Severity Of Obsessive-compulsive Symptoms Research Articles

Self-compassion and emotion regulation difficulties in obsessive-compulsive disorder.

Lack of self-compassion and deficits in emotion regulation are associated with various psychopathological symptoms and may play a role in the development and maintenance of obsessive-compulsive disorder (OCD). However, further empirical research is still needed to better understand these constructs in the context of this disorder. The present study investigated the relation between self-compassion, emotion regulation difficulties, obsessive beliefs, and obsessive-compulsive symptom severity in 90 patients with OCD using self-report questionnaires. Symptom severity and obsessive beliefs were negatively correlated to self-compassion and positively associated with emotion regulation difficulties. Additionally, self-compassion showed a negative relation to emotion regulation difficulties. Emotion regulation difficulties-but not self-compassion-predicted symptom severity when controlling for obsessive beliefs and depression in a hierarchical regression analysis. Further analyses showed that emotion regulation deficits mediated the relationship between self-compassion and OCD symptom severity. Our results provide preliminary evidence that targeting self-compassion and putting more emphasis on emotion regulation deficits might be promising treatment approaches for patients with OCD. Future studies could investigate which specific interventions that directly address these variables improve treatment outcome.

Sleep duration and timing in obsessive-compulsive disorder (OCD): evidence for circadian phase delay

ObjectivesTo investigate potential delays in endogenous melatonin in individuals with obsessive-compulsive disorder (OCD). MethodsFirst, data are presented for 15 individuals with OCD and matched healthy controls. Next, nine additional participants with OCD who did not have matched controls were added, resulting in a sample of 24 individuals with OCD. All participants were assessed for sleep and circadian rhythm disturbance. Dim light melatonin onset (DLMO) was derived from salivary melatonin and was used in conjunction with sleep diaries, interview measures, and questionnaires. A subset of the OCD group (n = 16) also used actigraphy. ResultsIn sum, 42% percent (10/24) of the patients with OCD met the criteria for delayed sleep-wake phase disorder (DSWPD) in comparison to 0% in the control sample. DLMO was significantly later in individuals with OCD compared to controls. DLMO and bedtime were not significantly associated with the severity of obsessive-compulsive symptoms or negative affect. ConclusionsReplication of the findings presented herein, particularly the DLMO results, is warranted. Further, there are now three studies showing that nearly ½ of individuals with OCD meet criteria for a DSWPD. Future studies can explore the mechanisms underlying these connections and the implications of this comorbidity. These findings may increase our understanding of OCD and inform future interventions.

The Persian version of the Dimensional Obsessive-Compulsive Scale (P-DOCS): A psychometric evaluation

The Dimensional Obsessive-Compulsive Scale (DOCS) is a self-report measure of the severity of obsessive-compulsive symptoms (OCS) along with four dimensions. The aim of this study was to assess the factor structure, reliability and validity of the Persian version of the DOCS (P-OCDS) among patients with obsessive-compulsive disorder (OCD). A total of 764 outpatients with a DSM-IV diagnosis of OCD completed the P-DOCS, the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Vancouver Obsessive-Compulsive Inventory (VOCI), the Obsessive-Compulsive Inventory-Revised (OCI-R), the Penn State Worry Questionnaire-Short Form (PSWQ-SF), and the Beck Depression Inventory-II (BDI-II). Similar to the original version of the DOCS, results showed that the P-DOCS had a four-factor structure. Also, the P-DOCS showed good reliability through calculating McDonald's Omega and test-retest. In addition, convergent and discriminant validity of the P-DOCS was confirmed through its strong and weak correlations with other OCD measures and measures of global psychological distress respectively. Findings indicate that the DOCS is a reliable scale to use in Iranian clinical samples with OCD.

Obsessive-Compulsive Personality Symptoms Predict Poorer Response to Gamma Ventral Capsulotomy for Intractable OCD.

Gamma ventral capsulotomy (GVC) is a radiosurgical procedure which aims to create lesions in the ventral part of the anterior limb of the internal capsule (ALIC). It has been used as a treatment option for patients with intractable obsessive–compulsive disorder (OCD) who do not respond to several first-line treatments attempts. However, changes in personality disorder symptoms after GVC have not been investigated. The aims of this study are to investigate changes in personality disorder symptoms after GVC and to search for baseline personality disorder symptoms that may predict clinical response to GVC. Fourteen treatment-intractable OCD patients who underwent GVC completed the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) at baseline and one year after the procedure. Wilcoxon signed-rank test was performed to investigate personality disorder symptom changes before and after surgery. Linear regression models were utilized to predict treatment response, using baseline personality disorder symptoms as independent variables. We did not observe any quantitative changes in personality disorder symptoms after GVC, compared with baseline. Higher severity of obsessive-compulsive personality disorder symptoms at baseline was correlated with worse treatment response after GVC for OCD (β = −0.085, t-value = −2.52, p-value = 0.027). These findings advocate for the safety of the GVC procedure in this specific population of intractable OCD patients, in terms of personality disorder symptom changes. They also highlight the importance of taking into account the severity of obsessive–compulsive personality disorder symptoms when GVC is indicated for intractable OCD patients.

Динамика психологических реакций на начальном этапе пандемии COVID-19

The goal of the work is to study the dynamics of psychological changes unfolding during the COVID-19 pandemic. The paper presents an analysis of the responses to the survey on the Internet, received from 03.22.2020 to 04.04.2020, when the spread of COVID-19 begins in Russia. The study was conducted on the Internet using Google Forms. Links to the survey were posted on social networks. The survey involved 430 people, including 188 people in Moscow, and the answers were divided into 3 groups with respect to the date when they were received: March 23–24 (79 people), March 29–30 (46 people), March 31–April 4 (63 people). The survey included a general block of questions and methods SCL-90-R, COPE, OKM97. Statistical processing was carried out with the SPSS statistical package. The results of the study show an increase in psychopathological symptoms (somatization, phobic symptoms, sleep disturbances), a decrease in the level of constructive thinking and indicators of emotional consciousness, an expansion of ideas about esoteric thinking, naïve optimism, categorical thinking, a turn to religion and a search for existential explanations for what is happening. In the Moscow sample, a V-shaped graphs were noted for the parameters of the level of depression, for the severity of obsessive-compulsive symptoms, for the parameters for “turning to religion”, “esoteric thinking,” along with a constant increase in the level of anxious, phobic symptoms and somatization, which leads to the presence of the negation phase after the phase of shock and before the adoption of a situation. Conclusions: with prolonged situation a further increase in psychopathological symptoms is possible, which can have a wide range of negative consequences.

Self-reported and neurocognitive impulsivity in obsessive-compulsive disorder

BackgroundAlthough a behavioural addiction model of obsessive-compulsive disorder (OCD) has been proposed, it is still unclear if and how self-report and neurocognitive measures of impulsivity (such as risk-taking-, reflection- and motor-impulsivities) are impaired and/or inter-related in this particular clinical population. MethodsSeventeen OCD patients and 17 age-, gender-, education- and IQ-matched controls completed the Barratt Impulsivity Scale, the Obsessive-Compulsive Inventory-Revised, and the Beck Depression Inventory and were evaluated with the Yale-Brown Obsessive-Compulsive Scale and three computerized paradigms including reward (the Cambridge Gambling Task), reflection (the Information Sampling Task) and motor impulsivity (Stop Signal Task). ResultsDespite not differing from healthy controls in any neurocognitive impulsivity domain, OCD patients demonstrated increased impulsivity in a self-report measure (particularly attentional impulsivity). Further, attentional impulsivity was predicted by severity of obsessive-compulsive symptoms. ConclusionsOur findings suggest that OCD is characterized by a subjective (rather than objective) impulsivity; in addition, self-reported impulsivity was largely determined by severity of OCD symptoms.

Validation of the Chinese Version of Obsessive-Compulsive Inventory-Revised.

The Obsessive-Compulsive Inventory-Revised (OCI-R) is a psychometrically sound and valid self-report measure for evaluating the severity of six dimensions of obsessive-compulsive symptoms: washing, obsessing, hoarding, ordering, checking, and neutralising. We aimed to validate the Chinese version of the OCI-R (C-OCI-R) in patients with obsessive-compulsive disorder (OCD) in Hong Kong. The C-OCI-R was forward and backward translated and reviewed by an expert panel and a focus group. The internal consistency and test-retest reliability (2-week interval) were examined. Confirmatory factor analysis was used to examine the construct validity of the C-OCI-R. Concurrent validity was examined by the correlation between the C-OCI-R and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), whereas divergent validity was examined by the correlation of the C-OCI-R with the Beck Depression Inventory-Second Edition and the Hamilton Depression Rating Scale. 130 OCD patients were recruited. The C-OCI-R showed excellent internal consistency (Cronbach's alpha = 0.92) and test-retest reliability (Spearman's rho correlation coefficient = 0.96). The original six-factor model was supported by confirmatory factor analysis. Concurrent validity and divergent validity were established. However, the neutralising subscale may need further development, and the divergent validity of the obsessing subscale was unsatisfactory. The structure of OCD symptoms was similar in Chinese and western patients. The C-OCI-R is a valid and reliable measure for assessing the severity of obsessive-compulsive symptoms in local Chinese patients with OCD.

Development and psychometric evaluation of the Mandarin Chinese version of the Yale-Brown Obsessive-Compulsive Scale – Second Edition

Objective:To examine the psychometric properties of the Chinese version of the Yale-Brown Obsessive Compulsive Scale – Second Edition (Y-BOCS-II).Method:A total of 86 adults with a primary diagnosis of obsessive-compulsive disorder (OCD), ranging in age from 15 to 78 years, participated in the study. Participants were administered the Y-BOCS-II by a trained clinician who also rated overall illness severity on two additional measures. Patients completed the Obsessive Compulsive Inventory-Revised and Depression Anxiety Stress Scale-21.Results:Results indicated high internal consistency and fair 1-week test retest reliability. The Y-BOCS-II scales correlated strongly with clinician-rated obsessive-compulsive severity and modestly with self-reported obsessive-compulsive symptom frequency and distress. The relationship between Y-BOCS-II total score and depressive and anxiety symptoms was strong, which may reflect high rates of comorbid conditions in this sample or the linkage between obsessive-compulsive symptom severity and distress. Factor analysis demonstrated a two-factor structure consisting of obsession and compulsion factors, with interference due to obsessions cross-loading.Conclusions:Overall, these results support the use of the Y-BOCS-II among individuals from China. Future study by an independent group is necessary to replicate these findings, as well as investigate interrater reliability and treatment sensitivity.

Cognitive training for neurocognitive and functional impairments in obsessive compulsive disorder: A case report

Obsessive-compulsive disorder (OCD) is associated with impairments in neurocognition, especially on executive functioning and visuospatial memory, which tend to persist despite clinical improvement. Impairments in social and occupational functioning are likely related to neurocognition but are rarely targeted by existing treatments for OCD. Previous studies of cognitive training in OCD have been limited by narrow transfer of effects. We report a case of an individual referred for cognitive training in view of persisting cognitive and functional difficulties despite clinical improvement. The intervention consisted of therapist-guided sessions along with homework practice. A smartphone application was developed for cognitive stimulation, and used with other techniques for cognitive stimulation, strategy use, and generalization to achieve transfer of effects. Following 12 weeks of intervention, changes were observed on executive functions including verbal fluency and planning, and smaller changes across measures of attention and working memory. Notably, there was simultaneous reduction on severity of anxiety, depression, and obsessive-compulsive symptoms. Further, there was improvement in subjectively perceived cognitive difficulties as well as work, family and social functioning. The cognitive training intervention has promising implications for individuals with OCD with persisting cognitive and functional impairments despite clinical improvement.

Effects of comorbidity on Tourette's tic severity and quality of life.

ObjectiveThe aim of this study is to gain more insight in the differential contributions of anxiety, depression and obsessive‐compulsive (OC) symptom severity to quality of life (QoL) and tic severity in adults with Tourette Disorder (TD).MethodsSelf‐reported OC symptom, anxiety and depression severity measures were used to investigate their predictive value on QoL and Tic severity in adult TD patients (N = 187), using correlation, regression, and mediation analyses.ResultsTic severity has no effect on QoL. Depression severity directly reduces QoL, whereas anxiety and OC symptom severity have an indirect effect on QoL, mediated by depression severity. OC symptom severity directly affects tic severity, whereas depression and anxiety severity do not have a direct effect on tic or OC severity. Finally, anxiety severity indirectly impacts tic severity, with OC symptom severity functioning as a mediator.ConclusionIn line with and extending previous studies, these findings indicate that OC symptom severity directly influences tic symptom severity whereas depression severity directly influences QoL in TD. Results imply that to improve QoL in TD patients, treatment should primarily focus on diminishing OC and depressive symptom severity rather than focusing on tic reduction.

Comparing the Severity of Obsessive-Compulsive Symptoms in Pre-pregnancy, Pregnancy, and Postpartum Period among Women of reproductive age

Background & aim: Obsessive-Compulsive disorder is considered as one of the most common disorders in pregnancy and postpartum period. There are few studies in this regard in Iran. Therefore, the purpose of the current study was to compare the severity of obsessive-compulsive symptoms in pre-pregnancy, pregnancy, and postpartum period among women of reproductive age. Methods: This descriptive-comparative study was carried out on 900 eligible women (500 non-pregnant women, 200 pregnant women, and 200 in postpartum period) referred to health centers in Mashhad in 2011, who were selected using multi-stage sampling method. The data were collected by Madezly and Yale Brown Obsessive-Compulsive scale and analyzed using descriptive statistics, Kruskal–Wallis one-way analysis of variance, and Mann-Whitney U test in SPSS software (version 11) with the confidence level of 95%. Results: The obtained results of Kruskal-Wallis test showed that there was significant statistical difference between the groups of pre-marriage (15.9±7.1), pregnancy (20.6±4.5), and postpartum period (20.9±5.1) in terms of mean score of obsessive-compulsive symptoms (P=0.007). Conclusion: Women in their pregnancy and postpartum period are at risk of obsessive-compulsive disorder that mostly are not recognized. As a Consequence, it is necessary for healthcare centers to take required measures in this regard.

Comorbidity of Obsessive-Compulsive Disorder and Schizotypal Personality Disorder: Clinical Response and Treatment Resistance to Pharmacotherapy in a 3-Year Follow-Up Naturalistic Study.

The present study aims to analyze the clinical and socio-demographic characteristics of patients with obsessive-compulsive disorder (OCD) in comorbidity with schizotypal personality disorder (SPD), as well as the response rate to pharmacological treatments. OCD+SPD patients had a younger age at onset, a higher probability to have more severe obsessive-compulsive symptoms, a higher rate of schizophrenia spectrum disorders in their first-degree relatives, and a poorer insight compared to OCD patients. During the 3-year follow-up period, these patients showed a lower rate of recovery, thus requiring augmentation with different psychotropic medications, including low doses of antipsychotics. Our findings suggest that the comorbidity of OCD and SPD causes a poor treatment response, and a reduced probability to recover using standard pharmacological treatment strategies. Further investigations are needed to identify alternative strategies, including psychoeducation and cognitive behavioral therapy, to manage such frequent comorbidity in clinical practice.

The course and clinical correlates of obsessive-compulsive disorder during the postpartum period: A naturalistic observational study

BackgroundIn this study, we aimed to investigate the course of obsessive-compulsive disorder (OCD) and the demographic and clinical correlates associated with significant changes in symptom severity in postpartum women. MethodsData were collected form 37 consecutive postpartum women who were diagnosed with OCD during psychiatric interviews by means of the Structured Clinical Interview for DSM-IV (SCID-I). Psychiatric assessments were carried out on the first day after delivery and at 6 to 8 weeks in the postpartum period. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was administered at both assessments while the Hospital Anxiety and Depression Scale (HADS), Coping orientation to problems Experienced (COPE) and Multidimensional Scale of Perceived Social Support (MSPSS) and Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A), were administered to the participants at the first assessment. ResultsThe mean score of Y-BOCS was significantly reduced from the baseline to the 6–8 week postpartum period. The proportion of patients with a decreaseof at least 35% in the total score of Y-BOCS during the postpartum period was 43.2%. When the patient groups with and without ≥35% decrease in the total score of Y-BOCS were compared, the group showing the decrease had a higher score of COPE-supression of competing activities, COPE-humor and TEMPS-A-hyperthymic affective temperament and more frequently reported a decrease in the severity of OCD symptoms after a previous childbirth. Logistic regression analysis indicated that the last two variables could accurately predict a ≥ 35 decrease in the severity of OCD symptoms during the postpartum period. LimitationsThe study has relatively small sample size. ConclusionsThe current results suggest that patients with OCD who exhibit hyperthymic affective temperament character and a decrease in symptoms following a previous childbirth may experience a significant alleviation in the severity of obsessive-compulsive symptoms during the postpartum period.

Sudden gains in cognitive behavioral therapy among children and adolescents with obsessive compulsive disorder

Background and objectivesThis study examined the occurrence of sudden gains (or reversal of gains) among children with obsessive-compulsive disorder (OCD) during the course of cognitive-behavioral therapy (CBT), as well as the association of sudden gains with treatment response, treatment group, and pre-treatment clinical characteristics. MethodsThe sample consisted of 136 youth (ages 7–17) with a primary diagnosis of OCD who were randomized in a double-blinded fashion to 10 sessions of CBT with augmentation of either d-cycloserine or placebo. Sudden gain status was determined based on clinician-rated obsessive-compulsive symptom severity, which was collected on 9 occasions across the study period. Results42.6% of youth experienced at least one sudden gain, which tended to occur either after starting exposure and response prevention or towards the end of treatment. After applying the Benjamini-Hochberg procedure for multiple comparisons, there were no significant pre-treatment predictors of sudden gains and only reduced insight predicted the reversal of gains. Individuals with at least one sudden gain had improved overall treatment outcomes, measured both by reduction in OCD symptom severity, and by global illness severity. LimitationsSeveral clinical constructs were not examined. Symptomatology was not assessed at every treatment session. Differences in those who achieved sudden gains and those who did not may be obscured. There is the possibility that a sudden gain reflected a scoring error generated by an optimistic or inaccurate report. Finally, a relatively homogenous sample may limit the generalizability of results. ConclusionsThe course of CBT for pediatric OCD is variable with many children experiencing sudden gains, but a sizable percentage experience a reversal of gains which was related to reduced insight. Sudden gains tended to occur after starting exposure and response prevention and towards the end of treatment. TrialsregistrationClinicaltrialsgovRegistry:NCT00864123. https://www.clinicaltrials.gov/ct2/show/NCT00864123.

The "Obsessive Paradox": The Complex Relationship Between Cognitive and Obsessive Dimensions in Schizophrenia.

The objective of the study was to investigate the relationship between cognitive functions and obsessive-compulsive dimension in schizophrenia and a possible moderating effect of schizophrenia symptom dimensions on this association. Sixty-one schizophrenia patients were administered the Positive and Negative Syndrome Scale, the Yale-Brown Obsessive-Compulsive Scale (YBOCS), and the Matrics Consensus Cognitive Battery. A U-shaped curve described a gradual transition from an inverse association to a positive relationship between YBOCS and processing speed scores, along a severity gradient of obsessive dimension. This effect ("the obsessive paradox") was not moderated by other symptom dimensions. The present study suggests that severe obsessive-compulsive symptoms may participate to counterbalance processing speed impairment independently from other symptom dimensions. These results highlight the complexity of the relationship between cognitive and obsessive dimensions in schizophrenia.

Increased psychiatric symptoms in university students with autism spectrum disorder are associated with reduced adaptive behavior

High variability in adaptive behavior in cognitively-able adults with autism spectrum disorder has been previously reported, and may be caused by the high prevalence of psychiatric comorbidity in this population. This study's goals were to examine self-reported psychiatric symptoms in students with ASD, and to identify their relative contribution to the variance in adaptive behaviors. The study population included 95 students: 55 diagnosed with ASD (4 females; age range 18–34) who participated in a university integration program (ASD group), and 40 regularly matriculated students (non-ASD group, 7 females; age range 20–36). The ASD group showed a lower adaptive skill level than the non-ASD group as measured by the Adaptive Behavior Assessment System (GAC-ABAS). Significantly higher scores for the ASD group were found for social anxiety, trait anxiety, obsessive-compulsive symptoms, and depression symptoms. The level of adaptive skills correlated negatively and significantly with the severity of social anxiety symptoms in both groups and with severity of obsessive-compulsive symptoms only in the ASD group. Additionally, in a regression model, significant contributions of having an ASD diagnosis and severity of social anxiety explained 41.7% of the variance in adaptive skills. Adequate evaluation and treatment, if needed, are recommended in this population.

The Effectiveness of Emotion-Focused Therapy on Emotion Regulation Styles and Severity of Obsessive-Compulsive Symptoms in Women With Obsessive-Compulsive Disorder

The Effectiveness of Emotion-Focused Therapy on Emotion Regulation Styles and Severity of Obsessive-Compulsive Symptoms in Women With Obsessive-Compulsive Disorder

Congruence and discrepancy between self-rated and clinician-rated symptom severity on the Yale–Brown Obsessive-Compulsive Scale (Y-BOCS) before and after a low-intensity intervention

The Yale–Brown Obsessive Compulsive Scale (Y-BOCS) is the most common measure of Obsessive-Compulsive symptom severity. The Y-BOCS interview is considered gold standard, but its self-rating format is increasingly used in clinical trials. Few studies investigated congruency and potential changes over treatment. This question is highly relevant, as a systematic bias might obscure results of clinical trials. We examined the relationship of self- and clinician-rated Y-BOCS scores in participants with obsessive-compulsive disorder in pre (N = 128), post, (4 weeks, n = 104) and follow-up (6 months, n = 98) assessments of a randomized-controlled clinical trial. We administered Y-BOCS interview via telephone paralleling online administration of the self-report form. Analyses showed medium-to-strong correlations of Y-BOCS interview and self-rating scores at pre-assessment. Patients rated symptoms lower than clinicians. Larger discrepancies were associated with hoarding and age. Congruency was inferior for obsessions relative to compulsions, largely owing to the “resistance against obsessions” item. Agreement strongly increased at post and follow-up. Though overall congruency between the two Y-BOCS forms was satisfactory, results suggest a “correction over time” effect. Such bias may distort the precise interpretation of treatment effects. Therefore, we made several suggestions to improve the reliability of change scores assessed with the Y-BOCS self-rating.

Criterion Validity of the Yale-Brown Obsessive-Compulsive Scale Second Edition for Diagnosis of Obsessive-Compulsive Disorder in Adults.

Background: While the Yale-Brown Obsessive-Compulsive Scale Second Edition (Y-BOCS-II) is the gold-standard for measurement of obsessive-compulsive (OC) symptom severity, its factor structure is still a matter of debate and, most importantly, criterion validity for diagnosis of OC disorder (OCD) has not been tested. This study aimed to clarify factor structure and criterion validity of the Y-BOCS-II.Methods: We first validated and quantified the psychometric properties of a culturally adapted Portuguese translation of the Y-BOCS-II (PY-BOCS-II). The PY-BOCS-II and other psychometric instruments, including the OCD subscale of the Structured Clinical Interview for the DSM-IV, used to define OCD diagnosis, were administered to 187 participants (52 patients with OCD, 18 with other mood and anxiety disorders and 117 healthy subjects). In a subsample of 20 OCD patients and the 18 patients with other diagnoses, PY-BOCS-II was applied by clinicians blinded to diagnosis.Results: PY-BOCS-II had excellent internal consistency (Cronbach's α = 0.96) and very good test-retest reliability (Pearson's r = 0.94). Exploratory factor analysis revealed a two-factor structure with loadings consistent with the Obsessions and Compulsions subscales, and there was good to acceptable convergent and divergent validity. Importantly, the area under the curve (AUC) of the receiver operating characteristic (ROC) curve suggested elevated accuracy in discriminating between patients with OCD and control subjects (AUC = 0.96; 95% confidence interval [CI]: 0.92–0.99), that was retained in comparisons with age, gender and education matched controls (AUC = 0.95; 95% CI: 0.91–0.99), as well as with patients with other mood and anxiety disorders (AUC = 0.93; 95% CI: 0.84–1). Additionally, a cut-off score of 13 had optimal discriminatory ability for the diagnosis of OCD, with sensitivity ranging between 85 and 90%, and specificity between 94 and 97%, respectively when all samples or only the clinical samples were considered.Conclusion: The PY-BOCS-II has excellent psychometric properties to assess the severity of obsessive-compulsive symptoms, reflecting obsessive, and compulsive dimensions, compatible with currently defined subscales. Furthermore, we found that a cut-off of 13 for the Y-BOCS-II total score has good to excellent sensitivity and specificity for the diagnosis of OCD.

Clinical predictors of quality of life in a large sample of adult obsessive-compulsive disorder outpatients

BackgroundOCD causes impairment in different areas of the patients' quality of life (QoL), such as sociability, family relationships, and occupational performance. The literature has emphasized the relevance of assessing QoL as a critical outcome in mental health studies. AimsThe aim of this study was to investigate sociodemographic and clinical predictors of QoL, including treatment response, in a large sample of OCD subjects. Procedures575 adult OCD outpatients were interviewed as part of the Brazilian OCD Consortium (CTOC). A smaller number of subjects (N = 143) participated on a clinical trial conducted by one of the CTOC sites. ResultsOCD patients were more impaired in their QoL when compared to the Brazilian normative data. Obsessive-compulsive symptoms (OCS) severity had significant correlations with all Medical Outcome Short-Form questionnaire (SF-36) domains. Different OCS dimensions had specific correlations with each SF-36 domain. OCS, depression and anxiety severity significantly increased the impairment risk for the SF-36 domains. Suicidality increased the relative risks for impairment in the Role-Functioning and the Vitality domains by 51% and 17%, respectively. There was a significant improvement in some SF-36 dimensions after treatment. ConclusionsQoL domains are highly compromised in OCD patients. Each SF-36 domain had distinct associations with sociodemographic and clinical variables, including OCS dimensions, suicidality and treatment response. These findings emphasize the OCD heterogeneity and the need for including QoL assessment in clinical practice and research studies.