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Zhou Y, Cao X, Wang J, Gao R, Chen Y, Liu Y, Zhang Z, Wang Z, Storch EA, Fan Q. Association between miscellaneous symptoms and primary symptom dimensions among chinese adults with obsessive-compulsive disorder. Psychiatry Res 2019; 274:274-279. [PMID: 30825727 DOI: 10.1016/j.psychres.2019.02.042] [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: 07/08/2018] [Revised: 02/02/2019] [Accepted: 02/18/2019] [Indexed: 11/28/2022]
Abstract
Obsessive compulsive-disorder (OCD) is a common mental illness characterized by the presence of obsessions and/or compulsions. Symptom presence and severity is typically evaluated through the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). However, miscellaneous symptoms embedded within the Y-BOCS Symptom Checklist have often been overlooked despite being associated with certain dimensions. In this study, we used exploratory factor analysis and logistic regression to explore the relationship between various miscellaneous symptoms and OCD symptom dimensions among 123 Chinese adults with OCD. A four-dimensional model was factorially derived: Obsessions, Symmetry/Ritual, Contamination/Cleaning and Contamination/Cleaning. In general, 11 out of 17 miscellaneous symptoms were associated with one or more of the symptom dimensions. Among them, the Obsessions dimension was significantly associated with seven miscellaneous symptoms: "Fear of not saying just the right thing," "Intrusive (non-violent) images," "Intrusive nonsense sounds, words", etc. The Symmetry/Ritual dimension was significantly associated with "Need to tell, ask, or confess." The Contamination/Cleaning dimension was related to "Need to know or remember". The Hoarding/Religion dimension was related to "Fear of losing things," and "Superstitious fears". Results contribute to the clinical assessment, diagnosis and treatment of Chinese patients with OCD by understanding the extent to which certain miscellaneous symptoms are associated with primary symptom dimensions.
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Affiliation(s)
- Yuxin Zhou
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Xuan Cao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Jianyu Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Rui Gao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Yongjun Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Ying Liu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Zongfeng Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Zhen Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Eric A Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
| | - Qing Fan
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai, 200030, China.
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García-Soriano G, Rufer M, Delsignore A, Weidt S. Factors associated with non-treatment or delayed treatment seeking in OCD sufferers: a review of the literature. Psychiatry Res 2014; 220:1-10. [PMID: 25108591 DOI: 10.1016/j.psychres.2014.07.009] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 05/22/2014] [Accepted: 07/07/2014] [Indexed: 12/16/2022]
Abstract
Obsessive-compulsive disorder (OCD) is a disabling disorder that can be successfully treated. However, a high percentage of sufferers neither ask for nor receive treatment for their symptoms, or they delay seeking treatment. The factors underlying the treatment-seeking behaviour of OCD patients are still not clear. This review includes 12 studies published before April 2014 that analyse the possible variables related to the delayed help-seeking behaviour of OCD patients. Studies showed that individuals who asked for help were more impaired and reported poorer quality of life. Help-seeking behaviour was associated with greater insight, severity, specific obsessive-compulsive symptoms, such as aggressive and other unpleasant obsessions, and comorbidity. Common barriers to seeking treatment were shame about the symptoms or about asking for treatment, not knowing where to find help, or inconveniences associated with treatment. Inconsistencies among the reviewed studies highlight the need to further evaluate the variables that keep OCD patients from seeking help. The review highlights the need for educational campaigns designed to detect underdiagnosed OCD individuals and improve access to mental health services, which could shorten delays in seeking treatment and, therefore, reduce the personal and financial costs of OCD. Guidelines for educational programs and future lines of research are discussed.
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Affiliation(s)
- Gemma García-Soriano
- Universitat de València Departamento Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Avda. Blasco Ibáñez 21, 46010 Valencia, Spain.
| | - Michael Rufer
- University Hospital Zürich, Department of Psychiatry and Psychotherapy, Culmannstrasse 8,8091 Zürich, Switzerland.
| | - Aba Delsignore
- University Hospital Zürich, Department of Psychiatry and Psychotherapy, Culmannstrasse 8,8091 Zürich, Switzerland.
| | - Steffi Weidt
- University Hospital Zürich, Department of Psychiatry and Psychotherapy, Culmannstrasse 8,8091 Zürich, Switzerland.
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Demet MM, Deveci A, Taşkin EO, Erbay Dündar P, Türel Ermertcan A, Mizrak Demet S, Bayraktar D, Oztürkcan S. Risk factors for delaying treatment seeking in obsessive-compulsive disorder. Compr Psychiatry 2010; 51:480-5. [PMID: 20728004 DOI: 10.1016/j.comppsych.2010.02.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2009] [Revised: 12/22/2009] [Accepted: 02/08/2010] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Despite the multiple alternatives of treatment, it is well known that patients with obsessive-compulsive disorder (OCD) delay seeking treatment. In this study, the aim was to determine the risk factors for delaying treatment seeking in OCD patients. METHODS The sample consisted of 132 OCD who completed the Yale-Brown Obsessive-Compulsive Scale, Yale-Brown Obsessive-Compulsive Scale Symptom Checklist, and Beck Depression Inventory. RESULTS In univariate analyses with risk evaluation, income level, being single or divorced, having a history of psychiatric treatment, poor insight for the symptoms, and obsessions of hoarding were the variables that were found to be significant. In the regression model, history of psychiatric treatment and duration of OCD were the 2 variables that remained statistically significant. CONCLUSION This was the first study wherein the sample included patients who were recruited from a nonpsychiatric department: the dermatology clinic. Application to dermatology has not been determined as a risk factor for delaying treatment seeking in OCD patients.
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Affiliation(s)
- Mehmet Murat Demet
- Department of Psychiatry, School of Medicine, Celal Bayar University, Manisa, Turkey.
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Li Y, Marques L, Hinton DE, Wang Y, Xiao ZP. Symptom dimensions in Chinese patients with obsessive-compulsive disorder. CNS Neurosci Ther 2010; 15:276-82. [PMID: 19691547 DOI: 10.1111/j.1755-5949.2009.00099.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
To study the symptom dimensions of Chinese patients with obsessive-compulsive disorder (OCD), the symptom checklist of the Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS) was used to assess the symptom dimensions of 139 OCD patients at a mental health center in Shanghai. The most common symptom dimensions were symmetry (67.6%), contamination (43.2%), and aggression (31.7%). The frequency of patients with the miscellaneous, sexual/religious, and hoarding symptom dimensions was 25.9%, 10.8%, and 8.6%, respectively. The frequency of male patients with symmetry concerns was higher than that of the female patients, and the frequency of female patients with contamination concerns was higher than that of male patients. OCD symptom dimensions can be identified in the Chinese context but there is a low frequency of endorsement of certain dimensions: sexual/religious, aggression, and hoarding concerns. Future studies need to further investigate the sociocultural and gender factors that may result in these findings: low numbers of people in China with a religious affiliation and the Chinese emphasis on Confucian harmony philosophy, thrift, and saving.
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Affiliation(s)
- Ying Li
- Shanghai Mental Health Center, Shanghai Jiaotong University, Shanghai, China
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Abstract
Epidemiological and clinical data from a variety of cultural and geographic settings on obsessive-compulsive disorder (OCD), and many of the obsessive-compulsive spectrum disorders, suggest that this is a group of disorders with a good degree of transcultural homogeneity. However, the content and themes that predominate in patients with these disorders, and the course of illness, can be shaped by cultural, ethnic, and religious experiences. Across cultures, OCD is commonly comorbid with mood, anxiety, and impulse-control disorders. However, little is known about the mechanisms by which culture and ethnicity may affect the expression of OCD and related disorders. Cross-national comparative studies exploring culturally influenced differences in clinical course, treatment outcome, including ethnogenetic differences in drug response, and prognosis are needed.
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Affiliation(s)
- Hisato Matsunaga
- Department of Neuropsychiatry, Osaka City University Medical School, Osaka, Japan
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Saad G. Sex differences in OCD symptomatology: An evolutionary perspective. Med Hypotheses 2006; 67:1455-9. [PMID: 16828981 DOI: 10.1016/j.mehy.2006.05.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2006] [Revised: 05/03/2006] [Accepted: 05/05/2006] [Indexed: 11/27/2022]
Abstract
Some evolutionists have construed obsessive-compulsive disorder (OCD) as the over-activation of warning systems in areas of evolutionary import. Using evolutionary theorizing, it is posited here that sex differences in the instantiation of specific obsessions and/or compulsions might correspond to sex-specific differences in the evolutionary import of the domain to which the particular symptom maps onto (e.g., mating versus parenting). Even in instances where no sex differences are found in the incidence of a particular obsession and/or compulsion (e.g., the extent to which men and women might suffer from intrusive thoughts), an evolutionary perspective might nonetheless propose that the contents of such thoughts map onto sex-specific adaptive concerns (e.g., social status and appearance-related concerns for men and women, respectively). An evolutionary approach might help not only in explaining sex differences in OCD phenomenology but also in elucidating within-sex manifestations of OCD symptoms (e.g., the shifting strength of contamination fears across a woman's menstrual cycle). The current evolutionary perspective not only provides an integrative ultimate-level meta-framework in understanding previously-found sex differences in OCD but also it permits OCD researchers to propose innovative hypotheses that otherwise might have been unlikely to be posited if one were to strictly focus on a proximate exploration of OCD. Cross-cultural clinical data, originating from a heterogeneous set of cultures and highlighting universal patterns of sex-specific OCD symptomatology, would provide a strong test of the posited hypotheses.
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Affiliation(s)
- Gad Saad
- John Molson School of Business, Concordia University, 1455 de Maisonneuve Blvd. West, Montreal, QC, Canada H3G 1M8.
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Demet MM, Deveci A, Taskin EO, Ermertcan AT, Yurtsever F, Deniz F, Bayraktar D, Ozturkcan S. Obsessive-compulsive disorder in a dermatology outpatient clinic. Gen Hosp Psychiatry 2005; 27:426-30. [PMID: 16271657 DOI: 10.1016/j.genhosppsych.2005.04.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2005] [Revised: 04/20/2005] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aims of present study were to (a) to determine the prevalence of obsessive-compulsive disorder (OCD) in dermatological patients, (b) to determine the possible relationship between dermatological lesions and OCD and (c) to determine the clinical and phenomenological features of the OCD subgroup. METHOD The sample consisted of 166 out of 250 consecutively presenting dermatological patients who agreed to participate in the study. The subjects were assessed with the Structured Clinical Interview for DSM-IV Turkish Version (SCID-I) and also completed the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). RESULTS Of the whole sample, 41 (24.7%) met DSM-IV criteria for OCD. Only 14.6% of them had previously been diagnosed as OCD. The mean score of Y-BOCS in the OCD group was 17.05 +/- 9.75. The most common obsessions were contamination (61%) and pathologic doubt (53.7%), while washing (61%) and checking (51.2%) were the most frequent compulsions. Those suffering from diseases of sebaceous glands were the only group that showed a significant difference between the OCD and non-OCD group. CONCLUSION There is a high prevalence of OCD in dermatological patients, although the nature of the relationship between OCD and dermatology has not previously been ascertained. Genetic-based studies and future researches focused on individual anxiety, and sensitivity may provide information that better explains this relationship.
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Affiliation(s)
- Mehmet Murat Demet
- Department of Psychiatry, School of Medicine, Celal Bayar University, Manisa, Turkey
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Polimeni J, Reiss JP, Sareen J. Could obsessive–compulsive disorder have originated as a group-selected adaptive trait in traditional societies? Med Hypotheses 2005; 65:655-64. [PMID: 16005572 DOI: 10.1016/j.mehy.2005.05.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2005] [Accepted: 05/09/2005] [Indexed: 01/19/2023]
Abstract
Obsessive-compulsive disorder (OCD) possesses distinctive characteristics inviting evolutionary and anthropological explanations. A genetically based condition with low fecundity persisting through generations is paradoxical. The concept of group selection is an evolutionary principle capable of clarifying the perplexing epidemiology of OCD. Using a group-selection paradigm, the authors propose that OCD reflects an ancient form of behavioural specialization. The majority of compulsions such as checking, washing, counting, needing to confess, hoarding and requiring precision, all carry the potential to benefit society. Focussing primarily on hunting and gathering cultures, the potential evolutionary advantages of OCD are explored.
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Affiliation(s)
- Joseph Polimeni
- Department of Psychiatry, University of Manitoba, 771 Bannatyne Avenue, Winnipeg, MB, Canada.
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Fontenelle LF, Mendlowicz MV, Marques C, Versiani M. Trans-cultural aspects of obsessive-compulsive disorder: a description of a Brazilian sample and a systematic review of international clinical studies. J Psychiatr Res 2004; 38:403-11. [PMID: 15203292 DOI: 10.1016/j.jpsychires.2003.12.004] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2003] [Revised: 12/15/2003] [Accepted: 12/19/2003] [Indexed: 12/15/2022]
Abstract
Little is known about the extent and the mechanisms through which culture may affect the clinical manifestations of obsessive-compulsive disorder (OCD). In this study, our objective was to identify culture-related symptomatological patterns in OCD. We described the socio-demographic and phenomenological characteristics of 101 adult patients with OCD seen at an university clinic for anxiety and depressive disorders in Rio de Janeiro, Brazil, and compared them with those reported in 15 clinical samples from North and Latin America, Europe, Africa, and Asia identified through a systematic review in MEDLINE, PsychINFO, and LILACS. Patients with OCD were almost universally characterized by: (1) a predominance of females, (2) a relatively early age of onset, and (3) a preponderance of mixed obsessions and compulsions. In contrast, a predominance of aggressive and religious obsessions was found only in Brazilian and Middle Eastern samples, respectively. The core features of OCD are probably relatively independent of cultural variations. The sole exception to this rule seems to be the content of the obsessions, in which cultural factors may play a significant role.
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Affiliation(s)
- Leonardo F Fontenelle
- The Anxiety and Depression Research Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (IPUB/UFRJ), Rupa Lopes Trovão, 88, apt., 1501, Bloco A, Icaraí, Niterói, RJ, CEP: 24220-071, Brazil.
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