On Obsessive-compulsive Disorder Patients Research Articles

The impact of childhood abuse on patients with obsessive–compulsive disorder: an Egyptian study

BackgroundThe presence of childhood abuse is expected to have a great impact on several psychological domains on obsessive–compulsive disorder (OCD) patients. This study was designed to assess the psychological impact of history childhood abuse (emotional abuse, physical abuse, sexual abuse, and emotional and physical neglect) on five psychological domains among OCD patients (self-esteem, depression, suicidal risk, cognitive functions, and anxiety).MethodsThis cross-sectional study included 101 OCD patients who were seen in the psychiatric department’s outpatient clinic at Zagazig University Hospital. They were diagnosed according to DSM-IV (SCID-I interview). All the patients were assessed using Childhood Trauma Questionnaire (CTQ-28), the Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HAM-A), Beck’s Suicide Scale, Rosenberg Self-Esteem Scale, and the MoCA scale (Montreal Cognitive Assessment Test).ResultsThe prevalence of childhood abuse in the studied group was 74.3%. 24.8% with emotional abuse, 20.8% with physical abuse, 16.8% with sexual abuse, and 11.9% of patients with emotional and physical neglect. The different types of childhood abuse (emotional, physical, and sexual abuse) were significantly associated with decreased self-esteem and increased depressive symptoms, while emotional and physical neglect were associated with decreased self-esteem only among OCD patients. The most powerful and significant predictor of lower self-esteem and depression was sexual abuse, and it was also the only significant predictor of increased suicidal risk among OCD patients.ConclusionsHistory of childhood abuse was significantly associated with decreased self-esteem and increased depressive symptoms among OCD patients. Only history of sexual abuse was significantly associated with increased suicidal risk. So, evaluation of the childhood abuse history is highly important among OCD patients to be incorporated in the management plan to reduce the suffering of OCD patients and for better improvement.

Symptomatic and Therapeutic Significance of Generalized Anxiety Disorder Comorbidity in Patients with Obsessive-Compulsive Disorder

Background: Psychiatric disorders frequently accompany comorbid conditions, which can have negative prognostic effects. The etiological and phenomenological distinctions between these conditions may have significant implications for their therapeutic approach and clinical course. Objectives: Our study aimed to investigate the symptomatic and therapeutic significance of comorbid generalized anxiety disorder (GAD) on obsessive-compulsive disorder (OCD). Methods: This cross-sectional study included OCD patients referred to private and institutional psychiatric clinics in Rasht, Guilan, in 2021. All participants were divided into two groups: those with OCD and those with both OCD and GAD (OCD-GAD). The diagnoses were determined using structured clinical interviews that followed the DSM-5-research version (DSM-5-RV) criteria and included psychiatric histories. Patients were assessed using the Hamilton anxiety rating (HAM) scale, Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), and Global Assessment of Functioning (GAF). The data were analyzed using SPSS version 20. Results: Out of the 146 participants, 80 had only OCD, while 66 had both OCD and GAD. Both groups demonstrated significant improvements in GAF scores throughout the treatment period (P < 0.0001); however, there was no significant difference between the groups in terms of these improvements. The Y-BOCS score was significantly higher in the OCD group at baseline (P < 0.0001), and it decreased more during the first 3 months in the OCD-GAD group (P = 0.006). The severity of obsessive-compulsive symptoms related to symmetry (P = 0.014), hoarding (P = 0.034), taboo thoughts (P = 0.023), and aggression (P = 0.002) was significantly higher in the group with OCD. Both HAM-A and Y-BOCS scores decreased over time, but HAM-A showed a greater decline at the first follow-up, while Y-BOCS showed a greater decline at the second follow-up. Conclusions: Considering our findings, OCD-GAD diagnosis is not a unique subcategory of current psychiatric disorders, and it is not necessarily beneficial to regard it as such. However, we found that the comorbidity of GAD did not harm the prognosis of patients with OCD. Further investigations are recommended to evaluate the clinical significance of OCD-GAD comorbidity.

Phenomenological Considerations of the World of the Obsessive Patient.

Despite significant scientific advances in research on obsessive-compulsive disorder (OCD), the psychological and behavioral symptoms of this pathological condition remain hard to understand, until they seem paradoxical. The present work seeks to consider the significance and potential contribution of a phenomenological reading of OCD and how phenomenalism has influenced some cognitive models of this disorder. Transcendental phenomenology is a philosophical approach that attaches primary importance to intuitive experience and considers all phenomena intrinsically associated with the subject's inner world. Thus, the subject's intuition is considered the starting point for understanding their essential experience. This approach has had a profound influence on modern cognitive sciences. Among current cognitive models, post-rationalist cognitivism and cognitive neuropsychological psychotherapy seem most effective in capturing the world experiences of OCD patients. Both apply a phenomenological approach to identify these experiences, which are typically characterized by hyper-reflexivity, at the expense of 'natural evidence.' The models have found that OCD patients experience the world emotionally as a sterile set of rules, and this experience determines their suffering.

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

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

Investıgation of vitamin D levels in obsessive-compulsive disorder.

Background:The impact of vitamin D on obsessive-compulsive disorder (OCD) remains unknown.Aim:Studies suggest that vitamin D deficiency may be associated with neuropsychiatric diseases. The purpose of this study is to investigate vitamin D levels in those diagnosed with OCD. In addition, the relation between OCD symptom severity and serum vitamin D level is investigated.Methods:About 174 patients newly diagnosed with OCD and 170 healthy volunteers were included in the study. Yale–Brown Obsessive Compulsive Scale (YBOCS) was used to assess the severity of OCD symptoms. Serum vitamin D levels of the two groups were compared.Results:The serum vitamin D levels of the OCD group were found to be significantly lower than the control group. Serum vitamin D levels were negatively correlated with the obsession, compulsion, and total scale scores measured in YBOCS but there was no correlation between the serum vitamin D levels and illness duration of OCD patients.Conclusions:To the best of our knowledge, this is one of the first studies to investigate vitamin D levels in newly diagnosed adult OCD patients without comorbidities. Although our findings suggest that vitamin D may play a role in the pathophysiology of OCD, further studies are needed to support our findings.

Cognitive Functions in Obsessive Compulsive Disorder and Its Relationship with Oxidative Metabolism.

While data on oxidative stress in psychiatric disorders are increasing, studies on obsessive-compulsive disorder (OCD) are limited. Although many studies report neurocognitive deficits in OCD, to our knowledge, no study exists examining the relationship between neurocognitive functions and oxidative stress in OCD. This study investigated the neurocognitive functions in OCD and its relationship with OCD severity and oxidative metabolism. In our study, 50 OCD patients and 50 healthy controls were included. The groups were well-matched for age, gender, education years, and other socio-demographic characteristics. Comorbid psychiatric diagnoses were excluded. To assess cognitive functions, a battery of neurocognitive tests was used. Oxidative metabolism parameters such as oxidants homocysteine, malondialdehyde, nitric oxide and antioxidants; sialic acid and glutathione peroxidase were measured. Obsessive-compulsive disorder severity was assessed with Yale-Brown-Obsession-Compulsion-Scale (YBOCS). Patients with OCD and control groups were compared in terms of neurocognitive functions, oxidative stress and OCD severity. OCD group performed significantly worse in various aspects of attention, memory, executive functions (p<0.05). Homocysteine, nitric oxide, malondialdehyde, sialic acid levels were significantly (p<0.05) higher, glutathione peroxidase was significantly (p<0.05) lower in patients versus controls. Yale-Brown-Obsession-Compulsion-Scale scores correlated negatively with most of neurocognitive functions. The relationship between oxidative parameters and cognitive tests was contradictory as some results were opposite to what was expected. Cognition is affected by OCD and worsens with disorder severity. Considering oxidative parameters were meaningful in patients, oxidative metabolism may be a risk factor for OCD. However, more studies are needed to evaluate the effect of oxidative metabolism on cognitive functions.

Narrative Review of COVID-19 Impact on Obsessive-Compulsive Disorder in Child, Adolescent and Adult Clinical Populations.

Background: The COVID-19 pandemic and quarantine had a significant impact on mental health which resulted in an increase of anxiety and depression in adult, child and adolescent clinical populations. Less is known about the potential effect of pandemic on obsessive-compulsive disorder (OCD) so there is a lack of review work to illustrate the impact of the COVID-19 pandemic on OCD.Purpose: The main objective is to review all the empirical contributions published after March 2020 that dealt with the impact of the COVID-19 pandemic on OCD in adults, children and adolescents, investigating the state-of-the-art literature concerning the impact on OCD and detailing limitations.Methods: The literature search was conducted using PsycINFO, PsycARTICLES, MEDLINE, Scopus, Web of Science, PubMed, and Google Scholar. This review analyzed all studies from January 2020 to 8 January 2021, focusing on clinical populations of children, adolescents, and adults with OCD.Results: A total of 102 articles were screened, resulting in the identification of 64 full-text articles to be further scrutinized. Upon closer examination, there was consensus that 39 articles met the study inclusion criteria and 14 of these were selected for study. Analysis of the results revealed that COVID-19 had an impact on OCD in both adults and young people and seems to have caused exacerbation of symptoms, especially of the contamination/washing subtypes. Eight studies in adult samples showed an increase in the severity of obsessive-compulsive symptoms; two studies underlined a minimal impact of COVID-19 on OCD patients and one study showed a slight improvement in symptoms. Two out of three studies on children and adolescents showed an exacerbation of OCD and a worsening even in the presence of an ongoing treatment.Conclusions: The studies reviewed are few. There are more studies on adult OCD than on children and adolescents. The results are controversial: few studies examined OCD subtypes; in most studies the typology of treatment was not clear and the samples covered a wide age range; a large number of studies did not use the same monitoring period or quantitative measures, both of which make it difficult to compare or rely on the results.

Microstructural white matter abnormalities in obsessive-compulsive disorder: A coordinate-based meta-analysis of diffusion tensor imaging studies.

There are no conclusive diffusion tensor imaging (DTI) findings on obsessive-compulsive disorder (OCD) for now. We conducted a comprehensive meta-analysis of DTI studies to identify white matter (WM) microarchitecture changes in OCD, and also to compare the results differences between the two most frequently used methods (voxel-based analysis, VBA versus tract-based spatial statistics, TBSS) for DTI data. A systematic search was performed on relevant studies that reported fractional anisotropy (FA) alterations between patients with OCD and healthy controls (HC). Seed-based d mapping (SDM) was applied to analyze microstructural WM abnormalities in OCD patients. Subgroup meta-analysis was subsequently performed to explore methodological differences between VBA and TBSS approaches. A total of 30 studies (with 31 datasets) that comprised 855 patients and 875 HC were identified. OCD patients exhibited significantly decreased FA in the right cerebellar hemispheric lobule, corpus callosum (CC), left superior frontal gyrus (orbital part), right gyrus rectus, left superior longitudinal fasciculus and right lenticular nucleus in the pooled meta-analysis. The VBA subgroup showed lower FA in several brain regions while the TBSS subgroup only exhibited significant FA reductions in the CC. According to the pooled meta-analysis, OCD patients presented microstructural abnormalities in distributed WM tracts. However, heterogeneous results were found between VBA and TBSS studies.

The effects of depression on the treatment of OCD in a residential sample.

Studies investigating the impact of depressive symptoms on obsessive-compulsive disorder (OCD) treatment have yielded mixed findings. The purpose of the study is to extend previous research, which primarily used outpatient samples, to determine whether depression affects OCD treatment outcome among patients receiving intensive residential treatment. OCD patients receiving residential treatment based primarily on exposure and response prevention (ERP) provided data regarding symptoms of depression and OCD at admission and discharge. Patients reported large and significant reductions in OCD symptoms over the course of treatment. Change in OCD symptoms was not significantly affected by depressive symptoms, including patients with severe depressive symptoms. Change in depressive symptoms over the course of treatment was, however, robustly related to change in OCD symptoms, especially among patients who began treatment with severe symptoms of depression. These findings suggest that cognitive-behavior therapy delivered in a residential treatment setting drastically reduces OCD symptoms regardless of depressive symptoms.

Impact of COVID-19 on Obsessive Compulsive Disorder (OCD).

Objective: Handwashing is now considered as one of the best safety measures to prevent COVID-19 infection. The effect of excessive handwashing for health on obsessive compulsive disorder (OCD) patients who are already having washing compulsion is not known. Furthermore, the fear of contamination of COVID-19 in patients who already have obsession of contamination is not known. This study aims to evaluate the effect of COVID-19 on OCD patients. Method : Phone interviews were done with 84 patients previously diagnosed with obsession of contamination and compulsive washing. Yale Brown Obsessive Compulsive Scale was used and the scores of the participants were compared to their prepandemic scores. Results: Only 5 patients (6%) had exacerbation of symptoms after the COVID-19 pandemic. Most of the patients did not report any deterioration of symptoms due to the pandemic. Conclusion: Handwashing protocol does not aggravate the washing compulsion of patients. Similarly, the fear of infection with COVID-19 does not increase their fear of contamination.

A Computational Approach for the Assessment of Executive Functions in Patients with Obsessive-Compulsive Disorder.

Previous studies on obsessive–compulsive disorder (OCD) showed impairments in executive domains, particularly in cognitive inhibition. In this perspective, the use of virtual reality showed huge potential in the assessment of executive functions; however, unfortunately, to date, no study on the assessment of these patients took advantage of the use of virtual environments. One of the main problems faced within assessment protocols is the use of a limited number of variables and tools when tailoring a personalized program. The main aim of this study was to provide a heuristic decision tree for the future development of tailored assessment protocols. To this purpose, we conducted a study that involved 58 participants (29 OCD patients and 29 controls) to collect both classic neuropsychological data and precise data based on a validated protocol in virtual reality for the assessment of executive functions, namely, the VMET (virtual multiple errands test). In order to provide clear indications for working on executive functions with these patients, we carried out a cross-validation based on three learning algorithms and computationally defined two decision trees. We found that, by using three neuropsychological tests and two VMET scores, it was possible to discriminate OCD patients from controls, opening a novel scenario for future assessment protocols based on virtual reality and computational techniques.

Serum Proteomic Study of Women With Obsessive-Compulsive Disorder, Washing Subtype.

Introduction:Many genetic studies are conducted on Obsessive-Compulsive Disorder (OCD). however, a high-throughput examination of proteome profile of this severe disease has not been performed yet.Methods:Here, the proteomic study of OCD patients’ serum samples was conducted by the application of Two-Dimensional Electrophoresis (2DE) followed by Mass Spectrometry (MALDI-TOF-TOF).Results:A total of 240 protein spots were detected and among them, five significant differentially expressed protein spots with the fold change of ≥1.5 were considered for further evaluations. These proteins include IGKC, GC, HPX, and two isoforms of HP. While IGKC and HP show down-regulation, GC and HPX indicate up-regulation. Moreover, a validation study of overall HP levels in patients’ serum via nephelometric quantification confirmed the lower levels of this protein in the serum of OCD patients. Additionally, enrichment analysis and validation test revealed that inflammation is one of most dominant processes in OCD.Conclusion:It is suggested that these candidate proteins and their underlying processes (especially, inflammation) may be linked to OCD pathophysiology and can promise a clinical use after extensive validation studies.

Soft Neurological Signs and Cognitive Function in Obsessive-compulsive Disorder Patients

Objective:Modern research on obsessive-compulsive disorder (OCD) indicates that the primary cause of OCD, which was earlier explained only on basis of psychoanalytical theories, is biological. Our study attempts to investigate the neurobiological signs in form of soft neurological signs and cognitive function in OCD.Methods:A cross sectional study was conducted at psychiatric facility of Seth G.S. Medical College and KEM Hospital.Materials and Method:50 OCD patients and age- and education-matched controls were selected for the study. Established instruments were used to assess the neurological soft signs (NSS) and the cognitive deficits.Results:OCD patients had significant more NSS in tests for motor coordination, sensory integration, complex motor tasks, hard signs, and right/left and spatial orientation. Cognitive deficits in the domains of visuospatial ability, executive function, attention, and working memory were significantly more in OCD patients compared to controls.Conclusion:Our study highlights the role of biological factors in form of soft neurological signs and cognitive dysfunction in the development of the OCD.

Tryptophan hydroxylase gene polymorphism in patients with obsessive-compulsive disorder

Objective: There is limited number of studies on the effects of tryptophan hydroxylase-1 (TPH-1) A218C gene polymorphism on obsessive-compulsive disorder (OCD) etiology. This study aims to scrutinize the role of TPH-1 A218C gene polymorphism on OCD etiology. Methodology: Sixty patients diagnosed with OCD, applied to our clinic and fitting the study criteria were accepted as patient group. A group of 60 healthy individuals matching the patient group in age and gender were selected as the control group. In the study the Clinical Interview Scale Structured for DSM-IV Axis-I Disorders, Sociodemographic and Clinical Data Form, Yale-Brown Obsessive Compulsive Rating Scale (Y-BOCS) and Hamilton Depression Rating Scale were applied to participants initially. Consequently, they were classified into two groups of ‘responsive to therapy’ and ‘resistant to therapy’ based on their therapy histories and Y-BOCS points. For DNA isolation 300 μl blood samples were used in compliance with standard methods. Restriction Fragment Length Polymorphism method was used to evaluate A218C polymorphism in TPH-1 gene within the blood samples. Results: No significant difference was observed between patient and control groups related to TPH-1 genotypes. However, a significant increase was observed in AA genotype frequency for TPH-1 gene in the patient group resistant to therapy and in CC genotype frequency in the patient group responsive to therapy. The difference of the allele type ratios in this polymorphism between each patient group could be related to the response to therapy. To confirm the findings of the study, more research on the same gene polymorphisms is required with OCD patients in different societies.

From Circuit Activity to Network Connectivity and Back: The Case of Obsessive-Compulsive Disorder

From Circuit Activity to Network Connectivity and Back: The Case of Obsessive-Compulsive Disorder

Editorial: Categories and dimensions: reflections on obsessive-compulsive disorder (OCD)

Editorial: Categories and dimensions: reflections on obsessive-compulsive disorder (OCD)

Serotonin transporter gene polymorphism implicates reduced orbito-frontal cortex in obsessive–compulsive disorder

Although a number of magnetic resonance imaging (MRI) and genetic studies have been performed on obsessive–compulsive disorder (OCD), only limited studies in which genetic and neuroanatomical variables are evaluated concurrently have been performed. Therefore, the aim of our present study is (to understand) better understanding how genetic variation in the promoter region of the 5-HTT gene (5-HTTLPR) is associated with key brain structures in OCD, orbito-frontal cortex (OFC), thalamus and anterior cingulate. 5-HTT genotypes (SS, SL, LL) were determined for 40 patients with OCD and the same number of healthy controls. MRI-derived volumes of the OFC, thalamus, and anterior cingulate were determined by reliable tracing techniques. Volumetric measurements were made with T1-weighted coronal MRI images, with 1.5-mm-thick slices, at 1.5 T, and were done blindly. In comparison with controls, OCD patients demonstrated volumes reduction in OFC, increased volumes of thalamus and total white matter volumes, but no difference in total brain volume, total gray matter volumes and anterior cingulate volumes. No significant difference was observed in allelic frequencies between the patients and controls. The stronger effects of 5-HTT polymorphism on brain morphology in OCD than those in controls were determined in the both OFC and thalamus. On the other hand, for the OCD patients, ANCOVA revealed a significant main effect of genotype for both the OFC and thalamus and a significant genotype-by-side interaction for the OFC, demonstrating that the short variants had a smaller right OFC than the long variants. In conclusion, we found a significant genotype-diagnosis interaction effects on key brain structures, with a stronger effects of 5-HTT polymorphism in OFC and thalamus of OCD patients, whereas no morphological changes related to the polymorphism were found in normal individuals.

Was Freud partly right on obsessive–compulsive disorder (OCD)? Investigation of latent aggression in OCD

Inflated responsibility is increasingly regarded a pathogenetic mechanism in obsessive–compulsive disorder (OCD). In seeming contrast, there is mounting evidence that latent aggression is also elevated in OCD. Building upon psychodynamic theories that an altruistic façade including exaggerated concerns for others is partly a defense against latent aggression, evidence was recently obtained for high interpersonal ambivalence in OCD patients relative to psychiatric and healthy controls using a newly developed instrument entitled the Responsibility and Interpersonal Behaviors and Attitudes Questionnaire (RIBAQ). A total of 46 OCD patients and 23 healthy participants took part in the present study. OCD patients displayed a higher social responsibility than controls. At the same time, patients also disclosed more latent aggression/calculating behavior and interpersonal distrust. While the pathogenic role of latent aggression is still not fully uncovered, it may deserve more consideration in treatment in view of frequent tensions in the families of OCD patients. Longitudinal studies with at-risk sample are needed to assess the relationship between problems with anger expression as well as (exaggerated) moral standards in OCD.

A Review on Quality of Life and Depression in Obsessive-Compulsive Disorder

Quality of life (QoL) is increasingly recognized as a pivotal outcome parameter in research on obsessive-compulsive disorder (OCD). While the concept remains somewhat ill-defined, there is now little dispute that the patients' personal goals deserve foremost consideration during the course of treatment as the primary aim of treatment should be relief from individual despair, which is related but by no means synonymous to symptom reduction. Studies using generic (ie, illness-unspecific) instruments have confirmed poor QoL in OCD patients across a wide range of domains, especially with respect to social, work role functioning, and mental health aspects. Scores are sometimes as low as those obtained by patients with schizophrenia. Depression and obsessions are the symptom clusters that most strongly contribute to low QoL. Findings from a novel survey of 105 OCD participants point to multiple daily life problems, poor work status, and tense social networks in these patients. In order to achieve therapeutic success and improve QoL, functional problems at work and comorbid disorders such as secondary depression and physical impairments should be targeted. While successful treatment sometimes positively impacts well-being, in some studies symptom decline did not translate into improved QoL.

Severity of subjective cognitive impairment in patients with obsessive-compulsive disorder and depression

Previous research on obsessive-compulsive disorder (OCD) has consistently found cognitive impairments in the domains of executive and nonverbal (memory) functioning, particularly in patients with comorbid depressive symptoms. In contrast, little is known about the degree to which such deficits are cognizant to patients or the degree to which these impairments interfere with daily activities. The aim of the present study was to assess prevalence and specificity of subjective cognitive dysfunction in OCD patients. A self-rating scale, the Subjective Neurocognition Inventory (SNI), was administered to 67 OCD patients upon admission to hospital. Forty healthy and 30 depressed participants served as controls. Relative to healthy participants, OCD patients reported greater impairment on SNI subscales measuring psychomotor speed, selective and divided attention. Impairments in the OCD group were particularly pronounced in patients with severe OCD or depressive psychopathology. OCD patients were no more disturbed than depressed participants on any of the domains tested. Memory problems were only reported by a minority of OCD patients—even in patients with checking compulsions. In conjunction with prior studies showing few memory difficulties in non-depressed OCD patients, present findings further challenge the memory deficit hypothesis which claims that checking compulsions are a dysfunctional compensation for real or imagined forgetfulness.