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PubMed1997

Recollections of parent-child relationships in OCD out-patients compared to depressed out-patients and healthy controls.

The present study examined the relationship between parental bonding in 26 psychiatric out-patients with obsessive-compulsive disorder (OCD) compared to 34 out-patients with major depressive disorder (MDD) and 41 healthy controls. The results indicated significantly lower levels of parental care and higher levels of maternal overprotection for the patients with a current principal diagnosis of depression, compared to healthy controls. In multiple regression analyses, the presence of depressive disorder was related to all Parental Bonding Inventory (PBI) subscales. When the presence of current depressive disorder was controlled for statistically, the diagnosis of OCD was not associated with abnormal patterns of parental bonding on the PBI.

Adult↗
PubMed1998

Comorbidity between obsessive-compulsive disorder (OCD) and personality disorders.

The aims of the present study were to examine the frequency of personality disorders in 36 patients with obsessive-compulsive disorder (OCD), and to investigate whether patients with a coexisting personality disorder could be characterized by certain personality traits assessed by means of the Karolinska Scales of Personality (KSP). In total, 27 (75%) of the OCD patients fulfilled the DSM-III-R criteria for a personality disorder, and 13 patients (36%) had an obsessive-compulsive personality disorder. Subjects with a comorbid personality disorder had significantly higher scores on most of the KSP scales, including all anxiety scales, as well as scales measuring indirect aggression, irritability, guilt and detachment, whereas subjects without personality disorders did not differ significantly from healthy controls with regard to personality traits.

Adult↗
PubMed1992

Treatment of depressive and obsessive-compulsive symptoms in OCD by imipramine and behaviour therapy.

The efficacy of behavioural treatment of obsessive-compulsive disorder (OCD) has been well documented. However, severely depressed OCD patients showed fewer short- and long-term benefits than less depressed patients. The present study tested the hypothesis that reduction of depression by imipramine prior to behaviour therapy would enhance the effects of behavioural therapy on depressed OC patients. Thirty-eight patients were divided into highly and mildly depressed groups according to their scores on the Beck Depression Inventory; half of each group received imipramine and half received placebo for six weeks. All patients then received three weeks of daily behavioural treatment (exposure and response prevention) followed by 12 weekly sessions of supportive psychotherapy. Results indicated that although imipramine improved depressive symptoms in depressed patients, it did not affect OC symptoms. Behaviour therapy markedly reduced OC symptoms but, contrary to our hypothesis, imipramine did not potentiate the effects of behaviour therapy. No differences between highly depressed and mildly depressed patients on OC symptoms were found in their responses to behavioural or supportive therapy.

Adult↗
PubMed1995

Does imagined exposure to the consequences of not ritualising enhance live exposure for OCD? A controlled study. I. Main outcome.

BACKGROUND: This randomised controlled study tested whether adding imagined to live exposure plus ritual prevention would enhance gains in obsessive-compulsive disorder (OCD). METHOD: Out-patients with OCD were randomly allocated to either have nine sessions of daily live self-exposure and ritual prevention to external cues alone (Ex) (n = 23) or to have, in addition to Ex, daily self-exposure to the imagined internal cues of the consequences of not ritualising (group Exi) (n = 23). All patients had the same sessional exposure time of 1 h 30 min (Exi 1 h live, 30 min imagined; Ex 1 h 30 min live), and had to practise either Exi or Ex daily for the same duration and to keep diaries of that self-exposure homework throughout treatment. Patients were followed up to week 32. Outcome measures were YBOCS for rituals and obsessions, compulsion checklist, target rituals and obsession, general anxiety, depression (Beck, Hamilton), work and social disability, clinical global impression (CGI). RESULTS: At weeks 4, 9, 20 and 32 the two groups improved similarly with no significant difference between them, neither for washers nor for checkers. Imagined exposure was more difficult to do than live exposure and there were more drop-outs. CONCLUSIONS: Daily imaged exposure to internal cues did not enhance exposure to external cues. Perhaps longer imagined exposure would have been more enhancing.

Adolescent↗
PubMed1995

Does imagined exposure to the consequences of not ritualising enhance live exposure for OCD? A controlled study. II. Effect on behavioural v. subjective concordance of improvement.

BACKGROUND: This study tested whether adding imagined exposure to live exposure would increase the concordance between behavioural and subjective improvement in obsessive-compulsive disorder (OCD). METHOD: 46 OCD out-patients were randomly allocated to 9 weekly sessions of either combined live+imagined exposure/ritual prevention (Exi, n = 23), or only live exposure/ritual prevention (Ex, n = 23). Patients were asked to do 90 min of daily self-exposure at home (corresponding to Exi or Ex). Measures were: (A) behavioural; (B) subjective; (C) clinical global impression (CGI). RESULTS: After 9 weeks of treatment, improvement was greater on behavioural than subjective measures (similar for the Exi and Ex groups). At 20 weeks (3-month follow-up) each group had improved slightly more on subjective measures and slightly less on behavioural ones. Two subjective measures improved less during Exi than Ex, but this difference disappeared at follow-up. The greater difference between behavioural and subjective improvement scores in Exi than in Ex did not relate to clinical outcome at the end of treatment or follow-up. CONCLUSIONS: Compared to live exposure alone, combined imagined plus live exposure did not enhance behavioural/subjective concordance.

Adolescent↗
PubMed1999

Cognitive behavioral therapy of childhood OCD.

Obsessive-compulsive disorder is a chronic, recurrent, and often disabling disorder in childhood. Comorbid emotional and behavioral disturbance and family dysfunction are common and can serve to complicate both course of illness and treatment outcome. Although traditional psychotherapies have not been shown to be effective for treating core OCD symptoms, controlled trials with adults have shown cognitive-behavioral approaches that include ERP to be highly effective in treating the disorder. The recent development and open evaluation of a handful of standardized and developmentally sensitive ERP-based treatment protocols for childhood OCD indicates that this treatment approach is similarly effective and well-tolerated in teh younger age group. These studies also suggest that adjunctive interventions including family involvement in treatment, anxiety management training, cognitive restructuring, contingency management, and supportive therapy may enhance the efficacy of ERP through the enhancement of treatment compliance and motivation. More study is needed to evaluate the best use of medication and CBT in children and adolescents.

Adolescent↗
PubMed2001

[Pharmacological treatment of children and adolescents with OCD].

This review describes the pharmacological treatment of obsessive-compulsive disorder (OCD) in children and adolescents. Several randomised, placebo-controlled trials have shown the efficacy of SSRI drugs in the treatment of this often disabling condition. Treatment with SSRI drugs for OCD in children and adolescents can be considered safe, according to published experiences. Side effects are similar to those described in adults and about 10% of children and adolescents treated have had to stop the treatment, owing to side effects. The use of medical treatment achieves a reduction in rather than a total remission of obsessive-compulsive symptoms. Therefore, medical treatment should always be combined with other strategies, of which the cognitive behavioural therapy (CBT) is best documented. The need for further research is stressed, especially studies combining different treatment strategies, and the efficacy of treatment in the long term.

Adolescent↗
PubMed1997

Update on pharmacologic management of OCD: agents and augmentation.

A preponderance of patients with obsessive-compulsive disorder (OCD) experience little or no improvement in their symptoms when treated with serotonin reuptake inhibitors (SRIs). It is hypothesized that SRI-refractory patients may have altered serotonin neurotransmission different from patients responsive to SRIs, or that they may have abnormalities in their dopamine function. When drugs affecting serotonin function (e.g., tryptophan, fenfluramine, lithium, buspirone) are added to SRI therapy in SRI-refractory patients, results are mixed and not consistently encouraging. However, when drugs affecting dopamine function (e.g., pimozide, haloperidol, risperidone) are added to SRI therapy in SRI-refractory OCD patients, individuals with either a personal history or family history of tics experience a reduction in their symptoms.

Clinical Trials as Topic↗
PubMed1987

Oculomotor factors in the aetiology of occupational cervicobrachial diseases (OCD).

The traditional posture-ergonomic perspective on the aetiology of Occupational Cervicobrachial Disease (OCD) is discussed and criticized in the light of present knowledge of oculomotor strain during sustained visual work at short distances. Two experiments on ocularly induced neck muscular tension are reported. In both experiments EMG's were taken from six different muscles in the head, neck and shoulder region during a visual discrimination task. In Experiment 1, accommodation and fusion requirements were systematically varied by changing viewing distance in combination with the application of minus-lenses and base-out prisms. EMG was shown to increase as a function of accommodation and fusion load. In Experiment 2, a clinical population with severe and long lasting neck and shoulder problems and inappropriate optical corrections was studied with the same experimental design. EMG was shown to decrease when habitual corrections were replaced by more appropriate ones.

Arm↗
PubMed2004

Age differences in an animal model of obsessive-compulsive disorder: participation of dopamine: dopamine in an animal model of OCD.

The putative age difference in the effect of chronically administered quinpirole (0.125 and 0.5 mg/kg, 11 injections) on alternation in a T maze was studied. Male juvenile (43 days old) and adult (around 90 days old) rats exhibited similar control values of alternation. In adults, quinpirole (0.5 mg/kg) produced a drastic perseveration after 10 and 11 injections (mean number of repetitive choices of 3.4 and 3.1, respectively); conversely, in juvenile, such treatment produced a less marked perseveration (mean number of repetitive choices of 1.7 and 2.1, for the 10th and 11th injection, respectively). We also studied the age difference in the protective actions of clomipramine subchronically administered (15 mg/kg, three times) on the quinpirole-induced perseveration. Clearly, as previously demonstrated, in adult animals, this tricyclic antidepressant completely prevented the drug-induced perseveration (mean number of repetitive choices of 1.7); while in juvenile, animals only produced a weak action (mean number of repetitive choices of 1.8). Data agreed with basic research showing a hyposensitivity of juvenile animals to dopaminergic agonists and with clinical findings suggesting a weaker effect of clomipramine treatment in youth. These results reinforce perseveration in a T maze as a useful animal model for studying age differences in obsessive-compulsive disorder (OCD).

Aging↗
PubMed2001

Thought-action fusion in individuals with OCD symptoms.

Rachman (Rachman, S. (1993). Obsessions, responsibility, and guilt. Behaviour Research and Therapy, 31, 149-154) suggested that patients with OCD may interpret thoughts as having special importance, thus experiencing thought-action fusion (TAF). Shafran, Thordarson and Rachman (Shafran, R., Thordarson, D. S. & Rachman, S. (1996). Thought-action fusion in obsessive compulsive disorder. Journal of Anxiety Disorders, 710, 379-391) developed a questionnaire (TAF) and found that obsessives scored higher than non-obsessives on the measure. In the current study, we modified the TAF to include a scale that assessed the "likelihood of events happening to others" as well as ratings of the responsibility and cost for having these thoughts. Replicating previous findings, we found that individuals with OC symptoms gave higher ratings to the likelihood of negative events happening as a result of their negative thoughts. Individuals with OC symptoms also rated the likelihood that they would prevent harm by their positive thoughts higher than did individuals without OC symptoms. These results suggest that the role of thought-action fusion in OCs may extend to exaggerated beliefs about thoughts regarding the reduction of harm.

Adult↗
PubMed1997

Looming vulnerability to spreading contamination in subclinical OCD.

The present study examined the hypothesis, stimulated by the looming vulnerability model of anxiety (Riskind, in press, Behaviour Research and Therapy), that subclinical OCD is associated with a subjective sense of looming vulnerability. One-hundred and four undergraduates rated vignettes of common, everyday situations involving exposure to possible dirt, germs, or contamination. Participants in a subclinical obsessional group had a far higher sense of looming vulnerability to spreading contamination than did those in a control group. Results verified that the subjective sense of looming vulnerability still had separate, distinct and significant contributions to fear-of-contamination symptoms, with the effects of cognitive appraisals of other aspects of threat (such as probability of harm, or lack of control) removed. In contrast, these other cognitive appraisals had no significant associations with symptoms that proved to be independent of the subjective sense of looming vulnerability. A path analysis further explored the dependency of these other cognitive appraisals on looming vulnerability. This analysis found that part of the effects of the subjective sense of looming vulnerability on fears may be indirect and mediated via correlated effects of other cognitive appraisals.

Adult↗
PubMed2004

[Convergence of psychotherapeutic and neurobiological outcome measure in a patient with OCD].

We used psychotherapeutic measures and functional magnetic resonance imaging (fMRI) to assess the effect of a combined psychodynamic and cognitive behavioral treatment of a patient suffering from a severe obsessive compulsive disorder (OCD). The clinical outcome was controlled by a detailed case description and psychometric test instruments. Intensive exploration of the patient made possible the creation of an idiosyncratic imagination paradigm suitable for fMRI. The patient shows at the end of treatment a decrease in symptoms as assessed by clinical as well as psychometric instruments. Especially recapitulation and cleaning obsessions decreased, but the cognitive avoidance strategies remained almost unchanged. fMRI showed no orbito-fronto-striatothalamic activation corresponding to obsessive compulsive symptoms, but an increased activation of the medial prefrontal (MFC) and anterior cingulate cortex (ACC). The lack of activation of the orbito-fronto-striatothalamic circuits and at the same time the occurrence of the increased activation of the MFC and ACC reflects the cognitive avoidance strategies still triggered by the symptom provoking stimulus.

Adult↗
PubMedDate not supplied

Osteochondrodystrophy (ocd): a new autosomal recessive mutation in the mouse.

Osteochondrodystrophy (ocd) is a new autosomal recessive mouse mutation characterized by a short, slightly domed head, reduced body size, disproportionately shortened long bones of the legs, supination of the forefeet, and short thickened tail. Histologically, the epiphyses are thinner than normal. The columnar organization of the proliferative zone of cartilage is disorderly, with pleomorphic and occasionally necrotic chondrocytes. Osteochondrodystrophy has been mapped to a position near the centromere of mouse chromosome (Chr) 19.

Animals↗
PubMed2000

The Maudsley Obsessional-Compulsive Inventory and OCD in a Norwegian nonclinical sample.

The 30 item Maudsley Obsessional-Compulsive Inventory (MOCI) was given to 294 under graduate students. The inventory achieved an acceptable internal consistence, but somewhat low reliability. There were no sex difference in total MOCI score, or in any of the subscales. 31% of the variance seemed to be explained by item 18: "attending too much to details", and more than 65% of the variance is explained by the checking subscale. The data give some interesting indications of the prevalence of OCD in the population.

Adult↗
PubMed1998

OCD in Bahrain: a phenomenological profile.

Fifty patients with a primary diagnosis of Obsessive-Compulsive Disorder (OCD) were studied during the course of the year 1994 from a phenomenological point of view in order to delineate the various forms and contents of obsessions and compulsions. An attempt was made to highlight the frequency with which the different forms and contents occur. Six types of obsessions were identified: doubts, thoughts, fear (phobia), images, impulses and miscellaneous. Compulsive acts were classified into two types: yielding and controlling. The contents of obsessions could be classified into eight broad categories as relating to: dirt and contamination, germs, aggression, sex, religion, blasphemy, illness and indecisiveness. Thirty eight percent of the patients displayed obsessional thoughts related to dirt and contamination, while forty per cent showed religious and blasphemous obsessional thoughts and doubts. Fifty six percent of the patients had compulsions of which 36% were multiple, while 20% displayed only a single compulsion. The paper discusses these findings and emphasizes the role played by sociocultural and religious factors in shaping the character of an obsessional thought content.

Adolescent↗
PubMedDate not supplied

[Psychotherapeutic methods in the treatment of obsessive-compulsive disorder (OCD) in children and adolescents].

The psychiatric and psychological literature was systematically reviewed for studies applying psychotherapeutic principles to young persons with obsessive-compulsive disorder. Abundant clinical and empirical evidence suggest that cognitive-behavioral psychotherapy, alone or in combination with pharmacotherapy, is an effective treatment for OCD in children and adolescents. Thirty-two investigations, most of them single case reports, showed some benefit for such kind of interventions. Graded exposure and response prevention form the core of treatment; anxiety management training and specific family interventions may play an adjunctive role.

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↗