Obsessive-compulsive Symptoms Research Articles

The potential relationship between loot box spending, problem gambling, and obsessive-compulsive gamers.

Loot boxes are digital containers of randomised rewards available in many video games. Individuals with problem gambling symptomatology spend more on loot boxes than individuals without such symptoms. This study investigated whether other psychopathological symptomatology, specifically symptoms of obsessive-compulsive behaviour and hoarding may also be associated with increased loot box spending. In a large cross-sectional, cross-national survey (N = 1,049 after exclusions), participants recruited from Prolific, living in Aotearoa New Zealand, Australia, and the United States, provided self-reported loot box spending, obsessive-compulsive and hoarding symptomatology, problem gambling symptomatology, and consumer regret levels. There was a moderate positive relationship between loot box spending and obsessive-compulsive symptoms and hoarding. Additionally, greater purchasing of loot boxes was associated with increased consumer regret. Results identified that those with OCD and hoarding symptomatology may spend more on loot boxes than individuals without OCD and hoarding symptomatology. This information helps identify disproportionate spending to more groups of vulnerable players and may assist in helping consumers make informed choices and also aid policy discussions around the potentialities of harm.

Exploring the reform of college mental health education based on multi-source data

Abstract With the primary study emphasis on feature extraction, this article first suggests an algorithm for identifying students’ mental health issues based on multi-source data and employs one-dimensional convolutional neural networks to extract the online trajectory patterns of pupils from online behavior segments. Anomaly ratings were computed based on student consumption statistics from the cafeteria in order to depict the dietary variations among students. Next, a DeepPsy-based algorithm for identifying pupils with mental health issues was recommended after the algorithm suggested in the preceding phase was improved. A two-dimensional convolutional neural network was used to build the Internet trajectory matrix and retrieve the daily Internet trajectory pattern. A long and short-term memory network was used to record the time-dependent connection between each day, and a deep learning network was created by fusing the fundamental features and the Internet trajectory pattern. Through experimental research, the DeepPsy model was able to detect 75.5% of pupils with mental health issues and obtained a Recall of 0.755, outperforming the multi-source-based algorithm by 19.5%. Obsessive-compulsive symptoms took the top spot among the many variables influencing mental health, coming in at 22.8%, followed by interpersonal sensitivity at 17.25%. Depression came in third with a proportion of 10.76%. As a result, instructors can use the algorithm suggested in this article to spot pupils who may be suffering from undiagnosed mental health issues.

Obsessive–compulsive symptoms and disorder in clozapine-treated schizophrenia

BackgroundObsessive–compulsive symptoms (OCS) and obsessive–compulsive disorder (OCD) are commonly reported in patients with schizophrenia. Furthermore, the use of clozapine in treatment-resistant schizophrenia has been thought to induce or aggravate these disorders. To date, there is a paucity of research regarding the prevalence and associated factors. Hence, this study aims to report the prevalence of OCS and OCD, and examine potential risk factors, in clozapine-treated schizophrenia. MethodsThis is a cross-sectional study conducted in the only tertiary hospital for psychiatric patients in Singapore. In total, 162 patients on a stable dose of clozapine were recruited for this study; 159 patients with a diagnosis of schizophrenia or schizoaffective disorder were included in the current analysis. Sociodemographic, clinical and treatment factors were analysed to identify factors associated with OCS and OCD. ResultsThe prevalence of OCS and OCD is 21.4% and 12.6% respectively. Factors associated with OCS include younger age (OR:0.96, p=0.033) and younger age of onset of psychosis (OR:0.92, p=0.017). There were no significant factors associated with OCD. However, in an analysis of both OCS and/or OCD, factors associated include younger age (OR:0.96, p=0.027) and younger age of onset of psychosis (OR:0.91, p=0.016). Severity of psychotic illness and Clozapine dose were not associated with OCS or OCD in clozapine-treated schizophrenia. Discussion & conclusionsOur results suggest a high prevalence of OCS and OCD in clozapine-treated schizophrenia which clinicians should routinely screen for. Further research is warranted to establish the link between the factors identified in this study and OCS/OCD in clozapine-treated schizophrenia.

The Relationship of Emotional Intellectual, Obsessive-Compulsive Symptoms, and Body Image Disorder in Vitiligo Patients

The Relationship of Emotional Intellectual, Obsessive-Compulsive Symptoms, and Body Image Disorder in Vitiligo Patients

The therapeutic effect of ikebana teaching combined with ACT on obsessive-compulsive disorder college students

BackgroundIn recent years, due to academic pressure, changes in interpersonal relationships, and living environments, the mental health problems of college students have gradually become prominent, with obsessive-compulsive disorder (OCD) becoming an indispensable part. Patients with obsessive-compulsive disorder often suffer from recurring obsessive-compulsive beliefs and behaviors, seriously affecting their daily lives and academic performance. Therefore, seeking effective intervention methods is crucial.Subjects and MethodsThe experiment selected 60 students with obsessive-compulsive disorder from a particular school and randomly divided them into an experimental group and a control group, with 30 students in each group. The experimental group received practical teaching of flower arrangement art and acceptance commitment therapy (ACT). The control group only used traditional psychological counseling methods. The experimental period is six months, and the data is statistically processed using SPSS 24.0 and Excel.ResultsAfter a 6-month intervention, the obsessive-compulsive symptoms in the experimental group were significantly reduced, with a total effective rate of 90%, while the effective rate in the control group was 60%. In addition, the experimental group’s self-efficacy, emotional regulation ability, and quality of life also significantly improved.Conclusions The combination of flower arrangement art practice teaching and acceptance commitment therapy has shown sound intervention effects in treating obsessive-compulsive disorder college students. This combined treatment method can not only effectively alleviate obsessive-compulsive symptoms but also enhance the patient’s psychological resilience and self-management ability. Promoting this method has significant practical value in future mental health work.AcknowledgementHunan Province General Higher Education Teaching Reform Research Project (General Education Project) (No. HNJG-2020-1170).

Relationship between obsessional dissociation and family adjustment and anxiety sensitivity in individuals with obsessive-compulsive disorder

Purpose: The aim of this study was to determine the relationship between obsessional dissociation, family accommodation, and anxiety sensitivity in individuals with obsessive-compulsive disorder (OCD).
 Materials and Methods: The participants of this descriptive and relationship-seeking study were 62 individuals with OCD and 43 healthy controls. We collected data using a sociodemographic data form, the Yale-Brown Obsessive Compulsive Scale (YBOCS), the Family Accommodation Scale-Patient Version (FAS-PV), the Anxiety Sensitivity Index-3 (ASI-3), and the Van Obsessional Dissociation Questionnaire (VOD-Q).
 Results: Both the ASI-3 and VOD-Q subscale and global scores of the patients participating in the study were higher than those of the healthy controls, and there was a statistically significant difference between the two groups. Sixty-two percent of the total score of VOD-Q was explained by the ASI-3 total and subscale scores, 16% by the YBOCS total and subscale scores, and 11% by the FAS-PV total and subscale scores (F:38.622; F:6.797; and F:2.941, respectively).
 Conclusion: In our study, individuals diagnosed with OCD had higher levels of obsessional dissociation than healthy individuals and anxiety sensitivity, obsessive-compulsive symptoms, and family accommodation are effective in the development of obsessional dissociation in individuals diagnosed with OCD.

Decision-making deficits in obsessive-compulsive disorder are associated with abnormality of recency and response consistency parameter in prospect valence learning model.

Patients with obsessive-compulsive disorder (OCD) have deficits in decision-making in the Iowa Gambling Task (IGT). However, no study has investigated the parameters of the prospect valence learning (PVL) model in the IGT for OCD. This study aimed to investigate deficits in decision-making in OCD using the PVL model and identify whether the parameters of the PVL model were associated with obsessive-compulsive severity. Forty-seven medication-free patients with OCD were compared with 47 healthy controls (HCs). Decision-making was measured using the total net and block net scores of the IGT. A PVL model with a decay-reinforcement learning rule (PVL-DecayRI) was used to investigate the parameters of the model. Correlation analysis was conducted between each parameter of the PVL-DecayRL and obsessive-compulsive symptoms. The total net score of patients with OCD was significantly lower than that of the HCs. The block net scores of the OCD group did not differ across the five blocks, whereas in the HCs, the fifth block net score was significantly higher than the block net scores of the first and second blocks. The values of the recency and response consistency parameters of the PVL-DecayRI in patients with OCD were significantly lower than those in HCs. The recency parameter positively correlated with the Y-BOCS obsessive score. Meanwhile, there was no correlation between consistency parameter values and symptom severity in OCD. Our detailed analysis of the decision-making deficit in OCD suggests that the most recent outcome has a small influence on the expectancy of prospect valence, as indicated by the lower recency parameter, and is characterized by more impulsive choices, as indicated by the lower consistency parameter.

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.

An Exploratory Study of Obsessive-Compulsive Behavior and School Problems Associated with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS)

Pediatric acute-onset neuropsychiatric syndrome (PANS) is an increasingly studied disorder that has been linked to negative neuropsychiatric outcomes, with the most frequently cited consequence being rapid onset of obsessive-compulsive symptoms. Little is known, however, about the educational impacts of this disorder on school-aged children. This study aimed to learn (1) what school-related problems do parents report in children with PANS?; (2) with what frequency do school-aged children with PANS receive formal special services at school?; (3) what types and severity of obsessions and compulsions are exhibited by school-aged children with PANS?; and (4) does OCD symptom severity classification predict the presence of a school special service plan? Parents (n = 208) of children with PANS participated in this study by completing a survey that included the Children’s Yale-Brown Obsessive-Compulsive Scale Parent Report (CY-BOCS-PR) and additional questions regarding child school performance and participation in formal special services at school. Anxiety and inattention, among a variety of other school-based problems, are reported at school in this population. Approximately 60% of the children received some form of school special services across their educational career. A variety of mild to severe obsessive-compulsive behaviors were reported in the children, though the severity of those behaviors did not predict the existence of a school special services plan. School psychologists must be prepared to evaluate children with PANS and recommend evidence-based interventions.

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.

Hoarding behavior and its association with mental health and functioning in a large youth sample.

Hoarding behavior is prevalent in children and adolescents, yet clinicians do not routinely inquire about it and youth may not spontaneously report it due to stigma. It is unknown whether hoarding behavior, over and above obsessive-compulsive symptoms (OCS), is associated with major clinical factors in a general youth population. This observational study included N = 7054 youth who were not seeking help for mental health problems (ages 11-21, 54% female) and completed a structured interview that included evaluation of hoarding behavior and OCS, as a part of the Philadelphia Neurodevelopmental Cohort between November 2009 and December 2011. We employed regression models with hoarding behavior and OCS (any/none) as independent variables, and continuous (linear regression) or binary (logistic regression) mental health measures as dependent variables. All models covaried for age, sex, race, and socioeconomic status. A total of 374 participants endorsed HB (5.3%), most of which reported additional OCS (n = 317). When accounting for OCS presence, hoarding behavior was associated with greater dimensional psychopathology burden (i.e., higher P-factor) (β = 0.19, p < .001), and with poorer functioning (i.e., lower score on the child global assessment scale) (β = - 0.07, p < .001). The results were consistent when modeling psychopathology using binary variables. The results remained significant in sensitivity analyses accounting for count of endorsed OCS and excluding participants who met criteria for obsessive-compulsive disorder (n = 210). These results suggest that hoarding behavior among youth is associated with poorer mental health and functioning, independent of OCS. Brief hoarding-behavior assessments in clinical settings may prove useful given hoarding behavior's stigma and detrimental health associations.

A meta-analysis of systematic reviews and meta-analyses to evaluate the psychological consequences of COVID-19

BackgroundSeveral meta-analysis studies have been reported in the literature on the incidence of psychopathological conditions resulting from the COVID-19 pandemic. This investigation aims to compile and analyze the findings of previously published meta-analysis research, as shown by the present meta-analysis of previous meta-analysis studies.MethodsThe PubMed and Scopus databases were searched from 1 January 2019 to 30 May 2022. The procedure was carried out according to the PRISMA flow chart and the qualities of the identified studies were analyzed using AMSTAR 2. Heterogeneities and risk of bias were assessed using the Meta-MUMS tool. The corresponding results, forest and funnel plots of the psychological consequences of COVID-19 were synthesized.ResultsEleven meta-analysis studies were included. Random-effects meta-analysis of anxiety and depression showed (ER = 0.318 p-value < 0.001, ER = 0.295 p-value < 0.001) high heterogeneities (I2 = 99.70%, I2 = 99.75) between studies. Random-effects meta-analyses of sleep difficulties and insomnia were shown (ER = 0.347 p-value < 0.001, ER = 0.265, p-value < 0.001) along with heterogeneities (I2 = 99.89, I2 = 99.64). According to the random meta-analysis of post-traumatic stress syndrome (PTSS) and post-traumatic stress disorder (PTSD) (ER = 0.246, p-value = 0.001, ER = 0.223 p-value < 0.001) with heterogeneities (I2 = 99.75, I2 = 99.17). Random-effects meta-analyses of somatic and fear symptoms have been shown (ER = 0.16 p-value < 0.001, ER = 0.41, p-value = 0.089) with high heterogeneities (I2 = 99.62, I2 = 98.63). Random-effects meta-analysis of obsessive–compulsive symptoms and distress (ER = 0.297 p-value = 0.103; ER = 0.428, p-value = 0.013) with high heterogeneity, as I2 = 99.38%. Subgroup analysis of all symptoms and Egger's tests for detecting publication bias were also assessed.ConclusionThe data from the current meta-analysis showed different psychological disorders of COVID-19 during the pandemic. Clinicians should be aware of the prevalence with which COVID-19-infected patients experience emotional distress, anxiety, fatigue, and PTSD. About half of the included systematic reviews (SRs)/meta-analyses (MAs) suffered from poorer methodological quality and increased risk of bias, reducing confidence in the findings. There must be more SRs/MAs and high-quality clinical trials conducted to confirm these findings.

Two Years after the Beginning of COVID-19: Comparing Families Who Had or Did not Have Patients with COVID-19 on Health Beliefs and Obsessive-Compulsive Symptoms.

Objective: This study aimed to compare health beliefs and obsessive-compulsive symptoms (OCS) in families with (FIM+) or without an infected member (FIM-) two years after the beginning of COVID-19. Additionally, this research intended to predict a decrease in OCS from baseline (T1) to 40 days later (T2) based on health beliefs. Method : In a longitudinal survey, 227 participants in two groups, including FIM+ (n = 98; M = 30.44; SD = 5.39) and FIM- (n = 129; M = 29.24; SD = 4.93), were selected through purposive sampling. They responded to measurements consisting of demographic characteristics, the Obsessive-Compulsive Inventory-Revised (OCI-R), Patient Health Questionnaire (PHQ-9), Impact of Event Scale-Revised (IES-R), and COVID-19 Health Belief Questionnaire (COVID-19-HBQ) at the final assessment phase (T2). To investigate differences between the two groups and predict OCS changes from T1 to T2, data were analyzed using Chi-squared, t-tests, U-Mann-Whitney, Kruskal-Wallis, Pearson correlations, and linear regression analyses. Results: At T1, FIM+ demonstrated significantly greater OCS, health beliefs, posttraumatic stress symptoms (PTS), and depressive symptoms than FIM-. Furthermore, FIM+ showed a decrease in OCS from T1 to T2 after its infected member recovered from COVID-19 (P < 0.001). A decrease in OCS was correlated with a decrease in perceived susceptibility, severity, and barriers. Lack of a vulnerable family member, lower educational attainment, and being a primary caregiver were associated with a greater decrease in OCS. Changes in perceived severity and self-efficacy accounted for 17% of variation in OCS. Conclusion: Even two years after the onset of the pandemic, COVID-19 not only impacts the life of patients with COVID-19 but family members who care for such patients respond to the disease by engaging in excessive health behaviors in the form of OCS.

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.

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.

Longitudinal exploration of biopsychosocial profiles in individuals with anorexia nervosa

BackgroundPrevious work in individuals with Anorexia Nervosa (AN) has demonstrated a range of psycho-social difficulties such as increased anxiety, depression, obsessive-compulsive symptoms, as well as difficulties in work and with interpersonal interactions. However, making inferences regarding the stability of these psycho-social difficulties from previous studies is challenging, due to lack of a control group and known frequentist statistical issues. Methods134 participants, 40 healthy controls (HC) and 94 participants with AN, completed self-reported measures designed to explore eating disorder concerns, body mass index, mood symptoms, work and social functioning as well as traits associated with autism at two time points, two years apart. A principal component analysis and Bayesian mixed effects models were used to build and explore group differences in bio-psychosocial profiles at time points. ResultsThe Bayesian models demonstrated evidence for individuals with AN having higher scores for a component representing psycho-social difficulties and lower scores for a component representing biological difficulties compared to HC, at both time points. There was no evidence of a group difference for a component representing autism. ConclusionsOur results demonstrate that persistent psycho-social difficulties are a feature in individuals with AN.

Structural Fingerprinting of the Frontal Aslant Tract: Predicting Cognitive Control Capacity and Obsessive-Compulsive Symptoms.

White matter of the human brain is influenced by common genetic variations and shaped by neural activity-dependent experiences. Variations in microstructure of cerebral white matter across individuals and even across fiber tracts might underlie differences in cognitive capacity and vulnerabilities to mental disorders. The frontoparietal and cingulo-opercular networks of the brain constitute the central system supporting cognitive functions, and functional connectivity of these networks has been used to distinguish individuals known as "functional fingerprinting." The frontal aslant tract (FAT) that passes through the two networks has been implicated in executive functions. However, whether FAT can be used as a "structural fingerprint" to distinguish individuals and predict an individual's cognitive function and dysfunction is unknown. Here we investigated the fingerprinting property of FAT microstructural profiles using three independent diffusion MRI datasets with repeated scans on human participants including both females and males. We found that diffusion and geometric profiles of FAT can be used to distinguish individuals with a high accuracy. Next, we demonstrated that fractional anisotropy in different FAT segments predicted distinct cognitive functions, including working memory, inhibitory control, and relational reasoning. Finally, we assessed the contribution of altered FAT microstructural profiles to cognitive dysfunction in unmedicated patients with obsessive-compulsive disorders. We found that the altered microstructure in FAT was associated with the severity of obsessive-compulsive symptoms. Collectively, our findings suggest that the microstructural profiles of FAT can identify individuals with a high accuracy and may serve as an imaging marker for predicting an individual's cognitive capacity and disease severity.SIGNIFICANCE STATEMENT The frontoparietal network and cingulo-opercular network of the brain constitute a dual-network architecture for human cognitive functions, and functional connectivity of these two networks can be used as a "functional fingerprint" to distinguish individuals. However, the structural underpinnings of these networks subserving individual heterogeneities in their functional connectivity and cognitive ability remain unknown. We show here that the frontal aslant tract (FAT) that passes through the two networks distinguishes individuals with a high accuracy. Further, we demonstrate that the diffusion profiles of FAT predict distinct cognitive functions in healthy subjects and are associated with the clinical symptoms in patients with obsessive-compulsive disorders. Our findings suggest that the FAT may serve as a unique structural fingerprint underlying individual cognitive capability.

Association between the COVID-19 pandemic and psychiatric symptoms in people with preexisting obsessive-compulsive, eating, anxiety, and mood disorders: a systematic review and meta-analysis of before-after studies.

To determine whether the coronavirus disease 2019 (COVID-19) pandemic was associated with a change in psychiatric symptoms in people with preexisting obsessive-compulsive, eating, anxiety, and mood disorders compared to their prepandemic levels. We searched MEDLINE, CINAHL, PsycINFO, and Embase from inception until February 16, 2022. Studies were included if they reported prepandemic and during-pandemic psychiatric symptoms, using validated scales, in people with preexisting mood, anxiety, eating, or obsessive-compulsive disorders. Two reviewers independently screened studies, extracted data, and assessed evidence certainty. Random-effects meta-analyses were conducted. Effect sizes were reported as standardized mean differences (SMDs) with 95% confidence intervals (CIs). Eighteen studies from 10 countries were included. Of the 4465 included participants, 68% were female and the average age was 43 years. Mood and obsessive-compulsive disorders were the most studied disorders. During-pandemic psychiatric measurements were usually collected during nationwide lockdown. Obsessive-compulsive symptoms worsened among people with obsessive-compulsive and related disorders, with a moderate effect size (N = 474 [six studies], SMD = -0.45 [95% CI, -0.82 to -0.08], I2 = 83%; very low certainty). We found a small association between the COVID-19 pandemic and reduced anxiety symptoms in people with mood, anxiety, obsessive-compulsive, and eating disorders (N = 3738 [six studies], SMD = 0.11 [95% CI, 0.02-0.19], I2 = 63%; very low certainty). No change in loneliness, depressive, or problematic eating symptoms was found. People with obsessive-compulsive and related disorders may benefit from additional monitoring during the COVID-19 pandemic and possibly future pandemics. Other psychiatric symptoms were stable in people with the specific disorders studied. Overall, evidence certainty was very low.

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.