Manifestation Of Obsessive-compulsive Disorder Research Articles

The modulatory effect of Al-Assi river trout fish meal on OCD manifestations and molecular mechanisms in BALB/c Mice

Background: Obsessive-Compulsive Disorder (OCD) is a type of anxiety disorder that is marked by intrusive and distressing thoughts, as well as repetitive behaviors. Trout fish (Oncorhynchus mykiss) is a functional food that might have potential therapeutic effects on many neurological disorders including OCD. Objective: This study aims to explore the effects of Al-Assi River trout fish meal, a dietary source of tryptophan, on obsessive-compulsive disorder (OCD) symptoms and related molecular pathways in BALB/c mice. Methods: OCD mice were divided into five groups: one control group without any treatment, one group treated with fluoxetine (a selective serotonin reuptake inhibitor), and three groups fed with different doses of trout fish meal (0, 7.5, and 15 g/kg body weight). The mice were subjected to various behavioral tests, such as the marble test, tail suspension test, sucrose preference test, and forced swim test, to evaluate OCD and depressive-like behaviors. Moreover, the expression and protein levels of genes involved in the serotonergic and GABAergic systems were measured. Results: The results indicated that trout fish meal had dose-dependent effects on OCD-like behaviors, revealing exacerbation at lower doses and improvement at higher doses. For instance, in the marble test, OCD mice fed with 7.5 g of trout fish/kg body weight buried more marbles than those fed with 15 g/kg of trout fish (4.5 vs 3.33 out of 6, p>0.05). In the tail suspension test, the immobility time of OCD mice treated with fluoxetine was numerically lower than that of the untreated OCD mice (63.6 vs 87.3 seconds, p>0.05). Furthermore, normal mice had different baseline gene expression profiles than OCD mice. Normal mice had the highest fold increase of Gabra gene expression (3.75) compared to the untreated OCD group, followed by groups treated with 7.5 and 15 g of trout fish/kg body weight (2.02 and 1.44, respectively). Conclusions: This study suggests that dietary interventions rich in tryptophan, such as trout fish meal, may have modulatory effects on OCD symptoms and molecular mechanisms in mice. However, the optimal dosing and individual variability need to be considered. More research is required to clarify the underlying mechanisms and to evaluate the potential efficacy of trout fish meal in treating OCD in humans. Keywords: BALB/c mice, OCD, qPCR, Western blotting, Gabra, Serotonin, Trout fish, Tryptophan.

Obsessive-compulsive disorder: conceptual and clinical aspects

Obsessive-compulsive disorder (OCD) is a chronic, prevalent, and disabling psychiatric disorder that affects people of all ages and may have been worsened by the COVID-19 pandemic. This study aims to review conceptual and clinical aspects of OCD, including its history, diagnosis, symptom dimensions, etiology, assessment, prevention, and treatment. The history of OCD shows the transition from religious to medical conceptions. The main symptoms of OCD involve the presence of obsessive thoughts and compulsive acts, which can manifest themselves in four dimensions: ‘contamination and cleanliness’, ‘order and symmetry’, ‘doubt and verification’, and ‘disgusting thoughts and mental rituals’. This heterogeneity in the manifestation of OCD can make it difficult to understand its causes and to compare treatment responses. OCD management involves symptom assessment; prevention through psychoeducation and reducing family accommodation; pharmacological and psychotherapeutic treatment. First-line treatments involves the administration of serotonin reuptake inhibitor drugs and/or cognitive-behavioral therapy, with exposure and ritual avoidance techniques, and cognitive reappraisal.

Do clergy recognize and respond appropriately to the many themes in obsessive-compulsive disorder?: Data from a Pacific Island community

ABSTRACT Obsessive-compulsive disorder (OCD) is a debilitating psychiatric condition with high rates of misdiagnoses and extended treatment gaps. These may derive in part from poor mental health literacy (MHL) among clergy, who are frequently consulted by those with mental health problems. Therefore, the current study examined the MHL of OCD among clergy on Guam. Clergy (N = 110) provided diagnostic impressions, treatment recommendations, and referral recommendations in response to one of six randomized vignettes describing a common manifestation of OCD: contamination, symmetry, religion, homosexuality, pedophilia, or aggression. Clergy typically misidentified OCD (64.5%), especially in vignettes describing taboo thoughts. They more often recommended that the cases described in the vignettes receive pastoral/biblical counseling and a referral to a clergyperson for professional help rather than professional medical or mental health services. Overall, results reveal needs among clergy for increased MHL, especially concerning OCD's heterogeneous symptomology and evidence-based treatments.

Changes in the psychoemotional state under the influence of derivatives of neuroactive amino acids of rats after chronic alcohol intoxication

To study an effect of neuroactive amino acids derivatives glufimet and mefargin on the psychoemotional state of rats after chronic alcohol intoxication (CAI). The study was carried out on 10-month-old female Wistar rats. CAI was modeled by replacing drinking water with a 10% solution of ethyl alcohol sweetened with sucrose (50 g/l) for 6 months. Animals (age - 16 months) were divided into groups at the end of alcoholization: 1 (n=15) - intact group - rats without CAI; 2 (n=14) - control - females after CAI; 3 (n=11), 4 (n=14), 5 (n=11) and 6 (n=10) - experimental - females after CAI who received the GABA derivative mefargin (25 mg/kg), the glutamic acid derivative glufimet (29 mg/kg) and comparison drugs phenotropil (25 mg/kg) and heptral (100 mg/kg), respectively. Substances were administered to rats after 6 months of alcoholization intraperitoneally once a day for 14 days, the intact and control groups received physiological saline. The psychoemotional state of the animals was studied in the «Open field» test, «Elevated plus maze» test, «Marble burying» test and the Porsolt swim test after the treatment. In animals of the control group, an increase in anxiety was noted, as evidenced by a greater number of boluses in the Open Field test (3.43±0.56 vs. 1.47±0.39) compared to the intact group (p<0.05), short duration of stay in open arms (26.07±3.47 vs. 68.67±10.08) and fewer hangings from them (3.07±0.25 vs. 6.67±0.79) in the «Elevated plus maze» test. Rats after CAI buried more balls (8.79±1.15 versus 2.73±0.71, p<0.05), which indicated that they had compulsive behavior. In addition, females of the control group were observed to be depressed, as evidenced by a long period of immobilization in the Porsolt swim test (2.36±0.41 versus 0.87±0.31, p<0.05). Mefargin, glufimet, phenotropil and heptral restricted anxiety and manifestations of obsessive-compulsive disorder in females subjected to alcoholism (p<0.05). The antidepressant effect was observed in animals treated with phenotropil and heptral after CAI (p<0.05).

The Unity of Opposites: The Flux Between Impulsiveness and Compulsiveness Mediated by the Endocannabinoid System

Background: Impulsiveness and compulsiveness, though traditionally assumed to represent the opposite poles of a spectrum, have increasingly been understood to have common, rather than disparate, features. Objective: We investigated the influence of the ECS on the intricate interplay between impulsiveness and compulsiveness. Method: We conducted a search in PubMed, PsyhInfo, and Scopus by using the keywords compulsiveness, Obsessive-Compulsive Disorder (OCD), impulsiveness, Impulse Control Disorders (ICDs), addiction, ECS, serotonin, and dopamine. Results: The ECS is famous for its role in motivational processes and reward signaling, contributing to the hedonic effect elicited by pleasurable activities. Impulsiveness involves an inability to delay pleasure; compulsiveness, in contrast, is associated with a postponement of present pleasure due to an increased sense of menace. Impulsiveness and compulsiveness work together to result in addiction. The manipulation of the ECS through pharmacological or genetic methods is effective on the manifestations of OCD, ICDs, and impulsiveness. The ECS is distributed throughout the basal ganglia, prefrontal cortex, amygdala, and hippocampus and interacts with serotonergic, dopaminergic, noradrenergic, GABAergic, and glutamatergic neural circuits which are all involved in impulsive and compulsive symptomatology. The ECS or cannabinoids exhibit divergent effects depending on environmental conditions, dose, and duration of exposure. The endocannabinoids are retrograde messengers inhibiting the presynaptic neurons (causing a braking effect) and released “on demand”, generating a fine-tuning adjustment of the neural activity. Conclusion: How impulsiveness and compulsiveness, two apparently opposite traits, interoperate might be accounted for by the specific functions of the ECS.

“Why do I obsess about my child's flaws?”: Assessing the role of parental self‐vulnerabilities in parent–child relationship obsessive compulsive disorder (ROCD) symptoms

ObjectiveRelationship obsessive compulsive disorder (ROCD) is a manifestation of obsessive compulsive disorder (OCD) that refers to obsessions, doubts, and compulsive behaviours focusing on one's relationship and relationship partner. ROCD symptoms occur in various types of relationships including parent–child dyads, involving obsessional preoccupations with the perceived flaws of one's child (parent–child ROCD symptoms). Such preoccupations have been shown to be associated with decreased mood and significant parental distress. We examined the double self‐vulnerability hypothesis—that the co‐occurrence of parental contingency of self in specific domains (i.e., intelligence and appearance) and child‐value contingent self‐worth would be associated with increased parent–child ROCD symptoms.MethodA total of 175 parents participated in the study and completed self‐report questionnaires to assess ROCD and depressive symptoms and parental self‐contingencies. We used linear regression with simple slope analyses to estimate interaction effects.ResultsParents whose self‐worth were strongly dependent on their child's perceived value showed higher parent–child ROCD symptoms, particularly when co‐occurring with parental intelligence and appearance self‐contingencies. These findings were maintained when controlling for depression symptoms, parental age, and gender.ConclusionsResults supported the double self‐vulnerability hypothesis suggesting that parents with child‐value and domain‐relevant self‐vulnerabilities might be susceptible to child‐related obsessions. More research is needed to further explore susceptibility of vulnerable parents to the development and maintenance of parent–child ROCD symptoms.

Conditioned Fear Extinction, Neuropsychological, and Psychological Aspects of OCD in Latinos

Background: Although culture can affect emotional and behavioral reactions, there is little research on the manifestations of obsessive-compulsive disorder (OCD) among Latinos. Previous studies using a fear extinction model with a non-Latino population showed that individuals with OCD have difficulty maintaining safety memories. Their neuropsychological performance has shown inconsistent findings. We compared Puerto Ricans with OCD and healthy controls on fear extinction retention, neuropsychological performance, and psychological self-reports. Methods: 17 healthy and 11 Puerto Rican adults with OCD underwent a fear conditioning and extinction paradigm using neutral visual cues that were paired or unpaired with an electric stimulus to elicit skin conductance responses. Neuropsychological tests (WCST,EST,MSIT) and psychological self-reports (BAI,BDI,STAI,PANAS,EDS)were administered. Results: OCD subjects did not show impaired extinction recall. However, they showed higher reaction times towards neutral than threat-related words on the EST, compared to healthy controls. No differences on neuropsychological tests that lacked emotional content were observed. OCD subjects showed increased symptoms of anxiety, trait anxiety, depression, negative affect, and emotional dysregulation. Conclusions: Puerto Ricans with OCD may have physiological and neuropsychological characteristics that are similar to healthy subjects, but a different psychological profile, which can be used to tailor cultural adaptations of evidence-based treatments for OCD.

Clinical features of scrupulosity: Associated symptoms and comorbidity.

Scrupulosity is a manifestation of obsessive-compulsive disorder (OCD) characterized by religious or moral core fears. Clinicians often struggle to treat scrupulosity, which may be associated with several features known to predict poor treatment outcome. The purpose of this study was to examine these features in participants with scrupulous OCD, contamination OCD, and healthy controls. A total of 68 participants (57.4% women, agemean = 34.01) completed diagnostic interviews, and measures of symptoms and quality-of-life. Relative to comparison groups, scrupulous participants had higher rates of obsessive-compulsive personality disorder, more severe schizotypal symptoms, and more severe symptoms of depression. In addition, OCD severity was strongly associated with poor insight in the scrupulous group. Both OCD groups reported poorer quality of life than did healthy controls. Clinicians working with scrupulous individuals may enhance the efficacy of treatment in this challenging population by assessing carefully for these features, and incorporating treatment elements that address them.

Exposure and Response Prevention for Postpartum Obsessive-Compulsive Disorder.

Pregnancy and postpartum periods are associated with increased risk for onset and exacerbation of obsessive-compulsive disorder (OCD) symptoms. Common themes of the obsessive thoughts in this period are fears of accidently or intentionally harming the baby. Postpartum OCD may go underdiagnosed or misdiagnosed due to lack of standardized screening and potential shame associated with reporting these symptoms. Without treatment, OCD symptoms often persist and continue to impair mother's quality of life and interactions with the child. Literature on treatment specific to postpartum OCD is limited to case series and small studies. Exposure and response prevention (ERP), a gold-standard treatment for OCD, seems to be effective for this particular manifestation of OCD. This article presents a case history and ERP treatment course for a patient presenting with sudden onset of OCD following the birth of her child. Key differential diagnostic features, specific treatment strategies, and practice points are also explored.

Introduction to the Special Issue: Challenges in Treating Obsessive-Compulsive Disorder With Cognitive-Behavioral Therapy.

Cognitive-behavioral therapy (CBT) is a recommended treatment for obsessive-compulsive disorder (OCD). CBT offers specific interventions with demonstrated efficacy, including both cognitive therapy and exposure and ritual prevention (ERP). Yet, implementing these techniques with individual patients can present clinical challenges. In this special issue, expert clinicians and researchers present cases in which they addressed some common challenges in implementing CBT for OCD, including comorbid depression, poor insight, and family accommodation of symptoms in pediatric OCD. Other papers present how CBT can be tailored to specific OCD manifestations, including post-partum OCD, taboo thoughts, and relationship OCD. Other authors detail how they have augmented standard ERP with additional treatment techniques to maximize outcomes. These articles present a diverse set of case histories and specific treatment techniques that illustrate ways to maximize the effectiveness of CBT for OCD, serving as a useful guide for clinicians in practice and highlighting areas for future research.

Orthorexia nervosa - a separate clinical entity, a part of eating disorder spectrum or another manifestation of obsessive-compulsive disorder?

The aim of the study was to determine the prevalence of orthorexia nervosa in the population of adolescents and young adults, as well as to determine whether orthorexia is a separate clinical entity, a part of eating disorder or another manifestation of obsessivecompulsive disorder. The study group consisted of 864 subjects (599 females and 265 males). The mean age of female participants was 20.21±3.27 years, and of male participants 18.93±3.67 years. As a part of the study, we used a proprietary questionnaire to collect patient data, as well as following diagnostic questionnaires: ORTO-15 by Donini et al. (Polish version validated by Janas-Kozik et al.), EAT-26 by Garner and Garfinkel, and MOCI (Maudsley Obsessive Compulsive Inventory) by Hodgson and Rachman. The results were analysed statistically. 27% of subjects were found to be at risk of orthorexia nervosa (score of 35 was considered a cut-off point). These subjects achieved significantly higher scores in the EAT-26. There were no statistically significant differences in the MOCI scores. The highest risk of orthorexia was observed in subjects aged 13-16 years old (junior secondary school) and the lowest in 16-19-year-olds (senior secondary school). Individuals with suspected orthorexia tended to have significantly higher BMI. Specific analysis of environmental features will be exposed in the next issue. Orthorexia nervosa is not a separate clinical entity. It does not belong to the OCD spectrum, but meets the criteria of eating disorder spectrum.

Variation in obsessive-compulsive symptoms between children and adults

The complexity and diversity of clinical manifestations of obsessive-compulsive disorder have intrigued psychiatrists for a long time. Various differences have been noted in the presentation of obsessive-compulsive disorder of different age group. It was aimed to assess the variations of presentation of symptoms in children and adults in a tertiary level hospital. This study was done in an outpatient department from May 2015 to April 2017. Four hundred patients were included in the study consecutively after considering the inclusion and exclusion criteria. Respondents were interviewed with a semi-structured questionnaire which includes demographic variables, psychiatric diagnoses (DSM-IV-TR) and Y-BOCS symptom checklist. Obsessive-compulsive disorder started before adulthood in 41.5% of patients and onset after 18 years was found to be 58.5%. In this study, cases of obsessions, dirt and contamination was seen to predominate in both early- and late-onset obsessive compulsive disorder (68.3 and 71.4% respectively) and among the cases of compulsions, cleaning variety was found to be highest in both early- and late-onset (65.8 and 73.3% respectively). Age should be taken into account when evaluating obsessive compulsive disorder patients. The results suggest that more studies are necessary to determine whether in fact, it defines a homogeneous and particular group in obsessive-compulsive disorder.

Effects of Anterior Capsulotomy on Decision Making in Patients with Refractory Obsessive–Compulsive Disorder

Despite various lines of evidence implicating impaired decision-making ability in individuals with obsessive–compulsive disorder (OCD), neuropsychological investigation has generated inconsistent findings. Although the cortico-striato-thalamo-cortical (CSTC) circuitry has been suggested, the involvement of the cortex has not yet been fully demonstrated. Moreover, it is unknown whether surgical intervention on the CSTC circuitry results in a predicted improvement of decision-making ability of OCD. Here we present a study of decision making based on the Iowa Gambling Task (IGT) to investigate decision making in a large sample of individuals with treatment-resistant OCD with and without anterior capsulotomy (AC). Task performance was evaluated in healthy subjects, individuals with OCD that had not undergone surgery, and postsurgical OCD patients with AC. The latter group was further divided into a short-term postsurgical group and a long-term postsurgical group. We found that the OCD patients without surgery performed significantly worse than the healthy controls on the IGT. There were no significant differences in decision-making between the presurgical OCD patients and those at the short-term postsurgical follow-up. Decision-making ability of the long-term postsurgical OCD patients was improved to the level comparable to that of healthy controls. All clinical symptoms (OCD, depression, and anxiety) assessed by psychiatric rating scales were significantly alleviated post-surgically, but exhibited no correlation with their IGT task performance. Our findings provide strong evidence that OCD is linked to impairments in decision-making ability; that impaired CSTC circuitry function is directly involved in the manifestation of OCD; and that AC related improvements in cognitive functions are caused by long-term plasticity in the brain circuitry.

Altered serotonergic and GABAergic neurotransmission in a mice model of obsessive-compulsive disorder

There is ample evidence that obsessive-compulsive disorder (OCD) is based on reduced serotonergic function. Replicated bidirectional selection for thermoregulatory nest-building behavior in the laboratory house mouse (Mus musculus) resulted in compulsive-like, non-compulsive-like and randomly bred control mice that represent a non-induced animal model of OCD. The present study aimed at investigating the neurochemical patterns in specific brain regions of compulsive-like (HA) versus non-compulsive-like (LA) and normal (CA) mice. The neurochemical investigation of several brain regions of the corticostriato-thalamocortical circuity, i.e., nucleus caudatus (CPU), nucleus accumbens (NAc), globus pallidus (GP), hippocampus (HPC), amygdala (AM), ventral tegmental area (VTA) and substantia nigra (SN) was performed by electrochemical (serotonin and dopamine) and fluorescence (glutamate and GABA) HPLC detection. HA mice displayed significantly decreased 5-HT concentrations in the mPFC and LA mice displayed a significant increase in GABA concentrations in the mPFC. This supports the pathophysiological relevance of serotonin in the manifestation of OCD and adding to the construct validity of the non-induced mouse model of OCD.

School Refusal: How to Address When He is an Adolescent with Asperger’s Syndrome - A Case Report

A fifteen and a half years old adolescent boy was referred by the psychiatrist to the Child Development Centre (CDC) for an evaluation of his mental status as he was stubbornly resisting to take medication in spite of regular counselling efforts. This boy presented with school refusal with manifestations of Obsessive Compulsive Disorder (OCD) with a complicated family dynamic to the psychiatrist. His interesting atypical development in early childhood led to clinician’s concern of excluding Autism Spectrum Disorder (ASD). He was finally diagnosed and jointly managed as a case of High Functioning Autism (HFA) with co-morbid conditions by a joint multidisciplinary team approach of CDC and Psychiatry Department of AHD.Pulse Vol.9 January-December 2016 p.64-68

COMT and MAO-A polymorphisms and obsessive-compulsive disorder: a family-based association study.

ObjectiveObsessive-compulsive disorder (OCD) is a common and debilitating psychiatric illness. Although a genetic component contributes to its etiology, no single gene or mechanism has been identified to the OCD susceptibility. The catechol-O-methyltransferase (COMT) and monoamine oxidase A (MAO-A) genes have been investigated in previous OCD studies, but the results are still unclear. More recently, Taylor (2013) in a comprehensive meta-analysis of genetic association studies has identified COMT and MAO-A polymorphisms involved with OCD. In an effort to clarify the role of these two genes in OCD vulnerability, a family-based association investigation was performed as an alternative strategy to the classical case-control design.MethodsTransmission disequilibrium analyses were performed after genotyping 13 single-nucleotide polymorphisms (eight in COMT and five in MAO-A) in 783 OCD trios (probands and their parents). Four different OCD phenotypes (from narrow to broad OCD definitions) and a SNP x SNP epistasis were also analyzed.ResultsOCD, broad and narrow phenotypes,were not associated with any of the investigated COMT and MAO-A polymorphisms. In addition, the analyses of gene-gene interaction did not show significant epistatic influences on phenotype between COMT and MAO-A.ConclusionsThe findings do not support an association between DSM-IV OCD and the variants of COMT or MAO-A. However, results from this study cannot exclude the contribution of these genes in the manifestation of OCD. The evaluation of broader spectrum phenotypes could help to understand the role of these and other genes in the pathophysiology of OCD and its spectrum disorders.

Orthorexia Nervosa- a Review

Orthorexia nervosa is characterized by an obsession with avoiding foods perceived to be unhealthy. It seems to be more common in men than in women and in those with a lower level of education. It may be a food-centered manifestation of obsessive compulsive disorder. Orthorexia is an emotionally disturbed, self-punishing relationship with food that involves a progressively shrinking universe of foods deemed acceptable. The more restrictive the diet, the more likely it is to set off the psychological factors that lead to an eating disorder. Raw foods veganism is on the other extreme, and has a fairly high orthorexic potential. Orthorexia sufferers often display signs and symptoms of anxiety disorders that frequently co-occur with anorexia nervosa or other eating disorders. An orthorexic may avoid numerous foods, including those made with artificial colors, pesticides, fat, sugar, salt, animal or dairy products. A woman with orthorexia may find that her food obsessions begin to hinder everyday activities. Orthroxia can put a strain on relationships with family and friends, as relationships become less important than holding to dietary patterns. Maintaining an obsession with health food may cause a restriction of calories merely because available food isn't considered to be good enough. Orthorexia is a discrete diagnosis like anorexia nervosa or bulimia nervosa. Obsession with weight is one of the primary signs of anorexia, bulimia, and other eating disorders, but is not a symptom of orthorexia. orthorexia is a medical disease that can result in irreversible health complications, including death.

Turner’s syndrome And Obsessive Compulsive Disorder – A Case Report

The loss of all or part of one X sex chromosome during embryogenesis results in Turner's syndrome (TS). Certain studies showed specific cognitive deficits and psychiatric manifestations like mood and anxiety disorder .There are case reports of concomitant TS with schizophrenia. We present here a case of TS with clinical features of delayed attainment of secondary sexual characters, short stature, overweight, wide carrying angle and short bilateral 4 th metacarpals and metatarsals. Her ultrasound of abdomen and pelvis, showed hypoplastic infantile uterus and streak like ovaries. The TS patient had psychiatric manifestation of obsessive compulsive disorder, which has not been reported so far. The co-existence of Turner's syndrome and OCD gives a clue of any possibility of genes related to aetiology of OCD. It is important for the practitioners to understand the clinical spectrum and natural courses, including the development of psychiatric disorder in TS.

P265 – 1749 A novel suspicion index tool to aid diagnosis of Niemann-Pick disease type C (NP-C) in paediatric patients

afebrile multifocal epilepsy. CT brain revealed calcification in the basal ganglia bilaterally, thalami and white matter of cerebral hemispheres. This was extensively investigated and no abnormalities were detected. Parents are very poor historians and were reluctant to disclose family history. His five siblings all have a diagnosis of ADHD. Recently his behaviour has deteriorated and he is being investigated for ADHD. Of note the patient’s mother had a previous CT brain which demonstrated striking calcification in the basal ganglia, cerebellum and white matter felt to be consistent with the rare diagnosis of Fahr’s disease. Case report 2: A 13 year old girl was referred to tertiary neurology with focal seizures. She had a background history of delayed motor milestones, stereotypical movements and marked Obsessive Compulsive Disorder manifestations. CT brain revealed bilateral basal ganglia calcification. Discussion: None of these children had significant neurological signs or symptoms but both have neuropsychiatric comorbidities; OCD and ADHD. In case two a heterozygous mutation o SLC20A2 gene has been identified, known to be associated with autosomal dominant intracranial calcification. This same mutation has also been identified in her father. Gene testing is currently awaited in case one. We conclude that CT brain scanning should be considered in all children with psychiatric co-morbidities, seizures and a family history of neuropsychiatric/neurological disorders to look for calcification.

Transcultural perspectives of sensory phenomena in Arab Muslim patients suffering from obsessive-compulsive disorder.

The manifestations of obsessive-compulsive disorder (OCD) may vary across cultures. This is article discusses six case presentations of Arabic Muslim people suffering from OCD and is closely associated with practising religious rituals which tend to dominate the clinical picture. This is particularly relevant to sensory phenomena, which are often perceived as abnormal perceptions or hallucinations. We conclude that these phenomena are not uncommon in OCD and have relevant cultural, diagnostic and therapeutic issues in some cases.