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PubMed2005

Memory function in patients with obsessive compulsive disorder and the problem of confidence in their memories: a clinical study.

AIM: To examine obsessive-compulsive patients for memory of obsessive-compulsive relevant material and confidence in their memory. METHODS: Memory function was examined by a recognition task using neutral and obsessive-compulsive relevant sentences in 32 patients with obsessive-compulsive disorder and 31 control subjects. We also investigated the participants' confidence in the accuracy of their recognition. The severity of obsessive-compulsive disorder was evaluated by using the Yale-Brown Obsessive Compulsive Scale. The Maudsley Obsessive Compulsive Questionnaire, the Hamilton Depression Rating Scale, and the State-Trait Anxiety Inventory were also administered to the two groups. RESULTS: Whereas obsessive-compulsive disorder patients were not significantly different from control subjects on measures of recognition memory for both obsessive-compulsive relevant and neutral material, they were significantly less confident in the memory for obsessive-compulsive relevant and neutral sentences. Also, the State-Trait Anxiety Inventory (STAI) scores were negatively correlated with the recognition performance of obsessive-compulsive disorder relevant sentences and the levels of confidence in memory in the obsessive-compulsive disorder group. The obsessive-compulsive patients with checking compulsions were not different from non-checking obsessive-compulsive patients. CONCLUSION: Our results suggest that obsessive-compulsive patients experience difficulties in confidence in their memory, possibly related to anxiety rather than primary memory deficits.

Adult↗
PubMed2004

A comparison of autogenous/reactive obsessions and worry in a nonclinical population: a test of the continuum hypothesis.

Employing the autogenous-reactive model of obsessions (Behaviour Research and Therapy 41 (2003) 11-29), this study sought to test a hypothesized continuum where reactive obsessions fall in between autogenous obsessions and worry with respect to several thought characteristics concerning content appraisal, perceived form, and thought triggers. Nonclinical undergraduate students (n=435) were administered an online packet of questionnaires designed to examine the three different types of thoughts. Main data analyses included only those displaying moderate levels of obsessions or worries (n=252). According to the most distressing thought, three different groups were formed and compared: autogenous obsession (n=34), reactive obsession (n=76), and worry (n=142). Results revealed that (a) relative to worry, autogenous obsessions were perceived as more bizarre, more unacceptable, more unrealistic, and less likely to occur; (b) autogenous obsessions were more likely to take the form of impulses, urges, or images, whereas worry was more likely to take the form of doubts, apprehensions, or thoughts; and (c) worry was more characterized by awareness and identifiability of thought triggers, with reactive obsessions through these comparisons falling in between. Moreover, reactive obsessions, relative to autogenous obsessions, were more strongly associated with both severity of worry and use of worrying as a thought control strategy. Our data suggest that the reactive subtype represents more worry-like obsessions compared to the autogenous subtype.

Adolescent↗
PubMed1995

A case-controlled study of repetitive thoughts and behavior in adults with autistic disorder and obsessive-compulsive disorder.

OBJECTIVE: The purpose of this study was to investigate the types of repetitive thoughts and behavior demonstrated by adults with autistic disorder and compare them with those of age- and sex-matched adults with obsessive-compulsive disorder. METHOD: Fifty consecutive patients admitted to the Yale Adult Pervasive Developmental Disorders (Autism) Clinic with a primary diagnosis of autistic disorder (DSM-III-R and DSM-IV) completed the symptom checklist of the Yale-Brown Obsessive Compulsive Scale. Types of current obsessions and compulsions were evaluated. The comparison group consisted of 50 age- and sex-matched adults with obsessive-compulsive disorder (without tics) (DSM-III-R and DSM-IV). RESULTS: Direct discriminant function analysis showed that the patients with autistic disorder could be distinguished from those with obsessive-compulsive disorder on the basis of the types of current repetitive thoughts and behavior that they demonstrated. Compared to the obsessive-compulsive group, the autistic patients were significantly less likely to experience thoughts with aggressive, contamination, sexual, religious, symmetry, and somatic content. Repetitive ordering; hoarding; telling or asking (trend); touching, tapping, or rubbing; and self-damaging or self-mutilating behavior occurred significantly more frequently in the autistic patients, whereas cleaning, checking, and counting behavior was less common in the autistic group than in the patients with obsessive-compulsive disorder. In addition, a specific subset of seven obsessive-compulsive variables from the Yale-Brown Obsessive Compulsive Scale symptom checklist was identified that reliably predicted membership in the autistic group. CONCLUSIONS: These results suggest that the repetitive thoughts and behavior characteristics of autism differ significantly from the obsessive-compulsive symptoms displayed by patients with obsessive-compulsive disorder. Future studies are warranted to assess the treatment response and neurobiological underpinnings of repetitive thoughts and behavior in patients with autism and obsessive-compulsive disorder.

Adolescent↗
PubMedDate not supplied

[Obsessive-compulsive disorders and structural cerebral alterations. Description of 3 cases].

Obsessive-compulsive spectrum disorders have emerged as a differentiated entity, characterized with intrusive and obsessive thoughts or repetitive behaviors whose major syndrome would be the classical obsessive-compulsive disorder. In order to spread this concept among neurologists, we present three cases that can be considered as obsessive-compulsive spectrum disorders, in which structural cerebral lesions co-exist. Obsessive-compulsive spectrum disorders share with obsessive-compulsive disorder several clinical and neurobiological characteristics as well as their therapeutic response. Nevertheless, obsessive-compulsive spectrum disorders have a lesser positive familial history incidence and a later start than obsessive-compulsive disorder. Recent neurobiological studies using functional and structural neuroimaging in patients with obsessive-compulsive disorder together with neuropsychological studies reveal the existence of defects in the following neural circuits: frontal-orbital-basal ganglia-thalamus-cortical and their limbic connections. In a similar manner as it occurs with obsessive-compulsive disorder, research on obsessive-compulsive spectrum disorders will provide the pathophysiological basis of the obsessive-compulsive disorder in the dysfunctionality of the previously mentioned neurological circuits.

Adult↗
PubMed1998

[Obsessive-compulsive symptoms in children and pre-adolescents: clinical observation of inpatients].

I investigated the phenomenology of obsessive-compulsive disorder (DSM-IV) in 22 children and pre-adolescents (8 boys and 14 girls, 6-15 years old, mean 12.2 years) admitted to the psychiatric ward of Kanagawa Children's Medical Center between 1989 and 1996. Some patients were concomitantly diagnosed with psychotic disorder, or eating disorder (DSM-IV). Girls dominated boys, and all cases except a girl were over ten years old. Patients were divided into four types according to their obsessive-compulsive symptoms. Type I (7 cases, 31.8%): Recurrent idea and repetitive behavior were painful. The patients recognized these ideas and behaviors to be a product of their own mind. They also recognized the behavior to be excessive or unreasonable, and tried to resist at least while the symptoms were mild. Four patients showed good courses, but in three patients showed severe obsessive-compulsive symptoms that persisted for a long time after admission. Type II (13 cases, 59.1%) consisted of 2 subtypes. Type IIa (10 cases, 45.5%): The obsession or compulsion was recurrent and distressful, but insight into the problem was unclear or poor. We noted 4 Type IIa patients with this type resisted their symptoms, but the others' did not. This type was the most prevalent of the four types, and seemed to be the main type of obsessive-compulsive disorder among children and pre-adolescents. Type IIb (3 cases, 13.6%): Compulsion dominated obsession. The subjects experienced distress from their severe compulsion, but seldom complained of it. Furthermore, patients could hardly discern and resist their symptoms. So it resembled obsessive desire for the maintenance of sameness, or stereotypy in developmental disorders. Patients recognized the idea or the behavior to be the product of their own mind. Severe symptoms persisted for a long time after admission. Type III (2 cases, 9.1%): The patients experienced their recurrent idea and repetitive behavior as agonizing. They had insights that their obsession or compulsion was excessive or unreasonable, and tried to resist it. The symptoms were similar to those of psychoses, but patients did not have definite psychotic symptoms. Severe symptoms persisted for a long time after admission. Categorization according to obsession and compulsion supported the criteria for obsessive-compulsive disorder in DSM-IV. It showed concretely that a number of children and adolescents with severe obsessive-compulsive symptoms had marginal features of the symptoms. Of 20 cases excluding 2 cases classified as atypical type III, seven patients (35.0%) understood that their symptoms were excessive or unreasonable, and 10 cases (50.0%) showed objective resistance to their symptoms. However, insight or resistance to the obsessive-compulsive symptom was not as stable as that in adult patients with such symptoms, and vacillated during the course of the disease.

Adolescent↗
PubMed2006

Abnormal and normal obsessions: a reconsideration.

Contemporary cognitive approaches to obsession assume that the content of clinical obsessions does not differ from non-clinical obsessive intrusions. This assumption goes back to a classic study by Rachman and De Silva [(1978). Abnormal and normal obsessions. Behaviour Research and Therapy, 16, 233-248]. In the present paper, it is argued that Rachman and De Silva did not postulate a complete indifference between clinical and non-clinical obsessions. Study 1 is a simple statistical analysis of data presented by Rachman and De Silva. This analysis suggested that psychologists are able to discriminate clinical and non-clinical obsessions beyond chance level, merely by looking at the content of obsessions. In study 2, a list of 23 clinical and 47 non-clinical obsessions was presented to 11 psychotherapists and 90 psychology undergraduates. Both therapists and students were able to distinguish clinical and non-clinical obsession beyond chance level. It is concluded that some clinical obsessions can be identified as being evidently abnormal, and that additional theory and research is needed to identify the causes of these recognisable obsessions.

Data Interpretation, Statistical↗
PubMed2000

Relationships between thought-action fusion, thought suppression and obsessive-compulsive symptoms: a structural equation modeling approach.

Research has shown that there are strong similarities in content between the obsessions and compulsions that characterize obsessive-compulsive disorder and nonclinical obsessions and compulsions. However, clinical and nonclinical obsessions and compulsions do differ with respect to characteristics like frequency, intensity, discomfort and elicited resistance. Two separate concepts have been invoked to explain how normal obsessions and compulsions may develop into clinical phenomena. First, it is suggested that thought-action fusion (TAF) contributes to obsessive-compulsive symptoms. Second, thought suppression may intensify obsessive-compulsive symptoms due to its paradoxical effect on intrusive thoughts. Although both phenomena have been found to contribute to obsessive-compulsive symptoms, possible interactions between these two have never been investigated. The current study explored how TAF and thought suppression interact in the development of obsessive-compulsive symptoms. Undergraduate psychology students (N = 173) completed questionnaires pertaining to TAF, thought suppression and obsessive-compulsive symptoms. Covariances between the scores on these questionnaires were analyzed by means of structural equation modeling. Results suggest that TAF triggers thought suppression, while thought suppression, in turn, promotes obsessive-compulsive symptoms.

Adolescent↗
PubMed1996

A spectrum for obsession and personality disorders.

Obsession was introduced by Kraepelin in 1915 and has been studied extensively since. When a person with obsession becomes physically exhausted with chronic rumination accompanied by suspicion, he or she is driven to impulsive acts, and develops a personality disorder that displays persistent abnormal activities. Obsession is related closely to depression and schizophrenia. Obsession is induced when uncertainty and instability dominates intelligence and creativity. The current social hierarchy of a strongly controlled society rejects diversity of humanity and often triggers personality disorders. This article reviews obsession and a myth as primitive mentality, normal and abnormal obsession, obsession vs possession, society and obsession/ impulsion/degeneration, obsession and slowness/autism, a recent biological approach to obsession and a spectrum for obsession.

Adult↗
PubMed1995

A family study of obsessive-compulsive disorder.

OBJECTIVE: The goal of this study was to determine 1) whether obsessive-compulsive disorder is familial, 2) whether there is a familial relationship between obsessive-compulsive disorder and Gilles de la Tourette's syndrome and chronic tics, and 3) whether different familial types of obsessive-compulsive disorder exist. METHOD: In this family study, all available first-degree relatives of 100 probands with obsessive-compulsive disorder were interviewed directly with structured interviews, and best-estimate diagnoses were assigned. In addition to the 466 first-degree relatives of the probands, 113 comparison subjects who were first-degree relatives of 33 psychiatrically unaffected subjects were studied with the same interviews. RESULTS: The rates of obsessive-compulsive disorder and subthreshold obsessive-compulsive disorder were significantly greater among the relatives of the probands with obsessive-compulsive disorder (10.3% and 7.9%, respectively) than among the comparison subjects (1.9% and 2.0%, respectively). Furthermore, the rate of tics (Tourette's disorder and chronic tics) was also significantly greater among the relatives of the probands (4.6%) than among the comparison subjects (1.0%). The relatives of female probands with obsessive-compulsive disorder were more likely to have tics, and the relatives of probands with early onset were at higher risk for both obsessive-compulsive disorder and tics. CONCLUSIONS: Obsessive-compulsive disorder is a heterogeneous condition. Some cases are familial and related to tic disorders, some cases are familial and unrelated to tics, and in other cases there appears to be no family history of either obsessive-compulsive disorder or tics.

Adolescent↗
PubMed1995

DSM-IV field trial: obsessive-compulsive disorder.

OBJECTIVE: Three issues relevant to revising the DSM-III-R criteria for obsessive-compulsive disorder were examined in a field trial: 1) the requirement that symptoms of obsessive-compulsive disorder be viewed by the patient as excessive or unreasonable, 2) the presence of mental compulsions in addition to behavioral compulsions, and 3) ICD-10 subcategories. METHOD: The authors studied symptom patterns of obsessive-compulsive disorder as well as strength of obsessive belief among 431 patients with obsessive-compulsive disorder at seven hospital outpatient clinics. Two methods of subject selection were used: consecutive entry of everyone who contacted the clinics for evaluation of obsessive-compulsive disorder and entry of patients with obsessive-compulsive disorder who had continuing contact with the clinics since before the field trial and who were still symptomatic. Primary measures were the Yale-Brown Obsessive Compulsive Scale and face-valid questions about fixity of obsessive-compulsive beliefs. RESULTS: The large majority of patients were uncertain about whether their obsessive-compulsive symptoms were unreasonable or excessive, and most had both mental and behavioral compulsions. Results on the ICD-10 subcategories were equivocal. CONCLUSIONS: The present results converge with previous findings to indicate a broad range of insight among patients with obsessive-compulsive disorder. The DSM-III-R requirement for insight should be de-emphasized in DSM-IV, and mental rituals should be included in the definition of compulsions.

Adult↗
PubMed1996

Quality of life for patients with obsessive-compulsive disorder.

OBJECTIVE: The health-related quality of life of patients with obsessive-compulsive disorder was compared to published norms for the general U.S. population and for patients with either depressive disorders or diabetes. METHOD: Sixty medication-free outpatients with moderate to severe obsessive-compulsive disorder were evaluated by using the Structured Clinical Interview for DSM-III-R and the Yale-Brown Obsessive Compulsive Scale. Health-related quality of life was measured with the self-rated Medical Outcomes Study 36-Item Short-Form Health Survey. RESULTS: The instrumental role performance and social functioning of the patients with obsessive-compulsive disorder were worse than those of the general population and of diabetes patients. The more severe the obsessive-compulsive disorder, the lower were the patients' social functioning scores, even after depression ratings were controlled for; scores on instrumental role performance did not correlate with severity of obsessive-compulsive disorder. The ratings of the obsessive-compulsive disorder patients on physical health domains resembled those of the general population and exceeded those of the diabetes patients. The general health and physical health ratings of the obsessive-compulsive disorder patients exceeded those of the depressed patients. In mental health domains, after adjustment for differences in gender distribution, quality of life ratings were similar for the patients with obsessive-compulsive disorder and those with depressive disorders. CONCLUSIONS: Moderate to severe obsessive-compulsive disorder is associated with impaired social functioning and impaired instrumental role performance, but only impairment in social functioning is linearly related to severity of obsessive-compulsive disorder.

Adult↗
PubMed2006

Obsessive-compulsive disorder: prevalence, comorbidity, impact, and help-seeking in the British National Psychiatric Morbidity Survey of 2000.

OBJECTIVE: There is little information about obsessive-compulsive disorder in large representative community samples. The authors aimed to establish obsessive-compulsive disorder prevalence and its clinical typology among adults in private households in Great Britain and to obtain generalizable estimates of impairment and help-seeking. METHOD: Data from the British National Psychiatric Morbidity Survey of 2000, comprising 8,580 individuals, were analyzed using appropriate measurements. The study compared individuals with obsessive-compulsive disorder, individuals with other neurotic disorders, and a non-neurotic comparison group. ICD-10 diagnoses were derived from the Clinical Interview Schedule-Revised. RESULTS: The authors identified 114 individuals (74 women, 40 men) with obsessive-compulsive disorder, with a weighted 1-month prevalence of 1.1%. Most individuals (55%) in the obsessive-compulsive group had obsessions only. Comorbidity occurred in 62% of these individuals, which was significantly greater than the group with other neuroses (10%). Co-occurring neuroses were depressive episode (37%), generalized anxiety disorder (31%), agoraphobia or panic disorder (22%), social phobia (17%), and specific phobia (15%). Alcohol dependence was present in 20% of participants, mainly men, and drug dependence was present in 13%. Obsessive-compulsive disorder, compared with other neurotic disorders, was associated with more marked social and occupational impairment. One-quarter of obsessive-compulsive disorder participants had previously attempted suicide. Individuals with pure and comorbid obsessive-compulsive disorder did not differ according to most indices of impairment, including suicidal behavior, but pure individuals were significantly less likely to have sought help (14% versus 56%). CONCLUSIONS: A rare yet severe mental disorder, obsessive-compulsive disorder is an atypical neurosis, of which the public health significance has been underestimated. Unmet need among individuals with pure obsessive-compulsive disorder is a cause for concern, requiring further investigation of barriers to care and interventions to encourage help-seeking.

Comorbidity↗
PubMed1990

Adolescence and eating disorder: the obsessive-compulsive syndrome.

Although it is widely recognized that eating disorders primarily begin during the adolescent period, the centrality of obsessive-compulsive symptomatology and dynamisms and their relationship to adolescent conflict and development has not been generally accepted or understood. Social pressures toward conformity with the ideal of feminine thinness, which are especially influential during the adolescent period, combine with obsessive-compulsive predispositions to produce eating disorder symptoms and patterns of behavior. Obsessive preoccupation with images of food as well as ruminative calorie counting, and ritualistic behavior regarding food, use of laxatives, and vomiting, together with an underlying focus on control, undoing and other obsessive-compulsive defenses, and a sado-masochistic orientation to the body all point to an essential obsessive-compulsive disorder. The presence of dysphoric affect and the erratic success of antidepressant medication with eating disorder patients has led to a belief in an underlying affective disorder. However, careful assessment of eleven studies presenting differential diagnostic data regarding anorexia nervosa reveals that noneating related obsessive-compulsive patterns and symptoms are second overall in incidence to depressive patterns and symptoms. With critical re-evaluation of data presented, the obsessive-compulsive condition equals or supersedes the depressive one in many samples. Moreover, given the intense achievement orientation of persons with obsessive-compulsive illness, along with other psychodynamic factors, depressive symptoms could well be considered a secondary breakdown effect. If the all-pervasive obsessive-compulsive nature of eating-related symptomatology discussed here is taken into consideration, depressive symptoms must be considered either secondary or incidental. As patients with eating disorders are notoriously secretive and oftentimes misleading about their symptoms and themselves, a diagnostic assessment of such patients in intensive treatment at a long-term hospital facility was carried out. Compared with a control group randomly selected from the remainder of the hospital patient population, obsessive-compulsive manifestations of rumination, ritualistic behavior, excessive cleanliness, excessive orderliness, perfectionism, miserliness, rigidity, and scrupulousness and self-righteousness were all significantly associated with the eating disorder patient group. The current eating disorder picture, therefore, appears to be a modern form of obsessive-compulsive illness beginning during the adolescent period.

Adolescent↗
PubMed1999

A Case Series of Women With Postpartum-Onset Obsessive-Compulsive Disorder.

BACKGROUND: There is emerging evidence that postpartum women are at risk for the development or worsening of obsessive-compulsive disorder. The purpose of this study was to provide data regarding the demographics, phenomenology, associated psychiatric comorbidity, family history, and response to open treatment with fluvoxamine in subjects with postpartum-onset obsessive-compulsive disorder. METHOD: Seven consecutive subjects were recruited from an outpatient obstetrical practice and by advertisement. Subjects completed the Structured Clinical Interview for DSM-IV, the Yale-Brown Obsessive Compulsive Scale, and a semistructured interview for family history, demographic data, and clinical features. Three of the 7 subjects participated in a 12-week, open-label trial of fluvoxamine treatment of postpartum-onset DSM-IV obsessive-compulsive disorder. RESULTS: The women described a mean age at onset of 28 years, and 4 subjects had a chronic course. Six subjects reported onset after the birth of their first child, and the mean time to onset was 3.7 weeks postpartum. All subjects experienced both obsessions and compulsions and reported aggressive obsessions that involved their children. None of the subjects acted on their obsessions to harm the children, but 5 reported dysfunctional mother-child behavior. All 7 subjects met criteria for at least 1 comorbid psychiatric disorder, with a mood disorder the most common. Family histories were notable for high rates of mood disorders and psychoactive substance use disorders in first-degree relatives. Two of the 3 subjects who entered the open-label trial of fluvoxamine experienced a positive response, defined as a 30% or greater decrease in the total score of the Yale-Brown Obsessive Compulsive Scale. CONCLUSION: Obsessive-compulsive disorder may present in the postpartum period and become chronic. Symptoms of the disorder may adversely affect the mother-child relationship, and it is important to assess for obsessions and compulsions in postpartum women who present with anxiety and/or depression. Fluvoxamine may be effective in reducing the symptoms of postpartum-onset obsessive-compulsive disorder. Controlled studies are needed to confirm these findings.

Journal Article↗
PubMedDate not supplied

Bulimia nervosa with and without obsessive-compulsive syndromes.

The present study was performed in a group of bulimic (BN) females (1) to assess prevalence rates of comorbid obsessive-compulsive phenomena; (2) to investigate whether BN patients display a characteristic cluster of obsessive-compulsive symptoms; and (3) to determine whether obsessive-compulsive symptoms influence the clinical picture of BN. Thirty-eight DSM-IV BN females were interviewed by means of the Structured Clinical Interview for DSM-III-R (SCID) to assess the prevalence rate of obsessive compulsive disorder (OCD); the Yale-Brown Obsessive-Compulsive Symptom Scale (Y-BOCS) Symptom Check-List was also used to evaluate the presence of obsessive-compulsive symptoms. The phenomenology of BN females with obsessive-compulsive syndromes (OCS) as detected by the Y-BOCS was compared to that shown by a "control" group of nonbulimic OCD females. Finally, the eating-related psychopathology of BN women with and without OCS was compared. The current prevalence rates of OCD and of subthreshold obsessive-compulsive syndrome (sOCS) in our sample were 10.5% and 15.8%, respectively. Thus, a total of 26.3% of BN females had a current OCS that comprised both clinical disorders and subthreshold syndromes. No differences were detected between obsessive-compulsive symptoms of these females and those of the control group of nonbulimic OCD females. BN females with OCS had higher ratings on the Eating Disorder Inventory (EDI) total score and on the "drive for thinness" and the "bulimia" items of the scale, as compared to BN females without OCS. In conclusion, it appears that a considerable proportion of BN females display OCS, which sometimes are not severe enough to fulfill diagnostic criteria for OCD. Moreover, in these patients, obsessive-compulsive symptoms are undistinguishable from those of OCD females, and exert a negative influence on the clinical picture of the bulimic disorder.

Adult↗
PubMed2005

Clinical subtypes of obsessive-compulsive disorder based on the presence of checking and washing compulsions.

OBJECTIVE: We aimed at examining the utility of checking and washing compulsions as markers of valid subtypes of obsessive-compulsive disorder (OCD). METHODS: One hundred and six patients with obsessive-compulsive disorder were evaluated with a socio-demographic and clinical questionnaire, the Structured Clinical Interview for DSM-IV, the Yale-Brown Obsessive-Compulsive Scale, the Clinical Global Impression, the Beck Depression Inventory, the Hamilton Rating Scale for Depression, and the Global Assessment of Functioning. These individuals were allocated in one of four subgroups [checkers (OCD-Ch; n = 20), washers (OCD-Wa; n = 13), checkers and washers (OCD-CW; n = 48), and non-checkers and non-washers (OCD non-CW = 25)] on the basis of the presence and the clinical relevance of checking and/or washing compulsive behaviors across their lifetime. Socio-demographic and clinical variables were compared and contrasted between the groups by means of ANOVA followed by post-hoc Least Significant Difference or Dunnett's tests for continuous variables and chi-square tests followed by partitioned chi-square tests for categorical variables. RESULTS: OCD-Ch and OCD-Wa did not differ on most demographic and clinical features, the only exception being the number of different types of obsessions, which were significantly higher in the former group. The OCD-CW group was more likely to exhibit an insidious onset of obsessive-compulsive symptoms, to manifest itself as a mixed subtype of obsessive-compulsive disorder and to display obsessions with contamination themes. On the other hand, the OCD non-CW group was more likely to exhibit an acute onset, a shorter duration of illness, obsessions with religious themes, an episodic course, and less severe obsessive-compulsive symptoms. CONCLUSIONS: In our sample, the probing of the presence of checking and/or washing compulsions has provided significant empirical support to establish valid subtypes of obsessive-compulsive disorder.

Adolescent↗
PubMed1997

Obsessive compulsive comorbidity in the dieting disorders.

OBJECTIVE: This study investigated the comorbidity of obsessive compulsive disorder and obsessive compulsive personality disorder with the dieting disorders. A comorbid sample was examined in order to test the hypothesis that obsessive compulsive symptoms and personality are premorbid in these patients. METHOD: Sixty-eight inpatients (35 with anorexia nervosa and 33 with bulimia nervosa) were assessed for DSM-III-R Axis 1 and Axis 11 obsessive compulsive psychopathology using the Composite International Diagnostic Interview (CIDI) and the Personality Disorders Inventory (PDE), respectively. RESULTS: Twenty-one percent of the group met criteria for a diagnosis of obsessive compulsive disorder. Thirty-seven percent of anorexia nervosa patients were comorbid for obsessive compulsive disorder compared to only 3% of bulimia nervosa patients. In most, the obsessive compulsive disorder had predated the dieting disorder. Nineteen percent of patients were found to have premorbid obsessive compulsive personality disorder. DISCUSSION: This study supports the assumption of obsessive compulsive comorbidity within the dieting disorders and provides empirical support that this obsessionality is a premorbid characteristic.

Adolescent↗
PubMed2005

Thought disorder in patients with obsessive-compulsive disorder.

We examined the presence of disordered thinking/perception in patients with obsessive-compulsive disorder (OCD). Recently, an obsession model has been proposed, which classifies obsessions into two different subtypes: autogenous obsessions and reactive obsessions (Lee & Kwon, 2003). Based on this model, we hypothesized that OCD patients primarily displaying autogenous obsessions as opposed to reactive obsessions would display more severely disordered thinking/perception. We compared 15 OCD patients primarily displaying autogenous obsessions (AOs), 14 OCD patients primarily displaying reactive obsessions (ROs), 32 patients with schizophrenia (SPRs), and 28 patients with other anxiety disorders (OADs) with respect to thought disorders as assessed by the Comprehensive System of the Rorschach Inkblot Test. Results indicated that both AOs and SPRs displayed more severe thought disorders compared to ROs or OADs. Theoretical and clinical implications are discussed.

Adolescent↗