Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “OCD”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 613 records · Page 34Linked to original sources
PubMed2005

Impaired prepulse inhibition of acoustic startle in obsessive-compulsive disorder.

BACKGROUND: Animal and clinical studies suggest that impaired sensorimotor gating, as assessed with the prepulse inhibition (PPI) paradigm, may result from dysfunctional frontostriatal brain circuits and from neurochemical alterations which are also implied in the pathophysiology of obsessive-compulsive disorder (OCD). However, there is only preliminary evidence about impaired PPI in OCD so far. METHODS: Acoustic PPI was measured in 30 OCD patients and 30 matched healthy controls with a paradigm using different prepulse intensities. Psychopathology assessment included ratings for obsessions, compulsions, and depression. RESULTS: PPI was reduced in OCD patients, and this deficit was most pronounced for most intense (16 dB(A)) prepulses, where mean PPI was 39.6% in unmedicated patients (n = 4), 45.8% in medicated patients, and 58.9% in controls. No group differences were observed with regard to the habituation of acoustic startle magnitude. Startle measures were generally not associated with clinical measures, although such associations may have been obscured by medication effects. CONCLUSIONS: The present study confirms deficient central inhibitory functioning in patients with OCD and supports the model of deficient frontostriatal circuits in OCD. The relationship of PPI deficits to pharmacological and behavioral treatment and to possible subtypes of OCD merits further study.

Acoustic Stimulation↗
PubMed2005

Inferential confusion in obsessive-compulsive disorder: the inferential confusion questionnaire.

The current article represents the further validation of the construct of inferential confusion amongst clinical samples. Inferential confusion is proposed to be a meta-cognitive confusion particularly relevant to obsessive compulsive disorder (OCD) that leads a person to confuse an imagined possibility with an actual probability. As such, it conceptualizes OCD as a form of belief disorder similar to a delusion or overvalued idea that is a product of distorted reasoning processes. In contrast, other cognitive models of OCD emphasize a phobic model of development in OCD, and thus consider the exaggerated interpretation of intrusions as an essential element in OCD. The present study administered a revised version of the Inferential Confusion Questionnaire, and the Obsessive Belief Questionnaire (OBQ), to a total of 183 participants in three clinical groups and a non-clinical control group. Results suggest that OCD, at least in part, follows a non-phobic model of development with inferential confusion significantly related to obsessive-compulsive symptoms independently of cognitive domains as measured by the OBQ, and mood states. Further, scores on inferential confusion were particularly high in those with OCD and delusional disorder as compared to anxious and non-clinical controls.

Adolescent↗
PubMed2006

Responsibility and obsessive-compulsive disorder: an experimental test.

To test the causal status of responsibility in obsessive-compulsive disorder (OCD), an experiment was executed in which responsibility was experimentally manipulated. OCD patients, non-OCD anxiety controls, and non-patients executed a classification task in either a high or a low responsibility (LoRes) condition. Subjective ratings related to danger and responsibility indicated that the manipulation was successful. Subjective OCD-like experiences and checking behaviors were higher in OCD patients in the high responsibility (HiRes) condition than in all other groups. Although the checking subscale of the Padua Inventory correlated with subjective ratings in the OCD patients in the HiRes condition, it was not associated with checking behaviors. The results confirm the hypothesis that responsibility plays a causal role in OCD.

Adult↗
PubMed2006

An investigation of traumatic life events and obsessive-compulsive disorder.

Obsessive-compulsive disorder (OCD), like most other psychiatric disorders, is suspected of being influenced by an interaction between life events and genes, both with regard to onset and course of illness. To date, no specific genes have been identified as playing a frequent role, and only a relatively few empirical studies have assessed the association between stressful life events (SLEs) and OCD. The present study builds on past research by examining the potential contributions from traumatic life events (TLEs) on the severity and symptom features in 265 individuals with Structured Clinical Interview for DSM-IV (SCID)-diagnosed OCD. Of these participants 54% endorsed having experienced at least one TLE in their life time. The presence of one or more TLEs was associated with increased OCD symptom severity. This relationship remained significant despite controlling for key variables including age, OCD age-of-onset, comorbidity, and depressive symptoms. In addition, obsessions/checking and symmetry/ordering were two of four symptom factors that were specifically associated with the occurrence of TLEs. These results are generally supportive of a pathoplastic relationship between TLEs and OCD symptomatology and thus suggest the need for greater systematic consideration of life stresses in research focused on the nature and treatment of OCD.

Adult↗
PubMedDate not supplied

Obsessive-compulsive symptoms in patients with panic disorder.

Comorbidity studies have shown an important association between panic disorder (PD) and obsessive-compulsive disorder (OCD). The aim of the current study was to evaluate the prevalence of obsessive-compulsive symptoms (OCS) and OCD in patients with PD. Forty-eight consecutive PD cases (DSM-IV diagnostic criteria) referred to a Brazilian university hospital clinic were studied. The Yale Brown Obsessive Compulsive scale (Y-BOCS) checklist was used to identify the OCS. Subclinical OCD was considered when subjects met all but one DSM-IV criteria for OCD (symptoms did not cause significant distress and interference, did not last more than 1 hour per day, or were not considered excessive or irrational), and OCS when only the criterion for presence of obsessions or compulsions was met. Twenty-nine (60.4%) of the 48 patients evaluated (19 men and 29 women) had at least one OCS: nine (18.8%) had mild OCS, 11 (22.9%) had subclinical OCD, and nine (18.8%) had comorbid OCD. Therefore, 41.7% of the patients had either clinical or subclinical OCD. OCS occurred more frequently in women and, in 70.4% of the cases, preceded the onset of PD. Our results suggest that it is important to evaluate systematically the co-occurrence of OCS in patients with PD, due to the considerable overlap found in symptoms, which may have therapeutic implications. As panic symptoms are usually the main complaint, OCS are often found only when directly investigated.

Adolescent↗
PubMedDate not supplied

Comorbidity of obsessive-compulsive disorder and attention-deficit/hyperactivity disorder in referred children and adolescents.

OBJECTIVE: The aim of this study was to explore whether comorbid attention-deficit/hyperactivity disorder (ADHD) affects the clinical expression and outcome of obsessive-compulsive disorder (OCD) in a clinical sample. METHOD: A consecutive series of 94 children and adolescents (mean age, 13.6 +/- 2.8 years) with current diagnosis of OCD were included in the study. Twenty-four (25.5%) patients were diagnosed as having a comorbid ADHD. Subjects with OCD plus ADHD were compared with subjects with OCD but without ADHD. RESULTS: Comorbid ADHD with OCD was significantly associated with a higher rate of males, an earlier onset of OCD, a greater psychosocial impairment, and a heavier comorbidity, namely, with bipolar disorder, tic disorder, and oppositional defiant disorder/conduct disorder. Phenomenology of obsessions and compulsions and outcome were not affected by ADHD comorbidity. CONCLUSIONS: A screening for ADHD should be performed in patients with OCD, as these patients and their parents are frequently not aware that the impairment may be partly due to a comorbid ADHD.

Adolescent↗
PubMed2006

A prospective long-term follow-up study of alexithymia in obsessive-compulsive disorder.

BACKGROUND: Studies evaluating the stability of alexithymia over long follow-up periods are rare. We examined the temporal stability of alexithymia in patients with obsessive-compulsive disorder (OCD) over 6 years and the association of alexithymia with the long-term outcome of OCD. SAMPLING AND METHODS: Of 42 patients with OCD, 34 (81%) could be reassessed 6 years after inpatient treatment. The 20-item Toronto Alexithymia Scale, Yale-Brown Obsessive-Compulsive Scale, and Hamilton Depression Rating Scale were used at pretreatment, posttreatment, and follow-up. RESULTS: The 20-item Toronto Alexithymia Scale total scores and its factors 1 and 2 decreased significantly during follow-up, whereas factor 3 remained stable. High correlations of the 20-item Toronto Alexithymia Scale total scores (r = 0.84, P < .001) and its 3 factors emerged between posttreatment and follow-up, suggesting relative stability over several years. Regression analyses (with and without controlling for depressive symptoms) showed that higher alexithymia scores did not predict a worse long-term outcome of OCD. CONCLUSIONS: Relative stability over such a very long follow-up period strongly supports the view that alexithymia is a stable psychologic characteristic in patients with OCD. The result that higher alexithymia scores were not associated with poorer long-term outcome of OCD might be explained with the decrease of alexithymia during treatment and follow-up. However, our sample size was small, and further research is clearly required to evaluate the impact of changes in alexithymia and its association with the course of OCD.

Adult↗
PubMed2005

Obsessive compulsive disorder: a review of possible specific internal representations within a broader cognitive theory.

Obsessive Compulsive Disorder (OCD) is one of the most incapacitating of anxiety disorders, and is rated as a leading cause of disability by the World Health Organization (1996). Current cognitive models of OCD have focused on beliefs and management strategies involved in the development, maintenance, and exacerbation of OCD. However, despite evidence of their association to psychopathology, few researchers have applied the idea of underlying cognitive-affective structures, such as perceptions about the self and world, as operating in individuals with obsessive-compulsive thoughts and behaviors. This paper critically engages with current cognitive, developmental, and attachment research associated with views about the self and world. It is argued that consideration of such underlying cognitive-affective vulnerabilities may lead to a broader understanding of the development and maintenance of OCD. Consistent with previous theoretical work (e.g. ), we also argue that early experiences of parenting lead to the development of a dysfunctional self-structure and world-view relevant to OCD. Thus, this paper aims to extend the focus of current OCD research by exploring the possible role of a broader range of underlying vulnerability structures in the development and maintenance of OCD-related dysfunctional beliefs and symptoms.

Adult↗
PubMed2006

Shared executive dysfunctions in unaffected relatives of patients with autism and obsessive-compulsive disorder.

BACKGROUND: Executive dysfunctions have been studied as a potential endophenotype associated with the genetic basis of autism. Given that recent findings from clinical and molecular genetic studies suggest that autism and obsessive-compulsive disorder (OCD) could share a common pattern of heritability, we assessed executive functions as a possible common cognitive endophenotype in unaffected family members of individuals with either autism or OCD. METHODS: Five tests assessing executive functions (Tower of London, verbal fluency, design fluency, trail making and association fluency) were proposed to 58 unaffected first-degree relatives (parents and siblings) of probands with autism and 64 unaffected first-degree relatives of OCD patients. Results were compared with those of 47 healthy controls matched for age, sex, and level of education. RESULTS: In the Tower of London test, both groups of unaffected relatives showed significantly lower scores and longer response times compared with controls. No differences were observed between autism and OCD relatives and healthy controls in the four other tasks (verbal fluency, design fluency, trail making test and association fluency). CONCLUSIONS: Our findings show the existence of executive dysfunction in the unaffected first-degree relatives of probands with OCD, similar to those observed in the relatives of patients with autism. These results support and extend previous cognitive studies on probands indicating executive dysfunctions in autism and OCD. Planning and working memory processes could thus represent a common cognitive endophenotype in autism and OCD that could help in the identification of genes conferring vulnerability to these disorders.

Adolescent↗
PubMed2005

Do dysfunctional beliefs play a role in all types of obsessive-compulsive disorder?

Some but not all models of obsessive-compulsive disorder (OCD) emphasize the role of dysfunctional beliefs in the etiology and maintenance of this disorder. Clinical observations suggest that some OCD patients have prominent dysfunctional beliefs associated with their obsessions and compulsions, while other patients do not show this pattern. It is possible that dysfunctional beliefs play a role in only a subgroup of cases of OCD and, by extension, that different models might apply to different subtypes of the disorder. To examine this issue, patients with OCD (N = 244) completed measures of dysfunctional OC-related beliefs, along with measures of OC symptoms and demographics. These measures were also completed by three comparison groups; anxious (N = 103), student (N = 284), and community (N = 86) controls. Cluster analysis revealed two OCD clusters: low versus high scores on beliefs (OC-low, OC-high). Belief scores for OC-low were in the range of scores for the comparison groups, which were all significantly lower than those of OC-high. Thus, a cluster of OCD patients was identified who did not have elevated scores on measures of dysfunctional beliefs. OC-low and OC-high did not differ on some OC measures (contamination, checking, grooming), but OC-high had higher scores on measures of harming obsessions. These results are consistent with the view that dysfunctional beliefs may play a role in only some types of OCD.

Adult↗
PubMed2006

A self-report version of the Yale-Brown Obsessive-Compulsive Scale Symptom Checklist: psychometric properties of factor-based scales in three samples.

Current research in Obsessive-Compulsive Disorder (OCD) recognizes substantial symptom heterogeneity and emphasizes dimensional assessment of core domains. This study administered a self-report version of the Yale-Brown Obsessive-Compulsive Scale Symptom Checklist to OCD patients (n=53), non-OCD psychiatric patients (n=96), and students (n=419). Factor analyses of category- versus item-level data produced different solutions (4 or 5 vs. 3 factors, respectively), but support a multidimensional framework for OCD symptoms. For between-groups analyses, the two patient groups scored significantly higher than students on nearly all dimensions. However, OCD and non-OCD patients differed significantly only on Symmetry/Ordering symptoms. These findings provide novel data concerning this instrument and suggest that most of its scales may not distinguish OCD patients clearly when administered in this manner. We provide recommendations for improving subsequent self-report versions but caution users not to over-extend its intended use.

Adolescent↗
PubMed2005

Disgust sensitivity and obsessive-compulsive symptoms in a non-clinical sample.

Disgust sensitivity has been posited to play a role in the etiology and/or maintenance of obsessive-compulsive disorder (OCD); however, results of studies in this area have been mixed. We examined the relationship between specific domains of disgust sensitivity and specific OCD symptom patterns. One thousand and five undergraduate volunteers completed an internet battery of questionnaires including measures of OCD symptoms, depression, anxiety, and disgust sensitivity. Results indicated that even when controlling for depression and anxiety, several OCD symptom groups (checking, ordering, and washing) were associated with disgust sensitivity. Analysis of residuals, in which we controlled for every other OCD and disgust sensitivity domain for each paired comparison, indicated that the clearest relationship was between washing symptoms of OCD and disgust sensitivity toward hygiene-related stimuli. Examination of these items, however, raises questions about whether commonly accepted measures of disgust sensitivity might confound disgust with other forms of aversion. We discuss possible strategies for clarifying the degree to which fear and disgust are involved in OCD symptoms.

Adolescent↗
PubMed2005

Dysfunctional action monitoring hyperactivates frontal-striatal circuits in obsessive-compulsive disorder: an event-related fMRI study.

Converging evidence suggests that hyperactivity in frontal-striatal circuits and in action-monitoring processes characterizes obsessive-compulsive disorder (OCD). It remains unclear, however, just how these abnormalities in brain function translate into the cognitive, affective, and behavioral manifestations of OCD. One possibility is that exaggerated or false error signals generated by the anterior cingulate (ACC) underlie compulsive behaviors by triggering the feeling that things are "not just right" even when no actual error has been made. Since recurrent compulsive behavior typically follows correct completion of a behavioral task (e.g., hand washing), ACC hyperactivity should be observed during correctly completed, high-conflict trials as well as during error trials. Frontal-striatal regions would also be expected to be activated during both trial types, as these regions are robustly associated with OCD across multiple neuroimaging paradigms. To test this hypothesis, 14 OCD patients and 14 matched controls completed a speeded reaction time task during functional magnetic resonance imaging (fMRI). Only correctly rejected, high-conflict trials produced excessive activation in both action monitoring (rostral and caudal ACC, LPFC) and frontal striatal regions (lateral orbitofrontal cortex (OFC), caudate, and thalamus) among OCD patients when compared to healthy controls. Portions of the posterior cingulate were also hyperactive among OCD patients. These results suggest that correctly rejected, high-conflict trials that require response inhibition may provide a better model than error trials of compulsive behaviors in OCD.

Adult↗
PubMed2006

Mechanisms of action of current and potential pharmacotherapies of obsessive-compulsive disorder.

A significant body of evidence documented that the orbitofrontal cortex (OFC) and the head of caudate nucleus are involved in the mediation of obsessive-compulsive disorder (OCD) symptoms. Potent serotonin (5-HT) reuptake inhibitors (SRIs) are the only antidepressant agents thus far shown to be effective in the treatment of OCD. The present review summarizes information on 5-HT release and the adaptive changes in pre- and postsynaptic 5-HT receptors sensitivity induced by SRI treatment in rat and guinea pig structures involved in OCD. It emphasizes that the time course for the occurrence of increased 5-HT release and terminal 5-HT1D desensitization is congruent with the delayed therapeutic response to SRI in OCD. In addition, a greater dose of SRI inducing a greater degree of reuptake inhibition may play an essential role in this phenomenon. This is consistent with the common clinical observation that high doses of SRIs are sometimes necessary to obtain an anti-OCD effect, and with the results of some fixed-dose double blind trials showing a dose-dependent therapeutic effect of SRIs. It is hypothesized that enhanced 5-HT release in the OFC is mediated by the activation of normosensitive postsynaptic 5-HT2-like receptors and underlies the therapeutic action of SRI in OCD. This is supported by the beneficial effect of some hallucinogens with 5-HT2 agonistic properties in obtaining a more rapid therapeutic response. Finally, based on this knowledge, new strategies aimed at producing more rapid, effective and safe anti-OCD drugs, such as a selective action on terminal 5-HT1D receptors, on 5-HT2 receptors as well as on the glutamate system, are discussed.

Frontal Lobe↗
PubMed2006

Association between obsessive-compulsive disorder and a variable number of tandem repeats polymorphism in intron 2 of the serotonin transporter gene.

BACKGROUND: Pharmacological studies indicate a dysregulation of the serotonergic system in obsessive-compulsive disorder (OCD). A variable number tandem repeats (VNTR) polymorphism with three alleles (Stin2.9, Stin2.10, Stin2.12) has been described in intron 2 of the serotonin transporter (5-HTT) gene. This polymorphism has been associated with unipolar depression, bipolar disorder, schizophrenia, and anxiety disorders including OCD. METHODS: The association between OCD and the polymorphism is examined in 97 OCD patients, 578 psychiatric controls and 406 healthy controls, all Spanish Caucasians. RESULTS: Genotype frequencies for the polymorphism were significantly different in OCD patients, psychiatric patients and controls. There was a significant excess of 12/12 and 12/10 genotypes in OCD patients compared to psychiatric patients and controls. CONCLUSIONS: Our results indicate a possible association between the Stin2.12 allele of the VNTR polymorphism and OCD.

Alleles↗
PubMed2006

Cognitive retraining for organizational impairment in obsessive-compulsive disorder.

Individuals with obsessive-compulsive disorder (OCD) have difficulties in organizing information during encoding associated with subsequent memory impairments. This study was designed to investigate whether impairments in organization in individuals with OCD can be alleviated with cognitive training. Thirty-five OCD subjects and 36 controls copied and recalled the Rey-Osterrieth Complex Figure Test (RCFT) [Osterrieth, P.A., 1944. Le test de copie d'une figure complexe: Contribution a l'étude de la perception et de la memoire (The test of copying a complex figure: A contribution to the study of perception and memory). Archive de Psychologie 30, 286-350.] before being randomly assigned to a training or non-training condition. The training condition was designed to improve the ability to organize complex visuospatial information in a meaningful way. The intervention phase was followed by another copy and recall trial of the RCFT. Both OCD and control subjects who underwent training improved more in organization and memory than subjects who did not receive organizational training, providing evidence that the training procedure was effective. OCD subjects improved more in organizational during encoding than control subjects, irrespective of whether or not they had received training. This suggests that organization impairment in OCD affects primarily the ability to spontaneously utilize strategies when faced with complex, ambiguous information but that the ability to implement such strategies when provided with additional trials is preserved. These findings support a distinction in OCD between failure to utilize a strategy and incapacity to implement a strategy.

Adult↗
PubMed2006

Anorexia nervosa with excessive exercise: a phenotype with close links to obsessive-compulsive disorder.

Anorexia nervosa (AN) and obsessive-compulsive disorder (OCD) are highly comorbid, and appear to share a common neurophysiological dysfunction that contributes to the obsessional thoughts and compulsive behaviours seen in both disorders. Obsessive-compulsive personality (OCP) traits are also important risk factors for AN. Since excessive exercise has also been associated with greater obsessionality, we hypothesised that AN patients with a hyperactive behavioural profile represent a phenotype more closely linked to OCD than their non-exercising counterparts. We examined prospectively 50 female AN-Restrictor patients whom we classified as "excessive" or "non-excessive" based on their exercise status i) at admission and ii) over the lifetime of their illness. Validated measures of OCD symptoms and OCP traits were obtained at admission and after refeeding at discharge. On both classification methods, excessive exercisers had greater OCD symptoms and OCP traits than the non-excessive group, but did not differ on body mass index. OCD symptoms, but not OCP traits, decreased between admission and discharge. Findings support our prediction that AN patients with excessive physical activity constitute a subtype of the disorder with strong links to OCD. Indeed, this phenotype may be a culture-bound variant of OCD.

Adolescent↗
PubMed2004

Obsessive-compulsive disorder after epilepsy surgery.

It is a well-known fact that after epilepsy surgery (ES) preexisting psychopathology may deteriorate or de novo psychopathological syndromes, mainly of a depressive and psychotic nature, may appear. Previously, recovery of obsessive-compulsive disorder (OCD) after ES has been reported in patients who had comorbid OCD preoperatively; however, there have been no reports on the appearance of de novo OCD interfering with daily living activities post-ES. This is the first report of OCD after ES in patients with mesial temporal lobe epilepsy (MTLE). Five patients with MTLE were identified with obsessive personality traits before surgery. Within the first 2 months after ES, two of these MTLE patients fulfilled OCD diagnostic criteria. These OCD patients were not any different from the other three patients with respect to age, age of onset of epilepsy, seizure types, and seizure frequency. All patients stopped having seizures postoperatively, but the OCD patients had worse quality of life postoperatively than preoperatively. Our findings show that those patients with obsessive traits preoperatively should be carefully monitored after ES.

Adult↗