The Association of Anger with Symptom Subtypes in Severe Obsessive-Compulsive Disorder Outpatients

Abstract

Background: Despite the theoretical and clinical relevance of psychopathological dimensions in obsessive-compulsive disorder (OCD), no studies to date have investigated their possible association with obsession subtypes. Thus, we aimed to examine whether, in OCD patients, anger and other psychopathological dimensions are associated with specific obsession subtypes. Methods: We consecutively recruited 57 first-visit OCD patients (66.7% female, mean age 34 years) at our Psychiatric Outpatient Clinic. We used the point biserial coefficient (r_pbi) to measure the correlation between psychopathological dimensions and obsession subtypes. Results: We found significant correlations (p < 0.05) between the following: (1) anger/aggressiveness dimension and aggressive, contamination, and sexual obsessions; (2) apprehension/fear dimension and contamination, religious, and somatic obsessions; (3) sadness/demoralization dimension and contamination and somatic obsessions; (4) impulsivity dimension and aggressive and sexual obsessions, and (5) somatic concern/somatization dimension and contamination and somatic obsessions. We also found that OCD patients with comorbid obsessive-compulsive personality disorder - but not schizotypal or histrionic disorders - showed higher levels (p < 0.05) of obsessiveness/iterativity and anger/aggressiveness than OCD patients without the personality disorder. Conclusions: Anger and other psychopathological dimensions seem to be linked with specific obsession subtypes in OCD patients, suggesting an association between these dimensions and OCD.