Obsessive-compulsive Disorder Symptom Dimensions Research Articles

State-dependent effects of repetitive transcranial magnetic stimulation on symptom dimensions of obsessive-compulsive disorder: A case report

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation procedure that is FDA-cleared for treating obsessive-compulsive disorder (OCD). Evidence suggests that controlling brain state during rTMS treatment can influence treatment outcomes. We present the case of a patient with refractory OCD who received symptom provocation immediately preceding rTMS treatment sessions. The patient experienced more subjective and objective improvement in OCD symptoms targeted by provocations than in other symptom domains. These results suggest the importance of brain state during rTMS and could be used to guide and optimize neuromodulation treatment for OCD.

Increases in functional connectivity between the default mode network and sensorimotor network correlate with symptomatic improvement after transcranial direct current stimulation for obsessive-compulsive disorder

BackgroundNon-invasive neuromodulation is a promising intervention for obsessive-compulsive disorder (OCD), although its neurobiological mechanisms of action are still poorly understood. Recent evidence suggests that abnormalities in the connectivity of the default mode network (DMN) and the supplementary motor area (SMA) with other brain regions and networks are involved in OCD pathophysiology. We examined if transcranial direct current stimulation (tDCS) alters these connectivity patterns and if they correlate with symptom improvement in treatment-resistant OCD. MethodsIn 23 patients from a larger clinical trial (comparing active tDCS to sham) who underwent pre- and post-treatment MRI scans, we assessed resting-state functional MRI (rs-fMRI) data. The treatment involved 30-minute daily tDCS sessions for four weeks (weekdays only), with the cathode over the SMA and the anode over the left deltoid. We conducted whole-brain connectivity analysis comparing active tDCS-treated to sham-treated patients. ResultsWe found that active tDCS, but not sham, led to connectivity increasing between the DMN and the bilateral pre/postcentral gyri (p = 0.004, FDR corrected) and temporal-auditory areas plus the SMA (p = 0.028, FDR corrected). Also, symptom improvement was directly associated with connectivity increasing between the left lateral sensorimotor network and the left precuneus (r = 0.589, p = 0.034). LimitationsLimited sample size (23 participants with resting-state neuroimaging), inability to analyze specific OCD symptom dimensions (e.g., harm, sexual/religious, symmetry/checking, cleaning/contamination). ConclusionsThese data offer novel information concerning functional connectivity changes associated with non-invasive neuromodulation interventions in OCD and can guide new brain stimulation interventions in the framework of personalized interventions.

Study on symptom dimensions and clinical characteristics in patients with obsessive-compulsive disorder.

The aim of this study was to explore the symptom dimensions and clinical characteristics of obsessive-compulsive disorder in the context of Chinese culture. In this cross-sectional study, the severity of obsessive-compulsive symptoms, the distribution of symptoms, and symptom scores of 263 patients with obsessive-compulsive disorder were assessed using the Yale-Brown Obsessive-Compulsive Scale and Yale-Brown Obsessive-Compulsive Inventory Symptoms Checklist. System cluster analysis and Pearson analysis were performed to explore the relationships between the main clinical characteristics and symptom dimensions. Cluster analysis identified four symptom dimensions of obsessive-compulsive disorder: (1) symmetry precision; (2) contamination cleaning; (3) aggression examination; and (4) taboo thinking. The symmetry precision dimension showed an association with years of education. The compulsive score, total Yale-Brown Obsessive Compulsive Scale score, contamination cleaning dimension, and aggression examination dimension had significant relationships. Age, age at onset, obsessive score, and compulsive score had a significant correlation with the taboo-thinking dimension. The symptom dimensions of obsessive-compulsive disorder in China are similar to those in other regions. Each of the four symptom dimensions had distinct clinical characteristics.

Implicit aggressive self-concept in patients with obsessive-compulsive disorder: Results from an approach-avoidance task

Background and objectivesPatients with obsessive-compulsive disorder (OCD) have reported higher anger and aggression than healthy individuals in previous studies using explicit measures. However, studies using implicit measures have demonstrated mixed results. The aim of the present study was to investigate implicit aggressiveness in OCD using an approach-avoidance task (AAT). MethodsSeventy-eight patients with OCD and 37 healthy controls underwent structured clinical interviews and measures of anger, OCD, and depressive symptoms as well as a computerized AAT that included aggressive, peaceful, negative, and positive stimuli. ResultsIn line with previous studies, patients with OCD reported higher scores on explicit anger. With respect to the implicit measure, repeated measures ANOVAs did not show any differences in mean reaction times for pushing compared to pulling aggressive versus peaceful and negative versus positive words. However, analyses of specific OCD symptom dimensions demonstrated significantly faster reaction times for pulling compared to pushing aggressive words for patients with high scores in the OCD symptom dimensions obsessing and hoarding. LimitationsEighty percent of patients with OCD showed psychiatric comorbidities and all were seeking treatment. ConclusionThe present study supports previous studies reporting the absence of higher aggressiveness in patients with OCD compared to healthy controls using implicit measures. However, in contrast to previous studies, we found an implicit approach bias towards aggressive self-statements for OCD patients scoring high in the symptom dimensions obsessing and hoarding compared to healthy controls. Future studies should further elucidate putative functional relationships between different OCD symptom dimensions and implicit aggressiveness.

Obsessive-Compulsive Symptom Dimensions and Their Relationships with Obsessive Beliefs: A Structural Equation Modeling Analysis.

Dysfunctional beliefs are central in the development and maintenance of obsessive-compulsive disorder (OCD) as well as its treatment. Yet, research suggests that not all dysfunctional beliefs are equally important for each of the symptom dimensions of OCD. However, results are inconsistent in that studies contradict each other regarding the associations between specific symptom dimensions and belief domains. The aim of the present study was to clarify which belief domain is specifically associated with which OCD symptom dimension. Results could help to tailor treatments more specifically to the patient's OCD symptom dimension. In- and outpatients with OCD (N = 328; 43.6% male and 56.4% female) filled out questionnaires on symptom dimensions of OCD (Obsessive-Compulsive Inventory Revised) and dysfunctional beliefs (Obsessive Beliefs Questionnaire). A structural equation model analysis was conducted to identify the associations between dysfunctional beliefs and symptom dimensions. Our results showed that perfectionism/intolerance of uncertainty was associated with hoarding and symmetry/ordering, (2) overestimation of threat/inflated responsibility was associated with checking compulsions, and (3) importance of thoughts/control of thoughts was associated with obsessing. These results were largely supported by a backward selection. Our results demonstrated associations of specific dysfunctional beliefs and specific OCD symptom dimensions. However, future studies are necessary to replicate these findings with other measures (e.g., clinician ratings).

The contribution of guilt sensitivity in the prediction of obsessive-compulsive disorder symptom dimensions: Replication and extension

BackgroundObsessive-compulsive disorder (OCD) is associated with particular cognitive processes, such as beliefs about the importance of intrusive thoughts. The present study examined the explanatory power of guilt sensitivity to OCD symptom dimensions after controlling for well-established cognitive predictors. Methods164 patients with OCD completed self-reported measures of OCD and depressive symptoms, obsessive beliefs, and guilt sensitivity. Bivariate correlations were examined, and latent profile analysis (LPA) was used to generate groups based on symptom severity scores. Differences in guilt sensitivity were examined across latent profiles. ResultsGuilt sensitivity was most strongly associated with unacceptable thoughts and responsibility for harm OCD symptoms, and moderately with symmetry. After controlling for depression and obsessive beliefs, guilt sensitivity added explanatory power to the prediction of unacceptable thoughts. LPA identified 3 profiles; profile-based subgroups significantly differed from one another in terms of guilt sensitivity, depression, and obsessive beliefs. ConclusionsGuilt sensitivity is relevant to various OCD symptom dimensions. Above and beyond depression and obsessive beliefs, guilt sensitivity contributed to the explanation of repugnant obsessions. Theory, research, and treatment implications are discussed.

Relationship between white matter alterations and contamination subgroup in obsessive compulsive disorder: A diffusion tensor imaging study.

Approximately 2%-3% of the world population suffers from obsessive-compulsive disorder (OCD). Several brain regions have been involved in the pathophysiology of OCD, but brain volumes in OCD may vary depending on specific OCD symptom dimensions. The study aims to explore how white matter structure changes in particular OCD symptom dimensions. Prior studies attempt to find the correlation between Y-BOCS scores and OCD patients. However, in this study, we separated the contamination subgroup in OCD and compared directly to healthy control to find regions that exactly related to contamination symptoms. To evaluate structural alterations, diffusion tensor imaging was acquired from 30 OCD patients and 34 demographically matched healthy controls. Data were processed using tract-based spatial statistics (TBSS) analysis. First, by comparing all OCD to healthy controls, significant fractional anisotropy (FA) decreased in the right anterior thalamic radiation, right corticospinal tract, and forceps minor observed. Then by comparing the contamination subgroup to healthy control, FA decreases in the forceps minor region. Consequently, forceps minor plays a central role in the pathophysiology of contamination behaviors. Finally, other subgroups were compared to healthy control and discovered that FA in the right corticospinal tract and right anterior thalamic radiation is reduced.

Measuring symptoms of obsessive-compulsive and related disorders using a single dimensional self-report scale.

Obsessions and compulsions are heterogenous but can be classified into obsessive-compulsive disorder (OCD), body dysmorphic disorder (BDD), hoarding disorder (HD), hair-pulling disorder (HPD), and skin-picking disorder (SPD). OCD is in itself heterogenous, with symptoms clustering around four major symptom dimensions: contamination/cleaning, symmetry/ordering, taboo obsessions, and harm/checking. No single self-report scale captures the full heterogeneity of OCD and related disorders, limiting assessment in clinical practice and research on nosological relations among the disorders. To provide a single self-report scale of OCD and related disorders that respects the heterogeneity of OCD, we expanded the DSM-5-based Obsessive-Compulsive and Related Disorders-Dimensional Scales (OCRD-D) so that is also includes the four major symptom dimensions of OCD. A psychometric evaluation and an exploration of the overarching relations among the dimensions were conducted using an online survey which was completed by 1,454 Spanish adolescents and adults (age span = 15-74 years). Approximately 8 months after the initial survey, 416 participants completed the scale again. The expanded scale showed excellent internal psychometric properties, adequate test-retest correlations, known groups validity, and correlations in the expected directions with well-being, depression/anxiety symptoms, and satisfaction with life. The higher-order structure of the measure indicated that harm/checking and taboo obsessions formed a common disturbing thoughts factor and that HPD and SPD formed a common body-focused repetitive behaviors factor. The expanded OCRD-D (OCRD-D-E) shows promise as a unified way to assess symptoms across the major symptom dimensions of OCD and related disorders. The measure may be useful in clinical practice (e.g., screening) and research, but more research on construct validity, incremental validity, and clinical utility is needed.

The association between OCD and Shame: A systematic review and meta-analysis.

Due to rumination and self-criticism over unwanted obsessions and repetitive rituals, shame is a common emotion experienced by individuals with obsessive-compulsive disorder (OCD). Shame is also theorized to have relevance to unacceptable thoughts in OCD. However, empirical research looking at the relationship between OCD and shame is still emerging and findings have been mixed. Our review systematically examines the association of shame with OCD and unacceptable thoughts. The last updated search was conducted across five databases between 27 and 29 February 2022. The final selection included 20 papers, 18 of which were used in the primary meta-analysis to calculate pooled effect sizes between OCD and shame measures using a random effects model. In a separate analysis, three papers were used to calculate pooled effect sizes between shame and OCD symptom dimensions also using a random effects model. The meta-analyses identified a significant, moderate and positive correlation between total OCD and shame scores r=.352, 95% CI [0.260, 0.438]. In addition, significant, weak and positive relationships were found between shame and three OCD symptom dimensions: unacceptable thoughts r=.252, 95% CI [-0.467, 0.9708], harm obsessions r=.224, CI [-0.190, 0.638] and symmetry concerns r=.200, CI [-0.108, 0.509]. Shame measures in the reviewed studies were not specific to OCD, and between-study variance in the analyses examining unacceptable thoughts was significant. Our findings support a medium positive relationship between shame and OCD. As shame in OCD can be a barrier to seeking treatment and impair quality of life, it is imperative to address this emotion through psychoeducation, assessment and treatment.

Sensory Processing Difficulties in Children and Adolescents with Obsessive-Compulsive and Anxiety Disorders

Altered sensory processing has been linked to symptoms of obsessive-compulsive disorder (OCD) and anxiety disorders (ADs) in youth, but few studies have examined sensory processing in clinical samples and no study has analyzed self-report data from youth meeting diagnostic criteria for OCD or ADs. This study included 86 youth with OCD, 82 youth with ADs, and 46 youth without psychiatric disorders. Participants completed the adolescent version of the Sensory Profile and scales measuring three symptom dimensions of OCD, four symptom dimensions of anxiety, and symptoms of major depression. Results showed that different forms of sensory processing difficulties (sensitivity, avoidance, low registration) were adequately captured by one broad sensory processing factor. Youth with OCD and ADs reported statistically significantly more sensory difficulties than youth without psychiatric disorders, but the two clinical groups did not differ from each other. Altered sensory processing in the clinical groups was not explained by the presence of neurodevelopmental disorders. Sensory difficulties were moderately to strongly related to all self-reported symptom dimensions, and uniquely related to the OCD dimension of symmetry/ordering and the anxiety dimensions of panic and social anxiety. Most youth in the clinical groups were classified as having difficulties with sensory processing. The present study shows that sensory processing difficulties are common in youth with OCD and ADs, not explained by co-occurring neurodevelopmental disorders, and linked to a host of internalizing symptoms. More research is needed to identify whether sensory processing difficulties precede, follow, or mutually reinforce the development of OCD and ADs in youth.

OCD symptom dimensions and treatment: a new dimension?

IntroductionBackground: Obsessive-compulsive disorder (OCD) is a condition that includes distressing obsessions and repetitive compulsions. Usually presents with a wide range of symptons normally grouped into different clusters or dimensions. clinical impression and some empirical data suggest that certain groups of symptoms or clusters are more responsive to treatment than others, thus it can help clinicians to better guide initial treatment choices and management of individual patientsObjectivesObjetictive: to describe the symptom dimensions in a clinical database that includes patients accompannied in an obssessive conpulsive disorder consultation in a tertiary hospital in Portugal and to point out some differences in treatment outcomes.MethodsWe searched Pubmed and Cochrane Library database for english language articles.ResultsTo date it appears that pharmacotherapy and CBT are an effective treatment for the various OCD dimensions, although not all dimensions have been adequately studied or respond well to treatment. Knowing a specific symptom profile may have implications in treatment components that clinicians should be aware of.ConclusionsMore research will be needed to determine the best tailor treatments to each patient’s profile and Modifications to treatment may be needed. Clinical implications and directions for future research are discussed.DisclosureNo significant relationships.

Psychometric properties of the Swedish translation of the Obsessive-Compulsive Inventory-Revised and the population characteristics of the symptom dimensions of OCD.

EGOS is an epidemiological obsessive-compulsive disorder (OCD) cohort in Sweden. Individuals contributed DNA for genotyping and sequencing and completed a Swedish translation of the Obsessive-Compulsive Inventory-Revised (OCI-R), a self-report questionnaire for assessing the severity of OCD. This study aimed first to evaluate the psychometric properties of the Swedish translation of the OCI-R and then shed light on the frequency, severity, and symptom dimensions of OCD comorbid with other psychiatric disorders. OCI-R data were available for1010 individuals diagnosed with OCD, and 124 individualsdiagnosed with chronic tic disorders without OCD used as a comparison group. We first performed a confirmatory factor analysis to confirm the six-factor structure of OCI-R. Then, we estimated Cronbach's α coefficient and the generalizability coefficient to evaluate the internal consistency of the OCI-R. We linked the data from the Swedish national registries to access and analyze psychiatric comorbidities of OCD. The Swedish translation of OCI-R demonstrated internal consistency and clear agreement with the OCI-R six-factor model. The mean total OCI-R score for females was significantly higher than for males. The most comorbid psychiatric condition to OCD were anxiety disorders (13.6%) and major depression (12%). The Swedish translation of OCI-R was a valid and reliable measure for assessing the severity of OCD. We observed that individuals with OCD frequently had additional comorbid psychiatric disorders and that the severity of OCD was significantly higher in individuals with at least one additional psychiatric comorbidity as compared to individuals with no psychiatric comorbidity.

Symptom Dimension Breakpoints for the Obsessive-Compulsive Inventory-Child Version (OCI-CV)

Pediatric obsessive-compulsive disorder (OCD) clusters around three major symptom dimensions: contamination/cleaning, symmetry/ordering, and disturbing thoughts/checking. The Obsessive-Compulsive Inventory-Child Version (OCI-CV) is a self-report questionnaire that provides scores along six theory-based OCD dimensions, but no study has evaluated how well OCI-CV identifies clinically significant symptoms within each of the three major symptom dimensions of OCD. We examined this question using data from 197 Swedish and Spanish youth with OCD. All youth completed the OCI-CV and clinically significant symptom severity within each major OCD dimension was established with a validated interview-based measure. Results showed that a score ≥ 3 on the OCI-CV washing scale excellently captured those with clinically significant contamination/cleaning symptoms (AUC = 0.85 [0.80–0.90], 79% accuracy). A score ≥ 4 on the obsessing scale adequately captured those with disturbing thoughts/checking symptoms (AUC = 0.71 [0.64–0.78], 67% accuracy) and a score ≥ 3 on the ordering scale adequately captured those with symmetry/ordering symptoms (AUC = 0.72 [0.65–0.79], 70% accuracy). Similar accuracy of the breakpoints was found in the Swedish and Spanish samples. OCI-CV works well to identify youth with pediatric OCD that have clinically significant contamination/cleaning symptoms. The measure can also with adequate precision identify those with clinically significant disturbing thoughts/checking and symmetry/ordering symptoms. The breakpoints provided in this study can be used to examine differences in clinical presentation and treatment outcome for youth with different types of OCD.

Prevalence and correlates of suicidality in obsessive-compulsive disorder

BackgroundA growing body of evidence suggest individuals with obsessive-compulsive disorder (OCD) are at an increased risk for suicidal thoughts and behaviors (SITB). However, the literature on suicidality in OCD remains limited. Thus, the present study examined the prevalence and predictors of suicidality in a sample of adults seeking treatment for OCD. MethodsA total of 687 patients seeking care through a network of intensive treatment centers consented to participate. Participants completed validated self-report questionnaires of depression and OCD symptom severity, as well as psychodiagnostic interviews. ResultsAlmost half of the participants reported current suicidal ideation. The presence of a comorbid diagnosis was associated with increased likelihood of more severe SITB. Specifically, the presence of a co-occurring anxiety, depressive, or bipolar mood disorder predicted increased severity of SITB. In addition, obsession severity was positively associated with suicidality, while compulsion severity negatively predicted the severity of SITB. Regarding OCD symptom dimensions, repugnant thoughts emerged as a significant predictor of SITB severity. ConclusionsSITB is a prevalent concern in treatment-seeking patients with OCD. Clinicians are encouraged to assess and consider the treatment implications of SITB, particularly among patients with co-occurring mood and anxiety disorders, or symptoms involving taboo thought content. Future directions and theoretical considerations are discussed.

Validation of Symptom Dimensions and Sub-Type Responses in Cognitive Behavioral Therapy in Obsessive Compulsive Disorder: A Systemic Review and Meta-Analysis

Background: Obsessive-compulsive disorder (OCD) is a clinically heterogeneous condition without a conclusive subtype dimension. This study will focus on the meta-analysis of the clinical responses of OCD subtypes to cognitive behavioral therapy (CBT), which might clarify this issue. Methods: We performed a systematic search and a meta-analysis for the studies of OCD subtypes and the response to CBT in PubMed, ScienceDirect, Embase, Web of Science, and Scopus databases. The selective criteria were the OCD without significant medical or psychiatric co-morbidities and pre-and post-treatment changes in scores of OCD dimension. In addition, different subtypes of OCD in symptom dimensions, such as symmetry, contamination, unacceptable thoughts, and hoarding, were compared to find the most significant subtype using the treatment response parameters by CBT. After limited selection, four studies and 479 OCD subjects were enrolled. The meta-analysis was performed by Review Manager 5.4, and only significant results were reported. Results: Among the OCD subtypes, the meta-analysis favors the hoarding subtype with poorer responses to CBT than symmetry, contamination, and unacceptable thoughts. The meta-analysis results were negative mean differences, significant tests for overall effect, and limited heterogeneities in the random effects model. In addition, the results were more significant when the hoarding subtype was compared with non-hoarding subtypes. Conclusion: The hoarding subtype might be the most significant representative subtype of OCD symptom dimension under the impression of unfavorable clinical response to CBT. However, future studies with more treatment parameters will be warranted to confirm this finding.

Intolerance of uncertainty and obsessive-compulsive disorder dimensions

Intolerance of uncertainty (IU), which can include prospective (i.e., desire for predictability) and inhibitory (i.e., uncertainty paralysis) IU, is widely understood to be a central underlying component of obsessive-compulsive disorder (OCD). IU has several treatment implications, yet research on the differences in IU underlying OCD dimensions is limited and does not account for covarying effects of overlapping symptoms, shared variance in IU, demographic variables, and comorbid psychiatric conditions like generalized anxiety disorder (GAD) and posttraumatic stress disorder (PTSD). A sample of 974 patients with diagnosed OCD enrolled in residential, partial hospitalization, and intensive outpatient treatment programs for OCD and anxiety completed self-report measures of OCD symptoms and IU at admission. Structural equation modeling included prospective. inhibitory IU, and common IU and covariates (i.e., race, ethnicity, level of care, and comorbid GAD and PTSD) as predictors of four common OCD dimensions found that contamination and unacceptable thoughts symptoms evidenced a unique relationship with IU. Specifically, whereas a common IU factor predicted all four OCD symptom dimensions, inhibitory IU uniquely predicted contamination and unacceptable thoughts symptoms over and above covarying effects. Individuals with contamination and unacceptable thoughts symptoms may be more likely to feel “paralyzed” by uncertainty due to overreliance on overt immediate rituals, outright avoidance, rumination, or difficulties with emotion regulation, and may benefit from additional psychoeducation, problem-solving, and accountability. Broadly, individuals with OCD may benefit from explicit discussions about IU-related expectancies and disconfirmation of fears.

Neural Mechanisms of Symptom Dimensions During Provocation in Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is highly heterogenous, yet it remains unclear how this heterogeneity may be related to differential neurocircuitry. This study investigated neural mechanisms associated with symptom heterogeneity in OCD by examining the relationship between fMRI activation during a provocation task and severity of four different symptom dimensions in OCD.

Are There Familial Patterns of Symptom Dimensions in Obsessive-Compulsive Disorder?

Background: Obsessive-compulsive disorder (OCD) is a heterogeneous illness, and emerging evidence suggests that different symptom dimensions may have distinct underlying neurobiological mechanisms. We aimed to look for familial patterns in the occurrence of these symptom dimensions in a sample of families with at least two individuals affected with OCD.Methods: Data from 153 families (total number of individuals diagnosed with DSM-5 OCD = 330) recruited as part of the Accelerator Program for Discovery in Brain Disorders using Stem Cells (ADBS) was used for the current analysis. Multidimensional Item Response Theory (IRT) was used to extract dimensional scores from the Yale-Brown Obsessive-Compulsive Scale (YBOCS) checklist data. Using linear mixed-effects regression models, intra-class correlation coefficients (ICC), for each symptom dimension, and within each relationship type were estimated.Results: IRT yielded a four-factor solution with Factor 1 (Sexual/Religious/Aggressive), Factor 2 (Doubts/Checking), Factor 3 (Symmetry/Arranging), and Factor 4 (Contamination/Washing). All except for Factor 1 were found to have significant ICCs, highest for Factor 3 (0.41) followed by Factor 4 (0.29) and then Factor 2 (0.27). Sex-concordant dyads were found to have higher ICC values than discordant ones, for all the symptom dimensions. No major differences in the ICC values between parent-offspring and sib-pairs were seen.Conclusions: Our findings indicate that there is a high concordance of OCD symptom dimensions within multiplex families. Symptom dimensions of OCD might thus have significant heritability. In view of this, future genetic and neurobiological studies in OCD should include symptom dimensions as a key parameter in their analyses.

Severity related neuroanatomical alteration across symptom dimensions in obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) is a symptomatically heterogeneous disease. Symptoms of OCD can be grouped into a six-factor structure including washing, checking, neutralizing, obsessing, ordering and hoarding. These different symptom profiles might be one of the critical factors contributing to the inconsistent neuroanatomical findings in OCD according to the literature. In this study, whole-brain voxel-based morphometry was used to examine neuroanatomical alterations in gray matter (GM) for OCD compared to healthy controls, and the variations associated with differing symptoms of OCD. The high-quality structural imaging data from 39 OCD individuals and 42 age-matched healthy controls were recruited. First, we found increased cortical GM volume in the left postcentral gyrus in OCD participants compared to healthy controls. Next, six independent regression analyses were conducted to examine the correlation between OCD symptom dimensions and inter-individual variation in neuroanatomy. After a rigorous multiple comparison correction, greater hoarding symptom was robustly found associated with greater GM volumes at various frontotemporal regions (including orbitofrontal, middle frontal and superior temporal GMs). Additionally, greater washing symptoms were associated with increased GM volume at the superior temporal cortex. The symptom-specific GM alterations observed here support the notion that OCD is an etiologically heterogeneous disorder, with both overlapping and distinct neuroanatomical structure across symptom dimensions.

Association of insight, avoidance behavior, indecisiveness, and inflated responsibility with other clinical characteristics in children and adolescents with obsessive-compulsive disorder.

Objectives:Although the Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) includes ancillary symptom dimensions – insight, avoidance, degree of indecisiveness, inflated sense of responsibility, pervasive slowness/disturbance of inertia, and pathological doubting –, we know little about their clinical/scientific utility. We examined these ancillary dimensions in childhood obsessive-compulsive disorder (OCD), and tested their associations with clinical characteristics.Methods:Treatment-seeking children and adolescents (n=173) with a DSM-5 OCD diagnosis were recruited from six centers in India and evaluated with a semi-structured proforma for sociodemographic/clinical details, the Structured Clinical Interview for DSM-5, the CY-BOCS, the Children’s Depression Rating Scale, and the Family Interview for Genetic Studies. Regression analysis was used to study the associations between ancillary dimensions (independent variables) and clinical variables (dependent variables).Results:87.9% of the sample reported at least a mild-moderate severity of ancillary dimensions, which were highly intercorrelated. Multiple ancillary dimensions were correlated with illness severity on the CY-BOCS. On regression analysis, only insight and avoidance retained significance. There were few differential associations between OCD symptom and ancillary dimensions.Conclusion:Ancillary dimensions are more a feature of illness severity than differentially associated with individual symptom dimensions in childhood OCD. Insight and avoidance should be considered for inclusion in the assessment of illness severity in childhood OCD.