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PubMedDate not supplied

Comparison of clinical characteristics in obsessive-compulsive disorder and body dysmorphic disorder.

Recent research has suggested that body dysmorphic disorder (BDD) is part of the spectrum of obsessive-compulsive disorders. In order to determine the extent of similarity for psychopathology measures, patients diagnosed with BDD were compared to a group of patients diagnosed with obsessive-compulsive disorder (OCD) on obsessionality, compulsivity, overvalued ideas, depression, and anxiety. Results indicate that BDD patients are similar to OCD patients for measures of obsessionality and compulsivity when BDD symptoms are assessed as such. BDD and OCD patients were also similar for measures of depression, and state and trait anxiety. OCD patients had higher levels of anxiety when measuring common physical symptoms associated with this affective reaction. BDD patients had higher levels of overvalued ideas, but fewer obsessive and compulsive symptoms. Overall, the results suggest that BDD is a variant of OCD, with special considerations given to degree of belief conviction (overvalued ideas.

Adult↗
PubMedDate not supplied

The neuropsychology of trichotillomania.

The pathophysiology of trichotillomania (TM) is not well understood. Overlap with obsessive compulsive disorder (OCD) has been proposed, although extant data are inconsistent in this regard. In the neuropsychological domain, some data have supported the proposed TM-OCD overlap. However, the available studies are limited in number, and they typically have sampled a restricted range of performance domains. To examine further neuropsychological functioning in TM, the present study compared performance of 21 patients with TM and 17 normal control (NC) participants on a broad battery of tests assessing intellectual functioning, auditory perception and language, visual perception, somatosensory function, motor ability, memory, concept formation, attention and information processing speed, impulsivity, and cerebral dominance. The TM group demonstrated poorer performance on all measures of divided, but not focused, attention. Correlational data suggested the potentially important role of negative affect in TM. Implications of the data for the conceptualization of TM are discussed.

Adolescent↗
PubMedDate not supplied

Automatic and strategic processing in obsessive-compulsive disorder: attentional bias, cognitive avoidance or more complex phenomena?

Slowed color naming of threat-related words on the modified Stroop task has been interpreted as indicative of selective processing biases, although alternative models have been proposed to explain inconsistent findings. The present study compared the performance of participants with obsessive-compulsive disorder (OCD) and normal controls on a computerized version of the modified Stroop, and investigated the relationship of Stroop effects to avoidant cognitive strategies. Contrary to predictions, control and OCD groups were notably faster at color naming OCD threat, general threat, and positive words compared to neutral words at the strategic level of awareness. This was not the case for OCD threat words at the automatic level of awareness where faster color naming was observed, although the expected differences between groups were not found. A thought replacement measure was generally predictive of OCD participants' automatic pattern of interference for negatively valenced words. Results indicate the complexity of the Stroop effect and the need for its ongoing review.

Adult↗
PubMedDate not supplied

Beliefs in obsessive-compulsive disorder.

Several types of beliefs have been hypothesized to be associated with obsessive-compulsive disorder (OCD), including responsibility for harm, need to control thoughts, overestimates of threat, intolerance of uncertainty, and beliefs about the consequences of anxiety and capacity to cope. The present study compared 62 subjects with OCD, 45 with other anxiety disorders (AD) and 34 controls, using 3 measures of OCD-related beliefs. OCD subjects scored higher than AD and control samples on 2 general belief measures. A closer analysis of specific belief domains indicated that OCD subjects scored higher than AD and control subjects on all 6 specific belief domains (responsibility, control, estimation of threat, tolerance of uncertainty, beliefs about the consequences of anxiety, and the capacity to cope). Four of the 6 domains showed reasonable convergent and discriminant validity with measures of OCD symptoms compared to other psychopathology; anxiety and coping beliefs were the exceptions. In regression analyses, cognitive measures contributed significant explanatory power beyond mood state and worry with uncertainty predicting severity of OCD symptoms above all other belief domains. Further research on OCD-relevant belief domains in etiology, maintenance and treatment is warranted.

Adaptation, Psychological↗
PubMedDate not supplied

Family distress and involvement in relatives of obsessive-compulsive disorder patients.

Obsessive compulsive disorder (OCD) affects the lives of patients as well as their relatives. Calvocoressi et al. (1995) suggested that accommodation (e.g., participating in the patient's rituals) by relatives of patients with OCD was related to global family dysfunction and distress. These investigators did not, however, examine the relationship between family accommodation and severity of the patients' OCD symptoms. In the present study we examined the relationship between families' reactions to the patient's illness (e.g., assistance with rituals, modification of family routine, rejection of the patient, etc.) and the patient's Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score and Hamilton Depression scale ratings. We also examined the effects of family accommodation and rejection on treatment outcome. Results revealed that family distress, accommodation, and rejection were related to depression and anxiety in the family members, but not to severity of the patients' OCD. At posttreatment, family accommodation and modification of routine was related to the severity of patients' OCD. These results remained significant when the effect of pretreatment OCD severity was partialled out.

Adolescent↗
PubMed2001

Quality of life and disability in patients with obsessive-compulsive disorder.

UNLABELLED: The aim of this study is to describe the situation of Spanish obsessive-compulsive disorder (OCD) patients and compare it to that of the general population and other patient groups. METHODS: Thirty-six OCD patients on maintenance treatment were evaluated using the Y-BOCS, SF-36, and DAS-S. Their SF-36 scores were compared to Spanish norms and to those obtained from U.S. OCD patients, schizophrenic outpatients, depressed outpatients, heroin dependents, patients on hemodialysis, and kidney transplant recipients. RESULTS: Sixty-one percent of the patients had severe or extremely severe symptoms. Their quality of life was worse when compared with the Spanish norms in all SF-36 areas, but especially with respect to mental health. In contrast to U.S. OCD patients, social functioning is more impaired in the Spanish OCD patients. OCD patients reported the same quality of life as schizophrenics in the areas of mental health, but better in the areas of physical health. Compared with heroin dependents and depressed patients, their quality of life was worse. On mental health scales, OCD patients scored worse than somatic patients. CONCLUSIONS: OCD in the Spanish population was shown to be associated with worse quality of life than for any other patient group (including physical groups), except schizophrenics.

Adolescent↗
PubMed2003

Elevated thalamic and prefrontal regional cerebral blood flow in obsessive-compulsive disorder: a SPECT study.

Functional neuroimaging studies have pointed to a possible role of cerebral circuits involving the prefrontal and anterior cingulate cortices, the striatum, and thalamus in the pathophysiology of obsessive-compulsive disorder (OCD). Regional cerebral blood flow (rCBF) of 16 drug-free Brazilian patients with OCD and 17 healthy subjects matched for age, gender, handedness and level of education was measured with [99m-Tc] HMPAO single photon emission computed tomography. Analysis of covariance identified four regions of interest with significantly higher rCBF: the right superior and inferior frontal cortex and the right and left thalamus. Positive correlations between symptom severity measured by Clinical Global Impression scores and rCBF were found in the right and left inferior frontal lobes and in the right basal ganglia. Compulsive behavior was inversely correlated with rCBF in the right thalamus, and duration of illness correlated positively with rCBF in the right and left superior frontal lobes and with the right thalamus. The findings of this SPECT study conducted in Brazil are in agreement with prior studies and provide additional support for the involvement of prefrontal-subcortical circuits in the pathophysiology of OCD. Furthermore, the study suggests that similar brain mechanisms appear to be involved cross-culturally.

Adolescent↗
PubMed2003

Brain reactivity to specific symptom provocation indicates prospective therapeutic outcome in OCD.

A pertinent question in biological psychiatry is what differentiates responders and non-responders to pharmacological treatment. One possibility is that individual differences in the symptomatic spectrum as well as in the underlying biology of the disorder lead to the known 40% failure in pharmacological treatment. Our study aimed to maximize individual brain markers of obsessive-compulsive disorder (OCD) by applying single photon emission computed tomography (SPECT) during a provoked symptomatic state prior to and following treatment. Four brain SPECT scans were obtained from 26 OCD patients prior to and at 6 months of sertraline treatment. At each time point, two SPECT scans were performed in a counterbalanced order of two specific states; one a symptom-provoking condition and the other a relaxed condition. At 6 months of treatment, patients were divided into responders and non-responders according to a predetermined clinical criterion. Prospective responders showed significantly lower brain perfusion in the dorsal-caudal anterior cingulum and higher brain perfusion in the right caudate, when compared to non-responders, only during symptom provocation. When pre- and post-treatment scans during symptom provocation were compared, only responders showed significant change in brain response: increased perfusion in the left anterior temporal cortex and prefrontal cortex at 6 months' treatment. These findings suggest that obtaining functional brain imaging during specific symptom provocation emphasizes individual differences in brain reactivity. Thus can indicate prospective responders to symptom-related treatment in OCD and mark the relevant brain regions for effective response to treatment.

Adult↗
PubMed1976

Gene interaction in the phenotypic expression of mental diseases.

A genealogical analysis is carried out on the pedigrees of 10 twin pairs with two or more psychoses. The probands' symptoms reveal some peculiar aspects, i.e., an atypical phenomenology possibly due to the interference of more pathological genes. Schizophrenia, depression, epilepsy, and obsessive neurosis, are found in the pedigrees in different combinations. The study of these pedigrees would lead to the conclusion that interaction of more than one psychosis gives rise to atypical forms as a result of an attempt to establish a state of balance between opposing dynamic actions, as in reversible chemical reactions. Probands' symptoms are less severe and with an often more favourable prognosis. Epilepsy tends to become independent and the major psychoses seem to be epistatic on it. As for obsessive-compulsive neurosis, probands may progress into schizophrenia or depression if one of these psychoses is present in the pedigree, or may represent the neurotic form of the major disease.

Adolescent↗
PubMed1977

Costs and benefits of behavioural psychotherapy: a pilot study of neurotics treated by nurse-therapists.

A pilot study is reported of costs and benefits from behavioural psychotherapy by nurse-therapists for selected neurotic problems. Figures are based on the treatment of 42 neurotics (mainly phobics and obsessive-compulsives) who completed treatment with nurse-therapists in a mean of 9 sessions (16 hours). The year before and after treatment was studied. Apart from significant and lasting reduction in patients' distress, economic benefits to them, their families and the community yielded a worthwhile internal rate of return when benefits from the cohort continue for 3 years, a reasonable assumption on available other evidence. Though untreated phobics did not improve elsewhere over 5 years follow-up, a controlled study would seem desirable.

Absenteeism↗
PubMed1976

Obsessional scores and subjective general psychiatric complaints of patients with duodenal ulcer or ulcerative colitis.

The Leyton Obsessional Inventory (LOI), together with 46 questions taken from Sections M-R or the Cornell Medical Index, were administered to 30 inpatients suffering from duodenal ulcer and to 30 patients admitted for ulcerative colitis to test the hypothesis that the latter have more obsessional traits than the former. The results indicated that although the two groups did not differ much in their obsessive personality traits, the ulcerative colitis patients were significantly more worried and concerned about them. None of the socio-cultural factors measured, which are known from other studies to influence these obsessive scores, was associated with the differences found. An analysis of the individual LOI items between the two groups showed that the ulcerative colitis patients were more indecisive, and also more morose, more rigid and more punctual than the duodenal ulcer patients, i.e. traits traditionally associated with obsessional personality types. The two groups did not differ on the Cornell score.

Adolescent↗
PubMed1980

A comparison of written and postbox forms of the Leyton Obsessional Inventory.

Two groups of medical students answered a modified version of the Leyton Obsessional Inventory twice, with 8 weeks between tests. On one occasion it was administered in its original card-sorting (postbox) form; on the other, it was given as a written questionnaire. Fifty students answered the postbox form first, 50 the questionnaire first. Correlation between the 2 tests was reasonably good (r = 0.73-0.77). Scores on the first occasion of testing were significantly higher than on the second, but differences between scores on the 2 forms were not significant. Mean scores of male and female students were similar.

Compulsive Personality Disorder↗