Compulsive Score Research Articles

The eating attitudes, body image, and depression of Japanese female university students

We examined the interrelationship of eating attitudes, body-checking behavior cognition, and depression among Japanese female university students. The 197 student participants were divided, according to their Eating Attitudes Test (EAT-26) scores, into 3 groups: high (EAT-H), medium (EAT-M), and low (EAT-L). Body-checking behavior and depression scores were compared among the 3 groups, using a 1-way analysis of variance. Results showed that the EAT-L group had the lowest scores for objective verification, body control, and depression. Further, the obsessive thoughts body image score increased as scores on the EAT-26 did, indicating that inappropriate eating attitudes have a strong impact on obsessive thoughts. In addition, the EAT-M group had a higher reassurance–confidence score than that of the EAT-L group, and the EAT-H group had the highest scores for objective verification, obsessive thoughts, body control, and depression. Implications of the findings are discussed and directions for future research proposed.

Do Cyber Pornography Use Inventory-9 Scores Reflect Actual Compulsivity in Internet Pornography Use? Exploring the Role of Abstinence Effort

ABSTRACTThe present study aimed to explore whether scores on the Cyber Pornography Use Inventory-9 (CPUI-9) are reflective of actual compulsivity. We examined whether CPUI-9 scores are predicted by failed abstinence attempts and failed abstinence attempts × abstinence effort (conceptualized as actual compulsivity), controlling for moral disapproval. A group of 76 male Internet pornography users received instructions to abstain from Internet pornography for 14 days and to monitor their failed abstinence attempts. Greater Perceived Compulsivity scores (but not Emotional Distress scores) were predicted by abstinence effort, and failed abstinence attempts when abstinence effort was high. Moral disapproval predicted Emotional Distress scores, but not Perceived Compulsivity scores. Implications of the findings are discussed.

Intrinsic functional connectivity alteration of dorsal and rostral anterior cingulate cortex in obsessive-compulsive disorder: A resting fMRI study.

Cortico-striato-thalamo-cortical (CSTC) circuit has been implicated in OCD pathophysiology by converging neuroimaging findings. The anterior cingulate cortex (ACC), as an important part within CSTC circuit, plays a critical role in OCD etiology. The ACC can be divided into dorsal and rostral parts anatomically, which are involved in cognitive process and emotional function, respectively. However, the diverse function of intrinsic signals from dorsal and rostral ACC regions remains unclear in OCD study. In this work, we applied resting-state functional magnetic resonance imaging (rs-fMRI) technology to investigate and differentiate the functional connectivity (FC) characteristics between dACC and rACC in unmedicated OCD patients. Also, the correlation between the altered FC and clinical symptom severity was analyzed. Decreased FC of rACC-DLPFC and increased FC between dACC and caudate were found. Moreover, the altered dACC-caudate FC was positively correlated with total Y-BOCS and compulsion score in OCD patients. Our findings implied the crossed function of dorsal and rostral circuits in the pathophysiologic mechanism of OCD. The dorsal cingulate-striatum functional pathway served as a potential biomarker for OCD symptomatology and merits further investigations.

Effect of clozapine on psychiatric comorbidities in patients with schizophrenia

IntroductionClozapine has superior efficacy in treatment-resistant schizophrenia, and has various effects on psychiatric comorbidities, which may affect the illness course.AimsWe aimed to assess the past and current psychiatric comorbidities in schizophrenia patients treated with clozapine, and study their relationship with clinical variables.MethodsConsecutive 122 outpatients who met DSM-IV criteria for schizophrenia receiving clozapine were included. Information about past and current clinical status were gathered through a clinical interview and review of the medical records, along with laboratory test results. Patients were assessed with structured clinical interview for Axis-I Disorders for DSM-IV, Clinical Global Impression Scale, Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale, Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Panic and Agoraphobia Scale (PAS), WHO-Disability Assessment Schedule-II.ResultsThere was a significant decrease in the diagnosis of depression, alcohol and substance use disorder, number of suicide attempts, and an increase in the diagnosis of obsessive compulsive disorder (OCD) after clozapine initiation. Clozapine related de novo OCD appeared in 48.4% of the patients, and there was a positive correlation between Y-BOCS total scores and clozapine dose and plasma levels. In the de novo OCD group, compulsion scores were higher than obsession scores with checking most prevalent among compulsions. Total PANSS, Y-BOCS, PASscores were positively correlated withtotal disability score.ConclusionsClozapine seems to decrease comorbid depression, alcohol and substance use and number of suicide attempts and increase OCD. Assessment and treatment of psychiatric comorbidities in clozapine using schizophrenia patients is vital to decrease disability.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A model-based analysis of decision making under risk in obsessive-compulsive and hoarding disorders

Attitudes towards risk are highly consequential in clinical disorders thought to be prone to “risky behavior”, such as substance dependence, as well as those commonly associated with excessive risk aversion, such as obsessive-compulsive disorder (OCD) and hoarding disorder (HD). Moreover, it has recently been suggested that attitudes towards risk may serve as a behavioral biomarker for OCD. We investigated the risk preferences of participants with OCD and HD using a novel adaptive task and a quantitative model from behavioral economics that decomposes risk preferences into outcome sensitivity and probability sensitivity. Contrary to expectation, compared to healthy controls, participants with OCD and HD exhibited less outcome sensitivity, implying less risk aversion in the standard economic framework. In addition, risk attitudes were strongly correlated with depression, hoarding, and compulsion scores, while compulsion (hoarding) scores were associated with more (less) “rational” risk preferences. These results demonstrate how fundamental attitudes towards risk relate to specific psychopathology and thereby contribute to our understanding of the cognitive manifestations of mental disorders. In addition, our findings indicate that the conclusion made in recent work that decision making under risk is unaltered in OCD is premature.

Effectiveness of cognitive behavioral therapy and fluoxetine on sexual function of women with obsessive compulsive disorder: A double-blind randomized controlled trial.

BackgroundObsessive compulsive disorder (OCD) is a mental health concern due to its various negative consequences, especially in sexual function. Therefore, the treatment of sexual dysfunction in women with OCD is important in order to improve the patient’s marital function and mental health.ObjectivesTo compare the sexual behavior and sexual and marital satisfaction in women with obsessive-compulsive disorder (OCD) before and after treatment with fluoxetine and cognitive behavior therapyMethodsThis randomized clinical trial was conducted at psychiatric and psychological counseling centers in Kashan (Iran) from January 2, 2014, to December 29, 2014. Fifty-eight women with OCD were included in the study. In order to compare the effectiveness of pharmacological treatment (fluoxetine) and psychological treatment, cognitive behavior therapy (CBT), 58 female patients with OCD (diagnosed based on DSM-IV-T criteria) were randomized equally to either fluoxetine (at a dose of 60–80 mg daily for 3 months) or CBT (10 45-minute sessions). OCD and sexual behavior status of the patients before and after the intervention was assessed with the Yale–Brown Obsessive Compulsive Scale (Y-BOCS) and Female Sexual Function Index (FSFI) questionnaire, respectively. The data were analyzed using SPSS version 22. To compare changes between the two groups, an independent T-test was used. Finally, the effects of all potential factors on treatment outcome were analyzed using factorial ANCOVA.ResultsThe mean score for OCD in the fluoxetine group was 25.6 ± 4.8 at the beginning of the experiment and 18.79 ± 4.26 at the end of the study, while in the CBT group it was 25.6 ± 4.8 and 18.79 ± 4.26, respectively. No significant differences were found between two groups regarding obsession score changes. These scores in fluoxetine group were 58.1 and 52.8, respectively (p=0.046). There was a significant difference between the two groups in terms of sexual performance (p=0.003).ConclusionIn this study, our findings demonstrate a significant reduction in symptom severity of OCD after treatment with fluoxetine and CBT, indicating CBT can be an alternative for fluoxetine therapy in such patients. Therefore, both pharmacotherapy and CBT can be used for this purpose in clinical practices, but more studies are needed.Clinical trial registrationThe trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT2013091014619N1.FundingThe authors received no financial support for the research, authorship, and/or publication of this article.

Impact of cognitive-behavioral group therapy for obsessive-compulsive disorder on family accommodation: A randomized clinical trial.

The aim of this study was to assess the impact of cognitive-behavioral group therapy (CBGT) with the brief involvement of family members on family accommodation and to identify predictors of family accommodation reduction (patient and family member characteristics). This randomized clinical trial assessed 98 pairs of patients with obsessive-compulsive disorder (OCD) and their family members: 52 (53.1%) were allocated to the intervention group (12 CBGT sessions - two with the family member), and 46 (46.9%) to a waiting list (control group). Symptom severity and family accommodation were assessed before and after CBGT. There was significant improvement of OCD symptoms and family accommodation scores after CBGT in the intervention group vs. the control group. The following variables were significant predictors of family accommodation reduction after multivariate analysis: patient characteristics - absence of comorbid unipolar disorder, lower obsession score, and higher education level; family member characteristics - higher hoarding score. The model explained 47.2% of the variance in family accommodation scores after treatment. CBGT for patients with OCD and the brief involvement of family members contributed to reduce family accommodation. Both patient and family member characteristics were predictors of family accommodation reduction. This finding can help qualify CBGT protocols.

Exploring yale-brown obsessive-compulsive scale symptom structure in Iranian OCD patients using item-based factor analysis.

Obsessive compulsive disorder (OCD) is a heterogeneous psychiatric disorder. This study aimed to reach a comprehensive perspective of OCD symptoms in Iranian patients. Item-based factor analysis of Y-BOCS checklist from 216 outpatients resulted in five factors including aggression/checking, contamination/cleaning, symmetry/ordering/repeating/counting/hoarding, sexual and somatic. Regression analyses showed that miscellaneous items can be predicted by these factors. Results showed that OCD subtypes in Iranian patients resemble to those of other nations except the aggressive, sexual and religious obsessions; demonstrating the influence of the culture on obsession manifestation. The correlation analyses of factors and clinical characteristics demonstrated that aggression/checking was associated with high obsession scores and more avoidance. Contamination/cleaning was correlated with higher compulsion score. Patients with higher scores on symmetry/ordering/counting/repeating/hoarding had familial OCD pattern with earlier age of onset, lower age at assessment, higher obsession and more avoidance. Sexual factor was associated with less compulsion scores and somatic factor was associated with higher obsessions and compulsions as well as less familial history and more avoidance. These findings provide a comprehensive view of OCD symptom structure in Iranian OCD patients and will be of value to studies using symptom factor to lead investigation of its causes, correlates and treatment strategies considering cross-cultural differences.

Men at Risk of HIV: Sexual Sensation Seeking, Sexual Compulsivity and Sexual Risk Behavior Among Australian MSM Who Frequently Present for Post-Exposure Prophylaxis

ABSTRACTThe increase in Australian Human Immunodeficiency Virus (HIV) infections since the 1990s is considered to be due to a subgroup of MSM (men who have sex with men) who engage in behaviors that increase the risk of sexual transmission of HIV. A population of MSM at risk are those who present for PEP (Post-Exposure Prophylaxis). In this article, data from a sample of N = 23 MSM who repeatedly attended an Australian PEP program and sought psychological assistance regarding sexual risk taking are examined. Findings revealed the current sample had more sexual risk behaviors than those of the wider MSM population and had higher Sexual Compulsivity (SC) and Sexual Sensation Seeking (SSSS) scores than previous samples of gay men, along with the finding that SC and SSSS were positively associated with sexual risk taking. Unfortunately, sexual behavior syndromes may be resistant to change, leaving affected MSM at ongoing risk of HIV. If these data can be replicated with larger samples, they point to the value of offering psychological care to affected PEP recipients, and to the role PreP (Pre-Exposure Prophylaxis) may play in providing a safety net against transmission until behavior change occurs.

The Impact of Psychological Factors on Device Removal Surgery.

BackgroundImplant removal is a common procedure in orthopedic surgery which can be associated with many complications such as scar formation, hematoma, nerve injury, infection, and refracture. Indications for orthopedic implant removal have declined in recent years. Most studies have considered orthopedic hardware removal as an unnecessary procedure in the absence of severe complications such as nonunion. Some studies have reported the complications of orthopedic hardware removal to be 24% to 50% dependent on their types and locations as well as on other factors such as patient’s condition and the orthopedist’s experience.ObjectivesThe present study surveyed possible mental and psychological causes among patients who asked for removal procedures in spite of orthopedic surgeons’ advice and being aware of complications.Patients and MethodsPatients who had undergone plating for the treatment of radius and ulna fractures from 2011 to 2013, were told that it is not necessary to remove the plate and they were warned of all the risks of removal surgery, such as anesthesia, possible nerve or vascular damage, and the cost of surgery. Then, their tendency to remove the plate was examined based on evaluation criteria scores. Patients were divided into two groups: patients who insisted on surgery despite all the risks and patients who had little tendency or gave up after explanations. Both groups were given visual analog pain scale (VAS), symptom checklist-90 (SCL-90), and pain catastrophizing scale (PCS) questionnaires. The questions were explained for patients by an expert trained in the clinic and in case of ambiguity further explanations were given to the patients. The data were then entered into statistical package for the social science (SPSS) version 20 for analysis.ResultsA total of 29 patients with plates were enrolled. The first group consisted of 16 male and 13 female patients. In the control group (group II), there were 30 patients with no tendency for plate removal. In this group, 15 patients were male and 15 were female. The mean age of the first group was 38.25 ± 11.12 years and for the second group it was 36.82 ± 12.01 years. There was no significant difference between the two groups in terms of age and gender. Mean discomfort of patients was 7.75 ± 1.74 in the first and 3.96 ± 1.90 in the second group, indicating a statistically significant difference (P = 0.000). Mean VAS score was 3.96 ± 1.20 in the first group and 3.80 ± 1.15 in the second group, which was not statistically significant (P = 0.593). Mean daily pain and discomfort was 10.62 ± 3.09 hours in the first and 4.86 ± 2.23 hours in the control group, indicating a statistically significant difference (P = 0.000). Linear regression analysis results demonstrated a significant correlation between increased VAS scores in the first group (P = 0.000), but it was not significant in the second group (P = 0.083). The results also showed that increase in time of daily pain and discomfort had a linear relationship with increased discomfort score in both groups (P = 0.00). Mean pain catastrophizing scale (PCS) score was 10.13 ± 3.62 in the first and 9.56 ± 3.07 in the second group, which was not statistically significant. Mean somatization score was 52% ± 6.53% and 47.96% ± 7.17% in the first and second groups, respectively, which showed no significant differences (P = 0.013). Obsessive compulsive score was 54.63 ± 5.34 in the first and 46.63 ± 4.49 in the second group, which was statistically significant (P = 0.000).ConclusionsMental and psychological backgrounds can affect the severity of discomfort of the implant. Given that so far the present study is the only study investigating the relationship between mental criteria and tendency of patients for implant removal, further studies with larger sample sizes seem warranted.

Application effect of TCM emotional nursing in patients with psoriasis

Objective To explore the influence of TCM emotional nursing on emotions, size of skin lesions and psoriasis area and severity index (PASI) in patients with psoriasis vulgaris. Methods A total of 86 out-patients with psoriasis vulgaris from June 2014 to August 2015 in Longgang District Central Hospital of Shenzhen were randomly divided into control group (43 cases, decoction for cooling blood + routine nursing) and experimental group (43 cases, decoction for cooling blood + TCM emotional nursing based on seven emotions) according to random number table method. Emotions and score of PASI were compared before and 6 weeks after intervention between two groups. Results After intervention, the score of PASI was (5.44±0.39) in experimental group which was significantly lower than that (6.53±0.29) in control group (P<0.05); the proportion of active stage, rest stage, catagen was 11.63%, 32.56%, 55.81% in experimental group which were better than those (20.93%, 46.51%, 32.56%) in control group with significant differences (P<0.05); the score of compulsion, somatization, interpersonal relationship, depression, terror, anxiety and total score in experimental group were lower than those in control group with significant differences (P<0.05). Conclusions TCM emotional nursing based on seven emotions has an important significance on promoting rehabilitation, relieving clinical symptoms and negative emotions in patients with psoriasis. Key words: Psoriasis; Emotion; TCM emotional nursing; Skin lesions; Severity level

Altered intrinsic insular activity predicts symptom severity in unmedicated obsessive-compulsive disorder patients: a resting state functional magnetic resonance imaging study.

BackgroundPrevious neuroimaging data indicated that the dysfunction in cortico-striato-thalamo-cortical (CSTC) circuit contributed to the neuropathological mechanism of obsessive-compulsive disorder (OCD). Whereas, emerging work has shown that the pathophysiology of OCD might be related to more widely distributed large-scale brain systems including limbic system and the salience network. This study aims to investigate the aberrant spontaneous neuronal activity within the whole brain, and its association with the symptom severity for unmedicated OCD patients.MethodTwenty-eight unmedicated OCD adults and twenty-eight matched healthy controls were recruited for a resting state functional magnetic resonance imaging (fMRI) study. The amplitude of low-frequency fluctuation (ALFF) analysis over whole brain was performed to examine the intrinsic cerebral activity of subjects. In addition, we conducted the voxel-based Pearson’s correlative analysis to probe into the relationship between ALFF values and symptom severity for OCD patients.ResultsOur results showed that OCD patients had increased ALFF measures in the left frontopolar cortex and left orbital frontal cortex (OFC), with decreased ALFF values in the right insula. Moreover, the right insular intrinsic activity was significantly correlated with total YBOCS score (r = 0.611, p = 0.002) and compulsion score (r = 0.640, p = 0.001) for OCD patients.ConclusionThe results showed abnormal intrinsic neuronal activity within CSTC circuit and salience network of OCD patients. Our finding of aberrant insular activity advanced the understanding of OCD pathophysiology beyond the traditional CSTC circuit. To the best of our knowledge, it is the first finding about a reduced insular activity at the resting state for unmedicated OCD patients, which might serve as an informative biomarker for OCD pathophysiology.

Vitamin D Deficiency in Obsessive-Compulsive Disorder Patients with Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections: A Case Control Study.

Previous studies have indicated that vitamin D deficiency is common in psychiatric patients, particularly in those with neuropsychiatric disorders such as autism and schizophrenia. Vitamin D is an important neurosteroid hormone and immunomodulatory agent that also has bone metabolic effects. There has been an increasing interest in immune-related neuropsychiatric symptoms that are triggered by group A beta-hemolytic streptococcal infections. In this study, we aimed to compare the serum levels of vitamin D between obsessive-compulsive disorder (OCD) patients with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and control subjects. Thirty-three OCD patients with PANDAS and 20 healthy controls were enrolled in the study. Serum 25-hydroxyvitamin D (25-(OH) D), calcium, phosphorus, alkaline phosphatase, and parathormone levels of the two groups were compared. Serum 25-(OH) D levels of <15 ng/mL were classified as vitamin D deficiency. The children's Yale-Brown Obsessive Compulsive Scale (YBOCS) and Clinical Global Impression (CGI) were used to assess the severity of OCD symptoms. There was no significant difference in serum 25-(OH) D levels between the patient and control groups. However, vitamin D deficiency was significantly more frequent in the patient group than in the control group (48.5% vs. 20.0%; p=0.038). Moreover, OCD patients with vitamin D deficiency had higher rates of comorbid ADHD than those without vitamin D deficiency (87.5% vs. 52.6%; p=0.027). While serum phosphorus levels were negatively correlated with age as well as alkaline phosphatase and ASO levels, they were positively correlated with the YBOCS total score and global severity score. Serum parathormone levels were positively correlated with the YBOCS total score, compulsion score, obsession score, and global severity score. This study supports the hypothesis that an association between vitamin D metabolism and PANDAS-related OCD exists. We suggest that biochemical parameters predicting metabolic bone diseases are more common in PANDAS patients. There is a need for prospective studies to show a clear association between PANDAS and bone metabolic turnover based on autoimmune mechanisms.

The Study of Use of Obsessive–Compulsive Drinking Scale, For Craving in Alcohol-Dependent Patients: Relationship to Alcoholism Severity

Background: Many clinicians and researchers believe that “craving” an abusable substance is a central phenomenon related to addiction. Craving for alcohol appears to be intimately related to the loss of control over consumption and to compulsive alcohol use. Aim: To compare the scores of obsessive compulsive drinking scale with visual analogue scale, severity of alcohol dependence questionnaire and addiction severity index. Materials and Methods: Literate patients who met DCR-ICD-10 criteria for alcohol dependence syndrome were taken in the study and they must have been drinking alcohol daily till 1 week ago and the subjects were required to consume at least 6 standard drinks per day over the last month. Instruments used in this study were Obsessive Compulsive Drinking Scale – OCDS, Severity of Alcohol Dependence Questionnaire – SADQ, Addiction Severity Index – ASI ,Visual Analogue Scale – VAS, Mini Mental Status Examination – MMSE, Timeline Method – TL. Results: Among 40 patients, the mean age of these patients was 38 yrs (38.55+ 9.60). 95% of them were Hindus and 5 % Christians. 82.5 % were married. And 50% of patients have the income between Rs.15000-20000 per month. The correlation matrix of OCDS variables (OCDS-T,OCDS-O,OCDS-C),ASI-A,SADQ,VAS variables(G,F,I) and TL on all four follow-ups were measured. All correlations were positive and significant at p&lt;0.001.obsessive compulsive drinking scale total score in 2 drinking outcome groups during 8 week treatment period was seen in which there is a difference between in two patient groups at baseline. i.e., abstinent group had lower score than relapse group. This difference was consistently observed between the groups over the entire period of follow-up. Conclusion: Craving was higher among those who relapsed than those who did not. Craving did predict high alcohol consumption and high index of severity at baseline and all through the follow-up.

Factors Associated with Depression in Obsessive-Compulsive Disorder: A Cross-Sectional Study.

Major depressive disorder (MDD) is the most frequent comorbid psychiatric condition associated with obsessive-compulsive disorder (OCD). This study aimed to evaluate the prevalence of current depression in OCD, differences in socio-demographic and clinical characteristics, and obsessive-compulsive symptoms between OCD patients with and without depression. Additionally, factors associated with comorbid depression were investigated in our study. In total, 140 OCD patients, of which 63 were OCD patients with MDD (OCD+MDD, n=63) and 77 were OCD patients without depression (OCD-MDD, n=77) were included in the study. All patients were diagnosed with OCD using the Structured Clinical Interview for DSM-IV. The Yale-Brown Obsessive-Compulsive Scale, Beck Anxiety Scale, and Beck Depression Scale were administered to all patients. After the socio-demographic and clinical variables and scales were accomplished, the OCD patients divided into two groups as OCD with or without depression and we compared their mean scores of the variables and scales. Univariate analyses were followed by logistic regression. There were no significant differences in age, gender, marital status, period without treatment, profession, medical and family history, and social support between the two groups. Anxiety, depression, and obsession and compulsion scores were significantly higher in the OCD+MDD group. The avoidance, insight, instability, and retardation scores of the OCD+MDD group were also significantly higher than those of the OCD-MDD group. Our study suggests that many factors are strongly associated with depression in OCD. Positive correlations between poor insight, severity of obsession and compulsion, and stressful life events during the last six months increased the risk of depression in OCD. Our study suggests that high level of avoidance, instability and retardation, history of suicidal attempt, and delayed treatment are other notable factors associated with the development of depression in OCD.

Obsessive-compulsive disorder is a heterogeneous disorder: evidence from diffusion tensor imaging and magnetization transfer imaging.

BackgroundCurrent models of obsessive compulsive disorder (OCD) propose abnormalities of cortico-striatal circuits that involve the orbitofrontal cortex, anterior cingulate cortex, thalamus and the striatum. Nevertheless, during the last years, results of morphometric studies were contradictory. Since fully automated whole-brain voxel-based morphometry (VBM) and diffusion tensor imaging (DTI) are used to assess structural changes in OCD patients, increased consistent evidence has been reported that brain abnormalities are not limited exclusively to the “affective” orbitofronto-striatal circuit. Moreover, several studies conducted using a symptom dimensional approach demonstrated that different symptoms are mediated by distinct neural systems.MethodWe investigated structural brain abnormalities in 14 carefully selected adult (≥18 years), male and unmedicated patients with OCD - separately for obsession and compulsion scores (Y-BOCS) - compared to 20 healthy controls as reflected according to white matter changes by fractional anisotropy and apparent diffusion coefficient. Moreover, this is the first study in OCD patients, using magnetization transfer imaging (MTI). This method is said to be more sensitive to subtle structural brain changes than conventional volumetric imaging.ResultsIn our study, we show a positive correlation between MTR and Y-BOCS obsession scores with an increased integrity of tissue structure in the parietal cortex, including myelination and axonal density reflected by the magnetization transfer ratio (MTR) which was used for the first time in our study. Furthermore, Y-BOCS scores for compulsions correlated negatively with ADC-maps in the left nucleus lentiformis and the cingulum.ConclusionThe results support the hypothesis that OCD is a heterogeneous disorder with distinct neural correlates across symptom dimensions and call for a substantial revision of such a model that takes into account the heterogeneity of the disorder.

The effect of psychodynamic psychotherapy combination with paroxetine on treatment of obsessive-compulsive disorder and its defense mechanism

Objective To evaluate the effect of psychodynamic psychotherapy on treatment of obsessive-compulsive disorder and its defense mechanism. Methods According to the standard set of obsessive-compulsive disorder, patients were randomly divided into study group(42 cases) and the control group(45 cases). The study group received the psychodynamic psychotherapy combined with paroxetine therapy and control group received only paroxetine therapy.The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was measured before and at the 4th, 8th and 12th weekend after treatment.Defense Style Questionnaire (DSQ) was measured before and after treatment. Results Among the 42 cases in study group, the total efficacy rate were 73.8%, while the 45 cases in control group , the total efficacy rate were 53.3%, showing significant difference between the 2 groups (χ2=3.92, P<0.05). Since the 8th weekend after treatment, the study group got lower Y-BOCS obsessive thoughts factor score(8.25±4.29) and total score(16.42±5.78) than the control group(11.44±5.54; 21.74±4.88), the scores of Y-BOCS compulsive behavior factor score in study group(5.55±3.81) was lower than the control group(8.24±3.27) by the 12th weekend.The differences were statistical significance(t=2.99, 4.65, 3.54, P<0.05). In the study group, the score of immature defense mechanism was reduced after treatment(4.24±1.27 vs 5.74±1.28), the score of mature defense mechanism was higher after treatment(5.56±1.74 vs 4.01±1.45). The differences were statistical significance(t=5.39, 4.44, P<0.05). Conclusion Psychological psychotherapy is effective in patients with obsessive-compulsive disorder and psychological dynamic psychotherapy can improve the patient's psychological defense mechanism. Key words: Obsessive-compulsive disorder; Psychodynamic psychotherapy; Defense mechanism

Prediction of remission in obsessive compulsive disorder using a novel machine learning strategy.

The study objective was to apply machine learning methodologies to identify predictors of remission in a longitudinal sample of 296 adults with a primary diagnosis of obsessive compulsive disorder (OCD). Random Forests is an ensemble machine learning algorithm that has been successfully applied to large-scale data analysis across vast biomedical disciplines, though rarely in psychiatric research or for application to longitudinal data. When provided with 795 raw and composite scores primarily from baseline measures, Random Forest regression prediction explained 50.8% (5000-run average, 95% bootstrap confidence interval [CI]: 50.3-51.3%) of the variance in proportion of time spent remitted. Machine performance improved when only the most predictive 24 items were used in a reduced analysis. Consistently high-ranked predictors of longitudinal remission included Yale-Brown Obsessive Compulsive Scale (Y-BOCS) items, NEO items and subscale scores, Y-BOCS symptom checklist cleaning/washing compulsion score, and several self-report items from social adjustment scales. Random Forest classification was able to distinguish participants according to binary remission outcomes with an error rate of 24.6% (95% bootstrap CI: 22.9-26.2%). Our results suggest that clinically-useful prediction of remission may not require an extensive battery of measures. Rather, a small set of assessment items may efficiently distinguish high- and lower-risk patients and inform clinical decision-making.

Music therapy as an adjunct to standard treatment for obsessive compulsive disorder and co-morbid anxiety and depression: A randomized clinical trial

BackgroundPrevious studies have highlighted the potential therapeutic benefits of music therapy as an adjunct to standard care, in a variety of psychiatric ailments including mood and anxiety disorders. However, the role of music in the treatment of obsessive–compulsive disorder (OCD) have not been investigated to date. MethodsIn a single-center, parallel-group, randomized clinical trial (NCT02314195) 30 patients with OCD were randomly assigned to standard treatment (pharmacotherapy and cognitive-behavior therapy) plus 12 sessions of individual music therapy (n=15) or standard treatment only (n=15) for one month. Maudsley Obsessive–Compulsive Inventory, Beck Anxiety Inventory, and Beck Depression Inventory-Short Form were administered baseline and after one month. ResultsThirty patients completed the study. Music therapy resulted in a greater decrease in total obsessive score (post-intervention score: music therapy+standard treatment: 12.4±1.9 vs standard treatment only: 15.1±1.7, p<0.001, effect size=56.7%). For subtypes, significant between-group differences were identified for checking (p=0.004), and slowness (p=0.019), but not for washing or responsibility. Music therapy was significantly more effective in reducing anxiety (post-intervention score: music therapy+standard treatment: 16.9±7.4 vs standard treatment only: 22.9±4.6, p<0.001, effect size=47.0%), and depressive symptoms (post-intervention score: music therapy+standard treatment: 10.8±3.8 vs standard treatment: 17.1±3.7, p<0.001, effect size=47.0%). LimitationsInclusion of a small sample size, lack of blinding due to the nature of the intervention, short duration of follow-up. ConclusionIn patients with OCD, music therapy, as an adjunct to standard care, seems to be effective in reducing obsessions, as well as co-morbid anxiety and depressive symptoms.

Clinically related or predictive factors and impacts on long-term treatment outcomes of involvement behaviors in patients with obsessive–compulsive disorder

BackgroundPatients with obsessive–compulsive disorder (OCD) frequently exhibit involvement behaviors (IBs) in which they accommodate their caregivers to their OCD symptoms by 1) asking them for reassurance, 2) forcing them to participate in their rituals, or 3) forcing them to assist in avoidance according to the patients’ rules or demands. Such behaviors correspond to those of their caregivers, and are referred to as family accommodation (FA). MethodsWe performed multifactorial comparisons between 256 OCD patients with and without IBs in order to examine the clinical characteristics and long-term treatment outcomes of OCD patients with IBs. A multiple logistic regression analysis was also performed to identify the related and predictive factors of IBs. ResultsA total of 108 out of the 256 OCD patients examined (42%) were determined to exhibit IBs. OCD patients with IBs were differentially characterized by demographic and phenomenological characteristics (e.g. female predominance and poorer insight), more severe psychopathological features (e.g. lower GAFS, higher anxiety, or a depressive status), and poorer treatment outcomes. Furthermore, the predictive factors of IBs such as being female, having a higher compulsive score, and lower GAFS were identified by logistic analyses and structural equation modeling. ConclusionThe presence of IBs correlated with the severe clinical features, treatment refractoriness, and poorer long-term outcome of OCD. The severity of compulsions, being female, and lower GAFS were identified as predictive factors for the presence of IBs. Similar to FA, these findings appear to support the effectiveness of early identification and family-focused intervention in the treatment of OCD patients with IBs.