Compulsive Score Research Articles

Abnormal functional connectivity of the putamen in obsessive-compulsive disorder

The putamen has been proposed to play a critical role in the development of obsessive-compulsive disorder (OCD). The primary objective of this study was to examine the resting-state regional activity and functional connectivity patterns of the putamen in individuals diagnosed with OCD. To achieve this, we employed resting-state functional magnetic resonance imaging (rs-fMRI) to collect data from a sample of 45 OCD patients and 53 healthy control participants. We aimed to use the regional amplitude of low-frequency fluctuation (ALFF) analysis to generate the ROI masks of the putamen and then conduct the whole brain functional connectivity of the putamen in individuals with OCD. Compared to controls, the OCD group demonstrated decreased ALFF in bilateral putamen. The right putamen also displayed decreased FC with the left putamen extending to the inferior frontal gyrus (IFG), bilateral precuneus extending to calcarine, the right middle occipital cortex extending to the right middle temporal cortex, and the left middle occipital gyrus. The decreased connectivity between the right putamen and the left IFG was negatively correlated with Yale-Brown Obsessive Compulsive scale (Y-BOCS) Obsession Scores. This study aimed to reveal the putamen changes in resting-state activity and connectivity in OCD patients, highlighting the significance of aberrant ALFF/FC of the putamen is a key characteristic of OCD.

THE RELATIONSHIP OF OBSESSIONS AND COMPULSIONS WITH AGGRESSION IN PATIENTS WITH OBSESSIVE COMPULSIVE DISORDER.

Obsessive-compulsive disorder (OCD) is a psychiatric disorder that is frequently encountered in the clinic and affects the functionality of patients significantly. Patients with higher levels of aggression have lower treatment compliance and recovery rates for their current mental illnesses. In our study, the relationships between OCD and its subtypes and aggression were examined. A total of 87 patients with OCD were included in the study. Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and Buss-Perry Aggression Questionnaire (BPAQ) were applied to the patients. In this study, the relationship between Obsession subtypes and aggression total and subtypes was evaluated. Hostility (p=0.004), anger (p=0.034), verbal aggression (p=0.002) and total aggression scores (p=0.017) were significantly higher in patients with aggression obsessions. Hostility (p=0.021) and aggression total scores (p=0.043) were significantly higher in patients with contamination obsession. Anger total scores of patients with hoarding obsessions (p=0.025) and symmetry obsessions (p=0.023) were found to be significantly higher. Anger levels of patients with counting compulsions (p= 0.038) were significantly higher. Anger levels (p= 0.047) and verbal aggression levels (p= 0.018) were significantly higher in patients with hoarding compulsion. A positive and significant correlation was found between the levels of total obsession score and total aggression scores (p=0.038 r= 0.222). However there was no significant correlation between the total compulsion score and the total aggression score.

The impact of the prolonged COVID-19 pandemic on adolescents with eating disorders: a follow-up study from Türkiye.

At the onset of the pandemic, we conducted a study on adolescents with eating disorders (EDs) and found no deterioration in ED symptoms. The objective of this subsequent study was to conduct a follow-up evaluation of the same cohort and investigate the consequences of the prolonged pandemic. This longitudinal study was conducted one year after the first study between May 2021 and June 2021 with 37 adolescents aged 12-18 years (pre-existing EDs). The reassessment included an evaluation of sociodemographic and clinical characteristics, the impact of pandemic-related restrictions on ED behaviors, well-being, and quality of life. All the participants underwent a re-administration of the ED examination questionnaire (EDE-Q), Beck Depression Inventory, the State Anxiety Inventory for Children, and the Maudsley Obsessive Compulsive Inventory. No significant difference was observed in the EDE-Q scores or the ED examination questionnaire scores between the initial (T1) and subsequent (T2) study. The ED-related quality of life was seen to have slightly improved in the later stage. While depression (T1: 18, T2: 15, p=0.883) and obsession scores (T1: 11, T2: 14, p: 0.536) showed no disparity between the studies, anxiety scores (T1: 38, T2: 43, p:0.011) exhibited a significant increase. Consistent with the early phase, no exacerbation of ED symptoms in adolescents was observed during the later stages of the pandemic. Close clinical monitoring during the pandemic might have been protective against the deteriorating effects of the pandemic. During social isolation, it is important to monitor adolescents with EDs continously for depression and anxiety.

The role of life events in obsessive-compulsive disorders

Background: A small number of studies are available to assess the role of stressful life events (SLEs) in obsessive-compulsive disorder (OCD). The previous studies have reported contradictory results and they have methodological limitations. Aims and Objectives: The objectives of our study are (i) to find out the frequency of life events in patients with OCD in comparison to their matched healthy controls and (ii) to find out the impact of life events on the severity of the disorder. Materials and Methods: Sixty patients fulfilling Diagnostic and Statistical Manual of Mental Disorder, 5th edition (DSM-V) criteria of OCD were rated with Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Hamilton Rating Scale for Anxiety (HAM-A), Hamilton Rating Scale for Depression (HAM-D), and Presumptive Stressful Life Events Scale (PSLES). A group of 60 normal controls were also rated on PSLES. Finally, both groups were compared in terms of life events. Results: The frequency of life events, past 1 year (t=5.307, P=0.006) and lifetime (t=11.527, P<0.001), were significantly higher in the patient group in comparison to controls. PSLES scores showed asignificant correlation with Y-BOCS total scores, Y-BOCS obsession scores, and HAM-A scores. There was a positive correlation between past 1 year PSLES score and HAM-D scores. Step-wise linear regression analysis showed PSLES scores significantly positively predicted Y-BOCS total score, Y-BOCS obsession score, and Y-BOCS compulsion score. Conclusion: Life events were significantly more frequent in OCD patients both past 1 year and lifetime, as compared to healthy controls. The severity of obsessive compulsive symptoms was found to be directly proportional to the number of SLEs experienced in the past 1 year and lifetime.

Study on symptom dimensions and clinical characteristics in patients with obsessive-compulsive disorder.

The aim of this study was to explore the symptom dimensions and clinical characteristics of obsessive-compulsive disorder in the context of Chinese culture. In this cross-sectional study, the severity of obsessive-compulsive symptoms, the distribution of symptoms, and symptom scores of 263 patients with obsessive-compulsive disorder were assessed using the Yale-Brown Obsessive-Compulsive Scale and Yale-Brown Obsessive-Compulsive Inventory Symptoms Checklist. System cluster analysis and Pearson analysis were performed to explore the relationships between the main clinical characteristics and symptom dimensions. Cluster analysis identified four symptom dimensions of obsessive-compulsive disorder: (1) symmetry precision; (2) contamination cleaning; (3) aggression examination; and (4) taboo thinking. The symmetry precision dimension showed an association with years of education. The compulsive score, total Yale-Brown Obsessive Compulsive Scale score, contamination cleaning dimension, and aggression examination dimension had significant relationships. Age, age at onset, obsessive score, and compulsive score had a significant correlation with the taboo-thinking dimension. The symptom dimensions of obsessive-compulsive disorder in China are similar to those in other regions. Each of the four symptom dimensions had distinct clinical characteristics.

Hyperconnecitivity between dorsal attention and frontoparietal networks predicts treatment response in obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) presented with repetitive obsessions and/or compulsions were associated with disrupted resting-state functional connectivity (rs-FC). To investigate the pharmacological treatment effect on rs-FC changes in OCD patients we conducted the seed-to-voxel FC analyses using dorsal attention network (DAN), default mode network (DMN), salience network (SN) and frontoparietal network (FPN) and basal ganglia seeds. Twenty-two healthy subjects and twenty-four unmedicated OCD patients underwent resting-state functional magnetic resonance imaging. Patients were rescanned after 12 weeks of escitalopram treatment. We found increased FC both within the DAN and between the DAN and the FPN which was ameliorated after medication and correlated significantly with the clinical improvement in obsession scores. We also observed an anticorrelation between the left caudate and the supplementary motor area in unmedicated OCD patients which also normalized with treatment. Results further showed treatment related normalization of orbitofrontal cortex hyperconnectivity with DMN and hypoconnectivity with DAN whereas aberrant FC between the SN and visual areas appears to be a medication effect. We suggest that DAN to FPN hyperconnectivity which is positively correlated with clinical improvement in obsession scores at pre-treatment stage in present study has a potential for being a neuroimaging marker to predict the treatment response in OCD.

Alexithymia, resilience and suicidal ideation among patients with obsessive–compulsive disorder

BackgroundObsessive–compulsive disorder (OCD) is a psychiatric illness with a considerable risk of alexithymia, and suicide may make this risk worse. This study aimed to assess alexithymia, resilience, and suicidal ideation among patients with obsessive–compulsive disorder. A cross-sectional study was established at the psychiatric outpatient clinic at Zagazig University Hospitals in addition to Abbasyia Hospital for Mental Health in Cairo City. A purposive sample of 140 obsessive–compulsive patients. Five tools were used for data collection, including the socio-demographic questionnaire, the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Toronto Alexithymia Scale (TAS-20), the Resilience Scale, and the Scale for Suicidal Ideation (SSI).ResultsThe study findings demonstrated that in excess of two-thirds of the studied subjects had mild obsessive–compulsive disorder, slightly more than two-thirds of them suffered from alexithymia, more than half of patients had a moderate level of resilience, and the majority of them had suicidal ideation. Patients’ obsessive–compulsive score was a statistically significant positive predictor for suicidal ideation.ConclusionsA positive and significant correlation was found between patients’ obsessive–compulsive scores and both alexithymia and suicidal ideation scores. Negatively significant correlations were found between resilience and each patient’s obsessive–compulsive score, alexithymia, and suicidal ideation. Therefore, it is recommended implementing longitudinal studies to establish the causality between OCD Sufferers’ resilience, alexithymia, and ideations of suicide.

Decision-making deficits in obsessive-compulsive disorder are associated with abnormality of recency and response consistency parameter in prospect valence learning model.

Patients with obsessive-compulsive disorder (OCD) have deficits in decision-making in the Iowa Gambling Task (IGT). However, no study has investigated the parameters of the prospect valence learning (PVL) model in the IGT for OCD. This study aimed to investigate deficits in decision-making in OCD using the PVL model and identify whether the parameters of the PVL model were associated with obsessive-compulsive severity. Forty-seven medication-free patients with OCD were compared with 47 healthy controls (HCs). Decision-making was measured using the total net and block net scores of the IGT. A PVL model with a decay-reinforcement learning rule (PVL-DecayRI) was used to investigate the parameters of the model. Correlation analysis was conducted between each parameter of the PVL-DecayRL and obsessive-compulsive symptoms. The total net score of patients with OCD was significantly lower than that of the HCs. The block net scores of the OCD group did not differ across the five blocks, whereas in the HCs, the fifth block net score was significantly higher than the block net scores of the first and second blocks. The values of the recency and response consistency parameters of the PVL-DecayRI in patients with OCD were significantly lower than those in HCs. The recency parameter positively correlated with the Y-BOCS obsessive score. Meanwhile, there was no correlation between consistency parameter values and symptom severity in OCD. Our detailed analysis of the decision-making deficit in OCD suggests that the most recent outcome has a small influence on the expectancy of prospect valence, as indicated by the lower recency parameter, and is characterized by more impulsive choices, as indicated by the lower consistency parameter.

Cognitive inflexibility is linked to abnormal frontoparietal-related activation and connectivity in obsessive-compulsive disorder.

Although it was acknowledged that patients with obsessive-compulsive disorder (OCD) would exhibit cognitive inflexibility, the underlying neural mechanism has not been fully clarified. Therefore, this study aimed to investigate the neural substrates involved in cognitive inflexibility among individuals with OCD. A total of 42 patients with OCD and 48 healthy controls (HCs) completed clinical assessment and functional magnetic resonance imaging (fMRI) data collection during cued task switching. Behavioral performances and fMRI activation were compared between the OCD group and the HC group. Psychophysiological interactions (PPIs) analyses were applied to explore functional connectivity related to task switching. Pearson correlation was used to investigate the relationships among behavioral performance, fMRI activity, and obsessive-compulsive symptoms in OCD. The OCD group had a greater switch cost than HCs (χ2 = 5.89, p < .05). A significant difference in reaction time was found during switch (χ2 = 17.72, p < .001) and repeat (χ2 = 16.60, p = .018) between the two groups, while there was no significant difference in group accuracy. Comparison of group differences showed that the OCD group had increased activation in the right superior parietal cortex (rSPL) during task switching, and exhibited increased connectivity of frontoparietal network/default mode network (FPN-DMN; i.e., middle frontal gyrus [MFG]/inferior parietal cortex-precuneus, MFG-middle/posterior cingulate gyrus) and within the FPN (inferior parietal cortex-postcentral gyrus). In the OCD group, the compulsion score was positively correlated with accuracy during switch (r = .405, p = .008, FDRq <.05), and negatively correlated with activation of rSPL (r = -.328, p = .034, FDRq >.05). Patients with OCD had impaired cognitive flexibility and cautious response strategy. The neural mechanism of cognitive inflexibility in OCD may involve increased activation in the rSPL, as well as hyperconnectivity within the FPN and between the FPN and DMN.

Abnormal voxel-mirrored homotopic connectivity in first-episode, drug-naïve patients with obsessive-compulsive disorder.

Prior studies suggest that obsessive-compulsive disorder (OCD) can cause both anatomical and functional variations in the brain, but to date, altered functional synchronization between two functional hemispheres remains unclear in OCD patients. Voxel-mirrored homotopic connectivity (VMHC) is defined as the temporal correlation of spontaneous low-frequency blood oxygenation level-dependent signal fluctuations across mirror regions of hemisphere revealing the homotopic connectivity between each voxel in one hemisphere and its mirrored counterpart in the contralateral hemisphere. To investigate the alterations of brain regional function and VMHC in patients with OCD, the current study enrolled 103 OCD patients and 118 healthy controls, undergoing resting-state functional magnetic resonance imaging. Compared to healthy controls (HCs), patients had decreased VMHC in bilateral cerebellum, lingual and fusiform gyrus; bilateral paracentral lobule, pre and postcentral gyrus; and bilateral superior and middle temporal gyrus, putamen and bilateral precuneus without global signal regression. And we found mostly similar results after regressing global signals; apart from the regions mentioned above, decreased in bilateral cuneus and calcarine was also showed. Furthermore, the mean VMHC values of the left cerebellum were negatively correlated with the obsession scores (ρ = -.204, π = .039). The decreased values in right fusiform and putamen were negatively correlated with duration of disease (ρ = -.205, π = .038; ρ = -.196, π = .047). We confirmed a significant VMHC reduction in OCD patients in broad areas. Our findings suggest that the patients tend to disconnect information exchange across hemispheres.

Investigation and Analysis on Occupational Exposure Causes and Mental Status of Infectious Diseases in Pre-Hospital Emergency Medical Personnel.

We aimed to probe into the occupational exposure causes and mental status of infectious diseases in pre-hospital emergency medical personnel. Forty medical personnel with occupational exposure to infectious diseases who participated in pre-hospital emergency work in 120 emergency center of The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China were selected as respondents from February 2018 to February 2021. The occupational exposure modes, exposure degrees, exposure sites, exposure sources and exposure causes of infectious diseases were summarized, and the mental status of emergency medical personnel after occupational exposure to infectious diseases was analyzed. In the occupational exposure modes of infectious diseases, needle stick injuries were overtly higher than mucosal pollution, hematic and humoral pollution and incised wound by glass (P<0.05). In exposure degrees, slight bleeding was notably higher than excessive bleeding, bleeding and no bleeding (P<0.05). The hand was distinctly higher than the eye in exposure sites (P<0.05). In exposure sources, hepatitis B virus was visibly higher than hepatitis C virus, HIV, syphilis, intravenous drug, hemorrhagic fever and unknown cause (P<0.05). The scores of somatic symptoms, anxiety, depression, fear, interpersonal sensitivity, hostility, compulsion and paranoia in medical personnel were clearly higher than the norm in Chinese adults after occupational exposure to infectious diseases (P<0.05), with no statistical significance in the comparison of psychotic scores. The occupational exposure risk of infectious diseases among pre-hospital emergency medical personnel is high. It is necessary to strengthen pre-job training and education and improve standardized management for protection.

Abnormal resting-state effective connectivity in large-scale networks among obsessive-compulsive disorder.

Obsessive-compulsive disorder (OCD) is a chronic mental illness characterized by abnormal functional connectivity among distributed brain regions. Previous studies have primarily focused on undirected functional connectivity and rarely reported from network perspective. To better understand between or within-network connectivities of OCD, effective connectivity (EC) of a large-scale network is assessed by spectral dynamic causal modeling with eight key regions of interests from default mode (DMN), salience (SN), frontoparietal (FPN) and cerebellum networks, based on large sample size including 100 OCD patients and 120 healthy controls (HCs). Parametric empirical Bayes (PEB) framework was used to identify the difference between the two groups. We further analyzed the relationship between connections and Yale-Brown Obsessive Compulsive Scale (Y-BOCS). OCD and HCs shared some similarities of inter- and intra-network patterns in the resting state. Relative to HCs, patients showed increased ECs from left anterior insula (LAI) to medial prefrontal cortex, right anterior insula (RAI) to left dorsolateral prefrontal cortex (L-DLPFC), right dorsolateral prefrontal cortex (R-DLPFC) to cerebellum anterior lobe (CA), CA to posterior cingulate cortex (PCC) and to anterior cingulate cortex (ACC). Moreover, weaker from LAI to L-DLPFC, RAI to ACC, and the self-connection of R-DLPFC. Connections from ACC to CA and from L-DLPFC to PCC were positively correlated with compulsion and obsession scores (r = 0.209, p = 0.037; r = 0.199, p = 0.047, uncorrected). Our study revealed dysregulation among DMN, SN, FPN, and cerebellum in OCD, emphasizing the role of these four networks in achieving top-down control for goal-directed behavior. There existed a top-down disruption among these networks, constituting the pathophysiological and clinical basis.

L-theanine combination therapy with fluvoxamine in moderate-to-severe obsessive-compulsive disorder: a placebo-controlled, double-blind, randomized trial.

The main aim of this study was to investigate the additional effects of L-theanine, an amino acid in tea and an analog of glutamate with neuroprotective and anti-depressant properties, on obsessive-compulsive disorder (OCD) symptoms in combination with fluvoxamine. Patients from either sex aged between 18-60 years diagnosed with OCD, based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), who had a Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score of more than 21 were enrolled in a double-blinded, parallel-group, placebo-controlled, clinical trial of 10 weeks to receive either L-theanine (100 mg twice daily) and fluvoxamine (100 mg daily initially followed by 200 mg daily after week 5) or placebo and fluvoxamine. The primary outcome of interest in this study was the Y-BOCS total score decrease from baseline. From a total of 95 evaluated patients, 50 completed our study; 30 were randomly assigned to each group. Multivariate analysis (ANOVA) showed a significant effect of time × treatment for L-theanine in obsession subscale (F = 5.51, p-value = 0.008) of the Y-BOCS score but not in the total and compulsion scores. Our results showed significantly more improvement in obsession subscale scores in L-theanine compared to placebo group (p = 0.007, Cohen's d = 0.82). Also, total Y-BOCS scores were lower in L-theanine compared to placebo group at week 5 (p = 0.039, Cohen's d = 0.60) and 10 (p = 0.008, Cohen's d = 0.80). However, there was no significant between-group differences in compulsion subscale scores. Complete response was also more frequent in the L-theanine group (p = 0.0001). Findings in this study suggest L-theanine as a relatively safe and effective adjuvant therapy for moderate to severe OCD. This article is protected by copyright. All rights reserved.

Resting-state fMRI functional connectivity and clinical correlates in Afro-descendants with schizophrenia and bipolar disorder

Schizophrenia (SCZ) and bipolar disorder (BD) exhibited altered activation in several brain areas, including the prefrontal and temporal cortex; however, a less explored topic is how brain connectivity and functional disturbances occur in non-Caucasian samples of SCZ and BD. Individuals with SCZ (n=20), BD (n=21), and healthy controls (HC, n=21) from indigenous and African ethnicity were submitted to clinical screening and functional assessments. Mood, compulsive and psychotic symptoms were also correlated to network dysfunction in each group. Two distinct networks' subcomponents demonstrated significant lower global efficiency (GE) in SCZ versus HC, corresponding to left posterior dorsal attention and medial left ventral attention (VA) networks. Lower GE was found in BD versus controls in four subcomponents, including the left medial and right VA. Higher compulsion scores correlated in BD with lower GE in the left VA, whereas increased report of alcohol abuse was associated with higher GE in left default mode network. Although preliminary, differences in the activation of specific networks, notably the left hemisphere, in SCZ versus controls, and lower activation in VA areas, in BD versus controls. Results highlight default mode and salient network as relevant for the emotional processing of SCZ and BD of indigenous and black ethnicity.Abstract: schizophrenia, bipolar disorder, functional neuroimaging, ethnicity, default network

Influences of Comprehensive Psychological Intervention on the Psychological Behavior Problems and Learning Adaptability of Students at Age of 6-12 Years Old.

The age of 6-12 yr show different degrees of learning adaptability problems. We aimed to explore the influence of comprehensive psychological intervention on the psychological behavior problems and learning adaptability of students at age of 6-12 yr old. In March 2022, 768 students were selected from two primary schools in Harbin of China, and divided into control and observation groups. The changes in the scores of Achenbach Child Behavior Checklist (CBCL) for parent use and Mental Health Rate Scale for Pupil (MHRSP), and self-cognitive ability and learning adaptability level before and after the intervention were compared between the two groups. After the intervention, the discipline violation, hostility, compulsion, immaturity, evil communication, schizoid personality, and physical symptom scores in the observation group (boys) were reduced compared with those before the intervention. In comparison with the situation before the intervention, the cruelty, aggression, immaturity, depression and withdrawal, physical symptom, anxiety, and compulsion scores in the observation group (girls) were reduced, and the CBCL scores were improved better than those in the control group (P<0.05). In comparison with the situation before the intervention, the scores of MHRSP, self-cognitive ability, and learning adaptability score and level in the observation group were elevated after the intervention, and the above scores were improved obviously to a greater extent than those in the control group (P<0.05). Comprehensive psychological intervention can effectively improve the psychological behavior problems of children at the age of 6-12 yr, and enhance their self-cognitive ability and learning adaptability.

Analysis of the Clinical Effect of Visual Electrophysiological Examination Combined with Targeted Health Education Nursing in Children.

To analyze the clinical effect of visual electrophysiological examination combined with targeted health education nursing in children. A total of 100 children who underwent visual electrophysiological examinations in the Ophthalmology Department of our hospital from March 2019 to March 2021 were selected as the study subjects. The children were randomly divided into two groups, the control group and the observation group, with 50 children in each group. Children in the control group received routine nursing, while those in the observation group received a combination of routine nursing and targeted health education nursing. The nursing satisfaction, degree of cooperation with examination, examination time, changes in the psychological state, and the stress response of the children and their families were then compared and analyzed. The nursing satisfaction of the observation group was higher than that of the control group (94.0% vs. 80.0%) (P < 0.05). The degree to which children in the observation group cooperated with examination was higher than that of children in the control group (96.0% vs. 78.0%) (P < 0.05). The average time spent on VEP and ERG examinations by children in the observation group was 6.33 ± 1.37 hours and 55.25 ± 4.92 hours, respectively, significantly lower than that of 12.45 ± 1.02 hours and 70.36 ± 5.31 hours, respectively, spent by children in the control group (P < 0.05). After intervention, the depression, hostility, anxiety, and obsession scores of children in the observation group were all significantly lower than those of children in the control group (P < 0.05). There was an increase in the heart rate, respiratory rate, and mean arterial pressure in children from both groups, but the magnitude of increase in the observation group was much smaller than that in the control group (P < 0.05). The combination of visual electrophysiological examination and targeted health education nursing in children has a remarkable clinical effect. It improves the children's degree of comfort as well as the parents' degree of satisfaction. It also reduces the time spent on examinations, facilitates the smooth completion of examinations, and improves the efficiency of examinations. This nursing method is one that merits more widespread promotion and clinical application.

Granisetron-mediated augmentation of sertraline therapeutic effect in obsessive-compulsive disorder: a double-blind placebo-controlled, randomized clinical trial

BackgroundMedications currently recommended for the treatment of Obsessive-Compulsive Disorder (OCD) usually relieve the severity of symptoms by as much as 20–30%, and satisfactory treatment is obtained in 40–60% of patients with OCD. Nevertheless, the remaining symptoms continue to impair the patients’ function. Therefore, it is necessary to investigate possible strategies to improve the mitigation of symptoms. In this study, the main objective was to examine and investigate the effectiveness of granisetron, which is a serotonin 5-hydroxytryptamine receptor type 3 (5-HT3) antagonist, as an adjunct therapy to selective serotonin reuptake inhibitors, for the purpose of ameliorating OCD symptoms.Methodsfifty-eight patients diagnosed with OCD, based on Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, who had a Yale-Brown obsessive-compulsive scale (Y-BOCS) score of more than 21 were recruited in a double-blinded, parallel-group, placebo-controlled, clinical trial of 10 weeks to receive either granisetron (1 mg twice daily) and sertraline (100 mg daily initially followed by 200 mg daily after week 4) or placebo and sertraline. The primary outcome was OCD symptoms measured by the Y-BOCS.ResultsY-BOCS total score significantly dropped in both groups (28.9 to 17.7 for granisetron plus sertraline and 27.5 to 19.3 for placebo plus sertraline group with a slightly greater drop for granisetron plus sertraline group), while the granisetron plus sertraline group experienced a significantly greater reduction in obsession scores (Greenhouse-Geisser F(2.32,97.57) = 4.52,p-value = 0.01). Moreover, in comparison with the placebo plus sertraline group, the proportion of the patients showing complete response was considerably higher among the granisetron plus sertraline group (P-value < 0.01). No major adverse effects were observed in any of the groups.ConclusionThe results suggest that granisetron augmentation of sertraline may increase the rate of response in patients with moderate to severe non-refractory OCD. Further studies are suggested in this regard.

Neurological and Psychiatric Disorders in Patients with Rheumatic Heart Disease: Unveiling what is Beyond Cardiac Manifestations.

Background:Rheumatic heart disease (RHD) is the most serious manifestation of rheumatic fever, which may also affect the brain. The current study assessed the prevalence of neuropsychiatric manifestations in patients with RHD, including clinical features associated with basal ganglia motor dysfunction (BGMD).Methods:We conducted neurologic and psychiatric assessments in consecutive patients with RHD referred to a tertiary center for heart valve diseases. Echocardiography was performed to assess the pattern of valvular involvement and RHD severity. Validated questionnaires for the evaluation of cognition, depression, anxiety, and obsessive-compulsive symptoms (OCS) were applied. BGMD was clinically defined by the presence of hyperkinetic movement disorders.Results:Fifty patients with age of 43.2 ± 10.8 years, 84% female, were included. Mitral valve was affected in 47 patients (94%), and 21 of them (42%) also had aortic valve involvement. Chorea (22%), chronic tics (18%), OCS (48%), major depression (34%), generalized anxiety disorder (54%), cognitive complaints (66%), migraine (52%) and seizures (18%) were frequently reported. The factors associated with BGMD were age (p = 0.018), major depression (p = 0.013), and Yale-Brown Obsessive Compulsive (Y-BOCS) score (p = 0.011). The severity of heart disease was not associated with BGMD.Conclusions:Neuropsychiatric manifestations are frequent in RHD patients, which may persist up to three decades after acute rheumatic fever. Age, major depression and severity of OCS were independently associated with BGMD. These manifestations deserve a close attention of clinicians and researchers dealing with adult patients with RHD.

A dimensional approach to affective disorder: The relations between Scl-90 subdimensions and QEEG parameters.

ObjectivesQEEG reflects neuronal activity directly rather than using indirect parameters, such as blood deoxygenation and glucose utilization, as in fMRI and PET. The correlation between QEEG spectral power density and Symptom Check List-90-R may help identify biomarkers pertaining to brain function, associated with affective disorder symptoms. This study aims at determining whether there is a relation between QEEG spectral power density and Symptom Check List-90-R symptom scores in affective disorders.MethodsThis study evaluates 363 patients who were referred for the initial application and diagnosed with affective disorders according to DSM-V, with QEEG and Scl-90-R. Spectral power density was calculated for the 18 electrodes representing brain regions.ResultsSomatization scores were found to be correlated with Pz and O1 theta, O1 and O2 high beta. Whereas FP1 delta activities were correlated with anxiety, F3, F4, and Pz theta were correlated with obsession scores. Interpersonal sensitivity scores were found to be correlated with F4 delta, P3, T5, P4, T6 alpha and T5, and T6 theta activities. While depression scores were correlated with P3 and T4 delta, as well as T4 theta, there was a correlation between anger and F4, as well as T4 alpha and F8 high beta activities. Paranoia scores are correlated with FP1, F7, T6 and F8 theta, T5 and F8 delta, and O2 high beta activities.ConclusionsAccording to our results, anxiety, obsession, interpersonal sensitivity, depression, anger, and paranoia are related to some spectral powers of QEEG. Delta-beta coupling seems to be a neural biomarker for affective dysregulation.

Impact of Attention-Deficit/Hyperactivity Disorder Comorbidity on Phenomenology and Treatment Outcomes of Pediatric Obsessive-Compulsive Disorder.

Objective: This study, with a case-control design, investigates the impact of attention-deficit/hyperactivity disorder (ADHD) comorbidity on the phenomenology and treatment outcomes in a clinical sample of pediatric obsessive-compulsive disorder (OCD). Methods: The data were derived from an evaluation of the sociodemographic and clinical characteristics of 364 children with OCD who were regularly followed up over a 4-year period. Between-group analyses of psychiatric scales were used to compare patients with ADHD comorbidity (n = 144, 39.5%) with their ADHD-free opponents. The clinical course and treatment outcomes of each patient were evaluated based on 4-year clinical follow-up data. Results: Substantial clinical variations in pediatric OCD caused by ADHD comorbidity were identified, including a male preponderance, higher rates of concurrent conduct problems, tic disorders, and learning disabilities, as well as prolonged symptom and treatment durations accompanied by poor response to first-line treatments and higher rates of treatment resistance. Contrary to previous findings, ADHD comorbidity had no impact on the age of OCD onset, and the severity of OCD symptoms was lower in ADHD. With ADHD comorbidity, the OCD symptom course tended to be chronically stable, which may have resulted in complaints persisting into adulthood. In ADHD-free patients, contamination, doubt, religious, somatic obsessions, and cleaning were all more common than in those with ADHD. There was a positive correlation between compulsion scores and the severity of ADHD symptoms, which may be related to increased compulsive coping in ADHD. Impulsivity or compulsivity dominance in the symptom presentation of OCD-ADHD comorbidity may determine phenomenological distinctions such as whether concurrent traits are more prone to tics, conduct problems, or internalizing problems. The primordial associations for clinical characteristics, which were independently associated with ADHD comorbidity, were adjusted using multivariate logistic regression analysis. Clinical variables such as being male, absence of cleaning compulsion, the existence of concurrent conduct problems, tic disorders, and dyslexia, as well as longer treatment duration and poorer treatment response, were all independent predictors of ADHD comorbidity. With an 80.8% accurate classification and relatively fine goodness-of-fit model, the regression model consisting of those predictors had good predictiveness for ADHD comorbidity (R2 = 0.543). Conclusions: The close association between pediatric OCD, ADHD, and tic disorders can be defined as a specific subtype of pediatric OCD, characterized by more conduct problems, a chronically stable course of OCD symptoms, and poorer treatment outcomes. Correlational analyses in a longitudinal design and the inclusion of an impulsivity scale would be beneficial for further research to interpret the impulsivity-related correlates in the findings on tic and conduct problems.