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Morris OJ, Wiese AD, Pinciotti CM, Pacheco R, Mallen MCM, Schweissing EJ, Soileau KJ, Crowley JJ, Storch EA. Obsessive-compulsive disorder among individuals of Hispanic and Latin American ancestry: Cultural considerations for assessment and psychotherapy. Bull Menninger Clin 2024; 88:148-170. [PMID: 38836850 DOI: 10.1521/bumc.2024.88.2.148] [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] [Indexed: 06/06/2024]
Abstract
Research specific to obsessive-compulsive disorder (OCD) among individuals of Hispanic and Latin American (H/L) ancestry is limited, as are culturally relevant assessment and treatment recommendations. This article discusses the implications of underrepresentation of H/L populations in OCD research and emphasizes the need to consider issues related to assessment, treatment, and structural barriers that hinder delivery of culturally appropriate first-line psychotherapy. Recommendations for assessment and treatment are provided to aid clinicians in distinguishing culturally normative thoughts and behaviors from OCD, as well as to inform the implementation of psychotherapeutic interventions with cultural humility. This manuscript offers recommendations for future research to tackle health equity concerns with respect to assessment and treatment and structural factors limiting access to culturally appropriate psychotherapy. Wide-scale efforts are needed to comprehensively understand how H/L cultures intersect with various OCD presentations and to further disseminate treatments to populations that have historically lacked access to mental health care.
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Affiliation(s)
- Olivia J Morris
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - Andrew D Wiese
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - Caitlin M Pinciotti
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | | | | | | | - Keaton J Soileau
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - James J Crowley
- Department of Genetics and with the and the Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina
| | - Eric A Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
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Liu C, Albertella L, Lochner C, Tiego J, Grant JE, Ioannidis K, Yücel M, Hellyer PJ, Hampshire A, Chamberlain SR. Conceptualising compulsivity through network analysis: A two-sample study. Compr Psychiatry 2023; 127:152429. [PMID: 37832377 DOI: 10.1016/j.comppsych.2023.152429] [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: 06/29/2023] [Revised: 09/21/2023] [Accepted: 10/02/2023] [Indexed: 10/15/2023] Open
Abstract
Compulsivity is a transdiagnostic construct crucial to understanding multiple psychiatric conditions and problematic repetitive behaviours. Despite being identified as a clinical- and research-relevant construct, there are limited insights into the internal conceptual structure of compulsivity. To provide a more nuanced understanding of compulsivity, the current study estimated the structure of compulsivity (indexed using the previously validated Cambridge-Chicago Compulsivity Trait Scale, CHI-T) among two large-scale and geographically distinct samples using the network estimation method. The samples consisted of a United Kingdom cohort (n = 122,346, 51.4% female, Mean age = 43.7, SD = 16.5, range = 9-86 years) and a South Africa cohort (n = 2674, 65.6% female, Mean age = 24.6, SD = 8.6, range = 18-65 years). Network community analysis demonstrated that compulsivity was constituted of three interrelated dimensions, namely: perfectionism, cognitive rigidity and reward drive. Further, 'Completion leads to soothing' and 'Difficulty moving from task to task' were identified as core (central nodes) to compulsivity. The dimensional structure and central nodes of compulsivity networks were consistent across the two samples. These findings facilitate the conceptualisation and measurement of compulsivity and may contribute to the early detection and treatment of compulsivity-related disorders.
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Affiliation(s)
- Chang Liu
- BrainPark, Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Victoria, Australia.
| | - Lucy Albertella
- BrainPark, Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Victoria, Australia
| | - Christine Lochner
- SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Western Cape, South Africa
| | - Jeggan Tiego
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Victoria, Australia
| | - Jon E Grant
- Department of Psychiatry & Behavioural Neuroscience, University of Chicago, Chicago, USA
| | - Konstantinos Ioannidis
- Department of Psychiatry, Faculty of Medicine, University of Southampton, UK; Southern Health NHS Foundation Trust, Southampton, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Murat Yücel
- BrainPark, Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Victoria, Australia
| | - Peter J Hellyer
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Adam Hampshire
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Samuel R Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, UK; Southern Health NHS Foundation Trust, Southampton, UK
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Giff A, Noren G, Magnotti J, Lopes AC, Batistuzzo MC, Hoexter M, Greenberg B, Marsland R, Miguel EC, Rasmussen S, McLaughlin N. Spatial normalization discrepancies between native and MNI152 brain template scans in gamma ventral capsulotomy patients. Psychiatry Res Neuroimaging 2023; 329:111595. [PMID: 36680842 PMCID: PMC10153791 DOI: 10.1016/j.pscychresns.2023.111595] [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: 11/09/2022] [Revised: 12/30/2022] [Accepted: 01/10/2023] [Indexed: 01/18/2023]
Abstract
In neurosurgery, spatial normalization emerged as a tool to minimize inter-subject variability and study target point locations based on standard coordinates. The Montreal Neurological Institute's 152 brain template (MNI152) has become the most widely utilized in neuroimaging studies, but has been noted to introduce partial volume effects, distortions, and increase structure size in all directions (x/y/z axes). These discrepancies question the accuracy of the MNI template, as well as its utility for studies that examine and form conclusions from group-level data. Given that surgical precision in obsessive-compulsive disorder is essential to patient outcomes, we retrospectively investigated lesion size and location in patients (n = 21) who underwent capsulotomy for intractable OCD, comparing deviations in the native scans to those in standard space. MNI measurements were significantly larger than native measurements across several structures in both coronal and axial slices, and we found that MNI transformation increases the size of many subcortical structures in a significant and proportional way for both females and males. These findings urge caution when using MNI as a reference space, as well as a stronger consideration of population-specific brain templates when examining connectivity-based networks.
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Affiliation(s)
- Alexis Giff
- Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA.
| | - Georg Noren
- Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA; Department of Psychiatry and Human Behavior, Butler Hospital, Providence, Rhode Island, USA
| | - John Magnotti
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Antonio Carlos Lopes
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Marcelo Camargo Batistuzzo
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil; Department of Methods and Techniques in Psychology, Pontifical Catholic University, São Paulo, Brazil
| | - Marcelo Hoexter
- Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Benjamin Greenberg
- Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA; Department of Psychiatry and Human Behavior, Butler Hospital, Providence, Rhode Island, USA
| | - Richard Marsland
- Department of Psychiatry and Human Behavior, Butler Hospital, Providence, Rhode Island, USA
| | | | - Steven Rasmussen
- Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA; Department of Psychiatry and Human Behavior, Butler Hospital, Providence, Rhode Island, USA
| | - Nicole McLaughlin
- Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA; Department of Psychiatry and Human Behavior, Butler Hospital, Providence, Rhode Island, USA
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4
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Worden BL, Tolin DF. Co-occurring Obsessive-Compulsive Disorder and Hoarding Disorder: A Review of the Current Literature. J Cogn Psychother 2022; 36:271-286. [PMID: 36635053 DOI: 10.1891/jcp-2021-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Current research suggests obsessive-compulsive disorder (OCD) co-occurs in around 20% of people with hoarding disorder (HD). The article discusses the theoretical conceptualization of co-occurring HD and OCD (HD+OCD), highlighting similarities between the disorders that may contribute to comorbidity, such as potentially overlapping etiological factors, comorbidity profiles, and phenomenological aspects; and differences that are important to consider in differential diagnosis and conceptualization, such as belief patterns, ego-syntonicty/dystonicity, and trajectory. The combination of HD+OCD versus either disorder alone appears to be associated with a profile characterized by higher nonhoarding OCD symptoms, anxiety symptoms, depression, and tic disorders, and which may be more treatment-refractory. The authors discuss some commonly used measures to assess hoarding that may be relevant in the context of OCD, as differential diagnosis of hoarding behaviors is often difficult, and hoarding may be difficult to detect in patients with OCD, especially in children. The article ends with a discussion on considerations for the treatment of HD+OCD with cognitive-behavioral therapy, as hoarding symptoms are less likely to respond to gold-standard exposure and response prevention, and there are no established treatment protocols that are designed to treat co-occurring HD and OCD.
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Affiliation(s)
| | - David F Tolin
- Institute of Living, Hartford, CT.,Yale University School of Medicine, New Haven, CT
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5
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Linde ES, Varga TV, Clotworthy A. Obsessive-Compulsive Disorder During the COVID-19 Pandemic-A Systematic Review. Front Psychiatry 2022; 13:806872. [PMID: 35401266 PMCID: PMC8989845 DOI: 10.3389/fpsyt.2022.806872] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 02/04/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic and its associated restrictions may contribute to a deterioration in mental health; individuals with obsessive-compulsive disorder (OCD) may be particularly affected. This systematic review aimed to investigate the effects of the current pandemic on people diagnosed with OCD, and whether pandemics may affect the development of OCD symptoms. METHODS We conducted a systematic search using NCBI PubMed, SCOPUS, and Google Scholar on February 9, 2021. Research articles related to OCD and COVID-19 or other pandemics were attempted to be identified using pre-defined search terms. Case reports, clinical guidelines, letters, and clinical research articles including ≥100 participants were included; reviews were excluded. The systematic review adheres to PRISMA guidelines and the Newcastle-Ottawa Scale was used to assess the quality of the included clinical research articles. RESULTS A total of 79 articles were included in the full-text assessment. Of these, 59 were clinical research articles, two were clinical guidelines, six were case reports, and 12 were letters. The research articles examined OCD symptoms in adult patients with diagnosed OCD, the general population, pregnant women, healthcare workers, students, and young adults, children, and adolescents. Only one study on OCD in previous pandemics was identified. CONCLUSION This systematic review found that people both with and without diagnosed OCD prior to the pandemic generally experienced a worsened landscape of symptoms of OCD during the COVID-19 pandemic. However, the responses are heterogeneous and many factors other than the pandemic seemed to affect the development of OCD symptoms. To prevent the impairment of symptoms and the development of new cases, close monitoring of patients with OCD and education of the general public is essential. Literature is still limited; thus, multinational and cross-cultural, longitudinal studies are warranted to gain further insights on this topic.
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Affiliation(s)
- Elisabeth S Linde
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Tibor V Varga
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Amy Clotworthy
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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6
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Simpson HB, van den Heuvel OA, Miguel EC, Reddy YCJ, Stein DJ, Lewis-Fernández R, Shavitt RG, Lochner C, Pouwels PJW, Narayanawamy JC, Venkatasubramanian G, Hezel DM, Vriend C, Batistuzzo MC, Hoexter MQ, de Joode NT, Costa DL, de Mathis MA, Sheshachala K, Narayan M, van Balkom AJLM, Batelaan NM, Venkataram S, Cherian A, Marincowitz C, Pannekoek N, Stovezky YR, Mare K, Liu F, Otaduy MCG, Pastorello B, Rao R, Katechis M, Van Meter P, Wall M. Toward identifying reproducible brain signatures of obsessive-compulsive profiles: rationale and methods for a new global initiative. BMC Psychiatry 2020; 20:68. [PMID: 32059696 PMCID: PMC7023814 DOI: 10.1186/s12888-020-2439-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 01/10/2020] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) has a lifetime prevalence of 2-3% and is a leading cause of global disability. Brain circuit abnormalities in individuals with OCD have been identified, but important knowledge gaps remain. The goal of the new global initiative described in this paper is to identify robust and reproducible brain signatures of measurable behaviors and clinical symptoms that are common in individuals with OCD. A global approach was chosen to accelerate discovery, to increase rigor and transparency, and to ensure generalizability of results. METHODS We will study 250 medication-free adults with OCD, 100 unaffected adult siblings of individuals with OCD, and 250 healthy control subjects at five expert research sites across five countries (Brazil, India, Netherlands, South Africa, and the U.S.). All participants will receive clinical evaluation, neurocognitive assessment, and magnetic resonance imaging (MRI). The imaging will examine multiple brain circuits hypothesized to underlie OCD behaviors, focusing on morphometry (T1-weighted MRI), structural connectivity (Diffusion Tensor Imaging), and functional connectivity (resting-state fMRI). In addition to analyzing each imaging modality separately, we will also use multi-modal fusion with machine learning statistical methods in an attempt to derive imaging signatures that distinguish individuals with OCD from unaffected siblings and healthy controls (Aim #1). Then we will examine how these imaging signatures link to behavioral performance on neurocognitive tasks that probe these same circuits as well as to clinical profiles (Aim #2). Finally, we will explore how specific environmental features (childhood trauma, socioeconomic status, and religiosity) moderate these brain-behavior associations. DISCUSSION Using harmonized methods for data collection and analysis, we will conduct the largest neurocognitive and multimodal-imaging study in medication-free subjects with OCD to date. By recruiting a large, ethno-culturally diverse sample, we will test whether there are robust biosignatures of core OCD features that transcend countries and cultures. If so, future studies can use these brain signatures to reveal trans-diagnostic disease dimensions, chart when these signatures arise during development, and identify treatments that target these circuit abnormalities directly. The long-term goal of this research is to change not only how we conceptualize OCD but also how we diagnose and treat it.
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Affiliation(s)
- Helen Blair Simpson
- grid.21729.3f0000000419368729Columbia University Irving Medical Center, Columbia University, New York, NY 10032 USA ,grid.413734.60000 0000 8499 1112The New York State Psychiatric Institute, New York, NY 10032 USA
| | - Odile A. van den Heuvel
- grid.12380.380000 0004 1754 9227Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands ,grid.12380.380000 0004 1754 9227Department of Anatomy and Neuroscience, Amsterdam UMC, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
| | - Euripedes C. Miguel
- grid.11899.380000 0004 1937 0722Obsessive-Compulsive Spectrum Disorders Program, Institute & Department of Psychiatry, Hospital das Clinicas-HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil ,grid.500696.cNational Institute of Developmental Psychiatry, Sao Paulo, Brazil
| | - Y. C. Janardhan Reddy
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Dan J. Stein
- grid.7836.a0000 0004 1937 1151SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Roberto Lewis-Fernández
- grid.21729.3f0000000419368729Columbia University Irving Medical Center, Columbia University, New York, NY 10032 USA ,grid.413734.60000 0000 8499 1112The New York State Psychiatric Institute, New York, NY 10032 USA
| | - Roseli Gedanke Shavitt
- grid.11899.380000 0004 1937 0722Obsessive-Compulsive Spectrum Disorders Program, Institute & Department of Psychiatry, Hospital das Clinicas-HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil ,grid.500696.cNational Institute of Developmental Psychiatry, Sao Paulo, Brazil
| | - Christine Lochner
- grid.11956.3a0000 0001 2214 904XSAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Petra J. W. Pouwels
- grid.12380.380000 0004 1754 9227Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
| | - Janardhanan C. Narayanawamy
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Ganesan Venkatasubramanian
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Dianne M. Hezel
- grid.21729.3f0000000419368729Columbia University Irving Medical Center, Columbia University, New York, NY 10032 USA ,grid.413734.60000 0000 8499 1112The New York State Psychiatric Institute, New York, NY 10032 USA
| | - Chris Vriend
- grid.12380.380000 0004 1754 9227Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands ,grid.12380.380000 0004 1754 9227Department of Anatomy and Neuroscience, Amsterdam UMC, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
| | - Marcelo C. Batistuzzo
- grid.11899.380000 0004 1937 0722Obsessive-Compulsive Spectrum Disorders Program, Institute & Department of Psychiatry, Hospital das Clinicas-HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil ,grid.500696.cNational Institute of Developmental Psychiatry, Sao Paulo, Brazil
| | - Marcelo Q. Hoexter
- grid.11899.380000 0004 1937 0722Obsessive-Compulsive Spectrum Disorders Program, Institute & Department of Psychiatry, Hospital das Clinicas-HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil ,grid.500696.cNational Institute of Developmental Psychiatry, Sao Paulo, Brazil
| | - Niels T. de Joode
- grid.12380.380000 0004 1754 9227Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands ,grid.12380.380000 0004 1754 9227Department of Anatomy and Neuroscience, Amsterdam UMC, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
| | - Daniel Lucas Costa
- grid.11899.380000 0004 1937 0722Obsessive-Compulsive Spectrum Disorders Program, Institute & Department of Psychiatry, Hospital das Clinicas-HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil ,grid.500696.cNational Institute of Developmental Psychiatry, Sao Paulo, Brazil
| | - Maria Alice de Mathis
- grid.11899.380000 0004 1937 0722Obsessive-Compulsive Spectrum Disorders Program, Institute & Department of Psychiatry, Hospital das Clinicas-HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil ,grid.500696.cNational Institute of Developmental Psychiatry, Sao Paulo, Brazil
| | - Karthik Sheshachala
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Madhuri Narayan
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Anton J. L. M. van Balkom
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, de Boelelaan 1117, Amsterdam, Netherlands ,grid.420193.d0000 0004 0546 0540GGZ inGeest, Specialised Mental Health Care, Amsterdam, The Netherlands
| | - Neeltje M. Batelaan
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, de Boelelaan 1117, Amsterdam, Netherlands ,grid.420193.d0000 0004 0546 0540GGZ inGeest, Specialised Mental Health Care, Amsterdam, The Netherlands
| | - Shivakumar Venkataram
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Anish Cherian
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Clara Marincowitz
- grid.11956.3a0000 0001 2214 904XSAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Nienke Pannekoek
- grid.11956.3a0000 0001 2214 904XSAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Yael R. Stovezky
- grid.21729.3f0000000419368729Columbia University Irving Medical Center, Columbia University, New York, NY 10032 USA ,grid.413734.60000 0000 8499 1112The New York State Psychiatric Institute, New York, NY 10032 USA
| | - Karen Mare
- grid.7836.a0000 0004 1937 1151SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry & Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Feng Liu
- grid.21729.3f0000000419368729Columbia University Irving Medical Center, Columbia University, New York, NY 10032 USA ,grid.413734.60000 0000 8499 1112The New York State Psychiatric Institute, New York, NY 10032 USA
| | - Maria Concepcion Garcia Otaduy
- grid.11899.380000 0004 1937 0722Obsessive-Compulsive Spectrum Disorders Program, Institute & Department of Psychiatry, Hospital das Clinicas-HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil ,grid.500696.cNational Institute of Developmental Psychiatry, Sao Paulo, Brazil
| | - Bruno Pastorello
- grid.11899.380000 0004 1937 0722Institute of Radiology, Hospital das Clinicas-HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Rashmi Rao
- grid.416861.c0000 0001 1516 2246National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore, India
| | - Martha Katechis
- grid.21729.3f0000000419368729Columbia University Irving Medical Center, Columbia University, New York, NY 10032 USA ,grid.413734.60000 0000 8499 1112The New York State Psychiatric Institute, New York, NY 10032 USA
| | - Page Van Meter
- grid.21729.3f0000000419368729Columbia University Irving Medical Center, Columbia University, New York, NY 10032 USA ,grid.413734.60000 0000 8499 1112The New York State Psychiatric Institute, New York, NY 10032 USA
| | - Melanie Wall
- grid.21729.3f0000000419368729Columbia University Irving Medical Center, Columbia University, New York, NY 10032 USA ,grid.413734.60000 0000 8499 1112The New York State Psychiatric Institute, New York, NY 10032 USA
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Xu C, Cao H, Liu D. Integrative analysis of shared genetic pathogenesis by obsessive‑compulsive and eating disorders. Mol Med Rep 2018; 19:1761-1766. [PMID: 30569105 DOI: 10.3892/mmr.2018.9772] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 10/18/2018] [Indexed: 11/06/2022] Open
Abstract
A number of common pathological features have been observed in obsessive‑compulsive disorder (OCD) and eating disorders (EDs). The present study examined the association between OCD and EDs at the genetic level in order to gain an improved understanding of the shared genetic basis of the diseases and identify novel potential risk genes for the two diseases. An integrated analysis using large‑scale disease‑gene association data and gene expression data was conducted. Disease‑gene association data were acquired from the Pathway Studio Mammalian database. Gene expression data were acquired from samples of 133 subjects, including 15 ED cases, 16 OCD cases and 102 normal controls. Genes associated with OCD and ED presented significant overlap (21 genes, P=6.70x10‑34), serving roles within multiple common genetic pathways (top 10 pathway enrichment P<4.30x10‑7) that were implicated in the two diseases. A genetic network of 17 genes was constructed, through which OCD and ED were observed to influence each other. Expression analysis revealed four novel common significant genes for OCD and ED (oxytocin receptor, glutamate decarboxylase 2, neuropeptide Y and glutamate ionotropic receptor kainate type subunit 3). These genes demonstrated a strong functional association with the two diseases. The results of the present study supported the presence of complex genetic associations between OCD and ED. Genes associated with one disease are worthy of further investigation as potential risk factors for the other. The findings of the present study may provide novel insights into the understanding of the pathogenesis of OCD and ED.
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Affiliation(s)
- Cheng Xu
- Department of Magnetic Resonance Imaging, Shanxi Province People's Hospital, Taiyuan, Shanxi 030001, P.R. China
| | - Hongbao Cao
- Department of Genomics Research, R&D Solutions, Elsevier, Inc., Rockville, MD 20852, USA
| | - Dongbai Liu
- Department of Neurology, The First People's Hospital Affiliated to Soochow University, Suzhou, Jiangsu 215006, P.R. China
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Kessler RC, Aguilar-Gaxiola S, Alonso J, Chatterji S, Lee S, Ustün TB. The WHO World Mental Health (WMH) Surveys. ACTA ACUST UNITED AC 2018. [PMID: 21132091 DOI: 10.1055/s-0038-1671923] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The paper presents an overview of the WHO World Mental Health (WMH) Survey Initiative and summarizes recent WMH results regarding the prevalence and societal costs of mental disorders. The WMH surveys are representative community surveys that were carried out in 28 countries throughout the world aimed at providing information to mental health policy makers about the prevalence, burden, and unmet need for treatment of common mental disorders. Results show that mental disorders are commonly occurring in all participating countries. The inter-quartile range (IQR: 25(th)-75(th) percentiles) of lifetime DSM-IV disorder prevalence estimates (combining anxiety, mood, disruptive behavior, and substance disorders) is 18.1-36.1%. The IQR of 12-month prevalence estimates is 9.8-19.1%. Analysis of age-of-onset reports shows that many mental disorders begin in childhood-adolescence and have significant adverse effects on subsequent role transitions. Adult mental disorders are found in the WMH data to be associated with high levels of role impairment. Despite this burden, the majority of mental disorders go untreated. Although these results suggest that expansion of treatment could be cost-effective from both the employer perspective and the societal perspective, treatment effectiveness trials are needed to confirm this suspicion. The WMH results regarding impairments are being used to target several such interventions.
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9
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Greenberg JL, Berman NC, Braddick V, Schwartz R, Mothi SS, Wilhelm S. Treatment utilization and barriers to treatment among individuals with olfactory reference syndrome (ORS). J Psychosom Res 2018; 105:31-36. [PMID: 29332631 DOI: 10.1016/j.jpsychores.2017.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 12/01/2017] [Accepted: 12/02/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Olfactory reference syndrome (ORS) is characterized by a preoccupation that one is emitting a foul or offensive odor. Despite the profound psychosocial impact of ORS, many patients do not receive appropriate treatment, and there is no empirical research on treatment-seeking behavior in ORS. This study investigated treatment utilization patterns and barriers to treatment in individuals with ORS. METHOD 253 subjects completed an online survey between January-March 2010. Data were obtained from the Yale-Brown Obsessive Compulsive Scale Modified for ORS (ORS-YBOCS), Depression Anxiety Stress Scales (DASS), Work and Social Adjustment Scale (WSAS), and questionnaires specific to treatment utilization and barriers. RESULTS The sample was ethnically diverse, predominately male (67%), with an average age of 33.7years, and moderately severe ORS symptoms. Most participants first sought care from a medical specialist (44%), and mental health services were underutilized (14%). Higher functional impairment was significantly correlated with seeking care from a mental health provider, compared to a medical specialist. Nearly all participants endorsed multiple barriers to treatment, including (a) logistical/financial, (b) stigma/discrimination, and (c) treatment perception barriers. ORS symptom severity was significantly, positively correlated with number of logistical/financial and stigma/discrimination barriers. Treatment barriers were significantly influenced by ethnic group, ORS symptom severity, and source of odor. CONCLUSION Results highlight the importance of increasing awareness and enhancing access to care for individuals with ORS.
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Affiliation(s)
- Jennifer L Greenberg
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Simches Research Building 185 Cambridge Street, Suite 2000, Boston, MA 02114, USA.
| | - Noah C Berman
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Simches Research Building 185 Cambridge Street, Suite 2000, Boston, MA 02114, USA.
| | - Valerie Braddick
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Simches Research Building 185 Cambridge Street, Suite 2000, Boston, MA 02114, USA.
| | - Rachel Schwartz
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Simches Research Building 185 Cambridge Street, Suite 2000, Boston, MA 02114, USA
| | - Suraj S Mothi
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Simches Research Building 185 Cambridge Street, Suite 2000, Boston, MA 02114, USA.
| | - Sabine Wilhelm
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Simches Research Building 185 Cambridge Street, Suite 2000, Boston, MA 02114, USA.
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Greenberg JL, Shaw AM, Reuman L, Schwartz R, Wilhelm S. Clinical features of olfactory reference syndrome: An internet-based study. J Psychosom Res 2016; 80:11-6. [PMID: 26721542 DOI: 10.1016/j.jpsychores.2015.11.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 11/03/2015] [Accepted: 11/04/2015] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Preoccupation with perceived bodily odor has been described in neuropsychiatric disorders for more than a century; however, empirical research on olfactory reference syndrome (ORS) is scarce. This study investigated the phenomenology of ORS in a broadly ascertained, diverse sample. METHOD Data were obtained from 253 subjects in an internet-based survey that operated from January - March 2010. Measures included the Yale-Brown Obsessive Compulsive Scale Modified for ORS (ORS-YBOCS), Work and Social Adjustment Scale (WSAS), Depression Anxiety Stress Scales (DASS), and symptom specific questionnaires developed for this study. RESULTS Individuals reported, on average, moderately severe ORS symptoms. The average age of onset of ORS symptoms was 21.1 years, with 54% reporting a chronic, unremitting course. Individuals endorsed a lifetime average of two malodorous preoccupations, most commonly stool, garbage, and ammonia. Odors were most often reported to emanate from the armpits, feet, and breasts. Nearly all participants engaged in time-consuming rituals to try to hide or fix their perceived malodor (e.g., checking and camouflaging). Eighteen percent reported poor or delusional insight and 64.0% reported ideas or delusions of reference. More severe ORS symptoms were moderately associated with female gender, poorer insight, and higher levels of impairment (in work, social leisure, ability to maintain close relationships, and consecutive days housebound). CONCLUSION This is the largest study on ORS to date. Results underscore the clinical significance and psychosocial impact of this understudied disorder, and highlight the need for subsequent research to examine clinical features and inform treatment.
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Affiliation(s)
- Jennifer L Greenberg
- Massachusetts General Hospital, Simches Research Building, 185 Cambridge Street, Suite 2200, Boston, MA 02114, United States; Harvard Medical School, Simches Research Building, 185 Cambridge Street, Suite 2200, Boston, MA 02114, United States; Department of Psychiatry, Simches Research Building, 185 Cambridge Street, Suite 2200, Boston, MA 02114, United States.
| | - Ashley M Shaw
- Massachusetts General Hospital, Simches Research Building, 185 Cambridge Street, Suite 2200, Boston, MA 02114, United States; Harvard Medical School, Simches Research Building, 185 Cambridge Street, Suite 2200, Boston, MA 02114, United States; Department of Psychiatry, Simches Research Building, 185 Cambridge Street, Suite 2200, Boston, MA 02114, United States; Department of Psychology, University of Miami, United States.
| | - Lillian Reuman
- Massachusetts General Hospital, Simches Research Building, 185 Cambridge Street, Suite 2200, Boston, MA 02114, United States; Harvard Medical School, Simches Research Building, 185 Cambridge Street, Suite 2200, Boston, MA 02114, United States; Department of Psychiatry, Simches Research Building, 185 Cambridge Street, Suite 2200, Boston, MA 02114, United States; Department of Psychology, University of North Carolina, Chapel Hill, United States.
| | - Rachel Schwartz
- Massachusetts General Hospital, Simches Research Building, 185 Cambridge Street, Suite 2200, Boston, MA 02114, United States; Harvard Medical School, Simches Research Building, 185 Cambridge Street, Suite 2200, Boston, MA 02114, United States; Department of Psychiatry, Simches Research Building, 185 Cambridge Street, Suite 2200, Boston, MA 02114, United States; Department of Psychology, University of Pennsylvania, United States.
| | - Sabine Wilhelm
- Massachusetts General Hospital, Simches Research Building, 185 Cambridge Street, Suite 2200, Boston, MA 02114, United States.
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The Biology of Obsessive-Compulsive Personality Disorder Symptomatology: Identifying an Extremely K-Selected Life History Variant. EVOLUTIONARY PSYCHOLOGICAL SCIENCE 2015. [DOI: 10.1007/s40806-015-0030-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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The obsessive compulsive spectrum in schizophrenia, a meta-analysis and meta-regression exploring prevalence rates. Schizophr Res 2014; 152:458-68. [PMID: 24361303 DOI: 10.1016/j.schres.2013.10.033] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 10/16/2013] [Accepted: 10/25/2013] [Indexed: 01/26/2023]
Abstract
AIMS The aims of this study were to conduct a meta-analysis and meta-regression to estimate the prevalence rates for obsessive compulsive symptoms (OCS) and obsessive compulsive disorder (OCD) in schizophrenia, and to investigate what influences these prevalence rates. METHOD Studies were identified via an online OVID database search, including PsychInfo, Embase and Medline until December 2009. RESULTS Forty-three studies summarizing outcomes for 3978 subjects met inclusion criteria. The mean OCD prevalence is 12.3%, slightly increasing to 13.6% after adjustment in meta-regression. The prevalence rate of OCS, defined as any obsession or compulsion is 30.7% (30.3% adjusted). Higher severity of OCS, DIGS assessment, and Sub-Saharan African origin of study are associated with a lower OCS/OCD prevalence rate, use of DSM-IV edition, Y-BOCS assessment and longer schizophrenia history are associated with a higher prevalence rate. CONCLUSION The prevalence of OCS and OCD in schizophrenia is substantial, specifically in more chronic patient populations and is influenced by the method of assessment.
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Leth I, Niclasen J, Ryding E, Baroud Y, Esbjørn BH. Psychological Difficulties among Children and Adolescents with Ethnic Danish, Immigrant, and Refugee Backgrounds. Scand J Child Adolesc Psychiatr Psychol 2014. [DOI: 10.21307/sjcapp-2014-005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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The clinical utility of symptom dimensions in obsessive-compulsive disorder. Psychiatry Res 2010; 180:25-9. [PMID: 20493537 DOI: 10.1016/j.psychres.2009.09.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2009] [Revised: 09/03/2009] [Accepted: 09/11/2009] [Indexed: 10/19/2022]
Abstract
Factor analyses in obsessive-compulsive disorder (OCD) have consistently identified several different symptom dimensions. Nevertheless the clinical utility of identifying such symptom dimensions remains somewhat unclear. On the basis of their principal symptoms, 343 OCD patients were divided into four symptom dimension subgroups; 1) contamination/washing, 2) hoarding, 3) symmetry/repeating and ordering, and 4) forbidden thoughts/checking. Clinical variables including 1-year treatment outcome were compared across these patient subgroups. Most patients (74%) could distinctively be categorized as falling into a particular symptom subgroup. The groups were differentially characterized by some demographic and clinical features. For instance, both the symmetry and hoarding groups were significantly associated with decreased global functioning and greater OCD severity. Moreover the hoarding group was significantly more likely than the others to show longer duration of illness, lower rate of marriage, poor insight, and poorer outcome. However, about a quarter of the participants could not be classified definitively into a particular group. Our findings provide partial support for the clinical utility of a simple measure of symptom dimensions in OCD. In clinical settings, however, the limitations of such a simple measure of predominant symptom dimensions should be borne in mind and further work on their validity and utility is needed.
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Anholt GA, van Oppen P, Cath DC, Emmelkamp PMG, Smit JH, van Balkom AJLM. Sensitivity to change of the Obsessive Beliefs Questionnaire. Clin Psychol Psychother 2010; 17:154-9. [PMID: 19658124 DOI: 10.1002/cpp.641] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The Obsessive-Compulsive Beliefs Questionnaire-87 (OBQ-87) has been constructed by leading obsessive-compulsive disorder (OCD) experts to assess dysfunctional beliefs typical for OCD patients. The OBQ-87 has recently been revised (Obsessive-Compulsive Beliefs Questionnaire-44 [OBQ-44]) to improve its psychometric properties. The current investigation entailed two goals: (1) to assess the sensitivity of both Obsessive Beliefs Questionnaire (OBQ) versions to treatment change and other OCD measures; and (2) to assess relations between symptom subtypes, OBQ beliefs and changes in beliefs as a consequence of treatment. One hundred and four patients have completed the OBQ before and after 12 sessions of behaviour therapy. Results suggest that (1) both OBQ versions exhibit an identical medium effect size; (2) overlap between clinical and non-clinical populations limit the use of the OBQ as a primary measure of treatment change; and (3) the symptom dimension obsessions + checking was related to initial OBQ scores, but no symptom dimensions were related to OBQ pre-treatment to post-treatment changes.
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Affiliation(s)
- Gideon A Anholt
- Department of Psychiatry and Institute for Research in Extramural Medicine, VU-Universtiy Medical Center and Academic Outpatient Clinic for Anxiety Disorders, GGZ Buitenamstel, Amsterdam, the Netherlands
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Clinical features and treatment characteristics of compulsive hoarding in Japanese patients with obsessive-compulsive disorder. CNS Spectr 2010; 15:258-65. [PMID: 20414175 DOI: 10.1017/s1092852900000092] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Compulsive hoarding has been studied primarily in Western countries. Here we sought to examine compulsive hoarding in Japanese patients with obsessive-compulsive disorder (OCD). The heterogeneous nature of hoarding was also investigated. METHODS One hundred and sixty-eight OCD outpatients were initially assessed to determine the presence or absence of compulsive hoarding, and whether hoarding was primary or secondary to another symptom dimension for which they had received treatment for 1 year. RESULTS Of the participants, 54 patients were found to have compulsive hoarding. Hoarders were significantly more likely than non-hoarding patients to have more severe psychopathology including elevated severity of OCD symptoms, poorer insight, higher prevalence of comorbid schizotypal or obsessive-compulsive personality disorder, closer association with symmetry dimension, and poorer treatment outcome. Comparisons of subjects with primary and secondary hoarding found that the former group had more severe clinical features, while the latter group hoarded a wider variety of items, including apparently bizarre ones. CONCLUSION The prevalence and clinical characteristics of compulsive hoarding in OCD subjects was similar to those reported in Western countries, supporting its trans-cultural consistency. The distinction between primary and secondary hoarding in OCD is clinically useful, and may contribute to the debate about whether hoarding should be a separate diagnostic entity.
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Lewis-Fernández R, Hinton DE, Laria AJ, Patterson EH, Hofmann SG, Craske MG, Stein DJ, Asnaani A, Liao B. Culture and the anxiety disorders: recommendations for DSM-V. Depress Anxiety 2010; 27:212-29. [PMID: 20037918 PMCID: PMC4337390 DOI: 10.1002/da.20647] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The anxiety disorders specified in the fourth edition, text revision, of The Diagnostic and Statistical Manual (DSM-IV-TR) are identified universally in human societies, and also show substantial cultural particularities in prevalence and symptomatology. Possible explanations for the observed epidemiological variability include lack of measurement equivalence, true differences in prevalence, and limited validity or precision of diagnostic criteria. One central question is whether, through inadvertent "over-specification" of disorders, the post-DSM-III nosology has missed related but somewhat different presentations of the same disorder because they do not exactly fit specified criteria sets. This review canvases the mental health literature for evidence of cross-cultural limitations in DSM-IV-TR anxiety disorder criteria. METHODS Searches were conducted of the mental health literature, particularly since 1994, regarding cultural or race/ethnicity-related factors that might limit the universal applicability of the diagnostic criteria for six anxiety disorders. RESULTS Possible mismatches between the DSM criteria and the local phenomenology of the disorder in specific cultural contexts were found for three anxiety disorders in particular. These involve the unexpectedness and 10-minute crescendo criteria in Panic Disorder; the definition of social anxiety and social reference group in Social Anxiety Disorder; and the priority given to psychological symptoms of worry in Generalized Anxiety Disorder. Limited evidence was found throughout, particularly in terms of neurobiological markers, genetic risk factors, treatment response, and other DSM-V validators that could help clarify the cross-cultural applicability of criteria. CONCLUSIONS On the basis of the available data, options and preliminary recommendations for DSM-V are put forth that should be further evaluated and tested.
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Affiliation(s)
- Roberto Lewis-Fernández
- Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York, New York 10032, USA.
| | - Devon E. Hinton
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Amaro J. Laria
- Massachusetts School of Professional Psychology, Boston, Massachusetts
| | | | | | - Michelle G. Craske
- Department of Psychology, University of California, Los Angeles, California
| | - Dan J. Stein
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Anu Asnaani
- Department of Psychology, Boston University, Boston, Massachusetts
| | - Betty Liao
- Department of Psychology, University of California, Los Angeles, California
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Clinical Correlates and Treatment Response of the Yale-Brown Obsessive Compulsive Scale Auxiliary Items. COGNITIVE THERAPY AND RESEARCH 2009. [DOI: 10.1007/s10608-009-9275-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kessler RC, Aguilar-Gaxiola S, Alonso J, Chatterji S, Lee S, Ormel J, Ustün TB, Wang PS. The global burden of mental disorders: an update from the WHO World Mental Health (WMH) surveys. EPIDEMIOLOGIA E PSICHIATRIA SOCIALE 2009; 18:23-33. [PMID: 19378696 PMCID: PMC3039289 DOI: 10.1017/s1121189x00001421] [Citation(s) in RCA: 1004] [Impact Index Per Article: 66.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
AIMS The paper reviews recent findings from the WHO World Mental Health (WMH) surveys on the global burden of mental disorders. METHODS The WMH surveys are representative community surveys in 28 countries throughout the world aimed at providing information to mental health policy makers about the prevalence, distribution, burden, and unmet need for treatment of common mental disorders. RESULTS The first 17 WMH surveys show that mental disorders are commonly occurring in all participating countries. The inter-quartile range (IQR: 25th-75th percentiles) of lifetime DSM-IV disorder prevalence estimates (combining anxiety, mood, externalizing, and substance use disorders) is 18.1-36.1%. The IQR of 12-month prevalence estimates is 9.8-19.1%. Prevalence estimates of 12-month Serious Mental Illness (SMI) are 4-6.8% in half the countries, 2.3-3.6% in one-fourth, and 0.8-1.9% in one-fourth. Many mental disorders begin in childhood-adolescence and have significant adverse effects on subsequent role transitions in the WMH data. Adult mental disorders are found to be associated with such high role impairment in the WMH data that available clinical interventions could have positive cost-effectiveness ratios. CONCLUSIONS Mental disorders are commonly occurring and often seriously impairing in many countries throughout the world. Expansion of treatment could be cost-effective from both employer and societal perspectives.
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Affiliation(s)
- Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115, USA.
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