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PubMed1995

Preschoolers' sexual behavior at daycare centers: an epidemiological study.

The frequency of sexual behaviors in a population of preschoolers (n = 251) attending Swedish daycare centers was studied using a questionnaire given to the staff. Some behaviors turned out to be frequently occurring, like searching for body contact and responding to such contact. However, several behaviors were very uncommon (1% or fewer): touching an adult's genitals; attempting to make the adult touch the child's genitals; using objects against own or other child's genitals/anus; to masturbate obsessively, without pleasure or in a way that caused pain. Other behaviors occurred more frequently but were still uncommon (less than 2% of the children displayed such a behavior "sometimes" or "often/daily"): exhibiting own genitals; playing sexually explorative games; initiating games with a similarity to adult sexual activity; using sexual words; attempting to touch a woman's breast. Only masturbation and clinging body contact were positively correlated with behavioral disturbance. The correlations between age and single behaviors may be summarized as manifestations of the process of socialization. The results offer an incipient frame of reference for statistically normal expected sexual behaviors in preschoolers at daycare centers. The rarity of certain behaviors implies that their occurrence in an individual case may necessitate special clinical attention.

Child↗
PubMed2006

Role of atypical opiates in OCD. Experimental approach through the study of 5-HT(2A/C) receptor-mediated behavior.

RATIONALE: The selective serotonin (5-HT) reuptake inhibitors (SSRIs) represent the first-line pharmacotherapy for obsessive-compulsive disorder (OCD), and atypical antipsychotic drugs, which block 5-HT2A receptors, are used in augmentation strategies. Opiate drugs are also effective in treatment-refractory OCD and Tourette syndrome. The 5-HT2A-related behavior (i.e., head twitch) has been related with tics, stereotypes, and compulsive symptoms observed in Tourette syndrome and OCD. OBJECTIVES: The aim of this study was to explore whether 5-HT2A-related behavior is affected by atypical opiate drugs. MATERIALS AND METHODS: Head-twitch response was induced in mice by administration of either 5-hydroxytryptophan (5-HTP) or the 5-HT2A/C agonist (+/-)-1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane (DOI). Dose-effect curves of atypical opiate drugs [(+/-)-tramadol, (-)-methadone and levorphanol], morphine, and other psychoactive drugs (fluvoxamine, desipramine, nefazodone, and clozapine) were performed. Opioid mechanisms were investigated by administration of naloxone. RESULTS: All the opiates tested reduced both 5-HTP and DOI-induced behavior in a naloxone-reversible fashion, atypical opiates being more effective. The effects of the other drugs depended on the protocol, clozapine being the most effective. CONCLUSIONS: Combined 5-HT and opioid properties result in a greater efficacy in antagonizing 5-HT2A-related behavior. These results provide behavioral evidence to support convergent effects of the 5-HT and opioid systems in discrete brain areas, offering the potential for therapeutic advances in the management of refractory stereotypes and compulsive behaviors.

5-Hydroxytryptophan↗
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↗
PubMed2002

[Comorbid disorders associated with tics].

INTRODUCTION: Tics are the most frequent abnormal movements in children. This is one reason for their importance. Another reason is their relationship to fascinating disturbances of human behaviour such as compulsion and obsessions. Several 'behavioural disorders', mainly attention-deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD), are more frequent in patients with tics than in the general population. These associated disorders (named 'comorbid') are probably of more consequence than the tics. Relationship between tics and comorbid disorders is not well known. This review considers data, consequences, hypothesis and management of comorbid disorders associated to tics. DEVELOPMENT: From the personal series of children with tics, data of comorbid disorders associated to tics was analysed. Of 340 cases of tics, 132 (39%) cases have ADHD, 135 (40%) cases have OCD, obsessive compulsive symptoms (OCS) or obsessive-compulsive behaviour (OCB). 68 (20%) cases have both ADHD and OCD. Considering only Tourette cases (219) the figures are only slight higher: ADHD (42%), OCD (45%) and ADHD plus OCD (24%) suggesting that all the spectrum of tics has a common basis. CONCLUSIONS: Familial studies shows that 44 percent of the patients with tics have a positive familial history of tics and 30 percent positive familial history of obsessive compulsive signs. The data of the literature on the tics and comorbid disorders relationship is also revised.

Attention Deficit Disorder with Hyperactivity↗
PubMed2002

Height distribution in children with Tourette syndrome.

Tourette syndrome is characterized by motor and vocal tics, frequently accompanied by attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder, coprolalia, aggressive or self-injurious behavior, and learning disabilities. We investigated the height distribution and clinical characteristics of 38 consecutive patients with Tourette syndrome. Seventeen patients with Tourette syndrome (44.7%) were in the lower height quartile versus 25% from a control group of 44 patients with ADHD (P <.05). The mean standard deviation score differential (patient height - [target height]) was -1.12 +/- 0.82 for patients in the first quartile (group A) compared with 0.42 +/- 0.63 in taller patients with Tourette syndrome (group B) (P < .001). The mean birthweight of boys in group A versus group B was 3023 +/- 351 g and 3363 +/- 486 g, respectively (P <.02); birthweight correlated with standard deviation score (r=.43). Current weight relative to height was normal. Conduct disorder and/or self-injurious behavior were more common in group A patients (P < .05). Relative short stature appears common in Tourette syndrome, and its presence with other features may implicate a neurotransmitter system that interacts with neuroendocrine pathways, controlling height.

Adult↗
PubMed1995

Applying the codependency model to a group for families of obsessive-compulsive people.

Obsessive-compulsive disorder places formidable burdens on family members who are drawn into bizarre enabling behaviors to pacify their ill relatives. Some families exhibit a high tolerance for inappropriate behavior and evidence characteristics similar to those seen in families of alcoholics. This article applies the codependency group model to families of obsessive-compulsive people based on a definition of codependency that views these families as normal, feeling people who are trying to cope with unremitting stress. Clinical vignettes illustrate how these families are similar to families of alcoholics in their management of emotions and in their dysfunctional behaviors. Recommendations are offered for practitioners who work with families of mentally ill people.

Adult↗
PubMed2006

Estrogen deficient male mice develop compulsive behavior.

BACKGROUND: Aromatase converts androgen to estrogen. Thus, the aromatase knockout (ArKO) mouse is estrogen deficient. We investigated the compulsive behaviors of these animals and the protein levels of catechol-O-methyltransferase (COMT) in frontal cortex, hypothalamus and liver. METHODS: Grooming was analyzed during the 20-min period immediately following a water-mist spray. Running wheel activity over two consecutive nights and barbering were analyzed. COMT protein levels were measured by Western analysis. RESULTS: Six-month old male but not female ArKO mice develop compulsive behaviors such as excessive barbering, grooming and wheel-running. Excessive activities were reversed by 3 weeks of 17beta-estradiol replacement. Interestingly, the presentation of compulsive behaviors is accompanied by concomitant decreases (p < .05) in hypothalamic COMT protein levels in male ArKO mice. These values returned to normal upon 17beta-estradiol treatment. In contrast, hepatic and frontal cortex COMT levels were not affected by the estrogen status, indicating region- and tissue-specific regulation of COMT levels by estrogen. No differences in COMT levels were detectable between female animals of both genotypes. CONCLUSIONS: This study describes the novel observation of a possible link between estrogen, COMT and development of compulsive behaviors in male animals which may have therapeutic implications in obsessive compulsive disorder (OCD) patients.

Animals↗
PubMed1996

Besipirdine (HP 749) reduces schedule-induced polydipsia in rats.

The aim of the present paper is to report on the adrenergic and serotonergic effects of besipirdine (HP 749) in vivo and to discuss its potential use in the treatment of obsessive compulsive disorder. Besipirdine inhibited biogenic amine uptake in vitro. It prevented tetrabenazine-induced ptosis in mice and potentiated the 5-hydroxytryptophan-induced serotonin syndrome in rats. Furthermore, it decreased schedule-induced polydipsic behavior in rats. Schedule-induced polydipsia may be a model for obsessive compulsive disorder. Previous results from our group have shown that certain selective serotonin reuptake inhibitors decrease schedule-induced polydipsia after 14-21 days of treatment. Besipirdine reduced schedule-induced polydipsic behavior immediately and this reduction lasted throughout the duration of the experiment (29 days).

8-Hydroxy-2-(di-n-propylamino)tetralin↗
PubMedDate not supplied

Obsessive-compulsive disorder: diagnosis and treatment in the primary care setting.

BACKGROUND: Obsessive-compulsive disorder is a common anxiety disorder found in 1 to 2 percent of the population. Obsessions are recurrent and persistent thoughts that cause marked anxiety or distress. Compulsions are repetitive behaviors or mental acts done to prevent or reduce anxiety. Patients might underreport symptoms or complain of coexisting depression or anxiety instead. The primary care physician is often the first to encounter this disorder in patients. METHODS: The authors cared for and observed a patient with obsessive-compulsive disorder at a family practice office and used her case to illustrate a literature review gathered by means of a MEDLINE search. RESULTS AND CONCLUSIONS: A combination of patient education, selective serotonin reuptake inhibitors, and behavioral techniques allow the family physician to maximize patient recovery and play a major role in the diagnosis and treatment of obsessive-compulsive disorder.

Adult↗
PubMed2002

Thought action fusion: can it be corrected?

The goal of this study was to investigate whether or not a brief educational intervention delivered prior to engaging in an anxiety-provoking task (writing a sentence about hoping that a friend/relative was in a car accident) would be effective in offsetting anxiety in college students with a strong propensity to endorse statements of thought action fusion (TAF). As hypothesized, individuals receiving the educational intervention were less anxious than a placebo intervention control group at post task; they were also less likely to endorse statements of TAF after receiving the educational intervention. Also, those who chose to neutralize after writing the sentence (regardless of experimental group) were more likely to report feeling guiltier, more immoral and a greater sense of responsibility about writing the sentence prior to neutralizing than those who did not subsequently neutralize. These results are discussed in relation to the cognitive theory of obsessive-compulsive disorder and implications for prevention programs.

Cognitive Behavioral Therapy↗
PubMed1991

Symptoms of eating disorders in patients with obsessive-compulsive disorder.

OBJECTIVE: This study was designed to explore potential overlap of the symptoms of obsessive-compulsive disorder and eating disorders. METHOD: The authors administered a structured, self-rating scale, the Eating Disorder Inventory, to 59 outpatients at an obsessive-compulsive disorder clinic and to 60 sex-matched normal volunteers. The Eating Disorder Inventory has been previously validated as a reliable measure of the specific cognitive and behavioral dimensions of the psychopathology typical of patients with eating disorders. The scores of the patients with obsessive-compulsive disorder and of the healthy comparison subjects were compared with those of 32 female inpatients with anorexia nervosa (N = 10) or bulimia nervosa (N = 22) who had also been given the inventory. RESULTS: The patients with obsessive-compulsive disorder scored significantly higher than the healthy comparison subjects on all eight subscales of the Eating Disorder Inventory: drive for thinness, bulimia, body dissatisfaction, ineffectiveness, perfectionism, interpersonal distrust, interoceptive awareness, and maturity fears. Relative to the healthy subjects, male patients with obsessive-compulsive disorder had more symptoms than female patients with obsessive-compulsive disorder. The scores of the female patients with obsessive-compulsive disorder were midway between those of the 32 female patients with eating disorders and those of the 35 female normal subjects. CONCLUSIONS: These results suggest that patients with obsessive-compulsive disorder display significantly more disturbed eating attitudes and behavior than healthy comparison subjects and that they share some of the psychopathological eating attitudes and behavior that are common to patients with eating disorders.

Adult↗
PubMed1999

Clarifying an ambiguous functional analysis with matched and mismatched extinction procedures.

Results of functional analysis were ambiguous in suggesting that self-injurious behavior (SIB) was maintained by escape, sensory reinforcement, or both. To help clarify these results, we compared escape extinction, sensory extinction, and the combined treatments. Sensory extinction proved to be a necessary and sufficient treatment, whereas escape extinction failed to decrease SIB. These analyses helped to clarify the function of SIB and to identify an effective and efficient treatment.

Adult↗
PubMed1990

Management of obsessive-compulsive disorder.

Obsessive-compulsive disorder is an anxiety disorder characterized by compulsive rituals such as excessive washing and repeated checking and phobic avoidance. The treatment of choice is behavioural psychotherapy, namely exposure and response prevention.

Antidepressive Agents↗
PubMed2000

Neuroanatomically based approaches to obsessive-compulsive disorder. Neurosurgery and transcranial magnetic stimulation.

Obsessive-compulsive disorder is a severe condition. Unfortunately, current medication and behavior therapies fail to adequately benefit some patients most severely affected. Advancing knowledge of brain circuit involvement has potential treatment implications. The neurosurgical techniques most often used in the United States for crippling, treatment-refractory obsessive-compulsive disorder are reviewed in the context of anatomic models of the illness. The use of transcranial magnetic stimulation to probe possible neuroanatomic and neurophysiologic substrates of this disorder is considered, and how the knowledge gained from such studies might advance treatment is presented.

Brain↗
PubMed2000

Obsessive-compulsive aspects of craving: development of the Obsessive Compulsive Drinking Scale.

"Craving" for alcohol needs improved definition and measurement. This review provides a rationale for considering at least certain aspects of craving as having obsessive and compulsive features. As such, there may be phenomenological, but not necessarily etiological, overlap with obsessive-compulsive disorder. There are increasing data that suggest a neuroanatomical overlap between addiction/craving and obsessive-compulsive symptoms. The self-rated Obsessive Compulsive Drinking Scale (OCDS), based on the Yale-Brown Obsessive Compulsive Scale for heavy drinking interview (YBOCS-hd), was developed to assist in the examination of certain aspects of "craving" in alcoholics. The development, reliability, face validity, congruent validity and predictive validity of the OCDS are presented and discussed in this paper. The utility of the OCDS as a measurement tool in cognitive-behavioral and pharmacological alcoholism treatment research is highlighted. The potential of this instrument as a research and clinical tool for the understanding and evaluation of alcohol dependence needs further evaluation.

Behavior, Addictive↗