Obsessive-compulsive Disorder Symptoms Research Articles

Predicting obsessive-compulsive disorder episodes in adolescents using a wearable biosensor-A wrist angel feasibility study.

Obsessive-compulsive disorders (OCD) are marked by distress, negative emotions, mental processes and behaviors that are reflected in physiological signals such as heart rate, electrodermal activity, and skin temperature. Continuous monitoring of physiological signals associated with OCD symptoms may make measures of OCD more objective and facilitate close monitoring of prodromal symptoms, treatment progress and risk of relapse. Thus, we explored the feasibility of capturing OCD events in the real world using an unobtrusive wrist worn biosensor and machine learning models. Nine adolescents (ages 10-17 years) with mild to moderate-severe OCD were recruited from child and adolescent mental health services. Participants were asked to wear the biosensor in the lab during conditions of rest and exposure to OCD symptom-triggering stimuli and for up to 8 weeks in their everyday lives and register OCD events. We explored the relationships among physiological data, registered OCD events, age, OCD symptom severity and symptom types. In the machine learning models, we considered detection of OCD events as a binary classification problem. A nested cross-validation strategy with either random 10-folds, leave-one-subject-out, or leave-week(s)-out in both layers was used. We compared the performance of four models: logistic regression, random forest (RF), feedforward neural networks, and mixed-effect random forest (MERF). To explore the ability of the models to detect OCD events in new patients, we assessed the performance of participant-based generalized models. To explore the ability of models to detect OCD events in future, unseen data from the same patients, we compared the performance of temporal generalized models trained on multiple patients with personalized models trained on single patients. Eight of the nine participants collected biosensor signals totaling 2, 405 h and registered 1, 639 OCD events. Better performance was obtained when generalizing across time compared to across patients. Generalized temporal models trained on multiple patients were found to perform better than personalized models trained on single patients. RF and MERF models outperformed the other models in terms of accuracy in all cross-validation strategies, reaching 70% accuracy in random and participant cross-validation. Our pilot results suggest that it is possible to detect OCD episodes in the everyday lives of adolescents using physiological signals captured with a wearable biosensor. Large scale studies are needed to train and test models capable of detecting and predicting episodes. ClinicalTrials.gov: NCT05064527, registered October 1, 2021.

Computational fluid science curriculum reform on students with obsessive-compulsive disorder

BackgroundComputational fluid science, as an interdisciplinary field, plays an increasingly important role in modern engineering and scientific fields. With the rapid development of technology and the gradual reform of education, the teaching methods and content of computational fluid science courses should also be updated to meet the needs of different student groups. Students with obsessive-compulsive disorder (OCD) may face specific psychological and cognitive challenges during their learning process, which may affect their understanding and mastery of the knowledge in computational fluid science. The research aims to explore the specific impact of computational fluid science curriculum reform on OCD students and provide targeted suggestions for educators to better meet the learning needs of these students.Subjects and MethodsThe study randomly divided 106 college students with OCD into an experimental group and a control group with same number in each. The control group received routine teaching; The experimental group was taught on the basis of a curriculum reform of computational fluid science. The study used the Yale Brown Obsessive Compulsive Scale (Y-BOCS) to assess the degree of changes in students’ obsessive-compulsive disorder.ResultsIn the measurement before the experiment, the degree of students’ OCD symptoms was relatively severe, but the difference between the two groups was not significant (P>0.05). After the experiment, the degree of obsessive-compulsive disorder in the experimental group was significantly improved and significantly lower than that in the control group (P<0.05).ConclusionsThe curriculum reform of computational fluid science can effectively alleviate students’ OCD symptoms and improve their learning outcomes.AcknowledgementThe research is supported by: Leshan City Science and Technology Bureau key research project (No.21GZD029).

The positive impact of environmentally artistic design in cultural architecture on OCD audience

BackgroundRecurrent compulsive thoughts and behaviors caused by obsessive-compulsive disorder (OCD) against the subjective wishes of the individual can lead to significant distress and anxiety for the patient. To improve the therapeutic effect on patients with severe OCD, to study the positive impact of environmental art design of cultural architecture under the characteristics of modern aesthetic psychology on patients with OCD.Subjects and MethodsTwenty-five patients with obsessive-compulsive disorder were selected as the experimental group and another 25 patients with obsessive-compulsive disorder as the control group. Maudsley Obsessive-Compulsive Inventory (MOCI) was used to collect data on the two groups. Learning and appreciating seven days of aesthetic art design as a cycle and three cycles as a course of treatment. In each process, the two groups of patients were tested for obsessive-compulsive disorder scores until the end of 5 courses.ResultsThe mean scores of the experimental and control groups were 33 and 35 after one course of treatment and 22 and 36 after five treatment methods, respectively. The experimental group significantly improved symptom relief, emotion regulation, and psychological comfort, while the control group had no significant change.ConclusionsCreating a building environment with aesthetic value and emotional resonance can significantly alleviate the symptoms of OCD and improve the audience’s emotional regulation ability and psychological comfort. Therefore, attention should be paid to the application and publicity of aesthetic and psychological characteristics in cultural architecture design to provide comfortable environmental art experiences for obsessive-compulsive disorder audiences.

Exploring the link between thought-action fusion and symptom-based shame in obsessive-compulsive disorder

The emotion of shame has been found to be closely related to obsessive-compulsive disorder (OCD). Thought-action fusion (TAF) might explain this relationship, but its causal role with regard to symptom-based shame is unclear. There is growing evidence showing that the metacognitive intervention of detached mindfulness (DM) helps to prevent the development of TAF and thereby shame. The current study investigates, (1) if a TAF induction condition with violent content increases shame compared to a control induction condition with neutral content in randomized nonclinical participants with heightened OCD symptoms (n = 88), and (2) if a subsequent brief DM intervention shows a preventive effect for developing shame compared to a control condition about mnemonic techniques. An ANOVA showed that shame in participants of the TAF induction significantly increased compared to the control condition. In a second ANOVA, the DM intervention failed to show a preventive effect on developing TAF and shame in a following TAF induction experiment compared to the control condition. The present findings suggest the importance of TAF beliefs for the development of shame. A more intense DM intervention or additional (meta-)cognitive interventions might be necessary to prevent the development of shame.

Duration of Untreated Illness in Patients with Obsessive-Compulsive Disorder and Its Impact on Long-Term Outcome: A Systematic Review.

Background: Duration of untreated illness (DUI)-defined as the time period between the onset of a mental disorder and its first adequate treatment-should influence patients' long-term prognosis and outcome. In patients with obsessive-compulsive disorder (OCD), DUI lasts on average from 87.5 up to 94.5 months, being significantly longer compared with data available from patients affected by other severe mental disorders, such as schizophrenia and bipolar disorder. We carried out a systematic review in order to assess the impact of DUI on long-term outcomes in OCD patients. Methods: A systemic review has been implemented, searching from inception to April 2023; only papers written in English were included. Results: Seventy-one articles were initially identified; only eight papers were included in the review. The DUI ranged from 7.0 ± 8.5 to 20.9 ± 11.2 years. Patients reporting a longer DUI have a poor long-term outcome in terms of lower level of treatment response and greater symptom severity. Conclusions: The present review confirms that longer DUI has a negative impact on the long-term outcome of patients with OCD. It should be useful to promote the dissemination of early interventions with a specific focus on OCD symptoms.

Prevalence and risk factors of psychological symptoms and quality of life in COVID-19 survivors: A cross-sectional study of three different populations.

Studies of the effects of COVID-19, especially post-acute COVID-19 syndrome, on psychological health in non-severe cases are limited. We aimed to evaluate the prevalence and associated risk factors of psychological symptoms, and quality-of-life in three groups of outpatients, hospitalized and intensive care patients. A total 276 patients, previously confirmed with SARS-CoV-2 infection, attending the COVID-19 follow-up outpatient clinic from December 2020 to July 2021 were interviewed face-to-face. In this cross-sectional, retrospective study, all participants were asked our self-designed demographic and screening questions to assess their psychological symptoms and administered the WHQOOL-BREF survey to evaluate quality of life. In screening questions, major depressive disorder symptoms were detected at a rate of 20.3%, generalized anxiety disorder symptoms at a rate of 16.7%, panic attack symptoms at a rate of 10.9%, post-traumatic stress disorder symptoms at a rate of 28.6% and obsessive-compulsive disorder symptoms at a rate of 18.1%. The outpatient group with COVID-19 infection had a higher risk of developing psychological symptoms and decreased quality of life. COVID-19 infection was found to have a considerable psychological impact on those treated as outpatients despite the less severe course of their illness.

OCD symptoms are related to seeking and relying on external information even in neutral perceptual decisions

IntroductionDoubt and decision-making difficulties are very common in obsessive-compulsive disorder (OCD). In the present study, we focused on a particular feature of decision-making in OCD – increased information-seeking. Based on the Seeking Proxies for Internal States and the Intolerance for Uncertainty theoretical frameworks, we hypothesized that OCD symptoms will be positively associated with information-seeking, even for neutral perceptual decisions. MethodFifty-eight UK participants were recruited via Prolific. They performed a perceptual decision-making task and completed questionnaires assessing OCD and associated variables. The perceptual task entailed locating the exact mid-point of a brightness continuum of a specific hue. Upon request, participants could obtain objective hints (purported responses of other participants), although hints incurred time-out penalties. ResultsConsistent with our hypothesis, OCD symptom levels predicted how many hints participants requested, even after controlling for anxiety and depression symptoms. Additionally, OCD symptoms were partially related to indecisiveness in the task. DiscussionOur findings suggest that obsessive-compulsive tendencies are related to indecisiveness and to seeking external information even in a neutral context. Moreover, OCD tendencies were related to finding external information desirable enough to justify mildly aversive penalties. This need for clarity and objectivity might account for the development of compulsions despite personal costs.

Clinical and demographic characteristics of patients with obsessive-compulsive symptoms using internet-delivered and face-to-face cognitive behavior therapy

ABSTRACT Objective Internet-delivered cognitive behavioural therapy (ICBT) is an effective treatment for obsessive-compulsive disorder (OCD). However, little is known about the characteristics of individuals who engage with this treatment and whether they are comparable to those who engage in face-to-face treatment for OCD. The aim of the current study was to examine the demographic and clinical characteristics of participants who engaged in a large open trial of self-guided ICBT for OCD and compare their characteristics with those who completed face-to-face treatment for OCD, as described in large, published studies. Method Three hundred and twenty-three participants (Mage = 33.27; SD = 12.22; 74.1% female) were included in the study. Results Participants in the ICBT group were significantly younger in age, were more likely to be female, and less likely to take psychotropic medication for their OCD symptoms, compared to participants who completed face-to-face treatment. There were no significant differences between the groups on OCD symptom severity or on depressive symptom severity. Conclusion Although slight differences in demographic characteristics were found between the ICBT group and face-to-face CBT group, the groups had similar clinical characteristics, indicating individuals who seek both treatment modalities are comparable to one another.

Agomelatine augmentation of sertraline in the treatment of moderate to severe obsessive-compulsive disorder: a randomized double-blinded placebo-controlled clinical trial

BackgroundAs 40–60% of the patients with obsessive-compulsive disorder (OCD) do not adequately respond to the first-line treatment, finding an effective second-line treatment is required. Our aim was to assess the efficacy and safety of agomelatine (a selective melatonin receptor agonist and a 5-hydroxytryptamine (HT)2 C antagonist) augmentation of sertraline in the treatment of patients with moderate to severe OCD.MethodsIn this 12-week randomized, double-blinded, placebo-controlled, parallel-group clinical trial, 65 patients with moderate to severe OCD according to the Diagnostic and Statistical Manual of Mental Disorders-Fifth edition (DSM–5) criteria and a Yale-Brown obsessive compulsive scale (Y-BOCS) score of over 21, were included. They were assigned with sertraline (100 mg/day for the first 4 weeks and 200 mg/day for the next 8 weeks) and either agomelatine (25 mg/day) or placebo. The primary outcome was OCD symptoms measured by the Y-BOCS.ResultsFifty patients (24 in agomelatine group and 26 in placebo group) completed the trial. The Y-BOCS scores in total (MD (95% CI) = 12.25 (11.00, 13.49) (P < 0.001) vs. MD (95% CI) = 12.46 (6.65, 15.74) (P < 0.001)), the obsession subscale (MD (95% CI) = 5.04 (4.19, 5.88) (P < 0.001) vs. MD (95% CI) = 5.00 (3.84, 6.16) (P = 0.0001)), and compulsion subscale (MD (95% CI) = 7.21 (6.34, 8.07) (P < 0.001) vs. MD (95% CI) = 7.460 (6.50, 8.42) (P < 0.001)) significantly decreased in both groups. Although, at the end of the trial, no significant difference was observed between the scores of the two groups in total (MD (95% CI) = 0.480 (-1.23, 2.19) (P = 0.78)), the obsession subscale (MD (95% CI) = 1.020 (-0.15, 2.19) (P = 0.38)), and the compulsion subscale (MD (95% CI) = 0.540 (-0.34, 1.42) (P = 0.54)). No major adverse effects were recorded, and the frequency of side effects was not significantly different between the groups.ConclusionAgomelatine in augmentation with sertraline is safe and tolerable in patients with moderate to severe OCD. However, our study does not support its efficacy in improving OCD symptoms, compared to placebo.Trial registrationThe trial was registered at the Iranian Registry of Clinical Trials on 14/07/2020 (www.irct.ir; IRCT ID: IRCT20170123032145N5).

Measurement Invariance Widely Holds for the Yale-Brown Obsessive Compulsive Scale

Abstract: The clinician-rated Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is a widely used assessment tool for obsessive-compulsive disorder (OCD). However, the measurement invariance (MI) properties of the Y-BOCS, a prerequisite for group or time point comparisons in clinical research, have received little attention in previous studies. In this study, we aim to comprehensively investigate the factor structure and MI of the Y-BOCS severity rating and its symptom checklist, utilizing a large sample of OCD patients ( N = 1,066). Our analysis considers various MI covariates, including time (pre- and post-therapy), severity, comorbidity, previous treatments, and demographics. Overall, the majority of tests conducted on the Y-BOCS severity rating and its symptom checklist revealed no substantial issues with MI, reinforcing the validity of the Y-BOCS for comparative clinical research. Specifically, we discuss a three-factor model for the severity rating, contrasting with a two-factor model for obsessions and compulsions when excluding the resistance items. Notably, our findings underscore the advantages and validity of employing latent factors rather than sum scores to model OCD severity and symptoms.

Cross-sectional direct and indirect relationships between the corrupted feared self and obsessive-compulsive symptoms in a clinical sample: The role of mental contamination.

There is a significant relationship between a general feared self and contact contamination concerns in obsessive-compulsive disorder (OCD), especially when the influence of mental contamination is considered a part of this relationship. However, these associations have not been explored in a clinical OCD sample when using each dimension of the multidimensional conceptualization of the feared self as the predictor (i.e., the corrupted, culpable, and malformed feared selves). We tested these associations using a cross-sectional design. Specifically, a sample of patients diagnosed with OCD (N = 417) completed a series of self-report measures of OCD symptoms and its related constructs. We also explored these associations with unacceptable thoughts as the outcome, rather than contamination concerns, due to unacceptable thoughts having evidenced strong associations with the feared self and mental contamination. After controlling for relevant cognitive (i.e., obsessive beliefs) and affective (i.e., depressive symptoms) constructs and comorbidity, the corrupted feared self was found to have a direct link, along with an indirect link through mental contamination, with symptoms of contact contamination and unacceptable thoughts. The fear of being corrupted may be associated with feelings of contamination in the absence of direct contact with a contaminant, which may then predict OCD symptoms of repugnant obsessional thoughts and contact contamination concerns. The corrupted feared self and mental contamination should therefore be targeted in treatments for repugnant obsessions and contamination-related OCD.

Deep brain stimulation for treatment resistant obsessive compulsive disorder; an observational study with ten patients under real-life conditions.

Obsessive-compulsive disorder (OCD) affects 2-3% of the global population, causing distress in many functioning levels. Standard treatments only lead to a partial recovery, and about 10% of the patients remain treatment-resistant. Deep brain stimulation offers a treatment option for severe, therapy-refractory OCD, with a reported response of about 60%. We report a comprehensive clinical, demographic, and treatment data for patients who were treated with DBS in our institution. We offered DBS to patients with severe chronic treatment resistant OCD. Severity was defined as marked impairment in functioning and treatment resistance was defined as non-response to adequate trials of medications and psychotherapy. Between 2020 and 2022, 11 patients were implanted bilaterally in the bed nucleus of stria terminalis (BNST). Patients were evaluated with YBOCS, MADRS, GAF, CGI, and WHOQOL-BREF. We performed the ratings at baseline (before surgery), after implantation before the start of the stimulation, after reaching satisfactory stimulation parameters, and at follow-up visits 3, 6, 9, and 12 months after optimized stimulation. One patient has retracted his consent to publish the results of his treatment, thus we are reporting the results of 10 patients (5 males, 5 females, mean age: 37 years). Out of our 10 patients, 6 have shown a clear response indicated by a YBOCS-reduction between 42 and 100 percent at last follow-up. One further patient experienced a subjectively dramatic effect on OCD symptoms, but opted afterwards to stop the stimulation. The other 3 patients showed a slight, non-significant improvement of YBOCS between 8.8 and 21.9%. The overall mean YBOCS decreased from 28.3 at baseline to 13.3 (53% reduction) at the last follow-up. The improvement of the OCD symptoms was also accompanied by an improvement of depressive symptoms, global functioning, and quality of life. Our results suggest that BNST-DBS can be effective for treatment-resistant OCD patients, as indicated by a reduction in symptoms and an overall improvement in functioning. Despite the need for additional research to define the patients' selection criteria, the most appropriate anatomical target, and the most effective stimulation parameters, improved patient access for this therapy should be established.

Nomophobia (No Mobile Phone Phobia) and Psychological Health Issues among Young Adult Students.

Smart phone use has become a part of people's everyday life. However, when the lack of using the smart phone to establish and maintain electronic communication is related to psychological distress, such a behavior may be considered a modern-age phobia, or nomophobia (no mobile phone phobia). The aims of the present study were to investigate among a sample of young adults the associations between scores for nomophobia and symptoms of depression, anxiety, stress, insomnia, and obsessive-compulsive disorders. A total of 537 students (mean age: 25.52 years; 42.3% females) participated in the study. They completed a booklet of self-rating questionnaires covering sociodemographic information and symptoms of nomophobia, depression, anxiety, stress, insomnia, and obsessive-compulsive disorders. Higher scores for nomophobia were associated with higher scores for depression, anxiety, and stress, but not with scores for insomnia and obsessive-compulsive disorders. The regression model confirmed that symptoms of anxiety predicted nomophobia. The present results support the assumption that nomophobia appears to be a mood disturbance related to stronger associations with symptoms of anxiety and, to a lesser extent, with symptoms of depression and stress. By contrast, nomophobia appeared to be unrelated to insomnia and symptoms of obsessive-compulsive disorders.

Online versus in-person delivery of cognitive behaviour therapy for obsessive compulsive disorder: An examination of effectiveness.

Cognitive behavioural therapy (CBT) including exposure and response prevention is the first-line psychological treatment for obsessive compulsive disorder (OCD). Given changes in the clinical landscape, there are increasing efforts to evaluate its effectiveness in online contexts. Mirroring the traditional in-person delivery, few studies have assessed the role of therapist-guided, manual-based CBT for OCD delivered in real-time via videoconferencing methods. The present study sought to fill this gap by comparing in-person and online delivery of group-based CBT for the treatment of OCD. A convenience sample of participants with moderate to severe OCD (n = 144) were recruited from a naturalistic database from two large OCD specialty assessment and treatment centres. Patients received group-based CBT that was provided in-person (pre-COVID-19 pandemic; March 2018 to March 2020) or online via videoconferencing (during the COVID-19 pandemic; March 2020 to April 2021). In both delivery methods, treatment consisted of 2-h weekly sessions led by trained clinicians. Analyses revealed that, regardless of treatment modality, both in-person and online groups demonstrated significant, reliable, and statistically equivalent improvements in OCD symptoms post-treatment. Videoconferenced, clinician-led CBT may be a promising alternative to in-person delivery for those with moderate to severe OCD symptoms.

Investigation of anxiety, depression, obsessive-compulsive disorder, and quality of life of children of healthcare workers during the COVID-19 pandemic

BackgroundThis study aimed to evaluate the anxiety, depression, obsessive-compulsive disorder symptoms, and quality of life of children whose parents were healthcare workers during the coronavirus disease 2019 (COVID-19) pandemic period. MethodsThe participants completed a sociodemographic questionnaire, the depression inventory for children (CDI), the screening for anxiety disorders in children (SCARED), the Maudsley obsessive compulsive question list (MOCQL), and the pediatric quality of life inventory (PedsQL) using online applications. A total of 153 children and adolescents whose parents were healthcare workers and 356 children and adolescents whose parents were not healthcare workers were included in the study. ResultsOne tenth of all children participating in our study had a high level of depression, and nearly half of them had a high level of anxiety. There was no significant difference in CDI (p = 0.306), SCARED (p = 0.841), and PedsQL (p = 0.863) scale scores between the two groups. The MOCQL scale scores were higher in the group whose parents were not health professionals for cleanliness (p<0.001), slowness (p = 0.001), and total score (p<0.001). ConclusionIt was found that all participants were affected by anxiety, depression, and quality of life decline; moreover, obsessive-compulsive symptoms were more common in children whose parents were healthcare workers. In this context, our findings could help determine possible mental health problems of children and adolescents whose parents are or are not healthcare workers.

Family Accommodation in Pediatric Obsessive-Compulsive Disorder: Investigating Prevalence and Clinical Correlates in the NordLOTS Study.

Family accommodation (FA) involves the actions taken by family members, particularly parents, to accommodate a child´s obsessive-compulsive disorder (OCD) symptoms, reducing distress or impairment. This behavior may maintain compulsive and avoidant behavior, preventing corrective learning or habituation. This study aims to investigate the prevalence and factors influencing FA in a large Scandinavian sample of children with OCD. We assessed 238 children using standardized diagnostic interviews, OCD symptom severity assessments and questionnaires evaluating functional impairment and internalizing and externalizing symptoms. FA was measured using the Family Accommodation Scale, a 12-item clinician-rated interview. Our results confirmed a high frequency of accommodation, with approximately 70% of primary caregivers reporting some accommodation daily and 98% at least once per week. FA was associated with increased OCD symptom severity, contamination/cleaning symptoms, internalizing and externalizing behavior, and functional impairment. Linear regression analysis showed that high levels of FA are specifically associated with lower age, higher OCD symptom severity, parent-reported impairment, internalizing, and externalizing symptoms. A path analysis revealed that FA partially mediated the relationship between OCD severity, externalizing symptoms, and child's age, highlighting the role of FA in the progression of OCD and related symptoms. The findings emphasize the importance of evaluating FA before initiating treatment and specifically addressing it during the therapeutic process.

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.

Chronic Deep Brain Stimulation of the Human Nucleus Accumbens Region Disrupts the Stability of Intertemporal Preferences.

When choosing between rewards that differ in temporal proximity (intertemporal choice), human preferences are typically stable, constituting a clinically relevant transdiagnostic trait. Here we show, in female and male human patients undergoing deep brain stimulation (DBS) of the anterior limb of the internal capsule/NAcc region for treatment-resistant obsessive-compulsive disorder, that long-term chronic (but not phasic) DBS disrupts intertemporal preferences. Hierarchical Bayesian modeling accounting for temporal discounting behavior across multiple time points allowed us to assess both short-term and long-term reliability of intertemporal choice. In controls, temporal discounting was highly reliable, both long-term (6 months) and short-term (1 week). In contrast, in patients undergoing DBS, short-term reliability was high, but long-term reliability (6 months) was severely disrupted. Control analyses confirmed that this effect was not because of range restriction, the presence of obsessive-compulsive disorder symptoms or group differences in choice stochasticity. Model-agnostic between- and within-subject analyses confirmed this effect. These findings provide initial evidence for long-term modulation of cognitive function via DBS and highlight a potential contribution of the human NAcc region to intertemporal preference stability over time.SIGNIFICANCE STATEMENT Choosing between rewards that differ in temporal proximity is in part a stable trait with relevance for many mental disorders, and depends on prefrontal regions and regions of the dopamine system. Here we show that chronic deep brain stimulation of the human anterior limb of the internal capsule/NAcc region for treatment-resistant obsessive-compulsive disorder disrupts the stability of intertemporal preferences. These findings show that chronic stimulation of one of the brain's central motivational hubs can disrupt preferences thought to depend on this circuit.

Obsessive-compulsive disorder symptoms and intrusive thoughts in the postpartum period: Associations with trauma exposure and PTSD symptoms.

In a community sample of trauma-exposed postpartum individuals (N=167; mean age=30, 90% White; 61.7% completed bachelor's degree or higher) longitudinally completed self-report measures on PTSD, depressive, and Obsessive-compulsive disorder (OCD) symptoms (specifically checking, ordering, washing, and obsessing symptoms), preoccupation with intrusive postpartum thoughts/neutralising strategies, and trauma exposure at 4 and 12weeks postpartum. PTSD symptoms were strongly associated with all OCD symptoms (r=0.32- 0.49, p<0.001), preoccupation with postpartum-specific intrusive thoughts (r=0.32-0.45, p<0.001), and preoccupation with neutralising strategies (r=0.21-0.29, p<0.05) at both time points. PTSD symptoms were also predictive of checking and obsessing symptoms. This study identified PTSD symptoms as a new correlate for preoccupation with postpartum-specific intrusive thoughts and neutralising strategies in the postpartum period in a community sample. These findings add to the evidence suggesting a strong association between PTSD and OCD symptoms across the lifespan, including in non-clinical samples. Future research should examine best practices to assess and treat a variety of postpartum psychopathology symptoms, not just depression.

ACEs and mental health problems as suicidality predictors in Mexican adolescents

BackgroundVarious factors, including mental health comorbidity, family dysfunction, interpersonal violence, and community and social violence, cause suicidal behavior. Adverse Childhood Experiences (ACEs) encompass these risk factors and are correlated with mental health problems and suicidal behavior in Mexican adolescents. MethodsA survey was conducted among Mexican school-aged adolescents to measure ACEs, MHP symptoms, and suicidal behavior. A binary logistic regression was used to examine the relationship between these variables. The study was conducted with IRB approval, and all participants provided informed consent. Those at risk of suicide were referred for online psychological care. Results7325 adolescents participated; 60 % were women, with an average age of 16 years (SD + 1), 87 % of the participants reported at least one ACE, 13 % symptoms of at least one MHP and 10 % suicidal behavior. MHP predictors of suicidal behavior were: conduct problems (OR = 5.67), symptoms of depression (OR = 3.27), obsessive-compulsive disorder (OR = 2.11), somatic problems (OR = 1.98), and attention deficit (OR = 1.69). EAI predictors were: live sexual violence (OR = 2.53), physical violence (OR = 2.21), negligence (OR = 2.05), bullying (OR = 2.10), and a family member with a mental health diagnosis (OR = 1.35). The cumulative effect of ACEs and MHP significantly increased the risk (OR = 78.08). Conclusions5 ACEs and 4 MHP were associated with suicidal behavior; their cumulative effect increased the risk to 78 times.