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PubMed2001

Complex phonic tic and disinhibition in Tourette syndrome: case report.

Tourette syndrome (TS) is a neuropsychiatric disorder characterized by a combination of multiple motor tics and at least one phonic tic. TS patients often have associated behavioral abnormalities such as obsessive compulsive disorder, attention deficit and hyperactive disorder. Coprolalia, defined as emission of obscenities or swearing, is one type of complex vocal tic, present in 8% to 26% of patients. The pathophysiology of coprolalia and other complex phonic tics remains ill-defined. We report a patient whose complex phonic tic was characterized by repetitively saying "breast cancer" on seeing the son of aunt who suffered from this condition. The patient was unable to suppress the tic and did not meet criteria for obsessive compulsive disorder. The phenomenology herein described supports the theory that complex phonic tics result from disinhibition of the loop connecting the basal ganglia with the limbic cortex.

Adolescent↗
PubMed1988

Beneficial effects of imipramine on Tourette's syndrome.

Gilles de la Tourette's syndrome (GTS) is a chronic neuropsychiatric disorder characterized by multiple involuntary motor and phonic tics associated with behavioural disturbances including obsessive-compulsive and aggressive behavior, depression and, rarely, psychosis. The relationship of GTS, presumed to be predominantly a dopaminergic disorder, and depression, presumed to be a noradrenergic-serotoninergic deficiency state, is currently poorly understood. The reports published to date on the effects of tricyclic antidepressants in GTS have been contradictory; while Messiha et al. (1976) used imipramine successfully in one GTS patient, Abuzzahab and Anderson (1973) and Fras (1978) on the other hand, found imipramine to exacerbate GTS symptoms and cautioned its usage in this syndrome. A more recent report suggested that imipramine is useful in GTS patients who exhibit symptoms of attention deficit disorder (Dillon et al., 1985). We report a patient with GTS whose depression and behaviour improved considerably when low-dose imipramine (Tofranil) was added to the regimen of anti-GTS medication. This report suggest that tricyclic antidepressants may be useful adjuncts in the management of GTS, and hints at norepinephrinergic and serotoninergic deficiencies as being components of the pathogenesis of the syndrome.

Child↗
PubMedDate not supplied

[Psychotic disorder in Prader Willi syndrome: a case report].

In the Prader-Willi Syndrome the psychiatric symptoms are fundamentally behavioral disorders and obsessive-compulsive symptoms in relation with food. These aspects have been published previously. Nevertheless, psychotic manifestations in this syndrome are infrequent. Let us present a case of this comorbidity and a bibliographic review in last years (Medline, EmBase, Cochrane) was done about this association.

Adult↗
PubMed1975

[Psychological resistances of women to the principal female methods of contraception. Clinical classification].

According to the literature and to the experience of the authors gathered at the family department at the Louvain Faculty of Medicine, these psychological resistances may schematically be classified as follows: normative and socio-cultural resistances; medical resistances (wish of pregnancy, personality traits, narcissm, sexual and technical resistances); psychopathological resistances (unspecific neurotic behavior, phobias, hypochondriasis, obsessive-compulsive neurosis, character neurosis); secondary resistances.

Attitude↗
PubMed2001

Case study: bibliotherapy and extinction treatment of obsessive-compulsive disorder in a 5-year-old boy.

Cognitive-behavioral therapy (CBT) is an effective treatment for childhood obsessive-compulsive disorder (OCD). However, no case studies of children younger than 7 years old have been published. This case report describes a 5-year-old boy with severe OCD. Treatment consisted of parent- and teacher-directed extinction of compulsive reassurance-seeking, and bibliotherapy with an age-appropriate book on OCD. Compulsive behavior decreased rapidly and remained at a low level through the remainder of treatment. At posttreatment and at 1- and 3-month follow-up assessments, the patient's OCD symptoms were markedly improved. This report suggests that very young children may respond well to brief CBT.

Child, Preschool↗
PubMed2001

Suppression of obsession-like thoughts in nonclinical individuals: impact on thought frequency, appraisal and mood state.

Wegner's (1994, Psychological Review, 101, 34-52) research on the paradoxical effect of thought suppression has been incorporated into contemporary cognitive-behavioural models of obsessive-compulsive disorder. However, findings on the effects of thought suppression on thought frequency have been inconsistent and few studies have actually examined the suppression of thoughts that are obsessional in nature. In the present study 219 nonclinical participants were randomly assigned to suppress or not suppress a neutral, obsessional or positive thought during an initial monitoring interval. In a second thought monitoring interval, all participants received instructions not to suppress their target thought. No paradoxical effect of suppression on frequency was observed for any type of thought, although suppression of obsessional thoughts was associated with greater subsequent discomfort and a more negative mood state than suppression of positive or neutral target thoughts.

Adolescent↗
PubMed2006

Hyperkalemia and hyperdopaminemia induced by an obsessive eating of banana in an anorexia nervosa adolescent.

Banana is known as a dopamine-rich and potassium-rich food, however no previous data regarding biochemical or psychological alteration induced by excess intake of banana has been reported. We have experienced an adolescent female case of Anorexia nervosa (AN) who denied eating anything but maximum 20 bananas and less than 500 ml mineral water per day for more than two years. During the period of massive banana eating habit, she showed increase of serum potassium (from 4.7 mEq/l to 6.1 mEq/l) and whole blood dopamine (from 11 ng/ml to 210 ng/ml; normal range 0.5-6.2 ng/ml), and obvious dysthymia that is inexplicable only by the pathology of AN. When the patient resumed other food ingestion after 26 months of obsessive and restricted eating of banana, the abnormalities in her blood data and her psychological state were all corrected toward normal. We conclude that in this case, the obsessive and restricted habit of banana ingestion resulted in hyperkalemia, hyperdopaminemia, and psychological change.

Adolescent↗
PubMed1999

Symptom structure in obsessive-compulsive disorder: a confirmatory factor-analytic study.

Although obsessive-compulsive disorder (OCD) has long been a unitary diagnosis, there is much recent interest in its potential heterogeneity, as manifested by symptom subgroups. This study evaluated existing models of symptom structure in a sample of 203 individuals with OCD. Using confirmatory factor analysis, we examined the ability of each model to account for two levels of data: a priori symptom groupings (second-order) and individual symptoms, identified by the Yale-Brown Obsessive Compulsive Scale symptom checklist. Four models were examined: a single-factor, a two-factor (i.e., obsessions and compulsions), and two multidimensional models, comprising three and four factors. Adequate fit was found solely for the four-factor model--specifying obsessions/checking, symmetry/ordering, contamination/cleaning, and hoarding--but only at the second-order level; it did not account for relationships among discrete symptoms. Parameter estimates showed within-factor heterogeneity, as well as overlap between factors, most notably the two representing checking and contamination-related symptoms. The implications of these findings are discussed. Results provide evidence for the multidimensionality of OCD symptoms, but suggest that a comprehensive model has yet to be identified. They also point to the inadequacy of groupings based solely upon overt behavioural similarities (e.g., 'checking'). Recommendations are made for future research.

Adult↗
PubMed2005

A family study of obsessive-compulsive disorder with pediatric probands.

Obsessive-compulsive disorder (OCD) is a heterogeneous disorder of unknown etiology. We examined the lifetime history of obsessions, compulsions, and OCD in the first- and second-degree relatives of 35 pediatric probands with OCD and 17 controls with no psychiatric diagnosis. All available first-degree relatives were directly interviewed blind to proband status with two semi-structured interviews. Parents were also interviewed to systematically assess the family psychiatric history of first- and second-degree relatives. Best-estimate lifetime diagnoses were made using all available sources of information. Data were analyzed with logistic regression by the generalized estimating equation method and with robust Cox regression models. The lifetime prevalence of definite OCD was significantly higher in case than control first-degree relatives (22.5% vs. 2.6%, P < 0.05). Compared to controls, case first-degree relatives also had significantly higher lifetime rates of obsessions and compulsions (both P < 0.05). There was no significant difference between case and control second-degree relatives in lifetime rates of OCD. First-degree relatives of case probands with ordering compulsions had a significantly higher lifetime rate of definite and subthreshold OCD than relatives of case probands without ordering compulsions (45.4% vs. 18.8%, P < 0.05). The lifetime prevalence of definite OCD was significantly higher in case first-degree relatives with a history of tics than in case first-degree relatives without a tic history (57.1% vs. 20.9%, P < 0.01). The results provide further evidence that early-onset OCD is highly familial and suggest that two clinical variables are associated with its familial aggregation.

Adolescent↗
PubMed1999

OCD-Like behaviors caused by a neuropotentiating transgene targeted to cortical and limbic D1+ neurons.

To study the behavioral role of neurons containing the D1 dopamine receptor (D1+), we have used a genetic neurostimulatory approach. We generated transgenic mice that express an intracellular form of cholera toxin (CT), a neuropotentiating enzyme that chronically activates stimulatory G-protein (Gs) signal transduction and cAMP synthesis, under the control of the D1 promoter. Because the D1 promoter, like other CNS-expressed promoters, confers transgene expression that is regionally restricted to different D1+ CNS subsets in different transgenic lines, we observed distinct but related psychomotor disorders in different D1CT-expressing founders. In a D1CT line in which transgene expression was restricted to the following D1+ CNS regions-the piriform cortex layer II, layers II-III of somatosensory cortical areas, and the intercalated nucleus of the amygdala-D1CT mice showed normal CNS and D1+ neural architecture but increased cAMP content in whole extracts of the piriform and somatosensory cortex. These mice also exhibited a constellation of compulsive behavioral abnormalities that strongly resembled human cortical-limbic-induced compulsive disorders such as obsessive-compulsive disorder (OCD). These compulsive behaviors included episodes of perseverance or repetition of any and all normal behaviors, repetitive nonaggressive biting of siblings during grooming, and repetitive leaping. These results suggest that chronic potentiation of cortical and limbic D1+ neurons thought to induce glutamatergic output to the striatum causes behaviors reminiscent of those in human cortical-limbic-induced compulsive disorders.

Aggression↗
PubMed2004

Obsessive-compulsive disorder secondary to bilateral frontal damage due to a closed head injury.

OBJECTIVE: To describe a patient who exhibited obsessive-compulsive disorder and frontal lobe dysfunction signs after a closed head trauma. BACKGROUND: Recent evidence indicates that frontal-subcortical circuits are involved in the pathogenesis of primary obsessive-compulsive disorder. There are a number of case reports of secondary obsessive-compulsive disorder after lesions involving certain parts of these circuits. METHOD: Clinical examinations, cognitive and behavioral assessments, and-lesion analysis based on magnetic resonance imaging were conducted. RESULTS: The patient displayed marked obsessive-compulsive behavior along with hyperorality and apathy. Magnetic resonance imaging showed symmetrical frontal-polar abnormal signal intensity. Topographic lesion analysis revealed involvement of Brodmann areas 11, 10, 24, 25, and 32. CONCLUSIONS: The patient presented in this report had both frontal lobe dysfunction signs and obsessive-compulsive disorder secondary to bilateral frontal damage due to a closed head injury. The etiological significance of head injury and frontal lobe involvement in obsessive-compulsive disorder is discussed in the context of the clinical and neuroimaging findings and of previous series of brain injured patients.

Adult↗
PubMed2001

Obsessive-compulsive symptoms, white noise and intrusions of self-relevant negative thoughts in a thought suppression paradigm.

Forty female students participated in an experiment where they were asked to suppress a negative self-relevant thought. Half the group suppressed in a loud white noise condition (90 decibels) whereas the other half suppressed in a noise condition of much lower intensity (50 decibels). The subjects were divided up into two groups on the basis of their scores on the Obsessive Compulsive Thoughts Checklist (Bouvard, Cottraux, Mollard, Arthus, Lachance, Guerin, Sauteraud & Yao, 1997). It was predicted that 1) Subjects scoring high on obsessive-compulsive symptoms would show more intrusive thoughts 2) Loud noise would increase intrusive thoughts, especially for subjects scoring high on obsessive-compulsive symptoms. As expected subjects who scored high on obsessive-compulsive symptoms showed more intrusive thoughts, but contrary to expectations loud noise did not increase intrusive thoughts. In fact obsessive-compulsive symptoms were related to more intrusions in the condition of noise of less intensity but not in the condition of loud noise. Implications are discussed.

Adult↗