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Results for “Obsessive Behavior”

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PubMed1991

Noradrenergic function in obsessive-compulsive disorder: behavioral and neuroendocrine responses to clonidine and comparison to healthy controls.

To evaluate noradrenergic (NE) function in obsessive-compulsive disorder (OCD), behavioral, physiological, and neuroendocrine responses to the alpha 2-adrenergic agonist clonidine were examined in 18 patients with OCD and 10 healthy subjects. Subjects received single i.v. doses of 2 micrograms/kg of clonidine administered under double-blind, placebo-controlled, random-assignment conditions. Following clonidine, but not following placebo, patients transiently experienced a significant reduction of obsessions and compulsions. Significant drowsiness and a reduction in anxiety were also noted, but the antiobsessional effect appeared independent of the soporific and antianxiety effects. Growth hormone (GH), cortisol, and 3-methoxy-4-hydroxyphenylglycol responses to clonidine did not differentiate patients from healthy controls. Blood pressure and pulse in response to clonidine did not differ between groups. Improvement in OCD symptoms after clonidine significantly correlated with GH response to clonidine, suggesting specific noradrenergic mediation. This finding lends only partial support for a primary defect of noradrenergic function in OCD.

Adolescent↗
PubMedDate not supplied

Compulsive behaviors and obsessive-compulsive disorder (OCD): lack of a relationship between OCD, eating disorders, and gambling.

The lifetime prevalence of eating disorders and pathologic gambling was assessed in first-degree relatives of subjects with obsessive-compulsive disorder (OCD) and well controls. There were no significant differences between the groups. The authors conclude that eating disorder and pathologic gambling have no familial relationship to OCD.

Adolescent↗
PubMed1990

Controlled comparisons of clomipramine and fluoxetine in the treatment of obsessive-compulsive disorder. Behavioral and biological results.

Treatment with fluoxetine hydrochloride was compared with treatment with clomipramine hydrochloride in two groups of patients with obsessive-compulsive disorder using two different experimental designs. In the first group of 11 patients with obsessive-compulsive disorder studied using a randomized, double-blind, crossover design, treatment with fluoxetine for 10 weeks was found to produce therapeutic effects similar to treatment with clomipramine for 10 weeks. There were significantly fewer total side effects reported during fluoxetine than clomipramine treatment. Drug tapering and placebo substitution in the 4-week crossover interval phase led to substantial relapses in obsessive-compulsive disorder symptoms and depression. Furthermore, responses to the second drug took as long to occur as responses to the first drug, although both drugs are thought to act by a common mechanism, serotonin uptake inhibition. A second group of 21 patients with obsessive-compulsive disorder that had been previously stabilized on clomipramine treatment with at least partial benefit were crossed over to fluoxetine treatment in a double-blind fashion. After 10 weeks of fluoxetine administration, most patients manifested behavioral rating scores of obsessive-compulsive disorder and depressive symptoms that were comparable with precrossover ratings completed during clomipramine treatment. A significant exacerbation in obsessive-compulsive disorder and depression ratings as well as a similar lag in therapeutic efficacy were also noted in this second cohort of patients with obsessive-compulsive disorder. Platelet 5-HT concentrations were reduced 95% during both clomipramine and fluoxetine treatment periods. These results suggest that fluoxetine may represent a viable alternative to clomipramine in the treatment of obsessive-compulsive disorder, although further studies with larger sample sizes are needed.

Adult↗
PubMed2001

Obsessive-compulsive-like behavioral changes in pure akinesia.

Pure akinesia is a disorder characterized by profound freezing in the absence of rigidity or tremor that is not improved by levodopa therapy. We report two cases of pure akinesia who developed obsessive-compulsive-disorder- (OCD-) like behavior during their illness. Although the pathophysiological mechanism underlying freezing is unclear, the coexistence of pure akinesia and OCD-like behavior suggests that both symptoms have a common pathological basis in these two cases, presumably damage to the pallidum.

Journal Article↗
PubMed1998

Acute intravenous administration of ondansetron and m-CPP, alone and in combination, in patients with obsessive-compulsive disorder (OCD): behavioral and biological results.

Obsessive-compulsive disorder (OCD) has been linked to abnormal function of brain serotonin (5-HT) pathways. Since ondansetron is a highly selective 5-HT3 receptor antagonist, the present study was undertaken to investigate 5-HT3 function in OCD. We administered m-CPP (0.08 mg/kg i.v.) and the potent 5-HT3 antagonist, ondansetron (0.15 mg/kg i.v.), to 11 OCD patients. All of the subjects received four separate challenges (m-CPP + placebo, m-CPP + ondansetron, ondansetron + placebo and placebo + placebo). In comparison to placebo, administration of m-CPP was associated with significant behavioral effects, particularly self-rated measures of anxiety, altered self-reality, functional deficit and OCD symptoms. Pretreatment with ondansetron did not affect any of the self-rated behavioral symptoms. After administration of m-CPP relative to placebo, significant increases in plasma cortisol and prolactin were found. These changes were not affected by ondansetron. In conclusion, our results do not support the hypotheses that 5-HT3 receptor-mediated mechanisms modulate m-CPP's behavioral and neuroendocrine effects in patients with OCD.

Adult↗
PubMedDate not supplied

[Behavior therapy of obsessive compulsive disorders].

Obsessive-Compulsive Disorders (OCD) were once considered a relatively rare condition and highly refractory to treatment. Behavioral treatments consisting primarily of various methods of exposure and response prevention are reported to be approximately 70% effective in treating this condition that may affect 2 to 3% of the population and, in many cases, the effectiveness of these interventions persists over a number of years. However much remains to be done in refining these strategies and determining which patients are most likely to respond to these interventions.

Behavior Therapy↗
PubMed1996

What predicts improvement and compliance during the behavioral treatment of obsessive compulsive disorder?

The aim of the study was to identify factors associated with treatment compliance and clinical improvement when obsessive compulsive disorder is treated with graded exposure and response prevention. The sample consisted of all patients with a diagnosis of obsessive compulsive disorder admitted over a 3-year period to a unit specialising in behavioral treatment. All subjects were diagnosed using reliable diagnostic criteria and all were followed-up for 12 months. A range of social and clinical variables was examined using stepwise regression analysis. Treatment compliance was associated with being employed during treatment and living with one's family. Clinical improvement was associated with never having been treated previously, being employed during treatment, having a fear of contamination, having overt ritualistic behaviour, the absence of depression and living with one's family.

Adolescent↗
PubMed1996

Symptom subtypes of obsessive-compulsive disorder in behavioral treatment studies: a quantitative review.

Recent reviews and meta-analytic studies have provided an encouraging account of the effectiveness of behavioral interventions for obsessive-compulsive disorder (OCD). One question regarding these estimates concerns their degree of generalizability to the range of OCD subtypes encountered in clinical settings. The purpose of the present study was to provide a quantitative description of the prevalence of various OCD subtypes (i.e. type of compulsions) within the behavioral treatment literature. We examined 65 studies that permitted classification of patients according to symptom subtype. Patients with primarily cleaning and/or checking compulsions predominated, accounting for 75% of the treatment population. On the other hand, patients with multiple compulsions or other compulsions, such as exactness, counting, hoarding, or slowness rituals were underrepresented, comprising only 12% of the population, which is markedly less than clinical epidemiological estimates. Rates of improvements in patients with OCD are most applicable to patients with cleaning and checking compulsions, but may not yet be generalizable to patients with other symptoms. These findings encourage studies of the efficacy of existing and novel interventions for patients with counting, repeating, symmetry, hoarding, or multiple compulsions in order to broaden the clinical application of OCD behavioral treatment.

Behavior Therapy↗
PubMed1997

Cognitive-behavioral treatment of obsessive thoughts: a controlled study.

Twenty-nine patients with obsessive-compulsive disorder as diagnosed in accordance with the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., revised; American Psychiatric Association, 1987) who did not have overt compulsive rituals were randomly assigned to treatment and waiting-list conditions. Patients in the treatment condition received cognitive-behavioral therapy consisting of a detailed explanation of the occurrence and maintenance of obsessive thoughts, exposure to obsessive thoughts, response prevention of all neutralizing strategies, cognitive restructuring, and relapse prevention. Compared with waiting-list patients, treated patients improved significantly on measures of severity of obsessions, current functioning, self-report obsessive-compulsive symptoms, and anxiety. When waiting-list patients were subsequently treated, the combined group improved on all outcome measures. Treatment gains were maintained at 6-month follow-up. Results indicate that cognitive-behavioral therapy is effective in the treatment of patients with obsessive thoughts, a group that has often been considered resistant to treatment.

Adult↗
PubMed2005

Cognitive behavioral therapy for obsessive-compulsive disorder: an update.

Cognitive-behavioral therapy (CBT) for obsessive-compulsive disorder (OCD) has been shown to be a highly effective treatment for children and adults. In the current review, we briefly describe the historical developments of the treatment, and recent findings related to five areas of inquiry: 1) Does intensity of CBT impact outcome? 2) Does CBT work better on some subtypes of OCD than others? 3) How do cognitive and behavioral strategies relate to outcome? 4) How well does CBT work for children and adolescents with OCD? and 5) Does the combination of CBT and medication work better than CBT alone? After a discussion of these questions, we mention some areas currently being examined.

Cognitive Behavioral Therapy↗
PubMed2004

[What is the place of emotion in cognitive-behavioral approaches of obsessive-compulsive disorders?].

The efficacy of behavioral techniques based on exposure and response prevention has been well validated in the treatment of obsessive-compulsive disorder. Nevertheless in a large proportion of patients the disease persists, among others due to refusal of the treatment or due to non-response. About one of two patient entering treatment seems therefore to possibly benefit from behavioral therapy (Ladouceur et al., 1999). Cognitive techniques may extend the behavioral approach, and may represent a more indirect and progressive method, and may improve patients' commitment in the therapy. However, the proportion of treatment resistant patients remains important. New techniques are therefore warranted in order to progress in the understanding and treatment of these patients. Emotion focused therapy could possibly represent an interesting approach based on the improvement of emotional awareness, the exploration and the cognitive restructuring of emotions. The different techniques are described throughout clinical case reports.

Adult↗
PubMed1995

Cognitive-behavioral treatment of obsessions.

Three patients with obsessive-compulsive disorder whose major complaints were obsessional thoughts with cognitive neutralization as opposed to overt rituals were treated with a cognitive-behavioral package. Cognitive neutralization involves both cognitive rituals and a variety of less ritualized coping strategies all designed to remove the thought and decrease discomfort. In a departure from earlier case studies, the patients were treated in a multiple baseline design across subjects. All three patients reported decreased discomfort and improved their professional and/or interpersonal functioning. Gains were maintained at follow-up (8 to 11 months).

Adaptation, Psychological↗
PubMed2004

Cognitive-behavioral treatment of repugnant obsessions.

Obsessions often occur in the form of repugnant sexual, aggressive, or blasphemous thoughts, images, impulses, or doubts. This article describes the phenomenon of repugnant obsessions and reviews the cognitive-behavioral model of obsessive-compulsive disorder (OCD). Caveats and recommendations are provided and a case illustration is presented. Repugnant obsessions are highly amenable to treatment; but developing an idiographic conceptualization of the client's obsessive-compulsive cycle is important. Treatment resources are presented throughout.

Aggression↗
PubMed1983

[Behavioral approach to obsessions].

Obsessive-- Compulsives complaints have shown good and sometimes marked improvements, since behaviour therapists have established principles of treatment for those psychological problems, i.e.: exposure to evoked stimuli and response prevention of rituals or avoidance behaviours. Pharmacological and behavioral treatments may be associated with success. It seems that the purpose of future research and investigation will be to focalise on the respective place and role of psychotropic drugs (antidepressive and BZD) in association with cognitive behaviour modifications.

Anti-Anxiety Agents↗
PubMed2004

Obsessive-compulsive personality disorder and behavioral disinhibition.

Although obsessive-compulsive personality disorder (OCPD) is an Axis II diagnosis that is not commonly associated with behavioral disinhibition, the literature contains reports of occasional explosive aggressive outbursts. Existing explanations of OCPD etiology do not address the coexistence of compulsive and impulsive features witnessed in some subpopulations of patients. In this study, the authors present a compensatory theory of OCPD in an effort to explain clinical observations of an unexpectedly large number of OCPD diagnoses among patients clinic referred and self-referred for aggression problems.

Aggression↗