Psychology › Clinical Psychology

Obsessive-Compulsive Spectrum Disorders

Works Count: 41658

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Description

This cluster of papers covers a wide range of topics related to obsessive-compulsive disorder (OCD) and its related conditions, including Tourette syndrome. The papers discuss the development and validation of assessment tools, various treatment approaches such as cognitive-behavior therapy and deep brain stimulation, neuroimaging studies, genetic associations, and the impact of OCD on neurocognitive functioning. Additionally, there is a focus on specific symptom dimensions, such as hoarding behavior, and the prevalence and epidemiology of these conditions.

Keywords

Obsessive-Compulsive Disorder; Tourette Syndrome; Neuroimaging; Cognitive-Behavior Therapy; Deep Brain Stimulation; Genetic Studies; Hoarding Behavior; Neuropsychological Performance; Psychometric Validation; Functional Neuroanatomy

Journal of Economic Theory

1993-08-01

Gareth D. Myles

A family study of obsessive-compulsive disorder

1995-01-01

David L. Pauls , John P. Alsobrook , Wayne K. Goodman +2 more

The goal of this study was to determine 1) whether obsessive-compulsive disorder is familial, 2) whether there is a familial relationship between obsessive-compulsive disorder and Gilles de la Tourette's syndrome … The goal of this study was to determine 1) whether obsessive-compulsive disorder is familial, 2) whether there is a familial relationship between obsessive-compulsive disorder and Gilles de la Tourette's syndrome and chronic tics, and 3) whether different familial types of obsessive-compulsive disorder exist.In this family study, all available first-degree relatives of 100 probands with obsessive-compulsive disorder were interviewed directly with structured interviews, and best-estimate diagnoses were assigned. In addition to the 466 first-degree relatives of the probands, 113 comparison subjects who were first-degree relatives of 33 psychiatrically unaffected subjects were studied with the same interviews.The rates of obsessive-compulsive disorder and subthreshold obsessive-compulsive disorder were significantly greater among the relatives of the probands with obsessive-compulsive disorder (10.3% and 7.9%, respectively) than among the comparison subjects (1.9% and 2.0%, respectively). Furthermore, the rate of tics (Tourette's disorder and chronic tics) was also significantly greater among the relatives of the probands (4.6%) than among the comparison subjects (1.0%). The relatives of female probands with obsessive-compulsive disorder were more likely to have tics, and the relatives of probands with early onset were at higher risk for both obsessive-compulsive disorder and tics.Obsessive-compulsive disorder is a heterogeneous condition. Some cases are familial and related to tic disorders, some cases are familial and unrelated to tics, and in other cases there appears to be no family history of either obsessive-compulsive disorder or tics.

The neuropsychology of obsessive compulsive disorder: the importance of failures in cognitive and behavioural inhibition as candidate endophenotypic markers

2005-02-25

Samuel R. Chamberlain , Aaron D. Blackwell , Naomi Fineberg +2 more

Dimensions of impulsive behavior: Personality and behavioral measures

2005-09-09

Brady Reynolds , Amanda Ortengren , Jerry B. Richards +1 more

Regional Cerebral Blood Flow Measured During Symptom Provocation in Obsessive-Compulsive Disorder Using Oxygen 15—Labeled Carbon Dioxide and Positron Emission Tomography

1994-01-01

Scott L. Rauch , Michael A. Jenike , Nathaniel M. Alpert +4 more

<h3>Background:</h3> The study was designed to determine the mediating neuroanatomy of obsessive-compulsive disorder (OCD). <h3>Methods:</h3> The short half-life tracer oxygen 15—labeled carbon dioxide was used to allow for repeated positron … <h3>Background:</h3> The study was designed to determine the mediating neuroanatomy of obsessive-compulsive disorder (OCD). <h3>Methods:</h3> The short half-life tracer oxygen 15—labeled carbon dioxide was used to allow for repeated positron emission tomographic determinations of regional cerebral blood flow on each of eight patients with OCD during a resting and a provoked (symptomatic) state. <h3>Results:</h3> Individually tailored provocative stimuli were successful in provoking OCD symptoms, in comparison with paired innocuous stimuli, as measured by selfreport on OCD analogue scales (<i>P</i>=.002). Omnibus subtraction images demonstrated a statistically significant increase in relative regional cerebral blood flow during the OCD symptomatic state vs the resting state in right caudate nucleus (<i>P</i><.006), left anterior cingulate cortex (<i>P</i><.045), and bilateral orbitofrontal cortex (<i>P</i><.008); increases in the left thalamus approached but did not reach statistical significance (<i>P</i>=.07). <h3>Conclusions:</h3> These findings are consistent with results of previous functional neuroimaging studies and contemporary neurocircuitry models of OCD. The data further implicate orbitofrontal cortex, caudate nucleus, and anterior cigulate cortex in the pathophysiology of OCD and in mediating OCD symptoms.

Deep brain stimulation of the ventral internal capsule/ventral striatum for obsessive-compulsive disorder: worldwide experience

2008-05-20

Benjamin D. Greenberg , Lutgardis Gabriëls , Donald A. Malone +7 more

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The Yale-Brown Obsessive-Compulsive Scale: Measures of internal consistency

1994-02-01

Suck Won Kim , Maurice W. Dysken , Alfred M. Pheley +1 more

The Yale-Brown Obsessive Compulsive Scale

1989-11-01

Wayne K. Goodman

• The development design and reliability of the Yale-Brown Obsessive Compulsive Scale have been described elsewhere. We focused on the validity of the Yale-Brown Scale and its sensitivity to change. … • The development design and reliability of the Yale-Brown Obsessive Compulsive Scale have been described elsewhere. We focused on the validity of the Yale-Brown Scale and its sensitivity to change. Convergent and discriminant validity were examined in baseline ratings from three cohorts of patients with obsessive-compulsive disorder (N = 81). The total Yale-Brown Scale score was significantly correlated with two of three independent measures of obsessive-compulsive disorder and weakly correlated with measures of depression and of anxiety in patients with obsessive-compulsive disorder with minimal secondary depressive symptoms. Results from a previously reported placebo-controlled trial of fluvoxamine in 42 patients with obsessive-compulsive disorder showed that the Yale-Brown Scale was sensitive to drug-induced changes and that reductions in Yale-Brown Scale scores specifically reflected improvement in obsessive-compulsive disorder symptoms. Together, these studies indicate that the 10-item Yale-Brown Scale is a reliable and valid instrument for assessing obsessive-compulsive disorder symptom severity and that it is suitable as an outcome measure in drug trials of obsessive-compulsive disorder.

Schizophrenia and employment

2004-05-01

Steven Marwaha , Sonia Johnson

The Yale Global Tic Severity Scale: Initial Testing of a Clinician-Rated Scale of Tic Severity

1989-07-01

James F. Leckman , Mark A. Riddle , Maureen T. Hardin +4 more

A cognitive-behavioral model of compulsive hoarding

1996-04-01

Randy O. Frost , Tamara L. Hartl

Three-Year Outcomes in Deep Brain Stimulation for Highly Resistant Obsessive–Compulsive Disorder

2006-07-19

Benjamin D. Greenberg , Donald A. Malone , Gerhard M. Friehs +7 more

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Obsessions and compulsions: The Padua inventory

1988-01-01

Ezio Sanavio

Obsessive-Compulsive Disorder in Children and Adolescents

1989-04-01

Susan E. Swedo

• We reviewed the phenomenology of obsessive-compulsive disorder (OCD) in 70 consecutive children and adolescents studied prospectively at the National Institute of Mental Health, Bethesda, Md, between 1977 and 1987. … • We reviewed the phenomenology of obsessive-compulsive disorder (OCD) in 70 consecutive children and adolescents studied prospectively at the National Institute of Mental Health, Bethesda, Md, between 1977 and 1987. There is striking similarity between the clinical presentation of OCD in children and in adult patients. Washing, grooming, and checking rituals and/or preoccupation with disease, danger, and doubt account for the great majority of cases. Twenty-five percent of subjects had a first-degree relative with OCD. The fixed content and style of symptoms within and across subjects, and the identical presentation across a wide age range, suggest an ethological model for OCD.

A cognitive theory of obsessions

1997-09-01

S. Rachman

Toward a Neurobiology of Obsessive-Compulsive Disorder

2000-11-01

Ann M. Graybiel , Scott L. Rauch

Obsessional-compulsive problems: A cognitive-behavioural analysis

1985-01-01

Paul M. Šalkovskis

Habit-reversal: A method of eliminating nervous habits and tics

1973-11-01

Nathan H. Azrin , R.G. Nunn

The Epidemiology of Obsessive-Compulsive Disorder in Five US Communities

1988-12-01

Marvin Karno

The prevalence of obsessive-compulsive disorder was measured in five US communities among more than 18,500 persons in residential settings as part of the National Institute of Mental Health (Bethesda, Md)--sponsored … The prevalence of obsessive-compulsive disorder was measured in five US communities among more than 18,500 persons in residential settings as part of the National Institute of Mental Health (Bethesda, Md)--sponsored Epidemiologic Catchment Area program. Lifetime prevalence rates ranged from 1.9% to 3.3% across the five Epidemiologic Catchment Area sites for obsessive-compulsive disorder diagnosed without DSM-III exclusions and 1.2% to 2.4% with such exclusions. These rates are about 25 to 60 times greater than had been estimated on the basis of previous studies of clinical populations.

Rethinking the mood and anxiety disorders: A quantitative hierarchical model for DSM-V.

2005-11-01

David Watson

The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) groups disorders into diagnostic classes on the basis of the subjective criterion of "shared … The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) groups disorders into diagnostic classes on the basis of the subjective criterion of "shared phenomenological features." There are now sufficient data to eliminate this rational system and replace it with an empirically based structure that reflects the actual similarities among disorders. The existing structural evidence establishes that the mood and anxiety disorders should be collapsed together into an overarching class of emotional disorders, which can be decomposed into 3 subclasses: the bipolar disorders (bipolar I, bipolar II, cyclothymia), the distress disorders (major depression, dysthymic disorder, generalized anxiety disorder, posttraumatic stress disorder), and the fear disorders (panic disorder, agoraphobia, social phobia, specific phobia). The optimal placement of other syndromes (e.g., obsessive-compulsive disorder) needs to be clarified in future research.

Cortico-striatal synaptic defects and OCD-like behaviours in Sapap3-mutant mice

2007-08-01

Jeffrey M. Welch , Jing Lü , Ramona M. Rodriguiz +7 more

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Children's Yale-Brown Obsessive Compulsive Scale: Reliability and Validity

1997-06-01

Lawrence David Scahill , Mark A. Riddle , Maureen McSwiggin-Hardin +5 more

To evaluate the reliability and validity of a semistructured measure of obsessive-compulsive symptom severity in children and adolescents with obsessive-compulsive disorder (OCD).Sixty-five children with OCD (25 girls and 40 boys, … To evaluate the reliability and validity of a semistructured measure of obsessive-compulsive symptom severity in children and adolescents with obsessive-compulsive disorder (OCD).Sixty-five children with OCD (25 girls and 40 boys, aged 8 to 17 years) were assessed with the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS). Interrater agreement was assessed by four raters in a subsample (n = 24). Discriminant and convergent validity were assessed by comparing CY-BOCS scores to self-ratings of depression, anxiety, and obsessive-compulsive symptoms.Internal consistency was high, measuring .87 for the 10 items. The intraclass correlations for the CY-BOCS Total, Obsession, and Compulsion scores were .84, .91, and .68, suggesting good to excellent interrater agreement for subscale and total scores. The CY-BOCS Total score showed a significantly higher correlation with a self-report of obsessive-compulsive symptoms (r = .62 for the Leyton survey) compared with the Children's Depression Inventory (r = .34) and the Children's Manifest Anxiety Scale (r = .37) (p = .02 and .05, respectively).The CY-BOCS yields reliable and valid subscale and total scores for obsessive-compulsive symptom severity in children and adolescents with OCD. Reliability and validity appear to be influenced by age of the child and the hazards associated with integrating data from parental and patient sources.

Human studies of prepulse inhibition of startle: normal subjects, patient groups, and pharmacological studies

2001-06-22

David Braff , Mark A. Geyer , Neal R. Swerdlow

The Obsessive-Compulsive Inventory: Development and validation of a short version.

2002-01-01

Edna B. Foa , Jonathan D. Huppert , Susanne Leiberg +4 more

This article reports on the development of a revised version of the Obsessive-Compulsive Inventory (OCI; E. B. Foa, M. J. Kozak, P. Salkovskis, M. E. Coles, & N. Amir, 1998), … This article reports on the development of a revised version of the Obsessive-Compulsive Inventory (OCI; E. B. Foa, M. J. Kozak, P. Salkovskis, M. E. Coles, & N. Amir, 1998), a psychometrically sound, theoretically driven, self-report measure. The revised OCI (OCI-R) improves on the parent version in 3 ways: It eliminates the redundant frequency scale, simplifies the scoring of the subscales, and reduces overlap across subscales. The reliability and validity of the OCI-R were examined in 215 patients with obsessive-compulsive disorder (OCD), 243 patients with other anxiety disorders, and 677 nonanxious individuals. The OCI-R, which contains 18 items and 6 subscales, has retained excellent psychometric properties. The OCI-R and its subscales differentiated well between individuals with and without OCD. Receiver operating characteristic (ROC) analyses demonstrated the usefulness of the OCI-R as a diagnostic tool for screening patients with OCD, utilizing empirically derived cutscores.

A meta-analysis of sex differences in human brain structure

2014-01-03

Amber Ruigrok , Gholamreza Salimi‐Khorshidi , Meng‐Chuan Lai +4 more

The prevalence, age of onset, and symptomatology of many neuropsychiatric conditions differ between males and females. To understand the causes and consequences of sex differences it is important to establish … The prevalence, age of onset, and symptomatology of many neuropsychiatric conditions differ between males and females. To understand the causes and consequences of sex differences it is important to establish where they occur in the human brain. We report the first meta-analysis of typical sex differences on global brain volume, a descriptive account of the breakdown of studies of each compartmental volume by six age categories, and whole-brain voxel-wise meta-analyses on brain volume and density. Gaussian-process regression coordinate-based meta-analysis was used to examine sex differences in voxel-based regional volume and density. On average, males have larger total brain volumes than females. Examination of the breakdown of studies providing total volumes by age categories indicated a bias towards the 18-59 year-old category. Regional sex differences in volume and tissue density include the amygdala, hippocampus and insula, areas known to be implicated in sex-biased neuropsychiatric conditions. Together, these results suggest candidate regions for investigating the asymmetric effect that sex has on the developing brain, and for understanding sex-biased neurological and psychiatric conditions.

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Integrating evidence from neuroimaging and neuropsychological studies of obsessive-compulsive disorder: The orbitofronto-striatal model revisited

2007-11-26

Lara Menzies , Samuel R. Chamberlain , Angela R. Laird +3 more

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The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication

2008-08-26

Ayelet Meron Ruscio , Dan J. Stein , Wai Tat Chiu +1 more

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FUNCTIONAL NEUROIMAGING AND THE NEUROANATOMY OF OBSESSIVE-COMPULSIVE DISORDER

2000-09-01

Sanjaya Saxena , Scott L. Rauch

Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections: Clinical Description of the First 50 Cases

1998-02-01

Susan E. Swedo , Henrietta L. Leonard , Marjorie A. Garvey +7 more

The purpose of this study was to describe the clinical characteristics of a novel group of patients with obsessive-compulsive disorder (OCD) and tic disorders, designated as pediatric autoimmune neuropsychiatric disorders … The purpose of this study was to describe the clinical characteristics of a novel group of patients with obsessive-compulsive disorder (OCD) and tic disorders, designated as pediatric autoimmune neuropsychiatric disorders associated with streptococcal (group A beta-hemolytic streptococcal [GABHS]) infections (PANDAS).The authors conducted a systematic clinical evaluation of 50 children who met all of the following five working diagnostic criteria: presence of OCD and/or a tic disorder, prepubertal symptom onset, episodic course of symptom severity, association with GABHS infections, and association with neurological abnormalities.The children's symptom onset was acute and dramatic, typically triggered by GABHS infections at a very early age (mean = 6.3 years, SD = 2.7, for tics; mean = 7.4 years, SD = 2.7, for OCD). The PANDAS clinical course was characterized by a relapsing-remitting symptom pattern with significant psychiatric comorbidity accompanying the exacerbations; emotional lability, separation anxiety, nighttime fears and bedtime rituals, cognitive deficits, oppositional behaviors, and motoric hyperactivity were particularly common. Symptom onset was triggered by GABHS infection for 22 (44%) of the children and by pharyngitis (no throat culture obtained) for 14 others (28%). Among the 50 children; there were 144 separate episodes of symptom exacerbation; 45 (31%) were associated with documented GABHS infection, 60 (42%) with symptoms of pharyngitis or upper respiratory infection (no throat culture obtained), and six (4%) with GABHS exposure.The working diagnostic criteria appear to accurately characterize a homogeneous patient group in which symptom exacerbations are triggered by GABHS infections. The identification of such a subgroup will allow for testing of models of pathogenesis, as well as the development of novel treatment and prevention strategies.

Abnormal and normal obsessions

1978-01-01

S. Rachman , P. de Silva

An international perspective on Tourette syndrome: selected findings from 3500 individuals in 22 countries

2000-07-01

Roger D. Fréeman , Diane K. Fast , Larry Burd +3 more

We have established a multisite, international database of 3,500 individuals diagnosed with Tourette syndrome (TS). The male:female ratio is 4.3:1 for the total sample, with wide variation among sites; the … We have established a multisite, international database of 3,500 individuals diagnosed with Tourette syndrome (TS). The male:female ratio is 4.3:1 for the total sample, with wide variation among sites; the male excess occurs at every site. Anger control problems, sleep difficulties, coprolalia, and self-injurious behavior only reach impressive levels in individuals with comorbidity. Anger control problems are strongly correlated with comorbidity, regardless of site, region, or whether assessed by neurologists or psychiatrists. The mean age at onset of tics is 6.4 years. At all ages, about 12% of individuals with TS have no reported comorbidity. The most common reported comorbidity is attention-deficit-hyperactivity disorder. Males are more likely to have comorbid disorders than females. The earlier the age at onset, the greater the likelihood of a positive family history of tics. An understanding of the factors producing these and other variations might assist in better subtyping of TS. Because behavioral problems are associated with comorbidity, their presence should dictate a high index of suspicion of the latter, whose treatment may be at least as important as tic reduction. The established database can be used as the entry point for further research when large samples are studied and generalizability of results is important.

Electrical stimulation in anterior limbs of internal capsules in patients with obsessive-compulsive disorder

1999-10-01

Bart Nuttin , Paul Cosyns , Hilde Demeulemeester +2 more

Randomized, Placebo-Controlled Trial of Exposure and Ritual Prevention, Clomipramine, and Their Combination in the Treatment of Obsessive-Compulsive Disorder

2004-12-30

Edna B. Foa , Michael R. Liebowitz , Michael J. Kozak +7 more

The purpose of the study was to test the relative and combined efficacy of clomipramine and exposure and ritual prevention in the treatment of obsessive-compulsive disorder (OCD) in adults. Serotonin … The purpose of the study was to test the relative and combined efficacy of clomipramine and exposure and ritual prevention in the treatment of obsessive-compulsive disorder (OCD) in adults. Serotonin reuptake inhibitors (SRIs) and cognitive behavior therapy by exposure and ritual prevention are both established treatments for OCD, yet their relative and combined efficacy have not been demonstrated conclusively.A double-blind, randomized, placebo-controlled trial comparing exposure and ritual prevention, clomipramine, their combination (exposure and ritual prevention plus clomipramine), and pill placebo was conducted at one center expert in pharmacotherapy, another with expertise in exposure and ritual prevention, and a third with expertise in both modalities. Participants were adult outpatients (N=122 entrants) with OCD. Interventions included intensive exposure and ritual prevention for 4 weeks, followed by eight weekly maintenance sessions, and/or clomipramine administered for 12 weeks, with a maximum dose of 250 mg/day. The main outcome measures were the Yale-Brown Obsessive Compulsive Scale total score and response rates determined by the Clinical Global Impression improvement scale.At week 12, the effects of all active treatments were superior to placebo. The effect of exposure and ritual prevention did not differ from that of exposure and ritual prevention plus clomipramine, and both were superior to clomipramine only. Treated and completer response rates were, respectively, 62% and 86% for exposure and ritual prevention, 42% and 48% for clomipramine, 70% and 79% for exposure and ritual prevention plus clomipramine, and 8% and 10% for placebo.Clomipramine, exposure and ritual prevention, and their combination are all efficacious treatments for OCD. Intensive exposure and ritual prevention may be superior to clomipramine and, by implication, to monotherapy with the other SRIs.

Cognitive assessment of obsessive-compulsive disorder

1997-07-01

Randy O. Frost , Gail Steketee , Nader Amir +7 more

Recent theories of obsessive-compulsive disorder (OCD) emphasize the importance of cognitive contents (beliefs and appraisals) and cognitive processes in the etiology and maintenance of OCD. In order to evaluate these … Recent theories of obsessive-compulsive disorder (OCD) emphasize the importance of cognitive contents (beliefs and appraisals) and cognitive processes in the etiology and maintenance of OCD. In order to evaluate these theories and to assess the mechanisms of treatment-related change, it is necessary to develop measures of the relevant cognitive contents and processes. Several scales have been developed, although many are unpublished and there is a great deal of overlap among measures. The purpose of the present article is to describe the progress of an international group of investigators who have commenced a coordinated effort to develop a standardized set of cognitive measures. This article describes the theoretical bases and clinical importance of such an endeavor, and the proceedings of the working group meetings are summarized. Several methods of assessment are reviewed, including idiographic methods, information processing paradigms, and self-report measures. The working group is currently developing and evaluating self-report measures of appraisals about intrusions, and self-report measures of OC-related beliefs. Consensus ratings indicated that 6 belief domains are likely to be important in OCD. These are beliefs pertaining to: (1) inflated responsibility; (2) overimportance of thoughts; (3) excessive concern about the importance of controlling one's thoughts; (4) overestimation of threat; (5) intolerance of uncertainty; and (6) perfectionism.

The Yale-Brown Obsessive Compulsive Scale

1989-11-01

Wayne K. Goodman

• The Yale-Brown Obsessive Compulsive Scale was designed to remedy the problems of existing rating scales by providing a specific measure of the severity of symptoms of obsessivecompulsive disorder that … • The Yale-Brown Obsessive Compulsive Scale was designed to remedy the problems of existing rating scales by providing a specific measure of the severity of symptoms of obsessivecompulsive disorder that is not influenced by the type of obsessions or compulsions present. The scale is a clinician-rated, 10-item scale, each item rated from 0 (no symptoms) to 4 (extreme symptoms) (total range, 0 to 40), with separate subtotals for severity of obsessions and compulsions. In a study involving four raters and 40 patients with obsessive-compulsive disorder at various stages of treatment, interrater reliability for the total Yale-Brown Scale score and each of the 10 individual items was excellent, with a high degree of internal consistency among all item scores demonstrated with Cronbach's α coefficient. Based on pretreatment assessment of 42 patients with obsessive-compulsive disorder, each item was frequently endorsed and measured across a range of severity. These findings suggest that the Yale-Brown Scale is a reliable instrument for measuring the severity of illness in patients with obsessive-compulsive disorder with a range of severity and types of obsessive-compulsive symptoms.

A Multidimensional Model of Obsessive-Compulsive Disorder

2005-01-27

David Mataix‐Cols , Maria Conceição do Rosário , James F. Leckman

Obsessive-compulsive disorder (OCD) is a clinically heterogeneous condition. This heterogeneity can reduce the power and obscure the findings from natural history studies to genome scans, neuroimaging, and clinical trials. The … Obsessive-compulsive disorder (OCD) is a clinically heterogeneous condition. This heterogeneity can reduce the power and obscure the findings from natural history studies to genome scans, neuroimaging, and clinical trials. The authors review the evidence supporting a multidimensional model of OCD.Computerized and manual literature searches were performed to identify factor-analytic studies of obsessive-compulsive symptoms before data from disciplines that bear on the potential usefulness of these dimensions were considered. Selection criteria included the novelty and importance of studies and their relevance to outcomes of interest to well-informed mental health professionals.Twelve factor-analytic studies involving more than 2,000 patients were identified that consistently extracted at least four symptom dimensions: symmetry/ordering, hoarding, contamination/cleaning, and obsessions/checking. These dimensions were associated with distinct patterns of comorbidity, genetic transmission, neural substrates, and treatment response. The evidence supporting the hoarding dimension is particularly robust.The complex clinical presentation of OCD can be summarized with a few consistent, temporally stable symptom dimensions. These can be understood as a spectrum of potentially overlapping syndromes that may 1) coexist in any patient, 2) be continuous with normal obsessive-compulsive phenomena, and 3) extend beyond the traditional nosological boundaries of OCD. Although the dimensional structure of obsessive-compulsive symptoms is imperfect, this quantitative approach to phenotypic traits has the potential to advance our understanding of OCD and may aid in the identification of more robust endophenotypes. The need for a dimensional rating scale and suggestions for future research aimed at reducing the burden of this disorder are discussed.

Neurocognitive endophenotypes of impulsivity and compulsivity: towards dimensional psychiatry

2011-12-12

Trevor W. Robbins , Claire M. Gillan , Dana Smith +2 more

Symptoms of obsessive-compulsive disorder

1997-07-01

James F. Leckman , Dorothy E. Grice , James P. Boardman +7 more

Obsessive-compulsive disorder encompasses a broad range of symptoms that represent multiple psychological domains, including perception, cognition, emotion, social relatedness, and diverse motor behaviors. The purpose of these analyses was to … Obsessive-compulsive disorder encompasses a broad range of symptoms that represent multiple psychological domains, including perception, cognition, emotion, social relatedness, and diverse motor behaviors. The purpose of these analyses was to evaluate the correlational relationships of the symptoms of obsessive-compulsive disorder.This study examined the 13 a priori categories used to group types of obsessions and compulsions in the Yale-Brown Obsessive Compulsive Scale symptom checklist in two independent groups of patients with obsessive-compulsive disorder (N = 208 and N = 98). A principal-components factor analysis with varimax rotation was performed, followed by a series of other exploratory analyses.The two data sets yielded nearly identical results. Four factors--obsessions and checking, symmetry and ordering, cleanliness and washing, and boarding--emerged in each data set, in total accounting for more than 60% of the variance.Obsessive-compulsive disorder is a multidimensional and etiologically heterogeneous condition. The four symptom dimensions identified in this study are largely congruent with those identified in earlier reports. These factors may be of value in future genetic, neurobiological, and treatment response studies.

Assessment of obsessive-compulsive symptom dimensions: Development and evaluation of the Dimensional Obsessive-Compulsive Scale.

2010-03-01

Jonathan S. Abramowitz , Brett J. Deacon , Bunmi O. Olatunji +7 more

Although several measures of obsessive-compulsive (OC) symptoms exist, most are limited in that they are not consistent with the most recent empirical findings on the nature and dimensional structure of … Although several measures of obsessive-compulsive (OC) symptoms exist, most are limited in that they are not consistent with the most recent empirical findings on the nature and dimensional structure of obsessions and compulsions. In the present research, the authors developed and evaluated a measure called the Dimensional Obsessive-Compulsive Scale (DOCS) to address limitations of existing OC symptom measures. The DOCS is a 20-item measure that assesses the four dimensions of OC symptoms most reliably replicated in previous structural research. Factorial validity of the DOCS was supported by exploratory and confirmatory factor analyses of 3 samples, including individuals with OC disorder, those with other anxiety disorders, and nonclinical individuals. Scores on the DOCS displayed good performance on indices of reliability and validity, as well as sensitivity to treatment and diagnostic sensitivity, and hold promise as a measure of OC symptoms in clinical and research settings.

Distinct Neural Correlates of Washing, Checking, and Hoarding SymptomDimensions in Obsessive-compulsive Disorder

2004-06-01

David Mataix‐Cols , Sarah C. Wooderson , Natalia Lawrence +3 more

Context: Obsessive-compulsive disorder (OCD) is clinically heterogeneous, yet most previous functional neuroimaging studies grouped together patients with mixed symptoms, thus potentially reducing the power and obscuring the findings of such … Context: Obsessive-compulsive disorder (OCD) is clinically heterogeneous, yet most previous functional neuroimaging studies grouped together patients with mixed symptoms, thus potentially reducing the power and obscuring the findings of such studies.Objective: To investigate the neural correlates of washing, checking, and hoarding symptom dimensions in OCD.

Serotonin Transporter Promoter Gain-of-Function Genotypes Are Linked to Obsessive-Compulsive Disorder

2006-04-04

Xian‐Zhang Hu , Robert H. Lipsky , Guanshan Zhu +7 more

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Voxel-wise meta-analysis of grey matter changes in obsessive–compulsive disorder

2009-11-01

Joaquim Raduà , David Mataix‐Cols

Background Specific cortico-striato-thalamic circuits are hypothesised to mediate the symptoms of obsessive–compulsive disorder (OCD), but structural neuroimaging studies have been inconsistent. Aims To conduct a meta-analysis of published and unpublished … Background Specific cortico-striato-thalamic circuits are hypothesised to mediate the symptoms of obsessive–compulsive disorder (OCD), but structural neuroimaging studies have been inconsistent. Aims To conduct a meta-analysis of published and unpublished voxel-based morphometry studies in OCD. Method Twelve data-sets comprising 401 people with OCD and 376 healthy controls met inclusion criteria. A new improved voxel-based meta-analytic method, signed differential mapping (SDM), was developed to examine regions of increased and decreased grey matter volume in the OCD group v. control group. Results No between-group differences were found in global grey matter volumes. People with OCD had increased regional grey matter volumes in bilateral lenticular nuclei, extending to the caudate nuclei, as well as decreased volumes in bilateral dorsal medial frontal/anterior cingulate gyri. A descriptive analysis of quartiles, a sensitivity analysis as well as analyses of subgroups further confirmed these findings. Meta-regression analyses showed that studies that included individuals with more severe OCD were significantly more likely to report increased grey matter volumes in the basal ganglia. No effect of current antidepressant treatment was observed. Conclusions The results support a dorsal prefrontal–striatal model of the disorder and raise the question of whether functional alterations in other brain regions commonly associated with OCD, such as the orbitofrontal cortex, may reflect secondary compensatory strategies. Whether the reported differences between participants with OCD and controls precede the onset of the symptoms and whether they are specific to OCD remains to be established.

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Caudate Glucose Metabolic Rate Changes With Both Drug and Behavior Therapy for Obsessive-Compulsive Disorder

1992-09-01

L.R. Baxter , Jeffrey M. Schwartz , K. Bergman +7 more

We used positron emission tomography to investigate local cerebral metabolic rates for glucose (LCMRG1c) in patients with obsessive-compulsive disorder before and after treatment with either fluoxetine hydrochloride or behavior therapy. … We used positron emission tomography to investigate local cerebral metabolic rates for glucose (LCMRG1c) in patients with obsessive-compulsive disorder before and after treatment with either fluoxetine hydrochloride or behavior therapy. After treatment, LCMRG1c in the head of the right caudate nucleus, divided by that in the ipsilateral hemisphere (Cd/hem), was decreased significantly compared with pretreatment values in responders to both drug and behavior therapy. These decreases in responders were also significantly greater than right Cd/hem changes in nonresponders and normal controls, in both of whom values did not change from baseline. Percentage change in obsessive-compulsive disorder symptom ratings correlated significantly with the percent of right Cd/hem change with drug therapy and there was a trend to significance for this same correlation with behavior therapy. By lumping all responders to either treatment, right orbital cortex/hem was significantly correlated with ipsilateral Cd/hem and thalamus/hem before treatment but not after, and the differences before and after treatment were significant. A similar pattern was noted in the left hemisphere. A brain circuit involving these brain regions may mediate obsessive-compulsive disorder symptoms.

Obsessive-compulsive disorder: beyond segregated cortico-striatal pathways

2011-12-07

Mohammed R. Milad , Scott L. Rauch

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The Epidemiology and Clinical Features of Obsessive Compulsive Disorder

1992-12-01

Steven A. Rasmussen , Jonathan A. Eisen

Psychometric validation of the obsessive belief questionnaire and interpretation of intrusions inventory—Part 2: Factor analyses and testing of a brief version

2005-07-26

Obsessive Compulsive Cognitions Working Group

Neuroimaging and frontal-subcortical circuitry in obsessive-compulsive disorder

1998-08-01

S Saxena , Arthur L. Brody , Jeffrey M. Schwartz +1 more

Neuroimaging studies provide strong evidence that the pathophysiology of obsessive-compulsive disorder (OCD) involves abnormal functioning along specific frontal-subcortical brain circuits.A literature search was carried out for all brain imaging studies … Neuroimaging studies provide strong evidence that the pathophysiology of obsessive-compulsive disorder (OCD) involves abnormal functioning along specific frontal-subcortical brain circuits.A literature search was carried out for all brain imaging studies of patients with OCD. We also reviewed the basic science literature on the functional neuroanatomy of cortico-basal ganglia circuits, and integrated this information with neuroimaging data in OCD to formulate a theoretical model of brain mediation of OCD symptoms and response to treatment.At least a subgroup of patients with OCD may have abnormal basal ganglia development. Functional neuroimaging studies indicate that OCD symptoms are associated with increased activity in orbitofrontal cortex, caudate nucleus, thalamus and anterior cingulate gyrus.OCD symptoms are mediated by hyperactivity in orbitofrontal-subcortical circuits, perhaps due to an imbalance of tone between direct and indirect striato-pallidal pathways. We present a model which describes how frontal-subcortical brain circuitry may mediate OCD symptomatology, and suggest a hypothesis for how successful treatments may ameliorate symptoms, via their effects on circuit activity.

Obsessive-compulsive disorder

2009-08-01

Jonathan S. Abramowitz , Steven Taylor , Dean McKay

Practice Guideline for the Treatment of Patients With Obsessive-Compulsive Disorder

2008-01-17

Lorrin M. Koran , Gregory L. Hanna , Eric Hollander +2 more

Cognitive-Behavior Therapy, Sertraline, and Their Combination for Children and Adolescents With Obsessive-Compulsive Disorder

2004-10-26

ContextThe empirical literature on treatment of obsessive-compulsive disorder (OCD) in children and adolescents supports the efficacy of short-term OCD-specific cognitive-behavior therapy (CBT) or medical management with selective serotonin reuptake inhibitors. … ContextThe empirical literature on treatment of obsessive-compulsive disorder (OCD) in children and adolescents supports the efficacy of short-term OCD-specific cognitive-behavior therapy (CBT) or medical management with selective serotonin reuptake inhibitors. However, little is known about their relative and combined efficacy.ObjectiveTo evaluate the efficacy of CBT alone and medical management with the selective serotonin reuptake inhibitor sertraline alone, or CBT and sertraline combined, as initial treatment for children and adolescents with OCD.Design, Setting, and ParticipantsThe Pediatric OCD Treatment Study, a balanced, masked randomized controlled trial conducted in 3 academic centers in the United States and enrolling a volunteer outpatient sample of 112 patients aged 7 through 17 years with a primary Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis of OCD and a Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) score of 16 or higher. Patients were recruited between September 1997 and December 2002.InterventionsParticipants were randomly assigned to receive CBT alone, sertraline alone, combined CBT and sertraline, or pill placebo for 12 weeks.Main Outcome MeasuresChange in CY-BOCS score over 12 weeks as rated by an independent evaluator masked to treatment status; rate of clinical remission defined as a CY-BOCS score less than or equal to 10.ResultsNinety-seven of 112 patients (87%) completed the full 12 weeks of treatment. Intent-to-treat random regression analyses indicated a statistically significant advantage for CBT alone (P = .003), sertraline alone (P = .007), and combined treatment (P = .001) compared with placebo. Combined treatment also proved superior to CBT alone (P = .008) and to sertraline alone (P = .006), which did not differ from each other. Site differences emerged for CBT and sertraline but not for combined treatment, suggesting that combined treatment is less susceptible to setting-specific variations. The rate of clinical remission for combined treatment was 53.6% (95% confidence interval [CI], 36%-70%); for CBT alone, 39.3% (95% CI, 24%-58%); for sertraline alone, 21.4% (95% CI, 10%-40%); and for placebo, 3.6% (95% CI, 0%-19%). The remission rate for combined treatment did not differ from that for CBT alone (P = .42) but did differ from sertraline alone (P = .03) and from placebo (P<.001). CBT alone did not differ from sertraline alone (P = .24) but did differ from placebo (P = .002), whereas sertraline alone did not (P = .10). The 3 active treatments proved acceptable and well tolerated, with no evidence of treatment-emergent harm to self or to others.ConclusionChildren and adolescents with OCD should begin treatment with the combination of CBT plus a selective serotonin reuptake inhibitor or CBT alone.

Beliren Yetişkinlerde Benlik Korkusu İle Obsesif Kompulsif Belirtiler Arasındaki İlişki

2025-06-25

Atanur Akar | Eğitim Bilimleri Dergisi

Bu çalışmada beliren yetişkinlerde benlik korkusu ile obsesif kompulsif belirtiler arasındaki ilişkinin incelemesi amaçlanmıştır. Çalışmanın tasarımı ilişkisel tarama modelidir. Amaçlı örnekleme tekniği kullanılan araştırmanın örneklemini 242 beliren yetişkin oluşturmuştur. Veriler … Bu çalışmada beliren yetişkinlerde benlik korkusu ile obsesif kompulsif belirtiler arasındaki ilişkinin incelemesi amaçlanmıştır. Çalışmanın tasarımı ilişkisel tarama modelidir. Amaçlı örnekleme tekniği kullanılan araştırmanın örneklemini 242 beliren yetişkin oluşturmuştur. Veriler çok değişkenli doğrusal regresyon analizi kullanılarak analiz edilmiştir. Benlik korkusunda meydana gelen 1 birimlik artışın toplam OKB belirti düzeyini 0,519 birim, temizlik boyutundaki belirti düzeyini 0,271 birim, düşüncelere kapılma boyutundaki belirti düzeyini 0,677 birim, kontrol boyutundaki belirti düzeyini 0,316 birim, dürtüler boyutundaki belirti düzeyini 0,323 birim ve kesinlik boyutundaki belirti düzeyini 0,310 birim artırdığı belirlenmiştir (p

Копинг-стратегии подростков-сирот и подростков, оставшихся без попечения родителей

2025-06-24

Е.В. Семина , О.С. Посыпанова | Психолого-педагогический поиск

В статье представлены результаты эмпирического исследования копинг-стратегий подростков-сирот и подростков, оставшихся без попечения родителей (социальных сирот), которые воспитываются в государственных социальных учреждениях. Актуальность работы состоит в том, что для воспитанников, … В статье представлены результаты эмпирического исследования копинг-стратегий подростков-сирот и подростков, оставшихся без попечения родителей (социальных сирот), которые воспитываются в государственных социальных учреждениях. Актуальность работы состоит в том, что для воспитанников, потерявших родителей, прошедших в кровных семьях через множество стрессовых жизненных ситуаций, важны конструктивные стратегии совладания с трудностями. Для профилактики девиантного, деструктивного и аддиктивного поведения сирот необходимо выявлять, какие стратегии совладания с жизненными обстоятельствами у них являются доминирующими и, соответственно, какие педагогические подходы могут быть эффективными для повышения их психологического благополучия. Целью исследования являлся анализ иерархии копинг-стратегий проживающих в государственных учреждениях подростков-сирот и подростков, оставшихся без попечения родителей, а также изучение вариативности копинг-стратегий в зависимости от некоторых социально-педагогических факторов. Выявлено, что у сирот преобладают такие конструктивные стратегии совладания с жизненными трудностями, как поиск социальной поддержки, положительная переоценка, принятие проблемы. К доминирующим у них неконструктивным стратегиям относятся стратегия ухода от решения проблемы и стратегия отрицания проблемы. Педагоги центров работают на снижение конфронтационного копинга и развитие ответственности сирот в сложных ситуациях. Исследование проводилось для повышения резилиентности и психологического благополучия данной социально уязвимой группы подростков. The article presents the results of an empirical study of coping strategies for orphans and adolescents left without parental care (social orphans) who are brought up in state-run social institutions. The relevance of the work is that constructive strategies for coping with difficulties are important for pupils who have lost their parents and have gone through many stressful life situations in their blood families. To prevent deviant, destructive or addictive behavior in orphans, it is necessary to identify which strategies for coping with life circumstances are dominant in them and, accordingly, which pedagogical approaches can be effective in improving their psychological well-being. The aim of the study was to analyze the hierarchy of coping strategies in orphaned adolescents and adolescents left without parental care in state-run institutions, as well as to study the variability of coping strategies depending on some socio-pedagogical factors. The research revealed such prevailing constructive strategies of coping with life difficulties as search for social support, positive reassessment, and acceptance of the problem among orphans. The dominant non-constructive strategies include the strategy of avoiding problem solving and the strategy of problem denial. The educators of the centers work to reduce confrontational coping and develop in orphans’ responsibility in difficult situations. The study was conducted to improve the resilience and psychological well-being of this socially vulnerable group of adolescents.

Acupuncture as A Potential Therapeutic Approach for Tourette Syndrome: Modulation of Neurotransmitter Levels and Gut Microbiota

2025-06-24

Bingxin Wu , Jinhua Ma , Xichang Huang +6 more | Chinese Journal of Integrative Medicine

A Tourette Syndrome/ADHD-like Phenotype Results from Postnatal Disruption of CB1 and CB2 Receptor Signalling

2025-06-24

Victoria Gorberg , Tamar Harpaz , Emilya Natali Shamir +6 more | International Journal of Molecular Sciences

Cannabinoid receptor 1 (CB1) signalling is critical for weight gain and for milk intake in newborn pups. This is important as in humans, low birth weight increases the risk for … Cannabinoid receptor 1 (CB1) signalling is critical for weight gain and for milk intake in newborn pups. This is important as in humans, low birth weight increases the risk for attention-deficit hyperactivity disorder (ADHD). Moreover, some children with ADHD also have Tourette syndrome (TS). However, it remains unclear if insufficient CB1 receptor signalling may promote ADHD/TS-like behaviours. Here, ADHD/TS-like behaviours were studied from postnatal to adulthood by exposing postnatal wild-type CB1 and Cannabinoid receptor 2 (CB2) knockout mouse pups to SR141716A (rimonabant), a CB1 receptor antagonist/inverse agonist. Postnatal disruption of the cannabinoid system by SR141716A induced vocal-like tics and learning deficits in male mice, accompanied by excessive vocalisation, hyperactivity, motor-like tics and/or high-risk behaviour in adults. In CB1 knockouts, rearing and risky behaviours increased in females. In CB2 knockouts, vocal-like tics did not develop, and males were hyperactive with learning deficits. Importantly, females were hyperactive but showed no vocal-like tics. The appearance of vocal-like tics depends on disrupted CB1 receptor signalling and on functional CB2 receptors after birth. Inhibition of CB1 receptor signalling together with CB2 receptor stimulation underlie ADHD/TS-like behaviours in males. This study suggests that the ADHD/TS phenotype may be a single clinical entity resulting from incorrect cannabinoid signalling after birth.

Personalized non-invasive neuromodulation for sensory-based urge suppression in individuals with OCD: a proof-of-concept investigation

2025-06-24

Goi Khia Eng , Arielle Tambini , Molly S. Hermiller +5 more | Frontiers in Human Neuroscience

Obsessive-compulsive disorder (OCD) is chronic and impairing. While OCD often involves fear of harm or bad events, many patients experience “sensory phenomena,” which are aversive sensory experiences that drive repetitive … Obsessive-compulsive disorder (OCD) is chronic and impairing. While OCD often involves fear of harm or bad events, many patients experience “sensory phenomena,” which are aversive sensory experiences that drive repetitive behaviors regardless of specific fears. Standard treatments do not effectively address sensory phenomena, and novel approaches are needed. Transcranial magnetic stimulation (TMS) is a safe and non-invasive neuromodulation technique increasingly used in psychiatric disorders, including OCD. This work presents a data-driven approach to identifying TMS brain targets for modulating sensory urges in OCD incorporating both behavioral and clinical criteria (Study 1) for a proof-of-concept investigation (Study 2). Study 1 included 69 individuals with OCD and 23 controls who completed an urges-for-action fMRI task involving instructed eyeblink suppression as an experimental model for sensory-based urges. Data-driven conjunction analysis revealed several brain regions, including the right postcentral gyrus, that were associated with more blink suppression failure (behavioral), more severe sensory phenomena (clinical), and were hyperactivated in OCD patients compared to controls. Study 2 administered single-session inhibitory TMS on 4 returning OCD patients using individualized targets within the postcentral gyrus identified from Study 1. Compared to sham, inhibitory TMS delivered to individualized postcentral gyrus targets resulted in fewer blink suppression failures, reduced activation in the target (postcentral gyrus) and key urge-related areas (insula, mid-cingulate), and greater reduction in self-reported urge to engage in OCD-related compulsions, with medium to large effect sizes. These findings demonstrate the potential of utilizing data-driven approaches incorporating behavioral and clinical criteria to target hard-to-treat sensory phenomena in OCD.

Overlapping Spectrum of Impulsivity and Compulsivity Across Psychiatric Disorders: A Narrative Review on Dimensional Perspectives

2025-06-23

Ali Kandeğer | Eurasian Journal of Medicine

Abstract: Impulsivity and compulsivity are complex constructs that underpin a wide range of psychiatric disorders. While traditionally viewed as opposing dimensions, emerging evidence suggests they exist on an overlapping spectrum, … Abstract: Impulsivity and compulsivity are complex constructs that underpin a wide range of psychiatric disorders. While traditionally viewed as opposing dimensions, emerging evidence suggests they exist on an overlapping spectrum, influencing diagnosis and treatment. Impulsivity is characterized by poorly planned, premature responses aimed at achieving gratification, while compulsivity involves repetitive behaviors driven by anxiety relief. Both constructs share common neurobiological substrates, such as impaired response inhibition and urgency, but differ in their executive dysfunction patterns. Psychiatric disorders traditionally associated with impulsivity (e.g., attention-deficit hyperactivity disorder, bipolar disorder) and those aligned with compulsivity (e.g., obsessive-compulsive disorder, anorexia nervosa) often exhibit overlapping symptoms. Additionally, the same disorder may present varying levels of impulsivity and compulsivity across individuals and time points. The impulsivity-compulsivity spectrum offers a dimensional framework for understanding psychiatric disorders, emphasizing the need for individualized clinical approaches. This review aims to highlight the shared and distinct features, as well as the neurobiological pathways, associated with this spectrum, while underscoring the need for future research to refine dimensional models that enhance diagnostic accuracy and guide personalized interventions. Cite this article as: Kandeğer A. Overlapping spectrum of impulsivity and compulsivity across psychiatric disorders: A narrative review on dimensional perspectives. Eurasian J Med. 2025, 57(2), 0749, doi: 10.5152/ eurasianjmed.2025.24749.

Remission of obsessive-compulsive disorder using ketogenic metabolic therapy in support of exposure and response prevention: a retrospective case report

2025-06-20

Nicole Laurent , Katherine A. Tague | Frontiers in Psychiatry

Background Obsessive-compulsive disorder (OCD) is a chronic and disabling condition that frequently resists standard interventions, including SSRIs and Exposure and Response Prevention (ERP). This case study explores the adjunctive use … Background Obsessive-compulsive disorder (OCD) is a chronic and disabling condition that frequently resists standard interventions, including SSRIs and Exposure and Response Prevention (ERP). This case study explores the adjunctive use of ketogenic metabolic therapy (KMT) in conjunction with ERP for a 26-year-old man with treatment-resistant OCD characterized by the symmetry/ordering symptom dimension. The patient achieved remission of OCD symptoms and sustained improvements in mood, emotional regulation, and quality of life. Methods A 26-year-old male with treatment-resistant OCD self-treated with a modified ketogenic diet and psychotherapy assisted ERP over 12 weeks. The diet featured a 1.5:1 macronutrient ratio (fat:protein+carbohydrates), self-monitored for nutritional ketosis (ketone levels ≥0.8 mmol/L), and included daily symptom tracking. ERP targeted symmetry/ordering-related compulsions. Symptom severity was assessed using the Dimensional Obsessive-Compulsive Scale (DOCS) and the Depression Anxiety Stress Scales (DASS-21). Long-term outcomes were evaluated over a 95-week follow-up. Results Within three weeks of initiating KMT and subsequent ERP, daily compulsive behaviors decreased from 3–8 hours to less than one hour. Significant reductions in DOCS symmetry/ordering subscale scores were sustained at 95 weeks. Concurrent improvements were observed in emotional distress, measured by DASS-21, with all subscale scores normalizing by week 7. Qualitative feedback highlighted enhanced emotional regulation, sleep quality, and ERP engagement, attributed to the ketogenic diet. Conclusion This case demonstrates rapid and sustained remission of OCD symptoms with the use of KMT and ERP. The findings suggest that KMT may provide a metabolic foundation that enhances the efficacy of ERP. Further research is warranted to explore the potential role of KMT in treatment-resistant OCD.

Tourette syndrome research highlights from 2024

2025-06-19

Andreas Hartmann , Per E. Andrén , Cyril Atkinson‐Clement +7 more | F1000Research

<ns3:p>We summarize research reports from 2024 relevant to Tourette syndrome, which the authors consider the most important or interesting. This working draft aims to submit this content for publication around … <ns3:p>We summarize research reports from 2024 relevant to Tourette syndrome, which the authors consider the most important or interesting. This working draft aims to submit this content for publication around the beginning of 2025 in the yearly Tourette Syndrome Research Highlights series on F1000Research. The authors welcome article suggestions and thoughtful feedback from readers, who can add a comment by clicking on the rectangular comment box icon to the left of the LOG IN link at the top of this page. For private comments, you can reach us by email ([email protected] or [email protected]).</ns3:p>

Challenging current diagnostic and classification criteria for primary tic disorders

2025-06-18

Christelle Nilles , Davide Martino , Julian Fletcher +2 more | European Child & Adolescent Psychiatry

Development and validation of a machine learning model to predict cognitive behavioral therapy outcome in obsessive-compulsive disorder using clinical and neuroimaging data

2025-06-18

Laurens A. van de Mortel , Willem B. Bruin , Pino Alonso +7 more | Journal of Affective Disorders

Autoimmune neuropsychiatric sequelae of group A streptococcal infections in Aboriginal and Torres Strait Islander people: an overlooked burden?

2025-06-17

Sarangan Ketheesan , Vicki Wade , Te‐Yu Hung +1 more | Australasian Psychiatry

Objective We highlight two autoimmune neuropsychiatric sequelae of group A streptococcal (GAS) infection that may cause disproportionate levels of psychiatric morbidity in Aboriginal and Torres Strait Islander people: Sydenham’s Chorea … Objective We highlight two autoimmune neuropsychiatric sequelae of group A streptococcal (GAS) infection that may cause disproportionate levels of psychiatric morbidity in Aboriginal and Torres Strait Islander people: Sydenham’s Chorea (SC) and Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS). GAS infections, along with better characterised immune-mediated sequelae such as acute rheumatic fever and rheumatic heart disease, are highly prevalent in Aboriginal and Torres Strait Islander people, particularly in rural and remote communities, yet there is minimal information in the literature about the neuropsychiatric sequelae that might be expected. We suspect that there is an under-recognised burden of disease in these groups and seek to understand reasons for this. Conclusions A multi-faceted, culturally attuned approach to better characterising and detecting the burden of these two conditions in Aboriginal and Torres Strait Islander people is required. Furthermore, larger scale clinical trials examining the efficacy of proposed treatments for SC and PANDAS are required to inform clinical guidelines.

Washing obsessive-compulsive symptoms as adaptation—insights from a 3-year longitudinal cohort during the COVID-19 pandemic

2025-06-17

Ana Daniela Costa , Catarina Raposo-Lima , Beatriz Couto +6 more | Frontiers in Psychology

Introduction Stressful events are one cause for the emergence and/or worsening of obsessive-compulsive symptoms. The public health measures employed to prevent the contraction of the COVID-19 virus overlap with common … Introduction Stressful events are one cause for the emergence and/or worsening of obsessive-compulsive symptoms. The public health measures employed to prevent the contraction of the COVID-19 virus overlap with common behaviors adopted by people diagnosed with obsessive-compulsive disorder. Thus, we decided to study the longitudinal impact of the pandemic in the general Portuguese population assessed with the Obsessive-Compulsive Inventory (OCI-R), and the Depressive, Anxiety, and Stress Scale (DASS-21). Methods One hundred and eighty-nine participants reported their scores at three different time-points of the pandemic in Portugal: March of 2020, March of 2021, and March of 2022. Non-parametric repeated measures analyses were performed on the OCI-R and DASS-21 scores to analyze differences in the levels of symptomatology throughout time. Results We found statistically significant differences with time in the OCI-R total and washing subscale scores, as well as in the anxiety subscale of DASS-21 score. For OCI-R total, we found significantly higher scores in 2020 compared to 2021 and 2022, and for the washing subscale we found statistically significant decreases with time. In terms of anxiety scores, we found significantly lower symptoms in 2021 compared to the others. Conclusion The reliance on the washing-like behaviors to contain the pandemic spreading explains its augmented scores in the acute phases of the pandemic and thus the continuous decrease of symptomatology with time. For anxiety, both the beginning and the end of the pandemic seem to have posed a threat, leading to an increase in worry and hypervigilance. In general, our results demonstrate the adaptative nature of humans and the instrumental role of psychological distress to cope with the world around us.

Looking Within: Visual Imagery Perspective Shifts Reliance on Internal States Versus Proxies

2025-06-17

Zachary Adolph Niese , Reuven Dar | Cognitive Therapy and Research

Clinical characteristics of tic disorders in children and adolescents with the chief complaint of abnormal blinking

2025-06-16

Na Tang , Yunjiao Wang , Xiaohan Jiang +4 more | Frontiers in Psychiatry

Abnormal blinking is a common symptom shared by allergic conjunctivitis (AC), dry eye disease (DED), and tic disorders (TD). This study explored clinical manifestations of TD in patients with the … Abnormal blinking is a common symptom shared by allergic conjunctivitis (AC), dry eye disease (DED), and tic disorders (TD). This study explored clinical manifestations of TD in patients with the chief complaint of abnormal blinking; its goal was to reduce misdiagnosis and missed diagnosis. In total, 1054 patients with the chief complaint of abnormal blinking completed a questionnaire and underwent comprehensive ophthalmic examinations and mental health assessments. Questionnaire data were compiled for patients with a confirmed diagnosis of TD; their clinical characteristics were analyzed. Of the 1054 patients presenting with abnormal blinking, 453 (42.98%) were diagnosed with a TD. Among these 453 patients, 253 (55.63%) had provisional tic disorder (PTD). 121 (26.71%) patients initially were misdiagnosed (primarily with AC) or experienced a missed diagnosis; Patients with PTD were more likely to seek ophthalmologic care, whereas those with CTD or TS were more likely to visit a paediatrician (P<0.001). The predominant eye tics were excessive and/or frequent blinking; 438 (96.69%) patients exhibited tics other than eye tics. Among the TD patients, 371 (81.90%) reported ocular symptoms, whereas 336 (74.17%) had comorbid eye diseases including AC and DED. PTD patients with AC had higher incidences of allergic rhinitis and asthma compared with patients displaying CTD and TS (P<0.05). TD are major causes of abnormal blinking, and PTD is the most common subtype. TD patients with abnormal blinking often have comorbid eye diseases, primarily AC and DED.

Modulação de circuitos neurais no Transtorno Obsessivo-Compulsivo: uma análise integrativa de estratégias terapêuticas

2025-06-16

Maria Alice Nunes Costa , Maria Clea Marinho Lima , Monica Montemor Bertazo +7 more | Caderno Pedagógico

O Transtorno Obsessivo-Compulsivo (TOC) é um transtorno neuropsiquiátrico crônico e incapacitante, caracterizado por obsessões, compulsões e fenômenos sensoriais, que afeta aproximadamente 2% da população mundial. Embora tratamentos convencionais como a … O Transtorno Obsessivo-Compulsivo (TOC) é um transtorno neuropsiquiátrico crônico e incapacitante, caracterizado por obsessões, compulsões e fenômenos sensoriais, que afeta aproximadamente 2% da população mundial. Embora tratamentos convencionais como a terapia cognitivo-comportamental (TCC) e os inibidores seletivos da recaptação de serotonina (ISRSs) sejam amplamente utilizados e eficazes, uma parcela considerável dos pacientes permanece refratária, exigindo abordagens terapêuticas alternativas. Este estudo teve como objetivo realizar uma análise integrativa das evidências disponíveis sobre técnicas de neuromodulação voltadas ao tratamento do TOC, com ênfase em métodos não invasivos, como a estimulação magnética transcraniana (EMT), estimulação transcraniana por corrente contínua (ETCC) e eletroconvulsoterapia (ECT). A metodologia adotada consistiu em uma revisão integrativa da literatura com abordagem qualitativa e delineamento exploratório, baseada em artigos indexados nas bases PubMed, Scopus, Web of Science, PsycINFO e SciELO, publicados até março de 2025. A análise temática dos estudos selecionados evidenciou que essas técnicas podem modular circuitos cortico-estriado-talâmicos disfuncionais, contribuindo para a melhora de sintomas obsessivo-compulsivos, especialmente em casos graves e refratários. Além disso, observou-se que a personalização dos alvos de estimulação com base em características clínicas e neurobiológicas pode otimizar a resposta terapêutica. Apesar dos avanços, os estudos ainda carecem de padronização metodológica, maior número de ensaios clínicos randomizados e avaliação da eficácia em longo prazo. Conclui-se que as estratégias de neuromodulação representam um campo promissor e em expansão no tratamento do TOC, reforçando a necessidade de investigações adicionais para sua consolidação clínica.

Artificial Intelligence in Obsessive-Compulsive Disorder: A Systematic Review

2025-06-14

Jiyeong Kim , Juan S. Lezama-Pacheco , Ashleigh Golden +7 more | Current Treatment Options in Psychiatry

Abstract Purpose of Review Obsessive-compulsive disorder (OCD) is a chronic and disabling condition, often leading to significant functional impairments. Despite its early onset, there is an average delay of 17 … Abstract Purpose of Review Obsessive-compulsive disorder (OCD) is a chronic and disabling condition, often leading to significant functional impairments. Despite its early onset, there is an average delay of 17 years from symptom onset to diagnosis and treatment, resulting in poorer outcomes. This systematic review aims to synthesize current findings on the application of AI in OCD, highlighting opportunities for early symptom detection, scalable therapy training, clinical decision support, novel therapeutics, computer vision-based approaches, and multimodal biomarker discovery. Recent Findings While previous reviews focused on biomarker-based OCD detection and treatment using machine learning (ML), the findings of the current review add information about novel applications of deep learning technology, specifically generative artificial intelligence (GenAI) and natural language processing (NLP). Among the included 13 articles, most studies (84.6%) utilized secondary data analyses, primarily through GenAI/NLP. Nearly 77% of these studies were published in the past two years, with high quality of evidence. The primary focus areas were enhancing treatment and management, and timely OCD detection (both 38.5%); followed by AI tool development for broader mental health applications. Summary AI technologies offer transformative potential for improvements related to OCD if diagnosis occurs earlier after onset; thereby lessening the consequential economic burden. Prioritizing investment in ethically sound AI research could significantly improve OCD outcomes in mental health care.

Efficacy and tolerability of vortioxetine monotherapy in SSRI-resistant OCD: a retrospective multicenter study

2025-06-13

Vassilis Martiadis , Enrico Pessina , C Cattaneo +7 more | Frontiers in Psychiatry

Introduction Treatment-resistant obsessive-compulsive disorder (OCD) remains a major clinical challenge, with a substantial proportion of patients failing to respond to standard treatment with selective serotonin reuptake inhibitors (SSRI). Vortioxetine, a … Introduction Treatment-resistant obsessive-compulsive disorder (OCD) remains a major clinical challenge, with a substantial proportion of patients failing to respond to standard treatment with selective serotonin reuptake inhibitors (SSRI). Vortioxetine, a multimodal antidepressant approved for major depressive disorder, has shown potential advantages in terms of tolerability and cognitive enhancement, but its efficacy in OCD has not been systematically explored. Methods This multicenter, retrospective, observational study analyzed the clinical records of 64 adult patients with a DSM-5 diagnosis of OCD who had failed to respond to at least one adequate SSRI trial and were treated with vortioxetine monotherapy (minimum dose: 20 mg/day; duration: ≥8 weeks). The primary outcome was reduction in total Y-BOCS score. Secondary outcomes included changes in HAM-D and HAM-A scores and frequency of adverse events. Results At week 8, 39.1% of patients met responder criteria (≥25% reduction in total Y-BOCS score). The mean Y-BOCS score decreased from 27.1 to 20.7 (p &lt; 0.001). HAM-D and HAM-A scores showed significant improvements (HAM-D: from 21.0 to 12.6; HAM-A: from 26.9 to 16.1; both p &lt; 0.001). The treatment was well tolerated, with nausea (29.7%) and sedation (18.8%) being the most common side effects; no serious adverse events occurred. Conclusion This study provides preliminary evidence of the efficacy and tolerability of vortioxetine monotherapy in SSRI-resistant OCD. The observed improvements in OCD, depressive and anxiety symptoms suggest that vortioxetine may represent a valuable therapeutic option. Further prospective controlled trials are needed to confirm these findings.

Altered resting-state amygdala-cerebellar functional connectivity is associated with intolerance of uncertainty in patients with obsessive-compulsive disorder: A longitudinal study

2025-06-13

Qihui Guo , Rongrong Zhu , Huixia Zhou +2 more | Journal of Anxiety Disorders

Hoarding disorder, therapeutic jurisprudence and residential tenancy law: A complex relationship and opportunities for reform

2025-06-13

Anthony Finkelstein , Marie Bismark , Rebecca Bentley +1 more | International Journal of Law and Psychiatry

Cognitive Behavioural Guided Therapy of Obsessive‑Compulsive Symptomatology in a Boy with Autism: Case Study

2025-06-13

Lenka Vacková | Listy klinické logopedie

Genomic Analysis of Trichotillomania

2025-06-13

Matthew Halvorsen , Melanie E. Garrett , Michael L. Cuccaro +2 more | American Journal of Medical Genetics Part B Neuropsychiatric Genetics

ABSTRACT Trichotillomania (TTM) is a psychiatric condition in which people feel an overwhelming urge to pull out their hair, resulting in noticeable hair loss and significant distress. Twin and family … ABSTRACT Trichotillomania (TTM) is a psychiatric condition in which people feel an overwhelming urge to pull out their hair, resulting in noticeable hair loss and significant distress. Twin and family studies suggest that TTM is at least partly genetic, but no genome‐wide analyses have been completed. To fill the gap in this field, we have conducted a case–control study of genotype array data from 101 European ancestry TTM cases and 488 ancestry‐matched unaffected controls. TTM cases were ascertained in the United States through web‐based recruitment, patient support groups, and conferences organized by the Trichotillomania Learning Center. Following clinical confirmation of a TTM diagnosis, patients completed self‐report assessments of frequency and duration of hair pulling, other psychiatric symptoms, and family history. Unaffected controls were also ascertained in the United States and were matched to cases by ancestry. In the first formal genome‐wide association study of TTM, we did not identify any common variants with a genome‐wide significant ( p < 5 × 10 −8 ) association level with case status. We found that cases carry a higher load of common polygenic risk for psychiatric disorders ( p = 0.008). We also detected copy number variants previously associated with neuropsychiatric disorders (specifically, deletions in NRXN1 , CSMD1, and 15q11.2). These results further support genetics' role in the etiology of TTM and suggest that larger studies are likely to identify risk variation and, ultimately, specific risk genes associated with the condition.

Efficacy of therapist-supported online remote behavioral therapy for tic disorders: a systematic review and meta-analysis

2025-06-13

Xiaolei Xu , Kathy Q. Zhu , Weiyi Wang +2 more | Frontiers in Psychiatry

Introduction Recently, several studies about therapist-supported online remote behavioral therapy (TSORBT) have been showed effective for tic disorders (TD). With the increasing adoption of telemedicine, a systematic review of existing … Introduction Recently, several studies about therapist-supported online remote behavioral therapy (TSORBT) have been showed effective for tic disorders (TD). With the increasing adoption of telemedicine, a systematic review of existing evidence is crucial to confirm the efficacy of TSORBT in treating TD. Aim We aim to assess the efficacy of TSORBT on the treatment of TD. Method This review followed PRISMA guidelines. We searched PubMed, Web of Science, Cochrane, and Embase up to September 2024 for clinical trials on TSORBT’s efficacy in TD. Two researchers independently screened studies, focusing on the Total Tic Severity Score of the Yale Global Tic Severity Scale (YGTSS-TTSS) and other subscores of the YGTSS-motor tic score (YGTSS-MTS), YGTSS-vocal tic score (YGTSS -VTS), YGTSS-impairment score and Parent Tic Questionnaire (PTQ). Risk of bias was assessed using Cochrane RoB 2. Data were analyzed in RevMan 5.4, with outcomes expressed as mean difference (MD) and 95% CI. Results In total, 2764 articles were identified for screening. Nine studies involving 1049 participants, with 527 assigned to the TSORBT and 522 to the control were included. TSORBT exhibited potential in addressing YGTSS-TTSS (MD = -2.22, 95% CI: [-3.16, -1.29], P &lt;0.00001), YGTSS-MTS (MD = -2.17, 95% CI: [-3.39, -0.96], P =0.0004), YGTSS-impairment score (MD= -1.69, 95% CI: [-3.26, -0.12], P =0.03) and PTQ score (MD= -6.05, 95% CI: [-8.65, -3.44], P &lt;0.00001);. Subgroup analyses revealed that TSORBT demonstrated nearly the same efficacy as face-to-face BT in addressing YGTSS-TTSS (MD = -0.38, 95% CI: [-3.20, 2.43], P =0.79), but more effective than online psychoeducation (MD = -2.37, 95% CI: [-3.64, -1.10], P = 0.0002). Conclusion The current study demonstrates the promising therapeutic efficacy of TSORBT in TD. Further rigorously designed studies, particularly those assessing long-term treatment durability, are warranted to consolidate the evidence base.

Deep learning in obsessive-compulsive disorder: a narrative review

2025-06-13

Brian A. Zaboski , Lora Bednarek , Karen Ayoub +1 more | Frontiers in Psychiatry

Obsessive-compulsive disorder (OCD) is a debilitating psychiatric condition characterized by intrusive thoughts and repetitive behaviors, with significant barriers to timely diagnosis and effective treatment. Deep learning, a subset of machine … Obsessive-compulsive disorder (OCD) is a debilitating psychiatric condition characterized by intrusive thoughts and repetitive behaviors, with significant barriers to timely diagnosis and effective treatment. Deep learning, a subset of machine learning, offers promising tools to address these challenges by leveraging large, complex datasets to identify OCD, classify symptoms, and predict treatment outcomes. This narrative review synthesizes findings from 10 studies that applied deep learning to OCD research. Results demonstrate high accuracy in diagnostic classification (80–98%) using neuroimaging, EEG, and clinical data, as well as promising applications in symptom classification and treatment response prediction. However, current models are limited by small sample sizes, lack of comparative treatment predictions, and minimal focus on early response detection or scalable monitoring solutions. Emerging opportunities include leveraging passively collected data, such as wearable sensors or electronic medical records, to enhance early detection and continuous symptom tracking. Future research should prioritize multimodal datasets, prospective study designs, and clinically implementable models to translate deep learning advancements into precision psychiatry for OCD.

A cognitive intervention for negative beliefs about losing control: impact on other cognitive domains and OCD symptoms

2025-06-12

Andrea Sandstrom , Adam S. Radomsky | Journal of Obsessive-Compulsive and Related Disorders

A narrative review of Phase III and IV clinical trials for the pharmacological treatment of Tourette’s syndrome in children, adults, and older adults

2025-06-06

Mohammed Alharthi | Medicine

Tourette syndrome (TS) is a neurodevelopmental disorder marked by involuntary movements and vocalizations (tics), often accompanied by cognitive and conduct challenges. Despite existing treatments, many remain ineffective, prompting increased focus … Tourette syndrome (TS) is a neurodevelopmental disorder marked by involuntary movements and vocalizations (tics), often accompanied by cognitive and conduct challenges. Despite existing treatments, many remain ineffective, prompting increased focus on Phase III and IV clinical trials for improved pharmacological options. These trials aim to refine symptom management and enhance the quality of life for individuals with TS. This review aims to identify the pharmacological treatments trialed in completed Phase III and IV clinical trials for managing TS in children, adults, and older adults. Phase III and IV clinical trials registered at ClinicalTrials.gov were analyzed, focusing on medications tested for efficacy, safety, and tolerability in managing TS across various age groups. As of February 2025, 15 relevant Phase III and IV trials were reviewed. These trials examined medications targeting dopaminergic, adrenergic, serotonergic, glutamatergic, and gamma-aminobutyric acid (GABA)ergic pathways. Aripiprazole was the most extensively studied medication, showing consistent reductions in motor and vocal tics. Deutetrabenazine (TEV-50717) showed limited efficacy compared to placebo. Other medications, including Clonidine, Guanfacine, Levetiracetam, Ondansetron, Topiramate, D-serine, and Riluzole, demonstrated varying levels of effectiveness, though some require further validation. Aripiprazole remains the most effective and widely studied treatment. Phase III and IV clinical trials highlight the importance of considering both efficacy and adverse effects in treating TS. Aripiprazole stands out as the most effective therapy, though further research is needed for other medications. Continued advancements in pharmacological interventions offer promise for improving the management of TS and enhancing the quality of life for affected individuals.