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Borrelli DF, Ottoni R, Provettini A, Morabito C, Dell'Uva L, Marchesi C, Tonna M. A clinical investigation of psychotic vulnerability in early-onset Obsessive-Compulsive Disorder through Cognitive-Perceptive basic symptoms. Eur Arch Psychiatry Clin Neurosci 2024; 274:195-205. [PMID: 36585492 DOI: 10.1007/s00406-022-01543-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 12/16/2022] [Indexed: 12/31/2022]
Abstract
Childhood-onset Obsessive-Compulsive Disorder (OCD) shows distinct comorbidity patterns and developmental pathways, as well as an increased risk of psychosis with respect to adult-onset forms. Nevertheless, little is known about the prodromal symptoms of psychosis in children and adolescents with a primary diagnosis of OCD. The present study was aimed at evaluating the occurrence of Cognitive-Perceptual basic symptoms (COPER) and high- risk criterion Cognitive Disturbances (COGDIS) in pediatric and adults OCD patients, verifying if they might vary according to the age of onset of OCD. The study included 90 outpatients with a primary diagnosis of obsessive-compulsive disorder. The study sample was collapsed into three groups according to the age at onset: 1) very early onset group (< 10 years); 2) early onset group (11-18 years); 3) adult-onset group (> 18 years). All patients were administered the Yale-Brown Obsessive- Compulsive Scale (Y-BOCS) and its Child version (CY-BOCS), the Schizophrenia Proneness Instrument-Adult (SPIA) and its Child and Adolescent version (SPI-CY) and the Social and Occupational Functioning Assessment Scale (SOFAS). COPER and COGDIS symptoms were positively associated with OCD severity and detectable, respectively, in 28.9 and 26.7% of our study sample. The very early onset group significantly had higher COPER and COGDIS symptoms than the adult-onset group. Our data suggest that COPER and COGDIS symptoms are frequent in obsessive patients, in particular in those with earlier onset; therefore, their detection in childhood-onset OCD may represent an early and specific indicator of psychotic vulnerability.
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Affiliation(s)
| | - Rebecca Ottoni
- Department of Mental Health, Local Health Service, Parma, Italy
| | - Andrea Provettini
- Department of Medicine and Surgery, PsychiatryUnit, University of Parma, Parma, Italy
| | - Chiara Morabito
- Department of Medicine and Surgery, PsychiatryUnit, University of Parma, Parma, Italy
| | - Laura Dell'Uva
- Department of Medicine and Surgery, PsychiatryUnit, University of Parma, Parma, Italy
| | - Carlo Marchesi
- Department of Medicine and Surgery, PsychiatryUnit, University of Parma, Parma, Italy
- Department of Mental Health, Local Health Service, Parma, Italy
| | - Matteo Tonna
- Department of Medicine and Surgery, PsychiatryUnit, University of Parma, Parma, Italy
- Department of Mental Health, Local Health Service, Parma, Italy
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Nejati A, Bazrafshan A, Mosavat SH. Agomelatine efficacy in treatment resistant obsessive-compulsive disorder: A randomized double-blind clinical trial. Int J Psychiatry Med 2023:912174231225763. [PMID: 38156645 DOI: 10.1177/00912174231225763] [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: 01/03/2024]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a prevalent and burdensome mental health condition, often resistant to conventional treatments. Agomelatine (Valdoxan), a compound acting on serotonin and melatonin systems, has shown promise in anecdotal reports and case studies for OCD treatment. METHODS A randomized, double-blind clinical trial was conducted with 60 patients diagnosed with treatment-resistant OCD. Participants were divided into an intervention group (receiving agomelatine 50 mg/day) and a control group (placebo). OCD symptoms were assessed using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) over a 12-week period. RESULTS There were no significant differences in age, gender, or baseline Y-BOCS scores between the groups. Agomelatine did not demonstrate a significant improvement in OCD symptoms compared to the placebo. Adverse events were comparable between groups, and liver enzyme levels remained within the normal range. CONCLUSION This study, while not confirming significant efficacy, underscores the need for continued investigation into agomelatine's potential in treating specific subgroups of OCD patients, emphasizing the necessity for more comprehensive and well-controlled trials in the future.
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Affiliation(s)
- Azadeh Nejati
- Research Center for Psychiatry and Behavioral Science, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Bazrafshan
- Substance Abuse Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Hamdollah Mosavat
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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3
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Alemany-Navarro M, Tubío-Fungueiriño M, Diz-de Almeida S, Cruz R, Lombroso A, Real E, Soria V, Bertolín S, Fernández-Prieto M, Alonso P, Menchón JM, Carracedo A, Segalàs C. The genomics of visuospatial neurocognition in obsessive-compulsive disorder: A preliminary GWAS. J Affect Disord 2023; 333:365-376. [PMID: 37094658 DOI: 10.1016/j.jad.2023.04.060] [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: 01/31/2023] [Revised: 04/04/2023] [Accepted: 04/14/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND The study of Obsessive-Compulsive Disorder (OCD) genomics has primarily been tackled by Genome-wide association studies (GWAS), which have encountered troubles in identifying replicable single nucleotide polymorphisms (SNPs). Endophenotypes have emerged as a promising avenue of study in trying to elucidate the genomic bases of complex traits such as OCD. METHODS We analyzed the association of SNPs across the whole genome with the construction of visuospatial information and executive performance through four neurocognitive variables assessed by the Rey-Osterrieth Complex Figure Test (ROCFT) in a sample of 133 OCD probands. Analyses were performed at SNP- and gene-level. RESULTS No SNP reached genome-wide significance, although there was one SNP almost reaching significant association with copy organization (rs60360940; P = 9.98E-08). Suggestive signals were found for the four variables at both SNP- (P < 1E-05) and gene-levels (P < 1E-04). Most of the suggestive signals pointed to genes and genomic regions previously associated with neurological function and neuropsychological traits. LIMITATIONS Our main limitations were the sample size, which was limited to identify associated signals at a genome-wide level, and the composition of the sample, more representative of rather severe OCD cases than a population-based OCD sample with a broad severity spectrum. CONCLUSIONS Our results suggest that studying neurocognitive variables in GWAS would be more informative on the genetic basis of OCD than the classical case/control GWAS, facilitating the genetic characterization of OCD and its different clinical profiles, the development of individualized treatment approaches, and the improvement of prognosis and treatment response.
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Affiliation(s)
- M Alemany-Navarro
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; IBIS (Universidad de Sevilla, HUVR, Junta de Andalucia, CSIC) Sevilla, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain.
| | - M Tubío-Fungueiriño
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Genetics Group, GC05, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela, (USC), Spain
| | - S Diz-de Almeida
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain
| | - R Cruz
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela, (USC), Spain
| | - A Lombroso
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - E Real
- Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
| | - V Soria
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
| | - S Bertolín
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - M Fernández-Prieto
- Genomics and Bioinformatics Group, Center for Research in Molecular Medicine and Chronic Diseases (CiMUS), Universidade de Santiago de Compostela (USC), Santiago de Compostela, Spain; Fundación Instituto de Investigación Sanitaria de Santiago de Compostela (FIDIS), Santiago de Compostela, Spain; Genetics Group, GC05, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain; Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela, (USC), Spain
| | - P Alonso
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
| | - J M Menchón
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
| | - A Carracedo
- Grupo de Medicina Xenómica, U-711, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Universidade de Santiago de Compostela, (USC), Spain; Genetics Group, GC05, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain; Fundación Pública Galega de Medicina Xenómica, Servicio Galego de Saúde (SERGAS), Santiago de Compostela, Spain
| | - C Segalàs
- OCD Clinical and Research Unit, Psychiatry Department, Hospital Universitari de Bellvitge, Barcelona, Spain; Institut d' Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, Barcelona, Spain; CIBERSAM (Centro de Investigación en Red de Salud Mental), Instituto de Salud Carlos III, Spain
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Ribeiro AP, Piquet-Pessôa M, Félix-da-Silva C, Mühlbauer JFE, de-Salles-Andrade JB, Fontenelle LF. Subjective assessments of research domain criteria constructs in addiction and compulsive disorders: a scoping review protocol. BMJ Open 2022; 12:e059232. [PMID: 36028270 PMCID: PMC9422856 DOI: 10.1136/bmjopen-2021-059232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Obsessive-compulsive and related disorders (OCRDs) and disorders due to addictive behaviours (DABs) are prevalent conditions that share behavioural and neurobiological characteristics. The Research Domain Criteria lists a series of constructs whose dysfunctions may be present in both groups of disorders. The present study will describe the research protocol of a scoping review of the literature on self-report scales and questionnaires that tap dysfunctional constructs that underlie OCRDs and DABs. METHODS AND ANALYSIS This protocol outlines a scoping review on self-report tools and questionnaires that assess OCRDs and DABs-related constructs. The scoping review will select sources in MEDLINE, EMBASE, PsychINFO and Web of Science databases. Inclusion and exclusion criteria will be designed according to the Population, Concept, Context, Types of source framework. Two reviewers will screen independently titles, abstracts and full texts to determine the eligibility of articles. A methodological framework including six stages steps ((1) identifying a research question; (2) identifying relevant studies; (3) study selection; (4) charting the data; (5) collating, summarising and reporting the result) will be used, and the findings will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Information extracted will be collated, and quantitative results will be presented using descriptive statistics such as percentages, tables, charts and flow diagrams as appropriate. ETHICS AND DISSEMINATION Ethical approval for conducting this scoping review is not required, as this study will involve secondary analysis of existing literature. The researchers will disseminate the study results via conference presentations and publication in a peer-reviewed journal. SCOPING REVIEW PROTOCOL REGISTRATION DOI 10.17605/OSF.IO/UJ7G5.
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Affiliation(s)
- Ana Paula Ribeiro
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (IPUB/UFRJ) and D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Marcelo Piquet-Pessôa
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (IPUB/UFRJ) and D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Carina Félix-da-Silva
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (IPUB/UFRJ) and D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Julia Fernandes Eigenheer Mühlbauer
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (IPUB/UFRJ) and D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Juliana B de-Salles-Andrade
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (IPUB/UFRJ) and D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Leonardo F Fontenelle
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (IPUB/UFRJ) and D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
- Department of Psychiatry, Monash University School of Clinical Sciences at Monash Health, Clayton, Victoria, Australia
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Wang Z, Fontaine M, Cyr M, Rynn MA, Simpson HB, Marsh R, Pagliaccio D. Subcortical shape in pediatric and adult obsessive-compulsive disorder. Depress Anxiety 2022; 39:504-514. [PMID: 35485920 PMCID: PMC9813975 DOI: 10.1002/da.23261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/22/2022] [Accepted: 04/16/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) implicates alterations in cortico-striato-thalamo-cortical and fronto-limbic circuits. Building on prior structural findings, this is the largest study to date examining subcortical surface morphometry in OCD. METHODS Structural magnetic resonance imaging data were collected from 200 participants across development (5-55 years): 28 youth and 75 adults with OCD and 27 psychiatrically healthy youth and 70 adults. General linear models were used to assess group differences and group-by-age interactions on subcortical shape (FSL FIRST). RESULTS Compared to healthy participants, those with OCD exhibited surface expansions on the right nucleus accumbens and inward left amygdala deformations, which were associated with greater OCD symptom severity ([Children's] Yale-Brown Obsessive-Compulsive Scale). Group-by-age interactions indicated that accumbens group differences were driven by younger participants and that right pallidum shape was associated inversely with age in healthy participants, but not in participants with OCD. No differences in the shape of other subcortical regions or in volumes (FreeSurfer) were detected in supplementary analyses. CONCLUSIONS This study is the largest to date examining subcortical shape in OCD and the first to do so across the developmental spectrum. NAcc and amygdala shape deformation builds on extant neuroimaging findings and suggests subtle, subregional alterations beyond volumetric findings. Results shed light on morphometric alterations in OCD, informing current pathophysiological models.
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Affiliation(s)
- Zhishun Wang
- The Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Martine Fontaine
- The Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Marilyn Cyr
- The Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Moira A. Rynn
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Helen Blair Simpson
- The Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - Rachel Marsh
- The Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
| | - David Pagliaccio
- The Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA,New York State Psychiatric Institute, New York, New York, USA
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Tonna M, Ottoni R, Pellegrini C, Mora L, Gambolo L, Di Donna A, Parmigiani S, Marchesi C. The motor profile of obsessive-compulsive rituals: psychopathological and evolutionary implications. CNS Spectr 2022; 28:1-9. [PMID: 35184763 DOI: 10.1017/s1092852922000165] [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: 11/07/2022]
Abstract
BACKGROUND Studies investigating obsessive-compulsive disorder from an ethological approach have highlighted a specific motor pattern of compulsive rituals with respect to corresponding ordinary behaviors. Particularly, compulsive motor profile is built through the repetition of acts, with prevalence of nonfunctional ones and redirection of attention to its basic structural units. These formal features would characterize ritual behavior throughout evolution, from nonhuman animals to human cultures. However, no study to date has investigated a possible relationship between such motor profile and underlying psychopathology. Therefore, the first objective of the study was to confirm previous findings on a larger sample size of obsessive patients; the second objective was to elucidate whether motor profile might be associated with obsessive-compulsive psychopathology and/or prepsychotic symptoms of schizophrenia. METHODS Twenty-one obsessive-compulsive outpatients provided a videotape of their rituals. An equal number of healthy controls, matched for sex and age, were registered for corresponding ordinary acts. Obsessive patients were administered the Yale-Brown Obsessive-Compulsive Scale, the Brown Assessment of Beliefs Scale, the Hamilton Rating Scale for Depression, and the Frankfurt Complaint Questionnaire. RESULTS The results of the present study confirm that ritual compulsions present a specific motor structure characterized by repetition of both functional and nonfunctional acts and their longer duration. Such a motor pattern is independent from obsessive-compulsive psychopathology, whereas it results specifically associated with prepsychotic symptoms of schizophrenia. CONCLUSIONS We argue that this association may reflect the adaptive significance of ritual behavior across evolution, that is, its homeostatic function in conditions of unpredictability.
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Affiliation(s)
- Matteo Tonna
- Department of Mental Health, Local Health Service, Parma, Italy
- Department of Medicine and Surgery, Psychiatric Unit, University of Parma, Parma, Italy
| | - Rebecca Ottoni
- Department of Mental Health, Local Health Service, Parma, Italy
| | | | - Lorenzo Mora
- Department of Medicine and Surgery, Psychiatric Unit, University of Parma, Parma, Italy
| | - Luca Gambolo
- Department of Medicine and Surgery, Psychiatric Unit, University of Parma, Parma, Italy
| | - Anna Di Donna
- Department of Medicine and Surgery, Psychiatric Unit, University of Parma, Parma, Italy
| | - Stefano Parmigiani
- Department of Chemistry, Life Sciences and Environmental Sustainability, Unit of Behavioral Biology, University of Parma, Parma, Italy
| | - Carlo Marchesi
- Department of Mental Health, Local Health Service, Parma, Italy
- Department of Medicine and Surgery, Psychiatric Unit, University of Parma, Parma, Italy
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Poli A, Pozza A, Orrù G, Conversano C, Ciacchini R, Pugi D, Angelo NL, Angeletti LL, Miccoli M, Gemignani A. Neurobiological outcomes of cognitive behavioral therapy for obsessive-compulsive disorder: A systematic review. Front Psychiatry 2022; 13:1063116. [PMID: 36569616 PMCID: PMC9780289 DOI: 10.3389/fpsyt.2022.1063116] [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: 10/08/2022] [Accepted: 11/22/2022] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Obsessive-compulsive disorder (OCD) is characterized by recurrent distressing thoughts and repetitive behaviors, or mental rituals performed to reduce anxiety. Recent neurobiological techniques have been particularly convincing in suggesting that cortico-striatal-thalamic-cortico (CSTC) circuits, including orbitofrontal cortex (OFC) and striatum regions (caudate nucleus and putamen), are responsible for mediation of OCD symptoms. However, it is still unclear how these regions are affected by OCD treatments in adult patients. To address this yet open question, we conducted a systematic review of all studies examining neurobiological changes before and after first-line psychological OCD treatment, i.e., cognitive-behavioral therapy (CBT). METHODS Studies were included if they were conducted in adults with OCD and they assessed the neurobiological effects of CBT before and after treatment. Two databases were searched: PsycINFO and PubMed for the time frame up to May 2022. RESULTS We obtained 26 pre-post CBT treatment studies performed using different neurobiological techniques, namely functional magnetic resonance imaging (fMRI), Positron emission tomography (PET), regional cerebral blood flow (rCBF), 5-HT concentration, magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), Electroencephalography (EEG). Neurobiological data show the following after CBT intervention: (i) reduced activations in OFC across fMRI, EEG, and rCBF; (ii) decreased activity in striatum regions across fMRI, rCBF, PET, and MRI; (iii) increased activations in cerebellum (CER) across fMRI and MRI; (iv) enhanced neurochemical concentrations in MRS studies in OFC, anterior cingulate cortex (ACC) and striatum regions. Most of these neurobiological changes are also accompanied by an improvement in symptom severity as assessed by a reduction in the Y-BOCS scores. CONCLUSION Cognitive-behavioral therapy seems to be able to restructure, modify, and transform the neurobiological component of OCD, in addition to the clinical symptoms. Nevertheless, further studies are necessary to frame the OCD spectrum in a dimensional way.
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Affiliation(s)
- Andrea Poli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Andrea Pozza
- Department of Medical Sciences, Surgery, and Neurosciences, University of Siena, Siena, Italy
| | - Graziella Orrù
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Ciro Conversano
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Rebecca Ciacchini
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Daniele Pugi
- Department of Medical Sciences, Surgery, and Neurosciences, University of Siena, Siena, Italy
| | - Nicole Loren Angelo
- Department of Medical Sciences, Surgery, and Neurosciences, University of Siena, Siena, Italy
| | | | - Mario Miccoli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Angelo Gemignani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
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8
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Viol K, Schiepek G, Kronbichler M, Hartl A, Grafetstätter C, Strasser P, Kastinger A, Schöller H, Reiter EM, Said-Yürekli S, Kronbichler L, Kravanja-Spannberger B, Stöger-Schmidinger B, Hütt MT, Aichhorn W, Aas B. Multi-level assessment of obsessive-compulsive disorder (OCD) reveals relations between neural and neurochemical levels. BMC Psychiatry 2020; 20:559. [PMID: 33238940 PMCID: PMC7687999 DOI: 10.1186/s12888-020-02913-5] [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: 05/19/2020] [Accepted: 10/11/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND While considerable progress has been made in exploring the psychological, the neural, and the neurochemical dimensions of OCD separately, their interplay is still an open question, especially their changes during psychotherapy. METHODS Seventeen patients were assessed at these three levels by psychological questionnaires, fMRI, and venipuncture before and after inpatient psychotherapy. Seventeen controls were scanned at comparable time intervals. First, pre/post treatment changes were investigated for all three levels separately: symptom severity, whole-brain and regional activity, and the concentrations of cortisol, serotonin, dopamine, brain-derived neurotrophic factor (BDNF), and immunological parameters (IL-6, IL-10, TNFα). Second, stepwise linear modeling was used to find relations between the variables of the levels. RESULTS The obsessive-compulsive, depressive, and overall symptom severity was significantly reduced after psychotherapy. At the neural level, the activity in the anterior cingulate cortex (ACC), in frontal regions, in the precuneus, and in the putamen had significantly decreased. No significant changes were found on the neurochemical level. When connecting the levels, a highly significant model was found that explains the decrease in neural activity of the putamen by increases of the concentrations of cortisol, IL-6, and dopamine. CONCLUSION Multivariate approaches offer insight on the influences that the different levels of the psychiatric disorder OCD have on each other. More research and adapted models are needed.
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Affiliation(s)
- Kathrin Viol
- grid.21604.310000 0004 0523 5263Institute of Synergetics and Psychotherapy Research, Paracelsus Medical University, Ignaz-Harrer-Strasse 79, 5020 Salzburg, Austria ,grid.21604.310000 0004 0523 5263Department of Psychosomatics and Inpatient Psychotherapy, University Hospital for Psychiatry, Psychotherapy and Psychosomatics, Paracelsus Medical University, Salzburg, Austria
| | - Günter Schiepek
- Institute of Synergetics and Psychotherapy Research, Paracelsus Medical University, Ignaz-Harrer-Strasse 79, 5020, Salzburg, Austria. .,Department of Psychosomatics and Inpatient Psychotherapy, University Hospital for Psychiatry, Psychotherapy and Psychosomatics, Paracelsus Medical University, Salzburg, Austria. .,Department of Psychology, Ludwig Maximilians University, Munich, Germany.
| | - Martin Kronbichler
- grid.7039.d0000000110156330Centre for Cognitive Neuroscience and Department of Psychology, Paris Lodron University of Salzburg, Salzburg, Austria ,grid.21604.310000 0004 0523 5263Neuroscience Institute, Christian-Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria
| | - Arnulf Hartl
- grid.21604.310000 0004 0523 5263Institute for Ecomedicine, Christian-Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria
| | - Carina Grafetstätter
- grid.21604.310000 0004 0523 5263Institute for Ecomedicine, Christian-Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria
| | - Peter Strasser
- grid.21604.310000 0004 0523 5263Institute of Biochemical Diagnostic, Paracelsus Medical University, Salzburg, Austria
| | - Anna Kastinger
- grid.21604.310000 0004 0523 5263Institute of Synergetics and Psychotherapy Research, Paracelsus Medical University, Ignaz-Harrer-Strasse 79, 5020 Salzburg, Austria ,grid.21604.310000 0004 0523 5263Department of Psychosomatics and Inpatient Psychotherapy, University Hospital for Psychiatry, Psychotherapy and Psychosomatics, Paracelsus Medical University, Salzburg, Austria
| | - Helmut Schöller
- grid.21604.310000 0004 0523 5263Institute of Synergetics and Psychotherapy Research, Paracelsus Medical University, Ignaz-Harrer-Strasse 79, 5020 Salzburg, Austria ,grid.21604.310000 0004 0523 5263Department of Psychosomatics and Inpatient Psychotherapy, University Hospital for Psychiatry, Psychotherapy and Psychosomatics, Paracelsus Medical University, Salzburg, Austria
| | - Eva-Maria Reiter
- grid.21604.310000 0004 0523 5263Department for Radiotherapy and Radio-Oncology, Christian-Doppler University Hospital of the Paracelsus Medical University, Salzburg, Austria
| | - Sarah Said-Yürekli
- grid.7039.d0000000110156330Centre for Cognitive Neuroscience and Department of Psychology, Paris Lodron University of Salzburg, Salzburg, Austria ,grid.21604.310000 0004 0523 5263Neuroscience Institute, Christian-Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria ,grid.21604.310000 0004 0523 5263Department for Neurology, Christian-Doppler University Hospital of the Paracelsus Medical University, Salzburg, Austria
| | - Lisa Kronbichler
- grid.7039.d0000000110156330Centre for Cognitive Neuroscience and Department of Psychology, Paris Lodron University of Salzburg, Salzburg, Austria ,grid.21604.310000 0004 0523 5263Neuroscience Institute, Christian-Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria
| | - Brigitte Kravanja-Spannberger
- grid.21604.310000 0004 0523 5263Department of Psychosomatics and Inpatient Psychotherapy, University Hospital for Psychiatry, Psychotherapy and Psychosomatics, Paracelsus Medical University, Salzburg, Austria
| | - Barbara Stöger-Schmidinger
- grid.21604.310000 0004 0523 5263Department of Psychosomatics and Inpatient Psychotherapy, University Hospital for Psychiatry, Psychotherapy and Psychosomatics, Paracelsus Medical University, Salzburg, Austria
| | - Marc-Thorsten Hütt
- grid.15078.3b0000 0000 9397 8745Department of Life Sciences and Chemistry, Jacobs University, Bremen, Germany
| | - Wolfgang Aichhorn
- grid.21604.310000 0004 0523 5263Institute of Synergetics and Psychotherapy Research, Paracelsus Medical University, Ignaz-Harrer-Strasse 79, 5020 Salzburg, Austria ,grid.21604.310000 0004 0523 5263Department of Psychosomatics and Inpatient Psychotherapy, University Hospital for Psychiatry, Psychotherapy and Psychosomatics, Paracelsus Medical University, Salzburg, Austria
| | - Benjamin Aas
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Ludwig Maximilians University, Munich, Germany ,grid.5252.00000 0004 1936 973XFaculty of Psychology and Educational Sciences, LMU Munich, Munich, Germany
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9
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Tonna M, Ponzi D, Palanza P, Marchesi C, Parmigiani S. Proximate and ultimate causes of ritual behavior. Behav Brain Res 2020; 393:112772. [PMID: 32544508 DOI: 10.1016/j.bbr.2020.112772] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/23/2020] [Accepted: 06/08/2020] [Indexed: 01/24/2023]
Abstract
Ritual behaviour, intended as a specific, repetitive and rigid form of action flow, appears both in social and non-social environmental contexts, representing an ubiquitous phenomenon in animal life including human individuals and cultures. The purpose of this contribution is to investigate an evolutionary continuum in proximate and ultimate causes of ritual behavior. A phylogenetic homology in proximal mechanisms can be found, based on the repetition of genetically programmed and/or epigenetically acquired action patterns of behavior. As far as its adaptive significance, ethological comparative studies show that the tendency to ritualization is driven by the unpredictability of social or ecological environmental stimuli. In this perspective, rituals may have a "homeostatic" function over unpredictable environments, as further highlighted by psychopathological compulsions. In humans, a circular loop may have occurred among ritual practices and symbolic activity to deal with a novel culturally-mediated world. However, we suggest that the compulsion to action patterns repetition, typical of all rituals, has a genetically inborn motor foundation, thus precognitive and pre-symbolic. Rooted in such phylogenetically conserved motor structure (proximate causes), the evolution of cognitive and symbolic capacities have generated the complexity of human rituals, though maintaining the original adaptive function (ultimate causes) to cope with unpredictable environments.
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Affiliation(s)
- Matteo Tonna
- Department of Mental Health, Local Health Service, Parma, Italy.
| | - Davide Ponzi
- Department of Medicine and Surgery, Neuroscience Unit, University of Parma, Italy
| | - Paola Palanza
- Department of Medicine and Surgery, Neuroscience Unit, University of Parma, Italy
| | - Carlo Marchesi
- Department of Medicine and Surgery, Neuroscience Unit, University of Parma, Italy
| | - Stefano Parmigiani
- Department of Chemistry, Life Sciences and Environmental Sustainaibility, Unit of Behavioral Biology, University of Parma, Italy
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10
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Psychiatric comorbidities in Asperger syndrome are related with polygenic overlap and differ from other Autism subtypes. Transl Psychiatry 2020; 10:258. [PMID: 32732888 PMCID: PMC7393162 DOI: 10.1038/s41398-020-00939-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 03/19/2020] [Accepted: 04/17/2020] [Indexed: 01/09/2023] Open
Abstract
There is great phenotypic heterogeneity within autism spectrum disorders (ASD), which has led to question their classification into a single diagnostic category. The study of the common genetic variation in ASD has suggested a greater contribution of other psychiatric conditions in Asperger syndrome (AS) than in the rest of the DSM-IV ASD subtypes (Non_AS). Here, using available genetic data from previously performed genome-wide association studies (GWAS), we aimed to study the genetic overlap between five of the most related disorders (schizophrenia (SCZ), major depression disorder (MDD), attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorders (OCD) and anxiety (ANX)), and AS, comparing it with the overlap in Non_AS subtypes. A Spanish cohort of autism trios (N = 371) was exome sequenced as part of the Autism Sequencing Consortium (ASC) and 241 trios were extensively characterized to be diagnosed with AS following DSM-IV and Gillberg's criteria (N = 39) or not (N = 202). Following exome imputation, polygenic risk scores (PRS) were calculated for ASD, SCZ, ADHD, MDD, ANX, and OCD (from available summary data from Psychiatric Genomic Consortium (PGC) repository) in the Spanish trios' cohort. By using polygenic transmission disequilibrium test (pTDT), we reported that risk for SCZ (Pscz = 0.008, corrected-PSCZ = 0.0409), ADHD (PADHD = 0.021, corrected-PADHD = 0.0301), and MDD (PMDD = 0.039, corrected-PMDD = 0.0501) is over-transmitted to children with AS but not to Non_AS. Indeed, agnostic clustering procedure with deviation values from pTDT tests suggested two differentiated clusters of subjects, one of which is significantly enriched in AS (P = 0.025). Subsequent analysis with S-Predixcan, a recently developed software to predict gene expression from genotype data, revealed a clear pattern of correlation between cortical gene expression in ADHD and AS (P < 0.001) and a similar strong correlation pattern between MDD and AS, but also extendable to another non-brain tissue such as lung (P < 0.001). Altogether, these results support the idea of AS being qualitatively distinct from Non_AS autism and consistently evidence the genetic overlap between AS and ADHD, MDD, or SCZ.
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11
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Dixit PV, Sahu R, Mishra DK. Marble-burying behavior test as a murine model of compulsive-like behavior. J Pharmacol Toxicol Methods 2020; 102:106676. [PMID: 31954839 DOI: 10.1016/j.vascn.2020.106676] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 01/09/2020] [Accepted: 01/10/2020] [Indexed: 01/04/2023]
Abstract
Object burying by rodents is a popular screening tool for anxiolytic agents. However, modulation of marble-burying by serotonin reuptake inhibitors prompted its link to obsessive-compulsive disorder/compulsive-like behavior. The Marble-burying behavior test is an acute test; however, some investigators incorporate the sub-acute treatment regimen as an essential component for screening anti-compulsive agents. The test exhibits between-laboratory methodological differences and demonstrates positive treatment responses to an array of pharmacotherapies, creating doubts about its predictive validity and construct validity. Numerous reviews are available on marble-burying behavior test, which incorporates the test as a part of anti-compulsive behavior-like screens, but none has made it a sole subject-matter for discussion. This review attempts to provide a comprehensive account of the marble-burying test as a model of compulsive-like disorders. It envisages the model's scientific origins, the preclinical research done and its correlation with the clinical research outcomes, and a detailed discussion about its validity. In conclusion, there appears a need to address the issue of construct and predictive validity of the model authoritatively; or the paradigm may remain squandered in the field of obsessive-compulsive disorder research.
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Affiliation(s)
- Pankaj Vinod Dixit
- Indore Institute of Pharmacy, Rau-Pithampur Road, Opposite Indian Institute of Management, Rau, Indore, 453331, M.P., India.
| | - Rohit Sahu
- Indore Institute of Pharmacy, Rau-Pithampur Road, Opposite Indian Institute of Management, Rau, Indore, 453331, M.P., India
| | - Dinesh Kumar Mishra
- Indore Institute of Pharmacy, Rau-Pithampur Road, Opposite Indian Institute of Management, Rau, Indore, 453331, M.P., India
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12
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Jacob S, Wolff JJ, Steinbach MS, Doyle CB, Kumar V, Elison JT. Neurodevelopmental heterogeneity and computational approaches for understanding autism. Transl Psychiatry 2019; 9:63. [PMID: 30718453 PMCID: PMC6362076 DOI: 10.1038/s41398-019-0390-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 10/31/2018] [Accepted: 12/09/2018] [Indexed: 12/17/2022] Open
Abstract
In recent years, the emerging field of computational psychiatry has impelled the use of machine learning models as a means to further understand the pathogenesis of multiple clinical disorders. In this paper, we discuss how autism spectrum disorder (ASD) was and continues to be diagnosed in the context of its complex neurodevelopmental heterogeneity. We review machine learning approaches to streamline ASD's diagnostic methods, to discern similarities and differences from comorbid diagnoses, and to follow developmentally variable outcomes. Both supervised machine learning models for classification outcome and unsupervised approaches to identify new dimensions and subgroups are discussed. We provide an illustrative example of how computational analytic methods and a longitudinal design can improve our inferential ability to detect early dysfunctional behaviors that may or may not reach threshold levels for formal diagnoses. Specifically, an unsupervised machine learning approach of anomaly detection is used to illustrate how community samples may be utilized to investigate early autism risk, multidimensional features, and outcome variables. Because ASD symptoms and challenges are not static within individuals across development, computational approaches present a promising method to elucidate subgroups of etiological contributions to phenotype, alternative developmental courses, interactions with biomedical comorbidities, and to predict potential responses to therapeutic interventions.
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Affiliation(s)
- Suma Jacob
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, 55414, USA.
| | - Jason J Wolff
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Michael S Steinbach
- Department of Computer Science and Engineering, University of Minnesota, Minneapolis, MN, 55416, USA
| | - Colleen B Doyle
- Institute of Child Development, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Vipan Kumar
- Department of Computer Science and Engineering, University of Minnesota, Minneapolis, MN, 55416, USA
| | - Jed T Elison
- Institute of Child Development, University of Minnesota, Minneapolis, MN, 55455, USA
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13
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Mancini C, Cardona F, Baglioni V, Panunzi S, Pantano P, Suppa A, Mirabella G. Inhibition is impaired in children with obsessive-compulsive symptoms but not in those with tics. Mov Disord 2018; 33:950-959. [DOI: 10.1002/mds.27406] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 02/15/2018] [Accepted: 03/11/2018] [Indexed: 01/26/2023] Open
Affiliation(s)
- Christian Mancini
- Department of Anatomy, Histology, Forensic Medicine & Orthopedics; Sapienza University; Rome Italy
| | | | | | - Sara Panunzi
- Department of Human Neuroscience; Sapienza University; Rome Italy
| | - Patrizia Pantano
- Department of Human Neuroscience; Sapienza University; Rome Italy
- Istituto di ricovero e cura a carattere scientifico (IRCCS) Neuromed, Pozzilli (IS); Italy
| | - Antonio Suppa
- Department of Human Neuroscience; Sapienza University; Rome Italy
- Istituto di ricovero e cura a carattere scientifico (IRCCS) Neuromed, Pozzilli (IS); Italy
| | - Giovanni Mirabella
- Department of Anatomy, Histology, Forensic Medicine & Orthopedics; Sapienza University; Rome Italy
- Istituto di ricovero e cura a carattere scientifico (IRCCS) Neuromed, Pozzilli (IS); Italy
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14
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Castro-Rodrigues P, Camacho M, Almeida S, Marinho M, Soares C, Barahona-Corrêa JB, Oliveira-Maia AJ. Criterion Validity of the Yale-Brown Obsessive-Compulsive Scale Second Edition for Diagnosis of Obsessive-Compulsive Disorder in Adults. Front Psychiatry 2018; 9:431. [PMID: 30254588 PMCID: PMC6141833 DOI: 10.3389/fpsyt.2018.00431] [Citation(s) in RCA: 17] [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: 06/15/2018] [Accepted: 08/21/2018] [Indexed: 01/17/2023] Open
Abstract
Background: While the Yale-Brown Obsessive-Compulsive Scale Second Edition (Y-BOCS-II) is the gold-standard for measurement of obsessive-compulsive (OC) symptom severity, its factor structure is still a matter of debate and, most importantly, criterion validity for diagnosis of OC disorder (OCD) has not been tested. This study aimed to clarify factor structure and criterion validity of the Y-BOCS-II. Methods: We first validated and quantified the psychometric properties of a culturally adapted Portuguese translation of the Y-BOCS-II (PY-BOCS-II). The PY-BOCS-II and other psychometric instruments, including the OCD subscale of the Structured Clinical Interview for the DSM-IV, used to define OCD diagnosis, were administered to 187 participants (52 patients with OCD, 18 with other mood and anxiety disorders and 117 healthy subjects). In a subsample of 20 OCD patients and the 18 patients with other diagnoses, PY-BOCS-II was applied by clinicians blinded to diagnosis. Results: PY-BOCS-II had excellent internal consistency (Cronbach's α = 0.96) and very good test-retest reliability (Pearson's r = 0.94). Exploratory factor analysis revealed a two-factor structure with loadings consistent with the Obsessions and Compulsions subscales, and there was good to acceptable convergent and divergent validity. Importantly, the area under the curve (AUC) of the receiver operating characteristic (ROC) curve suggested elevated accuracy in discriminating between patients with OCD and control subjects (AUC = 0.96; 95% confidence interval [CI]: 0.92-0.99), that was retained in comparisons with age, gender and education matched controls (AUC = 0.95; 95% CI: 0.91-0.99), as well as with patients with other mood and anxiety disorders (AUC = 0.93; 95% CI: 0.84-1). Additionally, a cut-off score of 13 had optimal discriminatory ability for the diagnosis of OCD, with sensitivity ranging between 85 and 90%, and specificity between 94 and 97%, respectively when all samples or only the clinical samples were considered. Conclusion: The PY-BOCS-II has excellent psychometric properties to assess the severity of obsessive-compulsive symptoms, reflecting obsessive, and compulsive dimensions, compatible with currently defined subscales. Furthermore, we found that a cut-off of 13 for the Y-BOCS-II total score has good to excellent sensitivity and specificity for the diagnosis of OCD.
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Affiliation(s)
- Pedro Castro-Rodrigues
- Champalimaud Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal.,Champalimaud Research, Champalimaud Centre for the Unknown, Lisbon, Portugal.,NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.,Centro Hospitalar Psiquiátrico de Lisboa, Lisbon, Portugal
| | - Marta Camacho
- Champalimaud Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - Sílvia Almeida
- Champalimaud Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal.,Champalimaud Research, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - Mónica Marinho
- Champalimaud Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal.,Centro Hospitalar Psiquiátrico de Lisboa, Lisbon, Portugal
| | - Catarina Soares
- NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - J Bernardo Barahona-Corrêa
- Champalimaud Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal.,Champalimaud Research, Champalimaud Centre for the Unknown, Lisbon, Portugal.,NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.,Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
| | - Albino J Oliveira-Maia
- Champalimaud Clinical Centre, Champalimaud Centre for the Unknown, Lisbon, Portugal.,Champalimaud Research, Champalimaud Centre for the Unknown, Lisbon, Portugal.,NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.,Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
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15
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Hood SD, Broyd A, Robinson H, Lee J, Hudaib AR, Hince DA. Effects of tryptophan depletion on selective serotonin reuptake inhibitor-remitted patients with obsessive compulsive disorder. J Psychopharmacol 2017; 31:1615-1623. [PMID: 29095069 DOI: 10.1177/0269881117736916] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Serotonergic antidepressants are first-line medication therapies for obsessive-compulsive disorder, however it is not known if synaptic serotonin availability is important for selective serotonin reuptake inhibitor efficacy. The present study tested the hypothesis that temporary reduction in central serotonin transmission, through acute tryptophan depletion, would result in an increase in anxiety in selective serotonin reuptake inhibitor-remitted obsessive-compulsive disorder patients. METHODS Eight patients (four males) with obsessive-compulsive disorder who showed sustained clinical improvement with selective serotonin reuptake inhibitor treatment underwent acute tryptophan depletion in a randomized, double-blind, placebo-controlled, within-subjects design, over two days one week apart. Five hours after consumption of the depleting/sham drink the participants performed a personalized obsessive-compulsive disorder symptom exposure task. Psychological responses were measured using the Spielberger State Anxiety Inventory, Yale-Brown Obsessive Compulsive Scale and Visual Analogue Scales. RESULTS Free plasma tryptophan to large neutral amino acid ratio decreased by 93% on the depletion day and decreased by 1% on the sham day, as anticipated. Psychological rating scores as measured by Visual Analogue Scale showed a significant decrease in perceived control and increase in interfering thoughts at the time of provocation on the depletion day but not on the sham day. A measure of convergent validity, namely Visual Analogue Scale Similar to past, was significantly higher at the time of provocation on both the depletion and sham days. Both the depletion and time of provocation scores for Visual Analogue Scale Anxiety, Spielberger State Anxiety Inventory, Yale-Brown Obsessive Compulsive Scale and blood pressure were not significant. CONCLUSIONS Acute tryptophan depletion caused a significant decrease in perceived control and increase in interfering thoughts at the time of provocation. Acute tryptophan depletion had no effect on the Spielberger State Anxiety Inventory or Visual Analogue Scale Anxiety measures, which suggests that the mechanism of action of selective serotonin reuptake inhibitors may be different to that seen in panic, social anxiety and post-traumatic stress disorder. Successful selective serotonin reuptake inhibitor treatment of obsessive-compulsive disorder may involve the ability of serotonin to switch habitual responding to goal-directed behaviour.
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Affiliation(s)
- Sean D Hood
- Division of Psychiatry, UWA Medical School, The University of Western Australia, Perth, Australia
| | - Annabel Broyd
- Division of Psychiatry, UWA Medical School, The University of Western Australia, Perth, Australia
| | - Hayley Robinson
- Division of Psychiatry, UWA Medical School, The University of Western Australia, Perth, Australia
| | - Jessica Lee
- Division of Psychiatry, UWA Medical School, The University of Western Australia, Perth, Australia
| | - Abdul-Rahman Hudaib
- Division of Psychiatry, UWA Medical School, The University of Western Australia, Perth, Australia
| | - Dana A Hince
- Division of Psychiatry, UWA Medical School, The University of Western Australia, Perth, Australia
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16
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Frydman I, de Salles Andrade JB, Vigne P, Fontenelle LF. Can Neuroimaging Provide Reliable Biomarkers for Obsessive-Compulsive Disorder? A Narrative Review. Curr Psychiatry Rep 2016; 18:90. [PMID: 27549605 DOI: 10.1007/s11920-016-0729-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
In this integrative review, we discuss findings supporting the use neuroimaging biomarkers in the diagnosis and treatment of obsessive-compulsive disorder (OCD). To do so, we have selected the most recent studies that attempted to identify the underlying pathogenic process associated with OCD and whether they provide useful information to predict clinical features, natural history or treatment responses. Studies using functional magnetic resonance (fMRI), voxel-based morphometry (VBM), diffusion tensor imaging (DTI) and proton magnetic resonance spectroscopy (1H MRS) in OCD patients are generally supportive of an expanded version of the earlier cortico-striatal-thalamus-cortical (CSTC) model of OCD. Although it is still unclear whether this information will be incorporated into the daily clinical practice (due to current conceptual approaches to mental illness), statistical techniques, such as pattern recognition methods, appear promising in identifying OCD patients and predicting their outcomes.
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Affiliation(s)
- Ilana Frydman
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Juliana B de Salles Andrade
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Paula Vigne
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Leonardo F Fontenelle
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil.
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Victoria, Australia.
- , Rua Visconde de Pirajá, 547, 617, Ipanema, Rio de Janeiro, RJ, 22410-003, Brazil.
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17
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Snorrason I, Lee HJ, de Wit S, Woods DW. Are nonclinical obsessive-compulsive symptoms associated with bias toward habits? Psychiatry Res 2016; 241:221-3. [PMID: 27183107 DOI: 10.1016/j.psychres.2016.04.067] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 03/07/2016] [Accepted: 04/21/2016] [Indexed: 10/21/2022]
Abstract
In a sample of student volunteers (N=93), we found that obsessive-compulsive symptoms (although not hoarding) were associated with overreliance on stimulus-response habits at the expense of goal-directed control during instrumental responding. Only checking symptoms were associated with bias toward habits after negative affect was controlled for. Further research is warranted to examine if overreliance on habits represents an aberrant learning process that confers risk for obsessive-compulsive psychopathology.
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Affiliation(s)
- Ivar Snorrason
- Department of Psychology, University of Wisconsin-Milwaukee, 2441 East Hartford Avenue, Milwaukee, WI 53211, USA
| | - Han Joo Lee
- Department of Psychology, University of Wisconsin-Milwaukee, 2441 East Hartford Avenue, Milwaukee, WI 53211, USA.
| | - Sanne de Wit
- Department of Clinical Psychology, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS Amsterdam, Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands
| | - Douglas W Woods
- Department of Psychology, Marquette University, Holthusen Hall, 305, Milwaukee, WI 53201, USA
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