The nature of prospective memory deficit in patients with obsessive-compulsive disorder

The relationship between cognitive phenotypes of compulsivity and impulsivity and clinical variables in obsessive-compulsive disorder: A systematic review and Meta-analysis

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.

I forgot that I forgot: PTSD symptom severity in a general population correlates with everyday diary-recorded prospective memory failures

Extant research suggests a complex relationship between prospective memory (PM) and post-traumatic stress disorder (PTSD) symptom severity. In a general population, this relationship exists for self-report assessment but not objective, in-lab PM performance (e.g., pressing a certain key at a particular time, or when particular words appear). However, both these measurement methods have limitations. Objective, in-lab PM tasks might not represent typical everyday performance, while self-report measurement might be biased by metacognitive beliefs. Thus, we used a naturalistic diary paradigm to answer the overarching question: are PTSD symptoms associated with PM failures in everyday life? We found a small positive correlation between diary-recorded PM errors and PTSD symptom severity (r = .21). Time-based tasks (i.e., intentions completed at a particular time, or after a specified time has elapsed; r = .29), but not event-based tasks (i.e., intentions completed in response to an environmental cue; r = .08), correlated with PTSD symptoms. Moreover, although diary-recorded and self-report PM correlated, we did not replicate the finding that metacognitive beliefs underpin the PM-PTSD relationship. These results suggest that metacognitive beliefs might be particularly important for self-report PM only.

Role of Prospective Memory in Obsessive Compulsive Disorder

BACKGROUND

The role of memory in obsessive-compulsive disorder (OCD) has been an area of research that has yielded mixed results, particularly in prospective memory (PM) functioning. Hence, one objective of the study was to assess PM deficits in patients with OCD. Also, research in this area has been sparse, and most researchers have used questionnaires and people with subclinical symptoms of OCD, which might have impacted the generalizability of the findings. Thus, the second objective was to assess PM functioning using a performance-based task in persons with OCD having clinical symptoms.

METHODS

This is a cross-sectional comparative study of 30 adults with OCD and 30 adults without psychiatric morbidity. The tools used were Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS), Hamilton Depression Rating Scale (HAMD), General Health Questionnaire-12 (GHQ 12), and Cambridge Prospective Memory Test (CAMPROMPT).

RESULTS

Event-based PM was significantly poor in the OCD group. In time-based PM, no significant difference was found between the groups. Three subgroups in OCD, predominantly obsessions, predominantly compulsions, and mixed types, did not differ significantly with respect to PM.

CONCLUSION

The result suggested a deficit of event-based PM in OCD, which can help understand the psychopathology of memory deficit in the clinical population and bridge the gap with respect to memory research in this domain.

The memory deficit hypothesis of compulsive checking in OCD: what are we really talking about? A narrative review

We reviewed studies that have specifically explored the memory deficit hypothesis of Obsessive Compulsive Disorder (OCD) checking, highlighting the methodological differences between these studies that may explain inconsistencies regarding memory deficits in OCD checkers. Based on Conway's proposition that one function of episodic memories is to keep an adaptive record of recent goal processing in order to check that actions have actually been accomplished, we suggest that impaired autonoetic consciousness -one of the main features of episodic memory- may be at the heart of the issue of checking compulsion. Autonoetic consciousness, that can be experimentally assessed by the Remember/Know/Guess paradigm,could be impaired in OCD checkers leading them to be unable to mentally relive their actions in order to be assured that they have been accomplished (e.g., having locked the door). We make methodological suggestions to improve the assessment of autonoetic consciousness deficit in OCD checkers and understand its role in the etiology and maintenance of compulsive checking.

Prospective memory in schizophrenia: A meta-analysis of comparative studies

BACKGROUND

Impairment of prospective memory (PM) in schizophrenia has gained increasing attention. This meta-analysis systematically examined PM impairment in schizophrenia.

METHODS

Both English (PubMed, PsycINFO, EMBASE, and Cochrane Library) and Chinese (WanFang, Chinese Biomedical and China Journal Net databases) databases were systematically searched from their inception until August 14, 2017. Case-control studies of PM in schizophrenia were included. Standardized mean differences (SMDs) and their 95% confidence interval (CI) were calculated using the random-effects model.

RESULTS

Twenty-nine case-control studies (n = 2492) were included in the analyses. The overall and three subtypes of PM were compared between patients with schizophrenia (n = 1284) and healthy controls (n = 1208). Compared to healthy controls, patients performed significantly poorer in overall (SMD = -1.125), time-based (SMD = -1.155), event-based (SMD = -1.068), and activity-based PM (SMD = -0.563). Subgroup analyses revealed significant differences between older and younger patients (SMD = -1.398 vs. -0.763), higher male predominance and no sex predominance (SMD = -1.679 vs. -0.800), lower and higher education level (SMD = -1.373 vs.-0.637), chronic and first-episode patients (SMD = -1.237 vs. -0.641) and between eco-valid and dual-task laboratory measurements (SMD = -1.542 vs. -0.725) regarding overall PM. Meta-regression analysis showed that higher negative symptom score was significantly associated with more severe overall PM impairment in patients (P = 0.022).

CONCLUSIONS

In this meta-analysis the overall PM and all its subtypes, particularly the time-based PM, were significantly impaired in schizophrenia.

Prospective memory in obsessive compulsive disorder

Studies on the nature and extent of prospective memory impairment in patients with obsessive-compulsive disorder are relatively scarce. The present study examined prospective memory in patients with obsessive-compulsive disorder in comparison to patients with schizophrenia and healthy controls. Prospective memory was assessed using Memory for Intentions Screening Test (MIST). Further, the participants were administered Delis-Kaplan Executive Function System Tower Test, Wisconsin Card Sorting Test, and Stroop Test for assessing their planning ability, mental flexibility and cognitive inhibition, respectively. Monitoring was assessed by frequency of clock checking. Results indicated that as compared to healthy controls, the patients with obsessive-compulsive disorder performed poorly on both time- and event-based prospective memory tasks, whereas, patients with schizophrenia performed poorly on time-based prospective memory task only. Further, both the patient groups had comparable performance across time- and event-based tasks. Results of error analysis indicated that patients with obsessive-compulsive disorder mainly committed no response and task substitution errors, whereas patients with schizophrenia committed no response errors. Except monitoring, none of the neurocognitive variables correlated with time or event-based prospective memory in any group. The findings are discussed in the light of their implications for retraining of prospective memory deficits in patients with obsessive-compulsive disorder and schizophrenia.