Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “OBSESSIONS”

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 865 records · Page 48Linked to original sources
PubMed2000

Sertraline and obsessive compulsive disorder: new indication. Limited assessment.

(1) Sertraline, a selective serotonin reuptake inhibitor (SSRI), is now licensed in France for the treatment of obsessive-compulsive disorder in adults. (2) In this indication the clinical file is of acceptable methodological quality, but it is incomplete: sertraline has not been compared with the other two serotonin reuptake inhibitors approved in obsessive-compulsive disorder, namely fluoxetine and paroxetine. (3) Three placebo-controlled trials have demonstrated the efficacy of sertraline in obsessive-compulsive disorder. (4) In a trial versus clomipramine, sertraline was no more effective in patients able to tolerate the drug, but the rate of treatment withdrawals for adverse events was higher on clomipramine.

Adult↗
PubMed2002

Sertraline: new indication. May help children with obsessive-compulsive disorder.

(1) The choice of treatment for children with obsessive-compulsive disorder is difficult. Behaviour therapy and antidepressants have not been assessed adequately in this setting, and their efficacy seems limited. Clomipramine was the first antidepressant to show a degree of efficacy. (2) Sertraline is the first drug to be licensed in France for children aged from 6 to 17 years with obsessive-compulsive disorder. (3) According to our literature search, the evaluation file on sertraline in this indication mainly contains data from a double-blind placebo-controlled trial involving 187 children. After 3 months of treatment, sertraline was significantly more effective than placebo, although most children remained symptomatic. Direct comparison is lacking, but sertraline seems as effective as clomipramine. (4) However, 13% of children receiving sertraline left this trial because of adverse events (3% on placebo; p = 0.02). The short-term safety profile of sertraline in children is the same as in adults, i.e. mainly nausea, agitation, headache, insomnia and tremor. (5) We have no data on the effects of prolonged sertraline therapy in children, particularly on neuropsychological development. (6) The first-line treatment of obsessive-compulsive disorder is behaviour therapy. Sertraline, like clomipramine, is an option when behaviour therapy fails or is unfeasible. The choice between sertraline and clomipramine should be discussed case by case, according to their safety profiles; however, we have more experience with clomipramine, which should therefore be preferred over sertraline.

Adolescent↗
PubMed1992

Personality disorders in obsessive compulsive disorder.

Standardized structured interview personality scales are now available that provide better reliability than clinician interview, but are still imperfect. These scales diagnose DSM III-R personality disorders, which are more illness-oriented than Freudian notions. Use of these scales has found that the majority of patients with OCD have at least one Axis II personality disorder, with most falling in cluster C. Obsessive compulsive personality disorder, as described in DSM-III-R, is, in most samples studied, present in the minority of patients with OCD, and is often less common than other personality disorders such as mixed, dependent, avoidant, and histrionic. The prevalence of this personality disorder as modified in DSM-III-R (making it easier for a patient to qualify for this personality disorder diagnosis) appears to be higher, although still present in a minority of patients with OCD. Obsessive compulsive personality disorder (along with the other cluster B and C personality disorders) has not been reported to have a consistent relation to treatment outcome. There is evidence that in some cases, obsessive compulsive personality disorder may be secondary to OCD. Swedo et al hypothesized that some children may develop compulsive personality traits as an adaptive mechanism to deal with OCD. This hypothesis is in accord with our finding that OCD often predates compulsive personality disorder and that mixed personality disorder may develop over time, possibly secondary to OCD. We found in our sample of 96 adult patients with OCD that the presence of mixed personality disorder was more likely with longer duration of OCD, suggesting that patients who do not have premorbid personality disorders may develop significant personality traits (especially avoidant, compulsive, and dependent), which may be related to behavioral and life-style changes that are secondary to OCD. This hypothesis is strengthened by our finding that patients with one of these personality disorders at baseline tended to no longer meet criteria for them following successful treatment of their OCD. It now appears that schizotypal personality disorder, which is thought to be related genetically to schizophrenia (e.g., in three male identical twin pairs concordant for OCD but discordant for schizophrenia or schizoaffective disorder, the nonpsychotic co-twins all had schizotypal personality disorder), is the only consistent personality disorder predictor of poorer outcome in OCD. These traits may help explain other proposed poor predictors of treatment outcome such as overvalued beliefs, poor compliance, and chaotic family situations.(ABSTRACT TRUNCATED AT 400 WORDS)

Comorbidity↗
PubMed1992

Tourette's syndrome and obsessive compulsive disorder. Clinical aspects.

Tourette's syndrome (TS) is a disorder that typically has its onset in childhood or early adulthood and is characterized by the presence of both motor and vocal tics. Obsessive compulsive symptoms (OCS) frequently occur in patients with tic disorders. The earliest descriptions of TS included obsessive thinking as a part of the symptom complex. Recent studies suggest that obsessive compulsive disorder (OCD) may occur in as many as 7% of patients with TS, and that both of these disorders share a similar clinical phenomenology and familial patterns of transmission. This article explores similarities and differences between these two disorders.

Behavior Therapy↗
PubMedDate not supplied

[A case of obsessive symptoms in Huntington's disease].

INTRODUCTION: Recently, some authors have postulated the existence of the so-called < >. This would include disorders that have the common point of the presence of repetitive thoughts and actions, which may either have a < > or < > nature. Certain neurological disorders with repetitive movements have also been grouped within this spectrum, including some forms of epilepsy, Parkinson's disease, Sydenham's Chorea or Huntington's disease. There is evidence that physiopathological connections may exist between some of these conditions. METHODS: A case of a patient with Huntington's Chorea with obsessive signs and symptoms is presented. The patient is a 50 year old male, diagnosed of Huntington's Chorea who is being treated with 25 mg/day of clozapine and 10 mg/day of clorazepate. The patient refused to eat certain foods for < >. He began to display other obsessive behaviors such as refusing to touch objects that might have been touched by others, and developed ritual checking methods. Treatment based on the administration of 40 mg/day of paroxetine was begun. With this treatment the compulsive symptoms have disappeared, as has the fear of choking. However, the choreic movements typical of his condition persist and the signs and symptoms associated with a process of dementia are becoming increasingly evident. CONCLUSIONS: It is concluded that the case described may well be a good example of obsessive spectrum, and that the underlying physio-pathology should be studied.

Humans↗
PubMed1992

Emergence of obsessive compulsive symptoms during treatment with clozapine.

BACKGROUND: Clozapine differs from other currently available antipsychotics in its prominent serotonin blockade. We explore the relationship between clozapine and obsessive compulsive symptoms, which have been linked to deficient serotonin. METHOD: We reviewed our experience in treating 49 chronic schizophrenic patients with clozapine. RESULTS: Five patients were identified who experienced either de novo obsessive compulsive symptoms or exacerbation of preexistent symptoms. Clinical details are provided for each case. CONCLUSION: Clozapine may produce or unmask obsessive compulsive symptoms. This may reflect a variation on the normal course of clinical improvement, or may more specifically result from clozapine's atypical pattern of CNS receptor antagonism. Further attention to this issue is warranted.

Adult↗
PubMedDate not supplied

Changes in compulsion and anxiety symptoms with nicotine transdermal patches in non-smoking obsessive-compulsive disorder patients.

OBJECTIVE: Some of the obsessive-compulsive disorder (OCD) symptoms can be elicited in rats by the administration of quinpirole (D2/D3 dopaminergic agonist). Nicotine administration blocked some aspect of checking behavior in that model. The main goal of this study was to determine if the clinical manifestations of OCD non smoking patients change with the administration of transdermal nicotine patches. MATERIAL AND METHODS: Eleven patients were studied (6 female and 5 males), average age 29.7 +/- 5.5 years. All of them were OCD according to DSM-IV criteria. Clinical scorings were done with Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). Nicotine (17.5 mg/day) or placebo transdermal patches were randomly administered for five continuous days. RESULTS: Nicotine administration reduced the total Y-BOCS and the compulsive score of that scale, but did not reduce obsessions. Also anxiety was reduced as was shown by the BAI scores, when patients were on nicotine patches, no changes were observed in BDI. CONCLUSIONS: The present results replicated the animal findings about reduction in compulsive behavior after nicotine administration. Also suggest that nicotine depending on the dysfunction of the different neurotransmitter systems may produce different behavior or cognitive effects, also that even nicotine showed some beneficial effect in OCD patients, the low rate of nicotine smoking in this type of patients, may show other mechanisms than may protect to smoke in some psychiatric patients.

Administration, Cutaneous↗
PubMedDate not supplied

[Eating behaviors, attitudes and obsessive-compulsive traits in adolescents of Buenos Aires City].

OBJECTIVE: Eating disorders are psychiatric illnesses of important prevalence in Argentina. Some typical characteristics of adolescence, such as body image fragility, media influence and social pressure lead partly into the development of eating disorders at that age. The objective of our study was to explore the eating behaviors, attitudes and obsessive-compulsive traits of the adolescents of Buenos Aires City. METHODS: A questionnaire survey was administered to 380 students of 5 Buenos Aires high schools (mean age:16,8 years old) and their answers were analyzed. RESULTS: Almost 50% of the adolescents were not satisfied with their weight, 43% of them has been on a diet at least once (the majority because of aesthetic reasons). A percentage of 23,5 had bulimic behaviors, 34,5% had a high number of obsessive-compulsive traits. Women were significantly more dissatisfied with their weight, had been on more diets and had more bulimic behaviors and obsessive-compulsive traits. CONCLUSIONS: Weight dissatisfaction and bulimic behaviors are frequent in adolescents of Buenos Aires City, specially among women. Preventive measures against eating disorders should be done on this population.

Adolescent↗
PubMed2004

Beyond refractory obsessions and anxiety states: toward remission.

At the Sixth International Obsessive-Compulsive Disorder Conference (IOCDC), held November 13-15, 2003, in Lanzarote, Spain, 2 issues were discussed that are of great importance to future research on obsessive-compulsive disorder (OCD). The first of these is the possible inclusion of obsessive-compulsive spectrum disorders (OCSD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. OCSD resemble OCD in their clinical symptoms, associated features, comorbidity, family/genetics, etiology, and neurocircuitry, as well as their selective response to treatment with serotonin reuptake inhibitors. The second issue is considering remission as the ultimate goal of treatment for OCD instead of just symptom reduction, as has been suggested in other disorders. These and other issues should be discussed at future meetings of the IOCDC and influence how we conceptualize the disorder and design future treatment trials.

Anxiety Disorders↗
PubMedDate not supplied

[The case of a patient with treatment-refractory obsessive-compulsive disorder operated by stereotactic bilateral cingulotomy].

This case report presents the first patient in Poland with treatment-refractory obsessive-compulsive disorder, operated by stereotactic bilateral cingulotomy. The patient, aged 38 years, with 20-year duration of illness, despite intensive pharmacological and psychotherapeutic treatment was totally unable to function due to obsessive-compulsive symptoms of extreme intensity. The paper presents the neuroimaging documentation of psychosurgery performed on 3rd December 2002. On the basis of nearly two-year follow-up of the patient, the result of the psychosurgery can be assessed as moderately favorable. The patient's subjective mood and social functioning have improved, as well as his cognitive functions measured by means of neuropsychological tests. In patients with severe, chronic and treatment-refractory obsessive-compulsive disorder psychosurgical treatment may be a therapeutic option.

Adult↗
PubMed2005

[Obsessive-compulsive disorders: how to recognize and treat them].

Obsessive-compulsive disorders are characterized by recurrent and persistent obsessive thoughts that are experienced as obtrusive and inappropriate, and (often stereotypic and repetitive) compulsive actions. Their lifetime prevalence is estimated to be 1-2%. Men and women are affected by such disorders in about equal numbers. The most common comorbidities are depression and anxiety. The etiology is considered to encompass both psychological and neurobiological aspects. The most effective therapeutic approach is cognitive behavioral therapy with exposure and response prevention as the central element, which leads to a lasting improvement in symptoms in some 60-80% of the patients. If a depressive disorder is also present, or if obsessive thoughts are predominant, a combination of cognitive behavioral therapy and pharmacological treatment with (selective) serotonin reuptake inhibitors has proven effective.

Adult↗
PubMed2005

[Clinical study on treatment of obsessive compulsive neurosis by acupoint stimulating control].

OBJECTIVE: To study the clinical effect of acupoint stimulating control (ASC) in treating obsessive compulsive neurosis. METHODS: The comparative study was conducted in 65 patients with obsessive compulsive neurosis, they were divided into two groups, the 33 patients in the control group treated with chlorimipramine and the 32 in the tested group treated with ASC. The therapeutic efficacy and adverse reaction were assessed according to the standard for clinical efficacy evaluation by Yale-Brown scale for obsession (Y-BOCS)and adverse reaction scale. RESULTS: The curative rate and markedly effective rate in the control group was 24.2% (8/33) and 27.3% (19/33), which in the tested group was 37.5% (12/32) and 34.4% (11/32) respectively. Significant difference was shown in comparison of Y-BOCS score between the two groups from the end of the 4th week of treatment (P < 0.05), indicating the efficacy in the tested group was better than that in the control group. Moreover, the occurrence of adverse reaction was higher in the control group than that in the tested group. CONCLUSION: ASC is a treatment with good effect, less adverse reaction and favourable safety superior to the treatment by chlorimipramine.

Acupuncture Points↗
PubMed2005

[When thoughts become compulsions. Obsessive-compulsive disorder in children].

OCD (obsessive-compulsive disorder) is characterised by the presence of annoying, unwelcome and intrusive obsessions and compulsions. The obsessions appear over and over and the child recognize them as something strange and unwelcome, but at the same time they are clearly a product of his/her own mind and not a hallucination or a thought disorder as seen in psychotic disturbances. Compulsions are imposed actions that the child feels it has to perform, often in a certain pattern. Both children and adults can suffer from OCD. Almost 2/3 of adults with OCD report onset of their OCD symptoms in childhood or early adolescence. Previously, OCD among children and adolescents was considered to be rare, but newer epidemiologic surveys show that 1-1% of children and adolescents suffer from OCD in such a degree that they fulfil the diagnostic criteria. The prevalence varies surprisingly little in various countries regardless of cultural background.

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↗
PubMed2005

[Schizophrenia and obsessive-compulsive disorder--some considerations based on a case].

The authors report the case of a male patient whose illness started with obsessive-compulsive symptoms and later developed into undifferentiated type schizophrenia. They explore the changes in the symptomatology of the young male and the treatment interventions used. The authors emphasize the common appearance of obsessive-compulsive symptoms with schizophrenia and present data on the epidemiology and psychopathology of the recently published schizo-obsessive subtype of schizophrenia. They point at the importance of early detection and complex treatment approaches.

Adult↗
PubMed1991

Acute psychostimulant challenge in primary obsessive-compulsive disorder.

The effects of acute oral administration of methylphenidate 40 mg versus dextroamphetamine 30 mg versus matched placebo were compared in 11 patients with primary obsessive-compulsive disorder. Dextroamphetamine but not methylphenidate had a significantly greater antiobsessive-compulsive effect as measured by the Comprehensive Psychiatric Rating Scale--Obsessive-Compulsive Subscale, as compared with placebo. This effect appeared unrelated to their effect on depression although a differential effect of the two psychostimulants on anxiety was observed. Although both these stimulants affect serotonin, the differences noted between dextroamphetamine and methylphenidate suggest that catecholamines may be implicated in the pathophysiology of obsessive-compulsive disorder.

Adult↗
PubMed2006

Reliability and validity of the Yale-Brown Obsessive-Compulsive Scale in schizophrenia patients.

Although a sizeable minority of people with schizophrenia manifest obsessive and compulsive symptoms, to our knowledge there are no studies of the psychometric performance of measures such as the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). The present study examined psychometric properties of the Y-BOCS in patients with recent-onset schizophrenia and comorbid obsessive-compulsive symptoms (OCS). To 37 patients with recent-onset schizophrenia and related disorders and comorbid OCS taken from 135 consecutively admitted patients we administered the Y-BOCS at admission and 6 weeks later. The Y-BOCS showed good internal consistency and interrater reliability in this population; however, findings concerning the divergent validity against depressive and negative symptoms are inconsistent.

Adolescent↗
PubMed1991

A controlled trial of lithium augmentation in fluvoxamine-refractory obsessive-compulsive disorder: lack of efficacy.

Two- and 4-week double-blind placebo-controlled trials of lithium augmentation of ongoing fluvoxamine treatment trials were conducted in 20 and 10 patients, respectively, with primary obsessive-compulsive disorder (OCD) who had failed to respond to fluvoxamine alone. Although 2 weeks of double-blind lithium augmentation produced a small but statistically significant reduction in obsessive-compulsive symptoms, most patients did not have a clinically meaningful response. Furthermore, there was no statistical or clinical improvement in obsessive-compulsive symptoms during the subsequent 4-week double-blind, placebo-controlled trial of lithium augmentation. On the basis of treatment response criteria, only 18% and 0% of the patients responded to lithium augmentation of fluvoxamine during the 2- and 4-week treatment trials, respectively. In light of the previously reported 44% response rate to lithium augmentation in treatment-resistant depressed patients on fluvoxamine, the results of this study suggest that pathophysiological differences may exist between OCD and depression. The routine use of lithium augmentation in the management of patients with OCD who are refractory to serotonin reuptake inhibitors is not supported by these findings.

Adult↗