Obsessive-compulsive Research Articles

Potential for Harm in the Treatment of Pediatric Obsessive-Compulsive Disorder: Pitfalls and Best Practices.

Pediatric obsessive-compulsive disorder (OCD) can be debilitating and chronic unless treated early with efficacious intervention. The past several decades of intervention research have identified cognitive-behavioral therapy (CBT) with exposure and response/ritual prevention (ERP) as the first-line, evidence-based psychological intervention for pediatric OCD. Yet, many youths with OCD unfortunately remain inadequately treated. In well-meaning but misguided efforts to treat this complex disorder, clinicians holding misconceptions about ERP may fail to apply evidence-based treatments, misapply generic CBT techniques and ERP principles, or turn to non-evidence-based interventions. Potentially harmful treatments may worsen symptoms, while ineffective treatments can waste resources, impede patient access to efficacious treatment, and weaken public confidence in psychotherapy. The overarching goals of this review paper are to describe potentially harmful and ineffective practices in the treatment of pediatric OCD and to offer recommendations aligned with evidence-based practice. First, we dispel common misconceptions about ERP that may underlie its underuse among clinicians. We then describe potentially harmful and ineffective interventions for pediatric OCD, starting with misapplication of generic CBT techniques and ERP principles. We also identify non-evidence-based treatments for pediatric OCD that have limited conceptual or empirical foundations. Finally, we conclude with recommendations for clinicians who treat pediatric OCD, intervention researchers, training programs across mental health-related disciplines, and policymakers.

Characteristics of Functional Connections and Topographical Properties Distinguished the Healthy State and Obsessive-Compulsive Disorder

Background: Obsessive-compulsive disorder (OCD) is characterized by alterations in brain connectivity, particularly within the default mode network (DMN) and the salience network (SN). Investigating these connectivity differences can provide a deeper understanding of the neural mechanisms underlying OCD. Methods: This cross-sectional study involved 58 patients diagnosed with OCD and 38 healthy control subjects, totaling 96 participants. Resting-state functional MRI (fMRI) data were acquired and analyzed using the CONN toolbox to examine functional connectivity within intrinsic resting-state networks. Graph theory metrics were applied to evaluate node connections and the overall network topology. Clinical symptoms were assessed using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), and their correlations with connectivity patterns and graph-theory parameters were analyzed. Results: The OCD patients and healthy controls were matched in terms of age, gender, marital status, socioeconomic status, and handedness. However, OCD patients had significantly worse general health, quality of life, and higher levels of depression and anxiety. Network analyses revealed altered whole-brain connectivity in OCD patients, particularly within the DMN and the frontoparietal network. The most significant between-group connectivity differences were observed between the posterior parietal cortex (PPC) and the precuneus. Disruptions in the DMN, specifically altered connectivity between the medial prefrontal cortex and posterior cingulate cortex, and changes in the SN involving the anterior insula and anterior cingulate cortex, were significantly correlated with the severity of OCD symptoms. Conclusions: The findings suggest that OCD is associated with distinct alterations in DMN connectivity, which may play a critical role in the disorder's pathophysiology. These disruptions offer potential targets for therapeutic intervention. Further research is needed to explore these connectivity changes in larger cohorts and at various stages of OCD to better understand their clinical significance.

Orthorexia Nervosa - unhealthy obsession on healthy lifestyle

Introduction: Eating disorders have expanded rapidly in recent years, with social media platforms like Instagram and TikTok playing a significant role. These platforms often showcase idealized images of healthy eating and body image, exposing young people to an overwhelming amount of information. This overstimulation can contribute to the development of various eating disorders. In our study, we focus particularly on orthorexia nervosa. Review methods: Our study was conducted as a literature review, with data gathered from PubMed and Embase. The state of knowledge: Orthorexia Nervosa (ON), introduced by Steven Bratman in 1997, could be defined as an unhealthy obsession with healthy eating. This obsession leads to strict dietary restrictions, where individuals often exclude certain food types, such as preservatives and GMOs, and experience significant stress and anxiety over food choices, planning, and preparation methods. The fixation on food purity can result in social isolation, anxiety, and major disruptions to daily life. In comparison to other eating disorders like anorexia nervosa and obsessive-compulsive disorder (OCD), ON is characterized by its focus on food quality rather than body image or weight. Conclusions: The classification of orthorexia as a mental disorder and the need for its recognition in DSM-5 are still debated. However, growing concern about its impact on mental and physical health has led to increased research and awareness.

Factors associated with obsessive-compulsive symptoms in medical students during the COVID-19 pandemic in Peru: a cross-sectional study.

Motivation for the study. The COVID-19 pandemic contributed to the development of mental disorders among medical students, including obsessive-compulsive symptoms. However, evidence on this problem in this population is still limited. Main findings. One in 10 medical students presented clinically significant obsessive-compulsive symptoms. Implications. The health crisis has had a negative impact on the mental health of medical students. Therefore, it is crucial to implement future interventions to promote the preservation of their psychological well-being. To determine the prevalence of obsessive-compulsive symptoms among medical students in Peru during the COVID-19 pandemic and its associated factors. Cross-sectional study in 270 medical students from a Peruvian public university. Participants were recruited through non-probability sampling. Obsessive-compulsive symptoms were assessed with the Yale-Brown Obsessive Compulsive Disorder Scale (Y-BOCS). After the descriptive analysis, Poisson regression with robust variance was used to determine the factors associated with probable obsessive compulsive disorder (probable OCD). The crude (PRc) and adjusted (PRa) prevalence ratios were calculated, along with their respective 95% confidence intervals (95% CI). The prevalence of obsessive-compulsive symptoms was 13.3% in medical students. During bivariate analysis, students with probable OCD were younger (p=0.044) and had a lower level of knowledge about COVID-19 (p=0.045). The crude model showed a lower prevalence of probable OCD among those with an adequate level of knowledge compared to those with an inadequate level (PR: 0.52, 95% CI: 0.28 to 0.98). However, after adjusting for other variables, none of the described variables were statistically significant. One in ten medical students presented clinically significant obsessive-compulsive symptoms. Implementing future interventions is crucial to preserve the mental well-being of this vulnerable population.

Cognitive performance, mental health, and quality of life in β-thalassemia individuals: a comprehensive analysis

IntroductionBeta-thalassemia is a prevalent autosomal recessive haemolytic disorder, particularly in the Middle East. Patients with beta-thalassemia major (βTM) require iron chelation therapy and regular blood transfusions, while those with beta-thalassemia intermedia (βTI) exhibit milder symptoms. This study aimed to evaluate cognitive function, behavioural problems, quality of life, and related aspects in individuals with βTM and βTI.MethodsThe cross-sectional study included 20 βTM participants, 20 βTI participants, and 19 healthy controls. Participants underwent psychiatric interviews, the Wechsler Adult Intelligence Scale (WAIS-III), Symptom Checklist-90 Revised (SCL-90R), and Short-Form Health Survey (SF-36). Clinical data and laboratory investigations were also collected.ResultsβTM participants exhibited lower vocabulary and picture completion scores on the WAIS-III compared to other groups. βTI participants had significantly higher scores on SCL-90R subscales for somatization, depression, anxiety, paranoid ideation, and psychoticism. Both patient groups reported poorer quality of life across all SF-36 domains compared with controls. Longer disease duration correlated with lower levels of somatization, interpersonal sensitivity, depression, anxiety, and paranoid ideation. Less frequent blood transfusions were associated with better physical and mental health summary scores but also higher somatization. Elevated serum iron levels corresponded with increased anxiety, hostility, and psychoticism symptoms, while higher serum ferritin related to more obsessive–compulsive behaviours but less somatization and psychoticism.ConclusionsIndividuals with thalassemia exhibit cognitive deficits, psychological disturbances, and diminished quality of life, with distinct patterns depending on disease severity. Regular monitoring and appropriate interventions are crucial for optimizing their overall well-being and functioning.

Examining mothers' obsessive and compulsive behaviors regarding baby care, cyberchondria level and maternal burnout in the postpartum period: Path analysis.

To examine the effects of postpartum women's obsessive and compulsive behaviors towards the care of their babies and maternal exhaustion levels on cyberchondria. The study, designed as a cross-sectional and correlation-seeking study, included 275 mothers. Data were collected from Turkish mothers with maternal burnout scale (MBS), scale for obsessive and compulsive behavıors of mothers ın the postpartum perıod wıth regard to baby care and cyberchondria severity scale (CSS). A total of 41.8% of the mothers, whose average age was 28.49 ± 5.04, had their first birth, 62.5% of the mothers were feeding their babies with breast milk, and 65.8% had regular sleep. The total mean score of the scales was 24.76 ± 5.15 for T-MBS, 81.19 ± 22.16 for CSS, and 16.11 ± 10.28 for the obsession scale. There was a statistically significant positive relationship between the maternal burnout and postpartum obsession scales and the cyberchondria severity scale. In the present study, mothers in the postpartum period did not show signs of burnout or obsessive-compulsive behaviors in the care of their babies, and their cyberchondria severity scores were at a moderate level.

BMI and deep brain stimulation: A comprehensive review and future directions with AI integration.

Deep brain stimulation (DBS) has revolutionized the treatment of movement disorders, including Parkinson's disease (PD), essential tremors, dystonia, and treatment-refractory obsessive-compulsive disorder (OCD). This systematic review and meta-analysis aimed to assess the impact of DBS on Body Mass Index (BMI). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, data from 49 studies were reviewed, with 46 studies specifically focusing on BMI and DBS. These studies involved 1,478 participants, predominantly PD patients, with an average age of 58.82years. The primary DBS implantation site was the subthalamic nucleus (STN). Over six months, the mean BMI increased from 25.69 to 27.41, despite a reduction in daily energy intake from 1992 to 1873kJ. While the findings suggest a correlation between DBS and weight gain, the study has limitations. The sample largely comprised PD patients (91%), preventing analysis of other subtypes. Additionally, most studies focused on the STN, limiting comparisons with other targets like the globus pallidus internus (GPi). Inconsistencies in assessing daily energy intake and food consumption further complicate the results. Integrating artificial intelligence (AI) in future research could address these gaps. For example, machine learning algorithms, such as those used by Oliveira et al., can predict post-DBS weight changes based on pre-surgical BMI and demographic factors. Similarly, AI-driven models like CLOVER-DBS can optimize DBS settings for improved motor control in PD patients. In conclusion, DBS affects BMI, and AI has the potential to enhance the precision of future studies.

Assessment of the Prevalence and Types of Mental Compulsions in Patients With Obsessive-Compulsive Disorder in North Karnataka: A Cross-Sectional Study

Assessment of the Prevalence and Types of Mental Compulsions in Patients With Obsessive-Compulsive Disorder in North Karnataka: A Cross-Sectional Study

Analyses of Rodent Grooming and its Behavioral Microstructure in Modern Neurobiological Studies

Grooming is a complex innate animal behavior used as an indicator of the physiological state of rodents under stress. Here, we analyze the impact of various experimental factors, including genetic, pharmacological and physiological, on self-grooming behavior of laboratory mice and rats. Analysis of grooming microstructure assesses not only the amount, but also the frequency, sequence, localization and consistency of this behavior, and can serve as a sensitive marker of changes in the brain, its response to stress, and predisposition to pathological conditions that model human mental illnesses, such as obsessive-compulsive disorder, autism and depression. Studying rodent self-grooming microstructure can provide valuable information about the mechanisms of brain pathogenesis and has multiple important translational implications for neuroscience research.

Insomnia as a predictor of treatment outcomes in adolescents receiving concentrated exposure treatment for OCD

BackgroundResearch suggests that individuals with obsessive-compulsive disorder (OCD) frequently experience insomnia. Some previous studies have suggested that insomnia may predict treatment outcomes, but the evidence is limited, especially for adolescents. This study examined the prevalence of insomnia in an adolescent OCD patient sample, explored the correlation between OCD and insomnia, and tested whether levels of insomnia at baseline predict outcomes for adolescent patients receiving the Bergen 4-Day Treatment (B4DT) for OCD.MethodsForty-three adolescent OCD patients who received B4DT were selected for this study. Treatment outcome was quantified as change in Children Yale-Brown Obsessive Compulsive Scale (CY-BOCS) scores across time from pre- to posttreatment and 3-month follow-up. Insomnia symptoms were measured by the Bergen Insomnia Scale (BIS). Linear mixed models were used to examine the relationship between the BIS and changes in CY-BOCS scores. We controlled for symptoms of general anxiety disorder measured by the GAD-7 and depression symptoms measured by the PHQ-9.ResultsIn this sample, 68.4% of the patients scored above the cutoff for insomnia on the BIS. There was a moderate correlation between baseline CY-BOCS and BIS that did not reach statistical significance (r = .32, p = .051). High BIS scores before treatment were significantly associated with poorer treatment outcomes, as measured by changes in CY-BOCS over time (p = .002). The association between baseline insomnia and change in OCD symptoms remained significant (p = .033) while controlling for GAD-7 and PHQ-9.ConclusionInsomnia is common among adolescents with OCD, and these data suggest that these patients may be at increased risk for poor treatment outcomes. Future research to explore mechanisms and adjunctive treatments is warranted.Trial registrationThe study was approved by the Regional Committee for Medical and Health Research Ethics of Northern Norway (REK Nord: 2023/606482).

Inference-Based Cognitive Behavioral Therapy versus Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder: A Multisite Randomized Controlled Non-Inferiority Trial

Introduction: Although cognitive behavioral therapy (CBT) effectively treats obsessive-compulsive disorder (OCD), many patients refuse CBT or drop out prematurely, partly because of anxiety regarding exposure and response prevention (ERP) exercises. Inference-based cognitive behavioral therapy (I-CBT) focuses on correcting distorted inferential thinking patterns, enhancing reality-based reasoning, and addressing obsessional doubt by targeting underlying dysfunctional reasoning, without incorporating an ERP component. We hypothesized that I-CBT would be non-inferior to CBT. Additionally, we hypothesized that I-CBT would be more tolerable than CBT. Methods: 197 participants were randomly assigned to 20 sessions CBT or I-CBT and assessed at baseline, posttreatment, and 6 and 12 months’ follow-up. The primary outcome was OCD symptom severity measured using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS; non-inferiority margin: 2 points). The secondary outcome, treatment tolerability, was assessed using the Treatment Acceptability/Adherence Scale (TAAS). A linear mixed-effects model was used to assess the non-inferiority of the primary outcome and superiority of secondary outcomes. Results: Statistically significant within-group improvements in the primary and secondary outcomes were observed in both treatments. No statistically significant between-group differences in Y-BOCS were found at any assessment point, but the confidence intervals exceeded the non-inferiority threshold, making the results inconclusive. The estimated mean posttreatment TAAS score was significantly higher in the I-CBT group than in the CBT group. Conclusion: While both CBT and I-CBT are effective for OCD, whether I-CBT is non-inferior to CBT in terms of OCD symptom severity remains inconclusive. Nevertheless, I-CBT offers better tolerability and warrants consideration as an alternative treatment for OCD.

Describing the Framework for AI Tool Assessment in Mental Health and Applying It to a Generative AI Obsessive-Compulsive Disorder Platform: Tutorial.

As artificial intelligence (AI) technologies occupy a bigger role in psychiatric and psychological care and become the object of increased research attention, industry investment, and public scrutiny, tools for evaluating their clinical, ethical, and user-centricity standards have become essential. In this paper, we first review the history of rating systems used to evaluate AI mental health interventions. We then describe the recently introduced Framework for AI Tool Assessment in Mental Health (FAITA-Mental Health), whose scoring system allows users to grade AI mental health platforms on key domains, including credibility, user experience, crisis management, user agency, health equity, and transparency. Finally, we demonstrate the use of FAITA-Mental Health scale by systematically applying it to OCD Coach, a generative AI tool readily available on the ChatGPT store and designed to help manage the symptoms of obsessive-compulsive disorder. The results offer insights into the utility and limitations of FAITA-Mental Health when applied to "real-world" generative AI platforms in the mental health space, suggesting that the framework effectively identifies key strengths and gaps in AI-driven mental health tools, particularly in areas such as credibility, user experience, and acute crisis management. The results also highlight the need for stringent standards to guide AI integration into mental health care in a manner that is not only effective but also safe and protective of the users' rights and welfare.

Obsessive-compulsive symptom trajectories from pregnancy through the postpartum: examining longitudinal course and risk factors during the COVID-19 pandemic.

The peripartum is a time of increased risk for the development or worsening of obsessive-compulsive (OC) symptoms. Existing evidence suggests that OC symptoms commonly surge immediately postpartum followed by a gradual recovery. Yet how societal conditions, such as a widespread public health crisis, may affect this pattern remains unknown. Increased OC symptom prevalence in the general population during the COVID-19 pandemic coupled with the pre-existing vulnerability of peripartum women suggests they may have been at particularly high risk for sustained symptoms. Thus, the aim of the current study was to examine trajectories in OC symptoms, particularly contamination concerns, in women who gave birth during the COVID-19 pandemic, and to look at risk and resiliency factors that may influence symptom course METHODS: A sample of 164 US pregnant women were recruited during the COVID-19 pandemic. They reported OC symptoms at 3 timepoints: April/May, 2020, July, 2020, and February, 2022. We used a growth mixture modeling approach to examine OC symptom trajectories from pregnancy through the postpartum across these timepoints, comparing the goodness of fit of models with 1-5 trajectory classes for overall OC symptoms and for contamination-related OC symptoms. For total OC symptoms, two classes of trajectories were identified: recovering (29.27%) versus stable low (70.73%) symptoms; for contamination symptoms alone, a subset of total symptoms, three trajectories were identified: recovering (8.54%), stable low symptoms (68.29%), and stable high symptoms (23.17%). Peripartum stress, but not sociodemographic or obstetric factors, predicted class membership. These findings suggest that peripartum OC symptoms, particularly related to contamination, may persist beyond the postpartum period in some women, particularly for women exposed to elevated stress in pregnancy and the postpartum.

Does nonacceptance of emotions and the fear of guilt influence the association between trait guilt and obsessive-compulsive symptoms? A moderation analysis in a non-clinical sample

ABSTRACT Objective Although cognitive-behavioural theory suggests a link between guilt and obsessive-compulsive disorder (OCD), the evidence is mixed. Given that how we relate to our emotions can determine behavioural responses, it is possible that high fear of guilt and a nonacceptance of emotions might increase the effects of guilt on OCD, and therefore explain mixed findings in previous research. Method We investigated whether fear of guilt and nonacceptance of emotions moderated the association between trait guilt and obsessive-compulsive symptoms in a non-clinical online MTurk sample (n = 231) recruited from cloudresearch.com. Participants completed measures of OCD, trait guilt, fear of guilt, nonacceptance of emotions, depression, and anxiety. Results We found that fear of guilt and nonacceptance of emotions, but not trait guilt, significantly predicted obsessive-compulsive symptoms even after controlling for depression and anxiety. Nonacceptance of emotions moderated the relationship between trait guilt and obsessive-compulsive symptoms, however fear of guilt did not. Simple slopes analyses showed a significant positive association between trait guilt and obsessive-compulsive symptoms for individuals with high nonacceptance of emotions. Conclusion Results support findings that nonacceptance of emotions, and to a lesser extent fear of guilt, play important roles in subclinical OCD. Furthermore, they suggest that a stronger acceptance of emotions may be linked to more adaptive experiences of guilt and reductions in obsessive-compulsive behaviour.

Uncovering the Motor Dynamics of Obsessive-Compulsive Rituals Through Cluster Analysis.

Rituals represent a prominent human behavior in different contexts such as daily routines, life cycle stages, and psychopathology, for example, obsessive compulsive disorder (OCD) where they are referred to as compulsions. OCD compulsions differ from habitual behaviors and stereotypies regarding their formal features: acts repetition, the addition of nonfunctional acts, and attentional focus on basic motor units. This study aims to categorize OCD compulsions based on the motor patterns of acts repetition and inclusion of nonfunctional acts. We analyzed 28 video-recorded OCD compulsions; we adopted a cluster analytic model to identify distinct patterns within the data and determine cluster characteristics. Our findings revealed a moderate negative covariance between nonfunctionality and repetitiveness, indicating that as nonfunctionality increased, repetitiveness decreased. Three distinct clusters in OCD rituals were identified according to the motor pattern: "idiosyncratic rituals," characterized by strong incorporation of nonfunctional acts; "iterative rituals" showing high repetitiveness; and "routines," with minimal repetition and limited inclusion of nonfunctional acts. These motor patterns highlight evolutionarily conserved behavioral strategies aimed at coping with conditions of environmental unpredictability. The findings might allow fine-grained discrimination of ritual compulsions and help target personalized interventions.

Small world properties of schizophrenia and OCD patients derived from fNIRS based functional brain network connectivity metrics

Individuals suffering from obsessive compulsive disorder (OCD) and schizophrenia (SCZ) frequently exhibit symptoms of cognitive disassociations, which are linked to poor functional integration among brain regions. The loss of functional integration can be assessed using graph metrics computed from functional connectivity matrices (FCMs) derived from neuroimaging data. A healthy brain at rest is known to exhibit small-world features with high clustering coefficients and shorter path lengths in contrast to random networks. The aim of this study was to compare the small-world properties of prefrontal cortical functional networks of healthy subjects with OCD and SCZ patient groups by use of hemodynamic data obtained with functional near infrared spectroscopy (fNIRS). 13 healthy subjects and 47 patients who were clinically diagnosed with either OCD (N = 21) or SCZ (N = 26) completed a Stroop test while their prefrontal cortex (PFC) hemodynamics were monitored with fNIRS. The Stroop test had a block design consisting of neutral, congruent and incongruent stimuli. For each subject and stimuli type, FCMs were derived separately which were then used to compute small world features that included (i) global efficiency (GE), (ii) clustering coefficient (CC), (iii) modularity (Q), and (iv) small-world parameter (σ\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\sigma $$\\end{document}). Small-world features of patients exhibited random networks which were indicated by higher GE and lower CC values when compared to healthy controls, implying a higher neuronal operational cost.

Secondary Female Anorgasmia in Patients with Obsessive Traits: A Study.

Background: In the literature, female anorgasmia (AO) is closely related to obsessive-compulsive disorder (OCD), but no publication has explored the role of individual obsessive traits that may also be typical of other disorders, assuming that repetitive thoughts and compulsions must necessarily correspond to an obsessive-type neurotic profile. It is worth investigating and assessing the specific weight of other morbid conditions involved, beyond OCD. Materials and Methods: This study was conducted during 2022-2023 by selecting 208 Italian clinical patients from private databases. They submitted to individual clinical interviews and two psychometric questionnaires (Perrotta Integrative Clinical Interviews 3, PICI-3-TA, and Perrotta Individual Sexual Matrix Questionnaire, PSM-Q). Results: Among the 208 patients (M: 39.05 years), divided into subgroups by age and obsessive symptomatology, no significant differences were found between the subgroups in the comparisons of the data obtained from the administration of the PSM-Q. Conclusions: This study confirms that it is not OCD that correlates with OA but obsessive traits, which are also common to other psychopathological disorders, such as bipolar disorder, borderline disorder, manic, and psychotic disorders and, therefore, in psychotherapy, it is necessary to intervene with a clinical approach that has in mind the patient's psychopathological personality picture and the causes that originated or reinforced OA.

Prevalence of Antidepressant Prescription in Adolescents Newly Diagnosed with Depression in Germany.

Depression is the most common mental illness in the world, found in nearly three in ten adolescents globally. This study aims to evaluate the prevalence of antidepressant prescriptions and the types of antidepressant therapy administered among adolescents diagnosed with depression in Germany. This retrospective cohort study, based on data provided by 30 child and adolescent psychiatrists, included adolescents aged 13-17 years with an initial diagnosis of depression between 2010 and 2022 (index date) documented in the IQVIATM Disease Analyzer database. Kaplan-Meier curves were used to investigate the one-year cumulative incidence of antidepressant prescriptions stratified by age, sex, and depression severity. Multivariable Cox regression analyses were used to assess the association between age, sex, depression severity, co-diagnoses, and antidepressant drug prescription. A total of 6338 adolescents (mean age: 16 years, 67% female, 59% with moderate depression) were available. The cumulative incidence of antidepressant prescriptions was 61% and increased with age from 13 years old to 17 years old. Fluoxetine was the most prescribed drug, followed by Sertraline, Escitalopram, Serotonin and Norepinephrine reuptake inhibitors, herbal medications, and Mirtazapine. Obsessive-compulsive disorder and eating disorders were found to be significantly associated with antidepressant prescriptions within the spectrum of co-diagnosed conditions. Higher age, depression severity, and a co-diagnosis of an obsessive-compulsive disorder or eating disorder were significantly positively associated with antidepressant prescriptions in adolescents. Fluoxetine was the most frequently prescribed drug for depression.

Harm avoidance and incompleteness core motivations in obsessive-compulsive disorder: validation of the Farsi version of the Obsessive-Compulsive Trait Core Dimensions Questionnaire (F-OC-TCDQ) in Iran

BackgroundAttention to the heterogeneous manifestations of obsessive-compulsive symptoms observed in clinical and nonclinical populations has motivated researchers to use tools to identify homogeneous subgroups of obsessive-compulsive disorder (OCD) patients. The Obsessive-Compulsive Trait Core Dimensions Questionnaire (OC-TCDQ) is used to evaluate two motivational dimensions of OCD (harm avoidance (HA) and incompleteness (INC)), which has been developed in recent years based on the core dimensions model, and to classify homogeneous subgroups. This study aimed to validate the Farsi version of the OC-TCDQ in Iran.MethodsThe psychometric properties of the OC-TCDQ were tested in two clinical samples (209 patients with OCD) and nonclinical samples (209 participants without OCD). Confirmatory factor analysis (CFA) was conducted to test the two-factor structure. The measurement invariance between the clinical and nonclinical groups was evaluated. Reliability was tested using Cronbach’s alpha, split-half, and retesting (two-week intervals). Convergent and divergent validity were analysed with Pearson’s correlation and the incremental validity of this scale in predicting Yale-Brown Obsession Scale (Y-BOCS) and Beck Anxiety Inventory (BAI) scores using hierarchical regression analysis. The discriminant validity of the two clinical and nonclinical groups was investigated with a t-test.ResultsSimilar to the original version, the CFA showed a good fit for the two-factor structure. The invariance of measurement between samples, good internal consistency and retest reliability, and convergent and divergent validity of this scale were confirmed. The results of hierarchical regression analysis indicated the increasing validity of this scale in predicting the Y-BOCS and BAI compared to the OBQ-44 (p < 0.05), and comparing the scores of two groups with and without OCD indicated its discriminant validity (p < 0.01).ConclusionThese findings show that the Farsi-OC-TCDQ is a valid tool for evaluating the motivational dimensions of harm avoidance and incompleteness in Iranian individuals with and without OCD, and it allows us to compare the scores across groups.

ASD or OCD? An evidence‐based differentiation of repetitive behaviors

While distinct diagnoses, the behavioral presentation of ritualistic/repetitive behaviors seen in obsessive compulsive disorder (OCD) and autism spectrum disorder (ASD) can present similarly. This results in difficulty with accurate diagnosis and implementation of evidence‐based treatments. OCD is characterized by prolonged and recurrent unwanted thoughts, known as obsessions, which cause a feeling of intense anxiety or distress. As a result, people with OCD perform repetitive behaviors known as compulsions to help alleviate distress. ASD is characterized as a developmental disorder causing persistent challenges associated with social communication, restricted and repetitive behaviors (RRB), and impairment in functioning. While the definitions are distinct, accurate conceptualization is not always clear. The picture can become even more complex with comorbidities. To parse these behaviors apart, we can consider the course of the behavior and assess the function. With better ability to differentiate, we can have a clearer picture of how to support the youth and family.