Severity Of Obsessive-compulsive Symptoms Research Articles

Direct changes of neurometabolic concentrations in the pregenual anterior cingulate cortex among obsessive-compulsive patients after repetitive transcranial magnetic stimulation treatment

Background and aimAlthough Repetitive Transcranial Magnetic Stimulation (rTMS) is a promising new noninvasive brain stimulation therapy, its underlying mechanisms of action remain unknown. OCD patients exhibit impaired response control and attention shifting, which is linked to some brain areas such as anterior cingulate cortex and basal ganglia. OCD patients also display altered neurometabolic concentrations in cortical cortical-striatal-thalamic-cortical (CSTC). In this study, we aimed to elucidate efficacy of rTMS treatment in alleviating related symptoms and pregenual anterior cingulate cortex (pACC) neurometabolites. MethodsOCD patients were randomly divided into either drug (n = 23) or drug + rTMS (n = 29) groups, and those in the latter group subjected to 4-week rTMS treatment. All participants were visited twice, at baseline and follow-up after four weeks. During both visits, all patients were subjected to 1H-MRS, then Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Global Assessment Function (GAF) used to assess severity of obsessive-compulsive symptoms. We also evaluated synchronous anxiety and depression by Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Hamilton Anxiety Scale (HAM-A) and Hamilton Depression Scale (HAM-D). ResultsAfter 4 weeks of treatment, patients in the Drug + rTMS group displayed significantly lower Y-BOCS (p = 0.038), BDI (p = 0.009), HAM-D (p = 0.013), HAM-A (p = 0.012) scores than their counterparts in the Drug group. Conversely, patients in the Drug + rTMS group had significantly higher tNAA concentrations (p = 0.030) than those in the Drug group. Notably, the Drug + rTMS group exhibited higher, but insignificant Glu (p = 0.055) and Glx (p = 0.068) concentrations compared to the Drug group. Partial correlation analysis revealed a significant negative correlation between post HAM-A scores and 4-week change of pACC glutamate levels in the Drug + rTMS group (r = −0.434, p = 0.02). ConclusionrTMS treatment is an efficacious treatment therapy for OCD, mainly by inducing changes in neurometabolites.

An analysis of the prevalence and impact of obsessive-compulsive personality disorder on the course of obsessive-compulsive disorder

Introduction Obsessive-compulsive disorder (OCD) is a disorder diagnosed on the basis of the presence of obsessions (persistently recurring, intrusive thoughts, images, impulses) and compulsions (compulsive and transiently satisfying actions performed in response to obsessions). A separate clinical phenomenon in the broadly understood anankastic spectrum is obsessive-compulsive disorder (OCPD). OCPD is characterized by scrupulousness, over-normative morality, perfectionism and an inability to make concessions in terms of cooperation. It is assumed that the incidence of OCPD in the course of OCD is 25-32% and it is a report with an unfavorable course and a more difficult therapeutic prognosis. It also means an early onset of OCD with a greater intensity of compulsions and a predominance of symptoms related to the sphere of purity, symmetry and gathering. Objectives The main aims of the study were as follows: 1. To assess the prevalence of OCPD in OCD patients. 2. To compare both groups of patients for the severity, level of insight, aggression, impulsiveness and affective symptoms. 3. To verify whether the presence of OCPD depend on factors such as age, gender, treatment duration and delay in starting treatment. Methods The study was conducted in a group of 78 patients diagnosed with and treated for OCD. The patients were divided into two groups: patients with OCD and OCPD (group 1, n=43) and patients with OCD without OCPD (group 2, n=35). The groups were subsequently compared for the severity of anankastic symptoms, the level of insight, aggression, impulsiveness and its components and affective symptoms (depression, mania). The following tools were used for the diagnosis: Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Hamilton Depression-Rating Scale (HDRS), Young Mania Rating Scale (YMRS), Buss-Perry Aggression Questionnaire (BPAQ), Barratt Impulsiveness Scale (BIS-11), Brown Assessment of Beliefs Scale (BABS) and DSM 5 criteria for OCPD. Results Our results confirmed that OCPD is common in OCD and occurred in 55,12% of patients with OCD (n=43; m=21; f=22). The study shows that the presence of OCPD in the course of OCD negatively affects the severity of obsessive-compulsive symptoms, the level of insight, the level of aggression and impulsiveness, and affective disorders. Patients with OCPD obtained higher scores on the YBOCS, BABS, HDRS, and YMRS scales compared to patients with OCD without OCPD. The occurrence of OCPD in the study group did not depend on gender, duration of OCD treatment, or delay in starting it. Conclusions The occurrence of OCPD is common in OCD and can cause delay of treatment, worse course, greater intensity of egosyntonic symptoms, and thus worse insight. The presence of OCPD can lead to more hostility and more affective disorders. Screening for OCPD in patients with OCD should be an integral part of an OCD diagnostic process. Disclosure of Interest None Declared

Obsessive-Compulsive Symptomatology and Disgust Propensity in Disordered Eating Behaviors of Adolescents with Celiac Disease.

Considering the importance of underlying psychopathological mechanisms that mediate maladaptive eating behaviors in celiac disease (CD) in the determination of cognitive-behavioral therapeutic approaches, we investigated the impact of obsessive-compulsive symptomatology and disgust propensity on disordered eating attitudes (DEA) and poor gluten-free diet (GFD) compliance in adolescents with CD. Adolescents with biopsy-proven CD (n = 148, aged 12-18years) were compared with age- and sex-matched controls (n = 104) in terms of eating attitudes/behaviors, obsessive-compulsive symptoms, and disgust propensity, as well as depression and anxiety to rule out depression- and anxiety-related covariates. The clinical implications associated with poor GFD compliance were determined using between-subgroup analysis. Multivariate linear regression and multiple logistic regression were used to identify predictors of DEA and GFD noncompliance, respectively. In adolescents with CD, DEA was remarkably associated with obsessive-compulsive symptom severity and disgust propensity, especially in contamination and core disgust sub-dimensions. Obsessionality and disgust propensity were independent predictors of DEA, of which the obsessive-compulsive symptom severity was the most decisive predictor of DEA. Higher DEA severity and lower body mass index were independent predictors of poor GFD compliance. Higher obsessionality, accompanied by disgust-related evaluative conditioning processes, may contribute to constructing a cognitive network consisting of hypervigilance and catastrophic interpretations towards benign somatic stimulations, food-related preoccupations, and avoidant behaviors in the disordered eating of adolescents with CD. The reciprocal relationship between lifelong GFD and DEA, mediated by obsessionality and disgust propensity, was supported by current findings that could guide clinicians in the management of maladaptive eating behaviors in adolescents with CD.

Obsessive-Compulsive Disorder During the COVID-19 Pandemic Process: A Narrative Review.

This study aimed to review all empirical contributions published between March 2020 and June 2022, addressing the impact of the COVID-19 pandemic on obsessive-compulsive disorder in adults. We searched the literature in PubMed, Google Scholar, and Web of Science. A total of 543 articles were scanned and 73 full-text articles were identified. Reviews, comments, letters to the editor, and case reports (except case series) were excluded. It was determined that 42 articles met the inclusion criteria, 6 studies involving only children and adolescents were excluded, and 36 were decided on their suitability for our study. The analysis determined that COVID-19 had an impact on obsessive-compulsive disorder. Characteristics such as liability for harm and unacceptable thoughts influenced the symptoms as well as contamination and washing. Some studies showed an increase in the severity of obsessive-compulsive symptoms, while some reported no worsening but improvement with treatment and follow-up. While some reported variations in outcomes related to sociodemographic characteristics and subtypes, some focused on the risk of suicide. There were also studies conducted on special groups such as pregnant women or healthcare workers. The results were controversial. While available data contain more information on worsening obsessive-compulsive disorder symptoms, data on the status of patients under treatment were scarce. There were not enough studies evaluating follow-up results. Influencing factors such as sociodemographic characteristics, subtypes, comorbid conditions, treatment, and support did not seem to have been adequately addressed.

Examining the role of emotion dysregulation in the association between obsessive compulsive symptom severity and suicide risk

Obsessive-compulsive disorder (OCD) has been found to be associated with increased risk for suicidal thoughts and behaviors. However, little research has explored factors that may account for the OCD-suicide link. One factor that holds promise in this regard is emotion dysregulation given its previously demonstrated association with obsessive-compulsive (OC) symptom severity and suicide risk. Therefore, the goal of this study was to examine whether emotion dysregulation accounts for the association between OC symptom severity and suicide risk. A sample of 109 adults (60.6% female, mean age = 39.85) seeking treatment at an anxiety disorders clinic completed a variety of self-report measures of OC symptom severity, emotion dysregulation, and recent (past two weeks) suicide risk upon intake into the clinic. As expected, emotion dysregulation accounted for the association between OC symptom severity and recent suicide risk. This result remained when anxiety symptom severity was included as a covariate. Results suggest that emotion dysregulation may be an important target for intervention in reducing suicide risk among individuals experiencing OC symptoms.

The Relationship Between Adverse Childhood Experiences, Symptom Severity, Negative Thinking, Comorbidity, and Treatment Response in Youth with Obsessive-Compulsive Disorder.

Although youth and adults with obsessive-compulsive disorder (OCD) endorse elevated incidence of exposure to traumatic life events during childhood, the existing literature on adverse childhood experiences (ACEs) and OCD is mixed and studies focusing on pediatric OCD are limited. The present study examines the relationship between ACEs and OCD onset, symptom severity, negative cognitive patterns, comorbidity, and cognitive-behavioral therapy (CBT) response in 142 children and adolescents with OCD. ACEs were ascertained from parent reports. Most parents reported child exposure to ACEs. Out of the parents who reported ACEs, 50% reported ACE exposure prior to OCD diagnosis and 50% reported ACE exposure after OCD diagnosis. No significant associations between ACEs and comorbidity or CBT response were found, suggesting that CBT for pediatric OCD is effective regardless of ACE exposure. Family financial problems were associated with increased obsessive-compulsive symptom severity and negative thinking. Implications for research and practice are discussed.

Associations Between the Severity of Obsessive-Compulsive Disorder and Vocal Features in Children and Adolescents: Protocol for a Statistical and Machine Learning Analysis.

Artificial intelligence tools have the potential to objectively identify youth in need of mental health care. Speech signals have shown promise as a source for predicting various psychiatric conditions and transdiagnostic symptoms. We designed a study testing the association between obsessive-compulsive disorder (OCD) diagnosis and symptom severity on vocal features in children and adolescents. Here, we present an analysis plan and statistical report for the study to document our a priori hypotheses and increase the robustness of the findings of our planned study. Audio recordings of clinical interviews of 47 children and adolescents with OCD and 17 children and adolescents without a psychiatric diagnosis will be analyzed. Youths were between 8 and 17 years old. We will test the effect of OCD diagnosis on computationally derived scores of vocal activation using ANOVA. To test the effect of OCD severity classifications on the same computationally derived vocal scores, we will perform a logistic regression. Finally, we will attempt to create an improved indicator of OCD severity by refining the model with more relevant labels. Models will be adjusted for age and gender. Model validation strategies are outlined. Simulated results are presented. The actual results using real data will be presented in future publications. A major strength of this study is that we will include age and gender in our models to increase classification accuracy. A major challenge is the suboptimal quality of the audio recordings, which are representative of in-the-wild data and a large body of recordings collected during other clinical trials. This preregistered analysis plan and statistical report will increase the validity of the interpretations of the upcoming results. DERR1-10.2196/39613.

The Obsessive-Compulsive Inventory-Revised (OCI-R): Translation and Validation of the European Portuguese Version.

The Obsessive-Compulsive Inventory-Revised has been developed to evaluate the severity of obsessive-compulsive symptoms in both clinical and non-clinical individuals. The aim of this study was to evaluate the psychometric properties of the Portuguese version. This questionnaire was applied to 90 people with obsessive-compulsive disorder and 246 without a known mental illness. In addition to this clinical evaluation instrument, participants completed other clinical assessment scales that helped characterize the two study groups. Given the objective of this study, to evaluate the structure by six factors, a confirmatory factor analysis was performed [patient group: χ2(120, n = 90) = 205.779, p < 0.01; CFI = 0.916; GFI = 0.814; RMSEA = 0.0890. χ2(120, n = 246) = 224.762, p < 0.01; CFI = 0.938; GFI = 0.904; RMSEA = 0.060]. To assess the internal consistency of the scale, Cronbach's alpha was determined (patient group: α = 0.913; control group: α = 0.888). Convergent validity was tested by determining the Spearman correlation between the scores obtained in the Obsessive-Compulsive Inventory-Revised and Y-BOCS in the patient group (r = 0.651; p < 0.01). Obsessive-Compulsive Inventory-Revised has proved to be a consistent, valid, and reliable instrument with good psychometric properties to determine the severity of obsessive-compulsive symptoms in the Portuguese population.

The Postpartum Obsessive-Compulsive Scale: Psychometric, Operative and Epidemiologic Study in a Portuguese Sample.

Background: Although obsessive-compulsive (OC) symptoms are common in the perinatal period, measures to comprehensively assess their presence, frequency, interference and severity are lacking. The Perinatal Obsessive–Compulsive Scale (POCS) is the only self-report questionnaire with context-specific items. It includes items to assess perinatal-specific obsessions and compulsions, a severity scale and an interference scale. Objectives: (1) to analyze the validity and reliability of the Portuguese version of the POCS; (2) to find Obsessive–Compulsive Disorder (OCD) prevalence in postpartum and determine the POCS cut-off scores and its accuracy (sensitivity, specificity and predictive values) in screening for OCD according to DSM-5 criteria; (3) to describe the prevalence, content, severity, interference and onset of OC symptoms in the postpartum. Methods: 212 women in postpartum filled in a booklet, including the POCS Portuguese preliminary version, the Perinatal Anxiety Screening Scale and the Postpartum Depression Screening Scale; they were interviewed with the Diagnostic Interview for Psychological Distress—Postpartum. Results: Confirmatory Factor Analysis revealed that POCS presented acceptable fit indexes (χ2/df = 2.2971; CFI= 0.9319; GFI = 0.8574; TLI = 0.9127; RMSEA = 0.860, p < 0.001). The Cronbach’s alphas were all > 0.800. The POCS cut-off point that maximized the Youden Index (J = 0.86, 95% CI [0.94–0.99]) was 20, corresponding to an Area Under the Curve of 0.970 (p < 0.001; Standard Error = 0.031; 95% CI: 0.937 to 0.988). The prevalence of postpartum OCD was 3.30%. The severity of thoughts and behaviors was moderate to severe for approximately 15% of women. For thirty-five percent of women, the onset of symptoms was in the first three months postpartum. Conclusions: The Portuguese version of POCS has good validity, reliability and accuracy and may be considered ready for use in both clinic and research fields. POCS provides specific information regarding symptoms and individual patterns experienced by each woman, which allows normalization, destigmatization and personalized intervention.

Internet addiction among teenagers in a Chinese population: Prevalence, risk factors, and its relationship with obsessive-compulsive symptoms

Background and aimsInternet addiction (IA) among teenagers has been reported frequently in China, although research has seldom focused on vocational high school students. This study investigated the prevalence and risk factors among this special adolescent population. Moreover, we illustrate the complex relationship between obsessive-compulsive (OC) symptoms, insomnia, psychological states, and IA. MethodsA cross-sectional design was applied to collect information from three different vocational high schools in Hunan Province, China. Socio-demographic characteristics, OC symptoms, insomnia, depression, anxiety, and stress symptoms were compared between the IA and non-IA groups. Then, a structural equation model (SEM) was established to test our hypothesis regarding different paths from OC symptoms to IA. ResultsIA prevalence was 13.4% among 7990 vocational high school students. Individuals with IA were more likely to be male and students with more severe depression, stress, anxiety, and insomnia symptoms (all p < 0.001). SEM verified that OC symptoms were related to IA both directly and indirectly, where the latter relationship was mediated through insomnia or mental disorders. LimitationsThis study cannot confirm the causal relationships among the variables and should be generalized cautiously to other groups. ConclusionsMore attention should be paid to Chinese vocational high school students, especially those with more severe OC symptoms, poor mental health, and insomnia. We should consider OC symptoms, insomnia, psychological suffering, and IA together when addressing related problems.

Optimizing Obsessive-Compulsive Symptom Measurement With the Yale-Brown Obsessive-Compulsive Scales-Second Edition.

The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) is a widely used measure for assessing the presence and severity of obsessive-compulsive disorder symptoms. The Yale-Brown Obsessive-Compulsive Scale-Second Edition (Y-BOCS-II) was developed, in part, to more comprehensively evaluate symptom severity, especially in extremely ill patients, and improve consistency in detecting and incorporating avoidance behaviors. We present 3 case studies that demonstrate the enhanced ability of the Y-BOCS-II to: (1) detect fluctuations in symptom severity among extremely ill patients, (2) systematically incorporate avoidance variables for more accurate ratings, and (3) maintain strong convergence with the Y-BOCS in assessing patients presenting with mild to moderate symptoms. In addition, we outline how to obtain both Y-BOCS and Y-BOCS-II scores within 1 administration by adding Y-BOCS item 4 to the Y-BOCS-II assessment, then "back-coding" the Y-BOCS-II ratings to Y-BOCS ratings and using Y-BOCS item 4 in place of Y-BOCS-II item 2. The use of this method allows for more robust data collection while providing comparability across the literature.

Altered Interoceptive Sensibility in Adults With Chronic Tic Disorder.

BackgroundInteroception refers to the sensing, interpretation, integration, and regulation of signals about the body’s internal physiological state. Interoceptive sensibility is the subjective evaluation of interoceptive experience, as assessed by self-report measures, and is abnormal in numerous neuropsychiatric disorders. Research examining interoceptive sensibility in individuals with chronic tic disorders (CTDs), however, has yielded conflicting results, likely due to methodologic differences between studies and small sample sizes.ObjectiveWe sought to compare interoceptive sensibility between adults with CTD and healthy controls, adjusting for co-occurring psychiatric symptoms, and to examine the relationship of interoceptive sensibility with other CTD clinical features, in particular, premonitory urge.MethodsWe recruited adults with CTDs and sex- and age-matched healthy controls to complete the Multidimensional Assessment of Interoceptive Awareness, Version 2 (MAIA-2), as well as a battery of measures assessing psychiatric symptoms prevalent in CTD populations. CTD participants additionally completed scales quantifying tic severity, premonitory urge severity, and health-related quality of life. We conducted between-group contrasts (Wilcoxon rank-sum test) for each MAIA-2 subscale, analyzed the effect of psychiatric symptoms on identified between-group differences (multivariable linear regression), and examined within-group relationships between MAIA-2 subscales and other clinical measures (Spearman rank correlations, multivariable linear regression).ResultsBetween adults with CTD (n = 48) and healthy controls (n = 48), MAIA-2 Noticing and Not-Worrying subscale scores significantly differed. After adjusting for covariates, lower MAIA-2 Not-Worrying subscale scores were significantly associated with female sex (β = 0.42, p < 0.05) and greater severity of obsessive-compulsive symptoms (β = –0.028, p < 0.01), but not with CTD diagnosis. After adjusting for severity of tics and obsessive-compulsive symptoms, a composite of MAIA-2 Noticing, Attention Regulation, Emotional Awareness, Self-Regulation, Body Listening, and Trusting subscales (β = 2.52, p < 0.01) was significantly associated with premonitory urge.ConclusionStudy results revealed three novel findings: adults with CTD experience increased anxiety-associated somatization and increased general body awareness relative to healthy controls; anxiety-associated somatization is more closely associated with sex and obsessive-compulsive symptoms than with CTD diagnosis; and increased general body awareness is associated with greater severity of premonitory urges.

The Role of N-Acetylcysteine in Obsessive-Compulsive (OCD) and Related Disorders

Introduction N-acetylcysteine is known for its uses in non-psychiatric conditions, such as paracetamol overdose and as a mucolytic. The rationale for its administration in psychiatric conditions is based on its ability reducing synaptic glutamate release, which was found to be increased in the cerebrospinal fluid of OCD patients.ObjectivesEvaluating N-acetylcysteine efficacy in OCD symptoms. Studying mechanisms underlying its action. Identifying the frequency of side effects.MethodsPubMed database search, with the “N-acetylcysteine obsessive compulsive” keyword expression. The search was restricted to English-only articles, published in the last ten years. Twenty-five results among the best match correspondence were selected. Reference lists of articles were reviewed to identify additional articles.ResultsOliver et al. found that a daily dose of 2.400 to 3.000 milligrams of N-acetylcysteine reduced the severity of obsessive-compulsive symptoms with minimal side effects; Smith et al. found inconclusive evidence on its efficacy. A clinical trial from Ghazinadeh et al. revealed N-acetylcysteine to be effective as an add-on to citalopram, reducing the score of resistance/control to obsessions after supplementing with N-acetylcysteine. Costa et al. found out it was superior to placebo in anxiety control as a secondary outcome.Conclusions The potential efficacy of N-acetylcysteine in the treatment of psychiatric disorders attracted interest. Mixed evidence was found that N-acetylcysteine may have some benefits controlling compulsions, both as an adjunctive as and as monotherapy. Thus, larger and more robust studies are required to further investigate the clinical effectiveness of N-acetylcysteine in this area.DisclosureNo significant relationships.

The effects of the COVID-19 pandemic on patients with obsessive-compulsive disorder

Objective Little is known about the impact of the COVID-19 pandemic on obsessive-compulsive disorder (OCD). The main aim of this study was to investigate how the pandemic has affected OCD patients and the relationship between the clinical features and the fear and obsession with COVID-19. Methods A total of 30 consecutive patients with OCD and 30 age-and sex-matched healthy controls were included in this cross-sectional study. Based on retrospective information provided by the patients, we evaluated changes in the severity of their OCD during the pandemic compared to the pre-pandemic period. We compared patients with OCD and healthy subjects using scores obtained from various scales. Results We found that symptom severity worsened in 60% of OCD patients during the pandemic compared to the pre-pandemic period, remained unchanged in 30%, and improved in 10%. The levels of obsession with COVID-19 were found to be higher in OCD patients than in healthy control subjects. The levels of fear of and obsession with COVID-19 both correlated with the anxiety levels of patients with OCD and healthy controls. Conclusions Our results suggest that the levels of COVID-19 related fear and obsession are not linked to the severity of OCD, but to anxiety levels. Key points Obsessive-compulsive symptom severity worsened in 60% of OCD patients in the pandemic. COVID-19 obsession levels were higher in OCD patients than healthy controls. COVID-19 fear levels did not differ between the OCD and healthy control groups. COVID-19 obsession levels were correlated with anxiety severity in OCD and healthy control groups.

Effectiveness of sleep hygiene to reduce insomnia among persons with suffering with obsessive compulsive disorder-pilot analysis

Obsessive-compulsive disorder frequently have insomnia, and those with acute insomnia who also have mental comorbidities without therapy, they are more likely to develop persistent insomnia. We present a case of OCD with acute insomnia that was successfully treated with early non-pharmacological sleep psychiatry intervention. Sleep is necessary for brain function and the maintenance of cognitive and emotional processes. Insomnia and anxiety problems are common, and they’re linked to a lot of damage and disability. In addition to being strongly comorbid with major depressive illness, there is evidence that sleeplessness and anxiety disorders frequently co-occur. The majority of insomnia psychological therapies include sleep hygiene. In terms of clinical practice, these instructions are a solid place to start. Obsessive-compulsive disorder is associated with sleep difficulties. Sleep difficulties are also common in people with obsessive-compulsive disorder, with up to 48% reporting them. Obsessive compulsive disorder research reveals a link between specific sleep habits and clinical factors such the severity of obsessive-compulsive symptoms, treatment resistance, and the age at which the disorder.

Effectiveness of sleep hygiene to reduce insomnia among persons with suffering with obsessive compulsive disorderpilot analysis

Obsessive-compulsive disorder frequently have insomnia, and those with acute insomnia who also have mental comorbidities without therapy, they are more likely to develop persistent insomnia. We present a case of OCD with acute insomnia that was successfully treated with early non-pharmacological sleep psychiatry intervention. Sleep is necessary for brain function and the maintenance of cognitive and emotional processes. Insomnia and anxiety problems are common, and they’re linked to a lot of damage and disability. In addition to being strongly comorbid with major depressive illness, there is evidence that sleeplessness and anxiety disorders frequently co-occur. The majority of insomnia psychological therapies include sleep hygiene. In terms of clinical practice, these instructions are a solid place to start. Obsessive-compulsive disorder is associated with sleep difficulties. Sleep difficulties are also common in people with obsessive-compulsive disorder, with up to 48% reporting them. Obsessive compulsive disorder research reveals a link between specific sleep habits and clinical factors such the severity of obsessive-compulsive symptoms, treatment resistance, and the age at which the disorder.

0693 A Characterization of Social Rhythms in Obsessive-Compulsive Disorder

Abstract Introduction Recent evidence has shown that obsessive-compulsive disorder (OCD) is linked to shifts in biologically driven sleep timing, indicating the role of biological rhythms within the disorder. Specifically, initial evidence suggests that biological disruptions in OCD may play a role in symptom severity and OCD treatment efficacy. Germane to the study of biological rhythmicity is the consideration of social rhythms within OCD. Disruptions in social rhythmicity are found in other psychological disorders associated with biological rhythm vulnerabilities (i.e., Bipolar Spectrum Disorder, Depression, and Post-Traumatic Stress Disorder.) Given the shared features and high rates of comorbidity between OCD and these disorders, it is reasonable that social rhythm disruptions would be found in OCD as well. As no research to date has examined this, we sought to examine the regularity and distribution of social rhythm in individuals with clinically significant obsessive-compulsive symptoms. Further, we examined the role of affect and symptom severity across OCD subtypes. Methods 19 adults meeting criteria for a primary diagnosis of obsessive-compulsive disorder completed the Social Rhythm Metric at home for a period of 7 days. As part of a larger study, participants completed measures of sleep (Pittsburgh Sleep Quality Index), affect (Positive and Negative Affect Schedule), and obsessive-compulsive symptom severity and subtype (Obsessive-Compulsive Inventory) following diagnosis. Results We found the mean social rhythmicity in those with an OCD diagnosis to be 3.05 (SD=1.14.), similar to means found previously in other psychiatric disorders such as Bipolar Spectrum Disorder and Post-Traumatic Stress Disorder. Individuals with OCD who also reported delayed bedtimes were shown to have significantly lower social rhythmicity (p=.005) than those without delayed bedtimes. Additionally, we found that social rhythmicity correlated similarly across OCD subtypes and was not strongly correlated with negative affect. Conclusion In the current study, we provide a preliminary characterization of social rhythmicity in those with OCD. Results suggest that social rhythm may play a role in OCD similar to bipolar disorder and further study is warranted. Overall, this study contributes to burgeoning research into the association between biological rhythms and OCD. Support (If Any)

A Randomized Controlled Trial Comparing Videoconference vs. Face-to-Face Delivery of Behavior Therapy for Youths With Tourette Syndrome in the Time of COVID-19.

ObjectiveTo evaluate the clinical effectiveness of online remote behavior therapy, compared with face-to-face therapy in reducing tics and co-occurring disorders associated with the tics in a sample of youths with Tourette Syndrome.DesignA randomized controlled trial. TS patients were randomized to receive face-to-face or online remote behavior therapy.Participants40 children aged between 9 and 16 years affected by Tourette Syndrome.ResultsOnline remote and face-to-face behavior therapy are equally effective in the treatment of tics and co-occurring disorders in children and adolescents affected by Tourette Syndrome. Both groups showed an improvement in the severity of tics, obsessive-compulsive symptoms, and anxiety symptoms, as assessed by neuropsychological findings. Online remote behavior therapy was more effective for reducing depressive symptoms than face-to-face behavior therapy.ConclusionsOnline remote behavior therapy is a promising tool for behavioral therapies for patients with Tourette Syndrome and may represents an alternative treatment option.

The Impact of COVID-19 Pandemic on Individuals With Pre-existing Obsessive-Compulsive Disorder in the State of Qatar: An Exploratory Cross-Sectional Study.

BackgroundPublished evidence about the impact of the COVID-19 pandemic on Obsessive-Compulsive Disorder (OCD) is conflicting. Most studies suggest an increase in the severity of OCD in people with pre-existing OCD, whereas some do not.AimGiven the conflicting evidence globally and lack of data from the Arab world, we aimed to explore the impact of the pandemic on obsessive-compulsive symptoms in adults with pre-existing OCD.MethodsA telephonic questionnaire-based cross-sectional study among adults with pre-existing OCD and specifically with fear of contamination and washing compulsions being major symptom dimensions of OCD. The severity of OCD during the pandemic was compared with their pre-pandemic scores. The severity of OCD was assessed using the Yale-Brown Obsessive-Compulsive Scale (YBOCS).ResultsThose with the duration of diagnosis of OCD of<10 years showed a statistically significant increase in the mean YBOCS score of 5.54 from pre-pandemic to during pandemic, which was significant at p = 0.006. This significance was maintained across the Compulsive and Obsessive subsets of the scale.ConclusionAdults with pre-existing OCD with fear of contamination reported a statistically significant increase in severity of obsessive-compulsive symptoms only if the duration of their OCD diagnosis was relatively shorter (<10 years). In the context of the conflicting evidence regarding the worsening of OCD symptoms due to the unique infection control measures of this pandemic, this study highlights the importance of the impact of the duration of the disorder and the subtype of the disorder. Such classification might help public health resources to be directed better at those most at risk and also help us understand the very nature of this disorder better.

The OCI-CV-R: A Revision of the Obsessive-Compulsive Inventory - Child Version.

The Obsessive-Compulsive Inventory-Children's Version (OCI-CV) was developed to assess obsessive-compulsive symptoms in youth. Recent changes in the Diagnostic and Statistical Manual (DSM-5) exclude hoarding from inclusion in the diagnosis of obsessive-compulsive disorder (OCD). Accordingly, the present study examined the reliability, validity, factorial structure, and diagnostic sensitivity of a revised version of the scale - the OCI-CV-R- that excludes items assessing hoarding. Participant were 1047 youth, including 489 meeting DSM criteria for primary OCD, 298 clinical controls, and 260 nonclinical controls, who completed the OCI-CV and measures of obsessive-compulsive symptom severity, depression, and anxiety at various treatment and research centers. Findings support a five-factor structure (doubting/checking, obsessing, washing, ordering, and neutralizing), with a higher order factor. Factorial invariance was found for older (12-17 years) and younger (7-11 years) children. Internal consistency of the OCI-CV-R was acceptable, and discriminant and convergent validity were adequate and akin to that of its progenitor. Diagnostic sensitivity and specificity were found for a total score of 8 and higher. It is recommended that the OCI-CV-R replace the former version, and that this measure serve as part of a comprehensive clinical assessment of youth with OCD. Recommendations for further research with ethnically and racially diverse samples, as well as the need to establish benchmark scores are discussed.