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PubMed1995

[Obsessive-compulsive disorders versus obsessive-compulsive syndromes. Comparative study of two surveys of the general population and of psychiatric consultants].

Recent epidemiological studies were conducted in the general population, showing high rate prevalence of obsessive-compulsive disorder (OCD), estimated between 2 and 3% in the community. Although investigation of OCD prevalence had challenged the "real" definition of diagnostic threshold-criteria. Recent data from the Zurich study and from a large french clinical survey had confirmed the high prevalence and the validity of the subsyndromal forms of OCD (which are labelled as OCS or Obsessive-Compulsive Syndroms). In the Zurich study, lifetime prevalence rates of OCS was estimated to 5.5%. Point prevalence rates of OCS was recorded at 19.2% in the French survey (population of 4364 new patients seeking psychiatric help). In the two studies, a significant association between OCS and other disorders (major depression, dysthymia, phobic disorders) was found. Lifetime suicide attempts rate was found in 16-18% of subjects suffering from OCS (respectively in the Zurich and the French studies). These results confirmed that OCS (or subsyndromal forms of OCD) seemed to represent a clinically valid subgroup which modern classification systems fail to recognize, requiring treatment.

Adolescent↗
PubMedDate not supplied

[Obsessive-compulsive symptoms in schizophrenia: remission with anti-obsessive treatment].

Despite obsessive-compulsive symptoms in schizophrenia have been described for over 60 years, their clinical significance and treatment still remain unclear. Described below is a schizophrenic patient with obsessional thinking and compulsive rituals who markedly reduced the obsessive-compulsive symptoms after fluoxetine was added to neuroleptic treatment.

Adult↗
PubMed1979

[Catamnestic observations regarding the case of an obsession. Demoniac obsession nowadays].

A report is given on the catamnesis of a 43-year-old, previously obsessed female person whose case history was in detail described and discussed in this journal [14: 203-225 (1971)]. Following the attempt of an interpretation of this clinically rare case, testified in its time, the phenomenon of the obsession was discussed in the light of psychiatry and theology at the present time, when man is haunted by fear for his existence and obviously has recourse again to exorcism.

Adult↗
PubMed1995

Is hyperarousal essential to obsessive-compulsive disorder? Diminished physiologic flexibility, but not hyperarousal, characterizes patients with obsessive-compulsive disorder.

OBJECTIVE: To examine the hypothesis that the pathologic features of obsessive-compulsive disorder (OCD) are facilitated by abnormal levels of arousal, we compared patients with OCD with controls on self-reports and psychophysiologic measures. METHODS: Twenty-three patients with OCD were compared with 21 controls on rating scales and on psychophysiologic measures (ie, heart interbeat interval, skin conductance, respiration, blood pressure, and electromyographic activity) during rest and during two psychologically stressful tasks. RESULTS: Patients rated themselves higher on psychic and somatic anxiety scales. Mean physiologic activities were not elevated at rest. During tasks, changes in electrodermal, cardiovascular (except blood pressure), and muscle activities were smaller in patients with OCD, indicating decreased physiologic flexibility. CONCLUSIONS: Hyperarousal, measured peripherally, is not an essential pathologic feature of OCD. Decreased physiologic flexibility indicates an anxiety-related, but not OCD-specific, impairment of psychophysiologic reactivity to one's environment.

Adult↗
PubMed2000

Prevalence, quality of life and psychosocial function in obsessive-compulsive disorder and subclinical obsessive-compulsive disorder in northern Germany.

BACKGROUND: Despite the worldwide relevance of obsessive-compulsive disorder (OCD) there are considerable differences in prevalence rates and gender ratios between the studies and a substantial lack of prevalence data on subclinical OCD. Moreover, data on quality of life and on psychosocial function of subjects with OCD and subclinical OCD in the general population are missing to date. METHODS: German versions of the DSM-IV adapted Composite International Diagnostic Interview were administered to a representative sample of 4075 persons aged 18-64 years living in a northern German region. Specific DSM-IV based criteria for subclinical OCD were used. RESULTS: The life-time prevalence rates for OCD and subclinical OCD were 0.5% and 2%, respectively. Twelve month prevalence rates were 0.39% and 1.6%, respectively. The gender female:male ratio was 5.7 in OCD and 1.2 in subclinical OCD. In various measures of psychosocial function and quality of life, OCD and subclinical OCD were significantly impaired. However, subclinical OCD subjects did not visit mental health professionals more often than controls. CONCLUSION: Due to different epidemiological characteristics subclinical OCD might represent a syndrome distinct from OCD which is also associated with significant impairments in personal and interpersonal functions and in quality of life.

Adolescent↗
PubMed2006

Pharmacotherapy of obsessive-compulsive disorder and obsessive-compulsive spectrum disorders.

This article reviews new developments of pharmacotherapy in obsessive-compulsive disorder (OCD) and OC spectrum disorders of the past five years. New developments primarily involved the ex-tension of evidence of efficacy of serotonin reuptake inhibitors(SRIs), the use of atypical antipsychotics in addition to SRIs for treatment refractory patients, the combination of pharmacotherapy with behavior therapy, and studies assessing predictors of response. Today, frontline pharmacological treatment of OCD still consists of drugs with potent serotonin reuptake inhibition proper-ties. In case of non-response, treatment options comprise adding another drug, increasing the dose, switching drugs, or changing the mode of delivery.

Brain↗
PubMed1997

Cognitive assessment of obsessive-compulsive disorder. Obsessive Compulsive Cognitions Working Group.

Recent theories of obsessive-compulsive disorder (OCD) emphasize the importance of cognitive contents (beliefs and appraisals) and cognitive processes in the etiology and maintenance of OCD. In order to evaluate these theories and to assess the mechanisms of treatment-related change, it is necessary to develop measures of the relevant cognitive contents and processes. Several scales have been developed, although many are unpublished and there is a great deal of overlap among measures. The purpose of the present article is to describe the progress of an international group of investigators who have commenced a coordinated effort to develop a standardized set of cognitive measures. This article describes the theoretical bases and clinical importance of such an endeavor, and the proceedings of the working group meetings are summarized. Several methods of assessment are reviewed, including idiographic methods, information processing paradigms, and self-report measures. The working group is currently developing and evaluating self-report measures of appraisals about intrusions, and self-report measures of OC-related beliefs. Consensus ratings indicated that 6 belief domains are likely to be important in OCD. These are beliefs pertaining to: (1) inflated responsibility; (2) overimportance of thoughts; (3) excessive concern about the importance of controlling one's thoughts; (4) overestimation of threat; (5) intolerance of uncertainty; and (6) perfectionism.

Cognition↗
PubMed2002

Anticipation of age at onset of obsessive-compulsive spectrum disorders in patients with obsessive-compulsive disorder.

Anticipation of age at onset has been observed in several neuropsychiatric disorders. Recent studies have associated anticipation with the presence of unstable DNA and have suggested that trinucleotide repeats may be the main cause in some of these diseases. However, several selection biases may mimic the presence of such an effect. In this study we evaluated the presence of this effect in 40 families of probands with obsessive-compulsive disorder (OCD) compared with affected subjects in the parental generation. We controlled for ascertainment biases by taking into account the age at interview of probands. Using a different recruitment strategy, we controlled for anticipation in a sub-sample of offspring of 13 OCD patients, affected with OC spectrum disorders. While the younger generation showed a significantly earlier age at onset than the parental generation, no effect of age at interview was observed. Drawing on the results, we hypothesised that the presence of anticipation in OCD and OC spectrum disorders could be due to a specific genetic effect (unstable DNA), as it has been hypothesised for other disorders showing this effect.

Adult↗
PubMed1999

Orbitofrontal cortex dysfunction in obsessive-compulsive disorder? II. Olfactory quality discrimination in obsessive-compulsive disorder.

BACKGROUND: Olfactory quality discrimination is a putative marker of orbitofrontal cortex function in mammals. As this portion of the cerebral cortex was repeatedly implicated in the pathophysiology of obsessive-compulsive disorder (OCD) this study was designed in an attempt to quantify this behavioural function in OCD patients. METHODS AND RESULTS: Olfactory quality discrimination was compared in OCD patients and healthy controls. Thirty two subjects participated in the study: 16 (13 women and 3 men) medication free OCD outpatients and 16 sex and age matched healthy controls. Olfactory tests consisted of determination of detection thresholds to isoamyl acetate, and a three way forced choice quality discrimination task, using isoamyl acetate, citral and eugenol as stimuli. No significant differences in sensitivity and performance of the quality discrimination task between the two groups were found. Within the OCD group the more severely affected patients (Y-BOCS>29) performed significantly better than the less severely affected (Y-BOCS<30) patients on the more difficult part of the quality discrimination task. Within this subgroup of patients the correlation between performance on the olfactory task and a previously reported alternation task tended to be negative as compared to a significantly positive correlation in the control group. CONCLUSIONS: It seems that olfactory quality discrimination may prove to be a useful noninvasive marker of prefrontal cortex function in OCD. Furthermore, the organization of functional modules within the orbitofrontal cortex, rather than a simple dysfunction, may prove to characterize OCD.

Adolescent↗
PubMed1993

Obsessive-compulsive disorder in children and adolescents. Self-reported obsessive-compulsive behaviour in pupils in Denmark.

A total of 1032 pupils in Denmark aged 11-17 years completed a survey form of the Leyton Obsessional Inventory - child version, consisting of 20 items. These pupils had higher scores for obsessional symptoms or traits than high school students in the United States, also when corrected for age differences, but the most frequently reported symptoms seemed to be the same: repetitive thoughts or words, having trouble making up one's mind and worrying about being clean enough. There was no significant sex difference in total score. From 0.5% to 5% reported considerable interference by each obsessional symptom, and 4.1% had a total interference score > 25, reflecting possible subclinical or clinical obsessive-compulsive disorder.

Adolescent↗
PubMed1990

Clusters of obsessive-compulsive phenomena in obsessive-compulsive disorder.

Clusters of phenomena were obtained by two clustering techniques, using the form and content of obsessions and compulsions. Significant clusters which emerged involved washing, checking, thoughts of past, and embarrassing behaviour. Depression occurred as a discrete cluster. Eighty-nine per cent of subjects could be fitted into at least one cluster; over half could be fitted into only one cluster. Washers and checkers made up more than half of the sample studied.

Cluster Analysis↗
PubMed2001

Obsessive compulsive behaviour in autism--towards an autistic-obsessive compulsive syndrome?

A portion of autistic patients exhibit compulsive-like behaviours. In addition it has been suggested that serotonin plays a major role in both obsessive compulsive disorder (OCD) and autistic disorder. Other neurohumors such as endogenous opioids and oxytocin have also been implicated in the two disorders. There is also some pharmacological overlap between the two disorders, as well as some similar neuroimaging studies. These similarities and overlaps have led us to propose a putative OCD-autistic disorder, which should be studied in greater detail.

Autistic Disorder↗