Presence Of Obsessive-compulsive Disorder Research Articles

The effect of obsessive compulsive disorder on sibling relationships in late childhood and early adolescence: Preliminary findings

AbstractThe present study examined the effect of Obsessive Compulsive Disorder (OCD) on child and adolescent sibling relationships. In previous research on adult OCD, siblings of OCD sufferers showed a high level of occommodotion to obsessive-compulsive symptoms and subsequent depression. No research has been conducted on the effect of OCD on child and adolescent sibling relationships. This small but important pilot study investigated sibling accommodation to obsessive-compulsive symptoms, sibling relationship quality, and depression and anxiety in siblings of children who have OCD. The study had two components. First, siblings of children with OCD were examined before and after a 14-week treatment program for OCD. Second, these siblings were compared at prebefore treatment with a comparison group of siblings whose brother or sister did not meet diagnostic criteria for either OCD or any other childhood disorders (i.e., comparison group). Three outcomes were noted. Siblings of OCD children accommodated to obsessive-compulsive symptoms and were distressed by the presence of OCD in their brother or sister. Furthermore, the quality of sibling relationships in OCD families improved with successful treatment of OCD. Finally, anxiety and depression were higher in siblings of an OCD child or adolescent, compared to siblings in the comparison group. Given the significant impact that OCD has on the sibling relationship, implications for family-based treatment, incorporating a sibling support component, are addressed.

A pilot study of penicillin prophylaxis for neuropsychiatric exacerbations triggered by streptococcal infections

Background: Some children with obsessive-compulsive disorder (OCD) and tic disorders appear to have symptom exacerbations triggered by group A beta-hemolytic streptococcal infections in a manner that is similar to rheumatic fever and its neurologic variant, Sydenham’s chorea. Because penicillin prophylaxis has proven to be effective in preventing recurrences of rheumatic fever, it was postulated that it might also prevent streptococcal-triggered neuropsychiatric symptom exacerbations in children with Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS). These children are identified by five clinical characteristics: presence of OCD or tic disorder, prepubertal onset, episodic symptom course, neurologic abnormalities (i.e., choreiform movements) and streptococcal-triggered symptom exacerbations.Methods: Thirty-seven children with PANDAS were enrolled in an 8 month, double-blind, balanced cross-over study. Patients were randomized to receive either 4 months of the active compound (twice daily oral 250 mg penicillin V) followed by 4 months of placebo, or placebo followed by penicillin V. Tic, OCD, and other psychiatric symptoms were monitored monthly. Throat cultures and streptococcal antibody titers were also obtained.Results: There were an equal number of infections in both the active and placebo phases of the study. There was no significant change seen in either the obsessive-compulsive or tic symptom severity between the two phases.Conclusions: Because of the failure to achieve an acceptable level of streptococcal prophylaxis, no conclusions can be drawn from this study regarding the efficacy of penicillin prophylaxis in preventing tic or OCD symptom exacerbations. Future studies should employ a more effective prophylactic agent, and include a larger sample size.

Family history and psychiatric comorbidity in persons with compulsive buying: preliminary findings.

The authors explored the family history and psychiatric comorbidity of a group of compulsive buyers who volunteered for medication studies. Compulsive buying is characterized by inappropriate shopping and spending behavior that leads to impairment. Thirty-three subjects who met the criteria of McElroy and colleagues for compulsive buying, and who scored more than two standard deviations above the mean on the Compulsive Buying Scale, were recruited. Twenty-two comparison subjects were recruited in the course of another study, and the presence of obsessive-compulsive disorder was the only reason for exclusion. Both groups were administered the Structured Clinical Interview for DSM-III-R disorders. The Family History Research Diagnostic Criteria were used to collect information about psychiatric disorders in first-degree relatives. Compulsive buyers had a mean age of 40 years; two (6%) were men. Comparison subjects had a mean age of 39 years; six (27%) were men. The two groups differed in gender distribution but not in age, marital status, or educational achievement. Compulsive buyers were more likely than comparison subjects to have lifetime mood disorders (especially major depression) and to have more than one psychiatric disorder. First-degree relatives of compulsive buyers were more likely than comparison relatives to suffer from depression, alcoholism, and a drug use disorder and to suffer more psychiatric disorders in general. These results indicate that persons who report compulsive buying behavior, and their first-degree relatives, are more likely to have a higher prevalence of psychiatric disorder than are comparison subjects.

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: clinical description of the first 50 cases.

The purpose of this study was to describe the clinical characteristics of a novel group of patients with obsessive-compulsive disorder (OCD) and tic disorders, designated as pediatric autoimmune neuropsychiatric disorders associated with streptococcal (group A beta-hemolytic streptococcal [GABHS]) infections (PANDAS). The authors conducted a systematic clinical evaluation of 50 children who met all of the following five working diagnostic criteria: presence of OCD and/or a tic disorder, prepubertal symptom onset, episodic course of symptom severity, association with GABHS infections, and association with neurological abnormalities. The children's symptom onset was acute and dramatic, typically triggered by GABHS infections at a very early age (mean = 6.3 years, SD = 2.7, for tics; mean = 7.4 years, SD = 2.7, for OCD). The PANDAS clinical course was characterized by a relapsing-remitting symptom pattern with significant psychiatric comorbidity accompanying the exacerbations; emotional lability, separation anxiety, nighttime fears and bedtime rituals, cognitive deficits, oppositional behaviors, and motoric hyperactivity were particularly common. Symptom onset was triggered by GABHS infection for 22 (44%) of the children and by pharyngitis (no throat culture obtained) for 14 others (28%). Among the 50 children; there were 144 separate episodes of symptom exacerbation; 45 (31%) were associated with documented GABHS infection, 60 (42%) with symptoms of pharyngitis or upper respiratory infection (no throat culture obtained), and six (4%) with GABHS exposure. The working diagnostic criteria appear to accurately characterize a homogeneous patient group in which symptom exacerbations are triggered by GABHS infections. The identification of such a subgroup will allow for testing of models of pathogenesis, as well as the development of novel treatment and prevention strategies.

Obsessive-compulsive disorder and rheumatic chorea: is there a connection?

There is increasing evidence to suggest basal ganglion involvement in the aetiopathogenesis of obsessive-compulsive disorder (OCD). Twenty subjects with rheumatic chorea were assessed for presence of OCD and evaluated on Leyton's Obsessional Inventory. Four subjects had OCD. The study group had markedly higher scores on all the scales of Leyton's Obsessional Inventory. The findings implicate that caudate dysfunction is not sufficient on its own to explain the presence of obsessive-compulsive behaviour and that additional basal ganglion regions/rostral connections also have to be involved to produce co-morbidity.

Obsessive-compulsive disorder in children and adolescents: predictors in childhood for long-term phenomenological course.

Prediction of the phenomenological course of obsessive-compulsive disorder (OCD) in adulthood was determined in 47 probands referred in childhood for in- or outpatient treatment for OCD. The only factor that predicted a poor outcome, defined as the presence of OCD in adulthood, was severity of OCD in childhood, as measured by the duration of the obsessive-compulsive symptoms. More females than males had an episodic course of OCD. However, just as many females as males had OCD, either chronically or episodically, in adulthood. Age of onset did not predict the phenomenological course of OCD.