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PubMed1997

[Obsessive-phobic disorders in anorexia and bulimia nervosa].

The data on 1500 patients with syndrome of anorexia and bulimia nervosa were summarised in terms of clinical-psychopathological, catamnestic and experimental-psychological investigation. This syndrome was considered as one disease which presented the variation of borderline mental pathology or the manifestation of schizophrenic process. Obsessive-phobic disorders were observed in majority of patients (95%). Such disorders were characterized by prevalence of obsessive phenomena with food content. It was noted that diagnosis and prognostic significance had either obsessive-phobic disturbances or obsessions with other content which occurred on the initial stage of disease, before development of syndrome of anorexia and bulimia and in period of pronounced cachexia. The therapeutic resistance of obsessive disturbances in patients with anorexia and bulimia were emphasized as well as the necessity of prolonged ambulatory treatment of such patients.

Adolescent↗
PubMed2001

Risperidone augmentation of specific serotonin reuptake inhibitors in the treatment of refractory obsessive-compulsive disorder: report of two cases.

The efficacy of specific serotonin reuptake inhibitors (SSRI) in the treatment of obsessive-compulsive disorder (OCD) has been established, but more than 40% of patients continue to have a poor response to SSRI. Low-dose antipsychotic augmentation of SSRI has contributed to the amelioration of symptoms in the treatment of refractory obsessive-compulsive disorder patients. Due to the risk of side effects from traditional antipsychotics, atypical novel antipsychotic augmentation of SSRI may be a good choice in the treatment of refractory obsessive-compulsive disorder. Herein we report our experience with two OCD patients, one with a poor response to fluoxetine 80 mg per day for 3 months, and the other with poor response to fluoxetine 60 mg per day for 3 months. Both OCD patients also proved to have a poor response to paroxetine 60 mg per day for 6 weeks. Neither patient had received any psychotherapy or behavioral therapy. Both patients showed significant improvement in their obsessive-compulsive symptoms as measured by the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), after risperidone 1 mg per day was added to their on-going use of paroxetine 60 mg per day. Within 4 weeks of adding risperidone, the two patients' Y-BOCS scores had decreased by 57% and 53%. This result suggests that risperidone augmentation of SSRI may be a good choice and an effective treatment strategy for refractory OCD.

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↗
PubMed1987

Clinical comparison of Tourette's disorder and obsessive-compulsive disorder.

The authors report on 16 outpatients with Tourette's disorder, 16 outpatients with obsessive-compulsive disorder, and 16 normal control subjects who underwent structured interviews and psychological testing. Previous findings of a high incidence of obsessive-compulsive disorder in patients with Tourette's disorder were confirmed. There was a significantly greater incidence of tics in the patients with obsessive-compulsive disorder and their relatives. Both patient groups had high rates of unipolar depressive and generalized anxiety disorders. Panic and phobic disorders were frequent in the patients with obsessive-compulsive disorder but not in the patients with Tourette's disorder. The patients with obsessive-compulsive disorder showed less coprolalia, echo phenomena, self-destructive behavior, and childhood attention deficit.

Adult↗
PubMed1997

Behavioral and emotional aspects of Tourette syndrome.

This article reviews the behavioral and emotional aspects of Tourette syndrome with a focus on behavioral phenomenology and psychiatric comorbidity. Tourette syndrome is a complex neuropsychiatric disorder characterized by disinhibition and dysfunction of the regulation of motor, cognitive, affective, and behavioral functions. Although multiple motor and vocal tics are the key diagnostic phenomena, hyperactivity, impulsivity, inattention, obsessive-compulsive, and emotional symptoms are common in many patients. Evaluation and treatment should take into account the behavioral and emotional symptoms as well as the tics. Treatment should incorporate multimodal strategies so as to address both the tics and symptoms.

Antidepressive Agents, Tricyclic↗
PubMed1995

The Coffin-Siris syndrome: data on mental development, language, behavior and social skills in 12 children.

In this report we present data on cognitive development, language, behavior and social skills in 12 children and adolescents, nine girls and three boys, aged between 2.5 and 19 years, with Coffin-Siris syndrome (CS). 1. Mental retardation was mild in three patients and moderate in the nine others. 2. Speech onset was severely retarded with little interest in language. In the older group (seven patients aged 7 to 19 years), language comprehension was appropriate to the mental level. 3. Gross-motor functioning and autonomy, with the lowest score on "Task-orientation", were equal to the mental development. 4. Most frequently, aggressive disturbed behavior was observed, especially in the youngest children, while mixed disturbed behavior was observed in the oldest patients. Almost half of the CS patients (5/11) presented symptoms of pervasive developmental disorder, with 2/11 scoring in the pathological range. Obsessive interests, strong dependence on patterns and rituals and unusual fears were characteristic behavioral problems also when they got older.

Adolescent↗
PubMed1988

Biological challenges in obsessive compulsive disorder.

1. Obsessive compulsive disorder and affective disorder have been investigated by means of various biological challenges. 2. Total sleep deprivation and methylphenidate challenge were used to determine the effects on a group of subjects with obsessive compulsive disorder. 3. The findings of a lack of response to total sleep deprivation and methylphenidate in obsessive compulsive patients contrasts with the findings in affective disorder patients. 4. The findings are more consistent with those in studies of panic disorder. 5. The relationship of obsessive compulsive disorder to affective and anxiety disorder may be elucidated by further studies.

Adult↗
PubMed2004

Case study: severe self-injurious behavior in comorbid Tourette's disorder and OCD.

This case report describes the successful treatment of severe self-injurious behavior in a 16-year-old adolescent with Tourette's disorder and obsessive-compulsive disorder. Treatment is described from initial presentation to the emergency department for severe self-inflicted oral lacerations through discharge from the inpatient psychiatric service. Modes of treatment included emergent medical intervention, intensive care services, psychopharmacology, and psychological services. The collection of treatment modalities implemented by this multidisciplinary team may serve as a guide to other health care professionals when severe self-injurious behavior is the presenting problem.

Adolescent↗
PubMed1990

A comparative examination of a role for serotonin in obsessive compulsive disorder, panic disorder, and anxiety.

Recent clinical and laboratory studies have suggested that changes in brain serotonin (5-HT) function may contribute to anxiety symptoms and anxiety-type behaviors. Among the anxiety disorders, perhaps the most compelling evidence implicating 5-HT exists for obsessive compulsive disorder (OCD). In controlled trials, patients with OCD were markedly more responsive to treatment with 5-HT-selective uptake inhibitors such as clomipramine, fluvoxamine, or fluoxetine than to norepinephrine-selective or nonselective uptake inhibitors or to other psychoactive drugs. Studies with 5-HT agonists and antagonists also support a role for 5-HT in OCD. In this review, pharmacologic studies involving 5-HT-selective therapeutic and anxiogenic agents and non-5-HT-selective anxiogenic agents in patients with OCD are compared and contrasted with similar studies in patients with anxiety and panic disorder.

Anxiety Disorders↗
PubMedDate not supplied

A psychoeducational and support group for obsessive-compulsive disorder patients and their significant others.

This report details the contents of a 10-week psychoeducational and support group for obsessive-compulsive disorder (OCD) patients and their significant others. As growing numbers of OCD patients seek behavioral and psychopharmacologic treatments for their disorder, the need for such a group has increased. Little is written about this type of group, despite the need. Successful research and evaluation of this treatment entity will rely on a clearly defined group protocol such as the one reported here. In the present study, the group averaged 21 members in attendance. The 17 members present at the final session rated the group an average of 3.8 on a 0 (poor) to 4 (excellent) scale across several content areas. These uncontrolled data suggest that the format has clinical utility as a tool for the delivery of information and support to OCD patients and their significant others.

Behavior Therapy↗
PubMed1991

Dimensional approach to obsessive-compulsive disorder in childhood and adolescence.

Based on a review of the charts of child and adolescent psychiatric patients, a group of patients with obsessive-compulsive symptoms and a control group were identified. Obsessive-compulsive symptoms described in the charts were classified according to form using the checklist of Khanna et al. By use of latent trait models, a 6-item obsessive-compulsive rating scale was established revealing a dimensional rather than a categorical distribution of obsessive-compulsive symptoms. The correlation with other clinical features was investigated.

Adjustment Disorders↗
PubMed2005

Chronic tics and Tourette syndrome in patients with obsessive-compulsive disorder.

Tourette syndrome (TS) and chronic motor/vocal tics (CMVT) are both common disorders in patients with obsessive compulsive disorder (OCD). However, there have been few studies evaluating the differences between the OCD with TS and OCD with CMVT subgroups. This study was conducted in order to further investigate possible differences between the expression of the OCD phenotype in OCD with TS and that seen in OCD with CMVT. One hundred and fifty-nine outpatients referred to an OCD research program were evaluated using the following instruments: the Structured Clinical Interview for DSM-IV; the Yale-Brown Obsessive Compulsive Scale; the Yale Global Tic Severity Scale; and the USP-HARVARD Repetitive Behaviors Interview. Patients were divided into three groups: OCD patients without tics (OCD-TICS, n=98), OCD patients with chronic motor or vocal tics (OCD+CMVT, n=31) and OCD patients with TS (OCD+TS, n=30). OCD+CMVT patients were similar to OCD+TS patients regarding the frequency of intrusive sounds, repeating behaviors, counting and tic-like compulsions (in both cases more frequent than in OCD-TICS patients). For age at obsessive-compulsive (OC) symptom onset, sensory phenomena score, number of comorbidities, frequency of somatic obsessions, bodily sensations and just-right perceptions, OCD+CMVT patients tended to be in between the other two groups. Our results suggest that there are qualitative and quantitative differences in the phenotypic expression of tic disorders in OCD patients, depending on whether the subject has TS or only CMVT.

Adolescent↗
PubMedDate not supplied

Memory deficits in patients with DSM-IV obsessive-compulsive disorder.

Neuropsychological testing provides increasing evidence that certain memory deficits might play an essential role in the emergence of doubts and, as a result, in perpetuating checkers' rituals. Another account of doubting implicates meta-cognitive factors, such as confidence in memory. The present study examined mnestic functioning and self-perception of memory ability in a group of 27 nondepressed patients with obsessive-compulsive disorder (OCD) and 27 normal controls. All patients met DSM-IV and ICD-10 criteria for OCD, displayed prominent behavioral checking rituals and had to show a score on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) of at least 16. Significant deficits in intermediate (Lern- und Gedächtnistest; LGT-3) and immediate (Corsi Block-Tapping Test) nonverbal memory were identified in the patients with OCD compared to normal controls. Contrary to predictions, OCD patients also showed a significant deficit in general memory and verbal memory (LGT-3). With respect to meta-cognition, OCD patients reported less confidence in their memories than controls. These findings suggest that obsessional doubt reflects a deficit in memory as well as a deficit in memory confidence. Depending on which dysfunction predominates, different therapeutic procedures seem to be required.

Adolescent↗
PubMed1990

Treating the anxiety: therapeutic options in obsessive compulsive disorder.

Obsessive compulsive disorder (OCD) is far more prevalent and frequently more severe than recognized previously. Behavior therapy with exposure and response-prevention has proven effective treatment, as have potent serotonin uptake inhibitors, especially clomipramine, despite a high relapse rate after drug discontinuation. These therapies are complementary and a combination of the two approaches shows great promise in the treatment of OCD.

Anxiety Disorders↗