Obsessive-compulsive Research Articles

The relationship between emotional inhibition, emotional deprivation, failure, vulnerability to harm schema, and severity of symptoms among patients with obsessive-compulsive disorder

ObjectiveAssess the relationship between emotional inhibition, emotional deprivation, failure, vulnerability to harm schema, and severity of symptoms among obsessive-compulsive disorder.MethodsA descriptive correlational study was conducted on 30 patients with obsessive-compulsive disorder who were recruited to complete the Yale-Brown Obsessive-Compulsive Scale, Young Schema Questionnaire-Long Form.ResultsThe results of the study indicate that 66.6% of the 30 subjects exhibited high levels of OCD symptom severity, with a mean score of 33.20 ± 4.67. In terms of early maladaptive schemas, 60% of subjects displayed severe emotional deprivation, 66.7% showed severe emotional inhibition, and 83.3% had severe failure schemas. A strong positive correlation was found between failure schemas and OCD symptoms (r = 0.697, p < 0.001). However, what truly impressed the researchers was the predictive power of the failure schema. It was the only significant predictor of OCD symptoms (Beta = 0.992, p < 0.001), explaining 55.2% of the variance.ConclusionThe study underscores the crucial influence of early maladaptive schemas on the severity of obsessive-compulsive disorder symptoms in individuals with obsessive-compulsive disorder. It proposes that considering early maladaptive schemas, such as emotional self-awareness, failure, and vulnerability to harm, can aid in gauging the severity of obsessive-compulsive disorder symptoms. Moreover, the study’s findings are of significant importance to mental health professionals, researchers, and individuals involved in the treatment and management of obsessive-compulsive disorder, as they provide a deeper understanding of the condition and suggest practical approaches for its management.

The effect of major depressive disorder comorbidity on ischemia-modified albumin levels, a marker of oxidative stress, and antioxidant defense system in patients with obsessive compulsive disorder.

The aim of this study was to examine the levels of oxidant and antioxidant markers in patients with obsessive-compulsive disorder (OCD) and to investigate whether these levels change in the presence of major depressive disorder (MDD) comorbidity. This study was completed with 23 OCD patients with MDD comorbidity (OCD+MDD), 21 OCD patients without MDD comorbidity (OCD-MDD) and 21 healthy controls. Oxidative stress levels of the cases' were determined by ischemia modified albumin (IMA) and malondialdehyde (MDA) measurements and antioxidant levels were determined by superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) measurements. One-way analysis of variance (ANOVA) and unpaired Student's t-test were used to compare the study groups. Post hoc Bonferroni test was used for the degree of significance between groups, and repeated measures analysis of covariance (ANCOVA) was used to investigate the effect of age and gender. IMA and MDA levels were significantly higher in the OCD group compared to the control group, and SOD, CAT and GSH-Px levels were lower in the OCD group compared to the control group (p<0.01). IMA levels were significantly higher in the OCD+MDD group compared to the OCD-MDD group, while SOD, CAT and GSH-Px levels were significantly lower in the OCD+MDD group compared to the OCD-MDD group (p<0101). MDA levels were significantly higher in the OCD+MDD group compared to the OCD-MDD group (p=0.009). When the entire OCD patient group was examined, significant, powerful, positive correlations were observed between Y-BOCS and HDRS scores and IMA and MDA, and significant powerful negative correlations between Y-BOCS and HDRS scores and SOD, CAT, and GSH-Px (p<0.001 for all). In OCD+MDD group, oxidative stress markers increased significantly in parallel with the severity of depression, while antioxidant levels decreased (p=0.003 for IMA, p<0.001 for others). We believe that parameters indicating impaired oxidant/antioxidant balance in patients with obsessive-compulsive disorder may help to elucidate the cause of the disease and may be potentially useful biomarkers in the diagnosis and determination of the severity of comorbid MDD.

Psychiatric Comorbidities in Pediatric Trichotillomania: AMulticenter Cohort Study.

Trichotillomania (TTM) significantly increases the risk of psychiatric comorbidities. Sparse research in pediatric populations necessitates larger studies to assess these risks. This study investigates the risk of developing psychiatric comorbidities in pediatric TTM patients. This case-control study assessed pediatric patients (< 18 years old) with TTM diagnosed between May 18, 2013, and January 1, 2024, using US-based data from the TriNetX global research network. TTM patients (ICD-10 diagnostic category F63.3) aged 18 years or younger at diagnosis and control patients (ICD-10 code Z00.129) matched for age, sex, race, and ethnicity were assessed. Propensity score matching yielded 16,590 patients in each cohort. The analysis assessed subsequent diagnoses of ADHD, conduct disorders, tic disorders, obsessive-compulsive disorder, anxiety disorders, dissociative, stress-related, and somatoform disorders, mood disorders, and suicide attempts compared to controls. TTM patients under 18 years exhibited significantly greater risks of subsequent diagnoses for ADHD (OR: 2.002; CI 1.841-2.178; p < 0.001), conduct disorders (OR: 3.668; 3.2-3.668; p < 0.0001), tic disorders (OR: 2.247; 1.826-2.765; p < 0.0001), obsessive-compulsive disorder (OR: 11.047; 8.822-13.832; p < 0.0001), anxiety disorders (OR: 3.583; 3.387-3.7; p < 0.0001), dissociative, stress-related, and somatoform disorders (OR: 6.179; 3.935-9.701; p < 0.0001), mood disorders (OR: 2.476; 2.288-2.68; p < 0.0001), and suicide attempts (OR: 1.81; 1.121-2.924; p = 0.0139) compared to controls. TTM patients had the greatest risk of psychiatric diagnosis 1 year postindex event. Pediatric TTM patients have higher psychiatric comorbidity risks, necessitating timely intervention and comprehensive management. Dermatologists can facilitate access to behavioral and pharmacological care, enhancing patient outcomes.

Moderators of outcome in self-guided internet-delivered cognitive-behavior therapy for obsessive-compulsive disorder

Internet-delivered cognitive behavioural therapy (ICBT) is an effective treatment for obsessive-compulsive disorder (OCD). Currently there is limited research examining the predictors and moderators of outcome in ICBT for OCD. This study examined moderators of treatment outcome in a sample of 216 individuals who commenced a self-guided ICBT intervention for OCD (Mage = 34.00; SD = 12.57; 72.7% female). The results indicated that those with higher baseline OCD severity, depression severity, and neuroticism had less improvement at post-treatment and follow up (resulting in 40%, 24% and 12% higher symptom severity for every standard deviation increase on the measure at post-treatment and 33%, 17% and 20% higher symptoms at follow up respectively). However, participants with higher baseline treatment expectancy and readiness to reduce rituals and compulsions had better outcomes at post-treatment and three-month follow up (resulting in a 5% and 7% lower symptom severity for every standard deviation increase on the measure at post-treatment and 12% and 12% lower symptoms at follow up respectively). The results have important implications for who may respond best to self-guided ICBT.

The Nature of Taboo within Cultural Complexes: Theoretical and Clinical Applications.

The symbolic nature of taboo is examined as a container that differentiates developmental stages between the social values order/disorder through a ritual, liminal process of separating order as clean/blessed/safety and disorder as polluted/disassociated/risky. Unconscious/conscious taboos embody that perilous journey across margins in rites of passage and their emotional value and intensity in the form of symptomology varies cross-culturally. Two clinical cases are presented to illustrate the influence of taboo on obsessive compulsions and anorexia nervosa. Particular attention is given as to whether dirt as disorder/rubbish can be recycled at the margins between safety and risk and value redistributed to the intrapsychic and psychosocial anomalous bits and pieces that are discarded as rubbish.

Causes and manifestations of infantilism as feelings of helplessness and despair: psychological and spiritual specifics (case analysis)

Obsessive-compulsive disorder (OCD) occurs in 1-3% of the adult population and is considered an extremely debilitating and severe disorder with concomitant complications in the social, professional and family spheres. At the same time, cultural-specific (ethnic, regional and religious) aspects of the manifestation of this condition are rarely highlighted, and even less often – the cultural specifics of psychological counseling.This article is an integral part of a series of publications in which, based on specific cases of child-parent relations, the positive dynamics of psychological work based on Ingush culture and religious values is shown. The results of the author's accumulated experience show that the multicultural competence of the therapist provides him not only with a high level of trust from the client, but also with a professional approach based on the cultural aspects of psychological assistance [1; 2; 3; 4; 5].

Examination of vitamin D status in individuals with obsessive-compulsive disorder

Examination of vitamin D status in individuals with obsessive-compulsive disorder

Seven Identities Co-existing, A Noteworthy Manifestation of Complex Childhood Trauma: A Case Report

Background Childhood trauma increases the risk for psychiatric disorders such as Dissociative Identity Disorder (DID), Other Specified Dissociative Disorder (OSDD), Depersonalisation/Derealisation disorder (DDD), Post-Traumatic Stress Disorder Dissociative Type (D-PTSD), and Borderline Personality Disorder (BPD). Children who experience prolonged stress, trauma, or abuse during developmental years of growth and change have a wide range of outcomes. Case Presentation We report a case of a 22-year-old female with a significant history of physical abuse and sexual assault who initially presented to the hospital for suicidal ideation with a stated plan. During the patient’s stay at the hospital, we encountered two of the six alternate identities of the patient. The patient revealed she experiences all 7 identities (her true self plus 6 alters) in parallel, recalls the events of each alter, and can intermittently switch between identities; all rare features of dissociative disorders. Conclusion Given our patient’s extensive history of trauma, previous psychiatric diagnoses, and current dissociative presentation, we conclude that a diagnosis of OSDD and defence mechanisms of dissociation and regression may be appropriate. The patient was discharged with clomipramine for Obsessive-Compulsive Disorder and mood, lurasidone for mood, mirtazapine for mood, insomnia, and appetite stimulation, clonidine for nightmares and Postural Orthostatic Tachycardia Syndrome (POTS), fludrocortisone for POTS, gabapentin for Generalized Anxiety and fibromyalgia, and levothyroxine for hypothyroidism, and counselled to follow up with an outpatient therapist specialising in trauma. This case highlights the impact that childhood physical, sexual, and emotional trauma can have on one’s psychiatric presentation and the complexity of diagnosing dissociative presentations in an inpatient psychiatry setting.

Microbiological bases of obsessive‑compulsive disorder - the role of viruses, bacteria, and parasites in the onset and progression of OCD.

Obsessive‑compulsive disorder (OCD) is a current topic of discussion nowadays. OCD presents a variety of different etiologies including environmental, viral, cognitive, or genetic aspects. In this article, we focused on the possible correlation between various infectious diseases as well as generally the relationship between viruses, bacteria, and parasites, and an increased OCD risk. In this narrative review, we analyzed different types of articles found on PubMed, Google Scholar, and Scopus, as well as the articles of the National Institute of Mental Health. Searching criteria included articles from 1991 till the end of November, research involving human and animal patients (including monkeys and rats), and research published in English. Research showed a relationship between Herpes simplex virus, Rubella virus, Human immunodeficiency virus, Borna disease virus, Mycoplasma pneumoniae, Toxoplasma gondii, streptococcal infections, as well as gut microbiota and increased OCD risk. The possible mechanisms of this relation include neuroinflammation, brain tissue damage, autoimmune processes, and impairments in neurotransmitter levels. Infections caused by Varicella zoster virus, Measles virus, Mumps virus, Epstein‑Barr virus, Cytomegalovirus, or Borrelia Burgdorferi may also contribute to the increased risk of OCD. Reports showed an increased frequency of OCD occurrence in a group of infected people compared to a healthy group. However, there is no evidence of the influence of Influenza virus, Coxsackie virus, Poliovirus, Parvovirus B19, Enterovirus 71, West Nile virus, Treponema Pallidum, or Toxocara infections on the OCD risk. There is a significant relationship between various infectious diseases and an increased OCD risk. However, further studies are crucial to discover the exact pathomechanisms of these correlations and the potential influence of other pathogens on the onset of OCD.

Striking long-term beneficial effects of single dose psilocybin and psychedelic mushroom extract in the SAPAP3 rodent model of OCD-like excessive self-grooming.

Obsessive compulsive disorder (OCD) is a highly prevalent disorder that causes serious disability. Available treatments leave 40% or more of people with OCD significantly symptomatic. There is an urgent need for novel therapeutic approaches. Mice that carry a homozygous deletion of the SAPAP3 gene (SAPAP3 KO) manifest a phenotype of excessive self-grooming, tic-like head-body twitches and anxiety. These behaviors closely resemble pathological self-grooming behaviors observed in humans in conditions that overlap with OCD. Following a preliminary report that the tryptaminergic psychedelic, psilocybin, may reduce symptoms in patients with OCD, we undertook a randomized controlled trial of psilocybin in 50 SAPAP3 KO mice (28 male, 22 female). Mice that fulfilled inclusion criteria were randomly assigned to a single intraperitoneal injection of psilocybin (4.4 mg/kg), psychedelic mushroom extract (encompassing the same psilocybin dose) or vehicle control and were evaluated after 2, 12, and 21 days by a rater blind to treatment allocation for grooming characteristics, head-body twitches, anxiety, and other behavioral features. Mice treated with vehicle (n = 18) manifested a 118.71 ± 95.96% increase in total self-grooming (the primary outcome measure) over the 21-day observation period. In contrast, total self-grooming decreased by 14.60 ± 17.90% in mice treated with psilocybin (n = 16) and by 19.20 ± 20.05% in mice treated with psychedelic mushroom extract (n = 16) (p = 0.001 for effect of time; p = 0.0001 for time × treatment interaction). Five mice were dropped from the vehicle group because they developed skin lesions; 4 from the psilocybin group and none from the psychedelic mushroom extract group. Secondary outcome measures such as head-body twitches and anxiety all showed a significant improvement over 21 days. Notably, in mice that responded to psilocybin (n = 12) and psychedelic mushroom extract (n = 13), the beneficial effect of a single treatment persisted up to 7 weeks. Mice initially treated with vehicle and non-responsive, showed a clear and lasting therapeutic response when treated with a single dose of psilocybin or psychedelic mushroom extract and followed for a further 3 weeks. While equivalent to psilocybin in overall effect on self-grooming, psychedelic mushroom extract showed superior effects in alleviating head-body twitches and anxiety. These findings strongly justify clinical trials of psilocybin in the treatment of OCD and further studies aimed at elucidating mechanisms that underlie the long-term effects to alleviate excessive self-grooming observed in this study. Prepared with BioRender ( https://www.biorender.com/ ).

A prediction analysis testing if internet-delivered cognitive-behaviour therapy is most suitable for the milder cases of pediatric obsessive-compulsive disorder

BackgroundCommon clinical sense would suggest that individuals with milder obsessive-compulsive disorder (OCD) symptoms should be the most suitable for guided internet-delivered cognitive behaviour therapy (CBT), with more intensive forms of treatment reserved for more severe or complex cases.ResultsIn this secondary data analysis of a non-inferiority clinical trial comparing internet-delivered CBT with in-person CBT for young people with OCD (N = 152), we found that higher baseline symptom severity predicted worse treatment outcomes in the in-person group but not the internet-delivered CBT group. Additional analyses showed that among individuals with milder symptoms, internet-delivered CBT was associated with worse outcomes than in-person CBT.ConclusionsIf replicated, these results would question the axiom that internet-delivered CBT is most suitable for milder cases.Trial registrationThe original trial was registered at ClinicalTrials.gov ID NCT03263546. Date of registration 2017–08–28.

Obsessive-compulsive symptoms relating to psychosocial functioning for people with schizophrenia, schizoaffective disorder, or bipolar disorder.

To assess the psychosocial functioning concerning obsessive-compulsive symptoms (OCS) and/or obsessive-compulsive disorder (OCD) comorbidity in people with schizophrenia, schizoaffective disorder, or bipolar disorder diagnosed in a large case register database in Southeast London. Data were retrieved from the South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLaM BRC) register using Clinical Record Interactive Search (CRIS) system, a platform allowing research on full but de-identified electronic health records for secondary and tertiary mental healthcare services. Information of schizophrenia, schizoaffective disorder, bipolar disorder diagnosis and OCS/OCD status was ascertained from structural or free-text fields through natural language processing (NLP) algorithms based on artificial intelligence techniques during the observation window of January 2007 to December 2016. Associations between comorbid OCS/OCD and recorded Health of the Nation Outcome Scales (HoNOS) for problems with activities of daily living (ADLs), living conditions, occupational and recreational activities, and relationships were estimated by logistic regression with socio-demographic confounders controlled. Of 15,412 subjects diagnosed with schizophrenia, schizoaffective disorder, or bipolar disorder, 2,358 (15.3%) experienced OCS without OCD, and 2,586 (16.8%) had OCD recorded. The presence of OCS/OCD was associated with more problems with relationships (adj.OR = 1.34, 95% CI: 1.25-1.44), ADLs (adj.OR = 1.31, 95%CI: 1.22-1.41), and living conditions (adj.OR = 1.31, 95% CI: 1.22-1.41). Sensitivity analysis revealed similar outcomes. Comorbid OCS/OCD was associated with poorer psychosocial functioning in people with schizophrenia, schizoaffective disorder, or bipolar disorder. This finding highlights the importance of identification and treatment of comorbid OCS among this vulnerable patient group.

Obsessive-compulsive disorder with compulsive exercise leading to intensive care treatment in an adolescent male: a case report.

Obsessive-compulsive disorder (OCD) and eating disorders (ED) are compulsive disorders with overlapping symptoms. However, weight loss and over-exercise causing secondary medical complications are rarely seen in OCD. We report the case of a 15-year-old male who presented with atypical symptoms of OCD leading to severe medical compromise. Covid-19 related team sport restrictions led to compulsive exercise associated with intrusive thoughts. The onset of stress fractures limited exercise ability,prompting compensatory food restriction. Bradycardia, hypothermia and hypoglycaemia resulted from severe malnourishment and weight loss in the context of OCD. His weight was 85.8% of ideal body weight on admission, reflective of a weight 10-15 kg lower than his premorbid weight. During admission, he developed exercise-induced rhabdomyolysis with significantly elevated creatinine kinase and required intensive care unit treatment. Psychotropic medication included lamotrigine, olanzapine and high dose fluoxetine alongside cognitive-behavioural therapy. Medical stabilisation and weight restoration allowed discharge to an outpatient Child and Adolescent Mental Health Service. This atypical case of OCD highlights the potentially life-threatening risks associated with excessive exercise and malnutrition. This paper highlights the complexities of treatment in a patient who cannot adhere to bed rest and the differential diagnoses of anorexia nervosa, orthorexia nervosa and exercise addiction.

Evaluation of akathisia in patients receiving selective serotonin reuptake inhibitors/serotonin and noradrenaline reuptake inhibitors.

Akathisia is an underestimated but disturbing extrapyramidal side effect of antidepressants, which could reduce treatment compliance in mood disorders. This study aimed to investigate the frequency and risk factors in patients treated with selective serotonin reuptake inhibitors/serotonin and noradrenaline reuptake inhibitors (SSRI/SNRI). In addition, we assessed the impact of akathisia on the quality of life (QoL). Patients were aged between 18 and 75 years, receiving an SSRI/SNRI for 4-8 weeks, and were diagnosed with anxiety, depression, or obsessive-compulsive disorder. The Barnes Akathisia Rating Scale was used to assess the severity of the akathisia. QoL was evaluated using the Short Form 36 (SF-36) questionnaire. Akathisia was observed in 25% (50/198) of patients. Smokers and younger patients were more frequent among patients with akathisia. Physical functioning, physical role, vitality, and mental health domains of the SF-36 were reduced in the presence of akathisia. In conclusion, our results suggest that akathisia is not a rare side effect of SSRI/SNRI in patients with mood disorders, especially in smokers and younger patients. In addition, akathisia may reduce treatment compliance owing to a reduction in QoL. Further investigations are needed to confirm the risk factors, frequency, and consequences of treatment compliance for SSRI/SNRI-induced akathisia in patients with mood disorders.

Update and validation of the Beliefs about Losing Control Inventory-II (BALCI-II): a psychometric investigation

ABSTRACT The Beliefs about Losing Control Inventory (BALCI) was developed to assess negative beliefs about losing control in obsessive-compulsive disorder (OCD). Since its creation, research and theoretical work support negative beliefs about losing control as a potential transdiagnostic construct. The present study revised and expanded the original BALCI to be more inclusive of control-related concerns beyond those that would be expected in OCD (e.g. concerns about losing control over how one comes across to others in social anxiety disorder; SAD). Undergraduate students (N = 440) completed a questionnaire battery including the BALCI-II item pool. An exploratory factor analysis of the 32-item BALCI-II supported a four-factor solution. Three of the identified factors capture the feared consequences of losing control: 1) overwhelming emotions, 2) dangerous behaviour, and 3) madness. The fourth factor captures inflated beliefs about probability/severity of those losses. The BALCI-II was found to have good convergent and divergent validity, good to excellent internal, and retest reliability and was shown to have predictive utility in both OCD and SAD, above and beyond existing disorder-specific maladaptive belief domains. Results suggest the BALCI-II is an improvement over the previous version and supports the relevance of these beliefs beyond OCD.

Competition and stereotypic behavior in Thoroughbred horses: The value of saliva as a diagnostic marker of stress.

Many horses exhibit stereotypies, especially when living in human controlled environments that may prevent horses from satisfying natural needs in terms of feeding, drinking, moving, and socializing. In human medicine, obsessive compulsive disorder and other severe psychiatric disturbances are associated with stereotypic behaviors; salivary biomarkers evaluation is considered a reliable tool for diagnosis of common mental health disorders because saliva collection easy to obtain and noninvasive. In this study, we hypothesized that salivary cortisol concentrations, in addition to alpha-amylase (sAA) and butyrylcholinesterase (BChE) activities, are considered stress biomarkers that may be influenced in horses trained for racing competition with stereotypic behaviors. Saliva at rest condition was obtained from ten non-stereotypic Thoroughbreds horses involved in high-level competition; eleven Thoroughbreds high-level competition horses showing stereotypic behaviors, and five Thoroughbreds leisure non-competition horses. Cortisol was found to be higher in high-level competition non-stereotypic horses and sAA was significantly higher in non-stereotypic leisure horses when compared to horses involved in competition, while BChE did not change between groups. These results may represent the basis for further behavioural evaluation to elucidate how stereotypic horses and horses involved in competition overcome stressful situations.

Sociodemographic, mental health, education, employment and income characteristics of adults with obsessive–compulsive disorder who accessed secondary health services in Aotearoa | New Zealand

ABSTRACT Little is known about New Zealanders who experience obsessive–compulsive disorder (OCD). Using population-level data for people aged 18–64 years, we identified a cohort of 5559 people who accessed secondary health services and had a diagnosis of OCD. We explored their characteristics in comparison to people without OCD. The rate of OCD per 10,000 people differed by ethnicity (European, 24.7; Māori, 13.4; Pacific Peoples, 5.6; Asian, 5.9). We observed variation in OCD rates by the geographic divisions of the public healthcare provider Health NZ which persisted following standardisation for age, sex, ethnicity and urban vs rural residence (Northern, 14.5; 95% confidence interval (CI) 13.7–15.2; Te Manawa Taki, 10.9; CI 10.0–11.8; Central, 19.7, CI 18.5–20.8; Te Waipounamu, 27.4, CI 26.2–28.7). These disparities suggest inequity of access to healthcare. Individuals in this cohort typically had at least one co-occurring mental health or related condition (78.8%) and were less likely to have at least level 4 educational qualifications (equivalent to first year of an undergraduate degree) (adjusted rate ratio (ARR) 0.94; CI 0.90–0.97), to be employed (ARR 0.69; CI 0.66–0.72) and to belong to a higher income bracket ($40,000 or higher, ARR 0.57; CI 0.53–0.62). These findings suggest wider support needs. What we already know Obsessive–compulsive disorder (OCD) is a mental health condition that is characterised by repetitive intrusive thoughts and compulsive behaviours and has a twelve-month prevalence of around 1–2% in adults. In clinic-based studies, most individuals with OCD have other mental health and related conditions and, to a lesser degree, this is also observed in community surveys. OCD is typically first experienced as a child, adolescent or young adult and can severely impact an individual’s ability to engage in education and employment. What this article adds Using the Integrated Data Infrastructure (IDI), a national collection of linked health and non-health data, we explored the characteristics of working-age adults with OCD who had accessed public secondary health services in Aotearoa | New Zealand (NZ). There were marked differences in the rates of OCD for geographic areas corresponding to the regional divisions of Health NZ | Te Whatu Ora, and, as previously described, by ethnicity. These findings suggest inequity of access to healthcare and merit further investigation. In comparison to other working-age adults, people in the study cohort were moderately less likely to have achieved higher level educational qualifications, and they were markedly less likely to be employed and to belong to a higher income bracket. Accessing public secondary health services is likely to be a proxy for more severe and/or complex psychological disability and many people in this cohort had other mental health and related conditions. Therefore, the characteristics of this cohort cannot be generalised to the entire group of people who experience OCD in NZ.

A coordinate-based meta-analysis of grey matter volume differences between adults with obsessive-compulsive disorder (OCD) and healthy controls

According to the cortico-striato-thalamo-cortical (CSTC) model of obsessive-compulsive disorder (OCD), the striatum plays a primary role in its neuropathophysiology. Hypothesising that volumetric alterations are more pronounced in subcortical areas of patients within the CSTC circuit compared to healthy controls (HCs), we conducted a coordinate-based meta-analysis of magnetic resonance imaging (MRI) studies. We included 26 whole-brain MRI studies, comprising 3,010 subjects: 1,508 patients (788 men, 720 women; mean age: 30.26 years, SD = 8.16) and 1,502 HCs (801 men, 701 women; mean age: 29.47 years, SD = 7.88). This meta-analysis demonstrated significant grey matter volume increases in the bilateral putamen, lateral globus pallidus, left parietal cortex, right pulvinar, and left cerebellum in adults with OCD, alongside decreases in the right hippocampus/caudate, bilateral medial frontal gyri, and other cortical regions. Volume increases were predominantly observed in subcortical areas, with the exception of the left parietal cortex and cerebellar dentate, while volume decreases were primarily cortical, aside from the right hippocampus/caudate. Further exploration of these neuropathophysiological correlates could inform specific prevention and treatment strategies, advancing precision mental health in clinical applications.

IVIG response in pediatric acute-onset neuropsychiatric syndrome correlates with reduction in pro-inflammatory monocytes and neuropsychiatric measures.

Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) is characterized by abrupt onset of obsessive-compulsive disorder or eating restriction along with the abrupt onset of other co-occurring symptoms (tics, behavioral and cognitive regression, etc.). PANS is thought to be a post-infectious immunopsychiatric disorder, although as with most post-infectious disorders, it is challenging to establish a causal relationship with proposed infectious triggers. Intravenous immunoglobulin (IVIG) can modulate inflammation and support the elimination of infection and has been used for treatment of many post-infectious inflammatory disorders and autoimmune conditions. The aim of the study is to explore the pro-inflammatory state in PANS before and after administration of IVIG. Children with moderate-to-severe PANS received six infusions of IVIG (Octagam 5%, Octapharma) every 3 weeks with post treatment follow-up. Blood samples and psychiatric measures were obtained at Visits 1 (pre-treatment), 7 and 8 (4 and 11 weeks after last infusion, respectively). Myeloid cell activation was assessed via flow cytometry. All ten patients included in the study were male, White, with mean age 12.4 years (range 6-16). Statistically significant improvements following IVIG treatment were demonstrated in all psychometric assessments and parent questionnaires including CY-BOCS (obsessive compulsive scale), YGTSS (tic scale) and a parent PANS rating scale (for all scales p<0.001). The fraction of pro-inflammatory monocytes and dendritic cells decreased from pre-IVIG treatment levels. The proportional reductions were not compensated by increases in total white blood cells; pro-inflammatory monocytes post-IVIG were decreased as a proportion of CD14+ myeloid cells and in absolute number. The results of this study suggest that active PANS is associated with a pro-inflammatory state. This pro-inflammatory profile and psychometric scores improved following IVIG treatment. Future work will aim to further elucidate the roles of innate and adaptive immune responses in PANS and the regulatory mechanism(s) of IVIG in PANS treatment.

Predicting OCD severity from religiosity and personality: A machine learning and neural network approach

Obsessive-compulsive disorder (OCD) affects a significant portion of the United States population. The present study investigated the complex relationships among OCD severity, personality traits, religiosity, and spirituality with a dataset of 229 participants. We applied advanced machine and deep learning techniques to identify key predictors of OCD severity, uncovering nuanced relationships and unexpected findings. Notably, item-level features were more influential than aggregate scores, challenging traditional analytical approaches. Moreover, a neural network model, despite not surpassing a linear regression in predictive accuracy, provided a more comprehensive understanding of OCD’s heterogeneity and of the nonlinear relationships between our variables. The inclusion of demographic factors provided further explanatory power for predicting OCD severity, emphasizing the multifaceted nature of the disorder. Our results show that machine learning models can nearly match traditional linear models in predictive power while retaining nonlinear relationships essential to understanding OCD. Our study advocates for the adoption of sophisticated predictive models in examining complex psychological phenomena, encouraging a reevaluation of conventional analytical approaches when prediction is central to research questions.