Abstract
This study aimed to investigate whether deficits in decision making were potential endophenotype markers for OCD considering different phases of the disease. Fifty-seven non-medicated OCD patients (nmOCD), 77 medicated OCD patients (mOCD), 48 remitted patients with OCD (rOCD) and 115 healthy controls were assessed with the Iowa Gambling Task (IGT), which measured decision making under ambiguity, and the Game of Dice Task (GDT), which measured decision making under risk. While the three patients groups showed impaired performance on the IGT compared with healthy controls, all patients showed intact performance on the GDT. Furthermore, the rOCD patients showed a preference for deck B, indicating that they showed more sensitivity to the frequency of loss than to the magnitude of loss, whereas the mOCD patients showed a preference for deck A, indicating that they had more sensitivity to the magnitude of loss than to the frequency of loss. These data suggested that OCD patients had trait-related impairments in decision making under ambiguity but not under risk, and that dissociation of decision making under ambiguity and under risk is an appropriate potential neurocognitive endophenotype for OCD. The subtle but meaningful differences in decision making performance between the OCD groups require further study.
Highlights
Neuropsychological impairments are potential endophenotype candidates in various psychiatric diseases[5]
One study investigating decision making under ambiguity measured by the Iowa Gambling Task (IGT) and decision making under risk measured by the Game of Dice Task (GDT) found that the performance of Obsessive-compulsive disorder (OCD) patients was lower than comparison subjects on the IGT, they performed on the GDT14
No differences were found between the non-medicated OCD (nmOCD), medicated OCD (mOCD), rOCD and healthy controls (HC) groups for age, years of education or sex
Summary
Neuropsychological impairments are potential endophenotype candidates in various psychiatric diseases[5]. In the context of OCD, studies have largely examined neuropsychological function in patients with medication during the symptomatic phase[5,6,7,8]. Neuropsychological research into decision making in OCD patients has received considerable attention, with many of these studies highlighting impaired decision making as a potential marker of this disorder[12,13,14,15]. Outcomes and probabilities are implicit, and the decision makers have to initially find effective information and determine the qualities of the options independently by processing feedback from previous choices This type of decision making is often termed decision making under ambiguity and is usually measured with the Iowa Gambling Task (IGT)[18,19]. Other studies have shown that OCD patients in the recovered phase have significant deficits in certain executive functions and nonverbal memory, with these findings demonstrating that specific neuropsychological deficits are state independent and remain unchanged in the remitted state, possibly supporting the utility of these specific neuropsychological deficits as candidate endophenotype markers for OCD4,26
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