Yale-Brown Obsessive Compulsive Symptom Research Articles

Prevalence and Pattern of Olanzapine Emergent Obsessive–Compulsive Symptoms: A Cross-sectional Study

Objective: Olanzapine is an atypical antipsychotic medication and known for metabolic side effects but olanzapine-induced obsessive–compulsive symptoms are another important behavioral side effects which are less studied and only a few case reports reported these side effects. This study aims to estimate the prevalence and pattern of olanzapine-induced obsessive–compulsive symptoms in schizophrenia and bipolar affective disorders (BPADs). Methods: Subjects were recruited from psychiatry outpatient department. Subjects with schizophrenia ( n = 41) and BPAD ( n = 18) taking olanzapine at least more than 6 months were evaluated for clinical profile and the presence of obsession and compulsion symptoms by means of Yale-Brown Obsessive–Compulsive Symptom (YBOCS) checklist scale and data were collected on the structured format. Results: Eighteen (30.5%) of the 59 patients met YBOCS checklist scale for both obsessive–compulsive symptoms among subjects with schizophrenia and BPAD subjects. The mean duration of olanzapine intake was 2 years and the mean dose of olanzapine was 12.5 ± 5.21 mg in obsessive–compulsive symptoms (OCSs) present subjects and the mean dose was 13.78 ± 5.21 mg in subjects not having OCSs. Contamination was the most common obsession and checking was the most common compulsion. Conclusions: These findings suggest that obsessive–compulsive symptoms occur in a substantial percentage of patients taking olanzapine in schizophrenia and BPAD and most of the subjects had more than one OCS.

Neurofeedback for obsessive compulsive disorder: A randomized, double-blind trial

We aim to develop fMRI neurofeedback as a treatment for obsessive compulsive disorder (OCD). In prior work, we found that providing neurofeedback of activity in the anterior prefrontal cortex (aPFC) improved control over contamination anxiety in a subclinical population. Here, we present the results of a randomized, double-blind clinical trial (NCT02206945) testing this intervention in patients with OCD. We recruited patients with primary symptoms in the fear-of-harm/checking or contamination/washing domains. During neurofeedback, they viewed symptom provocative images and attempted to up- and down-regulate the aPFC during different blocks of time. The active group received two sessions of neurofeedback and the control group received yoked sham feedback. The primary outcome measure was the Yale-Brown Obsessive-Compulsive Symptom scale. The secondary outcome was control over aPFC. Thirty-six participants completed feedback training (18 active, 18 control). The active group had a slightly but significantly greater reduction of obsessive-compulsive symptoms after neurofeedback compared to the control group (p<.05) but no significant differences in control over the aPFC. These data demonstrate that neurofeedback targeting the aPFC can reduce symptoms in OCD. Future investigations should seek to optimize the training protocol to yield larger effects and to clarify the mechanism of action.

The Impact of the Covid-19 Pandemic on Patients with Obsessive Compulsive Disorder (OCD).

An intense desire to avoid contamination is one of the most common symptoms of Obsessive-Compulsive Disorder (OCD). In March 2020, when the COVID-19 outbreak was classified as a pandemic, authorities announced measures to control its spread, including hand washing, quarantine, social distancing and lockdowns. The disease spreads rapidly and has potentially serious complications, and adherence to the recommendations was strongly encouraged. These measures, both by their direct effect and as a consequence of their impact on care provision may trigger complications in patients with OCD. An online survey was completed by 102 patients with a confirmed OCD diagnosis. The survey collected demographic data, medical and psychiatric history, and asked COVID-19 related questions, OCD-related questions, and included the Self-reported Yale-Brown Obsessive-Compulsive Symptom Checklist (Y-BOCS-II). The results reveal that new OCD patterns started during the COVID-19 pandemic, including pathological doubt/checking (2.0%), a need for symmetry, order or precision (2.9%), religious pattern (2.9%), somatic/health pattern (4.9%), and a contamination/washing pattern (5.9%), which was the most reported among all patterns. The results also show an increase in overall severity of OCD (36.3%), and (27.5%) of participants also reported an increase in the overall severity of anxiety. The questionnaire completed by patients previously diagnosed with OCD revealed that during the COVID-19 pandemic there was an increase in the severity of symptoms, with the greatest effect being in individuals with contamination/ washing patterns.

The relationship between obsessive-compulsive symptoms and depressive symptoms in patients with obsessive-compulsive disorder: A network analysis.

The network model suggests that the comorbidity of obsessive-compulsive disorder (OCD) and depression is due to direct interactions between OCD and depression symptoms. The study investigates the network structure of OCD and depressive symptoms in patients with OCD and explores the pathways that connect the OCD and depression symptoms. The items of Yale-Brown Obsessive-Compulsive Symptom (Y-BOCS) Scale and the Depression Self-Rating Scale of 445 patients with OCD were analyzed by network model. Statistical analysis and visualization of the network were conducted using R software. Two bridge edges "uneasiness" and "time consumed by obsessions" and "low spirit" and "distress caused by obsessions" connected the OCD symptoms to depressive symptoms. Two closely related edges were between "interference due to obsessions" and "interference due to compulsions" and between "difficulty resisting obsessions" and "difficulty resisting compulsions." The symptoms "interference due to compulsions," "distress caused by obsessions," "time consumed by compulsions," and "uneasiness" had the highest expected influence centrality. This study highlighted the relationship between "uneasiness" and "time consumed by obsessions" and between "low spirit" and "distress caused by obsessions." In addition, "interference due to compulsions" is found as the core symptom in the network. Targeting these symptoms may help prevent and treat the comorbidity of obsession-compulsion and depression in patients with OCD.

Can miRNA Expression Levels Predict Treatment Resistance to Serotonin Reuptake Inhibitors in Patients with Obsessive-Compulsive Disorder?

Obsessive-compulsive disorder is a psychiatric disorder with different clinical manifestations caused by the interaction of genetic and environmental factors. Recently, it has been shown that microRNAs play a role in the pathogenesis of some psychiatric diseases. We aimed to compare the expression levels of microRNAs between obsessive-compulsive disorder patients and healthy controls and investigate the association between miRNA expression levels and treatment resistance. Twelve miRNA expression levels in venous blood of 100 obsessive-compulsive disorder patients and 50 healthy controls were detected by real-time polymerase chain reaction. Patients were assessed using the Hamilton Depression Rating Scale, Yale-Brown Obsessive-Compulsive Scale, and Yale-Brown Obsessive-Compulsive Symptom Checklist. Each patient was scheduled for a monthly follow-up for a minimum 6-month-period after serotonin receptor inhibitor treatments were initiated. We found that miR-26a-5p (P < .001), miR-21-3p (P < .001), miR-219a-1-3p (P = .016), miR-106b-5p (P = .039), miR-6740-5p (P = .020), miR-320a (P = .001), miR-22-3p, and miR-16b-5p (P = .010) expression levels were statistically higher in obsessive-compulsive disorder patients than healthy controls; miR-135a-5p (P < .001) and miR-129-6b-5p (P < .001) expression levels were statistically lower. Also, it was determined that increased miR-106b-5p levels were associated with treatment-resistance (P = .020) and there was a negative correlation between miR-374b-3p and disease severity (P = .042). In obsessive-compulsive disorder, there may be a potential value in the relationship between various miRNA expression levels and treatment resistance and disease severity, and future studies may be beneficial.

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

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

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

The Nepean Belief Scale: preliminary reliability and validity in obsessive–compulsive disorder

Objectives: To examine the psychometric characteristics of the Nepean Belief Scale (NBS), a short clinician-administered scale that assesses the characteristics and intensity of beliefs in obsessive–compulsive disorder (OCD).Methods: The NBS was administered by two clinicians to 27 subjects with OCD as part of a larger study that included a comprehensive assessment using the Yale–Brown Obsessive Compulsive Symptom Scale (Y-BOCS), the Overvalued Ideas Scale (OVIS) and the Symptom Checklist 90-Revised (SCL-90R). Test–retest reliability of the NBS was assessed by administering the scale 5 days after initial administration.Results: The 5-item NBS proved easy to use with an assessment time of less than 5 min. Its interrater reliability revealed 99.5% concordance, while the kappa for test–retest reliability was 0.98 (95% CI = 0.95–1.00). Cronbach alpha coefficient for internal consistency was 0.87. The NBS was found to have excellent convergent and discriminant validity.Conclusions: Preliminary results suggest that the NBS could be a useful shorter alternative to the currently more widely used instruments for assessing beliefs such as the OVIS and the Brown Assessment of Belief Scale. The NBS has clear instructions and definitions, excellent interrater reliability and convergent validity, and it more accurately measures belief-related insight.

Predictors of remission at 1-year follow-up among ocd patients: Findings from The Netherlands obsessive-compulsive disorder association (NOCDA) study

IntroductionObsessive-compulsive disorder (OCD) is described as a chronic condition. However, relatively little is known about predictors affecting its long-term outcome.ObjectiveTo examine the contribution of clinical and interpersonal determinants in predicting remission status of 254 OCD patients at one-year follow-up (FU1).MethodsWe used the baseline and FU1 data of The Netherlands obsessive-compulsive disorder association (NOCDA) study. Clinical predictors were chronicity level, depressive and obsessive-compulsive symptom severity. Suspected interpersonal factors included attachment style, social support and expressed emotion. Remission status was defined using the Yale-Brown obsessive-compulsive symptom (Y-BOCS) scale. χ2 tests and ANOVAs were used for bivariate analyses, followed by multivariate multinomial logistic regression analyses to assess main effects and interactions in predicting remission status at FU1.ResultsBivariate tests demonstrated significant differences in remission status as a function of chronicity level, depressive and obsessive-compulsive symptom severity and social support. Regression analyses revealed that increased baseline OCD severity reduced the odds for both partial and full remission at FU1 (OR = .87, 95%CI = .82–93, P &lt; 0.001). Increased depressive severity at baseline reduced the odds for partial remission at FU1 (OR = .95, 95%CI = .91–.98, P &lt; 0.01). Interactions analyses demonstrated that the adverse effects of OCD severity on partial remission disappeared at the presence of secure attachment (IOR = 1.11, 95%CI = 1.05–1.24, P &lt; 0.05) and high social support (IOR = .88, 95%CI = .78–98, P &lt; 0.05).ConclusionsThe contribution of clinical severity is critical for understanding the prognosis of OCD. The interpersonal context of OCD patients may mitigate the unfavorable effect of severity on outcome, thus should be addressed in treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Journal Digest

Journal Digest

Factor analysis of Y-BOCS checklist and severity scale among patients with schizophrenia.

To carry out factor analysis of YBOCS checklist and YBOCS severity scale among patients with schizophrenia. 181 patients of schizophrenia were assessed on the Yale Brown Obsessive Compulsive Symptom (YBOCS) checklist, YBOCS severity scale and, positive and negative syndrome scale (PANSS). About one fourth (28.18%) of the patients fulfilled the diagnosis of current OCD and 29.83% of patients fulfilled the lifetime diagnosis of OCD. Factor analysis of YBOCS checklist yielded 5 factor structures. Factor analysis of YBOCS severity scale yielded a 2 factor model. The five factors of YBOCS checklist were named as: Hoarding (included hoarding obsessions and compulsions), contamination (included contamination obsessions and cleaning compulsions), symmetry & ordering (obsessions of symmetry and ordering compulsions), Blasphemous, religious & repetition (sexual and religious obsessions, repeating and counting compulsions) and Aggression and checking (aggressive and somatic obsessions, checking compulsions). In the two factor model of YBOCS severity scale, Factor-1 included 6 items related to time spent, interference and distress related to obsessions and compulsions; whereas factor-2 included items of resistance to and control over obsessions and compulsions. Present study suggests that YBOCS checklist yielded 5 factor structures and factor analysis of YBOCS severity scale results in a 2 factor model among patients with schizophrenia. The five factor model is comparable with what has been reported for patients with pure OCD.

Obsessive Compulsive Symptoms/disorder in patients with schizophrenia: Prevalence, relationship with other symptom dimensions and impact on functioning

The aim of this study was to evaluate the prevalence of comorbid obsessive compulsive symptoms/disorder and its impact on outcome among patients with schizophrenia. 181 patients with schizophrenia were evaluated on Yale-Brown Obsessive–Compulsive Symptom Checklist, Yale-Brown Obsessive–Compulsive Scale, Calgary Depression Scale for Schizophrenia, Positive and Negative Symptom Scale, Social Occupational Functioning Scale, Global Assessment of Functioning Scale and Indian Disability Evaluation and Assessment Scale. Slightly more than one-fourth of patients fulfilled the diagnosis of current (28.2%) and lifetime (29.8%) diagnosis of obsessive compulsive disorder. On Yale Brown Obsessive Compulsive Symptom Checklist, the most common lifetime obsessions were those of contamination (25.4%), followed by obsessions of need for symmetry or exactness (11.6%). The most common compulsions were those of cleaning/washing (27.1%), followed by those of checking (24.3%). Presence of obsessive compulsive symptoms was associated with younger age of onset, higher prevalence of comorbid depression, and current suicidal ideations. Thus, it can be concluded that a significant proportion of patients with schizophrenia have obsessive compulsive symptoms/disorder. Clinicians managing patients of schizophrenia should evaluate the patients thoroughly for presence of comorbid obsessive compulsive symptoms/disorder and must take the same into account while managing the patients.

The relation between depressive and obsessive-compulsive symptoms in obsessive-compulsive disorder: Results from a large, naturalistic follow-up study

ObjectiveDespite the frequent occurrence of depressive symptoms in obsessive-compulsive disorder (OCD), little is known about the reciprocal influence between depressive and obsessive-compulsive symptoms during the course of the disease. The aim of the present study is to investigate the longitudinal relationship between obsessive-compulsive and depressive symptoms in OCD patients. MethodWe used the baseline and 1-year follow-up data of the Netherlands Obsessive Compulsive Disorder Association (NOCDA) study. In 276 patients with a lifetime diagnosis of obsessive-compulsive disorder, depressive and obsessive-compulsive symptoms were assessed at baseline and at one-year follow-up with the Beck Depression Inventory (BDI) and the Yale-Brown Obsessive Compulsive Symptom (Y-BOCS) scale. Relations were investigated using a cross-lagged panel design. ResultsThe association between the severity of depressive symptoms at baseline and obsessive-compulsive symptoms at follow-up was significant (β=0.244, p<0.001), while the association between the severity of obsessive-compulsive symptoms at baseline and depressive symptoms at follow-up was not (β=0.097, p=0.060). Replication of the analyses in subgroups with and without current comorbid major depressive disorder (MDD) and subgroups with different sequence of onset (primary versus secondary MDD) revealed the same results. LimitationsThere may be other factors, which affect both depressive and obsessive-compulsive symptoms that were not assessed in the present study. ConclusionThe present study demonstrates a relation between depressive symptoms and the course of obsessive-compulsive symptoms in OCD patients, irrespective of a current diagnosis of MDD and the sequence of onset of OCD and MDD.

The Effectiveness of Group Cognitive Behavioral Therapy in Treating Obsessive-Compulsive Disorder in Women with Multiple Sclerosis (MS): A randomized double-blind controlled trial.

BackgroundObsessive-compulsive disorder (OCD) is one of the most prevalent psychiatric disorders and can cause problems for individuals in all aspects of life, including social and personal dimensions.ObjectiveTo study the effect of group cognitive-behavioral therapy on the reduction of OCD symptoms in female participants with multiple sclerosis (MS).MethodsThis double-blind randomized control trial was conducted from May 2012 to December 2014. The participants included 75 patients with MS who suffered from OCD and were referred to the Loghman Hakim and Imam Khomeini hospitals in Tehran, Iran. Thirty participants had been diagnosed through Yale-Brown Obsessive-Compulsive Symptoms (Y-BOCS). The participants were randomly divided into an experimental group (n=15) and a control group (n=15). Eleven sessions of cognitive-behavioral therapy were provided for the experimental group. Patients in the control group continued with their normal living. Hypotheses were tested using an analysis of covariance (ANCOVA).ResultsA significant reduction was found in the experimental group’s obsessive-compulsive symptoms after cognitive-behavioral therapy (p<0.001). In addition, mean scores for participants in the experimental group were significantly lower than for those in the control group (p=0.000).ConclusionIt can be inferred that cognitive-behavioral therapy could considerably reduce OCD symptoms in women with MS. The application of this method by therapists, especially Iranian clinicians, is recommended.

Neuropsychological, electrophysiological and neurological impairments in patients with obsessive compulsive disorder, their healthy siblings and healthy controls: Identifying potential endophenotype(s)

The etiology of obsessive-compulsive disorder (OCD) has not been clarified. This study aimed to investigate the cognitive, neurological, electrophysiological functions which are reflected in executive functions, memory, visuospatial integration; neurological examination and auditory event related potentials (AERP) (N100, N200, P200 and P300) in patients with OCD, their siblings, and control subjects and to determine potential endophenotypic markers. Thirty-three patients with OCD, 18 siblings and 21 controls; matched for age, gender and years of education were included. Yale Brown Obsessive Compulsive Symptoms Checklist Scale, Hamilton Depression-Rating Scale, an exhaustive neuropscyhological test battery and Neurological Evaluation Scale were administered. Their AERP recordings were obtained. Executive functions and visuospatial integration were highly impaired in patients and slightly in their siblings compared to controls. P200 amplitude was sorted as siblings>patients>controls. P300 amplitude was sorted as patients<siblings<controls. Neurological Evaluation Scale scores were lower in patients compared to siblings and controls. The logistic regression analysis showed that, higher P300 amplitude, better performance on block design test and faster completion of Stroop test would predict being in the control group, whereas higher P200 amplitude would predict being in the case (patient and sibling) groups. We suggest that these seem to be the potential endophenotypes of OCD.

Comprehensive evaluation of cortical structure abnormalities in drug-naïve, adult patients with obsessive-compulsive disorder: A surface-based morphometry study

The study objective was to comprehensively evaluate drug-naïve, adult patients with Obsessive Compulsive Disorder (OCD) for cortical structure abnormalities in comparison with healthy controls. In this cross-sectional study of case–control design, Magnetic Resonance Imaging (1-mm) was performed in drug-naïve OCD patients (N = 50) & age- sex-, education- and handedness-matched healthy controls (N = 40). We examined cortical volume, thickness, surface area & local Gyrification Index (LGI) through a completely automated surface-based morphometric analysis using FreeSurfer software. OCD symptoms and insight were assessed using Yale-Brown Obsessive Compulsive Symptom (Y-BOCS) check-list and severity scale. Illness severity was assessed using Clinical Global Impression Severity (CGI-S) Scale. OCD patients had significantly deficient volume, thickness and surface area of right anterior cingulate gyrus (ACG). Right lingual gyrus surface area was found to be significantly decreased in patients. Y-BOCS obsession score had significant negative correlation with left frontal pole volume. Y-BOCS compulsion score had significant negative correlations with right ACG volume and surface area and right lateral orbitofrontal cortex LGI. CGI-Severity score had significant negative correlations with right lingual gyrus volume, thickness and surface area as well as right lateral orbitofrontal area. Y-BOCS insight score showed a significant negative correlation with LGI of left medial OFC and left rostral ACG. Identification of novel deficits involving occipital brain regions and first-time observations of relevant correlations between various illness characteristics and cortical measures in OCD patients supports a network involving anterior cingulate, orbitofrontal and occipital brain regions in the pathogenesis of OCD.

14:15 DECREASED WHITE MATTER INTEGRITY IN PSYCHOTIC DISORDER: ASSOCIATION WITH CHILDHOOD TRAUMA?

The study objective was to comprehensively evaluate drug-naïve, adult patients with Obsessive Compulsive Disorder (OCD) for cortical structure abnormalities in comparison with healthy controls. In this cross-sectional study of case–control design, Magnetic Resonance Imaging (1-mm) was performed in drug-naïve OCD patients (N = 50) & age- sex-, education- and handedness-matched healthy controls (N = 40). We examined cortical volume, thickness, surface area & local Gyrification Index (LGI) through a completely automated surface-based morphometric analysis using FreeSurfer software. OCD symptoms and insight were assessed using Yale-Brown Obsessive Compulsive Symptom (Y-BOCS) check-list and severity scale. Illness severity was assessed using Clinical Global Impression Severity (CGI-S) Scale. OCD patients had significantly deficient volume, thickness and surface area of right anterior cingulate gyrus (ACG). Right lingual gyrus surface area was found to be significantly decreased in patients. Y-BOCS obsession score had significant negative correlation with left frontal pole volume. Y-BOCS compulsion score had significant negative correlations with right ACG volume and surface area and right lateral orbitofrontal cortex LGI. CGI-Severity score had significant negative correlations with right lingual gyrus volume, thickness and surface area as well as right lateral orbitofrontal area. Y-BOCS insight score showed a significant negative correlation with LGI of left medial OFC and left rostral ACG. Identification of novel deficits involving occipital brain regions and first-time observations of relevant correlations between various illness characteristics and cortical measures in OCD patients supports a network involving anterior cingulate, orbitofrontal and occipital brain regions in the pathogenesis of OCD.

PHENOMENOLOGY AND PREVALENCE OF OBSESSIVE COMPULSIVE AND OTHER AXIS I DISORDERS IN A TURKISH DERMATOLOGY CLINIC

Background: Previous studies report that many obsessive compulsive disorder (OCD) patients seek help especially from dermatology clinics. The aims of the present study were: to determine the prevalence of OCD and other DSM-IV Axis I disorders among patients attending an outpatient clinic of dermatology, to identify any possible relationship between dermatological diseases and OCD, to determine the clinical and phenomenological features of the OCD subgroup in this population. Methods: The study was conducted in the Dermatology Outpatient Clinic of Istanbul University, Cerrahpasa Medical Faculty. To achieve randomization, every fifth patient applying for the first time within the denoted period was included. Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Yale-Brown Obsessive Compulsive Symptoms Scale (Y-BOCS), and a Case Report (CRF) were used for psychiatric evaluation. The Statistical Package for Social Sciences (SPSS for Windows, Version 11.5, Chicago, IL., USA) was used for statistical analyses. Descriptive statistics, chi-square test and One-way Analysis of Variance (ANOVA, via Kruskal-Wallis test) were used for comparisons. The results were interpreted within a confidence interval (CI) of 95 % and p was set at 0.05. Results: Among 99 patients 21 (21.2%) were diagnosed as having OCD and 34 were (34.3%) found to have other mental disorders whereas 44 (44.4%) had no psychopathology. OCD was found to be significantly commoner among those who had disease more than a year. The most common obsession was found to be contamination (63.6%), ordering (22.7%) and symmetry (18.1%). Most frequent compulsions were found to be Washing/ Cleaning (63.6%), checking (40.9%) and counting (31.8%). Psycho-cutenous disorders and eczema were found to be related with OCD. Conclusion: We have found increased prevalences of both OCD and other axis I disorders among dermatology patients, especially those with psycho-cutenous reactions and eczema and we argue that a closer cooperation among dermatology and psychiatry is needed also in Turkey. Key words: consultation-liaison psychiatry, dermatology, obsessive compulsive disorder, psychopathology

Obsessive‐compulsive symptoms in primary focal dystonia: A controlled study

Primary focal dystonia is an idiopathic neurological disorder causing involuntary muscle contraction. Its pathophysiology probably involves the basal ganglia and cortical-basal pathways. Primary dystonia appears to be associated with significant obsessive-compulsive symptoms, but evidence remains scarce and contradictory. We addressed the following research questions: (1) Do primary dystonia patients have high obsessive-compulsive symptom scores? (2) Are these symptoms more severe in dystonia than in controls with equivalent peripheral neurological disorders? and (3) Is psychopathology different in botulinum toxin-treated and -untreated dystonia patients? This work was a cross-sectional, descriptive, controlled study comprising 45 consecutive patients with primary focal dystonia (i.e., blepharospasm, spasmodic torticollis, or writer's cramp) 46 consecutive patients with hemifacial spasm, cervical spondylarthropathy, or carpal tunnel syndrome, and 30 healthy volunteers. Assessment included the DSM-IV based psychiatric interview, Symptom Checklist 90R, Yale-Brown Obsessive-Compulsive Scale and Checklist, and the Unified Dystonia Rating Scale. Dystonia patients had higher Yale-Brown Obsessive-Compulsive Symptom scores than both control groups. Dystonia patients with obsessive-compulsive symptom scores above cut-off for clinical significance predominantly developed hygiene-related symptoms. Major depression and generalized anxiety disorder were the most frequent psychiatric diagnoses in primary focal dystonia. Obsessive-compulsive disorder frequency was 6.7%. Primary focal dystonia patients have higher obsessive-compulsive symptom scores than individuals with similar functional disabilities resulting from other neurological disorders, suggesting that obsessive-compulsive symptoms in dystonia are not reactive to chronic disability. Dystonic muscle contractions and obsessive-compulsive symptoms may share a common neurobiological basis related to cortical-basal dysfunction. Psychopathology, especially obsessive-compulsive symptoms, should be actively explored and treated in primary focal dystonia.

Sexual orientation obsessions in obsessive–compulsive disorder: Prevalence and correlates

Sexual obsessions are a common symptom of obsessive–compulsive disorder (OCD) that may be particularly troubling to patients. However, little research has examined concerns surrounding sexual orientation, which includes obsessive doubt about one's sexual orientation, fears of becoming homosexual, or fears that others might think one is homosexual. The present study reports rates and related characteristics of individuals with sexual orientation obsessions in a clinical sample. Participants from the DSM-IV Field Trial (n=409; Foa et al., 1995) were assessed with the Yale–Brown Obsessive Compulsive Symptom Checklist and Severity Scale (YBOCS). We found that 8% (n=33) reported current sexual orientation obsessions and 11.9% (n=49) endorsed lifetime symptoms. Patents with a history of sexual orientation obsessions were twice as likely to be male than female, with moderate OCD severity. Time, interference, and distress items from the YBOCS obsessions subscale were significantly and positively correlated with a history of obsessions about sexual orientation. Avoidance was positively correlated at a trend level (p=0.055). Obsessions about sexual orientation may be associated with increased distress, interference, and avoidance, which may have unique clinical implications. Considerations for diagnosis and treatment are discussed.