Severity Of Obsessive-compulsive Symptoms Research Articles

The effectiveness of acceptance and commitment therapy (ACT) on distress tolerance and the severity of obsessive-compulsive symptoms

The effectiveness of acceptance and commitment therapy (ACT) on distress tolerance and the severity of obsessive-compulsive symptoms

The reliability and validity of the Florida Obsessive-Compulsive Inventory in a Chinese clinical sample

BackgroundThe Florida Obsessive-Compulsive Inventory (FOCI) is a self-report measure designed to assess obsessive-compulsive symptom presence and severity. This study evaluated the reliability and validity of the Chinese version of the FOCI and its optimal cut-off score. MethodsA systematic translation process was used to translate the English FOCI into Chinese. Four hundred and fifty-three adults participated in the study including 153 individuals with OCD, 150 case-controls with a primary anxiety or depressive disorder, and 150 healthy controls. All three groups were evaluated by a set of measures including the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the FOCI, the Obsessive-Compulsive Inventory-Revised (OCI-R), the Beck Depression Inventory-Second Edition (BDI-Ⅱ), the Beck Anxiety Inventory (BAI), and the Short Form Health Survey (SF-36). Among the OCD patients, a subset of 47 participants were evaluated over a two-week interval to assess test-retest reliability of the FOCI. ResultsThe internal consistency of the FOCI Symptom Checklist and Severity Scale in the OCD group were0.813 and 0.840. Two-week test-retest reliability were 0.934 and 0.935. Convergent validity of the FOCI Symptom Checklist and Severity Scale were both strong. Correlations with diverging constructs were modest overall. Factor analysis of the FOCI Severity Scale was conducted, identifying a single factor solution explaining 62.3% of the variance. FOCI scores among those in the OCD group were higher than those from the case-control and healthy control groups. A cut-off score of 8 was optimal in predicting caseness. ConclusionsThe Chinese version of the FOCI demonstrated good psychometric properties including internal consistency, test-retest reliability, a stable factor structure, and convergent and divergent validity. A cut-off score of 8 was optimal in predicting caseness.

Obsessive compulsive symptoms severity among children and adolescents during COVID-19 first wave in Israel‏

Several current publications have considered persons with obsessive compulsive disorder (OCD) as particularly vulnerable during the COVID-19 period, and to require more frequent symptom monitoring. The purpose of this study was to evaluate whether OCD exacerbated during the first wave of COVID-19 in children and adolescents. Twenty-nine children and adolescents with OCD were evaluated in the midst of the first outbreak of the COVID-19 pandemic in Israel (April–May 2020). Obsessive-compulsive symptoms (OCS) were assessed using the Clinical Global Impression Scale (CGI), by means of a functional questionnaire and by the Obsessive-Compulsive Inventory-child version (OCI-CV) questionnaires. Obsessive-compulsive symptoms were not found to have exacerbated during the period investigated, as evident by a lack of change in CGI severity scores and by improvement rather than deterioration among more participants, based on the CGI improvement scores. Additionally, the children and adolescents reported better general functioning during the COVID-19 period and had relatively low scores on the OCI-CV scale. Our findings indicate that Israeli children and adolescents with OCD coped well with COVID-19 during the first two months of the pandemic and mostly did not experience exacerbation of OCS. However, due to the short duration of exposure to the pandemic at the time of the study, social isolation and lockdown might have masked OCS; thus, further longitudinal studies are needed.

Multi-level assessment of obsessive-compulsive disorder (OCD) reveals relations between neural and neurochemical levels

BackgroundWhile considerable progress has been made in exploring the psychological, the neural, and the neurochemical dimensions of OCD separately, their interplay is still an open question, especially their changes during psychotherapy.MethodsSeventeen patients were assessed at these three levels by psychological questionnaires, fMRI, and venipuncture before and after inpatient psychotherapy. Seventeen controls were scanned at comparable time intervals. First, pre/post treatment changes were investigated for all three levels separately: symptom severity, whole-brain and regional activity, and the concentrations of cortisol, serotonin, dopamine, brain-derived neurotrophic factor (BDNF), and immunological parameters (IL-6, IL-10, TNFα). Second, stepwise linear modeling was used to find relations between the variables of the levels.ResultsThe obsessive-compulsive, depressive, and overall symptom severity was significantly reduced after psychotherapy. At the neural level, the activity in the anterior cingulate cortex (ACC), in frontal regions, in the precuneus, and in the putamen had significantly decreased. No significant changes were found on the neurochemical level. When connecting the levels, a highly significant model was found that explains the decrease in neural activity of the putamen by increases of the concentrations of cortisol, IL-6, and dopamine.ConclusionMultivariate approaches offer insight on the influences that the different levels of the psychiatric disorder OCD have on each other. More research and adapted models are needed.

Clinical Correlates of False Positive Assignment in Bipolar Screening Measures Across Psychiatric Diagnoses among Patients without Bipolar Disorder.

ObjectiveIn this study, we aimed to determine clinical correlates of false positive assignment (FPA) on commonly used bipolar screening questionnaires. MethodsA retrospective chart review was conducted to a total of 3885 psychiatric outpatients. After excluding patients who have bipolar spectrum illnesses, patients who were assigned as having hypomania on the mood disorder questionnaire (MDQ) or the hypomania checklist-32 (HCL-32) were identified as patients who had FPA. Psychiatric diagnoses and severity of emotional symptoms were compared between patients with and without FPA. ResultsPatients with FPA on the MDQ showed significant associations with presence of major depressive disorder, generalized anxiety disorder, and alcohol-use disorder, while patients with FPA on the HCL-32 showed associations with presence of panic disorder and agoraphobia. FPA on the MDQ was also associated with greater emotional symptoms and lifetime history of suicide attempts. Logistic regression analysis showed that male sex, younger age, presence of alcohol-use disorder, and severity of depression and obsessive-compulsive symptoms were significantly associated with FPA on the MDQ. ConclusionThe FPA for the MDQ was associated with clinical factors linked to trait impulsivity, and the FPA for both the MDQ and the HCL-32 could be related to increased anxiety.

Multifaceted impulsivity in obsessive-compulsive disorder with hoarding symptoms

Objective Hoarding is common in obsessive-compulsive disorder (OCD), and OCD with hoarding may have poorer prognostic features than OCD without hoarding. The aim of this study was to investigate the relationship between multifaceted impulsivity and hoarding symptoms in individuals with OCD. This relationship is important to be able to understand the psychopathological mechanisms of hoarding symptoms in OCD patients. Methods The study included 136 individuals with OCD classified as OCD with high hoarding symptoms (OCDwHH, n = 41) and OCD with low/none hoarding symptoms (OCDwLH, n = 95), together with 94 healthy control subjects. All the participants completed the Hoarding Rating Scale-Interview, Barratt Impulsiveness Scale-11, Yale-Brown Obsessions and Compulsions Scale, Hamilton Depression Rating Scale, and Hamilton Anxiety Rating Scale. Results The OCDwHH group had more severe anxiety (p = 0.016) and attentional impulsivity (p = 0.002) than OCDwLH. Attentional impulsivity scores were positively correlated with hoarding symptom scores (p < 0.001). Both attentional and motor impulsivity scores were positively correlated with anxiety levels (p = 0.037, p = 0.045, respectively). In partial correlation analysis, motor impulsivity was positively correlated with the severity of hoarding symptoms controlling for anxiety severity (p = 0.045). In hierarchical linear regression analysis, only attentional impulsivity predicted the severity of hoarding symptoms independently of anxiety, severity of obsessive-compulsive symptoms and motor impulsivity (β = 0.268, Adjusted R 2 = 0.114, p = 0.006). Conclusion Attentional impulsivity is associated with hoarding symptoms in OCD. Future studies that reveal this relationship may contribute to treatment modalities for the OCD patients with hoarding symptoms.

Sensory Hypersensitivity Severity and Association with Obsessive-Compulsive Symptoms in Adults with Tic Disorder.

BackgroundSensory hypersensitivity, defined as heightened awareness of and reactivity to external stimuli, is a bothersome symptom that affects up to 80% of adults with Tourette syndrome (TS). Such widespread prevalence suggests sensory hypersensitivity is a core feature of the disorder, but its severity and association with other clinical features of TS remain largely unexplored. Complicating matters, sensory hypersensitivity has been observed in two neurodevelopmental disorders commonly comorbid with TS: obsessive-compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD).ObjectiveWe sought to measure sensory hypersensitivity in TS patients relative to healthy controls and to investigate the relationship of sensory hypersensitivity with OCD and ADHD symptoms in the context of TS.MethodsWe recruited 34 adults with TS or chronic tic disorder to undergo evaluation with the Yale Global Tic Severity Scale (YGTSS) and a battery of validated self-report instruments assessing sensory hypersensitivity (Sensory Gating Inventory, SGI; Sensory Perception Quotient, SPQ), premonitory urge (Premonitory Urge to Tic Scale, PUTS), OCD (Dimensional Obsessive-Compulsive Scale, DOCS), and ADHD (Adult ADHD Self-Report Screening Scale for DSM-5, ASRS-V). Age- and sex-matched healthy controls were recruited to complete SGI and psychiatric measures.ResultsSGI and SPQ scores strongly correlated (rs = −0.73, p < 0.0001) within patients. SGI total score was significantly higher in patients versus controls (119.0 vs 67.6, U =−5.3, p < 0.0001), indicating greater sensory hypersensitivity in the tic disorder group. SGI score correlated modestly with PUTS, DOCS, and ASRS-V scores but not with YGTSS total tic score. Hierarchical linear regression analysis revealed that, of the tested variables, only DOCS score contributed significantly to mean SGI score, with β ranging from 1.03 (p = 0.044) to 1.41 (p = 0.001). A simple linear regression model with DOCS as the independent variable accounted for 31.9% of SGI score variance.ConclusionSensory hypersensitivity is prominent in adults with tic disorder and is independently associated with obsessive-compulsive symptom severity.

Do Individuals With Obsessive-Compulsive Disorder and Obsessive-Compulsive Personality Disorder Share Similar Neural Mechanisms of Decision-Making Under Ambiguous Circumstances?

Impaired decision-making is well documented in obsessive-compulsive disorder (OCD) and a range of electrophysiological and functional neuroimaging measures have begun to reveal the pathological mechanisms that underlie the decision-making process. Obsessive-compulsive personality disorder (OCPD) has core symptoms that often overlap with OCD, but similarities between these disorders at the behavioral and neurological levels are often unclear, including whether OCPD exhibits similar decision-making deficits and shared neurological dysfunction. To address these issues, we examined 24 cases of OCD, 19 cases of OCPD, and 26 matched normal control (NC) subjects during the revised Iowa Gambling Task (IGT) using event-related potentials (ERPs). The net IGT scores were lower for OCD subjects than for OCPD or NC subjects, thus indicating that OCD subjects chose more disadvantageous options and were “short-sighted” with regards to information. The feedback-related negativity (FRN) waveform (lose-win) was larger in both OCD and OCPD subjects, which suggested that obstacles exist in the feedback process. Consequently, these subjects might share similar neural mechanisms under ambiguous decision-making circumstances. Furthermore, IGT net scores were significantly and negatively correlated with Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD) scales. This implies that more severe obsessive-compulsive symptoms inspired more negative emotions that led to worse decision-making ability. Therefore, although similar neural mechanisms might exist, this led to different behaviors in which OCPD is associated with better behavioral performance compared to OCD patients.

The Severity of Obsessive-Compulsive Disorder in Different Episodes of Bipolar Disorder

Background: The relationship between bipolar disorder (BD) and obsessive-compulsive disorder (OCD) is investigated in several studies. According to the reports, the comorbidity of these two-disorders is more than the general population. Objectives: The current study aimed to compare the severity of OCD in different episodes of BD. Methods: This cross-sectional (descriptive-analytic) study included 90 patients referred to Baharan Psychiatric Center affiliated to the Zahedan University of Medical Science in 2019 with a primary diagnosis of BD according to Semi-structured interview (SCID). The Yale-Brown Obsessive-Compulsive scale was used to measure the severity of OCD symptoms in different episodes of BD. Results: The severity of OCD symptoms in the depression group was significantly higher than the manic (P &lt; 0.01) and remission groups (P &lt; 0.01). Conclusions: Mood state influences the severity of obsessive-compulsive symptoms. Since the course of disorder in the comorbidity of these two disorders become chronic and diagnosis, and the OCD is difficult in the manic episode; it is necessary to be aware when diagnosing BD or OCD.

The severity of obsessive-compulsive symptoms in Tourette syndrome and its relationship with premonitory urges: a meta-analysis

ABSTRACT Objectives Nearly half of the patients with Tourette Syndrome (TS) present with comorbid Obsessive-Compulsive Symptoms (OCS) and premonitory urges (PUs). However, inconsistent results have been found in the correlation between PUs and OCS in patients with TS. Methods A meta-analysis was applied to identify the severity of OCS and its correlation with PUs in TS patients. Subgroup and meta-regression analyses were used to identify potential heterogeneity. Results A total of 13 studies, including 576 patients, were enrolled in this study. The pooled correlation coefficient (r) was 0.29 (95% confidence interval: 0.18, 0.38) and heterogeneity (I2) of pooled r was 40% based on a fixed-effect model. The mean level of OCS based on the assessment of Children’s Yale-Brown Obsessive-Compulsive Symptom Scale/Yale-Brown Obsessive-Compulsive Symptom Scale was 14.99 (95% CI: 11.41, 18.57) by a random effect model. Results of meta-regression analysis demonstrated that the severity of tic symptoms based on the assessment of the Yale Global Tic Severity Scale was the predictor of severity of OCS (p = 0.018). Conclusion There was a mild positive correlation between the PUs and OCS in patients with TS. The severity of OCS in TS patients was mild to moderate and positively predicted by the severity of tic symptoms.

Brain Functional Connectivity Correlates of Subclinical Obsessive-Compulsive Symptoms in Healthy Children

Commonly observed subclinical obsessive-compulsive symptoms in healthy children may predispose to obsessive-compulsive disorder (OCD). Therefore, investigating the underlying neurobiology may be relevant to identify alterations in specific brain circuits potentially accounting for clinical heterogeneity in OCD without the confounding effects of clinical samples. We analyzed the brain correlates of different obsessive-compulsive symptoms in a large group of healthy children using functional connectivity measures. We evaluated 227 healthy children (52% girls; mean [SD] age 9.71 [0.86] years; range, 8-12.1 years). Participants underwent clinical assessment with the Obsessive-Compulsive Inventory-Child Version and a resting-state functional magnetic resonance imaging examination. Total and symptom-specific severity were correlated with voxelwise global functional connectivity degree values. Significant clusters were then used as seeds of interest in seed-to-voxel analyses. Modulating effects of age and sex were also assessed. Global functional connectivity of the left ventral putamen and medial dorsal thalamus correlated negatively with total obsessive-compulsive symptom severity. Seed-to-voxel analyses revealed specific negative correlations from these clusters with limbic, sensorimotor, and insular regions in association with obsessing, ordering, and doubt-checking symptoms, respectively. Hoarding symptoms were associated with negative correlations between the left medial dorsal thalamus and a widespread pattern of regions, with such associations modulated by sex and age. Our findings concur with prevailing neurobiological models of OCD on the importance of cortico-striato-thalamo-cortical dysfunction to account for symptom severity. Notably, we showed that changes in cortico-striato-thalamo-cortical connectivity are present at subclinical stages, which may result in an increased vulnerability for OCD. Moreover, we mapped different symptom dimensions onto specific cortico-striato-thalamo-cortical circuit attributes.

PREVALENCE OF OBSESSIVE COMPULSIVE SYMPTOMS IN PSYCHIATRIC DISORDERS: A CROSS SECTIONAL STUDY

Background : Obsessive compulsive symptoms (OCS) have known to co-occur with various psychiatric disorders and have an impact on severity and course of these psychiatric disorders. Knowing the prevalence of OCS in different psychiatric disorders can give a better understanding about the illness and help in shaping its management. This study aims at finding prevalence, types &amp; severity of OCS in patients presenting with different psychiatric disorders in Psychiatry Out patient department at a tertiary care institute. Methodology : A total of 380 patients were included in the. Clinical diagnosis of obsessions &amp; compulsions was made as per criteria in Diagnostic &amp; Statistical Manual for Mental Disorders Fourth Edition, Text Revision (DSM IV- TR). Yale brown Obsessive Compulsive Scale (YBOCS) was applied for assessing severity of obsessive compulsive symptoms. Results &amp; Conclusion: Prevalence of OCs in Psychiatric Disorders to be 5%. The Prevalence of OCS in patients with Psychotic Disorders was found to be 9.9% , in patients with Mood Disorders was found to be 6.6%, in patients with Anxiety Disorders was found to be 2.3% and in patients with Substance Use Disorders was found to be 1.8%. The most common Form of Obsession was Obsessive Thoughts (31.6%), the most common Content was Inanimate-Impersonal (31.6%) and the most common Compulsion was Washing (60%). Mean YBOCS Score of all 19 patients was 9.95 (SD=5.1, Median=9). 36.8% patients had Subclinical Severity (0-7), 47.4% patients had Mild Severity (8-15) and 15.8% patients had Moderate Severity (16-23). Psychotic &amp; mood disorders were further assessed for types &amp; severity of OCS. Though the prevalence of OCS in current study is less compared to previous studies, it still is significant. Thus various psychiatric disorders should be evaluated for presence of OCS.

Symptom trajectories of early responders and remitters among youth with OCD

ObjectivesThis study examined the phenomenology and predictors of early response and remission among youth with obsessive-compulsive disorder (OCD) receiving cognitive-behavioral therapy (CBT). MethodsOne hundred and thirty-nine youth with a current primary diagnosis of OCD participated in this study. Participants received 10 sessions of CBT augmented by either placebo or d-cycloserine (DCS) as part of a randomized double-blind multi-site clinical trial. Early response and remission status were determined by clinician-rated global symptom improvement (CGI-I) and severity (CGI-S), respectively. ResultsAt the mid-treatment assessment, 45.3% of youth were early responders, and 28.1% were early remitters. At post-treatment assessment, 79.1% of youth were responders and 67.6% were remitters. Early response predicted a higher likelihood of post-treatment response and remission; early remission significantly predicted a higher likelihood of post-treatment remission. Bivariate logistic regressions showed that early response was predicted by lower baseline clinician-rated global severity (CGI-S) and lower depression severity; however, only depression severity remained a significant predictor in the multivariable logistic regression model. Furthermore, bivariate logistic regressions showed that early remission was predicted by lower baseline clinician-rated global severity (CGI-S), lower depression severity, and lower obsessive-compulsive symptom severity (CY-BOCS); however, only global severity remained a significant predictor in the multivariable logistic regression model. ConclusionsLower OCD and depression symptom severity predicted a greater likelihood of early treatment response and remission to CBT. Findings suggest that low OCD and depression symptom severity could serve as baseline characteristics to identify potential candidates for lower-intensity initial interventions in a stepped care approach. The modest predictive value of the variables examined suggests that additional factors could add to prediction of treatment response and remission. Trial registrationclinicaltrials.gov Identifier: NCT00864123.

Severity benchmarks and contemporary clinical norms for the Obsessive-Compulsive Inventory-Revised (OCI-R)

IntroductionThe obsessive-compulsive inventory revised (OCI-R) is commonly used for the assessment of obsessive-compulsive symptomseverity, yet no severity benchmarks have been developed, limiting utilization in clinical practice, clinical research, and analogue studies. Additionally, since its development, no large normative work has been published. We developed empirically derived cutoff scores, examined psychometric properties, and report contemporary norms for the OCI-R. MethodsData from 1339 participants with obsessive-compulsive disorder (OCD) were subjected to confirmatory factor analyses, internal consistency analyses, and ROC (sensitivity/specificity) analyses. We used the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) to determine empirically derived OCI-R severity benchmarks. ResultsA six-factor solution, and good to excellent internal consistency across factors were found. OCI-R severity benchmarks were identified with satisfactory sensitivity and specificity, especially for the cutoff between mild and moderate symptoms. Cutoffs at greater levels of severity were less sensitive and specific. DiscussionWe provide contemporary clinical norms and severity benchmarks for the OCI-R total score with acceptable sensitivity and specificity, and discuss limitations regarding their use. Total scores should be interpreted with caution given the structure of the OCI-R and the heterogeneous nature of OCD.

A prospective study of intensive in-patient treatment for obsessive-compulsive disorder

Multimodal in-patient treatment incorporating intensive cognitive-behaviour therapy (CBT) and medication management is a promising alternative for obsessive-compulsive disorder (OCD) patients who do not respond to standard out-patient treatment. We prospectively examined the short-term outcome and predictors of outcome of intensive in-patient treatment in a largely pharmacotherapy-resistant OCD sample. Fifty eight consecutive patients, admitted for treatment of OCD were evaluated at admission, at discharge and 2 months post-discharge for psychiatric diagnosis, personality disorders, obsessive beliefs, insight into obsessions and severity of obsessive-compulsive, depressive and anxiety symptoms. All patients received comprehensive treatment consisting of a combination of pharmacotherapy and intensive CBT. The mean Y-BOCS score was 29.38(±5.72) at admission, which reduced to 16.62(±7.91) at discharge and 16.75(±8.85) at follow-up. Thirty five participants (60.3%) met the prespecified criteria for response and 19 (32.8%) for remission. There was a significant reduction in Y-BOCS scores at discharge [43.67 (23.81)%] and post-discharge follow-up [2.18 (29.32)%] as compared to baseline (p<0.01). Baseline Browns Assessment of Beleifs Scale score (insight) was the only variable that statistically differentiated responders and non-responders. In-patient treatment is an effective treatment for medication resistant, severe and chronic OCD. Poor insight is a potential predictor of non-response to in-patient treatment.

The role of reassurance seeking in obsessive compulsive disorder: the associations between reassurance seeking, dysfunctional beliefs, negative emotions, and obsessive- compulsive symptoms

BackgroundThis study investigates the association of reassurance seeking with obsessive compulsive (OC) symptoms, dysfunctional beliefs, and negative emotions.MethodsReassurance Seeking Questionnaire, Obsessive-Compulsive Inventory, Obsessive Beliefs Questionnaire, Trait Anger Expression Inventory, and Guilt Inventory were applied to 53 obsessive compulsive disorder (OCD) patients and 591 non-clinical participants.ResultsThe results showed that the severity of the OC symptoms significantly predicted the carefulness of OCD patients during reassurance seeking, indicating increased carefulness during reassurance seeking as the severity of OC symptoms increased. Moreover, feelings of guilt increased with increasing intensity of reassurance seeking. In addition, carefulness during reassurance seeking significantly predicted the level of anxiety. Responsibility/threat estimation, perfectionism/need for certainty, and importance/control of thoughts significantly predicted the OC symptoms. Moreover, the dysfunctional beliefs directly associated with an increased need to seek reassurance from different sources and seek reassurance more carefully. In terms of mediational effect, the results revealed that the individuals who had distorted beliefs were more likely to have OC symptoms and, in turn, the OC symptoms increased carefulness during reassurance seeking. The analysis of the model test revealed mostly similar results to those obtained for the clinical sample.ConclusionsThe findings revealed a close relationship between OC symptoms and reassurance-seeking behaviors.

Psychometric Properties of the Dutch Dimensional Obsessive-Compulsive Scale (DOCS)

Abstract. The Dimensional Obsessive-Compulsive Scale (DOCS) is a self-report questionnaire aimed to measure the severity of obsessive-compulsive symptoms on four thematically different symptom dimensions (contamination, responsibility for harm, unacceptable thoughts, and symmetry and completeness). The DOCS was developed in the US in response to the insufficiency of existing OCD measures. The 20-item scale is used in research and clinical settings. We translated the DOCS into Dutch and examined the psychometric properties in a clinical sample. In addition, we further examined the US version of DOCS with respect to measurement invariance between patient and non-patients and also between the US and the Dutch version of the DOCS. The analyses showed that the Dutch version is a valid and reliable version of the DOCS. Measurement invariance tests indicated that patient scores can be validly compared with non-patient scores. Therefore, the DOCS is a good instrument to monitor the development of OCD, for example, during treatment. The same result was found for the US DOCS and the Dutch DOCS, hence US scores and Dutch scores can be validly compared. With these two studies we have extended our knowledge of the DOCS, beyond the common psychometric properties.

Development and preliminary psychometric properties of the Rumination on Obsessions and Compulsions Scale (ROCS)

Individuals with obsessive-compulsive disorder (OCD) use various strategies in response to their symptoms. We present the development of the Rumination on Obsessions and Compulsions Scale (ROCS), a 30-item questionnaire assessing mental neutralizing, OCD symptom rumination, and, additionally, acceptance, using three scales. We provide preliminary evidence for each scale's factor structure, the scales' intercorrelations, and correlations with scales measuring depressive, anxiety, and obsessive-compulsive symptom severity and depressive rumination in individuals with OCD (n = 99). Additionally, we investigate differences on the ROCS between individuals with OCD, individuals with major depressive disorder (n = 74), and individuals without mental disorders (n = 35). We found preliminary support for three mental neutralizing subscales and one-factor solutions for OCD symptom rumination and acceptance. Reliability and first indicators of convergent validity of mental neutralizing were good; one mental neutralizing subscale particularly overlapped with depressive and anxiety symptom severity. We propose adaptations to improve the scale's psychometric properties. Our results additionally provide first indications that the ROCS assesses OCD symptom rumination and acceptance reliably and validly and that future research can use these scales with small or no adaptations. Future studies should investigate factor structure and psychometric properties in large samples of individuals with OCD.

Impact of childhood maltreatment on obsessive-compulsive disorder symptom severity and treatment outcome

ABSTRACT Background Preliminary evidence suggests childhood maltreatment to play a causal role in the development and maintenance of obsessive-compulsive disorder (OCD). However, both the effect of childhood maltreatment on the course of OCD treatment and the role of specific subtypes of maltreatment remain largely unknown. Objective This study aimed to investigate the relationship between childhood maltreatment and the severity and time course of OCD symptoms within a clinical sample of OCD patients (N = 68). We hypothesized that higher levels of childhood maltreatment in OCD patients would be associated with higher symptom severity and worse treatment outcomes. Method Assessments of childhood maltreatment, OCD symptomatology, and related variables were completed in a sample of OCD patients before and after inpatient treatment as well as at 6 month follow-up. Results Emotional abuse, sexual abuse and neglect were highly prevalent in our sample. Additionally, the severity of experienced childhood maltreatment was associated with higher OCD symptom severity, with the strongest association found for emotional abuse. Hierarchical linear models indicated that patients with childhood maltreatment showed higher OCD symptom severity at pre-treatment, post-treatment, and follow-up compared to patients without these experiences. However, childhood maltreatment did not moderate symptom improvement during treatment. Conclusion Thus, although childhood maltreatment is not related to treatment outcome, it is highly prevalent among OCD patients and childhood trauma survivors still show higher OCD symptom severity after treatment. Therefore, childhood maltreatment should be considered in psychological interventions in individuals with OCD.

Integrating genetic variation with DNA methylation at SKA2 rs7208505 in analyses of obsessive-compulsive disorder disease risk and symptom severity

BackgroundObsessive-Compulsive Disorder (OCD) has a complex genetic component and may be preceded by environmental stressors. The spindle and kinetochore associated complex subunit 2 (SKA2)gene interacts with the glucocorticoid receptor and is implicated in mediating hypothalamic–pituitary-adrenal (HPA) axis function but has yet to be examined in OCD. We hypothesized that genetic and epigenetic variation of SKA2 may be involved in OCD disease risk and symptom severity. MethodsOCD patients (n = 54) were rated for disease severity using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Genotyping of SKA2 rs7208505 was performed using Taqman TM, while DNA methylation levels were quantified using bisulfite pyrosequencing. OCD genotype frequencies were compared to the general population (n = 379, 1000 Genomes Project Consortium) using Pearson’s chi-square test. The relationships among the rs7208505 variant, methylation density, and symptom severity were modeled using linear regression. ResultsGenotype distributions significantly differed between OCD patients and the 1000 Genomes sample (χ2 (2, n = 433) = 8.66, p = 0.013). The odds of having OCD was 1.66 times more likely for individuals carrying a C allele (OR 1.66 [95% CI: 1.09–2.55]; p = 0 0.02). Specifically, the odds of having the CC genotype was 2.58 times more likely for OCD patients (OR 2.58 [95% CI: 1.23–5.23]; p = 0.007). When examining symptom severity there was no effect of genotype (p > 0.05). Finally, epigenetic variation was not significantly associated with symptom severity in our statistical models. ConclusionsThese results provide preliminary evidence that SKA2 genetic variation may be associated with OCD disease status, while no association was detected when examining symptom severity, or methylation density at this locus. The rs7208505 minor allele occurs more frequently in OCD patients than in the general population, suggesting that there is merit in pursing further studies of this marker in larger sample sizes.