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Katz DE, Rector NA, Ornstein T, McKinnon M, McCabe RE, Hawley LL, Rowa K, Richter MA, Regev R, Laposa JM. Neurocognitive performance in the context of acute symptom reduction in OCD: Treatment effects and the impact of BDNF. J Affect Disord 2024; 362:679-687. [PMID: 39009317 DOI: 10.1016/j.jad.2024.07.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 06/13/2024] [Accepted: 07/12/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) has been associated with neurocognitive impairments. The present study examined the effect of treatment on neurocognitive performance in OCD and the relationship between neurocognitive change and symptom change. The present study also examined polymorphisms influencing brain derived neurotrophic factor (BDNF) as predictors of neurocognitive change. METHOD Treatment-seeking participants with OCD (N = 125) were assigned to cognitive behavioural therapy (CBT) alone, CBT combined with regular physical exercise, exercise alone, or a waitlist control group. Measures of OCD symptom severity and a neuropsychological battery were completed pre- and post-treatment. Blood or saliva samples were used to genotype the BDNF Val66Met polymorphism. RESULTS OCD symptom severity was not cross-sectionally associated with neurocognitive performance. Several neurocognitive measures improved over treatment. The BDNF Val66Met polymorphism was significantly associated with worse performance on the Stroop test but did not significantly predict change in neurocognitive performance over time. LIMITATIONS Limitations include lack of a healthy control group. CONCLUSION Improvement in neurocognitive performance corresponded to symptomatic improvement and was independent of the BDNF Val66Met genotype.
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Affiliation(s)
- Danielle E Katz
- Forest Hill Centre for Cognitive Behavioural Therapy, Toronto, Ontario, Canada
| | - Neil A Rector
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Department of Psychiatry, Toronto, Ontario, Canada; University of Toronto, Department of Psychiatry, Toronto, Ontario, Canada.
| | - Tish Ornstein
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Margaret McKinnon
- McMaster University, Department of Psychology and Behavioural Neurosciences, Hamilton, Ontario, Canada; Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Randi E McCabe
- McMaster University, Department of Psychology and Behavioural Neurosciences, Hamilton, Ontario, Canada; Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Lance L Hawley
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Department of Psychiatry, Toronto, Ontario, Canada; University of Toronto, Department of Psychiatry, Toronto, Ontario, Canada
| | - Karen Rowa
- McMaster University, Department of Psychology and Behavioural Neurosciences, Hamilton, Ontario, Canada; Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Margaret A Richter
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Department of Psychiatry, Toronto, Ontario, Canada; University of Toronto, Department of Psychiatry, Toronto, Ontario, Canada
| | - Rotem Regev
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Department of Psychiatry, Toronto, Ontario, Canada
| | - Judith M Laposa
- University of Toronto, Department of Psychiatry, Toronto, Ontario, Canada; Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto, Ontario, Canada
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Bednarek L, Glover S, Ma X, Pittenger C, Pushkarskaya H. Externally orienting cues improve cognitive control in OCD. J Behav Ther Exp Psychiatry 2024; 84:101959. [PMID: 38531125 PMCID: PMC11192454 DOI: 10.1016/j.jbtep.2024.101959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/31/2023] [Accepted: 03/01/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND AND OBJECTIVES An executive overload model of obsessive-compulsive disorder (OCD) posits that broad difficulties with executive functioning in OCD result from an overload on the executive system by obsessive thoughts. It implies that, if individuals with OCD "snap out" of their obsessive thoughts, their performance on neurocognitive tasks will improve. METHODS We test this prediction using the revised Attention Network Test, ANT-R, and distinct subsamples of data from unmedicated OCD and healthy controls (HC). ANT-R includes Simon and Flanker tasks; in both, incongruent trials take longer to resolve ('conflict costs'). On some trials, a warning cue helps participants to respond faster ('alerting benefits'). In OCD (N = 34) and HC (N = 46), matched on age, IQ, and sex, we tested (1) the effect of OCD on alerting benefits, and (2) the effect of OCD on warning cue related reductions in conflict costs. In a distinct subsample of OCD (N = 32) and HC (N = 51), we assessed whether alerting benefits and cue-related reductions in conflict costs are associated differently with different OCD symptoms. RESULTS A warning cue can help individuals with OCD more than HC to improve performance on Simon and Flanker tasks. This effect is positively associated with severity of contamination symptoms. LIMITATIONS This study did not directly assess how distracted participants are by obsessive thoughts. It relied on the ANT-R subtraction measures. Symptom severity was assessed using self-report measures. CONCLUSIONS Difficulties in resolving conflict during decision-making in OCD can be modulated by a warning cue presented immediately before an attentional task.
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Affiliation(s)
- Lora Bednarek
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Stephanie Glover
- PGSP-Stanford PsyD Consortium, Palo Alto University, Palo Alto, CA, United States
| | - Xiao Ma
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Christopher Pittenger
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States; Department of Psychology, Yale University, New Haven, CT, United States; Yale Child Study Center, Yale School of Medicine, New Haven, CT, United States; Wu Tsai Institute, Yale University, New Haven, CT, United States; Yale Center for Brain and Mind Health, Yale School of Medicine, New Haven, CT, United States
| | - Helen Pushkarskaya
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.
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Clarke AT, Fineberg NA, Pellegrini L, Laws KR. The relationship between cognitive phenotypes of compulsivity and impulsivity and clinical variables in obsessive-compulsive disorder: A systematic review and Meta-analysis. Compr Psychiatry 2024; 133:152491. [PMID: 38714143 DOI: 10.1016/j.comppsych.2024.152491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/23/2024] [Accepted: 03/04/2024] [Indexed: 05/09/2024] Open
Abstract
BACKGROUND This systematic review and meta-analysis explored the relationship between cognitive phenotypes of compulsivity and impulsivity and clinical variables in obsessive-compulsive disorder (OCD). METHODS We searched Pubmed, Scopus, Cochrane Library and PsychINFO databases until February 2023 for studies comparing patients with OCD and healthy controls on cognitive tests of compulsivity and impulsivity. The study followed PRISMA guidelines and was pre-registered on PROSPERO (CRD42021299017). RESULTS Meta-analyses of 112 studies involving 8313 participants (4289 patients with OCD and 4024 healthy controls) identified significant impairments in compulsivity (g = -0.58, [95%CI -0.68, -0.47]; k = 76) and impulsivity (g = -0.48, [95%CI -0.57, -0.38]; k = 63); no significant difference between impairments. Medication use and comorbid psychiatric disorders were not significantly related to impairments. No associations were revealed with OCD severity, depression/anxiety, or illness duration. CONCLUSION Cognitive phenotypes of compulsivity and impulsivity in patients with OCD appear to be orthogonal to clinical variables, including severity of OCD symptomatology. Their clinical impact is poorly understood and may require different clinical assessment tools and interventions.
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Affiliation(s)
- Aaron T Clarke
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.
| | - Naomi A Fineberg
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, UK; University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Luca Pellegrini
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, UK; Centre for Psychedelic Research, Imperial College London, London, UK
| | - Keith R Laws
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
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Abramovitch A, Herrera TA, Etherton JL. A neuropsychological study of misophonia. J Behav Ther Exp Psychiatry 2024; 82:101897. [PMID: 37657963 DOI: 10.1016/j.jbtep.2023.101897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/09/2023] [Accepted: 08/16/2023] [Indexed: 09/03/2023]
Abstract
BACKGROUND AND OBJECTIVES Misophonia is a recently identified condition characterized by negative emotional responsivity to certain types of sounds. Although progress has been made in understanding of neuronal, psychophysiological, and psychopathological mechanisms, important gaps in research remain, particularly insight into cognitive function. Accordingly, we conducted the first neuropsychological examination of misophonia, including clinical, diagnostic, and functional correlates. METHODS A misophonia group (n = 32) and a control group (n = 64) were screened for comorbidities using a formal semi-structured interview and completed a comprehensive neuropsychological battery and self-report measures of depression, anxiety, stress, impulsivity, and functional impairment. RESULTS The misophonia group significantly underperformed the control group on only 2 neuropsychological outcomes involving verbal memory retrieval. Subscales of the Misophonia Questionaaire (MQ) were inversely correlated only with measures of attention. The misophonia group reported significantly higher anxiety symptoms, behavioral impulsivity, and functional impairments, and had numerically higher rates of ADHD and OCD. LIMITATIONS To facilitate comparability, in lieu of a formal diagnostic algorithm for misophonia, we used a commonly used empirical definition for group allocation that has been utilized in numerous previous studies. CONCLUSIONS Misophonia was associated with a reduction in performance on a minority of cognitive tasks and a modest increase in some psychological symptoms and comorbid conditions. Correlational data suggest that difficulties with attention regulation and impulsivity may play a role in misophonia, albeit attention functions were intact. Results should be interpreted with caution given the variability in diagnostic definitions, and more research is needed to understand cognitive functioning under 'cold' conditions in misophonia.
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Affiliation(s)
| | - Tanya A Herrera
- Department of Psychology, Texas State University, San Marcos, TX, USA
| | - Joseph L Etherton
- Department of Psychology, Texas State University, San Marcos, TX, USA
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de Filippis R, Aguglia A, Costanza A, Benatti B, Placenti V, Vai E, Bruno E, De Berardis D, Dell’Osso B, Albert U, De Fazio P, Amore M, Serafini G, Ghaemi NS, Amerio A. Obsessive-Compulsive Disorder as an Epiphenomenon of Comorbid Bipolar Disorder? An Updated Systematic Review. J Clin Med 2024; 13:1230. [PMID: 38592113 PMCID: PMC10931838 DOI: 10.3390/jcm13051230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 02/06/2024] [Accepted: 02/13/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Bipolar disorder (BD) and obsessive-compulsive disorder (OCD) comorbidity is an emerging condition in psychiatry, with relevant nosological, clinical, and therapeutic implications. METHODS We updated our previous systematic review on epidemiology and standard diagnostic validators (including phenomenology, course of illness, heredity, biological markers, and treatment response) of BD-OCD. Relevant papers published until (and including) 15 October 2023 were identified by searching the electronic databases MEDLINE, Embase, PsychINFO, and Cochrane Library, according to the PRISMA statement (PROSPERO registration number, CRD42021267685). RESULTS We identified 38 new articles, which added to the previous 64 and raised the total to 102. The lifetime comorbidity prevalence ranged from 0.26 to 27.8% for BD and from 0.3 to 53.3% for OCD. The onset of the two disorders appears to be often overlapping, although the appearance of the primary disorder may influence the outcome. Compared to a single diagnosis, BD-OCD exhibited a distinct pattern of OC symptoms typically following an episodic course, occurring in up to 75% of cases (vs. 3%). Notably, these OC symptoms tended to worsen during depressive episodes (78%) and improve during manic or hypomanic episodes (64%). Similarly, a BD course appears to be chronic in individuals with BD-OCD in comparison to patients without. Additionally, individuals with BD-OCD comorbidity experienced more depressive episodes (mean of 8.9 ± 4.2) compared to those without comorbidity (mean of 4.1 ± 2.7). CONCLUSIONS We found a greater likelihood of antidepressant-induced manic/hypomanic episodes (60% vs. 4.1%), and mood stabilizers with antipsychotic add-ons emerging as a preferred treatment. In line with our previous work, BD-OCD comorbidity encompasses a condition of greater nosological and clinical complexity than individual disorders.
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Affiliation(s)
- Renato de Filippis
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), 1205 Geneva, Switzerland
- Department of Psychiatry, Faculty of Biomedical Sciences, University of Italian Switzerland (USI) Lugano, 6900 Lugano, Switzerland
| | - Beatrice Benatti
- Department of Biomedical and Clinical Sciences Luigi Sacco, Luigi Sacco Hospital, University of Milan, 20157 Milan, Italy
| | - Valeria Placenti
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Eleonora Vai
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Edoardo Bruno
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Domenico De Berardis
- NHS, Department of Mental Health, Psychiatric Service for Diagnosis and Treatment, Hospital “G. Mazzini”, 64100 Teramo, Italy
| | - Bernardo Dell’Osso
- Department of Biomedical and Clinical Sciences Luigi Sacco, Luigi Sacco Hospital, University of Milan, 20157 Milan, Italy
- “Aldo Ravelli” Center for Nanotechnology and Neurostimulation, University of Milan, 20122 Milan, Italy
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste and Department of Mental Health, Azienda Sanitaria Universitaria Giuliano Isontina—ASUGI, 34128 Trieste, Italy
| | - Pasquale De Fazio
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Nassir S. Ghaemi
- Department of Psychiatry, Tufts University School of Medicine, Boston, MA 02111, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
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Tumkaya S, Yücens B, Gündüz M, Maheu M, Berkovitch L. Disruption of consciousness depends on insight in OCD and on positive symptoms in schizophrenia. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.02.571832. [PMID: 38293050 PMCID: PMC10827121 DOI: 10.1101/2024.01.02.571832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Disruption of conscious access contributes to the advent of psychotic symptoms in schizophrenia but could also explain lack of insight in other psychiatric disorders. In this study, we explored how insight and psychotic symptoms related to disruption of consciousness. We explored consciousness in patients with schizophrenia, patients with obsessive-compulsive disorder (OCD) with good vs. poor insight and matched controls. Participants underwent clinical assessments and performed a visual masking task allowing us to measure individual consciousness threshold. We used a principal component analysis to reduce symptom dimensionality and explored how consciousness measures related to symptomatology. We found that clinical dimensions could be well summarized by a restricted set of principal components which also correlated with the extent of consciousness disruption. More specifically, positive symptoms were associated with impaired conscious access in patients with schizophrenia whereas the level of insight delineated two subtypes of OCD patients, those with poor insight who had consciousness impairments similar to patients with schizophrenia, and those with good insight who resemble healthy controls. Our study provides new insights about consciousness disruption in psychiatric disorders, showing that it relates to positive symptoms in schizophrenia and with insight in OCD. In OCD, it revealed a distinct subgroup sharing neuropathological features with schizophrenia. Our findings refine the mapping between symptoms and cognition, paving the way for a better treatment selection.
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Affiliation(s)
- Selim Tumkaya
- Department of Psychiatry, Pamukkale University School of Medicine, Denizli, Turkey
- Department of Neuroscience, Pamukkale University School of Medicine, Denizli, Turkey
| | - Bengü Yücens
- Department of Psychiatry, Pamukkale University School of Medicine, Denizli, Turkey
| | - Muhammet Gündüz
- Department of Psychiatry, Government Hospital of Bolvadin, Bolvadin, Turkey
| | - Maxime Maheu
- Department of Neurophysiology and Pathophysiology, Center for Experimental Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
- Department of Synaptic Physiology, Centre for Molecular Neurobiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Lucie Berkovitch
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
- University Department of Psychiatry, Pôle Hospitalo-Universitaire Psychiatrie Paris 15, Groupe Hospitalier Universitaire Paris, Paris, France
- Saclay CEA Centre, Neurospin, Gif-Sur-Yvette Cedex, France
- Paris Cité University, Paris, France
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Murayama K, Tomiyama H, Ohno A, Kato K, Matsuo A, Hasuzawa S, Sashikata K, Kang M, Nakao T. Decision-making deficits in obsessive-compulsive disorder are associated with abnormality of recency and response consistency parameter in prospect valence learning model. Front Psychiatry 2023; 14:1227057. [PMID: 37840793 PMCID: PMC10570432 DOI: 10.3389/fpsyt.2023.1227057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/07/2023] [Indexed: 10/17/2023] Open
Abstract
Background Patients with obsessive-compulsive disorder (OCD) have deficits in decision-making in the Iowa Gambling Task (IGT). However, no study has investigated the parameters of the prospect valence learning (PVL) model in the IGT for OCD. Aims This study aimed to investigate deficits in decision-making in OCD using the PVL model and identify whether the parameters of the PVL model were associated with obsessive-compulsive severity. Methods Forty-seven medication-free patients with OCD were compared with 47 healthy controls (HCs). Decision-making was measured using the total net and block net scores of the IGT. A PVL model with a decay-reinforcement learning rule (PVL-DecayRI) was used to investigate the parameters of the model. Correlation analysis was conducted between each parameter of the PVL-DecayRL and obsessive-compulsive symptoms. Results The total net score of patients with OCD was significantly lower than that of the HCs. The block net scores of the OCD group did not differ across the five blocks, whereas in the HCs, the fifth block net score was significantly higher than the block net scores of the first and second blocks. The values of the recency and response consistency parameters of the PVL-DecayRI in patients with OCD were significantly lower than those in HCs. The recency parameter positively correlated with the Y-BOCS obsessive score. Meanwhile, there was no correlation between consistency parameter values and symptom severity in OCD. Conclusion Our detailed analysis of the decision-making deficit in OCD suggests that the most recent outcome has a small influence on the expectancy of prospect valence, as indicated by the lower recency parameter, and is characterized by more impulsive choices, as indicated by the lower consistency parameter.
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Affiliation(s)
- Keitaro Murayama
- Department of Neuropsychiatry, Kyushu University Hospital, Fukuoka, Japan
| | - Hirofumi Tomiyama
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Aikana Ohno
- Integrated Center for Educational Research and Development, Faculty of Education, Saga University, Saga, Japan
- Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan
| | - Kenta Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akira Matsuo
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Suguru Hasuzawa
- Center for Health Sciences and Counseling, Kyushu University, Fukuoka, Japan
| | - Kenta Sashikata
- Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan
| | - Mingi Kang
- Graduate School of Human-Environment Studies, Kyushu University, Fukuoka, Japan
| | - Tomohiro Nakao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Nováková L, Anýž J, Forejtová Z, Rošíková T, Věchetová G, Sojka P, Růžička E, Serranová T. Increased Frequency of Self-Reported Obsessive-Compulsive Symptoms in Patients with Functional Movement Disorders. Mov Disord Clin Pract 2023; 10:1341-1348. [PMID: 37772279 PMCID: PMC10525059 DOI: 10.1002/mdc3.13812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 04/06/2023] [Accepted: 05/29/2023] [Indexed: 09/30/2023] Open
Abstract
Background Functional movement disorders (FMD) are associated with a high prevalence of psychiatric comorbidities. Objective To assess the frequency of obsessive-compulsive symptoms (OCS) in FMD. Methods A total of 167 consecutive patients with clinically definite FMD (mean age = 44.4 years, standard deviation [SD] = 12.0, 119 females) and 145 healthy controls (mean age = 43.2 years, SD = 11.8, 103 females) completed the Obsessive-Compulsive Inventory-Revised (OCI-R), which is a widely used tool for assessing OCS. The cutoff score ≥21 is indicative of clinically significant obsessive-compulsive disorder (OCD). Motor symptom severity was assessed using the Simplified FMD Rating Scale (S-FMDRS). All subjects completed questionnaires for depression, anxiety, pain, fatigue, cognitive complaints, health-related quality of life, and childhood trauma. Personality traits were assessed using the Big Five questionnaire. Results FMD patients had higher mean OCI-R score and higher proportion of individuals with OCI-R ≥ 21 42%, 95% confidence interval (CI) = (30.2, 54.6) versus 16%, 95% CI = (8.2, 28.2) in controls, P < 0.001. Patients had higher scores in three domains: checking, ordering, and obsessing (P < 0.001). FMD patients with OCI-R score ≥21 had higher depression, anxiety, cognitive complaints, and lower quality of life compared to those with score <21 (P < 0.001). No correlation between OCI-R and S-FMDRS scores was found. Conclusions FMD patients reported higher rates of OCS compared to controls, along with higher rates of non-motor symptoms and lower quality of life. This finding may have clinical implications and raises the possibility of shared risk factors and common pathophysiological mechanisms in FMD and OCD.
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Affiliation(s)
- Lucia Nováková
- Department of Neurology and Centre of Clinical NeuroscienceCharles University, 1st Faculty of Medicine and General University Hospital in PraguePragueCzech Republic
| | - Jiří Anýž
- Department of Cybernetics, Faculty of Electrical EngineeringCzech Technical University in PraguePragueCzech Republic
| | - Zuzana Forejtová
- Department of Neurology and Centre of Clinical NeuroscienceCharles University, 1st Faculty of Medicine and General University Hospital in PraguePragueCzech Republic
| | - Tereza Rošíková
- Department of Neurology and Centre of Clinical NeuroscienceCharles University, 1st Faculty of Medicine and General University Hospital in PraguePragueCzech Republic
| | - Gabriela Věchetová
- Department of Neurology and Centre of Clinical NeuroscienceCharles University, 1st Faculty of Medicine and General University Hospital in PraguePragueCzech Republic
| | - Petr Sojka
- Department of Neurology and Centre of Clinical NeuroscienceCharles University, 1st Faculty of Medicine and General University Hospital in PraguePragueCzech Republic
| | - Evžen Růžička
- Department of Neurology and Centre of Clinical NeuroscienceCharles University, 1st Faculty of Medicine and General University Hospital in PraguePragueCzech Republic
| | - Tereza Serranová
- Department of Neurology and Centre of Clinical NeuroscienceCharles University, 1st Faculty of Medicine and General University Hospital in PraguePragueCzech Republic
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Pan Y, Xu C, He T, Wei Z, Seger CA, Chen Q, Peng Z. A network perspective on cognitive function and obsessive-compulsive related symptoms. J Affect Disord 2023; 329:428-437. [PMID: 36863477 DOI: 10.1016/j.jad.2023.02.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/31/2022] [Accepted: 02/17/2023] [Indexed: 03/04/2023]
Abstract
BACKGROUND The relationship between cognitive function and psychopathological symptoms has been an important research field in recent years. Previous studies have typically applied case-control designs to explore differences in certain cognitive variables. Multivariate analyses are needed to deepen our understanding of the intercorrelations among cognitive and symptom phenotypes in OCD. METHODS The present study used network analysis to construct networks of cognitive variables and OCD-related symptoms in patients with OCD and healthy controls (N = 226), aiming to explore the relationship among numerous cognitive function variables and OCD-related symptoms in detail and compare the network features between the two groups. RESULTS In the network of cognitive function and OCD-related symptoms, nodes representing IQ, letter/number span test, accuracy of task switching test and obsession were much important in the network in terms of their larger strengths and edges. By constructing the networks of these two groups respectively, there was a strong similarity except that the symptom's network in healthy group had a higher degree of overall connectivity. LIMITATIONS Due to the small sample size, the stability of the network cannot be guaranteed. Due to the cross-sectional nature of the data, we were unable to determine how the cognitive-symptom network would change with disease deterioration or treatment. CONCLUSIONS The present study highlights the important role of variables such as obsession and IQ from a network perspective. These results deepen our understanding of the multivariate relationship between cognitive dysfunction and OCD symptoms, and may promote the prediction and diagnosis of OCD.
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Affiliation(s)
- Yimeng Pan
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, 510631 Guangzhou, China
| | - Chuanyong Xu
- Department of Child Psychiatry and Rehabilitation, Institute of Maternity and Child Medical Research, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, 518017 Shenzhen, China
| | - Tingxin He
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, 510631 Guangzhou, China
| | - Zhen Wei
- Department of Child Psychiatry and Rehabilitation, Institute of Maternity and Child Medical Research, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, 518017 Shenzhen, China
| | - Carol A Seger
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, 510631 Guangzhou, China
| | - Qi Chen
- School of Psychology, Shenzhen University, 518061 Shenzhen, China.
| | - Ziwen Peng
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, 510631 Guangzhou, China.
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10
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Alemany-Navarro M, Tubío-Fungueiriño M, Diz-de Almeida S, Cruz R, Lombroso A, Real E, Soria V, Bertolín S, Fernández-Prieto M, Alonso P, Menchón JM, Carracedo A, Segalàs C. The genomics of visuospatial neurocognition in obsessive-compulsive disorder: A preliminary GWAS. J Affect Disord 2023; 333:365-376. [PMID: 37094658 DOI: 10.1016/j.jad.2023.04.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/04/2023] [Accepted: 04/14/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND The study of Obsessive-Compulsive Disorder (OCD) genomics has primarily been tackled by Genome-wide association studies (GWAS), which have encountered troubles in identifying replicable single nucleotide polymorphisms (SNPs). Endophenotypes have emerged as a promising avenue of study in trying to elucidate the genomic bases of complex traits such as OCD. METHODS We analyzed the association of SNPs across the whole genome with the construction of visuospatial information and executive performance through four neurocognitive variables assessed by the Rey-Osterrieth Complex Figure Test (ROCFT) in a sample of 133 OCD probands. Analyses were performed at SNP- and gene-level. RESULTS No SNP reached genome-wide significance, although there was one SNP almost reaching significant association with copy organization (rs60360940; P = 9.98E-08). Suggestive signals were found for the four variables at both SNP- (P < 1E-05) and gene-levels (P < 1E-04). Most of the suggestive signals pointed to genes and genomic regions previously associated with neurological function and neuropsychological traits. LIMITATIONS Our main limitations were the sample size, which was limited to identify associated signals at a genome-wide level, and the composition of the sample, more representative of rather severe OCD cases than a population-based OCD sample with a broad severity spectrum. CONCLUSIONS Our results suggest that studying neurocognitive variables in GWAS would be more informative on the genetic basis of OCD than the classical case/control GWAS, facilitating the genetic characterization of OCD and its different clinical profiles, the development of individualized treatment approaches, and the improvement of prognosis and treatment response.
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Affiliation(s)
- M Alemany-Navarro
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; IBIS (Universidad de Sevilla, HUVR, Junta de Andalucia, CSIC) Sevilla, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain.
| | - M Tubío-Fungueiriño
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Genetics Group, GC05, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela, (USC), Spain
| | - S Diz-de Almeida
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - R Cruz
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela, (USC), Spain
| | - A Lombroso
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - E Real
- Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
| | - V Soria
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
| | - S Bertolín
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - M Fernández-Prieto
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Genetics Group, GC05, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela, (USC), Spain
| | - P Alonso
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
| | - J M Menchón
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
| | - A Carracedo
- Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela, (USC), Spain; Genetics Group, GC05, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain; Fundación Pública Galega de Medicina Xenómica, Servicio Galego de Saúde (SERGAS), Santiago de Compostela, Spain
| | - C Segalàs
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
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11
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Zou J, Yuan B, Hu M, Yuan X, Tang J, Chen J, Hu Z. A comparative study of cognitive functions between schizophrenia and obsessive-compulsive disorder. Heliyon 2023; 9:e14330. [PMID: 36938396 PMCID: PMC10015237 DOI: 10.1016/j.heliyon.2023.e14330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 02/23/2023] [Accepted: 02/28/2023] [Indexed: 03/07/2023] Open
Abstract
Background Schizophrenia (SZ) and obsessive-compulsive disorder (OCD) are closely linked, have a high comorbidity rate, and their differential diagnosis is challenging in clinic. Some studies have found common cognitive deficits in some domains between them. The goal of this research was to compare the cognitive functions of SZ and OCD in order to offer a clinical foundation for differential diagnosis and treatment of the two disorders. Methods A control design was used in this study, which comprised 61 patients with SZ, 60 individuals with OCD, and 51 healthy controls (HC). We assessed patients' cognitive functions by testing six domains, including visual learning, reasoning and problem solving, verbal learning, attention/vigilance, speed of processing and working memory. Results The results showed that patients with SZ had cognitive impairments in all areas except attention/vigilance, while patients with OCD only had cognitive impairment in reasoning and problem-solving. Overall, patients with SZ did not perform as well as patients with OCD in all domains. Conclusions In terms of neurocognition, both of SZ and OCD patients have defects in reasoning and problem solving. In addition to this, SZ patients also performed worse than HC in other areas such as speed of processing, working memory, verbal learning and visual learning. On the overall level, cognitive performance is better in OCD patients than in SZ patients. The field of reasoning and problem solving can be used as a new goal to study the relationship and treatment strategies between them in the future.
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Affiliation(s)
- Jingzhi Zou
- First School of Clinical Medicine, Nanchang University, Nanchang, Jiangxi Province, 330031, China
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, 330006, China
| | - Bin Yuan
- Department of Child and Adolescent Psychology, The Third Hospital of Fuzhou, Jiangxi Province, 344121, China
| | - Maorong Hu
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, 330006, China
- Corresponding author.
| | - Xin Yuan
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, 330006, China
| | - Jun Tang
- Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen, 361001, China
| | - Jinyuan Chen
- Maternal and Child Health Care Hospital, Guangming District, Shenzhen, 518107, China
| | - Zhizhong Hu
- Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, 330006, China
- School of Public Administration, Nanchang University, Nanchang, Jiangxi Province, 330031, China
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12
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Fornaro S, Vallesi A. Functional connectivity abnormalities of brain networks in obsessive–compulsive disorder: a systematic review. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04312-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Abstract
Obsessive-compulsive disorder (OCD) is characterized by cognitive abnormalities encompassing several executive processes. Neuroimaging studies highlight functional abnormalities of executive fronto-parietal network (FPN) and default-mode network (DMN) in OCD patients, as well as of the prefrontal cortex (PFC) more specifically. We aim at assessing the presence of functional connectivity (FC) abnormalities of intrinsic brain networks and PFC in OCD, possibly underlying specific computational impairments and clinical manifestations. A systematic review of resting-state fMRI studies investigating FC was conducted in unmedicated OCD patients by querying three scientific databases (PubMed, Scopus, PsycInfo) up to July 2022 (search terms: “obsessive–compulsive disorder” AND “resting state” AND “fMRI” AND “function* *connect*” AND “task-positive” OR “executive” OR “central executive” OR “executive control” OR “executive-control” OR “cognitive control” OR “attenti*” OR “dorsal attention” OR “ventral attention” OR “frontoparietal” OR “fronto-parietal” OR “default mode” AND “network*” OR “system*”). Collectively, 20 studies were included. A predominantly reduced FC of DMN – often related to increased symptom severity – emerged. Additionally, intra-network FC of FPN was predominantly increased and often positively related to clinical scores. Concerning PFC, a predominant hyper-connectivity of right-sided prefrontal links emerged. Finally, FC of lateral prefrontal areas correlated with specific symptom dimensions. Several sources of heterogeneity in methodology might have affected results in unpredictable ways and were discussed. Such findings might represent endophenotypes of OCD manifestations, possibly reflecting computational impairments and difficulties in engaging in self-referential processes or in disengaging from cognitive control and monitoring processes.
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13
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Executive functioning in body dysmorphic disorder and obsessive-compulsive disorder. CNS Spectr 2023; 28:33-40. [PMID: 34313212 DOI: 10.1017/s1092852921000705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess executive functions (EFs) in patients with body dysmorphic disorder (BDD) and obsessive-compulsive disorder (OCD) compared with healthy controls. METHODS Adults diagnosed with BDD (n = 26) or OCD (n = 29) according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and healthy controls (n = 28) underwent validated and computerized neuropsychological tests, spatial working memory (SWM), intra-extra-dimensional set shifting (IED), and stop signal task (SST), from the Cambridge Neuropsychological Test Automated Battery (CANTAB). Test performance was compared between groups, and correlated with standardized symptom severity of BDD and OCD. Significance level was set to P < .05. RESULTS There were no statistically significant between-group differences on key outcome measures in SWM, IED, or SST. There was a weak positive correlation between symptom severity and test errors on SWM and IED in both OCD and BDD groups; increased clinical severity was associated with more errors in these tests. Furthermore, there was a negative correlation between symptom severity and SST in the BDD group. CONCLUSIONS Patients with BDD or OCD did not differ from healthy control subjects in terms of test performance; however, there were several statistically significant correlations between symptom severity and performance in those with BDD or OCD. More studies on EFs in BDD and OCD are required to elucidate if there are differences in EFs between these two disorders.
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14
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Pampaloni I, Marriott S, Pessina E, Fisher C, Govender A, Mohamed H, Chandler A, Tyagi H, Morris L, Pallanti S. The global assessment of OCD. Compr Psychiatry 2022; 118:152342. [PMID: 36007341 DOI: 10.1016/j.comppsych.2022.152342] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 06/24/2022] [Accepted: 08/02/2022] [Indexed: 11/03/2022] Open
Abstract
Obsessive Compulsive Disorder (OCD) is a common mental disorder that often causes great sufferance, with substantial impairment in social functioning and quality of life and affects family and significant relationships. Notwithstanding its severity, OCD is often not adequately diagnosed, or it is diagnosed with delay, leading often to a long latency between onset of the OCD symptoms and the start of adequate treatments. Several factors contribute to the complexity of OCD's clinical picture: early age of onset, chronic course, heterogeneity of symptoms, high rate of comorbidity with other psychiatric disorders, slow or partial response to therapy. Therefore, it is of primary importance for clinicians involved in diagnosing OCD, to assess all aspects of the disorder. This narrative review focuses on the global assessment of OCD, highlighting crucial areas to explore, pointing out the clinical features which are relevant for the treatment of the disorder, and giving an overview of the psychometric tools that can be useful during the screening procedure.
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Affiliation(s)
- Ilenia Pampaloni
- South West London and St Georges Mental Health Trust, London, UK.
| | - Sabina Marriott
- South West London and St Georges Mental Health Trust, London, UK
| | | | - Claire Fisher
- South West London and St Georges Mental Health Trust, London, UK
| | - Anusha Govender
- South West London and St Georges Mental Health Trust, London, UK
| | - Heba Mohamed
- South West London and St Georges Mental Health Trust, London, UK
| | - Augusta Chandler
- South West London and St Georges Mental Health Trust, London, UK
| | - Himanshu Tyagi
- University College London Hospital NHS foundation Trust, London, UK
| | - Lucy Morris
- South West London and St Georges Mental Health Trust, London, UK
| | - Stefano Pallanti
- Albert Einstein Institute, New York, USA; Istututo di Neuroscienze, Firenze, Italy
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15
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Similarities and differences in working memory and neurometabolism of obsessive-compulsive disorder and major depressive disorder. J Affect Disord 2022; 311:556-564. [PMID: 35588910 DOI: 10.1016/j.jad.2022.05.069] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/07/2022] [Accepted: 05/13/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) and major depressive disorder (MDD) both showed cognitive impairment, and the altered neurometabolic may associate with cognitive impairment. However, there are limited comparative working memory (WM) and neuroimaging studies on these two disorders. Therefore, we investigated the characteristics of WM and neurometabolic changes in patients with OCD and MDD. METHODS A total of 64 unmedicated patients (32 OCD and 32 MDD), and 33 healthy controls (HC) were included to conduct WM assessment comprising Digit Span Test (DST), 2-back task and Stroop Color and Word Test (SCWT). Additionally, all subjects underwent protons magnetic resonance spectroscopy (1H-MRS) to collect neurometabolic ratios of N-acetyl aspartate (NAA) and choline-containing compounds (Cho) to creatine (Cr) in the prefrontal cortex (PFC) and lentiform nucleus (LN). Finally, differential and correlation analysis were conducted to investigate their characteristics and relationships. RESULTS Compared with HC, both OCD and MDD patients exhibited a lower accuracy rate in the 2-back task, and only MDD patients performed worse in DST scores and longer reaction times in SCWT (all p < 0.05). Both OCD and MDD patients had lower NAA/Cr ratios in bilateral PFC (all p < 0.05). And the decreased NAA/Cr ratios in right PFC were positively correlated to DST scores in MDD group (r = 0.518, p = 0.003). CONCLUSIONS Both OCD and MDD showed WM impairment and neurometabolic alterations in PFC. Besides, MDD performed more severe and broader WM impairment compared to OCD. Moreover, the dysfunction of PFC may underlie the neural basis of WM impairment in MDD.
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Spontaneous alternation and stereotypical behaviour in deer mice: response to escitalopram and levetiracetam. Behav Pharmacol 2022; 33:282-290. [PMID: 35621170 DOI: 10.1097/fbp.0000000000000678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Obsessive-compulsive disorder is varyingly associated with cognitive impairment, that is, deficits in spatial working memory, although it seems unlikely that this is generalised across all domains of functioning. Further, it is unclear whether symptoms will respond to potentially novel, non-serotonergic drugs that have shown promise as so-called cognitive enhancers. Here, we studied low (Norm-N; n = 31) and compulsive-like high (Comp-H; n = 34) stereotypical deer mice (Peromyscus maniculatus bairdii) to establish (1) whether there is a relationship between stereotypical intensity and working memory ability as measured by spontaneous T-maze arm alternation and (2) if and how stereotypy and its association with changes in working memory, would respond to the known anti-compulsive agent, escitalopram, and the proposed cognitive enhancer, levetiracetam. After assessing the stereotypical and alternation behaviour of all animals at baseline, they were divided into three socially housed drug exposure groups, that is, water control (n = 11 per phenotype), escitalopram 50 mg/kg/d (n = 11 per phenotype) and levetiracetam 75 mg/kg/d (Norm-N: n = 9; Comp-H: n = 12). Drugs were administered for 28 days before stereotypy and alternation assessment were repeated. The present data indicate a weak negative relationship between stereotypical intensity and spontaneous alternation. While levetiracetam increased the time spent engaging in normal rodent activity by Comp-H, but not Norm-N animals, neither of the interventions affected the expression of Comp-H behaviour or the alternation behaviour of deer mice. In conclusion, this work points to some degree of cognitive involvement in Comp-H expression, which should be explored to further our understanding of compulsive-like stereotypy.
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17
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Colzato LS, Hommel B, Zhang W, Roessner V, Beste C. The metacontrol hypothesis as diagnostic framework of OCD and ADHD: A dimensional approach based on shared neurobiological vulnerability. Neurosci Biobehav Rev 2022; 137:104677. [PMID: 35461986 DOI: 10.1016/j.neubiorev.2022.104677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 04/11/2022] [Accepted: 04/19/2022] [Indexed: 11/15/2022]
Abstract
Obsessive-compulsive disorder (OCD) and attention-deficit hyperactivity disorder (ADHD) are multi-faceted neuropsychiatric conditions that in many aspects appear to be each other's antipodes. We suggest a dimensional approach, according to which these partially opposing disorders fall onto a continuum that reflects variability regarding alterations of cortico-striato-thalamo-cortical (CSTC) circuits and of the processing of neural noise during cognition. By using theoretical accounts of human cognitive metacontrol, we develop a framework according to which OCD can be characterized by a chronic bias towards exaggerated cognitive persistence, equivalent to a high signal-to-noise ratio (SNR)-which facilitates perseverative behaviour but impairs mental flexibility. In contrast, ADHD is characterized by a chronic bias towards inflated cognitive flexibility, equivalent to a low SNR-which increases behavioural variability but impairs the focusing on one goal and on relevant information. We argue that, when pharmacology is not feasible, novel treatments of these disorders may involve methods to manipulate the signal-to-noise ratio via non-invasive brain stimulation techniques, in order to normalize the situational imbalance between cognitive persistence and cognitive flexibility.
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Affiliation(s)
- Lorenza S Colzato
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany; University Neuropsychology Center, Faculty of Medicine, TU Dresden, Germany; Cognitive Psychology, Faculty of Psychology, Shandong Normal University, Jinan, China
| | - Bernhard Hommel
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany; University Neuropsychology Center, Faculty of Medicine, TU Dresden, Germany; Cognitive Psychology, Faculty of Psychology, Shandong Normal University, Jinan, China
| | - Wenxin Zhang
- Cognitive Psychology, Faculty of Psychology, Shandong Normal University, Jinan, China
| | - Veit Roessner
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany.
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany; University Neuropsychology Center, Faculty of Medicine, TU Dresden, Germany; Cognitive Psychology, Faculty of Psychology, Shandong Normal University, Jinan, China
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18
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Varinelli A, Caricasole V, Pellegrini L, Hall N, Garg K, Mpavaenda D, Dell'Osso B, Albert U, Fineberg NA. Functional interventions as augmentation strategies for obsessive-compulsive disorder (OCD): scoping review and expert survey from the international college of obsessive-compulsive spectrum disorders (ICOCS). Int J Psychiatry Clin Pract 2022; 26:92-107. [PMID: 33502269 DOI: 10.1080/13651501.2021.1872646] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Patients with obsessive-compulsive disorder (OCD) commonly exhibit a range of functional difficulties, presumed linked to neurocognitive changes. Evidence-based first-line treatments have limited effect on improving these cognitive-functional problems. Candidate interventions could be used to augment evidence-based treatments by the multi-professional mental health team. METHODS A scoping review was performed to identify any intervention with at least one peer-reviewed report of clinical improvement in any of the 13 functional domains of the Cognitive Assessment Instrument of Obsessions and Compulsions (CAIOC-13). Next, an online survey of experts of the International College of Obsessive-Compulsive Spectrum Disorders was conducted. RESULTS Forty-four studies were identified reporting a positive outcome for 27 different kinds of intervention. Twenty-six experts from 12 different countries, including at least one expert from each continent, completed the opinion survey. Five interventions were identified as 'highly promising', none of which was moderated by rater-related factors, suggesting global applicability. CONCLUSION Patients with OCD may benefit from a detailed functional assessment, to identify areas of unmet need. A variety of interventions show theoretical promise for treating the complex functional difficulties in OCD as adjuncts to first-line treatments, but the published evidence is weak. Randomised controlled trials are needed to determine the clinical effectiveness of these interventions.HighlightsFunctional-cognitive problems are common in patients with OCD.First-line evidence-based treatments have limited effect on these functionalcognitive difficulties.In our scoping review we found 44 studies reporting of improved clinical outcomes in any of the 13 functional domains of the Cognitive Assessment Instrument of Obsessions and Compulsions (CAIOC-13).An online survey of experts of the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) was conducted and identified five interventions as "highly promising" candidate treatments for functional-cognitive problems in OCD.Randomised controlled trials are needed to determine the clinical effectiveness of these interventions.
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Affiliation(s)
- Alberto Varinelli
- Department of Mental Health, Department of Biomedical and Clinical Sciences, Luigi Sacco, University of Milan, Milan, Italy
| | - Valentina Caricasole
- Department of Mental Health, Department of Biomedical and Clinical Sciences, Luigi Sacco, University of Milan, Milan, Italy
| | - Luca Pellegrini
- Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, UK.,School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.,Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Natalie Hall
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Kabir Garg
- Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, UK
| | - Davis Mpavaenda
- Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, UK.,School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Bernardo Dell'Osso
- Department of Mental Health, Department of Biomedical and Clinical Sciences, Luigi Sacco, University of Milan, Milan, Italy.,Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford University, Stanford, CA, USA.,'Aldo Ravelli' Center for Neurotechnology and Brain Therapeutic, University of Milan, Milan, Italy
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, UCO Clinica Psichiatrica, University of Trieste, Trieste, Italy
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- International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) Expert Survey Workgroup: Michael Van Ameringen (Canada), Leonardo Fontenelle (Brazil), Giacomo Grassi (Italy), Jamie Feusner (US), Lior Carmi (Israel), Edna Grunblatt (Switzerland), Susanne Walitza (Switzerland), Christine Lochner (South Africa), Carolyn Rodriguez (US), Alexander Bystritsky (US), Maria Ceica Rosario (US), Peter van Roessel (US), Dan Geller (US), Eric Hollander (US), Humberto Nicolini (Mexico), Joseph Zohar (Israel), José Menchón (Spain)
| | - Naomi A Fineberg
- Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, UK.,School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.,School of Clinical Medicine, University of Cambridge, Cambridge, UK
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19
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Parvaresh-Rizi M, Ghadirivasfi M, Babaei S, Bagher Saberi Zafarghandi M, Fattahi A, Amirhasan Habibi S, Rohani M, Arezoomandan R. Psychopathological and neuropsychological outcomes of deep brain stimulation for severe- treatment-resistant obsessive-compulsive disorder: An open-label case series. J Clin Neurosci 2022; 98:229-234. [PMID: 35217502 DOI: 10.1016/j.jocn.2022.02.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/25/2022] [Accepted: 02/13/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Deep brain stimulation (DBS) is considered a promising intervention for treatment-resistant obsessive-compulsive disorder (OCD). The present study describes the outcomes of the first DBS procedures for OCD in Iran. METHODS Four women patients (age range, 25-35 years) with severe OCD meeting stringent criteria for refractoriness to treatment were selected by Psychosurgery Review Board. DBS electrodes were bilaterally implanted in the internal capsule and nucleus accumbens (NAc). Clinical and neuropsychological assessments were undertaken before and after implantation. The outcomes included Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Hamilton Anxiety Rating Scale (HAM-A), neuropsychological assessments including the Wisconsin Card Sorting Test, Wechsler Memory Scale, and adverse events. RESULTS The baseline mean score of the Y-BOCS and HAM-A was 32 ± 6 and 23 ± 14 respectively and decreased to 26 ± 8 and 17 ± 9 after one-year implantation, showing a 19% improvement. Two patients were responders and showed a notable improvement. One patient's score declined 28%, who was not satisfied with DBS results, and one patient worsened under-stimulation. Improvements in the severity of anxiety and cognitive performance were consistent with OCD improvement, and the successfully treated patients showed improvement in anxiety and cognitive performance. No significant cognitive declines were seen. Two patients' suicidal ideation appeared after DBS as an important adverse event. CONCLUSION Bilateral DBS of the internal capsule/NAc may be an effective and safe treatment for treatment-refractory OCD. However, there is a need to consider accessibility, high cost, cost-effectiveness, and standardized methodology in future research.
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Affiliation(s)
- Mansour Parvaresh-Rizi
- Department of Neurosurgery, Hazrat Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ghadirivasfi
- Mental Health Research Center, Department of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Shirzad Babaei
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), University of Medical Sciences, Iran
| | - Mohammad Bagher Saberi Zafarghandi
- Department of Addiction, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Azin Fattahi
- Department of Addiction, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Amirhasan Habibi
- Department of Neurology, Hazrat Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Rohani
- Department of Neurology, Hazrat Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Arezoomandan
- Department of Addiction, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran.
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20
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Patterns of Long COVID Symptoms: A Multi-Center Cross Sectional Study. J Clin Med 2022; 11:jcm11040898. [PMID: 35207171 PMCID: PMC8875229 DOI: 10.3390/jcm11040898] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/03/2022] [Accepted: 02/04/2022] [Indexed: 02/06/2023] Open
Abstract
Background: Long COVID has become a burden on healthcare systems worldwide. Research into the etiology and risk factors has been impeded by observing all diverse manifestations as part of a single entity. We aimed to determine patterns of symptoms in convalescing COVID-19 patients. Methods: Symptomatic patients were recruited from four countries. Data were collected regarding demographics, comorbidities, acute disease and persistent symptoms. Factor analysis was performed to elucidate symptom patterns. Associations of the patterns with patients’ characteristics, features of acute disease and effect on daily life were sought. Results: We included 1027 symptomatic post-COVID individuals in the analysis. The majority of participants were graded as having a non-severe acute COVID-19 (N = 763, 74.3%). We identified six patterns of symptoms: cognitive, pain-syndrome, pulmonary, cardiac, anosmia-dysgeusia and headache. The cognitive pattern was the major symptoms pattern, explaining 26.2% of the variance; the other patterns each explained 6.5–9.5% of the variance. The cognitive pattern was higher in patients who were outpatients during the acute disease. The pain-syndrome pattern was associated with acute disease severity, higher in women and increased with age. The pulmonary pattern was associated with prior lung disease and severe acute disease. Only two of the patterns (cognitive and cardiac) were associated with failure to return to pre-COVID occupational and physical activity status. Conclusion: Long COVID diverse symptoms can be grouped into six unique patterns. Using these patterns in future research may improve our understanding of pathophysiology and risk factors of persistent COVID, provide homogenous terminology for clinical research, and direct therapeutic interventions.
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21
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Balandeh E, Karimian M, Behjati M, Mohammadi AH. Serum Vitamins and Homocysteine Levels in Obsessive-Compulsive Disorder: A Systematic Review and Meta-Analysis. Neuropsychobiology 2022; 80:502-515. [PMID: 33744893 DOI: 10.1159/000514075] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 12/21/2020] [Indexed: 11/19/2022]
Abstract
Vitamin and homocysteine (Hcy) alternations have been associated with psychiatric disorders. The aim of this meta-analysis was to assess the association of serum vitamin and Hcy levels with obsessive-compulsive disorder (OCD). Following PRISMA protocol, we used the databases including Scopus, PubMed, Google Scholar, and Web of Science with no time restriction. Data were pooled using a random-effects model and/or fixed-effects model to estimate the standard mean difference (SMD) for evaluation of the strength of association analyses. Our data showed a significant reduction in vitamin B12 (SMD = -0.58, 95% CI = -1.08 to -0.08, p = 0.02, I2 = 65%; pheterogeneity = 0.06), vitamin E (SMD = -0.89, 95% CI = -1.23 to -0.56, p < 0.00001, I2 = 23%; pheterogeneity = 0.26), and vitamin C (SMD = -1.40, 95% CI = -2.44 to -0.36, p = 0.008, I2 = 92%; pheterogeneity < 0.0001) in OCD patients. In addition, the findings showed significantly higher levels of Hcy (SMD = 1.11, 95% CI = [0.48, 1.75], p = 0.0006, I2 = 73%; ph = 0.02) in patients compared to controls. Also, our data showed that vitamin B9 and D levels are not associated with OCD (vitamin B9: SMD = -0.23, 95% CI = -1.01 to 0.55, p = 0.56, I2 = 88%; pheterogeneity < 0.0001; vitamin D: SMD = -0.63, 95% CI = -1.41 to 0.15, p = 0.11, I2 = 88%; pheterogeneity = 0.0002). Our findings support significant impacts of Hcy and vitamin B12, E, and C levels in OCD pathogenesis. This will be important for prevention and treatment of OCD. However, further studies are recommended to elucidate more accurate conclusions.
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Affiliation(s)
- Ebrahim Balandeh
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Karimian
- Department of Molecular and Cell Biology, Faculty of Basic Sciences, University of Mazandaran, Babolsar, Iran
| | - Mohaddeseh Behjati
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Amir Hossein Mohammadi
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran, .,Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran,
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22
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Sternheim LC, van Passel B, Dingemans A, Cath D, Danner UN. Cognitive and Experienced Flexibility in Patients With Anorexia Nervosa and Obsessive Compulsive Disorder. Front Psychiatry 2022; 13:868921. [PMID: 35615449 PMCID: PMC9124825 DOI: 10.3389/fpsyt.2022.868921] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 04/14/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Anorexia nervosa (AN) and obsessive-compulsive disorder (OCD) share a neuropsychological profile characterized by cognitive inflexibility as evident in set-shifting problems, and by strong detail focus. Clinically, both patient groups display a strong rigidity which may be explained by these neurocognitive difficulties. Cognitive inflexibility may hinder treatment uptake and help explain suboptimal treatment outcomes in both AN and OCD. This is the first study to compare clinical AN and OCD groups andto examine similarities and differences in cognitive flexibility. Specifically, this study aims to investigate neuropsychological outcomes and self-reported difficulties in both clinical groups and a control group, and explore associations between the different flexibility outcomes and illness. METHOD Two hundred participants (61 AN, 72 OCD and 67 HC) performed neuropsychological tasks on set-shifting abilities (Trail Making Task, Stroop color-word interference, Intradimensional-Extradimensional shift task), detail focus (Group Embedded Figures Test) and self-reported set-shifting abilities and attention to detail (DFlex). RESULTS Similarities between patient groups were found in terms of reduced set-shifting ability on the Trail Making Task and detail focus. Moreover, both patient groups self-reported more set-shifting problems but a less strong detail focus than HC, which in turn were not related to neuropsychological task outcomes in either of the groups. In both patient groups longer illness duration was associated to longer reaction times in the switching tasks and for both groups symptom severity was associated to higher experienced inflexibility and attention to detail. CONCLUSION Cognitive inflexibility processes are largely similar in patients with AN and OCD. Both patient groups report inflexibility, yet this is unrelated to neuropsychological outcomes. Illness duration seems to contribute to poorer set-shifting and higher illness severity is linked to more experienced inflexibility. Findings highlight the need for entangling different domains of cognitive flexibility and detail focus and examining self-report measures for a cohesive understanding of clinically relevant flexibility weaknesses in AN and OCD.
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Affiliation(s)
| | - Boris van Passel
- Centre for Anxiety Disorders Overwaal, Institution for Integrated Mental Health Care, Pro Persona, Nijmegen, Netherlands.,Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | | | - Danielle Cath
- Department of Specialist Training, GGz Drenthe, Groningen, Netherlands.,Department of Psychiatry, Rijksuniversiteit Groningen and University Medical Center Groningen, Groningen, Netherlands
| | - Unna Nora Danner
- Department of Clinical Psychology, Utrecht University, Utrecht, Netherlands.,Altrecht Eating Disorders Rintveld, Zeist, Netherlands
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23
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Soref A, Liberman N, Abramovitch A, Poznanski Y, Dar R. Intact capacity for implicit learning in obsessive-compulsive disorder. J Behav Ther Exp Psychiatry 2021; 73:101667. [PMID: 34102538 DOI: 10.1016/j.jbtep.2021.101667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 04/29/2021] [Accepted: 05/28/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND OBJECTIVES Individuals with OCD tend to rely on explicit processing when performing implicit learning tasks. However, it is unclear whether this tendency reflects impaired capacity for implicit processing or a preference toward explicit processing. We sought to use a psychometrically valid task to examine the hypothesis that individuals with OCD have intact capacity for implicit learning. METHODS Twenty-four participants with OCD and 24 non-psychiatric controls completed a modified artificial grammar learning task where acquisition and retrieval of the underlying grammatical rules are considered strictly implicit. In an exploratory condition designed to examine the effect of nudging participants toward controlled processing, 12 participants in each group were told that the stimuli presented at acquisition were composed according to grammatical rules and were encouraged to identify these rules. RESULTS As predicted, participants with OCD acquired and expressed knowledge of the grammatical rule, demonstrating intact capacity for implicit learning, with no differences found between the OCD and controls on the extent of implicit learning. The exploratory intentional learning instructions had no effect, as participants in this condition were unable to adhere to the instructions, supporting the robust implicit nature of the artificial grammar learning task. LIMITATIONS The relatively small sample size did not allow comparisons between OCD symptom subtypes. CONCLUSIONS Our results provide evidence for intact implicit learning in OCD, and challenge previous studies suggesting a general deficiency in implicit learning in OCD.
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Affiliation(s)
- Assaf Soref
- School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel.
| | - Nira Liberman
- School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | | | | | - Reuven Dar
- School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel
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24
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Núñez-Núñez RM, Rubio-Aparicio M, Marín-Martínez F, Sánchez-Meca J, López-Pina JA, López-López JA. A Reliability Generalization Meta-analysis of the Padua Inventory-Revised (PI-R). Int J Clin Health Psychol 2021; 22:100277. [PMID: 34703467 PMCID: PMC8517387 DOI: 10.1016/j.ijchp.2021.100277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/13/2021] [Indexed: 12/14/2022] Open
Abstract
Background/Objective: The Padua Inventory-Revised (PI-R) is a widely applied instrument to measure obsessive-compulsive symptoms in clinical and nonclinical samples. We conducted a reliability generalization meta-analysis on the PI-R. Method: An exhaustive literature search yielded 118 empirical studies that had applied the PI-R, from which 30 studies (33 samples) reported an original reliability estimate. Results: Assuming a random-effects model, the average internal consistency reliability (Cronbach's alpha) was .92 (95% CI [.91, .93]) for the total scores, and ranged from .74 to .89 for the subscales. Assuming mixed-effects models, moderator analyses showed a positive statistically significant association between the standard deviation of the total scores and the reliability coefficients (p = .002; R2 = .38). Conclusions: In terms of reliability, the PI-R scale was found to be adequate for both research and clinical purposes, although exhibiting large heterogeneity across studies. Future empirical studies using the PI-R should be required to provide at least one reliability estimate based on their own data.
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Affiliation(s)
- Rosa María Núñez-Núñez
- Department of Behavioural and Health Sciences, Miguel Hernández University, Elche, Spain
| | - María Rubio-Aparicio
- Department of Health Psychology, University of Alicante, Spain
- Corresponding author: Department of Health Psychology, Faculty of Health Science, University of Alicante, Carretera San Vicente del Raspeig, s/n, 03690 San Vicente del Raspeig (Alicante), Spain
| | | | - Julio Sánchez-Meca
- Department of Basic Psychology and Methodology, University of Murcia, Spain
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25
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Simón-Martínez V, Laseca-Zaballa G, Lubrini G, Periáñez JA, Martínez Álvarez R, Torres-Díaz CV, Martínez Moreno N, Álvarez-Linera J, Ríos-Lago M. Cognitive deficits and clinical symptoms in patients with treatment-refractory obsessive-compulsive disorder: The role of slowness in information processing. Psychiatry Res 2021; 304:114143. [PMID: 34343878 DOI: 10.1016/j.psychres.2021.114143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/15/2021] [Accepted: 07/24/2021] [Indexed: 02/05/2023]
Abstract
Patients with Obsessive-Compulsive Disorder (OCD) present neuropsychological deficits across different cognitive domains, especially in executive functioning and information processing speed. Some studies have even suggested that speed deficits may underlie poor neuropsychological performance. However, this hypothesis remains unanswered in both OCD general population and OCD refractory subgroup. In addition, it is not clear whether such deficits are secondary to the clinical symptoms or may constitute a primary deficit. The aim of this study was to explore the speed of processing hypothesis in treatment-refractory OCD patients, and to clarify to what extent slowness is related to psychopathological symptoms. Both clinical and neuropsychological examination was conducted to assess 39 OCD refractory patients candidates for neurosurgery and 39 healthy matched individuals. Principal component analysis revealed a three-component structure in the neuropsychological battery being used, including a speed of processing, working memory, and conflict monitoring components. Group comparisons revealed that OCD patients performed significantly worse than healthy individuals in speed measures, but no differences were found in executive tests not influenced by time. Correlation analyses revealed a lack of association between neuropsychological and clinical measures. The results suggest that treatment-refractory OCD patients exhibit a primary deficit in information processing speed independent of clinical symptoms.
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Affiliation(s)
| | | | - Genny Lubrini
- Department Experimental Psychology, Complutense University of Madrid, Spain
| | - José A Periáñez
- Department Experimental Psychology, Complutense University of Madrid, Spain
| | - Roberto Martínez Álvarez
- Department of Radiosurgery and Functional Neurosurgery, Ruber International Hospital, Madrid, Spain
| | - Cristina V Torres-Díaz
- Department of Radiosurgery and Functional Neurosurgery, Ruber International Hospital, Madrid, Spain
| | - Nuria Martínez Moreno
- Department of Radiosurgery and Functional Neurosurgery, Ruber International Hospital, Madrid, Spain
| | | | - Marcos Ríos-Lago
- Department Basic Psychology II, UNED, Madrid, Spain; Brain Damage Service, Beata Maria Ana Hospital, Madrid, Spain.
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26
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Mohammadi AH, Balandeh E, Milajerdi A. Malondialdehyde concentrations in obsessive-compulsive disorder: a systematic review and meta-analysis. Ann Gen Psychiatry 2021; 20:34. [PMID: 34134751 PMCID: PMC8210354 DOI: 10.1186/s12991-021-00354-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 06/02/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND This meta-analysis aimed to investigate serum and plasma malondialdehyde (MDA) levels in patients with obsessive-compulsive disorder (OCD) in comparison to healthy controls. METHODS Following the PRISMA protocol, we searched for the relevant studies through the databases of Scopus, PubMed, Google Scholar, and web of science until September 2019 with no time restriction. Overall, nine studies were included in the current meta-analysis. Data were pooled using a random-effects model; in addition, standard mean difference (SMD) and/or weight mean difference (WMD) was calculated. Cochran's Q test and I-square (I2) statistics were used to evaluate between-study heterogeneity. The Newcastle-Ottawa scale (NOS) was used to evaluate the quality of the included studies. Statistical analyses were done using the STATA version 14. RESULTS Our systematic review included nine case-control studies (including 367 cases and 337 controls). Pooling findings from these studies showed a significantly higher MDA level in OCD patient compared to control groups (SMD = 1.62; 95% CI [0.53, 2.72]; I2 = 96.9%; Pheterogeneity (Ph) < 0.001). This finding remained unchanged among studies which reported MDA in the same unit (WMD = 1.93; 95% CI [0.27, 3.59]; I2 = 99.2%; Ph < 0.001). Subgroup analysis by the study location and sample size revealed findings that were also significant. CONCLUSION We found that MDA levels are higher in OCD patients than healthy controls. This finding highlights the importance of inflammatory responses in OCD patients that should be considered for future investigations. Further studies are recommended to expand current knowledge on this issue.
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Affiliation(s)
- Amir Hossein Mohammadi
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences (KAUMS), Kashan, Iran
| | - Ebrahim Balandeh
- Department of Clinical Psychology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Alireza Milajerdi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences (KAUMS), Kashan, Iran.
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27
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de Brouwer G, Engelbrecht J, Mograbi DC, Legoabe L, Steyn SF, Wolmarans DW. Stereotypy and spontaneous alternation in deer mice and its response to anti-adenosinergic intervention. J Neurosci Res 2021; 99:2706-2720. [PMID: 34115897 DOI: 10.1002/jnr.24867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 05/05/2021] [Accepted: 05/11/2021] [Indexed: 12/24/2022]
Abstract
Repetitive behavioral phenotypes are a trait of several neuropsychiatric disorders, including obsessive-compulsive disorder (OCD). Such behaviors are typified by complex interactions between cognitive and neurobiological processes which most likely contribute to the suboptimal treatment responses often observed. To this end, exploration of the adenosinergic system may be useful, since adenosine-receptor modulation has previously shown promise to restore control over voluntary behavior and improve cognition in patients presenting with motor repetition. Here, we employed the deer mouse (Peromyscus maniculatus bairdii) model of compulsive-like behavioral persistence, seeking to investigate possible associations between stereotypic motor behavior and cognitive flexibility as measured in the T-maze continuous alternation task (T-CAT). The effect of istradefylline, a selective adenosine A2A receptor antagonist at two doses (10 and 20 mg kg-1 day-1 ) on the expression of stereotypy and T-CAT performance in high (H) and non-(N) stereotypical animals, was investigated in comparison to a control intervention (six groups; n = 8 or 9 per group). No correlation between H behavior and T-CAT performance was found. However, H but not N animals presented with istradefylline-sensitive spontaneous alternation and stereotypy, in that istradefylline at both doses significantly improved the spontaneous alternation scores and attenuated the stereotypical expression of H animals. Thus, evidence is presented that anti-adenosinergic drug action improves repetitive behavior and spontaneous alternation in stereotypical deer mice, putatively pointing to a shared psychobiological construct underlying naturalistic stereotypy and alterations in cognitive flexibility in deer mice.
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Affiliation(s)
- Geoffrey de Brouwer
- Center of Excellence for Pharmaceutical Sciences, Department of Pharmacology, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Jaco Engelbrecht
- Center of Excellence for Pharmaceutical Sciences, Department of Pharmacology, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Daniel C Mograbi
- Department of Psychology, Pontifícia Universidade Católica - Rio (PUC-Rio), Rio de Janeiro, Brazil.,Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Lesetja Legoabe
- Center of Excellence for Pharmaceutical Sciences, Department of Pharmacology, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Stephan F Steyn
- Center of Excellence for Pharmaceutical Sciences, Department of Pharmacology, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - De Wet Wolmarans
- Center of Excellence for Pharmaceutical Sciences, Department of Pharmacology, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
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28
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Manarte L, Andrade AR, do Rosário L, Sampaio D, Figueira ML, Morgado P, Sahakian BJ. Executive functions and insight in OCD: a comparative study. BMC Psychiatry 2021; 21:216. [PMID: 33926404 PMCID: PMC8082868 DOI: 10.1186/s12888-021-03227-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 04/19/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Around 25 to 30% of patients with obsessive-compulsive disorder (OCD) do not respond to treatment. These patients have the longest duration of disease and the worst prognosis. Following years of research on this topic, insight has emerged as a potential explanation for this therapeutic resistance. Therefore, it has become important to characterize OCD patients with poor insight. Few studies have focused on the neuropsychological and cognitive characteristics of these patients. METHODS To help fill this gap, we divided 57 patients into two groups, one with good insight and the other with poor insight, assessed their neuropsychological functions-through a Rey's figure test, a California verbal learning test, a Toulouse-Piéron test and a Wisconsin Card Sorting Test (WCST)-and compared the results with those of a paired control group. RESULTS The statistical analysis, with a significance level of 95%, revealed differences in the executive function tests, and particularly in the WCST (p ≤ 0.001) and trail-making-test (TMT A/B) (p = 0.002). CONCLUSIONS These differences suggest that the neuropsychological profile of poor-insight patients is different from their good-insight counterparts, emphasize the role played by the executive functions in insight and highlights the need for more accurate neurocognitive research and treatment.
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Affiliation(s)
- Lucas Manarte
- Faculty of Medicine, University of Lisbon, Av. Prof. Egas Moniz, 1649-028, Lisbon, Portugal.
| | - António R Andrade
- IDMEC. Instituto Superior Técnico, University of Lisbon, Av. Rovisco Pais 1, 1049-001, Lisbon, Portugal
| | - Linete do Rosário
- Faculty of Medicine, University of Lisbon, Av. Prof. Egas Moniz, 1649-028, Lisbon, Portugal
| | - Daniel Sampaio
- Faculty of Medicine, University of Lisbon, Av. Prof. Egas Moniz, 1649-028, Lisbon, Portugal
| | - Maria Luísa Figueira
- Faculty of Medicine, University of Lisbon, Av. Prof. Egas Moniz, 1649-028, Lisbon, Portugal
| | - Pedro Morgado
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, R. da Universidade, 4710-057, Braga, Portugal
| | - Barbara J Sahakian
- Department of Psychiatry and Behavioural and Clinical Neuroscience Institute, University of Cambridge, Herchel Smith Building for Brain & Mind Sciences, Forvie Site, Robinson Way, Cambridge, CB2 0SZ, UK
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29
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Fruehauf LM, Fair JE, Liebel SW, Bjornn D, Larson MJ. Cognitive control in obsessive-compulsive disorder (OCD): Proactive control adjustments or consistent performance? Psychiatry Res 2021; 298:113809. [PMID: 33636516 DOI: 10.1016/j.psychres.2021.113809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 02/15/2021] [Indexed: 02/04/2023]
Abstract
Cognitive control is often parsed into proactive and reactive control components. In proactive control, task- and goal-relevant information is utilized in a top-down manner to improve performance, while reactive control is a late-response corrective mechanism that occurs after conflict or errors. We tested whether people with obsessive-compulsive disorder (OCD) would show specific proactive control dysfunction in 31 individuals with OCD and 30 psychiatrically-healthy controls. We employed two tasks that differentiate proactive and reactive cognitive control processes: the cued-Stroop and the AX version of a continuous performance task (AX-CPT). There was a 1s or 5s delay between the cue and probe for both tasks to allow for implementation of proactive control processes. Participants also completed a neuropsychological test battery and mood and symptom severity self-report questionnaires. Although there were group-level differences in OCD severity and depression/anxiety symptoms, there were no significant differences in response times (RT) and error rates between groups for delay or condition for the cued-Stroop or for the AX-CPT, indicating similar performance in implementing proactive control strategies. There were also no significant differences between OCD and control participants on neuropsychological test performance. Results suggest a convergence of evidence wherein individuals with OCD are not showing disproportionately altered proactive control abilities.
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Affiliation(s)
- Lindsay M Fruehauf
- Department of Psychology and Neuroscience Center, Brigham Young University, 244 TLRB, Provo, UT 84602, United States
| | - Joseph E Fair
- Utah Valley Orthopedics and Sports Medicine and Department of Physical Medicine and Rehabilitation, Utah Valley Hospital, Provo, Utah, United States
| | - Spencer W Liebel
- Department of Psychology, University of Georgia, Athens, Georgia; Milwaukee VA Medical Center, Milwaukee, Wisconsin, United States
| | - Daniel Bjornn
- Department of Psychology and Neuroscience Center, Brigham Young University, 244 TLRB, Provo, UT 84602, United States
| | - Michael J Larson
- Department of Psychology and Neuroscience Center, Brigham Young University, 244 TLRB, Provo, UT 84602, United States.
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Response Inhibition, Cognitive Flexibility and Working Memory in Obsessive-Compulsive Disorder, Generalized Anxiety Disorder and Social Anxiety Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073642. [PMID: 33807425 PMCID: PMC8036460 DOI: 10.3390/ijerph18073642] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/22/2021] [Accepted: 03/26/2021] [Indexed: 12/22/2022]
Abstract
This study analyzed response inhibition, cognitive flexibility and working memory in three groups of patients diagnosed with obsessive-compulsive disorder, social anxiety disorder and generalized anxiety disorder, considering some variables that may influence results (nonverbal reasoning, comorbidity, use of pharmacotherapy). Neuropsychological measures were completed using a computerized Wisconsin card sorting test, Stroop color word test, go/no-go task, digits and Corsi. Significant differences were obtained among groups in cognitive flexibility and working memory variables. The obsessive-compulsive disorder (OCD) group showed the worst results. The social anxiety disorder group obtained greater effect sizes in visuospatial memory. However, significant differences between groups in visuospatial memory were no longer present when nonverbal reasoning was controlled. Comorbidity influenced interference in the OCD and generalized anxiety disorder (GAD) groups. In addition, the executive functions were differently influenced by the level of obsessions and anxiety, and the use of pharmacotherapy. Study limitations include a non-random selection of participants, modest sample size and design type (cross-sectional). The OCD group showed the worst results in flexibility cognitive and verbal working memory. Comorbidity, use of pharmacotherapy and level anxiety and obsessions were variables influencing the performance of executive functions.
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31
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Martínez-Esparza IC, Olivares-Olivares PJ, Rosa-Alcázar Á, Rosa-Alcázar AI, Storch EA. Executive Functioning and Clinical Variables in Patients with Obsessive-Compulsive Disorder. Brain Sci 2021; 11:brainsci11020267. [PMID: 33672581 PMCID: PMC7924057 DOI: 10.3390/brainsci11020267] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/07/2021] [Accepted: 02/14/2021] [Indexed: 12/01/2022] Open
Abstract
Background: Cognitive flexibility, response inhibition, and working memory are considered the main mechanisms responsible for executive control. This study examined differences in cognitive flexibility, inhibition, and working memory in patients with obsessive–compulsive disorder (OCD) relative to a control group. Method: A total of 62 obsessive-compulsive participants (OCD = 32; healthy control = 32) aged between 17 and 56 years old (M = 33.16, SD = 9.23) were administered the computerized Wisconsin Card Sorting Test, Stroop Color–Word Test, Go/No-Go Task, Digit Test, and Corsi Block Test. Clinician-rated and self-reported obsessive–compulsive symptom severity, and anxiety, depression, and obsessive beliefs were evaluated. Results: The control group performed better than the OCD group in tasks involving cognitive flexibility, inhibition, and visuospatial working memory. Anxiety and obsessive beliefs influenced the participants’ performance on inhibition and working memory tasks. Similarly, comorbidity also influenced inhibition and working memory. In addition, the use of pharmacotherapy and the degree of OCD symptom severity influenced verbal working memory. Conclusions: Cognitive flexibility, inhibition, and visuospatial working memory deficits may be endophenotypes of OCD but require further examination for specificity. OCD severity, comorbidity patterns, anxiety, and obsessive beliefs may influence performance.
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Affiliation(s)
| | - Pablo J. Olivares-Olivares
- Department of Personality, Assessment & Psychological Treatment, University of Murcia, 30100 Murcia, Spain; (I.C.M.-E.); (P.J.O.-O.)
| | - Ángel Rosa-Alcázar
- Department of Psychology, Catholic University of Murcia, 30107 Murcia, Spain;
| | - Ana I. Rosa-Alcázar
- Department of Personality, Assessment & Psychological Treatment, University of Murcia, 30100 Murcia, Spain; (I.C.M.-E.); (P.J.O.-O.)
- Correspondence: ; Tel.: +34-868-883-444; Fax: +34-868-884-111
| | - Eric A. Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, USA;
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Kashyap H, Abramovitch A. Neuropsychological Research in Obsessive-Compulsive Disorder: Current Status and Future Directions. Front Psychiatry 2021; 12:721601. [PMID: 34790136 PMCID: PMC8591286 DOI: 10.3389/fpsyt.2021.721601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
Neuropsychological functions in obsessive-compulsive disorder (OCD) have been extensively investigated. Despite some common findings across studies indicating deficient test performance across cognitive domains with small to medium effect sizes, results remain inconsistent and heterogeneous. However, multiple past attempts to identify moderators that may account for such variability have been unrewarding. Typical moderators including symptom severity, age at onset, medication status, and comorbid conditions failed to provide sufficient explanatory power. It has then been posited that these inconsistencies may be attributed to the inherent heterogeneous nature of the disorder (i.e., symptom dimensions), or to the natural fluctuation in symptom severity. However, recent meta-analyses suggest that these factors may not account for the persistent unexplained variability. Other potential factors-some of which are unique to neuropsychological testing-received scarce research attention, including definition of cognitive impairments, specificity and selection of test and outcome measures, and their limited ecological validity. Other moderators, particularly motivational aspects, and metacognitive factors (e.g., self-efficacy) were not previously addressed despite their potential association to OCD, and their documented impact on cognitive function. The aim of the present mini-review is to provide an updated succinct overview of the current status of the neuropsychological literature in OCD and expanding upon oft-neglected potential moderators and their putative impact on neuropsychological findings in OCD. Our goal is to highlight important avenues for further research and provide a road map for investigators in order to advance our understanding of cognitive functions in OCD that has been stagnant in the past decade.
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Affiliation(s)
- Himani Kashyap
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Amitai Abramovitch
- Department of Psychology, Texas State University, San Marcos, TX, United States
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Wang P, Cao W, Chen T, Gao J, Liu Y, Yang X, Meng F, Sun J, Li Z. Mediating Role of Rumination and Negative Affect in the Effect of Mind-Wandering on Symptoms in Patients With Obsessive-Compulsive Disorder. Front Psychiatry 2021; 12:755159. [PMID: 34721118 PMCID: PMC8551573 DOI: 10.3389/fpsyt.2021.755159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
To explore the relationship between negative affect, mind-wandering, rumination and obsessive-compulsive symptoms, 100 patients with obsessive-compulsive disorder and 100 healthy controls were assessed using the Obsessive-Compulsive Inventory, the Beck Anxiety Inventory, the Beck Depression Inventory, the Mind Wandering Scale and the Ruminative Response Scale. The results show that (i) patients diagnosed with obsessive-compulsive disorder displayed higher obsessive-compulsive symptoms, negative affect, mind-wandering and rumination compared with healthy controls; (ii) negative affect, mind-wandering and rumination were positively correlated with the severity of obsessive-compulsive symptoms; (iii) mind-wandering predicted the severity of obsessive-compulsive symptoms (both directly and indirectly); (iv) rumination and negative affect mediated the relationship between mind-wandering and obsessive-compulsive symptoms. The results preliminarily reveal the relationship between mind-wandering and psychopathological obsessive-compulsive symptoms, providing a reference for exploring novel psychological treatments for obsessive-compulsive disorder.
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Affiliation(s)
- Pengchong Wang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Centre for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Wenwen Cao
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Centre for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Tao Chen
- Brain and Mind Center, The University of Sydney, Sydney, NSW, Australia.,School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Jian Gao
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Centre for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yifan Liu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Centre for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xiangyun Yang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Centre for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Fanqiang Meng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Centre for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Jing Sun
- Menzies Health Institute Queensland and School of Medicine and Dentistry, Griffith University, Brisbane, QLD, Australia
| | - Zhanjiang Li
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Centre for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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Hagland P, Thorsen AL, Ousdal OT, Gjestad R, de Wit SJ, Hansen B, Hagen K, Kvale G, van den Heuvel OA. Disentangling Within- and Between-Person Effects During Response Inhibition in Obsessive-Compulsive Disorder. Front Psychiatry 2021; 12:519727. [PMID: 33841194 PMCID: PMC8026876 DOI: 10.3389/fpsyt.2021.519727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 02/22/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Obsessive-compulsive disorder (OCD) has been related to worse performance, abnormal brain activity, and functional connectivity during response inhibition. Whether these findings are indications of stable traits that contribute to the development of the disorder, or whether they are a result of the state severity of obsessions and anxiety, remains unclear since previous research mainly has employed cross-sectional designs. The present study aimed to assess longitudinal between- and within-person relationships between symptoms, task performance, right inferior frontal gyrus brain activation, and connectivity between the right amygdala and the right pre-supplementary motor area in 29 OCD patients before and after concentrated exposure and response prevention treatment. Method: Patients received exposure and response prevention delivered during 4 consecutive days, following the Bergen 4-day Treatment format. Patients performed a Stop Signal Task during 3T functional Magnetic Resonance Imaging the day before treatment, as well as 1 week and 3 months after treatment completion. Multilevel models were used to analyze disaggregated within- and between-person effects over time. Independent variables were scores on the symptom severity scales for OCD, anxiety, depression, and state distress during scanning. Dependent variables were reaction time for go trials, stop signal response time, task-related brain activation and connectivity. Results: A positive between-person effect was found for obsessive-compulsive, anxiety, and depressive symptom severity on go trial reaction time, indicating that patients with higher symptom scores on average respond slower during accurate go trials. We also found no significant between- or within-person relations between symptom severity and task-related activation or fronto-limbic connectivity. Conclusions: The between-person findings may point toward a general association between slower processing speed and symptom severity in OCD. Longitudinal studies should disaggregate between- and within-person effects to better understand variation over time.
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Affiliation(s)
- Pernille Hagland
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Anders Lillevik Thorsen
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Olga Therese Ousdal
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway.,Department of Radiology, Haukeland University Hospital, Bergen, Norway.,Center for Crisis Psychology, University of Bergen, Bergen, Norway
| | - Rolf Gjestad
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Stella J de Wit
- Department of Anatomy and Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Bjarne Hansen
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway.,Center for Crisis Psychology, University of Bergen, Bergen, Norway
| | - Kristen Hagen
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway.,Psychiatric Department, Hospital of Molde, Molde, Norway
| | - Gerd Kvale
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Odile A van den Heuvel
- Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway.,Department of Anatomy and Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, Netherlands
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Youssef AM, AbouHendy WI, Elshabrawy A, Amin SI. Executive function in obsessive compulsive disorder at Zagazig University Hospitals: a case-control study. MIDDLE EAST CURRENT PSYCHIATRY 2020. [DOI: 10.1186/s43045-020-00033-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Executive function (EF) domain deficits which most reported include in particular set shifting and inhibition, which are considered main deficits in obsessive-compulsive disorder (OCD). So, this research aimed to assess EF in patients with a primary diagnosis of OCD in comparison to a healthy control group; in order to understand the impaction of this disorder on the patient’s neuropsychological status.
Results
There was no significant difference between OCD patients and controls regarding demographic characteristics. Average duration of illness in OCD group was 3.97 ± 5.08 years. Forty patients (60.6%) had OCD medication prior to the study. Depression was the most prevalent comorbidity among OCD group (36.4%) then anxiety (12.1%) and social anxiety (3%). Regarding WCST indices, a significant difference (P < 0.05) was found between both groups in total number of correct answers, total number of errors, mean of errors, total number of perseverative errors, mean of perseverative errors, total number of non-perseverative errors, mean of non-perseverative errors, and conceptual level responses without significant difference (P ≥ 0.05) in the remaining indices. In ToL indices, there was highly significant difference (P < 0.001) between both groups regarding total time, but not regarding total moves (P ≥ 0.05). The defect in EF was positively correlated to the severity of symptoms of OCD. There was no significant difference between patients who had been receiving medical treatment and those who had not, also between patients who had comorbidities accompanying OCD and those who had not regarding EF as evident by both WCST measured parameters and TOL parameters.
Conclusions
OCD patients appear to have EF deficits in the fields of set-shifting, inhibitory control, working memory, and planning ability.
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36
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Intelligence quotient level and treatment of obsessive-compulsive disorders: Meta-analyses. Med Hypotheses 2020; 144:109995. [DOI: 10.1016/j.mehy.2020.109995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/04/2020] [Accepted: 06/11/2020] [Indexed: 11/22/2022]
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Silveira VP, Frydman I, Fontenelle LF, Mattos P, de Oliveira-Souza R, Moll J, Hoexter MQ, Miguel EC, McLaughlin NC, Shephard E, Batistuzzo MC. Exploring response inhibition and error monitoring in obsessive-compulsive disorder. J Psychiatr Res 2020; 126:26-33. [PMID: 32413597 PMCID: PMC7313630 DOI: 10.1016/j.jpsychires.2020.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 04/15/2020] [Accepted: 04/16/2020] [Indexed: 10/24/2022]
Abstract
Behavioral evidence of impaired response inhibition (RI) and hyperactive error monitoring (EM) in obsessive-compulsive disorder (OCD) is inconsistent. Recent neuroimaging work suggests that EM plays a role in RI impairments in OCD, but this has rarely been investigated using behavioral measures. The aims of this study were to (1) compare RI and EM performance between adults with OCD and non-psychiatric controls (NPC) while investigating possible moderators, and (2) assess whether excessive EM influences RI in OCD. We compared RI and EM performance on the Stop-Signal Task (SST) between 92 adults with OCD and 65 NPC from two Brazilian sites. We used linear regression to investigate which variables (group, age, medication use, clinical symptomatology) influenced performance, as well as to examine possible associations between RI and EM. OCD and NPC did not differ in RI and EM. However, age moderated RI performance in OCD with a medium effect size, reflecting differential effects of age on RI between groups: age was positively associated with RI in OCD but not NPC. Further, OCD severity predicted EM with a medium to large effect size, suggesting that more symptomatic patients showed greater monitoring of their mistakes. Finally, group moderated the relationship between RI and EM with a small effect size. Our findings suggest that demographic factors may influence RI, whereas clinical factors may influence EM. Further, we found preliminary behavioral evidence to indicate that impaired RI and excessive EM are related in OCD.
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Affiliation(s)
- Vitor Portella Silveira
- Departmento de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR. R. Dr. Ovídio Pires de Campos, 785 - Cerqueira César, São Paulo, SP, 05403-903, Brazil.
| | - Ilana Frydman
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil. Av. Venceslau Brás, 71 - Botafogo, Rio de Janeiro - RJ, 22290-140, Brazil
| | - Leonardo F. Fontenelle
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil. Av. Venceslau Brás, 71 - Botafogo, Rio de Janeiro - RJ, 22290-140, Brazil,Turner Institute for Brain and Mental Health, Monash University, Wellington Rd, Clayton VIC 3800, Australia,D’Or Institute for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil. Rua Diniz Cordeiro, 30 - Botafogo, Rio de Janeiro - RJ, 22281-100, Brazil
| | - Paulo Mattos
- D’Or Institute for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil. Rua Diniz Cordeiro, 30 - Botafogo, Rio de Janeiro - RJ, 22281-100, Brazil
| | - Ricardo de Oliveira-Souza
- D’Or Institute for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil. Rua Diniz Cordeiro, 30 - Botafogo, Rio de Janeiro - RJ, 22281-100, Brazil
| | - Jorge Moll
- D’Or Institute for Research and Education (IDOR), Rio de Janeiro, RJ, Brazil. Rua Diniz Cordeiro, 30 - Botafogo, Rio de Janeiro - RJ, 22281-100, Brazil
| | - Marcelo Queiroz Hoexter
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo, SP, Brazil. R. Dr. Ovídio Pires de Campos, 785 - Cerqueira César, São Paulo - SP, 05403-903, Brazil
| | - Eurípedes Constantino Miguel
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo, SP, Brazil. R. Dr. Ovídio Pires de Campos, 785 - Cerqueira César, São Paulo - SP, 05403-903, Brazil
| | - Nicole C.R. McLaughlin
- Butler Hospital and Alpert Medical School of Brown University, Providence, Rhode Island, USA. 345 Blackstone Blvd, Providence, RI 02906, USA
| | - Elizabeth Shephard
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK. 16 De Crespigny Park, Camberwell, London SE5 8AF, UK
| | - Marcelo Camargo Batistuzzo
- Psychology Department, Health Sciences School, Pontifical Catholic University of São Paulo, São Paulo, SP, Brazil. Rua Monte Alegre 984 - Perdizes, São Paulo - SP, 05014-001, Brazil
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Bora E. Meta-analysis of neurocognitive deficits in unaffected relatives of obsessive-compulsive disorder (OCD): comparison with healthy controls and patients with OCD. Psychol Med 2020; 50:1257-1266. [PMID: 32476632 DOI: 10.1017/s0033291720001634] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) has been associated with cognitive deficits, particularly with executive functions. These findings support fronto-striatal dysfunction in OCD. However, it is not certain whether these findings are trait features of OCD. In recent years, a number of studies have investigated cognitive functions in unaffected relatives of OCD (OCDrel) but the findings of these studies are contradictory. METHODS A systematic review in Pubmed and Scopus databases was performed until 18 March 2019, to locate the studies comparing cognitive functions of OCDrel with healthy controls and OCD patients (OCDpt). A random-effects meta-analysis was conducted. RESULTS Current meta-analysis included 16 studies including 527 OCDrel, 445 OCDpt and 639 healthy controls. Healthy controls overperformed OCDpt in all cognitive domains (d = 0.36-0.86). OCDrel underperformed healthy controls in inhibition (d = 0.58, CI = 0.29-0.86), planning (d = 0.45, CI = 0.28-0.63), decision-making (d = 0.58, CI = 0.19-0.98). OCDrel also had small-sized deficits in set-shifting (d = 0.37, CI = 0.04-0.69) and visual memory (d = 0.28, CI = 0.08-0.49). OCDpt underperformed OCDrel in visual memory (d = 0.45, CI = 0.22-0.67) and set-shifting (d = 0.23, CI = 0.04-0.42). CONCLUSIONS Current findings suggest that abnormalities in inhibition, planning/problem solving and reward-based decision-making are shared features of OCDrel and OCDpt and might be trait markers related to vulnerability for developing OCD. Visual memory and set-shifting deficits might potentially be biomarkers of incipient illness or subthreshold OCD presentation among OCDrel. Further exploration of cognitive heterogeneity in OCDrel and investigating the effects of the subtypes of OCD in probands on cognitive impairment in OCDrel are needed.
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Affiliation(s)
- Emre Bora
- Department of Psychiatry, Dokuz Eylul University Medical School, Izmir35340, Turkey
- Department of Neuroscience, Dokuz Eylul University, Izmir35340, Turkey
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Carlton South, Victoria3053, Australia
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Negreiros J, Belschner L, Best JR, Lin S, Franco Yamin D, Joffres Y, Selles RR, Jaspers-Fayer F, Miller LD, Woodward TS, Honer WG, Stewart SE. Neurocognitive risk markers in pediatric obsessive-compulsive disorder. J Child Psychol Psychiatry 2020; 61:605-613. [PMID: 31749150 DOI: 10.1111/jcpp.13153] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/09/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) has complex genetic underpinnings, particularly in its early-onset form, which places siblings at a 10-fold increased risk of developing the disorder. Examination for neurocognitive markers preceding pediatric OCD onset has not been conducted, although markers have been identified in adult OCD. This study compared neurocognition across groups of OCD-affected youth (n = 87), unaffected siblings of those with early-onset OCD (n = 67), and healthy controls (HC; n = 79). METHODS A total of 233 participants aged 6-18 years old completed standardized neurocognitive tests of cognitive flexibility, decision making, planning, response inhibition, spatial working memory, attention, recognition nonverbal memory, and intelligence. They were administered the Anxiety Disorders Interview Schedule-Parent version (ADIS-P) and completed self-report anxiety and OCD questionnaires. Linear mixed-effects models tested for differences between groups, adjusting for age, gender, IQ, state anxiety, and ethnicity, and accounting for random effects of family membership. RESULTS OCD-affected youth and unaffected siblings performed significantly worse on planning in comparison to HCs (Cohen's d = 0.74; 95% CI = [0.11, 1.36]; Cohen's d = 0.75; 95% CI = [0.12, 1.38], respectively; omnibus group effect p = .007). No other significant between-group differences were identified. CONCLUSIONS Neurocognitive performance differences between groups identified planning as a preexisting trait marker of pediatric OCD, while no other domain presented as a marker of pediatric OCD. This differs from adult OCD, which is associated with broader cognitive impairments. Investigating longitudinal trajectories and predictive significance of neurocognition in those affected by, and at risk for, early-onset OCD is warranted. Ideally, this will enhance individualized risk stratification and inform future prevention and early intervention strategies.
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Affiliation(s)
- Juliana Negreiros
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Provincial OCD Program, British Columbia Children's Hospital, Vancouver, BC, Canada
| | - Laura Belschner
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Provincial OCD Program, British Columbia Children's Hospital, Vancouver, BC, Canada
| | - John R Best
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Provincial OCD Program, British Columbia Children's Hospital, Vancouver, BC, Canada
| | - Sarah Lin
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Provincial OCD Program, British Columbia Children's Hospital, Vancouver, BC, Canada
| | - Diana Franco Yamin
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Provincial OCD Program, British Columbia Children's Hospital, Vancouver, BC, Canada
| | - Yayuk Joffres
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Provincial OCD Program, British Columbia Children's Hospital, Vancouver, BC, Canada
| | - Robert R Selles
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Provincial OCD Program, British Columbia Children's Hospital, Vancouver, BC, Canada
| | - Fern Jaspers-Fayer
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Provincial OCD Program, British Columbia Children's Hospital, Vancouver, BC, Canada
| | - Lynn D Miller
- Department of Education and Counselling Psychology and Special Education, University of British Columbia, Vancouver, BC, Canada
| | - Todd S Woodward
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - William G Honer
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - S Evelyn Stewart
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Provincial OCD Program, British Columbia Children's Hospital, Vancouver, BC, Canada
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40
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Sleep duration and timing in obsessive-compulsive disorder (OCD): evidence for circadian phase delay. Sleep Med 2020; 72:111-117. [PMID: 32575000 DOI: 10.1016/j.sleep.2020.03.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/04/2020] [Accepted: 03/17/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To investigate potential delays in endogenous melatonin in individuals with obsessive-compulsive disorder (OCD). METHODS First, data are presented for 15 individuals with OCD and matched healthy controls. Next, nine additional participants with OCD who did not have matched controls were added, resulting in a sample of 24 individuals with OCD. All participants were assessed for sleep and circadian rhythm disturbance. Dim light melatonin onset (DLMO) was derived from salivary melatonin and was used in conjunction with sleep diaries, interview measures, and questionnaires. A subset of the OCD group (n = 16) also used actigraphy. RESULTS In sum, 42% percent (10/24) of the patients with OCD met the criteria for delayed sleep-wake phase disorder (DSWPD) in comparison to 0% in the control sample. DLMO was significantly later in individuals with OCD compared to controls. DLMO and bedtime were not significantly associated with the severity of obsessive-compulsive symptoms or negative affect. CONCLUSIONS Replication of the findings presented herein, particularly the DLMO results, is warranted. Further, there are now three studies showing that nearly ½ of individuals with OCD meet criteria for a DSWPD. Future studies can explore the mechanisms underlying these connections and the implications of this comorbidity. These findings may increase our understanding of OCD and inform future interventions.
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Cameron DH, Rowa K, McKinnon MC, Rector NA, McCabe RE. Neuropsychological performance across symptom dimensions of obsessive-compulsive disorder: a comment on the state and critical review of the literature. Expert Rev Neurother 2020; 20:425-438. [PMID: 32200686 DOI: 10.1080/14737175.2020.1746644] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Introduction: Obsessive-compulsive disorder (OCD) is a heterogeneous disorder, with multiple symptom presentations. Delineating the neuropsychological characteristics associated with previously identified symptom clusters may therefore be useful in assisting to better define symptom subtypes of OCD.Areas covered: This review summarizes the existing literature on the assessment of neuropsychological performance in symptom-based dimensions of OCD. Results of 23 studies are described and the methodological issues and challenges present in this body of literature are discussed.Expert opinion: The current state of the literature precludes a meaningful meta-analysis of cognitive dysfunction across the breadth of symptom dimensions of OCD. This is due primarily to significant methodological differences observed between studies, both in terms of neuropsychological measures and symptom subtyping methods employed, and any resulting meta-analytic results would be biased by varying quality of evidence. Future studies addressing these limitations should include more consistent neuropsychology measures and methods of classifying OCD symptoms with the aim of reproducing the results of previous research to identify more concrete patterns of neuropsychological performance across dimensions; best practices and alternative approaches are discussed.
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Affiliation(s)
- Duncan H Cameron
- Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Karen Rowa
- Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Margaret C McKinnon
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Neil A Rector
- Frederick W. Thompson Anxiety Disorders Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Psychiatry and Psychological Clinical Science, University of Toronto, Toronto, ON, Canada
| | - Randi E McCabe
- Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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Rosa-Alcázar Á, Olivares-Olivares PJ, Martínez-Esparza IC, Parada-Navas JL, Rosa-Alcázar AI, Olivares-Rodríguez J. Cognitive flexibility and response inhibition in patients with Obsessive-Compulsive Disorder and Generalized Anxiety Disorder. Int J Clin Health Psychol 2020; 20:20-28. [PMID: 32021615 PMCID: PMC6994753 DOI: 10.1016/j.ijchp.2019.07.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 07/25/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND/OBJECTIVE The main aim of this study was to analyze differences in inhibition and cognitive flexibility, taking into account some variables that may influence results (non verbal reasoning, depression, anxiety, intolerance of uncertainty, comorbidity, medication consumption). METHOD The participants were 95 adults aged 17-61 years old (M = 33.48, SD = 11.13), primary (most severe) Generalized Anxiety Disorder or Obsessive-Compulsive Disorder and a healthy control group. Neuropsychological neasures were completed using computerized Wisconsin Card Sorting Test, Stroop Color Word Test and Go/NoGo Task. RESULTS Clinical groups presented worse results in cognitive flexibility to the control group. The obsessive-compulsive group showed worse scores in flexibility than the generalized anxiety group, once non-verbal reasoning and tolerance to uncertainty were controlled. Comorbidity and medication use did not affect results in the obsessive compulsive group but did however influence the generalized anxiety group. CONCLUSIONS Cognitive flexibility could be included treatment in the treatment of obsessive-compulsive disorder and generalized anxiety disorder.
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Affiliation(s)
| | | | | | | | - Ana I. Rosa-Alcázar
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Universidad de Murcia, Spain
| | - José Olivares-Rodríguez
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Universidad de Murcia, Spain
- Facultad de Educación, Universidad de Murcia, Spain
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Hallion LS, Tolin DF, Billingsley AL, Kusmierski SN, Diefenbach GJ. "Cold" Cognitive Control and Attentional Symptoms in Anxiety: Perceptions Versus Performance. Behav Ther 2019; 50:1150-1163. [PMID: 31735249 DOI: 10.1016/j.beth.2019.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 04/08/2019] [Accepted: 04/12/2019] [Indexed: 01/15/2023]
Abstract
Clinically significant anxiety is associated with an array of attentional symptoms (e.g., difficulty concentrating; unwanted thought) that are subjectively experienced as severe. However, neuropsychological findings are mixed with respect to the presence of cognitive deficits that can account for these symptoms. Contextualizing predictions from established clinical theories (e.g., Attentional Control Theory) within contemporary, neurobiologically derived models of cognitive control (Dual Mechanisms of Control Theory), the present study investigated the relationship between "cold" proactive and reactive cognitive control, task effort, and subjective attentional symptoms (difficulty concentrating; unwanted thought) in a mixed clinical sample of individuals with generalized anxiety disorder (GAD) and/or obsessive-compulsive disorder (OCD) and a comparison sample of healthy controls. Clinical status moderated the relationship between attentional symptoms (attentional focusing and trait worry) and proactive cognitive control response time. Clinical status also moderated the relationship between trait worry and task effort. Higher trait worry was associated with slower proactive control and lower effort in healthy participants, but faster proactive control in clinical participants. Self-reported attentional focusing showed differential validity vis-à-vis proactive control response time in clinical versus healthy participants. Post-hoc conditional effects analysis suggested more accurate self-appraisals in healthy controls, but was not significant after correction for multiple comparisons. Preliminary evidence suggested that differences in task effort in anxious versus healthy adults may relate to subjective attentional symptoms in GAD and OCD.
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Affiliation(s)
- Lauren S Hallion
- University of Pittsburgh; Institute of Living, Hartford Hospital.
| | - David F Tolin
- Institute of Living, Hartford Hospital; Yale University School of Medicine
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Hallion LS, Tolin DF, Diefenbach GJ. Enhanced cognitive control over task-irrelevant emotional distractors in generalized anxiety disorder versus obsessive-compulsive disorder. J Anxiety Disord 2019; 64:71-78. [PMID: 31048095 DOI: 10.1016/j.janxdis.2019.02.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 02/15/2019] [Accepted: 02/20/2019] [Indexed: 02/07/2023]
Abstract
Generalized anxiety disorder (GAD) is defined in part by excessive and uncontrollable worry. However, little is known about cognitive control abilities in adults with GAD. The present study examined cognitive control over negative and neutral material in a mixed clinical sample of adults with GAD and/or obsessive-compulsive disorder and a comparison healthy control sample. Participants completed a novel emotional variant of the AX-CPT (eAX-CPT) to index proactive and reactive cognitive control in the presence of negative and neutral distractor stimuli. Participants with GAD demonstrated enhanced cognitive control specifically over negative emotional distractors, relative to neutral distractors (within-subjects) and relative to OCD and controls (between-subjects). Findings were specific to GAD versus trait worry; however, higher trait worry predicted better cognitive control in GAD only. These findings are inconsistent with deficit-based cognitive models of GAD and may be better accounted for by models that conceptualize worry as an intentional (albeit maladaptive) cognitive control or emotion regulation strategy that is actively maintained by individuals with GAD in order to avoid engaging with more distressing emotional information.
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Affiliation(s)
- Lauren S Hallion
- Department of Psychology, University of Pittsburgh, 210 S. Bouquet St., Pittsburgh, PA 15260, United States; Anxiety Disorders Center, Institute of Living, Hartford Hospital, 200 Retreat Ave, Hartford, CT 06106, United States.
| | - David F Tolin
- Anxiety Disorders Center, Institute of Living, Hartford Hospital, 200 Retreat Ave, Hartford, CT 06106, United States; Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510, United States
| | - Gretchen J Diefenbach
- Anxiety Disorders Center, Institute of Living, Hartford Hospital, 200 Retreat Ave, Hartford, CT 06106, United States; Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510, United States
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