Taboo Thoughts Research Articles

Treating taboo thoughts on a psychiatric intensive care unit: a four-phase mixed methods single case experimental design.

Well-designed evaluations of psychological interventions on psychiatric intensive care units (PICUs) are a rarity. To evaluate the effectiveness of cognitive behaviour therapy for intrusive taboo thoughts with a patient diagnosed with bipolar affective disorder admitted to a PICU due to significant ongoing risk of harm to self. This was a four-phase ABC plus community follow-up (D) mixed methods n=1 single case experimental design. Four idiographic measures were collected daily across four phases; the baseline (A) was during PICU admission, the first treatment phase (B) was behavioural on the PICU, the second treatment phase (C) was cognitive on an acute ward and the follow-up phase (D) was conducted in the community. Four nomothetic measures were taken on admission, on discharge from the PICU, discharge from the acute ward and then at 4-week follow-up. The participant was also interviewed at follow-up using the Change Interview. Compared with baseline, the behavioural and the cognitive interventions appeared effective in terms of improving calmness, optimism and rumination, but the effects on sociability were poor. There was evidence across idiographic and nomothetic outcomes of a relapse during the follow-up phase in the community. Eleven idiographic changes were reported in the interview and these tended to be unexpected, related to the therapy and personally important. Single case methods can be responsive to tracking the progress of patients moving through in-patient pathways and differing modules of evidence-based interventions. There is a real need to implement robust outcome methodologies on PICUs to better evaluate the psychological aspects of care in this context.

Big no depression: Flipbook-based brain gym innovation to prevent depression in teenagers

Indonesia has taboo thoughts about mental health, public indifference to mental health causes people with mental disorders to tend to shut themselves down and be ashamed. Seeing that the increase continues to occur, the service carries out an effort to prevent depression, namely Brain Gym Innovation. The aim of this intervention is to improve the knowledge and understanding of adolescents on UINAM Public Health's new knowledge of Brain Gym Innovation. Based on Flipbook as a depression prevention strategy. As for the description of the activities in this intervention by determining the origin of the problem with the ultrasound method and obtaining mental health as the priority that the intervention wants to be performed. The target of this activity was Department of Public Health freshman, FKIK UINAM which was held in the classrooms of AB campus 2 UINAM on Monday 11 December 2023 where the target activity was at least 20 people who attended this extension activity. The results obtained on the service carried out that the level of knowledge and understanding in the new students improved, where health extension related to brain gym innovation was carried out and pre-test & post-test measurements were carried out. states that the majority of students have a level of leadership with good categories. Therefore, it can be concluded that the health extension Brain Gym Innovation based on Flipbook has an influence on the level of knowledge of the respondents.

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

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

The relationship between obsessive-compulsive disorder symptom subtypes and social adjustment

BackgroundAlthough it has been widely established that poor social functioning is a characteristic of obsessive-compulsive disorder (OCD), little research has examined the relationship between OCD symptom subtypes and domains of social functioning. Thus, the present study sought to examine the specific ways in which impairment in social adjustment occurs in each symptom subtype of OCD. MethodsA total of 325 adult participants with a primary diagnosis of OCD were included in the study. Hierarchical linear regressions were used to compare the extent to which OCD symptom subtypes predicted social adjustment domains after controlling for OCD and depression severity. ResultsHoarding was shown to be significantly associated with work functioning. Whereas both contamination and symmetry subtypes were significantly associated with social functioning, only the contamination subtype was associated with functioning within the family unit. The symptom subtypes of doubt and taboo thoughts were not significantly associated with any domains of social adjustment. ConclusionConsistent with previous research, our results suggest a differential impact of OCD symptom subtypes on social adjustment. They offer important implications for the specific domains to target in treatment for different symptom subtypes.

Implementasi Pendidikan Seksual pada Siswa SMAN 2 Karawang

Talking about a child's education at school is the responsibility of parents, as parents need to pay attention to the provision of their first education when they were young, especially sex education for children at the age of middle age, sex education is very important to support their curiosity against the opposite sex at school. Where at their age there is a sense of liking and liking and sharing stories from one another and until finally a closeness arises between girls and boys, this needs to be owned and understood by all parents to fulfill their child's education. Sex education in schools is still a polemic at this time, there are still many parents who have taboo thoughts on sex education that tbe given to their children. Therefore, sex is naturally a task of adolescent development, it should be accompanied by the fulfillment of good sexual education. Islam considers sex as a sacred thing, the nature of every human being and even as a means of getting closer to Allah. Objectives Sexual education aims to teach about reproductive health organs, sexually transmitted diseases and HIV/AIDS, pregnancy, and contraceptives that can be used. Sexual education can also prevent acts of sexual violence, rape, sex outside of marriage, and also marriage at an early age. The method used in this research is qualitative based on data collection from books and magazines and is supported by field research to strengthen the theoretical results of existing expert opinions by linking them to practice in the field. The results obtained in this study which was carried out at SMAN 2 Karawang made many benefits, especially for teenagers and also the role of parents at home and the school to be more careful in maintaining and educating their children when entering adolescence by providing an understanding of the importance of sex education for children. himself and his future.

Do clergy recognize and respond appropriately to the many themes in obsessive-compulsive disorder?: Data from a Pacific Island community

ABSTRACT Obsessive-compulsive disorder (OCD) is a debilitating psychiatric condition with high rates of misdiagnoses and extended treatment gaps. These may derive in part from poor mental health literacy (MHL) among clergy, who are frequently consulted by those with mental health problems. Therefore, the current study examined the MHL of OCD among clergy on Guam. Clergy (N = 110) provided diagnostic impressions, treatment recommendations, and referral recommendations in response to one of six randomized vignettes describing a common manifestation of OCD: contamination, symmetry, religion, homosexuality, pedophilia, or aggression. Clergy typically misidentified OCD (64.5%), especially in vignettes describing taboo thoughts. They more often recommended that the cases described in the vignettes receive pastoral/biblical counseling and a referral to a clergyperson for professional help rather than professional medical or mental health services. Overall, results reveal needs among clergy for increased MHL, especially concerning OCD's heterogeneous symptomology and evidence-based treatments.

Obsessive-compulsive disorder misdiagnosis among mental healthcare providers in Latin America

Mental healthcare professionals often have limited awareness of different obsessive-compulsive disorder (OCD) symptom presentations, which may contribute to years between OCD symptom onset and treatment initiation. While research has identified high rates of OCD misdiagnosis among clinicians from the United States and Canada, research on OCD symptom awareness among healthcare providers in Latin American (LATAM) regions is limited. In this study, LATAM mental healthcare providers (N = 83) provided diagnostic impressions based on five OCD vignettes: three with symptoms centered on taboo thoughts (sexual, harming others, and religion/scrupulosity) and two about contamination or symmetry obsessions. Rates of incorrect (non-OCD) diagnoses were significantly higher for the taboo thoughts vignettes (sexual, 52.7%; harm/aggression, 42.0%; and religious, 34.7%) vs. contamination obsessions (11.0%) and symmetry obsessions (6.9%). The OCD vignette depicting sexual obsessions was often attributed to a paraphilic disorder (36.5%). Bachelor's level clinicians had significantly lower odds of accurately identifying all three vignettes related to taboo thoughts compared to respondents with a graduate degree. Accurate identification of the three taboo vignettes was also associated with first-line psychological treatment recommendations (i.e., cognitive-behavioral therapy) even when controlling for respondents' theoretical orientation. Exposure was rarely mentioned when clinicians were prompted to provide treatment recommendations for each vignette (8–9% of the time for symmetry and contamination vignettes, 5–7% for taboo though vignettes). Like clinicians in the United States and Canada, mental health professionals in LATAM may misidentify OCD symptom presentations, particularly sexual obsessions, highlighting a need for education and training.

Is Obsessive–Compulsive Disorder Preventive Against Addiction?

Obsessive–compulsive disorder (OCD) is unique among mental illnesses in that its comorbidity with alcohol use disorders (AUD), substance use disorders (SUD), and smoking has been reported to be common in the community but surprisingly less frequent in clinical settings. To better investigate this dual diagnosis, we screened the Medline, PsychInfo, and Scopus databases. We did not apply strict criteria for the selection of articles because this article is a narrative review. Relatively, mild OCD is characterized by a high prevalence of AUD/SUD. Comorbidity becomes less frequent as OCD grows more distressing up to a certain degree of illness severity, above which it rises once more. In contrast, the prevalence of AUD/SUD in anxiety disorders, depression, and bipolar disorder is higher in clinical samples than in the community. The high prevalence of AUD/SUD accompanying OCD in community settings may be accounted for by self-medication, whereas decreasing prevalence in clinical samples may reflect personality traits common among obsessive-compulsive people, such as an elevated sense of harm and risk avoidance. An increase in more severe patients may imply the interplay between impulsiveness and compulsiveness. The distinct symptom dimensions of OCD, such as washing, checking, and having taboo thoughts, may be associated with varying degrees of predisposition to AUD/SUD as well as with different rates for seeking treatment, thus affecting the contradictions in the comorbidity rates of OCD and AUD/SUD. Our search confirms the U-shaped curve model put forward to explain the intricate relationship between OCD and AUD/SUD.

Shared genetic etiology between obsessive-compulsive disorder, obsessive-compulsive symptoms in the population, and insulin signaling

Obsessive-compulsive symptoms (OCS) in the population have been linked to obsessive-compulsive disorder (OCD) in genetic and epidemiological studies. Insulin signaling has been implicated in OCD. We extend previous work by assessing genetic overlap between OCD, population-based OCS, and central nervous system (CNS) and peripheral insulin signaling. We conducted genome-wide association studies (GWASs) in the population-based Philadelphia Neurodevelopmental Cohort (PNC, 650 children and adolescents) of the total OCS score and six OCS factors from an exploratory factor analysis of 22 questions. Subsequently, we performed polygenic risk score (PRS)-based analysis to assess shared genetic etiologies between clinical OCD (using GWAS data from the Psychiatric Genomics Consortium), the total OCS score and OCS factors. We then performed gene-set analyses with a set of OCD-linked genes centered around CNS insulin-regulated synaptic function and PRS-based analyses for five peripheral insulin signaling-related traits. For validation purposes, we explored data from the independent Spit for Science population cohort (5,047 children and adolescents). In the PNC, we found a significant shared genetic etiology between OCD and ‘guilty taboo thoughts’. In the Spit for Science cohort, we additionally observed genetic sharing between ‘symmetry/counting/ordering’ and ‘contamination/cleaning’. The CNS insulin-linked gene-set also associated with ‘symmetry/counting/ordering’ in the PNC. Further, we identified genetic sharing between peripheral insulin signaling-related traits: type 2 diabetes with ‘aggressive taboo thoughts’, and levels of fasting insulin and 2 h glucose with OCD. In conclusion, OCD, OCS in the population and insulin-related traits share genetic risk factors, indicating a common etiological mechanism underlying somatic and psychiatric disorders.

Decision-making about intrusive thoughts: Relationships to attitudes towards them

Background and objectivesThe present study investigated decision-making strategies about and evaluations of intrusive thoughts in OCD presented in hypothetical targets in vignettes in a non-clinical population. It was expected participants would be hastier in their decisions for violent and sexual thoughts than checking and contamination thoughts and find those thoughts more credible. In addition, it was expected that hastier decision-making would be related to poorer evaluation of the targets. It was further expected that higher OC traits would be related to collecting fewer data. MethodsParticipants (N = 84) read four vignettes, two detailing a target with taboo intrusive thoughts and two detailing a target with non-taboo intrusive thoughts. Participants engaged in decision-making tasks about the targets before making decisions about the validity of the fears and rating their thoughts about the target. ResultsThere was a relationship between data gathering and evaluations of the targets, but only for targets with taboo thoughts - requesting fewer data was associated with believing that the violent and sexual thoughts were true and evaluating them more negatively. Participants with higher OC traits gathered fewer data before deciding on three of the four tasks. LimitationsThe sample was non-clinical and homogenous; stimuli may have been unbalanced across vignettes. ConclusionsReasoning about and attitudes about taboo intrusive thoughts appear to be considerably related.

Mindfulness predicts insight in obsessive-compulsive disorder over and above OC symptoms: An experience-sampling study

Insight in obsessive-compulsive disorder (OCD) is assumed to fluctuate over time. However, temporal variations of insight and its correlates in OCD have never been empirically studied. We used ecological momentary assessment (EMA) to analyze the temporal variation of insight into the unreasonableness of the threat-related core belief (1), into the senselessness of compulsions to prevent this belief from occurring (2), and into the belief, itself, as being due to OCD (3). Furthermore, we analyzed whether worry, self-punishment and mindfulness are associated with these aspects of insight. A total of 50 OCD patients underwent EMA 10 times a day over 6 consecutive days. Data were analyzed using multilevel modelling. Results revealed that multiple time-points within individuals accounted for up to 51.4% of insight variance, indicating a substantial fluctuation of insight over time. Root mean square successive difference (rMSSD) scores indicated significantly higher fluctuation patterns in the doubt/checking dimension as compared to taboo thoughts throughout all aspects of insight. As hypothesized, self-punishment and mindfulness significantly predicted insight into the unreasonableness of the threat-related belief and the senselessness of compulsions to prevent this belief from occurring. Mindfulness demonstrated the greatest predictive value and remained significant after controlling for OC symptoms. Contrary to expectation, worry, as it was measured in our study, was not associated with insight. Besides providing evidence for insight fluctuation, our results indicate that mindfulness-based strategies might be beneficial for increasing insight in OCD.

Introduction to the Special Issue: Challenges in Treating Obsessive-Compulsive Disorder With Cognitive-Behavioral Therapy.

Cognitive-behavioral therapy (CBT) is a recommended treatment for obsessive-compulsive disorder (OCD). CBT offers specific interventions with demonstrated efficacy, including both cognitive therapy and exposure and ritual prevention (ERP). Yet, implementing these techniques with individual patients can present clinical challenges. In this special issue, expert clinicians and researchers present cases in which they addressed some common challenges in implementing CBT for OCD, including comorbid depression, poor insight, and family accommodation of symptoms in pediatric OCD. Other papers present how CBT can be tailored to specific OCD manifestations, including post-partum OCD, taboo thoughts, and relationship OCD. Other authors detail how they have augmented standard ERP with additional treatment techniques to maximize outcomes. These articles present a diverse set of case histories and specific treatment techniques that illustrate ways to maximize the effectiveness of CBT for OCD, serving as a useful guide for clinicians in practice and highlighting areas for future research.

Treating Taboo or Forbidden Thoughts: Integrating Mindfulness, Acceptance, and Emotion Regulation Into an Exposure-Based Intervention.

Individuals with obsessive compulsive disorder (OCD) who struggle with taboo or unacceptable obsessions (i.e., aggressive, sexual, or religious intrusions) tend to rely upon mental rituals to regulate their distress and possess difficulties labeling and regulating their affective state. Moreover, these individuals respond poorly to exposure with response prevention when the treatment is grounded in emotional processing theory. To improve patients' therapeutic outcomes, clinicians can consider integrating mindfulness- and acceptance-based skills into an exposure-based treatment to: facilitate the identification and acceptance of covert ritualistic urges, improve the accuracy of emotion labeling, and increase the efficiency of emotion regulation efforts. Additionally, in line with inhibitory learning theory, clinicians can design exposures to violate expectancies to promote the maintenance of long-term gains. Through a case vignette, the current article will demonstrate how to integrate these strategies into a standard exposure with response prevention intervention to meet the needs of a patient with taboo thoughts.

M70 - DETERMINING THE GENETIC OVERLAP BETWEEN TOURETTE SYNDROME (TS), OBSESSIVE COMPULSIVE DISORDER (OCD) AND OCD/TIC-RELATED TRAITS

Background Tourette Syndrome (TS) and Obsessive-Compulsive Disorder (OCD) are heritable neuropsychiatric disorders with a childhood onset. TS is characterized by multiple and involuntary motor tics and at least one vocal tic that persists for more than one year. TS has a prevalence of 0,3-0,8%. OCD is characterized by recurring obsessions and/or compulsions and affects up to 2% of the population. The disorders often co-occur, with their comorbidity ranging between 20–60%. Moreover, there are striking similarities in the phenotypic representation of TS/tics and OCD. Previous studies indicate that TS and OCD may share some common genetic susceptibility factors - with an estimated genetic correlation of 0.41 - but also suggest that there are distinct components to the genetic architectures of the two disorders. Two recent population-based twin sample studies also reported genetic correlations between tics and OCD-related traits (0.37 and 0.45). In this study we further investigated the shared genetic etiology between TS, OCD, and OCD traits as well as tic traits in the general population. Methods We conducted a number of Polygenic Risk Score (PRS)-based analyses. For these analyses, we used the summary statistics data from the Genome-Wide Association Study (GWAS) of TS and the summary statistics from the meta-analysis of the two GWASs of OCD conducted by the Psychiatric Genomics Consortium (PGC) (unpublished, provided by PGC OCD Working Group) as the 'base' sample. As 'target' samples, we used summary statistics of GWASs of OCD traits and tic traits in the general population. For these GWASs, we used phenotypic and genotyping data from the Children's Hospital of Philadelphia (CHOP) cohort obtained from dbGaP (phs000607.v1.p1). To conduct the OCD trait GWASs, we first developed a questionnaire consisting of 22 OCD trait questions and conducted a factor analysis of the questionnaire, to reveal the subsets of OCD traits that group together and may better capture the underlying genetic architecture. We then conducted GWASs of the total score on the 22 OCD trait questions and of six OCD trait factors in 650 children and adolescents from the CHOP cohort. For tic traits, we conducted a GWAS on the total score on 4 tic trait questions in 207 individuals from the CHOP cohort. Results The factor analysis of the 22 OCD trait questions revealed 8 factors that constitute the best fit and explain 58,6% of the variance in the total score on the 22 questions, i.e. 'impairment', 'symmetry/counting/ordering', 'contamination/cleaning', 'aggressive taboo thoughts (tt)', 'repetition', 'guilty tt', 'distress' and 'religious tt'. The PRS-based analyses yielded a significant evidence for shared genetic etiology between OCD and the three OCD traits 'impairment' (1.06% variance explained (ve)), 'contamination/cleaning' (3.54% ve,) and 'guilty taboo thoughts' (5.64% ve). Furthermore, we found significant shared genetic etiology between TS and four OCD traits: 'symmetry/counting/ordering' (3.03% ve), 'contamination/cleaning' (1.28% ve), 'aggressive taboo thoughts' (4.96% ve) and 'distress' (1.83% ve), and between TS and the total score on tic traits (4.78% ve). OCD and TS did not show significant genetic overlap with the total score on the 22 OCD trait questions. Discussion Our findings provide additional and novel evidence that certain OCD traits show genetic overlap with OCD and TS, which adds to our understanding of the genetic risk factors that are shared by and unique to these comorbid disorders.

Emotion Regulation in Patients with Obsessive Compulsive Disorder: Unique Effects for Those with “Taboo Thoughts”

Emotion regulation (ER) is a modifiable and transdiagnostic construct that has been widely studied across the affective disorders; however, little research has evaluated the relationship between ER and obsessive–compulsive (OC) features (e.g., OC symptom dimensions, OC symptom severity, and obsessive beliefs). The current study therefore evaluates the relationship between ER difficulties and OC features in the largest sample of adults with OCD to date. Participants (N = 57) completed a clinician-administered diagnostic and OC symptom assessment, as well as self-report questionnaires. Results revealed a specific relationship between ER difficulties, the unacceptable thoughts dimension, and obsessive beliefs, even after controlling for co-occurring depressive symptomology. Specifically, patients with “taboo thoughts” and elevated obsessive beliefs experienced greater difficulties accepting unwanted emotions, engaging in goal-directed behaviors when upset, accessing ER strategies, and clarifying emotions. Pending replication with a longitudinal framework, results highlight the utility of integrating emotion regulation modules into typical behavior therapy protocols for patients with unacceptable thoughts. Additional clinical implications, limitations and future directions are discussed.

Getting it just right: A reevaluation of OCD symptom dimensions integrating traditional and Bayesian approaches

Previous research using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) suggests that the heterogeneous symptoms of obsessive-compulsive disorder (OCD) may reflect four underlying dimensions. However, past results vary substantially, which may be due to (a) the reliance on aggregated scores, (b) the common use of exploratory factor analyses, and (c) the exclusion of several symptoms. The present study tested the homogeneity of the original Y-BOCS categories using confirmatory factor analysis and modified categories where necessary. To test multidimensional models, data were further analyzed with Bayesian structural equation models, which better capture item heterogeneity in contrast to ordinary factor analysis. All analyses were run with two samples of patients with OCD allowing for cross-validation. Only a minority of the original Y-BOCS categories proved to be homogeneous. Modification yielded 10 homogeneous first-order factors, which can be reduced to four second-order factors: Incompleteness, Taboo Thoughts, Responsibility, and Contamination. This two-level factor model outperformed competing factor structures. The results corroborate the notion of four broader symptom dimensions in OCD, although the specific factor structure deviates from previous research. Differences presumably derive from using the full range of OCD symptoms and the combined exploratory and confirmatory approach with BSEM as a theoretically more appropriate analytical framework.

Prevalence and correlates of obsessive-compulsive disorder and subthreshold obsessive-compulsive disorder among college students in Kerala, India.

Context:There are scarce data on the prevalence of adult obsessive-compulsive disorder (OCD) in India.Aims:The aim was to study the point prevalence of OCD and subthreshold OCD and its psychosocial correlates among college students in the district of Ernakulam, Kerala, India.Settings and Design:A cross-sectional survey of 5784 students of the age range of 18–25 years from 58 colleges was conducted.Materials and Methods:Students were self-administered the OCD subsection of the Clinical Interview Schedule-Revised, the Composite International Diagnostic Interview for obsessive-compulsive symptoms (OCSs), and other relevant instruments to identify OCD, subthreshold OCD, and related clinical measures.Statistical Analysis:The point prevalence of OCD and subthreshold OCD was determined. Categorical variables were compared using Chi-square/Fisher's exact tests as necessary. Differences between means were compared using the ANOVA.Results:The point prevalence of OCD was 3.3% (males = 3.5%; females = 3.2%). 8.5% students (males = 9.9%; females = 7.7%) fulfilled criteria of subthreshold OCD. Taboo thoughts (67.1%) and mental rituals (57.4%) were the most common symptoms in OCD subjects. Compared to those without obsessive-compulsive symptoms (OCSs), those with OCD and subthreshold OCD were more likely to have lifetime tobacco and alcohol use, psychological distress, suicidality, sexual abuse, and higher attention-deficit/hyperactivity disorder symptom scores. Subjects with subthreshold OCD were comparable to those with OCD except that OCD subjects had higher psychological distress scores and academic failures.Conclusions:OCD and subthreshold OCD are not uncommon in the community, both being associated with significant comorbidity. Hence, it is imperative that both are identified and treated in the community because of associated morbidity.

OCD Taboo Thoughts and Stigmatizing Attitudes in Clinicians.

Individuals who suffer from obsessive-compulsive disorder have persistent intrusive thoughts that cause severe distress that impairs daily functioning. These individuals often conceal their intrusive thoughts and delay help-seeking for fear of being stigmatized. Stigma can be problematic when it is present among mental health professionals because they may distance themselves from their clients and have a negative outlook on treatment outcome. To date there has not been any research that focuses on stigma that clinician's may hold towards obsessive-compulsive disorder or specific obsessions; however, there is evidence that mental health professionals may have prejudices towards individuals who suffer from other mental illnesses. The current study aimed to explore clinician and student clinician attitudes about obsessional content from varying symptom dimensions. Results indicated participants were more likely to socially reject or be concerned by individuals with obsessions related to contamination, harming, and sexual obsessions than those with scrupulous obsessions, and that they would be less likely to reveal sexual obsessions to others if they were experiencing them than the other three types of obsessions.

Prevalence of attention deficit hyperactivity disorder among distinct symptom dimensions in adult patients with obsessive-compulsive disorder

Objective: Obsessive-compulsive disorder (OCD) is known to frequently coexist with attention deficit hyperactivity disorder (ADHD). However, the two disorders are characterized by a variety of opposite clinical and biological features. We investigated whether different symptom dimensions of OCD might account for this intriguing comorbidity given the different phenomenological and neurobiological characteristics exhibited by patients with OCD. Methods: The sample of this study comprised one hundred and ninety-six patients with OCD who were classified according to their principal obsession or compulsion: (1) contamination and washing; (2) taboo thoughts (sexual, aggressive, or religious obsessions); and 3) symmetry, counting, repeating, or ordering (SCRO). Our study examined whether or not ADHD accompanies any of the abovementioned symptom dimensions. The prevalence of ADHD was assessed by using the DSM-IV criteria. The prevalence of tic disorders, smoking, and alcohol or substance use disorder (SUD) was also examined. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS), 17-Item Hamilton Depression Rating Scale (HDRS-17), Beck Anxiety Inventory (BAI), and Barratt Impulsiveness Scale Version 11 (BIS-11) were administered. Results: The prevalence of ADHD in the following symptom dimensions was 11.6% (n=8) for washing, 20.4% (n=22) for taboo thoughts, and 26.3% (n=5) for SCRO. These differences, however, were not found to be significant. Additionally, neither the total BIS-11 scores nor its subscale scores concerning cognitive impulsiveness, motor impulsiveness, and non-planning differed significantly among the three symptom dimensions. Further, the scores of HDRS-17 and BAI and the prevalence of tic disorder, alcohol abuse, and SUDs were not significantly different among the symptom dimensions. On the other hand, the Y-BOCS scores including the scores of its subscales of obsession and compulsion were significantly higher in the washing symptoms group than the other two groups (p

An epidemological study of obsessive compulsive disorder in adolescents from India

ObjectivesThere is scarce data on the prevalence of OCD among adolescents in India. This study reports point prevalence of OCD among school students (age 12–18years) in the Kerala state of India and examines its association with ADHD, psychological distress, tobacco/alcohol abuse, suicide risk and history of sexual abuse. Method7560 students of 73 schools were self-administered the OCD subsection of Clinical Interview Schedule–Revised, the Composite International Diagnostic Interview (CIDI) for obsessive compulsive symptoms and other relevant instruments to identify OCD and related clinical measures. A diagnosis of ICD-10 OCD was derived through the CIS-R algorithm which required duration of at least 2weeks and at least a thought/behavior to be resisted along with a cut-off score for severity and impairment. ResultsIn the sample, 50.3% were males with a mean age of 15.2years (range of 12–18years). The response rate was 97.3% (7380 valid responses). 0.8% (n=61) fulfilled criteria for OCD with a male predominance (1.1 vs. 0.5%, p=0.005). Prevalence was higher among Muslims and increased with age. Taboo thoughts (62.3%) and mental rituals (45.9%) were the commonest symptoms. Those with OCD had significantly higher suicidal thoughts (59 vs. 16.3%, p<0.01) suicide attempts (24.6 vs. 3.8%, p<0.01), ADHD (28 vs. 4%, p<0.001), sexual abuse (24.6 vs. 4.2%, p<0.01), and tobacco use (23 vs. 6.8%, p=0.01). They also reported greater psychological distress and poorer academic performance. ConclusionsOCD is common among adolescents in India. Its associations with ADHD, sexual abuse, psychological distress, poorer academic performance and suicidal behavior are additional reasons for it to be recognized and treated early.