Obsessive Personality Traits Research Articles

Social cohesion and artistic resources, Two Clinical cases.

IntroductionTwo emblematic clinical cases will be addressed in this poster. The purpose of the poster is to relate the aspect of how the artistic resources of psychiatric patients are useful to improve social cohesion.ObjectivesCorrelate psychotherapy work on superior defenses to social cohesion and clinical improvement.MethodsPsychopharmacotherapy. Psychoanalytically oriented psychotherapy. Psychiatric rehabilitation.Social jutice idex (Schraad-Tishler, 2015) and BES (Istat 2015) as sources of social cohesion indicators.ResultsIn the first case we have a man with ciclotimic personality disorder and substace abuse with psicotic episodes. Previously, the patient underwent repeated hospitalizations . Once the therapeutic relationship was hooked up and introduced in addition to pharmacological treatment, a psychotherapy also aimed at activating personal resources, the patient began to take an interest in the activity of a street artist. Over time and with the improvement of this activity, aspects of social cohesion have been highlighted in the social context. Social relations both linked to work and affective activity, as well as friends; improvement of the economic situation both through the economic return of this activity and through associative loans linked to this activity; an improvement of social inclusion and non-discrimination in the cities where the artistic activities were carried out; the use of fixed environmental spaces where the activity can be carried out. These aspects have favored a recovery that has reached the complete economic independence of the patient, the establishment of a family unit of their own, the progressive remission of the toxicophilic relapses and therefore the psychotic imbalances they induce.In a second case, we have a 30-year-old patient with a severe depressive disorder, with narcissistic, paranoid and obsessive personality traits, graduated from the Academy of Fine Arts and with an artistic production both before and after the illness. In addition pharmacological therapy, the patient began psychotherapeutic interventions on the enhancement of superior defenses such as sublimation through artistic activity. So she began to rededicate herself to the artistic activity , she however progressively improved the recovery aspects for a long period of time up to living, working and emotional autonomy. During this path the aspects of social cohesion were also decisive, such an economic autonomy linked to the work activity of an employee in an art gallery, a progressive social inclusion, the conquest of spaces where you can exhibit your works and an increase in trust both towards the family and towards health workers and towards friends and work relationships.Image:Image 2:Image 3:ConclusionsIn this Clinical cases and others not reported exist correlation between psychotherapy work on superior defenses to social cohesion and clinical improvement.Disclosure of InterestNone Declared

My stomach is full

IntroductionAnorexia nervosa is an eating behavior disorder that is often related to various personality factors. The relationship between obsessive compulsive disorder and eating Disorders has been highlighted.Objectives To present a clinical case of a patient with eating disorder and gastric bezoar, secondary to compulsive hair ingestion.MethodsBibliographic review of articles published in relation to the comorbidity of these disorders, based on articles published in the last 5 years in Pubmed.Results 26-year-old female. Diagnosis of restrictive anorexia nervosa. She was admitted to the hospital on two occasions for nutritional disorders. In the last admission, she reported greater anxiety and significant weight loss. She reports that she has limited her food intake, but she does feel thin and is unable to eat for fear of gaining weight. Ruminative thoughts about her body image. During admission, the patient expressed a sensation of fullness, nausea and vomiting, later observing in abdominal X-ray and gastroscopy, the presence of a gastric trichobezoar, which was finally resolved conservatively.ConclusionsTrichotillomania is observerd in 1 in 2000 people, trichophagia is even less frequent. According to DSM- V, these disorders are grouped within obsessive-compulsive spectrum disorders. A Trichobezoar is a conglomerate that can be found in the stomach or intestine, composed mainly of hair, previously ingested. Trichotillomania can be associated with anorexia nervosa, especially in patients with obsessive personality traits, which occurs frequently. The gastric slowing that patients with anorexia often present is a factor that favors the formation of the bezoarDisclosureNo significant relationships.

Influence of COVID-19 in the development of delusional ideas disorder. A case report

IntroductionHypochondria is characterized by the presence, for 6 months or more, of a generalized and non-delusional concern with fear of having (or the idea that one has) a serious illness, based on the wrong interpretation of the symptoms. In somatic-type delusional disorder, the delusional idea is fixed, indisputable, and occurs intensely because the patient is fully convinced of the physical nature of the disorder.Objectives To describe a clinical case and make a differential diagnosis of hypochondriac disorder vs somatic-type delusional disorder.MethodsCase report: 61-year-old woman, after suffering from COVID-19, develops a hypochondriacal disorder vs. somatic delusional disorder, presenting anxiety-depressive symptoms and digestive somatic complaints, with a loss of 15 kg of weight. She made frequent visits to doctors and multiple complementary tests discarding organicity. She required involuntary hospital admission for 48 days, and pharmacological treatment with Venlafaxine 150 mg, Olanzapine 5mg, Mirtazapine 30mg and Alprazolam 1mg. The patient presented slow evolution during admission, with ups and downs and stagnation, meriting enteral nutrition due to refusal to ingest, given abdominal kinesthetic hallucinations and digestive evaluation (EDS) with a result of antral gastritis and negative H. pylori. In subsequent follow-ups after partial remission of symptoms, obsessive personality traits are glimpsed, although with better personal functioning.ResultsThe diagnosis at discharge was inconclusive, however the data points to a somatic-type delusional disorder.ConclusionsThe influence of COVID-19 as a triggering factor, social isolation and premorbid personality traits, influence the development of a Somatic Delusional Disorder vs Hypochondriac Disorder, regarding this case.DisclosureNo significant relationships.

The ugliest woman un the world

IntroductionThe main feature of body dysmorphic disorder (BDD) is impairing preoccupation with a physical defect that appears slight or non-existent to others.ObjectivesTo draw an overview of BDD through a clinical case of a patient with BDD and autolytic ideation, which improved after an adequate diagnosis and an early pharmacological and psychotherapeutic approach.MethodsBibliographic review of the treatment and diagnosis of BDD, from articles published in the last 5 years in Pubmed.Results18-year-old woman diagnosed with depression and obsessive ideation, which started at the age of 11, after a comment at school. The patient believes that she has intenseunder-eye bags or dark circles, this has caused her to abandon all activity and self-isolate at home. Symptoms included recurring obsessive and intruding thoughts related to the supposed defect, ritualized behaviors of hours of duration aiming toit through makeup, and autolytic ideation. Therapeutic approach combined psychopharmacological and psychotherapeutic treatments, obtaining gradual improvement of symptomatology and disappearance of the autolytic ideation.ConclusionsThe disorder is severe, which is reflected in high rates of suicide attempts. Differential diagnosis between obsessive and delirious dysmorphophobia is essential for improving outcomes; the egodystonic nature of the symptom, awareness of illness and obsessive personality traits facilitate the diagnosis. A multidisciplinary approach involving psychiatrists and clinical psychologists is necessary for a correct diagnosis and early treatment of this pathology, as well as recognition by dermatologists, surgeons and medical aesthetic professionals, where these patients go with the aim of finding solutions to their problem.DisclosureNo significant relationships.

A Novel Approach for Investigating Parkinson's Disease Personality and Its Association With Clinical and Psychological Aspects.

ObjectiveA complex relationship between neuropsychiatric symptoms, personality traits and neurochemical changes in patients with Parkinson’s disease (PD) has been highlighted in the past several decades. In particular, a specific Parkinson personality with obsessive traits has been described. However, despite the great amount of anecdotal evidence, this aspect, together with its neurobiological, psychological and clinical correlates, are still not clearly defined. Therefore, we performed a case-control study in order to investigate the presence and rate of obsessive personality traits in PD patients within the theoretical framework of cognitive-constructivist model. Moreover, the relationship between PD personality and clinical, psychological and quality of life (QoL) aspects in PD were investigated.MethodsFifty-one non-demented patients with probable or possible PD (not demented) were recruited at the inpatient-outpatient San Luca Hospital, IRCCS Istituto Auxologico Italiano. Control group was composed by forty-eight age- and education-matched healthy volunteers. Patients underwent a neurological investigation including Unified PD Rating Scale (UPDRS), Modified Hoehn and Yahr and Schwab and England staging scales. The following psychological questionnaires were administered to the overall sample: Personal Meaning Questionnaire (PMQ), State-Trait Anxiety Inventory-Form Y (STAI-Y), Beck Depression Inventory (BDI), Symptom Check List-90 (SCL-90), Short-Form Health Survey-36 (SF-36).ResultsNo significant differences in personality styles were observed in PD patients and controls, with a prevalence of phobic personal meaning organization (PMO) in both groups. However, PD patients showed more anxiety, depression and obsessive-compulsive (OC) symptoms than controls at the psychological questionnaires, as well as poorer QoL levels. The intensity of personality traits, and in particular for the obsessive personality style, were negatively associated with QoL and positively with disease severity. No significant relationships were observed between personality and other clinical aspects, such as side of onset and disease duration.ConclusionParkinson’s disease patients did not show a different personality profile according to the cognitive-constructivist model with respect to controls. However, in this population, a general enhancement in the tendency to codify experience by means of specific cognitive and emotional patterns was associated to disease progression and to a poorer QoL.

ABORDAGEM BIOPSICOSSOCIAL DE UM CASO DE DISFUNÇÃO SEXUAL MASCULINA

Diagnósticos biopsicossociais, incluindo mecanismos de medicações, são importantes para o tratamento das disfunções sexuais. Um homem de 23 anos referia ser muito tímido e exigente consigo mesmo. Às masturbações fazia estimulação anal e apresentava ejaculação precoce (EP). Só tentou ter a sua primeira relação sexual há nove meses, quando teve disfunção erétil (DE). Desde então teve poucas tentativas, sempre com DE e EP. Estava com varicocele e espermograma alterado. Tem pai idoso e com dificuldades para deambular. Os diagnósticos foram DE, EP, fobia social, fortes traços obsessivos de personalidade, reação depressiva e excitação por estimulação anal pela qual tinha sentimento de culpa. O tratamento incluiu psicoterapia, Sertralina 25 mg, Diazepam e Sildenafila se necessário, além de exercícios sexuais e avaliação urológica. Foi sugerida cirurgia para a varicocele, mas esta não justificava as disfunções sexuais. Relutou em iniciar o tratamento e manteve a DE e a EP. Quando usou Sildenafila, não teve DE mas apresentou EP. Quando iniciou a Sertralina conseguiu o retardo ejaculatório. A Sertralina trata a fobia social e retarda a ejaculação pelo efeito da serotonina, melhorando a EP. Foi usada em dose bem baixa, mesmo porque inibe a libido. O Diazepam também causa disfunções sexuais, por isso foi evitado. Assim, com essas medicações associadas à psicoterapia passou a ter relações normalmente. Pouco tempo depois, suspendeu as drogas sem prejuízo da função sexual. Continuou a psicoterapia na qual foram trabalhados os seguintes aspectos: o sentimento de culpa em relação às fantasias de estimulação anal; a baixa autoestima; o medo de ser criticado; as fantasias em relação à varicocele e à perda de mobilidade dos espermatozoides; a auto cobrança excessiva e o fraco pai interno. Com a melhora da autoestima e da autoconfiança, passou a ter uma vida sexual saudável.

TA Treatment of Depression: A Hermeneutic Single-Case Efficacy Design Study - 'Sergio'

This study is the fifth of a series of seven and belongs to the second Italian systematic replication of findings from previous series that investigatedthe effectiveness of a manualized Transactional Analysistreatment for depression through Hermeneutic Single-Case Efficacy Design.The therapist was a white Italian woman with 5years of clinical experience and the patient, Sergio, was a 39-year old white Italian man who attended sixteen sessions of transactional analysis psychotherapy. Sergio satisfied DSM 5 criteria for Persistent Depressive Disorder (Dysthymia) with melancholic features, Post-Traumatic Stress Disorder (PTSD) with Obsessive Personality traits. The treatment focused on the permission to enjoy and on self-protection. The focus on both depressive symptoms and obsessive traits allowed a remission of his dysthymia within the end of therapy. The judges evaluated the case as a good outcome: the depressive and anxious symptomatology clinically and reliably improved over the course of the therapy and these improvements weremaintained at the followups. Furthermore, the patient reported significant change in his post-treatment interview and these changes were directly attributed to the therapy. Citation - APA format: Benelli, E., Gentilesca, G., Boschetti, D., Piccirillo, C., Calvo, V., Mannarini, S., Palmieri, A. and Zanchetta, M. (2018). TA Treatment of Depression: A Hermeneutic Single-Case Efficacy Design Study - Sergio. International Journal of Transactional Analysis Research & Practice, 9(2), 23-41 https://doi.org/10.29044/v9i2p23

The psychological profile and the counter attitudes of encopretic children's mothers: A Tunisian study

IntroductionPersistent encopresis is part of a fairly specific pathologic complex including personality, and familial factors. To a very large extent, interest in encopresis issues has revolved around the mother–child relationship.ObjectivesIn this study, we aimed to assess the psychological profile and the counter attitudes of encopretic children's mothers.MethodsWe led a retrospective and descriptive study carrying on 91 medical records of children with encopresis, followed in the outpatient child psychiatry department of the Hédi Chaker university hospital of Sfax over a period of seven years, going from January 1st, 2000 till December 31st, 2006.ResultsIn our study, emotional deprivation was noted in 62.2% of cases. Besides, repeated separations from mothers were noted in 26.4% of cases with 2.2% cases of prolonged separations. Our study also revealed that 19.8% of mothers have obsessive personality traits while 14% have rather anxious traits. Furthermore, 6.6% of encopretic children's mothers were found to have anxio-depressive spectrum disorders according to the DSM-IV-TR. Mothers’ intolerance towards encopresis was estimated at 53.3%. This intolerance was mainly reflected in physical punishment, depreciation, blame and humiliation. Toilet training was rigid in more than half of cases (62.2%).ConclusionChildhood encopresis can be viewed as a result of a maternal-child conflict. In fact, the mother–child relationship appears to be directly involved in the genesis of encopresis. Nevertheless, the role of the own child neurodevelopmental state in response to the family system should not be ignored.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Vortioxetine efficiency in controlling obsessive symptoms in patients with depression. A case report

IntroductionObsessive symptomatology can sometimes be worsened when a patient with this personality trait suffers through a period of increased stress.AimTo review articles in PubMed related to how vorticoxetine affects obsessive symptoms in patients with depression.MethodsWe review the case of a 45-year-old male with obsessive personality traits diagnosed of recurrent depression. He was going through a period of stress at work that had worsened his obsessive symptoms (primarily obsessive thoughts). In a previous depressive episode, he was treated with an antidepressant that triggered sexual dysfunction as a side effect. Trying to prevent another antidepressant-induce sexual dysfunction, we decided to use voricoxetine because of its low tendency to interact with the sexual function.ResultsWe started treatment with vorticoxetine reaching a dose of 10 mg/day. Three weeks later the patient reported a decrease in his levels of anxiety, a slight upturn of his mood and a relieve of his obsessive symptoms.ConclusionsVorticoxetine can be considered a good therapeutic option in the treatment of obsessive symptoms in a depressive episode with patients with a history of antidepressant-induce sexual dysfunction.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Exploring the Possibility of Shared Familial Diathesis for Personality in OCD Probands

The present study aims to probe into the status of the big five personality factors in the OCD probands and their first degree relatives (FDR) viz a viz community controls and also look into the association of the big five factors with symptom severity and obsessive personality traits. Fifty dyads of probands and FDR and community controls matched on the basis of age, sex and education were assessed on NEO Five Factor Inventory, Yale Brown Obsession Compulsion Scale, Beck Depression Inventory and Leyton Obsessional Inventory to fulfill the aims of the study. The findings reveal higher neuroticism and lower extroversion and conscientiousness in the OCD group as compared to controls, endorsement of greater conscientiousness among the FDR as compared to the case-probands, with Agreeableness and Conscientiousness emerging as predictors associated with obsessive symptoms among OCD probands.

Cefalea y síntomas funcionales

Headaches are a common reason for visiting neurology clinics. They have their origin in a variety of causes and their specific diagnosis deteriorates as it overlaps with other chronic painful pathologies. Somatic functional syndromes are characterised by chronic painful conditions that have a negative effect on quality of life, and are accompanied by functional symptoms with no organic cause. The aim of this study is to evaluate the prevalence of functional symptoms in patients who visited due to headaches. The sample included all the patients who visited the walk-in neurology clinic because of headaches between March and September 2014. A semi-structured survey was carried out in order to evaluate obsessive personality traits, bruxism, gastrointestinal symptoms, anxiety, depression and sleep disorders. During the period under study, 125 patients visited due to headache. In all, 68.7% of patients with migraine presented functional symptoms and only 32.7% in the case of other headaches (p = 0.0001). Functional symptoms were prevalent in patients with headache, mainly in those with migraine.

Executive Functioning in People With Obsessive-Compulsive Personality Traits: Evidence of Modest Impairment

Investigations of executive dysfunctions among people with obsessive-compulsive personality disorders (OCPD) have yielded inconsistent results. The authors speculate that obsessive-compulsive personality traits (OCPT) from a nonclinical population may be associated with specific executive dysfunctions relative to working memory, attentional set-shifting, and planning. A sample consisting of 79 adults (39 females, 40 males) was divided into high and low scorers on the Personality Diagnostic Questionnaire-4 (PDQ-4; Hyler, 1994). In addition, these participants were interviewed using the SCID-II (First, Spitzer, Gibbon & Williams, 1997) to confirm the presence of symptoms of obsessive-compulsive personality. Participants completed a battery of executive tasks associated with the Cambridge Neuropsychological Test Automated Battery (CANTAB), including Spatial Working Memory, Intradimensional/Extradimensional (ID/ED), Attentional Set-Shifting, and Stockings of Cambridge. Also, self-report measures of executive functions as well as of anxiety and depressive symptoms were administered. The analysis of covariance revealed significant differences between participants with OCPT and controls on the Spatial Working Memory tasks, ID/ED tasks, Stockings of Cambridge, and the Dysexecutive Questionnaire (DEX). Nevertheless, there were no significant differences in the number of problems solved in minimum movements. These results suggest that executive dysfunctions are present in people with prominent OCPT and that there is a high convergence between clinical and ecological measures of executive functions in people with obsessive personality traits.

Cognitive flexibility in juvenile anorexia nervosa patients before and after weight recovery

Deficits in set-shifting abilities have been robustly described in adult patients with anorexia nervosa (AN). These deficits are associated with behavioral traits, such as rigidity and perfectionism, and are independent of starvation. However, little is known about neurocognitive deficits in juvenile patients with AN. The brain circuits that support set shifting are not fully mature in these patients. One possibility is that neuroendocrinological changes, such as elevated cortisol levels, contributing to alterations in cognitive performance in individuals with AN. Set-shifting abilities (Visual Set-Shifting Task), cortisol levels, self-reported perfectionism and obsessive personality traits were assessed in 28 female adolescent patients with AN before (T0) and after (T1) weight rehabilitation and compared with 27 age- and IQ-matched healthy controls (CG). Compared with the CG, AN patients showed increased reaction times (RT) in shift trials (p<0.001) and reduced error rates in both shift and non-shift trials across time points (p<0.05). Across all subjects, perfectionism was associated with increased RTs during shift trials at T1 (r=0.35, p<0.05). Subjects with lower cortisol levels showed increased RTs and more errors in non-shift trials (p<0.05). In contrast to the findings in adult patients, adolescent patients with AN did not display a marked deficit in set-shifting abilities. Instead, they demonstrated a perfectionistic cognitive style that was characterized by increased RTs in shift trials but improved accuracy. One could speculate that the shorter duration of illness and the incomplete maturation of the prefrontal cortices contribute to these findings.

P02-282 Gilles de la Tourette syndrome and epilepsy: A case report

Introduction:The association between tics, epilepsy and obsessive-compulsive symptoms, is still little explored in literature.Case report:The authors describe case of a male patient, 25 years old, with some obsessive personality traits and with the appearance of simple multiple tics, at 7-8 years old. The tics were vocal and motor, particularly facial and worsen with anxiety. Of the personal history is highlighted the existence of repetitive tonsilitis and in the family history the presence of tics in 3 paternal first cousins. This patient started only consultation of Neurology in 2003 and was medicated with haloperidol 1 mg / day. Already in 2007 it was triggered absence crisis, so that after additional study (EEG and MRI) and detection of focal paroxysmal activity in the left fronto-temporal region, the patient was medicated with levetiracetam 1000 mg / day. Currently holds the following therapy: levetiracetam 1500 mg / day, clonidine 0225 mg / day and buspirone 30 mg / day, with clinical improvement occurred.Conclusions:This patient on one hand, presents DSM-IV-TR (2001) diagnostic criteria for Gilles de la Tourette syndrome and on the other hand, criteria for the diagnosis of fronto-temporal epilepsy. It is also relevant the patient"s family history, that is consistent with the high risk of Tourette Syndrome in the first degree relatives.

P03-92 Diogenes syndrome and pathological hoarding behaviour: A case report

Background:Diogenes syndrome is the combination of severe self-neglect, domestic squalor, social withdrawal, a tendency to hoard excessively, and refusal of help, in elderly patients.Aim:To report a case of Diogenes’ syndrome underlying the impact of pathological hoarding behaviour in the quality of life of the patient. to discuss the pathological hoarding behaviour (syllogomania) in the context of this specific behavioural disorder.Methods:Case study and review of the literature.Results:The subject of this case study is a 78-year-old man with Diogenes syndrome. Hoarding behaviour is the major presentation symptom in this case, along with domestic squalor and social withdrawal. He has marked obsessive personality traits, no insight for his morbid condition and an attitude of refusal of treatment.Discussion:The literature reveals high comorbidity of Diogenes syndrome with psychiatric and somatic disorders. Some authors raise the possibility that obsessive-compulsive disorder may be the cause of hoarding rubbish in those cases of Diogenes syndrome in which hoarding exists and cannot be better explained by other psychopathology. other authors hypothesise Diogenes syndrome as a reaction to stress in elderly people with certain personality characteristics or as the end stage of a personality disorder. the ethiopathogeny of Diogenes syndrome remains unclear and there is no consensus about diagnostic criteria. It is a relevant area for future research, contributing for a better comprehension of the differential diagnosis of pathological hoarding behaviour and late life psychopathology.

Obsessive‐compulsive and eating disorders: Comparison of clinical and personality features

The aim of the present study was to determine whether anorexia nervosa (AN), bulimia nervosa (BN) and obsessive-compulsive disorder (OCD) share clinical and psychopathological traits. The sample consisted of 90 female patients (30 OCD; 30 AN; 30 BN), who had been consecutively referred to the Department of Psychiatry, University Hospital of Bellvitge, Barcelona. All subjects met DSM-IV criteria for those pathologies. The assessment consisted of the Maudsley Obsessive-Compulsive Inventory (MOCI), Questionnaire of obsessive traits and personality by Vallejo, Eating Attitudes Test-40 (EAT-40), Eating Disorder Inventory (EDI), and Beck Depression Inventory (BDI). ANCOVA tests (adjusted for age and body mass index) and multiple linear regression models based on obsessive-compulsiveness, obsessive personality traits and perfectionism, as independent variables, were applied to determine the best predictors of eating disorder severity. On ancova several significant differences were found between obsessive-compulsive and eating-disordered patients (MOCI, P < 0.001; EAT, P < 0.001; EDI, P < 0.001), whereas some obsessive personality traits were not eating disorder specific. A total of 16.7% OCD patients presented a comorbid eating disorder, whereas 3.3% eating disorders patients had an OCD diagnosis. In the eating disorder group, the presence of OC symptomatology was positively associated (r = 0.57, P < 0.001) with the severity of the eating disorder. The results were maintained after adjusting for comorbidity. Although some obsessive-compulsive and eating disorder patients share common traits (e.g. some personality traits especially between OCD and AN), both disorders seem to be clinically and psychopathologically different.

Prediction of outcome: Anxiety sensitivity: A dimension of obsessive personality in dysfunctional chronic pain patients?

Anxiety sensitivity (AS) is the fear of symptoms of anxiety due to concerns that these symptoms have harmful physical, emotional, and social consequences. AS predicts adjustment to a wide range of pain disorders. Research also shows that AS is associated with a fear of strong emotions, a core dimension of obsessive personality. The present study examined whether obsessive personality traits may partly account for the association between AS and poor adjustment to pain. One hundred and ninety-eight chronic pain patients completed self-report measures of personality and adjustment. Regression analyses indicated that obsessive personality traits partly account for the association between AS and poor adjustment to pain. Cluster analyses were also conducted to identify an obsessive cluster of patients. Between-cluster differences in adjustment scores were assessed. Future research should examine the behavioural processes through which AS and other dimensions of obsessive personality influence adjustment to chronic pain.

Obsessive–compulsive disorder after epilepsy surgery

It is a well-known fact that after epilepsy surgery (ES) preexisting psychopathology may deteriorate or de novo psychopathological syndromes, mainly of a depressive and psychotic nature, may appear. Previously, recovery of obsessive–compulsive disorder (OCD) after ES has been reported in patients who had comorbid OCD preoperatively; however, there have been no reports on the appearance of de novo OCD interfering with daily living activities post-ES. This is the first report of OCD after ES in patients with mesial temporal lobe epilepsy (MTLE). Five patients with MTLE were identified with obsessive personality traits before surgery. Within the first 2 months after ES, two of these MTLE patients fulfilled OCD diagnostic criteria. These OCD patients were not any different from the other three patients with respect to age, age of onset of epilepsy, seizure types, and seizure frequency. All patients stopped having seizures postoperatively, but the OCD patients had worse quality of life postoperatively than preoperatively. Our findings show that those patients with obsessive traits preoperatively should be carefully monitored after ES.

'Cleanliness is Next to Godliness': A further look

Lewis (1998) reviews the empirical relationship between aspects of religiosity (attitude, practice, and orientation) and measures of obsessionality (personality traits and obsessional symptoms) among non-clinical samples based on studies published between 1981-96. Lewis (1998) draws three conclusions: (1) religious attitude is associated with obsessional personality traits, but not with obsessional symptoms; (2) religious practice is associated with obsessional personality traits, but not with obsessional symptoms; and (3) limited data on the relationship between religious orientation and obsessionality is presently contradictory. However, extrinsic orientation may be associated with obsessional personality traits and obsessional symptoms. The present aim was to examine if these conclusions are challenged by findings from more recent published studies. Nine new studies were identified from the literature. The results from these studies not only largely corroborate the earlier conclusions of Lewis (1998), but also demonstrate the generalisability of the relationship between religiosity and obsessional personality traits across additional measures of both constructs and additional samples. Moreover, it is noted that this association is not 'contaminated' by social desirability. A suggestion for further research is given.

Polymorphisms of DRD4 and DRD3 and risk of avoidant and obsessive personality traits and disorders

We investigated whether polymorphisms of the dopamine D4 receptor ( DRD4) and polymorphisms of the dopamine D3 receptor ( DRD3) were associated with personality disorder symptomatology rather than with personality traits such as novelty seeking. DNA was obtained from 145 depressed patients in a clinical trial. These patients were assessed for the presence of personality disorder symptoms and disorders. The 2-repeat allele of the DRD4 exon III polymorphism was associated with increased rates of avoidant and obsessive personality disorder symptomatology. The T,T genotype of the DRD4 −521 C>T polymorphism was also associated with increased rates of avoidant and obsessive personality disorder symptomatology. The Gly9,Gly9 genotype of the DRD3 Ser9Gly polymorphism was associated with increased rates of obsessive personality disorder symptomatology. None of these three polymorphisms were associated with novelty seeking or other temperament traits on the Temperament and Character Inventory. Our results suggest that genetic polymorphisms of DRD4 and DRD3 may well be associated with personality traits, and that conflicting findings to date may arise from the problem of phenotype definition.