Handwriting and obsessive-compulsive disorder

Can a subgroup of OCD patients with motor abnormalities and poor therapeutic response be identified?

RATIONALE

In a subgroup of patients with obsessive-compulsive disorder (OCD), motor soft signs, tics and other movement disorders can be observed, indicating a special pathogenetic involvement of basal ganglia.

OBJECTIVES

The main objective of this study was to verify the hypothesis that such motor dysfunction characterises a subgroup of OCD patients with poor treatment response. For assessing even subtle motor dysfunction, a new method for kinematical analysis of hand movements has been applied.

METHODS

We examined the performance of 45 in-patients who met the DSM-IV criteria for OCD before and under therapy (sertraline and behaviour therapy) using a digitising tablet and kinematical analysis of simple handwriting and drawing movements. All subjects wrote a sentence, their signature and letter sequences. Moreover, they drew circles under different conditions. Three kinematical parameters (stroke duration, variation coefficient of peak velocity, stroke length) were calculated to quantify hand-motor performance.

RESULTS

Prior to therapy, non-responders wrote with significantly smaller amplitudes than responders. Additionally, non-responders drew significantly larger circles with the non-dominant hand at baseline, as compared to responders. Disturbances of handwriting were more frequent in non-responders than in responders.

CONCLUSIONS

Kinematical analysis of handwriting movements seems to be interesting for the prediction of poor response to treatments in OCD patients.

Sex, gender role, attribution of pathology, and handwriting tidiness

An archival study sampled personality test protocols with spontaneous handwriting specimens from 73 men and 168 women for signatures and scores on selected scales from the Minnesota Multiphasic Personality Inventory-2. Judges applied a 5-point scale to sort signatures for tidiness. Interrater agreement was .93. The mean handwriting tidiness score for men was 1.8 and 2.8 for women, a significant difference of 1 point. Correlations between handwriting tidiness and MMPI-2 scores did not support the hypothesis that erratic handwriting is associated with pathology but scores for gender role correlated significantly with handwriting tidiness. Masculine Gender Role predicted sloppy penmanship and Feminine Gender Role predicted tidy writing, independent of the writers' biological sex.