Yale-Brown Obsessive Compulsive Scale Symptom Research Articles

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.

Structural and functional deficits and couplings in severe and moderate OCD

Changes in gray matter volume and functional connections have been frequently observed in patients with obsessive compulsive disorder. However, different grouping may cause diverse volume alterations and could draw more adverse conclusions about the pathophysiology of obsessive compulsive disorder(OCD). Most of them preferred to divide subjects into patients and healthy controls, rather than a detailed subgroup. Moreover, multimodal neuroimaging studies about structural-functional defects and couplings are rather rare. Our aim was to explore gray matter volume(GMV) and functional networks abnormalities induced by structural deficits based on severity of Yale-Brown Obsessive Compulsive Scale(Y-BOCS) symptom including OCD patients with severe(S-OCD, n = 31) and moderate symptoms(M-OCD, n = 42) and healthy controls (HCs, n = 54); Voxel-based morphometry(VBM) method was used to detect GMV differences among three groups, then used as masks according to one-way analysis of variance(ANOVA) results for the subsequent resting-state functional connectivity(rs-FC) analysis. Besides, correlation and subgroup analysis were performed to detect the potential roles of structural deficits between every two groups. ANOVA analysis showed that both S-OCD and M-OCD had increased volume in anterior cingulate cortex(ACC), left precuneus(L-Pre) and paracentral lobule(PCL), postcentral gyrus, left inferior occipital gyrus(L-IOG) and right superior occipital gyrus(R-SOG) and bilateral cuneus, middle occipital gyrus(MOG), and calcarine. Additionally, increased connections between Pre and angular gyrus(AG) and inferior parietal lobule(IPL) have been found. Moreover, connections between the left cuneus and lingual gyrus, between IOG and left lingual gyrus, fusiform and between L-MOG and cerebellum were also included. Subgroup analysis showed that decreased GMV in left caudate was negatively correlated with compulsion and total score in patients with moderate symptom compared to HCs. Our findings indicated that altered GMV in occipital-related regions, Pre, ACC and PCL and the disrupted FC networks including MOG-cerebellum and Pre-AG and IPL. Moreover, subgroup GMV analysis furtherly revealed negative associations between GMV changes and Y-BOCS symptom, offering preparatory proof for the involvement of structural and functional deficits in cortical-subcortical circuitry. Thus, they could provide insights into the neurobiological basis.

Family Accommodation in Obsessive Compulsive Disorder and Its Association With Insight.

Family accommodation (FA) is defined as a family members' involvement by doing certain behavior in response to the daily rituals of patients with obsessive-compulsive disorder (OCD). FA is associated with more severe symptoms of OCD. Similarly, poor insight is associated with high severity of OCD symptoms. FA and insight are also related to each other, as more accommodative behavior of family members is associated with poor insight. This cross-sectional observational study assessed 103 adult OCD patients with an illness duration of at least one year. Participants were assessed using Yale-Brown Obsessive Compulsive Scale (Y-BOCS) symptom checklist, Y-BOCS to assess severity, and Family Accommodation Scale-SR (Hindi) to evaluate FA. Insight was assessed with the 11th item of Y-BOCS. FA was common in the families of our participants. The mean±SD Y-BOCS score was 28.72±5.09, and the mean FAS-SR score was 44.1±12.03. A significant positive correlation existed between the FA and YBOCS scores, that is, with the increase in FA, YBOCS scores also significantly increased. A considerable number reported poor insight, and had high scores on YBOCS and their caregiver had high FA scores. FA is indicative of high symptom severity of OCD and higher FA is associated with poor insight, so FA needs further research for its interplay with OCD symptomatology and role in the maintenance of symptoms.

Disability in Obsessive-Compulsive Disorder and its Impact on Caregiver’s Burden and Quality of Life

Abstract Background: Obsessive-compulsive disorder (OCD) is a chronic illness that can cause marked anguish and disability. OCD negatively affects the quality of life (QoL) and brings disability in marital, occupational, emotional, and social functioning. Family members of OCD patients unknowingly start adjusting their personal and family routine to lessen the patient’s anxiety or irritability due to compulsive behaviors. Their involvement with compulsive behaviors of OCD patients compromise their social activities that lead to feelings of social isolation and marked distress. Studies carried out on family members have also reported poor QoL in the domains of physical well-being, psychological well-being, and social well-being. Methods: This is a cross-sectional, observational, hospital-based study. Fifty adult patients with OCD were recruited in the study along with their caregivers, who were visiting the Department of Psychiatry, ABVIMS, Dr. R. M. L. Hospital, New Delhi, India. Patients diagnosed with OCD as per diagnostic and statistical manual 5 criteria were assessed on Yale-Brown Obsessive Compulsive Scale (Y-BOCS) symptom Checklist, Y-BOCS to know about the severity and Indian Disability Evaluation and Assessment Scale was used to assess disability. The primary caregivers, who were continuously staying with patient for last 2 years, were assessed on Zarit Burden Interview to assess caregiver’s burden and WHOQOL-BREF was used to assess the QoL. Results: There was a negative correlation between total YBOCS score, global disability score of patients, burden of caregivers with all domains of QoL of caregivers of patients, and statistically significant values were seen in psychological health and social domains. Caregiver burden was positively correlated with disability. Both QoL and severity of illness have more significant negative impact on caregiver QoL and burden. Conclusion: Severity of illness and disability in patients with OCD cause significant negative impact on QoL and brings about huge burden on caregivers.

Experience of Disgust and Symptom Severity in Contamination Subtype of Obsessive-Compulsive Disorder: Role of Experiential Avoidance.

The emotion of disgust has been linked with the underlying nature of the contamination subtype of obsessive-compulsive disorder (C-OCD). Prior studies show that disgust contributes to the development of C-OCD by reinforcing avoidance strategies. Therefore, experiential avoidance (EA) may influence the effect between disgust sensitivity (DS) and C-OCD symptom severity. This study aimed to investigate the mediational role of EA between DS and C-OCD severity. A cross-sectional design was adopted with 45 patients of OCD and 45 healthy controls. Both the groups were assessed on the Obsessive-Compulsive Inventory, the Disgust Scale (Revised), and Acceptance and Action Questionnaire-II. Yale-Brown Obsessive Compulsive Scale (Y-BOCS) checklist and symptom severity scale were additionally administered to the patients with OCD. Independent t-tests, Pearson's product-moment correlation, regression analysis, and mediation analysis were used. DS and EA were positively associated with contamination-washing symptoms and symptom severity. Regression analysis indicated that DS and EA were highly associated with contamination/washing severity scores among both the patients with C-OCD and the healthy controls. The study implicates that disgust is a central emotion underlying the presentation of obsessions and compulsions, which are of contamination concerns. Further, EA has a role in the maintenance of OCD through avoidance learning; however, it may not be interacting with DS to cause OCD.

MINDFULNESS BASED COGNITIVE THERAPY AND SYMPTOMS SEVERITY IN PATIENTS WITH OBSESSIVE COMPULSIVE DISORDER

BACKGROUND: Obsessive Compulsive Disorder (OCD) is a mental disorder characterized by the presence of obsessions and compulsions with lifetime prevalence of around 2%-3%. Increase in symptoms severity often signicantly seen impairment with work, relationships and other responsibilities. Therefore, timely and effective intervention is required. Literature favors cognitive Behavioral therapy (CBT) as intervention in the management of symptoms severity. AIM: The present study attempts to see the role of mindfulness based cognitive therapy in reducing symptoms severity in OCD. METHODS AND MATERIALS: Pre- and post- MBCT intervention with a control group design were used to conduct this study involving 34 patients with OCD. Patients were equally distributed in two groups where one group was given intervention Mindfulness based cognitive therapy (MBCT) sessions for 8 weeks. Pre- and post- intervention assessment was done using Yale-Brown Obsessive Compulsive Scale (YBOCS) symptoms severity. And the results were compared. RESULTS: Obtained research data indicates that there is a signicant declined in the composite score on YBOCS symptoms severity at post intervention assessment in the group which had been undergone MBCTas compare to the other group. CONCLUSION: Findings revealed that MBCThas a signicant effect on reducing symptoms severity in patients with OCD.

Assessment of antenatal anxiety, depression and obsessive-compulsive disorder in pregnant women in the COVID-19 era.

To assess the mental health of pregnant women, with reference to anxiety, depression and obsessive-compulsive (OC) symptoms, during the COVID-19 pandemic. A cross-sectional survey was conducted in Ireland during the third wave of the pandemic between February and March 2021. Psychiatric, social and obstetric information was collected from pregnant women in a Dublin maternity hospital, alongside self-reported measures of mental health status. Of 392 women responding, 23.7% had anxiety, scoring >9 for GAD-7 (7-item generalised anxiety disorder), 20.4% had depression, scoring >9 for PHQ-9 (9-item depression screening tool: Patient health questionnaire) and 10.3% had obsessive-compulsive disorder (OCD), scoring >13 for Yale-Brown obsessive-compulsive scale symptom checklist (Y-BOCS). Amongst self-reported OCD symptoms, there was a preponderance for obsessions rather than compulsions. Of 392 women, 36.2% described their mental health as worse during the pandemic, most frequently describing symptoms of anxiety and sleep disturbance. When analysed against test scores, self-reported worsening of mental health was significantly associated with higher scores on the GAD-7, PHQ-9 and Y-BOCS scales. The three scores were positively interrelated. Poor mental health scores were associated with self-reported strain in relationship with the baby's father, and current or previous history of mental illness. This study found high levels of depression, anxiety and OC symptoms amongst pregnant women during COVID-19. This highlights the vulnerability of this group to mental illness and the importance of enhanced screening and support during pandemics.

Clinical characteristics of moderate-severe obsessive-compulsive disorder in children and adolescents in China.

ObjectiveThis study reports clinical characteristic of moderate–severe obsessive–compulsive disorder (OCD) among school students in China.MethodsWe examined 153 patients for the distribution of OCD symptoms using the Yale-Brown Obsessive Compulsive Scale Symptoms Checklist, the severity of anxiety and depression symptoms using the Hamilton Anxiety Scale and the Hamilton Depression Scale-24, respectively, and impairment in learning, family and social functions using the Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire.ResultsThe number of total OCD, obsession and compulsion symptoms was 6.71 (standard deviation [SD] = 2.25), 3.77 (SD = 1.32) and 2.94 (SD = 1.59), respectively. The incidence of moderate and severe depressive symptoms for junior high school students was significantly higher than for primary and high school students. The number of children and adolescents with OCD increased with age, reaching a peak in the senior high school stage.ConclusionThe most common symptoms in children and adolescent OCD patients are miscellaneous obsessions, aggressiveness, religiousness, checking, miscellaneous compulsions, cleaning-washing and repeating. These patients show a relatively high co-occurrence rate of anxiety symptoms and depressive symptoms, which impairs their learning, as well as their family and social functions.

A comparison of cluster and factor analytic techniques for identifying symptom-based dimensions of obsessive-compulsive disorder

A growing body of literature suggests that obsessive-compulsive disorder (OCD) is a heterogeneous condition. The studies investigating symptom dimensions have been limited by numerous methodological differences and sample characteristics. The purpose of this study was to compare the two most commonly applied statistical techniques used in addressing this question in the same large cohort of individuals with OCD. Both cluster analysis and factor analysis were used to examine OCD symptom data as measured by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) Symptom Checklist for 355 individuals with a primary diagnosis of OCD. The factor analysis revealed a three-factor model best described as symmetry obsessions/ordering compulsions, contamination obsessions/cleaning compulsions and aggressive obsessions/checking compulsions. In contrast, the cluster analysis yielded a stable four-cluster solution best described as symmetry obsessions/ordering compulsions, contamination obsessions/cleaning compulsions, aggressive-somatic-religious obsessions/checking compulsions and a mixed symptom profile. Although there was overlap in the models resulting from these two statistical approaches, cluster analysis better captured the dimensional nature of OCD by demonstrating the prevalence of symptom categories in each subgroup. Though both analyses are capable of providing similar outputs, the validity of these results is limited given the input of a priori symptom categories from the Y-BOCS.

Predictors of drug treatment resistance in obsessive compulsive disorder

Objective: The aim of this study is to investigate the predictive factors related to pharmacotherapy resistance in patients with obsessive-compulsive disorder (OCD). Methods: Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Structured Clinical Interview for DSM-III-R Axis II Disorders (SCID-II), Yale-Brown Obsessive Compulsive Scale-Symptoms Checklist (YBOCS), Hamilton Depression Rating Scale (HDRS), Childhood Trauma Questionnaire (CTQ), Dissociative Experiences Scale, Level of Expressed Emotion were applied to 30 treatment resistant patient with OCD and 30 treatment responder patients with OCD. Expressed Emotion Scale (EES) were applied to the relatives of patients. Results: When the groups were compared, living out of city center, age of onset in disease, total disease duration and presence of psychiatric disease in the family, YBOCS, HDRS, OVIS, EES, CTQ sexual abuse scale scores and major depression comorbidity were significantly higher in treatment resistant group. High YBOCS total score and presence of mental illness in the family were found to be effective for predicting resistance to drug treatment. Conclusion: The high severity of the disease and the presence of psychiatric dis-eases in the family increase the risk of treatment resistance.

Effects of music as an adjunctive therapy on severity of symptoms in patients with obsessive-compulsive disorder: Randomized controlled trial

ABSTRACTIntroduction: Obsessive-compulsive disorder is a critical mental disorder. Music listening is non-invasive, safe and harmless, well-tolerated, inexpensive, and has therapeutic advantages in a wide range of mental disorders. The impact of passive music listening as an adjunctive therapy on symptoms severity in patients with obsessive-compulsive disorder was evaluated in this study.Methods: In a parallel posttest-study only randomized controlled trial, 36 patients (range 19 to 65 years) were randomly allocated to experimental group (n = 17) or control group (n = 19) in Duhok, Iraq in 2017. The experimental group received seven 50-minute relaxing music tracks to listen daily in addition to regular pharmacological treatment for a three-month period. The control group received regular treatment only. The severities of obsession, compulsion, and obsessive-compulsive symptoms were assessed using the Yale-Brown Obsessive Compulsive Scale symptom severity scale following study completion only.Results: The experimental group had significantly lower symptom severities than the control group in terms of obsessions and compulsions, and the overall obsessive-compulsive score, effect size: 0.77, 0.95, and 0.78,, and 95% CI: 6.29–9.43; CI: 6.22–9.43; and CI: 12.57–18.81, respectively.Discussion: The study showed that passive music listening as an adjunctive therapy to regular treatment is an effective method to reduce obsessions and compulsions severities in patients with obsessive-compulsive disorder. Clinical Trial Registration Number in the local registry: 21082016–6 (21 August 2016).

A clinical trial for the efficacy of Ashwagandha powder in obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) is a ceaseless mental issue that is causally connected to the dysregulation of the serotonergic framework. OCD is believed to be a standout amongst the most obstinate and impairing nervousness related mental issues in the network, described by steady and pain causing considerations (obsessions), which are egodystonic and apparently intentional conduct (impulses). The present examination has assessed the viability of Ashwagandha choorna (powder). The powder at a dose of 4.5 g, twice a day, after sustenance, nearby nectar was given to them orally for multi-month. In the wake of completing treatment, follow-up was done. Three examinations of before treatment, after treatment and after improvement were done. Criteria of examination relied upon the scoring of Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and Yale-Brown Obsessive Compulsive Symptom Checklist was used to perceive signs. Paired 't' test was used for real appraisal. The results showed that Ashwagandha powder gave 24.66% of help (p

Examining the factor structure of the self-report Yale-Brown Obsessive Compulsive Scale Symptom Checklist

Obsessive-compulsive symptom dimensions are important in studies about the pathogenesis and treatment of obsessive-compulsive disorder. More than 30 factor analytic studies using the Yale-Brown Obsessive Compulsive Scale Symptom Checklist (Y-BOCS-SC) interview version have been published. However, a drawback of the Y-BOCS-SC interview is that it is time-consuming for the clinician. Baer's self-report version of the Y-BOCS-SC could be a less time-consuming alternative. The purpose of this study was to examine the factor structure of Baer's self-report Y-BOCS-SC. In a sample of 286 patients, we performed two factor analyses, one using categories and one using items of the Y-BOCS-SC. Using category-level data, we identified four factors; when using items we identified six factors. Symptom dimensions for contamination/cleaning, symmetry/repeating/counting/ordering and hoarding were found in both analyses. The impulsive aggression, pathological doubt, sexual, religious somatic and checking categories formed one factor in the analysis using category-level data and divided into three factors using item-level data. These factors correspond with studies using the interview version and support our hypothesis that the self-report version of the Y-BOCS-SC could be an alternative for the interview version.

Schizophrenia and co-morbid obsessive - compulsive disorder: Clinical characteristics

Psychiatric co-morbidity is a common condition, partly due to the overlap of symptoms in the categorical diagnosis of mental disorders. The co-occurrence of schizophrenia (SZ) and obsessive compulsive disorder (OCD) is a common and challenging co-morbid condition. Also, the relationship between SZ and OCD remains unclear. The aim of this study was to describe the co-morbidity of obsessive-compulsive disorder (OCD) among schizophrenia (SZ) patients and compare clinical characteristics of schizophrenia patients with versus without comorbid OCD. A cohort-study was carried out on 396 patients enrolled between November 2011 to June 2014 at the Department of Psychiatry, Rumeilah Hospital in Qatar. We employed the WHO Composite International Diagnostic Interview (WHO-CIDI), and Structured clinical interview for DSM-5 (SCID-5) for diagnoses, the Yale-Brown Obsessive Compulsive Scale Symptom Checklist for scoring OCD. Patients were grouped in SZ patients with and without comorbid OCD (SZ-OCD vs SZ). 396 subjects were interviewed. Age of SZ-OCD patients was 42.69 ± 14.33 (years old) whereas SZ patients without OCD ranged 41.59 ± 13.59 years old. There were statistically significant differences in clinical characteristics between SZ with and without OCD : age (p = 0.010), BMI (body mass index; p = 0.011), education (p = 0.033), employment (p = 0.019), cigarette smoking (p = 0.039), sheesha smoking (p = 0.008), and prevalence of consanguinity (p = 0.043). In particular, the rate of consanguinity in the current generation was 31.8% [95% CI = 29.1-34.7]. Also, there were statistically significant differences at Hamilton Depression score, General Health Score, Clinical Global Impression- Score, duration of illnesses, and Global Assessment of Functioning (p < 0.001). The results show that anxious, mood and psychotic dimensions rated higher among SZ - OCD ones than SZ only patients. This study confirms that SZ-OCD is a common co-morbidity and prevalence of SZ OCD is higher among patients reporting a degree of consanguinity. Even if this condition is under-recognized in clinical practice, it may significantly change SZ presentation and outcome since psychopathological dimensions report higher scores in the co-morbidity sample.

Co-morbid obsessive-compulsive disorder and bipolar disorder in highly endogamous population: Which came first?

The aim of this study was to determine the prevalence of co-morbidity with obsessive-compulsive disorder (OCD) among bipolar disorder (BD) patients in order to assess the impact of OCD on the socio-demographic and clinical features of patients in a highly endogamous population. A cohort study was carried out on 396 patients enrolled between November 2011 to October 2013. We employed the WHO Composite International Diagnostic Interview (WHO-CIDI) and Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-IV/Clinical Version for diagnoses, the Yale-Brown Obsessive Compulsive Scale Symptom Checklist for scoring OCD. Patients were grouped in BD patients with OCD (BD-OCD) and BD patients without OCD.Groups were compared for socio-demographic and clinical variables. There were no significant differences for age, gender, BMI, and marital status, between BD patients with and without OCD. We found significant differences in level of education (P = 0.022), occupation status (P = 0.025), household income, (P = 0.049), cigarette smoking (P = 0.038), sheesha smoking (P = 0.007), and prevalence of consanguinity (P = 0.036) among these groups. Number of hospitalizations and Young Mania Rating Scale score were not different among BD patients with or without OCD whereas there were significant differences in Hamilton-Depression score, Clinical Global Impression-BD Score, duration of illnesses, and Global Assessment of Functioning (GAF). Also specific phobia, somatization, depression, mania, any mood disorder, oppositional defiant disorder, ADHD and personality disorder were more common in BD than OCD–BD group. This study confirms that BD-OCD is a common co-morbidity, largely under-recognized in clinical practice, which may significantly change BD presentation and outcome.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Exploring yale-brown obsessive-compulsive scale symptom structure in Iranian OCD patients using item-based factor analysis.

Obsessive compulsive disorder (OCD) is a heterogeneous psychiatric disorder. This study aimed to reach a comprehensive perspective of OCD symptoms in Iranian patients. Item-based factor analysis of Y-BOCS checklist from 216 outpatients resulted in five factors including aggression/checking, contamination/cleaning, symmetry/ordering/repeating/counting/hoarding, sexual and somatic. Regression analyses showed that miscellaneous items can be predicted by these factors. Results showed that OCD subtypes in Iranian patients resemble to those of other nations except the aggressive, sexual and religious obsessions; demonstrating the influence of the culture on obsession manifestation. The correlation analyses of factors and clinical characteristics demonstrated that aggression/checking was associated with high obsession scores and more avoidance. Contamination/cleaning was correlated with higher compulsion score. Patients with higher scores on symmetry/ordering/counting/repeating/hoarding had familial OCD pattern with earlier age of onset, lower age at assessment, higher obsession and more avoidance. Sexual factor was associated with less compulsion scores and somatic factor was associated with higher obsessions and compulsions as well as less familial history and more avoidance. These findings provide a comprehensive view of OCD symptom structure in Iranian OCD patients and will be of value to studies using symptom factor to lead investigation of its causes, correlates and treatment strategies considering cross-cultural differences.

The familiality of specific symptoms of obsessive-compulsive disorder

This study aimed to assess whether a family history of specific OCD symptoms was associated with the same OCD symptoms in study participants. Participants were sampled from the Nepean OCD study (N=206) and were assessed with the Yale-Brown Obsessive-Compulsive Scale Symptom Checklist (YBOCS-SC) and the Vancouver Obsessional Compulsive Inventory (VOCI) in order to determine their OCD symptoms. A family history screen was used to determine whether participants had a first-degree relative with a history of any of the following specific symptoms: hoarding, contamination/cleaning, symmetry/ordering, doubt/checking and/or other OCD symptoms. The characteristics of participants with a family history of a specific OCD symptom were compared to those of participants with a family history of any other OCD symptom. This was repeated for each specific OCD symptom. The roles of co-occurring tics and age of onset of OCD were also assessed. Distinct familial associations were detected for the symptoms of hoarding and contamination/cleaning. Age of onset of OCD was significantly younger in participants who reported a family history of “other” symptoms. These findings suggest that certain OCD symptom dimensions are more familial than others, which has significant implications for aetiology of OCD.

Inheritance in OCD in Moslems

There is increasing evidence that obsessive-compulsive disorder (OCD) is mediated by genetic factors. Although the precise mechanism of inheritance is unclear, recent evidence has pointed towards the involvement of the serotonergic and dopaminergic systems in the disorder's development. Objectives: To examine the clinical profile of symptoms in obsessive compulsive patients and their first and second degree relatives. Subjects and Methods: This study was designed in the Institute of psychiatry, Ain Shams University Hospitals. After signing an informed consent form, all the subjects 23 patients and 19 relatives were diagnosed according to DSM-IV and Structured Clinical Interview for DSM-IV (SCID I) and General Health Questionaire for psychiatric morbidity. Severity of OCD symptoms was assessed using Yale-Brown Obsessive Compulsive Scale (Y-BOCS) Symptom analysis was done on four symptom factor levels and presenting symptoms. Results: Showed 15 OCD patients had positive family history of psychiatric illness. 19 of their relatives showed 11 had OCD, 6 had psychosis and 3 had depression. The most prevalent symptom in OCD patients and their relatives was washing compulsions and religious obsessions. Conclusion: Genetic factors account for most of OCD symptoms in patients diagnosed with the disorder. Environmental factors also play a role in how these symptoms are expressed by observational learning.

Is impaired response inhibition independent of symptom dimensions in obsessive-compulsive disorder? Evidence from ERPs.

Impaired response inhibition has been consistently reported in patients diagnosed with obsessive-compulsive disorder (OCD). This clinically heterogeneous disorder is characterized by several symptom dimensions that may have distinct, but partially overlapping, neural correlates. The present study examined whether alterations in response inhibition may be related to symptom severity and symptom dimensions. Event-related potentials (ERPs) were recorded in a group of 42 medication-free OCD patients as well as 42 healthy controls during a stop-signal task. Symptom dimension scores were obtained using the Yale-Brown Obsessive Compulsive Scale symptom checklist. OCD patients showed longer stop-signal reaction times (SSRT, p < 0.01) and larger stop-N2 amplitudes (p < 0.01) compared to healthy controls. Neither the longer SSRT nor the larger stop-N2 scores were significantly correlated with symptom severity or present or lifetime OCD symptoms in OCD patients. These results indicate that deficient response inhibition is a common occurrence in OCD patients that is independent of global symptom severity and symptom dimensions. These data support the notion that impaired response inhibition may be a general attribute of patients with OCD.

Meta-Analysis of the Symptom Structure of Obsessive-Compulsive Disorder

Objective: OCD is a clinically heterogeneous condition. This heterogeneity has the potential to reduce power in genetic, neuroimaging, and clinical trials. Despite a mounting number of studies, there remains debate regarding the exact factor structure of OCD symptoms. The authors conducted a meta-analysis to determine the factor structure of the Yale-Brown Obsessive Compulsive Scale Symptom Checklist. Method: Studies were included if they involved subjects with OCD and included an exploratory factor analysis of the 13 Yale-Brown Obsessive Compulsive Scale Symptom Checklist categories or the items therein. A varimax-rotation was conducted in SAS 9.1 using the PROC FACTOR CORR to extract factors from sample-size weighted co-occurrence matrices. Stratified meta-analysis was conducted to determine the factor structure of OCD in studies involving children and adults separately. Results: Twenty-one studies involving 5,124 participants were included. The four factors generated were 1) symmetry: symmetry obsessions and repeating, ordering, and counting compulsions; 2) forbidden thoughts: aggression, sexual, religious, and somatic obsessions and checking compulsions, 3) cleaning: cleaning and contamination, and 4) hoarding: hoarding obsessions and compulsions. Factor analysis of studies including adults yielded an identical factor structure compared to the overall meta-analysis. Factor analysis of child-only studies differed in that checking loaded highest on the symmetry factor and somatic obsessions, on the cleaning factor. Conclusions: A four-factor structure explained a large proportion of the heterogeneity in the clinical symptoms of OCD. Further item-level factor analyses are needed to determine the appropriate placement of miscellaneous somatic and checking OCD symptoms. Reprinted with permission from the American Journal of Psychiatry 2008; 165:1532–1542