THE EFFICIENCY OF THE REGISTERED-AXIAL CLASSIFICATION OF OBSESSIVE-COMPULSIVE DISORDER

Abstract

  Rather simple in using, the registered-axial classification of the obsessive-compulsive disorder offers to define an OCD register (neurotic, psychopathic, psychotic, depressive, or vegetative). Furthermore, for diagnose adjustment or for the needs of different expertises, the respective axes are used (axis I – syndromes or particularity; axis II – ego-syntonic / ego-dystonic perception of symptoms; axis III – the level of awareness of obsessions; axis IV – chronization (dynamics); axis V – sensory phenomena, influence of the register to qualities of obsessions). Moreover, the above-mentioned classification allows interpreting the obsessive-compulsive disorder as a special phenomenon – a register-sensitive symptom; and this interpretation changes the theoretical views about the OCD. It is better to image such fact like a process, when every register sufficiently transfigures the main plots and qualities of obsessions. Thus, this theoretical statement allows differentiating almost the whole range of known obsessions and compulsions. The article objective is to introduce a new classification of the obsessive-compulsive disorder, which allows unifying the whole data about the OCD in the ICD and the DSM. Besides, the new concept will help differentiate and systematize the different types of obsessions and compulsions. By using such classification, it is easy to develop the general theory of obsessive conditions for needs of psychological and psychiatric expertises. 20 persons with the age from 23 to 62 were studied. Five psychological diagnostic methods were used: Yale-Brown obsessive-compulsive scale (Y-BOCS), Beck Depression Inventory, the inquirer of К. Leonhard−G. Shmishek, Rorschach test, Taylor Manifest Anxiety Scale (MAS). The obsessive-compulsive disorder is not an independent disorder. What is more, the experimental data confirmed the main hypothesis concerning the sufficient interconnection between the register of a main disorder and obsession symptoms (register-sensitivity). Therefore, this fact proved the topicality of the new registered-axial classification for the obsessive-compulsive disorder. Besides, the new classification points to some limitations of the Y-BOCS pathopsychological method. Namely, the absent etiological subscale in the scale decreases its efficiency. We determined, that the depression indirectly affects the development of the obsessive-compulsive symptomatology (the correlation between Beck Depression Inventory and Taylor Manifest Anxiety Scale was detected). Moreover, these data allows reviewing the depressive register of the register-axial classification not only as the theoretical aspect, but also as the practical factor. The review of the psychopathic register determined that some combinations of accentuations lead to the development of the OCD (stuck (rigid) – unstable (excitable) (t =0,007685, p<0,05); emotive (labile) – unstable (excitable) (t =0,007685, p<0,05); cyclotymic – excited (t =0,007685, p<0,05). The separate cyclothymic (cycloid) accentuation is also statistically significant (t =0,007685, p<0,05). Consequently, such data allow us to forecast that there are several types of the obsessive-compulsive personality disorders (OCPD) with rather different particularity. The data of the projective method –Rorschach test – confirm the idea, that the certain responders (30 % of the sample) with obsessions are expected to have some psychotic disorders (thus, the necessity to consider a separate category – the psychotic OCD register - was confirmed). The Pearson correlation coefficient, being calculated for the experimental and control group, demonstrates, that the positive correlations between Y-BOCS and Taylor Manifest Anxiety Scale (MAS) were detected (r = 0,656816) in the control group. Thus, the growth of anxiety affects to some degree the intensity of obsessions and compulsions, but this statement is quite fair only for those responders, who feel very mild OCD symptoms. Yet, anxiety is not significant for the patients with the intensive symptoms (probably, because of some compensatory mechanisms). The obsessions of different registers have different qualitative characteristics (their symptoms are different). Hence, the difficulties in the psychological and drug therapy of the obsessive-compulsive disorder is explained by the fact that several registers of the OCD may appear in the anamnesis (up to 5 registers). Finally, the efficiency of the registered-axial classification of the obsessive-compulsive disorder was proved. Such classification is worth introducing for the needs of the ICD and the DSM. &nbsp