1
|
Silverman ME, Nag S, Kalishman A, Cox PH, Mitroff SR. Increases in symptoms associated with obsessive-compulsive disorder among university students during the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1466-1472. [PMID: 35658099 DOI: 10.1080/07448481.2022.2080507] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 04/27/2022] [Accepted: 05/16/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The long-term consequences of the COVID-19 pandemic on college students' mental health remains unknown. The current study explored self-reported Obsessive-Compulsive symptomatology among college student cohorts from pre-, peak-, and later-pandemic time points. PARTICIPANTS Undergraduate college students (N = 524) who volunteered for course credit. METHODS Self-report responses on the Dimensional Obsessive-Compulsive Scale (DOCS), which includes subscales for contamination, unacceptable thoughts, harm responsibility, and symmetry, were collected from November 29, 2016 through April 27, 2021 and assessed for differences between the pre-, peak-, and later-pandemic cohorts. RESULTS Peak-pandemic responders reported higher symptomatology for contamination and unacceptable thoughts compared to pre-pandemic responders (and for pre- vs. later-pandemic for contamination), with no significant effects for symmetry or harm responsibility. CONCLUSIONS Although the longer-term consequences of the COVID-19 pandemic on students remains unknown, a greater shift in college mental health services from prevention to assessing and addressing more immediate challenges may be necessary.
Collapse
Affiliation(s)
| | - Samoni Nag
- The George Washington University, Washington, DC, USA
| | | | - Patrick H Cox
- The George Washington University, Washington, DC, USA
| | | |
Collapse
|
2
|
Maloney G, Ching T, Kichuk SA, Pittenger C, Kelmendi B. Mechanisms of therapeutic change after psychedelic treatment in OCD. Psychiatry Res 2024; 336:115907. [PMID: 38615521 PMCID: PMC11190873 DOI: 10.1016/j.psychres.2024.115907] [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: 12/28/2023] [Revised: 04/03/2024] [Accepted: 04/06/2024] [Indexed: 04/16/2024]
Abstract
Novel treatments are required for the 30-50% of individuals with obsessive-compulsive disorder (OCD) who remain resistant to first-line pharmacological and psychotherapeutic treatments. Recent pilot data suggest benefit from psilocybin-assisted psychotherapy (PAP) and from imagery rescripting (ImRs). We explore psychological mechanisms of change underpinning both interventions that appear to allow for reprocessing of negative emotions and core beliefs associated with past aversive events. A next critical step in PAP is the development of psychotherapeutic frameworks grounded in theory. We propose that basing PAP on an ImRs framework may provide synergistic benefits in symptom reduction, modification of core beliefs, and value-based living.
Collapse
Affiliation(s)
- Gayle Maloney
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States; Perth OCD Clinic, Perth, Australia.
| | - Terence Ching
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Stephen A Kichuk
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Christopher Pittenger
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States; Yale Child Study Center, Yale University School of Medicine, New Haven, CT, United States; Department of Psychology, Yale University, New Haven, CT, United States; Wu Tsai Institute, Yale University, New Haven, CT, United States; Center for Brain and Mind Health, Yale University School of Medicine, New Haven, CT, United States
| | - Benjamin Kelmendi
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| |
Collapse
|
3
|
Nasirpour N, Shalbafan M, Savari E, Pirani A, Baradaran HR, Motevalian A. Effort-reward imbalance and common mental disorders among public sector employees of Iran: a cross-sectional analysis. BMC Public Health 2024; 24:1447. [PMID: 38816820 PMCID: PMC11138094 DOI: 10.1186/s12889-024-18871-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 05/16/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND The effort-reward imbalance (ERI) model is a widely used theoretical model to measure stress in the workplace. The objective of this study was to investigate the relationship between ERI and three common mental disorders: major depressive disorder (MDD), generalized anxiety disorder (GAD), and obsessive-compulsive disorder (OCD). METHODS In this cross-sectional analysis, the study sample consisted of 4453 baseline participants of the Employees' Health Cohort Study of Iran (EHCSIR). Trained psychologists utilized the Persian version of the Composite International Diagnostic Interview (CIDI-2.1) during the baseline assessment to identify common mental disorders. Additionally, the validated Persian version of the 23-item ERI questionnaire was employed to assess effort, reward, overcommitment, and effort-reward ratio. To examine the association of ERI components with three common mental disorders (MDD, GAD, and OCD) over the past twelve months, multiple logistic regression analyses were conducted. RESULTS The prevalence of effort-reward imbalance in the study sample was 47.1%. Higher ERI score was significantly associated with MDD (OR: 3.43, 95% CI: 2.30-5.13), GAD (OR: 2.42, 95% CI: 1.27-4.63), and OCD (OR: 2.23, 95% CI:1.19-4.19). The study participants who reported higher scores on work overcommitment had a higher likelihood of having MDD (OR: 1.16, 95% CI:1.10-1.23), GAD (OR: 1.07, 95% CI: 1.01-1.14), and OCD (OR: 1.19, 95% CI: 1.09-1.29). CONCLUSIONS According to the study's findings, work-related stress, as determined by the ERI model, is a significant factor in the development of common mental disorders among employees in the public sector.
Collapse
Affiliation(s)
- Nastaran Nasirpour
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Shalbafan
- Mental Health Research Center, Psychosocial Health Research Institute (PHRI), Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ebtesam Savari
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Pirani
- Mental Health Research Center, Psychosocial Health Research Institute (PHRI), Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Baradaran
- Endocrine Research Center, Endocrinology & Metabolism Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Motevalian
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
- Research Center for Addiction and Risky Behaviors (ReCARB), Psychosocial Health Research Institute (PHRI), Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
4
|
Petrie DJ, Meeks KD, Fisher ZF, Geier CF. Associations between somatomotor-putamen resting state connectivity and obsessive-compulsive symptoms vary as a function of stress during early adolescence: Data from the ABCD study. Brain Res Bull 2024; 210:110934. [PMID: 38508468 DOI: 10.1016/j.brainresbull.2024.110934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/16/2024] [Accepted: 03/17/2024] [Indexed: 03/22/2024]
Abstract
Obsessive-compulsive symptoms (OCS) are relatively common during adolescence although most individuals do not meet diagnostic criteria for obsessive-compulsive disorder (OCD). Nonetheless, OCS during adolescence are associated with comorbid psychopathologies and behavioral problems. Heightened levels of environmental stress and greater functional connectivity between the somatomotor network and putamen have been previously associated with elevated OCS in OCD patients relative to healthy controls. However, the interaction of these factors within the same sample of individuals has been understudied. This study examined somatomotor-putamen resting state connectivity, stress, and their interaction on OCS in adolescents from 9-12 years of age. Participants (n = 6386) were drawn from the ABCD Study 4.0 release. Multilevel modeling was used to account for nesting in the data and to assess changes in OCS in this age range. Stress moderated the association between somatomotor-putamen connectivity and OCS (β = 0.35, S.E. = 0.13, p = 0.006). Participants who reported more stress than their average and had greater somatomotor-left putamen connectivity reported more OCS, whereas participants who reported less stress than their average and had greater somatomotor-left putamen connectivity reported less OCS. These data suggest that stress differentially affects the direction of association between somatomotor-putamen connectivity and OCS. Individual differences in the experience or perception of stress may contribute to more OCS in adolescents with greater somatomotor-putamen connectivity.
Collapse
Affiliation(s)
- Daniel J Petrie
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States; Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States.
| | - Kathleen D Meeks
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
| | - Zachary F Fisher
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
| | - Charles F Geier
- Department of Human Development and Family Science, University of Georgia, Athens, GA, United States
| |
Collapse
|
5
|
Hühne V, Dos Santos-Ribeiro S, Moreira-de-Oliveira ME, de Menezes GB, Fontenelle LF. Towards the correlates of stressful life events as precipitants of obsessive-compulsive disorder: a systematic review and metanalysis. CNS Spectr 2024:1-9. [PMID: 38685590 DOI: 10.1017/s1092852924000269] [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: 05/02/2024]
Abstract
Obsessive-compulsive disorder (OCD) is a prevalent condition with multifactorial etiology involving genetic and environmental factors. The present study aims to summarize the correlates of stressful life events (SLEs) in OCD by reviewing studies comparing OCD associated or not with SLEs before its onset. To do so, a systematic review was performed by searching PubMed, Web of Science, Scopus, and PsycINFO databases for studies published between the database's inception and November 27, 2023. Studies including individuals whose OCD was precipitated or not by SLEs (SLEs OCD and NSLEs OCD, respectively) were assessed. Effect sizes or odds ratios were then calculated to identify the strength of association between SLEs and clinical characteristics, such as gender, age of onset, family history of OCD, severity of OCD symptoms, depressive symptoms, and mood comorbidities among patients with OCD. Out of the 4083 records initially identified, 5 studies met the inclusion criteria and 3 were comparable through a meta-analysis. Notably, the analyses were limited by the small number of studies available in the literature. The meta-analysis demonstrated SLEs OCD to be associated with female gender, later OCD onset, and increased comorbidity rates with mood disorders. Despite the cross-sectional nature of the reviewed studies, women may be more vulnerable to develop a later onset of OCD following SLEs, which may also lead to mood disorders. Caution is needed to avoid prematurely classifying this presentation as a distinct subtype of OCD.
Collapse
Affiliation(s)
- Verônica Hühne
- Anxiety, Obsessions and Compulsions Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Samara Dos Santos-Ribeiro
- Anxiety, Obsessions and Compulsions Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Maria E Moreira-de-Oliveira
- Anxiety, Obsessions and Compulsions Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Gabriela B de Menezes
- Anxiety, Obsessions and Compulsions Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Leonardo F Fontenelle
- Anxiety, Obsessions and Compulsions Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| |
Collapse
|
6
|
Marazziti D, Fantasia S, Palermo S, Arone A, Massa L, Gambini M, Carmassi C. Main Biological Models of Resilience. CLINICAL NEUROPSYCHIATRY 2024; 21:115-134. [PMID: 38807984 PMCID: PMC11129343 DOI: 10.36131/cnfioritieditore20240201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
Objective Resilience is a complex process of adaptation to new conditions that would permit a positive outcome after adversities, traumas or other sources of stress. However, despite the growing interest in this topic, there is no universally accepted definition and no comprehensive bio-behavioural model. This systematic review aims to provide an overview of the main biological models that have been theorized to date, with a focus on new alternative theories to improve our understanding of the mechanisms underlying the development and strengthening of resilience, with potential implications for the prevention of some psychopathological disorders. Method This review was conducted according to PRISMA guidelines and includes 185 studies published in English in PubMed and Embase up to December 2023. Results Most studies use the stress-related model, which conceptualizes resilience as the absence of symptoms after the stressful event and mainly deal with the differences between stress-prone and resilient phenotypes in animals exposed to stress. However, the results of this search seem to suggest that resilience might be an independent construct with biological bases rooted in the stress system and the social brain, and widely sculptured by individual and environmental factors, especially early life events and affiliation. Conclusions This work contributes to ongoing efforts to understand the intricate mechanisms of resilience, while highlighting the potential of improving social relationships since our birth to promote coping strategies towards stress and traumas, and even a peaceful world.
Collapse
Affiliation(s)
- Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
- Saint Camillus International University of Health and Medical Sciences, Rome, Italy
| | - Sara Fantasia
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Stefania Palermo
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Alessandro Arone
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Lucia Massa
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Matteo Gambini
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| |
Collapse
|
7
|
Pickenhan L, Milton AL. Opening new vistas on obsessive-compulsive disorder with the observing response task. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2024; 24:249-265. [PMID: 38316708 PMCID: PMC11039534 DOI: 10.3758/s13415-023-01153-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/30/2023] [Indexed: 02/07/2024]
Abstract
Obsessive-compulsive disorder (OCD), a highly prevalent and debilitating disorder, is incompletely understood in terms of underpinning behavioural, psychological, and neural mechanisms. This is attributable to high symptomatic heterogeneity; cardinal features comprise obsessions and compulsions, including clinical subcategories. While obsessive and intrusive thoughts are arguably unique to humans, dysfunctional behaviours analogous to those seen in clinical OCD have been examined in nonhuman animals. Genetic, ethological, pharmacological, and neurobehavioural approaches all contribute to understanding the emergence and persistence of compulsive behaviour. One behaviour of particular interest is maladaptive checking, whereby human patients excessively perform checking rituals despite these serving no purpose. Dysfunctional and excessive checking is the most common symptom associated with OCD and can be readily operationalised in rodents. This review considers animal models of OCD, the neural circuitries associated with impairments in habit-based and goal-directed behaviour, and how these may link to the compulsions observed in OCD. We further review the Observing Response Task (ORT), an appetitive instrumental learning procedure that distinguishes between functional and dysfunctional checking, with translational application in humans and rodents. By shedding light on the psychological and neural bases of compulsive-like checking, the ORT has potential to offer translational insights into the underlying mechanisms of OCD, in addition to being a platform for testing psychological and neurochemical treatment approaches.
Collapse
Affiliation(s)
- Luise Pickenhan
- Department of Psychology, University of Cambridge, Downing Site, Cambridge, CB2 3EB, UK
| | - Amy L Milton
- Department of Psychology, University of Cambridge, Downing Site, Cambridge, CB2 3EB, UK.
| |
Collapse
|
8
|
Wilson C, Hannan AJ, Renoir T. Serotonergic agonism and pharmacologically-induced adolescent stress cause operant-based learning deficits in mice. Neuropharmacology 2024; 244:109801. [PMID: 38040286 DOI: 10.1016/j.neuropharm.2023.109801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/17/2023] [Accepted: 11/26/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND The interplay between environmental stress and genetic factors is thought to play an important role in the pathogenesis and maintenance of obsessive-compulsive disorder (OCD). However, the relative contribution of these causative antecedents in the manifestation of cognitive inflexibility-a phenotype often seen in obsessive-compulsive (OC)- spectrum disorders-is not fully understood. METHOD In this study, we treated mice with 50 mg/L corticosterone (CORT, a glucocorticoid stress hormone) in their drinking water during adolescence. In adulthood, we assessed anxiety-like behaviour and locomotor activity; along with operant-based discrimination and reversal learning. RU-24969, a selective serotonin receptor 5-HT1A/1B receptor agonist, was used as an acute pharmacological model of OC-like behaviour. RU-24969 (5 mg/kg) was administered prior to each reversal learning testing session. RESULTS We found that acute treatment with 5 mg/kg RU-24969 induced stereotyped hyperlocomotion in vehicle- and CORT-treated mice. Furthermore, pre-treatment with CORT in adolescence produced subtle anxiety-like behaviour in adult mice, and also resulted in an impairment to late-stage discrimination learning and alterations to reversal learning. Finally, acute treatment with 5 mg/kg RU-24969 caused an impairment to early-stage reversal learning. CONCLUSION Whilst we revealed dissociable detrimental effects of adolescent CORT treatment and acute 5-HT1A/1B receptor agonism on discrimination and reversal learning, respectively, we did not find evidence of additive deleterious effects of these two treatments. We therefore suggest that while disrupted serotonergic signalling is likely to be involved in the cognitive phenotype of OC-spectrum disorders, distinct neuropathological pathways may be at play in mediating the role of stress as an antecedent in OCD and related illnesses.
Collapse
Affiliation(s)
- Carey Wilson
- Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, University of Melbourne, Parkville, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
| | - Anthony J Hannan
- Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, University of Melbourne, Parkville, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
| | - Thibault Renoir
- Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, University of Melbourne, Parkville, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia.
| |
Collapse
|
9
|
Almeida NB, Maziero MP, Tanamatis T, Costa DLDC, Shavitt RG, Hoexter MQ, Batistuzzo MC. Impact of the COVID-19 pandemic on the symptomatology and routine of medicated patients with obsessive-compulsive disorder. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2024; 46:e20233333. [PMID: 38346021 PMCID: PMC11189129 DOI: 10.47626/1516-4446-2023-3333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/02/2023] [Indexed: 06/21/2024]
Abstract
OBJECTIVES To study the impact of coronavirus disease 2019 on the routine of patients with obsessive-compulsive disorder (OCD) and changes in symptoms and suicidal-related behavior, mainly in those with cleaning symptoms. METHODS In this cross-sectional study, 58 patients completed an online self-report questionnaire that included the Obsessive-Compulsive Inventory-Revised, Coronavirus Stress and Traumatic Events Scale, Coronavirus Health Impact Survey, Beck Anxiety and Beck Depression inventories, and Suicide-Related Behaviors Questionnaire. Comparisons were made with another pre-pandemic sample (n=524) regarding the last three measures. RESULTS During the pandemic, the patients spent more days inside their homes (χ² = 33.39, p = 0.007), changed their alcohol consumption patterns (χ² = 87.6, p < 0.001), and increased social media usage (χ² = 68.83, p < 0.001). Participants with cleaning symptoms did not significantly differ from the others in relation to stress, anxiety/depressive symptoms, or suicidal-related behaviors. Finally, our sample did not differ from an equivalent OCD sample assessed before the pandemic in terms of anxiety and depressive symptom severity or suicidal-related behaviors. CONCLUSION Overall, patients with OCD showed no lifestyle changes associated with higher stress levels during the pandemic. Patients with and without cleaning symptoms and patients before and during the pandemic presented similar results.
Collapse
Affiliation(s)
- Natália B. Almeida
- Departamento de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
- Centro Universitário São Camilo, São Paulo, SP, Brazil
| | - Maria Paula Maziero
- Departamento de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
- Department of Psychiatry & Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Tais Tanamatis
- Departamento de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Roseli G. Shavitt
- Departamento de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Marcelo Q. Hoexter
- Departamento de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Marcelo C. Batistuzzo
- Departamento de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
- Departamento de Métodos e Técnicas, Pontifícia Universidade Católica de São Paulo, São Paulo, SP, Brazil
| |
Collapse
|
10
|
Bezahler A, Kuckertz JM, McKay D, Falkenstein MJ, Feinstein BA. Emotion regulation and OCD among sexual minority people: Identifying treatment targets. J Anxiety Disord 2024; 101:102807. [PMID: 38101252 DOI: 10.1016/j.janxdis.2023.102807] [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: 06/23/2023] [Revised: 09/27/2023] [Accepted: 12/01/2023] [Indexed: 12/17/2023]
Abstract
Sexual minority individuals experience higher rates of psychopathology, such that sexual minority people are nine times more likely to receive a diagnosis or treatment for obsessive-compulsive disorder (OCD) compared to heterosexual people. Poor emotion regulation capacity is a risk factor for OCD, but little is known about sexual orientation differences in dimensions of emotion regulation and how dimensions of emotion regulation relate to OCD severity among sexual minority people. The aims of the current study include 1) comparing sexual minority to heterosexual people on OCD severity and emotion regulation capacity upon admission to treatment for OCD, and 2) examining emotion regulation in relation to OCD severity among sexual minority people. Participants (N = 470) were adults in partial hospital/residential treatment with an average stay of 59.7 days (SD = 25.3), including 22 % sexual minority people. Sexual minority people reported a lower emotion regulation capacity. Among the largest three subgroups (heterosexual, bi+, and gay/lesbian), bi+ individuals reported a lower emotion regulation capacity compared to heterosexual but not gay/lesbian people. Results suggest there are sexual orientation differences in emotion regulation capacity, and that bi+ people have the most difficulty with ER. There is a need for OCD treatment to directly target emotion regulation strategies and be affirming of sexual minority identities.
Collapse
Affiliation(s)
| | - Jennie M Kuckertz
- Obsessive Compulsive Disorder Institute, McLean Hospital, USA; Department of Psychiatry, Harvard Medical School, USA
| | - Dean McKay
- Psychology Department, Fordham University, USA
| | - Martha J Falkenstein
- Obsessive Compulsive Disorder Institute, McLean Hospital, USA; Department of Psychiatry, Harvard Medical School, USA
| | - Brian A Feinstein
- Department of Psychology, Rosalind Franklin University of Medicine and Science, USA
| |
Collapse
|
11
|
Fenlon EE, Pinciotti CM, Jones AC, Rippey CS, Wild H, Hubert TJJ, Tipsword JM, Badour CL, Adams TG. Assessment of Comorbid Obsessive-Compulsive Disorder and Posttraumatic Stress Disorder. Assessment 2024; 31:126-144. [PMID: 37904505 DOI: 10.1177/10731911231208403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
Obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) are commonly comorbid and share prominent features (e.g., intrusions, safety behaviors, and avoidance). Excellent self-report and clinician-administered assessments exist for OCD and PTSD individually, but few assess both disorders, and even fewer provide instruction on differential diagnosis or detection of comorbid OCD and PTSD. To address this gap in the literature, the current paper aims to (1) highlight diagnostic and functional similarities and differences between OCD and PTSD to inform differential diagnosis, (2) outline assessment recommendations for individuals with suspected comorbid OCD and PTSD, OCD with a significant trauma history or posttraumatic symptoms, or PTSD with significant obsessive-compulsive symptoms, and (3) explore future directions to evaluate and improve methods for assessing co-occurring OCD and PTSD.
Collapse
Affiliation(s)
| | | | - Alyssa C Jones
- Ralph H. Johnson VA Health Care System, Charleston, SC, USA
- Medical University of South Carolina, Charleston, USA
| | | | | | | | | | | | - Thomas G Adams
- University of Kentucky, Lexington, USA
- Yale School of Medicine, New Haven, CT, USA
| |
Collapse
|
12
|
Wislocki K, Kratz HE, Martin G, Becker-Haimes EM. The Relationship Between Trauma Exposure and Obsessive-Compulsive Disorder in Youth: A Systematic Review. Child Psychiatry Hum Dev 2023; 54:1624-1652. [PMID: 35488083 DOI: 10.1007/s10578-022-01352-5] [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] [Accepted: 03/17/2022] [Indexed: 11/28/2022]
Abstract
Extant literature suggests a possible relationship between childhood trauma exposure and the development and trajectory of obsessive-compulsive symptoms (OCS) and obsessive-compulsive disorder (OCD); however, this relationship is poorly understood. We conducted a systematic review that examined trauma exposure and OCS/OCD in youth. Primary inclusion criteria were English-language articles that addressed a sample with participants under 18 years of age. 46 articles met criteria for review, and were categorized into three groups of overlap: Post-traumatic Stress Disorder (PTSD) and OCS or OCD (n = 3), clearly defined Criterion A event trauma exposure and OCS or OCD (n = 30), and less well-defined potential trauma exposure and OCS or OCD (n = 13). There was mixed evidence linking trauma exposure and the development of OCS or OCD in youth. Major methodological limitations preclude formal conclusions. More research on co-occurring trauma exposure and OCD/OCS in youth is needed to advance research and improve treatment.
Collapse
Affiliation(s)
- Katherine Wislocki
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St., #3001, Philadelphia, PA, 19104, USA.
- Department of Psychological Science, University of California, Irvine, CA, USA.
| | - Hilary E Kratz
- Department of Psychology, La Salle University, Philadelphia, PA, USA
| | - Gerald Martin
- Department of Psychology, La Salle University, Philadelphia, PA, USA
| | - Emily M Becker-Haimes
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market St., #3001, Philadelphia, PA, 19104, USA
- Hall Mercer Community Mental Health, University of Pennsylvania Health System, Philadelphia, PA, USA
| |
Collapse
|
13
|
Khoodoruth MAS, Ahammad F, Khan YS, Mohammad F. The shared genetic risk factors between Tourette syndrome and obsessive-compulsive disorder. Front Neurol 2023; 14:1283572. [PMID: 37905190 PMCID: PMC10613519 DOI: 10.3389/fneur.2023.1283572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 09/25/2023] [Indexed: 11/02/2023] Open
Abstract
Tourette syndrome (TS) and obsessive-compulsive disorder (OCD) are two neuropsychiatric disorders that frequently co-occur. Previous evidence suggests a shared genetic diathesis underlying the comorbidity of TS and OCD. This review aims to comprehensively summarize the current literature on the genetic factors linked with TS and its comorbidities, with a focus on OCD. Family studies, linkage analysis, cytogenetic studies, and genome-wide association studies (GWAS) have played a pivotal role in identifying common and rare genetic variants connected with TS and OCD. Although the genetic framework of TS and OCD is complex and multifactorial, several susceptibility loci and candidate genes have been identified that might play a crucial role in the pathogenesis of both disorders. Additionally, post-infectious environmental elements have also been proposed to contribute to the development of TS-OCD, although the dynamics between genetic and environmental factors is not yet fully understood. International collaborations and studies with well-defined phenotypes will be crucial in the future to further elucidate the genetic basis of TS and OCD and to develop targeted therapeutic strategies for individuals suffering from these debilitating conditions.
Collapse
Affiliation(s)
- Mohamed Adil Shah Khoodoruth
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
- Child and Adolescent Mental Health Service, Hamad Medical Corporation, Doha, Qatar
| | - Foysal Ahammad
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Yasser Saeed Khan
- Child and Adolescent Mental Health Service, Hamad Medical Corporation, Doha, Qatar
| | - Farhan Mohammad
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| |
Collapse
|
14
|
Abdelnaim MA, Lang-Hambauer V, Hebel T, Schoisswohl S, Schecklmann M, Deuter D, Schlaier J, Langguth B. Deep brain stimulation for treatment resistant obsessive compulsive disorder; an observational study with ten patients under real-life conditions. Front Psychiatry 2023; 14:1242566. [PMID: 37779611 PMCID: PMC10533930 DOI: 10.3389/fpsyt.2023.1242566] [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: 06/19/2023] [Accepted: 08/23/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction Obsessive-compulsive disorder (OCD) affects 2-3% of the global population, causing distress in many functioning levels. Standard treatments only lead to a partial recovery, and about 10% of the patients remain treatment-resistant. Deep brain stimulation offers a treatment option for severe, therapy-refractory OCD, with a reported response of about 60%. We report a comprehensive clinical, demographic, and treatment data for patients who were treated with DBS in our institution. Methods We offered DBS to patients with severe chronic treatment resistant OCD. Severity was defined as marked impairment in functioning and treatment resistance was defined as non-response to adequate trials of medications and psychotherapy. Between 2020 and 2022, 11 patients were implanted bilaterally in the bed nucleus of stria terminalis (BNST). Patients were evaluated with YBOCS, MADRS, GAF, CGI, and WHOQOL-BREF. We performed the ratings at baseline (before surgery), after implantation before the start of the stimulation, after reaching satisfactory stimulation parameters, and at follow-up visits 3, 6, 9, and 12 months after optimized stimulation. Results One patient has retracted his consent to publish the results of his treatment, thus we are reporting the results of 10 patients (5 males, 5 females, mean age: 37 years). Out of our 10 patients, 6 have shown a clear response indicated by a YBOCS-reduction between 42 and 100 percent at last follow-up. One further patient experienced a subjectively dramatic effect on OCD symptoms, but opted afterwards to stop the stimulation. The other 3 patients showed a slight, non-significant improvement of YBOCS between 8.8 and 21.9%. The overall mean YBOCS decreased from 28.3 at baseline to 13.3 (53% reduction) at the last follow-up. The improvement of the OCD symptoms was also accompanied by an improvement of depressive symptoms, global functioning, and quality of life. Conclusion Our results suggest that BNST-DBS can be effective for treatment-resistant OCD patients, as indicated by a reduction in symptoms and an overall improvement in functioning. Despite the need for additional research to define the patients' selection criteria, the most appropriate anatomical target, and the most effective stimulation parameters, improved patient access for this therapy should be established.
Collapse
Affiliation(s)
- Mohamed A. Abdelnaim
- Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany
- Center for Deep Brain Stimulation, University Regensburg, Regensburg, Germany
| | - Verena Lang-Hambauer
- Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany
- Center for Deep Brain Stimulation, University Regensburg, Regensburg, Germany
| | - Tobias Hebel
- Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany
| | - Stefan Schoisswohl
- Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany
- Department of Psychology, University of the Bundeswehr Munich, Neubiberg, Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany
| | - Daniel Deuter
- Center for Deep Brain Stimulation, University Regensburg, Regensburg, Germany
- Department of Neurosurgery, University Regensburg, Regensburg, Germany
| | - Juergen Schlaier
- Center for Deep Brain Stimulation, University Regensburg, Regensburg, Germany
- Department of Neurosurgery, University Regensburg, Regensburg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany
- Center for Deep Brain Stimulation, University Regensburg, Regensburg, Germany
| |
Collapse
|
15
|
Pugi D, Angelo NL, Ragucci F, Garcia-Hernandez MD, Rosa-Alcázar AI, Pozza A. Longitudinal Course of Obsessive-Compulsive Symptoms During the Covid-19 Pandemic: A Systematic Review of Three Years of Prospective Cohort Studies. CLINICAL NEUROPSYCHIATRY 2023; 20:293-308. [PMID: 37791089 PMCID: PMC10544256 DOI: 10.36131/cnfioritieditore20230409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Objective During the pandemic, there has been a slight increase in obsessive-compulsive symptoms in both clinical and non-clinical samples. Three years after the pandemic, we conducted the first systematic review of prospective cohort studies assessing temporal changes in obsessive-compulsive symptoms and their extent in both patients with obsessive-compulsive disorder (OCD) and community samples, regardless of age or socio-cultural background, during any phase of the pandemic. Method Prospective cohort studies were included if validated self-report questionnaires or standardized interviews for obsessive-compulsive symptoms were used. Studies that enrolled OCD patients were included if OCD was diagnosed before the outbreak of the pandemic. The following were our exclusion criteria: cross-sectional and case-control studies, single case studies, editorials, commentaries, and reviews. Studies assessing the effectiveness of an intervention were excluded. Results 15 studies were included. Overall, studies showed a small upsurge in obsessive-compulsive symptoms, especially washing/contamination symptoms, during the coronavirus outbreak. The severity of symptoms seemed to follow the pattern of restriction measures and the increase in the number of COVID-19 cases. Conclusions Factors contributing to the worsening of obsessive-compulsive symptoms during the pandemic were discussed.
Collapse
Affiliation(s)
- Daniele Pugi
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, viale Mario Bracci 16 53100 Siena, Italy
| | - Nicole Loren Angelo
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, viale Mario Bracci 16 53100 Siena, Italy
| | | | - Maria Dolores Garcia-Hernandez
- Department Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Murcia, Espinardo Campus, 30100-Murcia, Spain
| | - Ana Isabel Rosa-Alcázar
- Department Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Murcia, Espinardo Campus, 30100-Murcia, Spain
| | - Andrea Pozza
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, viale Mario Bracci 16 53100 Siena, Italy
- Department of Mental Health, Psychology Unit, Azienda Ospedaliera Universitaria Senese, viale Mario Bracci 16 53100 Siena, Italy
| |
Collapse
|
16
|
Rosa-Alcázar Á, Parada-Navas JL, García-Hernández MD, Pozza A, Tondi P, Rosa-Alcázar AI. Severity and Changes in OCD Dimensions during COVID-19: A Two-Year Longitudinal Study. Brain Sci 2023; 13:1151. [PMID: 37626507 PMCID: PMC10452262 DOI: 10.3390/brainsci13081151] [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: 06/19/2023] [Revised: 07/23/2023] [Accepted: 07/27/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic appears to be associated with a worsening of obsessive-compulsive symptoms in both young people and adults with OCD and it is necessary to analyze the variables involved in this worsening over time. The main aim of this study was to examine long-term changes in total severity and obsessive-compulsive dimensions in obsessive-compulsive patients during the COVID-19 pandemic. METHOD A total 250 OCD patients were selected from various associations, clinical centers and hospitals. We discarded 75 as they did not meet the inclusion criteria. A total of 175 obsessive-compulsive participants aged between 16 and 58 years old (M = 33.33, SD = 9.42) were evaluated in obsessive-compulsive symptom severity and dimensions OCD assessed using the Y-BOCS and D-YBOCS scales in T1 (April-June 2020) and in T2 (March-April 2022). The evaluation was carried out through an online survey and face-to-face with a professional clinician at both time points. RESULTS Intragroup differences in severity were observed, reaching higher scores for patients with contamination, somatic, aggressive and religious. Some patients changed their main dimension, increasing the percentage of patients with contamination and somatic obsessions. CONCLUSIONS COVID-19 was associated with both changes in severity and also affected some dimensions more than others, particularly those related to the virus itself (contamination and somatic).
Collapse
Affiliation(s)
- Ángel Rosa-Alcázar
- Department of Personality, Assessment & Psychological Treatment, University of Murcia, Espinardo, 30100 Murcia, Spain; (Á.R.-A.); (M.D.G.-H.); (P.T.)
| | | | - Maria Dolores García-Hernández
- Department of Personality, Assessment & Psychological Treatment, University of Murcia, Espinardo, 30100 Murcia, Spain; (Á.R.-A.); (M.D.G.-H.); (P.T.)
| | - Andrea Pozza
- Department of Medical, Surgical and Neuroscience Sciences, University of Siena, 53100 Siena, Italy;
| | - Paolo Tondi
- Department of Personality, Assessment & Psychological Treatment, University of Murcia, Espinardo, 30100 Murcia, Spain; (Á.R.-A.); (M.D.G.-H.); (P.T.)
| | - Ana Isabel Rosa-Alcázar
- Department of Personality, Assessment & Psychological Treatment, University of Murcia, Espinardo, 30100 Murcia, Spain; (Á.R.-A.); (M.D.G.-H.); (P.T.)
| |
Collapse
|
17
|
Shafighi AH, Atashzadeh-Shoorideh F, Ebadi A, Ghadirian F. Prevalence and predicors of COVID-centred obsessive compulsive disorder among Iranian COVID-19 recovered individuals: a Bayesian analysis. BMC Psychiatry 2023; 23:310. [PMID: 37138256 PMCID: PMC10155131 DOI: 10.1186/s12888-023-04762-4] [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: 08/15/2022] [Accepted: 04/08/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND The evidence on the psychological consequences of coronavirus 2019 mainly relates to general psychiatric problems, and a few studies have reported the incidence and predictors of obsessive-compulsive disorder. OBJECTIVE To determine the prevalence of obsessive-compulsive disorder (OCD) and its predictors in Iranian COVID - 19 recovered individuals at 3-6 months, 6-12 months, and 12-18 months after recovery. METHOD In this cross-sectional analytical study, 300 participants were randomly selected based on the inclusion criteria from three hospitals in three different regions of Tehran, Iran, and were assessed by the Clinical Demographic Information Questionnaire, the Obsessive Compulsive Inventory-Revised (OCI-R), the Depression, Anxiety and Stress Scale 21 (DASS21), The Pittsburgh Sleep Quality Index (PSQI) and Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5). The obtained data were analyzed with SPSS version 26. RESULTS The results showed that the mean score of OCD is 30.58 ± 15.22, with a prevalence of 71% (n = 213). Female gender (BF = 0.50, p = 0.01), sleep disturbance (BF = 0.02, p = 0.001), PTSD (BF = 0.009, p = 0.0001), depression (BF = 0.0001, p = 0.0001), and stress (BF = 0.0001, p = 0.001) are the strongest predictors of the presence of OCD in recovered COVID - 19 individuals. CONCLUSION OCD-like symptoms was observed in the majority of COVID - 19 recovered individuals with mild to moderate severity. In addition, the stated prevalence, severity, and significance varied according to sociodemographic and health inequalities.
Collapse
Affiliation(s)
- Amir Hossein Shafighi
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Foroozan Atashzadeh-Shoorideh
- Psychiatric Nursing and Management Department, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Fataneh Ghadirian
- Psychiatric Nursing and Management Department, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
18
|
Chen JF, Choi DS, Cunha RA. Striatopallidal adenosine A 2A receptor modulation of goal-directed behavior: Homeostatic control with cognitive flexibility. Neuropharmacology 2023; 226:109421. [PMID: 36634866 PMCID: PMC10132052 DOI: 10.1016/j.neuropharm.2023.109421] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 12/30/2022] [Accepted: 01/08/2023] [Indexed: 01/11/2023]
Abstract
Dysfunction of goal-directed behaviors under stressful or pathological conditions results in impaired decision-making and loss of flexibility of thoughts and behaviors, which underlie behavioral deficits ranging from depression, obsessive-compulsive disorders and drug addiction. Tackling the neuromodulators fine-tuning this core behavioral element may facilitate the development of effective strategies to control these deficits present in multiple psychiatric disorders. The current investigation of goal-directed behaviors has concentrated on dopamine and glutamate signaling in the corticostriatal pathway. In accordance with the beneficial effects of caffeine intake on mood and cognitive dysfunction, we now propose that caffeine's main site of action - adenosine A2A receptors (A2AR) - represent a novel target to homeostatically control goal-directed behavior and cognitive flexibility. A2AR are abundantly expressed in striatopallidal neurons and colocalize and interact with dopamine D2, NMDA and metabotropic glutamate 5 receptors to integrate dopamine and glutamate signaling. Specifically, striatopallidal A2AR (i) exert an overall "break" control of a variety of cognitive processes, making A2AR antagonists a novel strategy for improving goal-directed behavior; (ii) confer homeostatic control of goal-directed behavior by acting at multiple sites with often opposite effects, to enhance cognitive flexibility; (iii) integrate dopamine and adenosine signaling through multimeric A2AR-D2R heterocomplexes allowing a temporally precise fine-tuning in response to local signaling changes. As the U.S. Food and Drug Administration recently approved the A2AR antagonist Nourianz® (istradefylline) to treat Parkinson's disease, striatal A2AR-mediated control of goal-directed behavior may offer a new and real opportunity for improving deficits of goal-directed behavior and enhance cognitive flexibility under various neuropsychiatric conditions. This article is part of the Special Issue on "Purinergic Signaling: 50 years".
Collapse
Affiliation(s)
- Jiang-Fan Chen
- Molecular Neuropharmacology Laboratory, Wenzhou Medical University, Wenzhou, China; Department of Neurology, School of Medicine, Boston University, Boston, MA, USA.
| | - Doo-Sup Choi
- Department of Molecular Pharmacology and Experimental Therapeutics, USA; Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN, USA.
| | - Rodrigo A Cunha
- CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal; FMUC-Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
| |
Collapse
|
19
|
van Leeuwen W, van der Straten A, Bögemann SA, Denys D, van Marle H, van Wingen G. Psychological distress modulates dorsal anterior cingulate cortex responses to salient stimuli in obsessive-compulsive disorder. J Affect Disord 2023; 325:185-193. [PMID: 36587910 DOI: 10.1016/j.jad.2022.12.145] [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: 02/11/2022] [Revised: 12/23/2022] [Accepted: 12/25/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Patients with obsessive-compulsive disorder (OCD) experience an exacerbation of symptoms under psychological distress. The neurobiological underpinnings of this effect of stress remain elusive. Here, we induced psychological distress to explore its effect on neural reactivity of the salience network during a symptom provocation task. METHODS Twenty-three patients with OCD and twenty-three healthy volunteers underwent functional magnetic resonance imaging scanning after stress induction and a control condition in a cross-over design. Psychological distress was induced using the socially evaluated cold pressor test (SECPT) and neural responses were measured during a symptom provocation task. RESULTS OCD participants showed a blunted cortisol response to the stressor. We found a group by stress interaction effect in the dorsal anterior cingulate cortex (dACC), such that psychological distress reduced dACC reactivity to emotionally salient pictures in OCD participants, whereas it increased dACC reactivity in healthy controls. LIMITATIONS A considerable proportion of OCD participants was on medication, and the neuroimaging session was conducted more than 1 h after the initial stressor. CONCLUSIONS Considering this timeline, we speculate that the blunted dACC reactivity towards emotionally salient pictures in OCD participants may reflect impaired emotion regulation in the aftermath of stress.
Collapse
Affiliation(s)
- W van Leeuwen
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Meibergdreef 5, PO Box 22660, 1100 DD Amsterdam, the Netherlands.
| | - A van der Straten
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Meibergdreef 5, PO Box 22660, 1100 DD Amsterdam, the Netherlands
| | - S A Bögemann
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, 6525 EN Nijmegen, the Netherlands
| | - D Denys
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Meibergdreef 5, PO Box 22660, 1100 DD Amsterdam, the Netherlands
| | - H van Marle
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Meibergdreef 5, PO Box 22660, 1100 DD Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Research and Innovation, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands
| | - G van Wingen
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Meibergdreef 5, PO Box 22660, 1100 DD Amsterdam, the Netherlands
| |
Collapse
|
20
|
Chronic stress causes striatal disinhibition mediated by SOM-interneurons in male mice. Nat Commun 2022; 13:7355. [PMID: 36446783 PMCID: PMC9709160 DOI: 10.1038/s41467-022-35028-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 11/16/2022] [Indexed: 11/30/2022] Open
Abstract
Chronic stress (CS) is associated with a number of neuropsychiatric disorders, and it may also contribute to or exacerbate motor function. However, the mechanisms by which stress triggers motor symptoms are not fully understood. Here, we report that CS functionally alters dorsomedial striatum (DMS) circuits in male mice, by affecting GABAergic interneuron populations and somatostatin positive (SOM) interneurons in particular. Specifically, we show that CS impairs communication between SOM interneurons and medium spiny neurons, promoting striatal overactivation/disinhibition and increased motor output. Using probabilistic machine learning to analyze animal behavior, we demonstrate that in vivo chemogenetic manipulation of SOM interneurons in DMS modulates motor phenotypes in stressed mice. Altogether, we propose a causal link between dysfunction of striatal SOM interneurons and motor symptoms in models of chronic stress.
Collapse
|
21
|
Jarrar Q, Ayoub R, Alhussine K, Goh KW, Moshawih S, Ardianto C, Goh BH, Ming LC. Prolonged Maternal Separation Reduces Anxiety State and Increases Compulsive Burying Activity in the Offspring of BALB/c Mice. J Pers Med 2022; 12:1921. [PMID: 36422097 PMCID: PMC9699014 DOI: 10.3390/jpm12111921] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/15/2022] [Accepted: 11/15/2022] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND The elevated plus maze (EPM) and the marble burying (MB) tests are common behavioral tests used for behavioral phenotyping in mouse models for neurodevelopmental disorders. However, the behavioral effects of maternal separation (MS), a standard paradigm for early life stress in animals, in both the EPM and MB tests remain incompletely known. OBJECTIVES This study aimed to investigate the behavioral effects of prolonged MS in the offspring of mice using the EPM and MB tests. METHODS Male BALB/c mice were isolated from their mothers for 4 h each day during the first 30 days after birth. On day 50 postnatal, groups of separated and non-separated mice (n = 18/each group) were subjected to the EPM and MB tests for comparative behavioral evaluations. In addition, the locomotor activity of mice was evaluated using the actophotometer test. RESULTS The findings of the EPM test revealed that separated mice exhibited anxiolytic-like behaviors, as evidenced by a significant increase in the latency to closed arms and the time spent in the open arms compared with non-separated mice. Separated mice also showed compulsive burying activity in the MB test, as determined by a significant increase in the number of buried marbles. The results of the actophotometer test did not show any significant change in locomotor activity. CONCLUSIONS Prolonged MS caused the adult offspring of mice to exhibit a decrease in anxiety state and increased compulsive burying activity, which were not associated with a change in locomotor activity. Further investigations with validated tests are needed to support these findings.
Collapse
Affiliation(s)
- Qais Jarrar
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman 11622, Jordan
| | - Rami Ayoub
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman 11622, Jordan
| | - Kawther Alhussine
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman 11622, Jordan
| | - Khang Wen Goh
- Faculty of Data Science and Information Technology, INTI International University, Nilai 71800, Malaysia
| | - Said Moshawih
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Gadong BE1410, Brunei Darussalam
| | - Chrismawan Ardianto
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Bey Hing Goh
- Biofunctional Molecule Exploratory Research Group, School of Pharmacy, Monash University Malaysia, Petaling Jaya 47500, Malaysia
- College of Pharmaceutical Sciences, Zhejiang University, Hangzhou 310058, China
| | - Long Chiau Ming
- PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Gadong BE1410, Brunei Darussalam
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia
| |
Collapse
|
22
|
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.
Collapse
Affiliation(s)
| | - David F Tolin
- Institute of Living, Hartford, CT.,Yale University School of Medicine, New Haven, CT
| |
Collapse
|
23
|
Maloney G, Kelmendi B, Pittenger C. Imagery Rescripting (ImRs) as an Adjunctive Treatment to Exposure and Response Prevention (ERP)-Resistant Obsessive-Compulsive Disorder: A Case Study. Clin Case Stud 2022. [DOI: 10.1177/15346501221123797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Exposure and response prevention (ERP), a specific type of Cognitive and Behaviour Therapy, is well recognised as the first-line psychological treatment in obsessive-compulsive disorder (OCD), either alone or in combination with selective serotonin reuptake inhibitor pharmacotherapy. However, given that up to half of patients suffering from OCD do not experience a clinically significant reduction in symptoms following ERP, further treatment options for treatment-resistant OCD are needed. Initial research into using ImRs as a psychological adjunct for treatment-resistant OCD has been encouraging. We provide a detailed case study of a 61-year-old male who continued, following ERP treatment, to suffer debilitating OCD symptoms of compulsive checking to prevent making mistakes. Following ERP, the individual received two sessions of ImRs as a therapy adjunct, which resulted in a further reduction of 56% in OCD symptoms. The individual reported associated improvements in mood, life satisfaction, and occupational and interpersonal relationships. This case study describes how ImRs can be incorporated into ERP treatment for OCD. Details of the ERP and ImRs treatment are provided, along with transcript excerpts to highlight the ImRs process. Further research is needed to enhance understanding of mechanisms and optimal deployment of ImRs in treatment sequencing for OCD sufferers.
Collapse
Affiliation(s)
- Gayle Maloney
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Perth OCD Clinic, Perth, Australia
| | - Benjamin Kelmendi
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Christopher Pittenger
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Yale Child Study Center and Interdepartmental Neuroscience Program, Yale University School of Medicine, New Haven, CT, USA
| |
Collapse
|
24
|
Kalenik AM, Topolski M, Górnik J, Wolańczyk T. The impact of the COVID-19 pandemic on the mental health of children with psychiatric diagnoses - multidimensional CCPCA Model. BMC Psychiatry 2022; 22:495. [PMID: 35870970 PMCID: PMC9308485 DOI: 10.1186/s12888-022-04144-2] [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: 12/06/2021] [Accepted: 07/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The study aimed to assess the severity of symptoms of anxiety and depression in children with previously diagnosed psychiatric disorders during the COVID-19 pandemic in Poland. METHODS Online questionnaires were used to investigate three groups of subjects: patients with a psychiatric diagnosis, primary school pupils, and children from children's homes. A total of 167 children with their parents or guardians participated in the study. In addition to basic statistics, a multidimensional Centroid Class Principal Component Analysis (CCPCA) model was used. RESULTS It was found that the strongest fear of the coronavirus was experienced by children from children's homes, while the most severe depressive symptoms and state anxiety were observed among patients diagnosed with psychiatric disorders. Parental care by assisting with school education and lack of close contact with other people (less than two metres) at parents/guardians' work had the most potent protective effect in reducing the fear of COVID-19. CONCLUSIONS There is a need for further research in children and adolescents to develop effective strategies for protecting their mental well-being when faced with social isolation or disease.
Collapse
Affiliation(s)
- Anna Maria Kalenik
- Department of Child Psychiatry, Medical University of Warsaw, Żwirki i Wigury 63A, 02-191, Warsaw, Poland.
| | - Mariusz Topolski
- grid.7005.20000 0000 9805 3178Faculty of Information and Communication Technology, Wrocław University of Science and Technology, Wybrzeże Wyspiańskiego 27, 50-370 Wroclaw, Poland
| | - Justyna Górnik
- grid.13339.3b0000000113287408Department of Child Psychiatry, Medical University of Warsaw, Żwirki i Wigury 63A, 02-191 Warsaw, Poland
| | - Tomasz Wolańczyk
- grid.13339.3b0000000113287408Department of Child Psychiatry, Medical University of Warsaw, Żwirki i Wigury 63A, 02-191 Warsaw, Poland
| |
Collapse
|
25
|
Initial Presentation of OCD and Psychosis in an Adolescent during the COVID-19 Pandemic. Case Rep Psychiatry 2022; 2022:2501926. [PMID: 35465254 PMCID: PMC9033362 DOI: 10.1155/2022/2501926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 04/05/2022] [Indexed: 11/17/2022] Open
Abstract
The COVID-19 pandemic is unparalleled in recent history when accounting for the true disease burden and dramatic impact on physical and mental health. Due to its infectious pathology, COVID-19 presents with a variety of symptoms including neuropsychiatric complications. Moreover, factors such as quarantine, social isolation, and fear of illness have negatively impacted the health of non-COVID-19 patients. There has been significant literature reporting new-onset psychiatric illness in all global populations including those without history of psychiatric illness. This report discusses an adolescent male without prior psychiatric history presenting with new onset symptoms of obsessive-compulsive disorder and psychosis in the context of COVID-19. There are considerable reports describing new-onset obsessive-compulsive disorder, albeit conflicting in terms of prevalence and exacerbations in the setting of COVID-19 in both adult and adolescent populations but limited reports of new-onset psychosis in those same populations and setting.
Collapse
|
26
|
D'Addario C, Pucci M, Bellia F, Girella A, Sabatucci A, Fanti F, Vismara M, Benatti B, Ferrara L, Fasciana F, Celebre L, Viganò C, Elli L, Sergi M, Maccarrone M, Buzzelli V, Trezza V, Dell'Osso B. Regulation of oxytocin receptor gene expression in obsessive-compulsive disorder: a possible role for the microbiota-host epigenetic axis. Clin Epigenetics 2022; 14:47. [PMID: 35361281 PMCID: PMC8973787 DOI: 10.1186/s13148-022-01264-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 03/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a prevalent and severe clinical condition. Robust evidence suggests a gene-environment interplay in its etiopathogenesis, yet the underlying molecular clues remain only partially understood. In order to further deepen our understanding of OCD, it is essential to ascertain how genes interact with environmental risk factors, a cross-talk that is thought to be mediated by epigenetic mechanisms. The human microbiota may be a key player, because bacterial metabolites can act as epigenetic modulators. We analyzed, in the blood and saliva of OCD subjects and healthy controls, the transcriptional regulation of the oxytocin receptor gene and, in saliva, also the different levels of major phyla. We also investigated the same molecular mechanisms in specific brain regions of socially isolated rats showing stereotyped behaviors reminiscent of OCD as well as short chain fatty acid levels in the feces of rats. RESULTS Higher levels of oxytocin receptor gene DNA methylation, inversely correlated with gene expression, were observed in the blood as well as saliva of OCD subjects when compared to controls. Moreover, Actinobacteria also resulted higher in OCD and directly correlated with oxytocin receptor gene epigenetic alterations. The same pattern of changes was present in the prefrontal cortex of socially-isolated rats, where also altered levels of fecal butyrate were observed at the beginning of the isolation procedure. CONCLUSIONS This is the first demonstration of an interplay between microbiota modulation and epigenetic regulation of gene expression in OCD, opening new avenues for the understanding of disease trajectories and for the development of new therapeutic strategies.
Collapse
Affiliation(s)
- Claudio D'Addario
- Faculty of Bioscience, University of Teramo, Teramo, Italy. .,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. .,Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, Via Renato Balzarini, 1, 64100, Teramo, Italy.
| | | | - Fabio Bellia
- Faculty of Bioscience, University of Teramo, Teramo, Italy
| | | | | | - Federico Fanti
- Faculty of Bioscience, University of Teramo, Teramo, Italy
| | - Matteo Vismara
- Department of Mental Health, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milano, Milano, Italy
| | - Beatrice Benatti
- Department of Mental Health, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milano, Milano, Italy
| | - Luca Ferrara
- Department of Mental Health, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milano, Milano, Italy
| | - Federica Fasciana
- Department of Mental Health, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milano, Milano, Italy
| | - Laura Celebre
- Department of Mental Health, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milano, Milano, Italy
| | - Caterina Viganò
- Department of Mental Health, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milano, Milano, Italy
| | - Luca Elli
- Department of Mental Health, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milano, Milano, Italy
| | - Manuel Sergi
- Faculty of Bioscience, University of Teramo, Teramo, Italy
| | - Mauro Maccarrone
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.,European Center for Brain Research/Santa Lucia Foundation IRCCS, Rome, Italy
| | | | | | - Bernardo Dell'Osso
- Department of Mental Health, Department of Biomedical and Clinical Sciences "Luigi Sacco", University of Milano, Milano, Italy. .,Department of Psychiatry, Department of Biomedical and Clinical Sciences "Luigi Sacco", Psychiatry Unit 2, ASST Sacco-Fatebenefratelli, Via G.B. Grassi, 74, 20157, Milan, Italy.
| |
Collapse
|
27
|
Den Ouden L, Suo C, Albertella L, Greenwood LM, Lee RSC, Fontenelle LF, Parkes L, Tiego J, Chamberlain SR, Richardson K, Segrave R, Yücel M. Transdiagnostic phenotypes of compulsive behavior and associations with psychological, cognitive, and neurobiological affective processing. Transl Psychiatry 2022; 12:10. [PMID: 35013101 PMCID: PMC8748429 DOI: 10.1038/s41398-021-01773-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 12/02/2021] [Accepted: 12/16/2021] [Indexed: 01/10/2023] Open
Abstract
Compulsivity is a poorly understood transdiagnostic construct thought to underlie multiple disorders, including obsessive-compulsive disorder, addictions, and binge eating. Our current understanding of the causes of compulsive behavior remains primarily based on investigations into specific diagnostic categories or findings relying on one or two laboratory measures to explain complex phenotypic variance. This proof-of-concept study drew on a heterogeneous sample of community-based individuals (N = 45; 18-45 years; 25 female) exhibiting compulsive behavioral patterns in alcohol use, eating, cleaning, checking, or symmetry. Data-driven statistical modeling of multidimensional markers was utilized to identify homogeneous subtypes that were independent of traditional clinical phenomenology. Markers were based on well-defined measures of affective processing and included psychological assessment of compulsivity, behavioral avoidance, and stress, neurocognitive assessment of reward vs. punishment learning, and biological assessment of the cortisol awakening response. The neurobiological validity of the subtypes was assessed using functional magnetic resonance imaging. Statistical modeling identified three stable, distinct subtypes of compulsivity and affective processing, which we labeled "Compulsive Non-Avoidant", "Compulsive Reactive" and "Compulsive Stressed". They differed meaningfully on validation measures of mood, intolerance of uncertainty, and urgency. Most importantly, subtypes captured neurobiological variance on amygdala-based resting-state functional connectivity, suggesting they were valid representations of underlying neurobiology and highlighting the relevance of emotion-related brain networks in compulsive behavior. Although independent larger samples are needed to confirm the stability of subtypes, these data offer an integrated understanding of how different systems may interact in compulsive behavior and provide new considerations for guiding tailored intervention decisions.
Collapse
Affiliation(s)
- Lauren Den Ouden
- BrainPark, The Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia.
| | - Chao Suo
- BrainPark, The Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Lucy Albertella
- BrainPark, The Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Lisa-Marie Greenwood
- BrainPark, The Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
- Research School of Psychology, ANU College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Rico S C Lee
- BrainPark, The Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Leonardo F Fontenelle
- BrainPark, The Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
- D'Or Institute for Research and Education and Anxiety, Obsessive, Compulsive Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Linden Parkes
- BrainPark, The Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
- Department of Bioengineering, School of Engineering & Applied Science, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Jeggan Tiego
- Neural Systems and Behaviour Lab, The Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Samuel R Chamberlain
- Department of Psychiatry, University of Southampton, Southampton, UK
- Southern Health NHS Foundation Trust, Southampton, UK
| | - Karyn Richardson
- BrainPark, The Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Rebecca Segrave
- BrainPark, The Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Murat Yücel
- BrainPark, The Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| |
Collapse
|
28
|
Bhattacharjee A, Ghosh T. COVID-19 Pandemic and Stress: Coping with the New Normal. JOURNAL OF PREVENTION AND HEALTH PROMOTION 2022; 3:30-52. [PMID: 35194577 PMCID: PMC8855221 DOI: 10.1177/26320770211050058] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
COVID-19 is the new face of pandemic. Since the discovery of COVID-19 in December 2019 in Wuhan, China, it has spread all over the world and the numbers are increasing day by day. Anyone can be susceptible to this infection but children, older adults, pregnant women, and people with comorbidity are more vulnerable. The spread of coronavirus resulted in closures of schools, businesses, and public spaces worldwide and forced many communities to enact stay at home orders, causing stress to all irrespective of their age, gender, or socioeconomic status. The sudden and unexpected changes caused by the outbreak of coronavirus are overwhelming for both adults and children, causing stress and evoking negative emotions like fear, anxiety, and depression, among different populations. The aim of the paper is to ascertain how stress during this pandemic inculcates various psychological health issues like depression anxiety, OCD, panic behavior, and so on. Further, the paper is an attempt to identify different general as well as population specific coping strategies to reduce the stress level among individuals and prevent various stress-induced psychological disorders with reference to different theories and research articles.
Collapse
Affiliation(s)
| | - Tatini Ghosh
- Dept. of Psychology,
Tripura
University, Suryamani Nagar, Tripura,
India
| |
Collapse
|
29
|
Cunning C, Hodes M. The COVID-19 pandemic and obsessive-compulsive disorder in young people: Systematic review. Clin Child Psychol Psychiatry 2022; 27:18-34. [PMID: 34171975 PMCID: PMC8814616 DOI: 10.1177/13591045211028169] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND The COVID-19 pandemic has impacted the world since the first cases were reported in China in January 2020. The secondary mental health impacts of the pandemic are thought to be significant. Obsessive-compulsive disorder is a condition defined by recurrent obsessions and compulsions. It has been hypothesised that the focus on hygiene and contamination during the pandemic could exacerbate obsessive-compulsive symptoms in young people. METHOD A systematic literature review was conducted. Papers were sought looking at the effect of the pandemic on obsessive-compulsive disorder in young people. RESULTS Six published cross-sectional and longitudinal studies were identified, of which four studies investigated clinic samples with a diagnosis of obsessive-compulsive disorder and two looked at community adolescent populations. Five out of the six studies found that obsessive-compulsive symptoms were exacerbated during the COVID-19 pandemic. CONCLUSION The COVID-19 pandemic appears to be associated with a worsening of obsessive-compulsive symptoms in young people. Being in treatment seems to have a protective effect. Maintaining mental health services during a pandemic is vital. It is important to be aware of the implications of pandemic on obsessive-compulsive symptoms in young people in order to allow them to access appropriate treatments. More research is needed in this area.
Collapse
Affiliation(s)
- Catherine Cunning
- Division of Psychiatry, 4615Faculty of Medicine, Imperial College London, London, UK
| | - Matthew Hodes
- Division of Psychiatry, 4615Faculty of Medicine, Imperial College London, London, UK.,Centre for Paediatrics and Child Health, 4615Faculty of Medicine, Imperial College London, London, UK
| |
Collapse
|
30
|
Tandt HL, Debruyckere I, Leyman L, Colman R, De Jaeghere EA, Van Parys H, Baeken C, Purdon C, Lemmens GM. How are OCD Patients and Family Members Dealing with the Waxing and Waning Pattern of the COVID-19 Pandemic? Results of a Longitudinal Observational Study. Psychiatr Q 2021; 92:1549-1563. [PMID: 34097247 PMCID: PMC8182341 DOI: 10.1007/s11126-021-09932-9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/30/2021] [Indexed: 12/23/2022]
Abstract
The current study aimed to investigate the impact of the COVID-19 pandemic on the mental health of people with OCD and the degree of family accommodation (FA) by live-in family members across phases of the lockdown measures imposed by the Belgian government. Forty-nine OCD patients and 26 live-in family members participated in the study. We assessed OCD symptom severity and FA of the live-in family members, as well as depressive symptoms, anxiety and stress levels and COVID-19 related psychological distress of patients and family members at four different timepoints: one month after the start of the lockdown (T1), during the gradual relaxation (T2), between the two waves (T3) and during the second wave (T4). Results showed that although COVID-19 related stress increased and decreased in accordance with the waxing and waning pattern of the pandemic, OCD symptoms showed an initial slight increase followed by a decrease at T3 and again at T4. Changes in family members' accommodation of symptoms followed the same course as the OCD symptoms. Furthermore, OCD symptoms correlated with depressive symptoms, anxiety and stress levels and COVID-19 related distress at all timepoints. It is important to involve family members in the treatment of OCD even during a pandemic. Clinicians should also pay attention to symptoms of depression, anxiety and stress during OCD treatment. Further research is necessary to entangle the causal relationship between OCD symptoms, FA and symptoms of depression, anxiety and stress.
Collapse
Affiliation(s)
| | - Inge Debruyckere
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium
| | - Lemke Leyman
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium
| | - Roos Colman
- Biostatistics Unit, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Emiel A De Jaeghere
- Department of Internal Medicine and Pediatrics, Medical Oncology, Ghent University Hospital, Ghent, Belgium.,Department of Human Structure and repair, Laboratory of Experimental Cancer Research, Ghent University, Ghent, Belgium
| | - Hanna Van Parys
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium
| | - Chris Baeken
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium.,Department of Psychiatry, Free University of Brussels, Brussels, Belgium
| | | | - Gilbert Md Lemmens
- Department of Psychiatry, Ghent University Hospital, Ghent, Belgium.,Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium
| |
Collapse
|
31
|
Al-Shatanawi TN, Sakka SA, Kheirallah KA, Al-Mistarehi AH, Al-Tamimi S, Alrabadi N, Alsulaiman J, Al Khader A, Abdallah F, Tawalbeh LI, Saleh T, Hijazi W, Alnsour AR, Younes NA. Self-Reported Obsession Toward COVID-19 Preventive Measures Among Undergraduate Medical Students During the Early Phase of Pandemic in Jordan. Front Public Health 2021; 9:719668. [PMID: 34820347 PMCID: PMC8606560 DOI: 10.3389/fpubh.2021.719668] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 09/28/2021] [Indexed: 12/16/2022] Open
Abstract
Background: Coronavirus disease 2019 (COVID-19) pandemic and its associated precautionary measures have substantial impacts not only on the medical, economic, and social context but also on psychological health. This study aimed to assess the obsession toward COVID-19 preventive measures among undergraduate medical students during the early phase of the pandemic in Jordan. Methods: Online questionnaires were distributed between March 16, 2020 and March 19, 2020. Socio-demographic characteristics were collected, and self-reported obsession toward COVID-19 preventive measures was assessed using a single question.COVID-19 knowledge, risk perception, and precautionary measures were evaluated using scales. Using the chi-square test, Student t-test, and one-way ANOVA, we assessed the differences in the obsession of students with socio-demographic characteristics and scores of the scales. Results: A total of 1,404 participants (60% were female participants) completed the survey with a participation rate of 15.6%. Obsession with preventive measures was reported by 6.8%. Obsession was significantly more common among women (9.2%) than men (3.3%) and students who attended COVID-19 lectures (9.5%) than those who did not attend such lectures (5.8%) (p < 0.001 and p = 0.015, respectively). Obsessed participants reported significantly higher levels of COVID-19 knowledge (p = 0.012) and precautionary measures (p < 0.001). COVID-19 risk perception had a mild effect size difference but with no statistical significance (p = 0.075). There were no significant differences in the academic levels of participants (p = 0.791) and universities (p = 0.807) between students who were obsessed and those who were not. Conclusions: Obsession is one of the significant but unspoken psychological effects of COVID-19 precautionary measures among undergraduate medical students. Medical schools should be equipped with means to handle pandemic psychological effects.
Collapse
Affiliation(s)
- Tariq N Al-Shatanawi
- Department of Public Health and Community Medicine, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
| | - Samir A Sakka
- Department of Special Surgery, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
| | - Khalid A Kheirallah
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Abdel-Hameed Al-Mistarehi
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Shawkat Al-Tamimi
- Department of Special Surgery, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
| | - Nasr Alrabadi
- Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Jomana Alsulaiman
- Department of Pediatrics, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Ali Al Khader
- Department of Pathology and Forensic Medicine, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
| | - Farah Abdallah
- Department of Mental Health, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | | | - Tareq Saleh
- Department of Basic Medical Sciences, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Waleed Hijazi
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Ayham R Alnsour
- Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
| | - Nidal A Younes
- Department of Surgery, Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan
| |
Collapse
|
32
|
Højgaard DRMA, Duholm C, Nissen JB, Jensen S, Thomsen PH. Immediate reactions to the covid-19 pandemic in adults with obsessive-compulsive disorder: a self-report survey. Nord J Psychiatry 2021; 75:582-589. [PMID: 33928838 DOI: 10.1080/08039488.2021.1912823] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Limited studies are available that investigate the reactions to COVID-19 pandemic by people suffering from obsessive-compulsive disorder (OCD). Due to the nature of the pandemic and the heightened focus on contamination, cleaning, and social distancing, it is likely that a deterioration of OCD symptoms and severity will be seen. AIMS Our aims were to evaluate (1) self-reported changes in OCD symptom severity of adults with OCD during the COVID-19 pandemic outbreak, (2) whether the COVID-19 pandemic would trigger self-reported contamination symptoms in persons with no history of such symptoms, (3) self-reported variables associated with OCD symptom severity change, and 4) self-reported changes in quality of life. METHOD A 47-item self-report questionnaire was sent to all members of the Danish OCD Association and the final sample comprised 201 adult participants. The association of OCD severity change with demographic and clinical variables was analyzed using linear regression. RESULTS 61.2% of participants reported an increase in OCD severity, based on the retrospective self-report. Female gender, self-reported contamination symptoms, and self-reported psychiatric comorbidity were found to have a significant association with increasing OCD severity. Five participants reported the emergence of contamination symptoms and two of harm related symptoms. Thirty participants reported a severe reduction in quality of life (≥80). CONCLUSIONS A large group of people suffering from OCD may require special attention and care during a pandemic like COVID-19 in order to lessen the deterioration of OCD symptoms and also to minimize the reduction in quality of life evident in this group.
Collapse
Affiliation(s)
- Davíð R M A Højgaard
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Denmark
| | - Charlotte Duholm
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Denmark
| | - Judith B Nissen
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Denmark
| | - Sanne Jensen
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Denmark
| | - Per Hove Thomsen
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Denmark
| |
Collapse
|
33
|
Kang JI, Park CI, Lin J, Kim ST, Kim HW, Kim SJ. Alterations of cellular aging markers in obsessive- compulsive disorder: mitochondrial DNA copy number and telomere length. J Psychiatry Neurosci 2021; 46:E451-E458. [PMID: 34291629 PMCID: PMC8519490 DOI: 10.1503/jpn.200238] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The present study examined whether mitochondrial DNA copy number (mtDNAcn) and telomere length - key markers of cellular aging - were altered in male and female participants with obsessive-compulsive disorder (OCD) compared to healthy controls. We also tested for associations between these alterations and OCD-related clinical features and inflammatory index. METHODS A total of 235 patients with OCD (38.7% female) and 234 healthy controls (41.5% female) were included. We quantified whole-blood mtDNAcn and leukocyte telomere length using quantitative polymerase chain reaction. We also calculated the neutrophil-to-lymphocyte ratio from complete blood cell counts. RESULTS Multivariate analysis of covariance showed that OCD status had a significant overall effect on cellular aging markers in men (Wilks λ = 0.889, F2,275 = 17.13, p < 0.001) and women (Wilks λ = 0.742, F2,182 = 31.61, p < 0.001) after controlling for age, body mass index and childhood trauma. In post-hoc comparisons, men with OCD had lower mtDNAcn than controls (p < 0.001), but we found no between-group difference for telomere length (p = 0.55). Women with OCD had a significantly lower mtDNAcn (p < 0.001) and shortened telomere length (p = 0.023) compared to controls. Moreover, the lower mtDNAcn shown in the OCD group was significantly correlated with an increase in systemic inflammation for both sexes, as measured by neutrophil-to-lymphocyte ratio. LIMITATIONS The present cross-sectional design did not allow us to infer a causal relationship between OCD disease status and cellular aging markers. CONCLUSION The present study is, to our knowledge, the first to demonstrate alterations in mtDNAcn and telomere shortening in OCD. These results suggest that aging-associated molecular mechanisms may be important in the pathophysiology of OCD.
Collapse
Affiliation(s)
- Jee In Kang
- From the Department of Psychiatry and Institute of Behavioural Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea (Kang, S.-T. Kim, S.-J. Kim); the Department of Psychiatry, CHA Bundang Medical Centre, CHA University, Seongnam, Republic of Korea (Park); the Department of Biochemistry and Biophysics, UCSF School of Medicine, San Francisco, CA, USA (Lin); and the Department of Medical Education, Yonsei University College of Medicine, Seoul, South Korea (H.-W. Kim)
| | - Chun Il Park
- From the Department of Psychiatry and Institute of Behavioural Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea (Kang, S.-T. Kim, S.-J. Kim); the Department of Psychiatry, CHA Bundang Medical Centre, CHA University, Seongnam, Republic of Korea (Park); the Department of Biochemistry and Biophysics, UCSF School of Medicine, San Francisco, CA, USA (Lin); and the Department of Medical Education, Yonsei University College of Medicine, Seoul, South Korea (H.-W. Kim)
| | - Jue Lin
- From the Department of Psychiatry and Institute of Behavioural Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea (Kang, S.-T. Kim, S.-J. Kim); the Department of Psychiatry, CHA Bundang Medical Centre, CHA University, Seongnam, Republic of Korea (Park); the Department of Biochemistry and Biophysics, UCSF School of Medicine, San Francisco, CA, USA (Lin); and the Department of Medical Education, Yonsei University College of Medicine, Seoul, South Korea (H.-W. Kim)
| | - Shin Tae Kim
- From the Department of Psychiatry and Institute of Behavioural Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea (Kang, S.-T. Kim, S.-J. Kim); the Department of Psychiatry, CHA Bundang Medical Centre, CHA University, Seongnam, Republic of Korea (Park); the Department of Biochemistry and Biophysics, UCSF School of Medicine, San Francisco, CA, USA (Lin); and the Department of Medical Education, Yonsei University College of Medicine, Seoul, South Korea (H.-W. Kim)
| | - Hae Won Kim
- From the Department of Psychiatry and Institute of Behavioural Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea (Kang, S.-T. Kim, S.-J. Kim); the Department of Psychiatry, CHA Bundang Medical Centre, CHA University, Seongnam, Republic of Korea (Park); the Department of Biochemistry and Biophysics, UCSF School of Medicine, San Francisco, CA, USA (Lin); and the Department of Medical Education, Yonsei University College of Medicine, Seoul, South Korea (H.-W. Kim)
| | - Se Joo Kim
- From the Department of Psychiatry and Institute of Behavioural Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea (Kang, S.-T. Kim, S.-J. Kim); the Department of Psychiatry, CHA Bundang Medical Centre, CHA University, Seongnam, Republic of Korea (Park); the Department of Biochemistry and Biophysics, UCSF School of Medicine, San Francisco, CA, USA (Lin); and the Department of Medical Education, Yonsei University College of Medicine, Seoul, South Korea (H.-W. Kim)
| |
Collapse
|
34
|
Samuels J, Holingue C, Nestadt PS, Bienvenu OJ, Phan P, Nestadt G. Contamination-related behaviors, obsessions, and compulsions during the COVID-19 pandemic in a United States population sample. J Psychiatr Res 2021; 138:155-162. [PMID: 33857786 PMCID: PMC8016179 DOI: 10.1016/j.jpsychires.2021.03.064] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/19/2021] [Accepted: 03/29/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Contamination-prevention behaviors such as mask wearing and physical distancing are crucial to reduce coronavirus transmission during the COVID-19 pandemic. We hypothesized that engagement in these behaviors could provoke obsessions and phobias in vulnerable individuals in the community. METHODS A total of 2117 participants, systematically selected to represent the age, gender, and race distributions of the US population, completed an online survey that assessed demographic characteristics, clinical features, COVID-19 risks, and COVID-19 contamination-prevention behaviors. Logistic regression was used to estimate the magnitude of the relationships between the COVID-19 behavior score and clinically significant contamination obsessions, contamination compulsions, and pre-COVID-19 to current change in obsessive-compulsive symptom scores. RESULTS The COVID-19 behavior score was significantly associated with contamination obsessions (odds ratio (OR) = 1.15, 95% CI = 1.12-1.16; p < 0.001) and contamination phobias (OR = 1.14, 95% CI = 1.12-1.16; p < 0.001). The COVID-19 behavior score also was associated with pre-pandemic to current increase in the overall obsessive-compulsive symptom score (OR = 1.16, 95% CI = 1.09-1.23; p < 0.001), as well as increase in obsessive-compulsive symptom score excluding washing items (OR = 1.13, 95% CI = 1.07-1.19; p < 0.001). The magnitude of these relationships did not appreciably change, after adjustment for other variables associated with the outcomes. Moreover, the relationship was significant in those with or without OCD, and in individuals with different levels of doubt and COVID-19 risk. CONCLUSIONS Contamination safety measures are critical for reducing the spread of COVID-19 in the community. However, they may be related to the development of contamination-related symptoms and OCD in vulnerable individuals, complicating the diagnosis and treatment of mental disorders during this period.
Collapse
Affiliation(s)
- Jack Samuels
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA.
| | - Calliope Holingue
- Department of Mental Health, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, 21201, USA
| | - Paul S. Nestadt
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - O. Joseph Bienvenu
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Phillip Phan
- The Johns Hopkins University Carey Business School, Baltimore, MD, 21202, USA,Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| |
Collapse
|
35
|
Sign Tracking in an Enriched Environment: A Potential Ecologically Relevant Animal Model of Adaptive Behavior Change. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2021; 22:703-721. [PMID: 33846950 PMCID: PMC8041392 DOI: 10.3758/s13415-021-00897-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/23/2021] [Indexed: 11/08/2022]
Abstract
When an object conditioned stimulus (CS) is paired with a food unconditioned stimulus (US), anticipatory goal-directed action directed at the US location (goal tracking) is accompanied by behavior directed at the object CS (sign tracking). Sign-tracking behavior appears to be compulsive and habit-like and predicts increased vulnerability to the addictive potential of drugs in animal models. A large body of the literature also suggests that environmental enrichment protects against the development of addiction-prone phenotypes. Thus, we investigated whether compulsive-like sign tracking develops in environmentally enriched rats trained directly in their enriched home environment. We demonstrate that adolescent enriched-housed male Sprague-Dawley rats readily sign track a 5% ethanol bottle CS in their home environment and at a rate higher than adolescent standard-housed rats. We also show that enriched adolescent rats sign track less than enriched adult-trained rats and that acute isolation stress affects sign- and goal-tracking performance of adolescents and adults differently. Sign tracking increased more in the adult than the adolescent rats. Whereas the younger rats showed a decrease in goal tacking after the final stressor manipulation, the adults showed increased goal tracking. Our results are consistent with recent studies, which suggest that although sign tracking performance is compulsive-like, it is not as inflexible and habit-like as previously assumed. Testing in an enriched home environment with object CSs having greater affordance than "neutral" lever CSs may provide greater ecological relevance for investigating the development and expression of adaptive and compulsive-like behaviors in translational research.
Collapse
|
36
|
Khosravani V, Aardema F, Samimi Ardestani SM, Sharifi Bastan F. The impact of the coronavirus pandemic on specific symptom dimensions and severity in OCD: A comparison before and during COVID-19 in the context of stress responses. J Obsessive Compuls Relat Disord 2021; 29:100626. [PMID: 33520614 PMCID: PMC7834974 DOI: 10.1016/j.jocrd.2021.100626] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 01/22/2021] [Accepted: 01/22/2021] [Indexed: 12/12/2022]
Abstract
The present study aimed to compare a group of patients with obsessive-compulsive disorder (OCD; N = 270) before and during COVID-19 on specific obsessive-compulsive (OC) symptom dimensions and symptom severity. In addition, the study aimed to evaluate the associations of COVID-19-related stress responses with change in OC symptom dimensions and severity of symptoms as the result of the pandemic. Results showed that patients with OCD had higher scores on all OC symptom dimensions and symptom severity during the pandemic as compared to their scores from before the pandemic. Thus, the effect of COVID-19 is not limited to an increase in fears of contamination alone, but occurs across other symptom dimensions, including responsibility for harm, unacceptable thoughts, and symmetry. In addition, regression analyses indicated that COVID-19-related stress responses significantly predicted the observed increase in specific OC symptom dimensions and general severity, after controlling for pre-COVID-19 scores of symptoms and severity. The increase of symptoms as the result of COVID-19 might be best understood in the context of a non-specific stress-related response similar to the effects observed in non-clinical and other clinical populations.
Collapse
Affiliation(s)
- Vahid Khosravani
- Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Frederick Aardema
- Montreal Mental Health University Institute Research Center, University of Montreal, Department of Psychiatry and Addictology, 7331 Hochelaga Street, Montreal, QC, H1N 3V2, Canada
| | - Seyed Mehdi Samimi Ardestani
- Departments of Psychiatry, Behavioral Sciences Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | |
Collapse
|
37
|
Sulaimani MF, Bagadood NH. Implication of coronavirus pandemic on obsessive-compulsive-disorder symptoms. REVIEWS ON ENVIRONMENTAL HEALTH 2021; 36:1-8. [PMID: 32866131 DOI: 10.1515/reveh-2020-0054] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 07/20/2020] [Indexed: 06/11/2023]
Abstract
This review assesses various sources regarding obsessive-compulsive disorder (OCD) symptoms and the coronavirus pandemic via a study of literature related to OCD conditions in the United States, China, the United Kingdom, and India. Coronavirus's morbidity and its status as a global pandemic transmittable from one person to another has subsequently intensified the personal perception of distress. The projected shortage of vital medical equipment to fight coronavirus due to daily increases in COVID-19 cases creates social unrest. The world confronts perpetual news about high numbers of coronavirus cases, more people in quarantine, and more deaths; those not infected feel increasing fear about its proximity. Social media, print media, and electronic sources offer much advice on how to prevent coronavirus infection. Pandemics extend beyond pathophysiology and medical phenomena to associations with intense psychosocial impact. Studies have established that people with existing mental disorders are prone to relapses, the fear of faulty COVID-19 prevention measures, distress, and suicidal thoughts during pandemics. Precautionary measures aim to slow the spread of coronavirus, but these radical repetitive measures create great anxiety in the mental health of individuals suffering from OCD. Despite the nature of their conditions, these people must adhere to routine processes, such as washing hands, wearing masks and gloves, and sanitizing hands. Given the asymptomatic nature of people suffering from OCD, the routine measures for addressing COVID-19 have a hectic and adverse effect on their mental health and their state of relaxation. Through a systematic literature review, this paper provides insight into the coronavirus pandemic's implications for OCD symptoms.
Collapse
Affiliation(s)
- Mona F Sulaimani
- Department of Special Education, Faculty of Educational Graduate Studies, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nizar H Bagadood
- Department of Special Education, College of Education, Umm Al-Qura University, 21955, Makkah, Saudi Arabia
| |
Collapse
|
38
|
Vats T, Fineberg NA, Hollander E. The Future of Obsessive-Compulsive Spectrum Disorders: A Research Perspective. Curr Top Behav Neurosci 2021; 49:461-477. [PMID: 33550566 DOI: 10.1007/7854_2020_208] [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] [Indexed: 12/24/2022]
Abstract
Obsessive-compulsive disorder (OCD) sits at the epicenter of a spectrum of related conditions (often referred to as obsessive-compulsive related disorders (OCRD) or obsessive-compulsive spectrum disorders (OCSD)) that can be as disabling as they are varied in presentation. Research in the field now encompasses diverse disciplines ranging from inflammatory mechanisms to computational psychiatry, to neurocognitive endophenotypes to functional imaging to pharmacogenomics to brain stimulation approaches. As these disorders become more clearly elucidated, there is a need to continually re-evaluate the implications of research findings and to incorporate these findings into new treatment approaches that benefit both patients and clinicians. Even the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) is intended to be flexible and to incorporate validated and reliable biomarkers and neuroscience findings as they become available. This concluding chapter highlights just a few areas of study that promise to influence our understanding of the pathophysiology and clinical practice of OCRD. These include patient-centered outcomes research, the study of developmental brain trajectories in spectrum conditions, robot models of OCRDs, goal-directed versus habit-based behaviors, pharmacogenomics, problematic use of the Internet, and digital interventions. For example, digital medicine may become increasingly useful by identifying patients early on in the course of their illness; providing biomarkers to subtype patients; predicting treatment response; serving as a more proximal outcome measure of treatment response; or providing easily accessible and less costly forms of care. In order to address unmet clinical needs in OCRD, it is helpful to take an interdisciplinary perspective, and the work described in this collection of articles is likely to be invaluable in shaping the future of the field.
Collapse
Affiliation(s)
- T Vats
- Autism and Obsessive-Compulsive Spectrum Disorders Program, Psychiatric Research Institute of Montefiore-Einstein, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - N A Fineberg
- Center for Clinical and Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.,Hertfordshire Partnership University NHS Foundation Trust, Rosanne House, Welwyn Garden City, Hertfordshire, UK.,University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - E Hollander
- Autism and Obsessive-Compulsive Spectrum Disorders Program, Psychiatric Research Institute of Montefiore-Einstein, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.
| |
Collapse
|
39
|
Zvolensky MJ, Garey L, Rogers AH, Schmidt NB, Vujanovic AA, Storch EA, Buckner JD, Paulus DJ, Alfano C, Smits JA, O'Cleirigh C. Psychological, addictive, and health behavior implications of the COVID-19 pandemic. Behav Res Ther 2020; 134:103715. [PMID: 32891956 PMCID: PMC7451060 DOI: 10.1016/j.brat.2020.103715] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/07/2020] [Accepted: 08/24/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA,HEALTH Institute, University of Houston, Houston, TX, USA,Corresponding author. Dept of Psychology, 3695 Cullen Blvd, Room 126, University of Houston, Houston, TX, 77204, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Andrew H. Rogers
- Department of Psychology, University of Houston, Houston, TX, USA
| | | | | | - Eric A. Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Julia D. Buckner
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | | | - Candice Alfano
- Department of Psychology, University of Houston, Houston, TX, USA
| | | | - Conall O'Cleirigh
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA,Harvard Medical School, Boston, MA, USA
| |
Collapse
|
40
|
Kracker Imthon A, Antônio Caldart C, do Rosário MC, Fontenelle LF, Constantino Miguel E, Arzeno Ferrão Y. Stressful Life Events and the Clinical Expression of Obsessive-Compulsive Disorder (OCD): An Exploratory Study. J Clin Med 2020; 9:E3371. [PMID: 33096706 PMCID: PMC7590000 DOI: 10.3390/jcm9103371] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/05/2020] [Accepted: 10/07/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND In obsessive-compulsive disorder (OCD), symptom content and severity appear to fluctuate over the course of the life cycle in accordance with stressful life events. The objective of this paper was to compare OCD patients with and without reported stressful life events (SLEs) in terms of the sociodemographics of patients and the clinical characteristics of OCD. METHODS This was a cross-sectional study involving 1001 patients with OCD. Data concerning SLEs were collected via the Yale OCD Natural History Questionnaire, while for OCD symptoms, the Dimensional Yale-Brown Obsessive-Compulsive Scale was used. RESULTS Of the 1001 OCD patients, 605 (60.5%) reported experiencing at least one SLE in their lifetime. Self-declared nonwhite skin color (odds ratio (OR) = 1.51), the presence of a sensory phenomenon (OR = 1.47), and comorbidity with post-traumatic stress disorder (PTSD) (OR = 2.38) were some of the logistic regression variables related to the reported SLEs with relevant statistical significance and risk (i.e., OR) values. CONCLUSIONS Our results indicate that SLEs may make Brazilian OCD patients vulnerable to the onset or exacerbation of obsessive-compulsive symptoms. The positive association of the occurrence of SLEs and sensory phenomena in this population could corroborate that environmental influences impact the neurobiology associated with OCD, and likely with other psychiatric disorders as well.
Collapse
Affiliation(s)
- André Kracker Imthon
- Psychiatric Service, President Vargas Hospital, Porto Alegre 90035-074, Brazil; (C.A.C.); (Y.A.F.)
- Department of Internal Medicine-Psychiatry, Federal University of Health Sciences of Porto Alegre, Porto Alegre 90050-170, Brazil
- The Brazilian Research Consortium on Obsessive–Compulsive Spectrum Disorders, São Paulo 05403-903, Brazil; (M.C.d.R.); (L.F.F.); (E.C.M.)
| | - César Antônio Caldart
- Psychiatric Service, President Vargas Hospital, Porto Alegre 90035-074, Brazil; (C.A.C.); (Y.A.F.)
- Department of Internal Medicine-Psychiatry, Federal University of Health Sciences of Porto Alegre, Porto Alegre 90050-170, Brazil
- The Brazilian Research Consortium on Obsessive–Compulsive Spectrum Disorders, São Paulo 05403-903, Brazil; (M.C.d.R.); (L.F.F.); (E.C.M.)
| | - Maria Conceição do Rosário
- The Brazilian Research Consortium on Obsessive–Compulsive Spectrum Disorders, São Paulo 05403-903, Brazil; (M.C.d.R.); (L.F.F.); (E.C.M.)
- Child and Adolescent Psychiatry Unit (UPIA) at the Department of Psychiatry, Federal University of São Paulo, São Paulo 04017-030, Brazil
| | - Leonardo F. Fontenelle
- The Brazilian Research Consortium on Obsessive–Compulsive Spectrum Disorders, São Paulo 05403-903, Brazil; (M.C.d.R.); (L.F.F.); (E.C.M.)
- Turner Institute for Brain and Mental Health, Monash University, Clayton VIC 3800, Australia
- D’Or Institute for Research and Education (IDOR) and Institute of Psychiatry (IPUB), Federal University of Rio de Janeiro, Rio de Janeiro 22290-140, Brazil
| | - Euripedes Constantino Miguel
- The Brazilian Research Consortium on Obsessive–Compulsive Spectrum Disorders, São Paulo 05403-903, Brazil; (M.C.d.R.); (L.F.F.); (E.C.M.)
- Department of Psychiatry, São Paulo University Medical School, São Paulo 05403-903, Brazil
| | - Ygor Arzeno Ferrão
- Psychiatric Service, President Vargas Hospital, Porto Alegre 90035-074, Brazil; (C.A.C.); (Y.A.F.)
- Department of Internal Medicine-Psychiatry, Federal University of Health Sciences of Porto Alegre, Porto Alegre 90050-170, Brazil
- The Brazilian Research Consortium on Obsessive–Compulsive Spectrum Disorders, São Paulo 05403-903, Brazil; (M.C.d.R.); (L.F.F.); (E.C.M.)
| |
Collapse
|
41
|
The immediate effect of COVID-19 pandemic on children and adolescents with obsessive compulsive disorder. BMC Psychiatry 2020; 20:511. [PMID: 33081741 PMCID: PMC7573524 DOI: 10.1186/s12888-020-02905-5] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 09/29/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Obsessive compulsive disorder (OCD) is a distressing psychiatric disorder. Traumas may trigger or aggravate OCD symptoms. COVID-19 pandemic has coursed a global crisis and has been associated with onset of psychiatric disorders in adults. Little is known about children/adolescents with OCD. The present study aimed to examine how children/adolescents with OCD react towards COVID-19 crisis. METHODS A questionnaire was distributed to two separate groups of children/adolescents. One group was a clinical group newly diagnosed at a specialized OCD clinic. All the children/adolescents had a current close contact to a therapist or doctor. The other group was a survey group identified through the Danish OCD Association. Most of these children/adolescents were diagnosed years ago, and their primary treatment was completed. For the clinical group, data from patient files was available. RESULTS In both groups, but most pronounced in the survey group, participants experienced a worsening of their OCD, anxiety, and depressive symptoms. The aggravation of OCD correlated with the worsening of anxiety, depressive symptoms, and the extent of avoidance behavior. For both groups, OCD aggressive symptoms predicted a significant worsening. Poor baseline insight showed a trend to predict a symptom worsening. The worsening was most pronounced in children with early age of onset and a family history of attention deficit hyperactivity disorder. CONCLUSIONS To our knowledge, this is one of the first studies examining the effect of COVID-19 in children/adolescents with OCD. The effect was examined in two separate populations strengthening the findings. The study points towards an influence of the OCD phenotype, baseline insight suggesting a continued vulnerability, and a family history of psychiatric disorders. TRIAL REGISTRATION The study is approved by the Danish Data Protection Agency (1-16-02-147-20) registered 1st of April 2020. Oral and written information was given to parents and patients and written consent from patients over 15 years and parents were received.
Collapse
|
42
|
Den Ouden L, Tiego J, Lee RS, Albertella L, Greenwood LM, Fontenelle L, Yücel M, Segrave R. The role of Experiential Avoidance in transdiagnostic compulsive behavior: A structural model analysis. Addict Behav 2020; 108:106464. [PMID: 32428802 DOI: 10.1016/j.addbeh.2020.106464] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 05/05/2020] [Accepted: 05/06/2020] [Indexed: 12/15/2022]
Abstract
Compulsivity is recognized as a transdiagnostic phenotype, underlying a variety of addictive and obsessive-compulsive behaviors. However, current understanding of how it should be operationalized and the processes contributing to its development and maintenance is limited. The present study investigated if there was a relationship between the affective process Experiential Avoidance (EA), an unwillingness to tolerate negative internal experiences, and the frequency and severity of transdiagnostic compulsive behaviors. A large sample of adults (N = 469) completed online questionnaires measuring EA, psychological distress and the severity of seven obsessive-compulsive and addiction-related behaviors. Using structural equation modelling, results indicated a one-factor model of compulsivity was superior to the two-factor model (addictive- vs OCD-related behaviors). The effect of EA on compulsivity was fully mediated by psychological distress, which in turn had a strong direct effect on compulsivity. This suggests distress is a key mechanism in explaining why people with high EA are more prone to compulsive behaviors. The final model explained 41% of the variance in compulsivity, underscoring the importance of these constructs as likely risk and maintenance factors for compulsive behavior. Implications for designing effective psychological interventions for compulsivity are discussed.
Collapse
|
43
|
Rohilla J, Tak P, Jhanwar S, Hasan S. Primary care physician's approach for mental health impact of COVID-19. J Family Med Prim Care 2020; 9:3189-3194. [PMID: 33102268 PMCID: PMC7567264 DOI: 10.4103/jfmpc.jfmpc_513_20] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 04/25/2020] [Accepted: 06/19/2020] [Indexed: 01/31/2023] Open
Abstract
As the world struggles to control coronavirus infection with the exhausting capacity of health care systems globally, the role of primary care physician and family physician becomes more important as the first point of contact with the community. Limited availability of mental health services in India requires general practitioners to deal with psychological disorders arising due to infection outbreak and its restrictive control strategies. This article discusses what and how primary physicians can manage the psychological burden of a pandemic, and therefore, reducing the reliance on mental health specialist.
Collapse
Affiliation(s)
- Jitendra Rohilla
- Department of Psychiatry, All India Institute of Medical Science, Rishikesh, Uttarakhand, India
| | - Pinki Tak
- Department of Pharmacology, All India Institute of Medical Science, Rishikesh, Uttarakhand, India
| | - Shubham Jhanwar
- Department of Psychiatry, All India Institute of Medical Science, Rishikesh, Uttarakhand, India
| | - Shazia Hasan
- Department of Medicine, Jawaharlal Nehru Medical College, Ajmer, Rajasthan, India
| |
Collapse
|
44
|
Lustberg D, Iannitelli AF, Tillage RP, Pruitt M, Liles LC, Weinshenker D. Central norepinephrine transmission is required for stress-induced repetitive behavior in two rodent models of obsessive-compulsive disorder. Psychopharmacology (Berl) 2020; 237:1973-1987. [PMID: 32313981 PMCID: PMC7961804 DOI: 10.1007/s00213-020-05512-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/26/2020] [Indexed: 02/06/2023]
Abstract
RATIONALE Obsessive-compulsive disorder (OCD) is characterized by repetitive behaviors exacerbated by stress. Many OCD patients do not respond to available pharmacotherapies, but neurosurgical ablation of the anterior cingulate cortex (ACC) can provide symptomatic relief. Although the ACC receives noradrenergic innervation and expresses adrenergic receptors (ARs), the involvement of norepinephrine (NE) in OCD has not been investigated. OBJECTIVE To determine the effects of genetic or pharmacological disruption of NE neurotransmission on marble burying (MB) and nestlet shredding (NS), two animal models of OCD. METHODS We assessed NE-deficient (Dbh -/-) mice and NE-competent (Dbh +/-) controls in MB and NS tasks. We also measured the effects of anti-adrenergic drugs on NS and MB in control mice and the effects of pharmacological restoration of central NE in Dbh -/- mice. Finally, we compared c-fos induction in the locus coeruleus (LC) and ACC of Dbh -/- and control mice following both tasks. RESULTS Dbh -/- mice virtually lacked MB and NS behaviors seen in control mice but did not differ in the elevated zero maze (EZM) model of general anxiety-like behavior. Pharmacological restoration of central NE synthesis in Dbh -/- mice completely rescued NS behavior, while NS and MB were suppressed in control mice by anti-adrenergic drugs. Expression of c-fos in the ACC was attenuated in Dbh -/- mice after MB and NS. CONCLUSION These findings support a role for NE transmission to the ACC in the expression of stress-induced compulsive behaviors and suggest further evaluation of anti-adrenergic drugs for OCD is warranted.
Collapse
Affiliation(s)
- Daniel Lustberg
- Department of Human Genetics, Emory University School of Medicine, 615 Michael St., Whitehead 301, Atlanta, GA, 30322, USA
| | - Alexa F Iannitelli
- Department of Human Genetics, Emory University School of Medicine, 615 Michael St., Whitehead 301, Atlanta, GA, 30322, USA
| | - Rachel P Tillage
- Department of Human Genetics, Emory University School of Medicine, 615 Michael St., Whitehead 301, Atlanta, GA, 30322, USA
| | - Molly Pruitt
- University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - L Cameron Liles
- Department of Human Genetics, Emory University School of Medicine, 615 Michael St., Whitehead 301, Atlanta, GA, 30322, USA
| | - David Weinshenker
- Department of Human Genetics, Emory University School of Medicine, 615 Michael St., Whitehead 301, Atlanta, GA, 30322, USA.
| |
Collapse
|
45
|
Valderrama J, Hansen SK, Pato C, Phillips K, Knowles J, Pato MT. Greater history of traumatic event exposure and PTSD associated with comorbid body dysmorphic disorder in a large OCD cohort. Psychiatry Res 2020; 289:112962. [PMID: 32446006 PMCID: PMC9017948 DOI: 10.1016/j.psychres.2020.112962] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 03/17/2020] [Accepted: 03/27/2020] [Indexed: 01/20/2023]
Abstract
The present study examined whether or not there are differential rates of traumatic event exposure and presumed Post-Traumatic Stress Disorder (PTSD) between individuals with OCD without comorbid presumed BDD (OCD-Non-BDD) and individuals with OCD with comorbid presumed BDD (OCD+BDD) within a large cohort of OCD participants (N = 605). Individuals in the OCD+BDD group had significantly higher rates of endorsing at least one lifetime traumatic event and presumed PTSD than individuals with OCD-Non-BDD. Additionally, individuals in the OCD+BDD group with comorbid presumed PTSD had significantly higher rates of major depressive disorder (MDD) and presumed panic disorder (PD). A logistic regression analysis revealed that presumed PTSD significantly predicted the presence of BDD symptoms among individuals who experienced at least one lifetime traumatic event in our sample. These findings suggest that individuals in the OCD+BDD group were more likely to have experienced a traumatic event in their lives, to experience presumed PTSD, and to have MDD and presumed PD than individuals in the OCD-Non-BDD group. Clinical implications and possible mechanistic pathways from trauma exposure to OCD and BDD symptomatology are discussed.
Collapse
Affiliation(s)
- Jorge Valderrama
- Institute for Genomic Health, SUNY Downstate Medical Center, Brooklyn, NY, USA,Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Stella Kim Hansen
- Institute for Genomic Health, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | | | - Carlos Pato
- Institute for Genomic Health, SUNY Downstate Medical Center, Brooklyn, NY, USA,Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Katharine Phillips
- Department of Psychiatry, New York-Presbyterian Hospital, New York, NY, USA,Weill Cornell Medical College, New York, NY, USA
| | - James Knowles
- Department of Cell Biology, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Michele T. Pato
- Institute for Genomic Health, SUNY Downstate Medical Center, Brooklyn, NY, USA,Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, NY, USA,College of Medicine, SUNY Downstate Medical Center, Brooklyn, NY, USA
| |
Collapse
|
46
|
Ketamine and rapid acting antidepressants: Are we ready to cure, rather than treat depression? Behav Brain Res 2020; 390:112628. [PMID: 32407817 DOI: 10.1016/j.bbr.2020.112628] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 02/21/2020] [Accepted: 03/24/2020] [Indexed: 12/12/2022]
Abstract
Depression is a leading cause of disability, with often chronic course of illness and high treatment resistance in a large proportion of patients. In the current short perspective paper, we present evidence supporting the presence of synaptic-based chronic stress pathology (CSP) in depression and across a number of psychiatric disorders. We summarize the synaptic connectivity model of CSP, and briefly review related preclinical and clinical evidence, while providing appropriate references for more comprehensive reviews and alternative models. We then underscore some gaps in the literature and provide various tips for future directions.
Collapse
|
47
|
Ashraf F, Jibeen T, Masood A. Perceived Stress in Relation to Obsessions and Compulsions in South Asian Adults: Moderating Role of Socio-demographic Characteristics. Community Ment Health J 2020; 56:680-691. [PMID: 31853693 DOI: 10.1007/s10597-019-00529-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 12/11/2019] [Indexed: 11/29/2022]
Abstract
This study examines perceived stress associated with obsessions and compulsions (OC) in a normative sample of adults. The aim was to discover whether socio-demographic characteristics (i.e., gender, marital status, employment status, age and education) had a moderating effect on perceived stress and OC symptoms. The participants were 362 Pakistani adults (M age = 26.82 years, SD = 4.75; males = 188, females = 174) and the findings were based on a demographic questionnaire, the perceived stress scale (Cohen et al., in Applied multiple correlation/regression analysis for the behavioral sciences, Taylor & Francis, London, 1983), and the Padua inventory of obsessive compulsion disorder symptoms (Burns et al., in Behav Res Ther, 34(2), 163-173, 1996). A series of stepwise regression analyses showed that socio-demographic characteristics (employment status, age, and education) significantly moderated the relationship between perceived stress and OC symptoms. The current findings have implications for clinicians and researchers in generating effective stress management programs and learning mechanism for managing OC symptoms, particularly in the context of socio-demographic characteristics.
Collapse
Affiliation(s)
- Farzana Ashraf
- Department of Humanities, COMSATS University, Lahore, Pakistan.
| | - Tahira Jibeen
- Department of Psychology, University of Management & Technology, Lahore, Pakistan
| | - Afsheen Masood
- Institute of Applied Psychology, University of the Punjab, Lahore, Pakistan
| |
Collapse
|
48
|
Nass SR, Hahn YK, McLane VD, Varshneya NB, Damaj MI, Knapp PE, Hauser KF. Chronic HIV-1 Tat exposure alters anterior cingulate cortico-basal ganglia-thalamocortical synaptic circuitry, associated behavioral control, and immune regulation in male mice. Brain Behav Immun Health 2020; 5:100077. [PMID: 33083793 PMCID: PMC7571616 DOI: 10.1016/j.bbih.2020.100077] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 04/25/2020] [Indexed: 12/28/2022] Open
Abstract
HIV-1 selectively disrupts neuronal integrity within specific brain regions, reflecting differences in viral tropism and/or the regional differences in the vulnerability of distinct neuronal subpopulations within the CNS. Deficits in prefrontal cortex (PFC)-mediated executive function and the resultant loss of behavioral control are a particularly debilitating consequence of neuroHIV. To explore how HIV-1 disrupts executive function, we investigated the effects of 48 h, 2 and/or 8 weeks of HIV-1 Tat exposure on behavioral control, synaptic connectivity, and neuroimmune function in the anterior cingulate cortex (ACC) and associated cortico-basal ganglia (BG)-thalamocortical circuitry in adult, Tat transgenic male mice. HIV-1 Tat exposure increased novelty-exploration in response to novel food, flavor, and environmental stimuli, suggesting that Tat triggers increased novelty-exploration in situations of competing motivation (e.g., drive to feed or explore vs. fear of novel, brightly lit open areas). Furthermore, Tat induced adaptability in response to an environmental stressor and pre-attentive filtering deficits. The behavioral insufficiencies coincided with decreases in the inhibitory pre- and post-synaptic proteins, synaptotagmin 2 and gephyrin, respectively, in the ACC, and alterations in specific pro- and anti-inflammatory cytokines out of 23 assayed. The interaction of Tat exposure and the resultant time-dependent, selective alterations in CCL4, CXCL1, IL-12p40, and IL-17A levels in the PFC predicted significant decreases in adaptability. Tat decreased dendritic spine density and cortical VGLUT1 inputs, while increasing IL-1β, IL-6, CCL5, and CCL11 in the striatum. Alternatively, IL-1α, CCL5, and IL-13 were decreased in the mediodorsal thalamus despite the absence of synaptic changes. Thus, HIV-1 Tat appears to uniquely and systematically disrupt immune regulation and the inhibitory and excitatory synaptic balance throughout the ACC-BG-thalamocortical circuitry resulting in a loss of behavioral control.
Collapse
Affiliation(s)
- Sara R. Nass
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Medical College of Virginia (MCV) Campus, Richmond, P.O. Box 980613, VA, 23298-0613, USA
| | - Yun K. Hahn
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, Medical College of Virginia (MCV) Campus, P.O. Box 980709, Richmond, VA, 23298-0709, USA
| | - Virginia D. McLane
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Medical College of Virginia (MCV) Campus, Richmond, P.O. Box 980613, VA, 23298-0613, USA
| | - Neil B. Varshneya
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Medical College of Virginia (MCV) Campus, Richmond, P.O. Box 980613, VA, 23298-0613, USA
| | - M. Imad Damaj
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Medical College of Virginia (MCV) Campus, Richmond, P.O. Box 980613, VA, 23298-0613, USA
| | - Pamela E. Knapp
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Medical College of Virginia (MCV) Campus, Richmond, P.O. Box 980613, VA, 23298-0613, USA
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, Medical College of Virginia (MCV) Campus, P.O. Box 980709, Richmond, VA, 23298-0709, USA
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Medical College of Virginia (MCV) Campus, P.O. Box 980059, Richmond, VA, 23298-0059, USA
| | - Kurt F. Hauser
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Medical College of Virginia (MCV) Campus, Richmond, P.O. Box 980613, VA, 23298-0613, USA
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, Medical College of Virginia (MCV) Campus, P.O. Box 980709, Richmond, VA, 23298-0709, USA
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Medical College of Virginia (MCV) Campus, P.O. Box 980059, Richmond, VA, 23298-0059, USA
| |
Collapse
|
49
|
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.
Collapse
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
| |
Collapse
|
50
|
Ferreira S, Couto B, Sousa M, Vieira R, Sousa N, Picó-Pérez M, Morgado P. Stress Influences the Effect of Obsessive-Compulsive Symptoms on Emotion Regulation. Front Psychiatry 2020; 11:594541. [PMID: 33551866 PMCID: PMC7854917 DOI: 10.3389/fpsyt.2020.594541] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 12/21/2020] [Indexed: 12/12/2022] Open
Abstract
Obsessive-compulsive disorder (OCD) is associated with emotion regulation impairments, namely the frequent use of maladaptive strategies such as suppression and the decreased use of reappraisal strategies. Additionally, these patients exhibit elevated stress levels. Since stress exposure affects emotion regulation abilities, stress might influence the relationship between obsessive-compulsive symptoms and emotion regulation. In this study, we explored the effects of stress and obsessive-compulsive symptoms on emotion regulation in a sample of healthy and OCD individuals. We used self-reported psychometric scales to measure stress levels, obsessive-compulsive symptoms, and emotion reappraisal and suppression skills. We applied multiple regression and mediation analyses. Our results demonstrated that increased reappraisal scores were associated with higher suppression scores. Additionally, elevated stress values predicted increased scores for suppression and decreased scores for reappraisal. Furthermore, the reappraisal abilities resulted from a combination of a direct effect of obsessive-compulsive symptoms and an indirect effect of obsessive-compulsive symptoms mediated by stress. The reliance on suppression strategies and the difficulty in using reappraisal approaches are explained by stress levels and are not directly explained by obsessive-compulsive symptoms. This study highlights the necessity of targeting stress in current therapy-based treatments for OCD.
Collapse
Affiliation(s)
- Sónia Ferreira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS-3Bs PT Government Associate Laboratory, Braga, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal
| | - Beatriz Couto
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS-3Bs PT Government Associate Laboratory, Braga, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal
| | - Mafalda Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS-3Bs PT Government Associate Laboratory, Braga, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal
| | - Rita Vieira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS-3Bs PT Government Associate Laboratory, Braga, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS-3Bs PT Government Associate Laboratory, Braga, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal
| | - Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS-3Bs PT Government Associate Laboratory, Braga, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal
| | - Pedro Morgado
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS-3Bs PT Government Associate Laboratory, Braga, Portugal.,Clinical Academic Center-Braga (2CA), Braga, Portugal
| |
Collapse
|