spectrum of the tic disorder in terms of its onset, severity, and course. As with tics, OCB is typically mild and not always substantially disabling. Although clinical features between TS + OCB and primary OCD overlap considerably, patients with TS + OCB appear to experience different types of obsessive thoughts and compulsive rituals. Compelling genetic evidence suggests that OCB may be an alternative expression of the TS phenotype, which may selectively affect female gene carriers. Identifying the TS gene in the future will substantially broaden our knowledge of this intriguing neurobehavioral disorder. Finally, neurobiologic evidence points to similar anatomic and chemical substrates in the pathogenesis of TS and OCD, suggesting that these two disorders share a common pathophysiology. The clinical evaluation of patients with TS and their families should always include an assessment for OCB. Self-rated inventories of OCD such as the LOI, LOI-CV, and MOCI are useful screening scales. A more structured interview using the Y-BOCS (CY-BOCS) is useful for determining the degree and severity of OCB in TS as well as the response to therapy. Clinicians should keep in mind that OCB may be the most disabling feature of TS and may require treatment. Pharmacologic agents, such as SSRIs, and traditional behavioral therapy are proven effective treatments for OCB, which can substantially reduce the full effect of TS on patients and their families.

Diagnostic Imaging↗
PubMed1999

Maladaptive behavior differences in Prader-Willi syndrome due to paternal deletion versus maternal uniparental disomy.

Maladaptive behavior was compared across 23 people with Prader-Willi syndrome due to paternal deletion to 23 age- and gender-matched subjects with maternal uniparental disomy. Controlling for the higher IQs of the uniparental disomy group, deleted cases showed significantly higher maladaptive ratings on the Child Behavior Checklist's Internalizing, Externalizing, and Total domains as well as more symptom-related distress on the Yale-Brown Obsessive-Compulsive Scale. Across both measures, deleted cases were more apt to skin-pick, bite their nails, hoard, overeat, sulk, and withdraw. A dampening of symptom severity is suggested in Prader-Willi syndrome cases due to maternal uniparental disomy. Findings are compared to Angelman syndrome, and possible genetic mechanisms are discussed, as are implications for Prader-Willi syndrome and obsessive-compulsive behaviors.

Adolescent↗