Yes: The Symptoms of OCD and Depression Are Discrete and Not Exclusively Negative Affectivity

Abnormalities in static and dynamic intrinsic neural activity and neurotransmitters in first-episode OCD

BACKGROUND

Obsessive-compulsive disorder (OCD) is a disabling disorder in which the temporal variability of regional brain connectivity is not well understood. The aim of this study was to investigate alterations in static and dynamic intrinsic neural activity (INA) in first-episode OCD and whether these changes have the potential to reflect neurotransmitters.

METHODS

A total of 95 first-episode OCD patients and 106 matched healthy controls (HCs) were included in this study. Based on resting-state functional magnetic resonance imaging (rs-fMRI), the static and dynamic local connectivity coherence (calculated by static and dynamic regional homogeneity, sReHo and dReHo) were compared between the two groups. Furthermore, correlations between abnormal INA and PET- and SPECT-derived maps were performed to examine specific neurotransmitter system changes underlying INA abnormalities in OCD.

RESULTS

Compared with HCs, OCD showed decreased sReHo and dReHo values in left superior, middle temporal gyrus (STG/MTG), left Heschl gyrus (HES), left putamen, left insula, bilateral paracentral lobular (PCL), right postcentral gyrus (PoCG), right precentral gyrus (PreCG), left precuneus and right supplementary motor area (SMA). Decreased dReHo values were also found in left PoCG, left PreCG, left SMA and left middle cingulate cortex (MCC). Meanwhile, alterations in INA present in brain regions were correlated with dopamine system (D2, FDOPA), norepinephrine transporter (NAT) and the vesicular acetylcholine transporter (VAChT) maps.

CONCLUSION

Static and dynamic INA abnormalities exist in first-episode OCD, having the potential to reveal the molecular characteristics. The results help to further understand the pathophysiological mechanism and provide alternative therapeutic targets of OCD.

Emotion Regulation in Obsessive-Compulsive Disorder: An Ecological Momentary Assessment Study

Emotion dysregulation is a central process implicated in the genesis and maintenance of obsessive-compulsive disorder (OCD). However, past research on OCD has examined emotion regulation with a trait-level approach, thereby neglecting important situational and temporal dynamics. The present study is the first one to examine moment-to-moment emotion regulation in individuals with OCD. A 6-day ecological momentary assessment was used to assess affect, emotion regulation strategies, perceived effectiveness of emotion regulation strategies, and acceptance of emotional experiences in n = 72 individuals with OCD and n = 54 psychologically healthy controls. As expected, individuals with OCD reported more negative and less positive affect. Group differences in positive (but not negative) affect did remain significant when controlling for baseline depression. Furthermore, the OCD group reported to use a higher momentary number of avoidance-oriented regulation strategies and less perceived effectiveness of emotion regulation, even when controlling for current symptoms and negative affect or baseline depression scores. Further, irrespective of group, more momentary negative affect amplified use of avoidance-oriented strategies and diminished perceived effectiveness and emotional acceptance. Contrary to expectations, these effects were not more pronounced in the OCD group. Possible explanations for unexpected findings and implications for future research, particularly regarding more holistic emotion regulation treatments, are discussed.

From Cognitive Function to Treatment Efficacy in Obsessive-Compulsive Disorder: Insights from a Multidimensional Meta-Analytic Approach

Meta-analysis is a statistical tool used to combine and synthesise the results of multiple independent studies on a particular topic. To this end, researchers isolate important moderators and mediators to investigate their influence on outcomes. This paper introduces a novel approach to meta-analysis, known as multidimensional meta-analysis (mi-MA), to study memory performance in those with obsessive-compulsive disorder (OCD). Unlike traditional meta-analyses, mi-MA allows researchers to extract multiple data points (e.g., using different measures) from single studies and groups of participants, facilitating the exploration of relationships between various moderators while avoiding multicollinearity issues. Therefore, in the first instance, we outline the use of the mi-MA approach to quantify the impact of complex models of memory performance in individuals with OCD. This approach provides novel insights into the complex relationship between various factors affecting memory in people with OCD. By showcasing the effectiveness of mi-MA in analysing intricate data and modelling complex phenomena, the paper establishes it as a valuable tool for researchers exploring multifaceted phenomena, both within OCD research and beyond.

Ketamine Infusion in a Resistant Obsessive-Compulsive Disorder Patient in Bangladesh with Severe Suicidal Ideation: A Case Report

Treatment of resistant obsessive-compulsive disorder (OCD) typically results in insufficient symptom alleviation, and even long-term medication often fails to have the intended effect. Ketamine is a potent non-competitive antagonist of the N-methyl-D-aspartate (NMDA) receptor. Studies have shown that low-dose ketamine infusion results in a considerable reduction in obsessive-compulsive symptoms and a rapid resolution of suicidal ideation. This is a case report on the effect of intravenous ketamine infusion on a patient with resistant OCD and severe suicidal ideation. Intravenous (IV) ketamine was given once a week over consecutive three weeks with necessary precautions. Psychometric tools such as the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Clinical Global Impressions Scale (CGI-S), the Beck Scale for Suicidal Ideations (BSSI), and Depression Anxiety and Stress Scale 21 (DASS-21) were applied before and after infusions. Obsessive-compulsive symptoms and suicidal severity started to decrease rapidly after the first infusion. However, after a transient improvement, these symptoms again began to increase after a stressful incident on the second day of the first infusion. All the symptoms measured by validated rating scales showed continued improvement after the following two infusions. The improvement was sustained until discharge (one week after the last infusion) and subsequent follow-up in the sixth and 12th weeks. The role of ketamine in reducing suicidal thoughts and behavior is already established. Very few studies emphasized its effectiveness in improving severe/resistant obsessive-compulsive symptoms. This pioneering work may offer scope for similar research in the relevant field.

Regional homogeneity in patients with obsessive-compulsive disorder and depression: A resting state functional magnetic resonance imaging study

OBJECTIVE

To explore the brain functional impairment of patients with obsessive-compulsive disorder (OCD) with and without depressive symptoms and analyze the correlation between the degree of impairment and the severity of symptoms.

METHOD

Fourteen patients with OCD who met the ICD-10 diagnostic criteria for OCD were included. The group having OCD with depression (OCDd) consisted of 15 patients, and 17 healthy controls (HC) matched for age and education were also included. The Yale-Brown OCD Scale (Y-BOCS) and the 24-item Hamilton Assessment of Depression Scale (HAMD) were administered to the OCD and OCDd groups. Resting-state functional brain magnetic resonance imaging was performed in the three groups of participants.

RESULT

The OCDd group had lower scores on the HAMD, Y-BOCS, and obsessive-compulsive thinking subscales compared with the OCD group (P < 0.05). The scores on the OCDd subscale were negatively correlated with the HAMD scores (R =  - 0.568, P = 0.027). The OCDd group had higher regional homogeneity (ReHo) values in the lingual gyrus than the OCD group. The OCDd group had higher ReHo values in the lingual gyrus than the HC group, and the OCDd group had higher ReHo values than the HC group. These differences were statistically significant (P < 0.05). After correction for multiple comparisons, significant difference was observed between the OCDd and HC groups (P＜0.05). In the OCD group, the ReHo value of the lingual gyrus was negatively correlated with the Y-BOCS total score and the compulsive behavior subscale score (R =  - 0.609, -0.552; P = 0.016, 0.033).

CONCLUSION

Abnormal ReHo values in the lingual gyrus and right medial superior frontal gyrus were found in the patients with OCDd. In the OCDd group, the ReHo values of the lingual gyrus were negatively correlated with the scores on the Y-BOCS total and obsessive-compulsive subscales, suggesting that abnormal local coherence of the lingual gyrus may be related to the severity of OCD.

Hierarchical Structure of Depression Knowledge Network and Co-word Analysis of Focus Areas

Contemporarily, depression has become a common psychiatric disorder that influences people's life quality and mental state. This study presents a systematic review analysis of depression based on a hierarchical structure approach. This research provides a rich theoretical foundation for understanding the hot spots, evolutionary trends, and future related research directions and offers further guidance for practice. This investigation contributes to knowledge by combining robust methodological software for analysis, including Citespace, Ucinet, and Pajek. This paper employed the bibliometric methodology to analyze 5,000 research articles concerning depression. This current research also employed the BibExcel software to bibliometrically measure the keywords of the selected articles and further conducted a co-word matrix analysis. Additionally, Pajek software was used to conduct a co-word network analysis to obtain a co-word network diagram of depression. Further, Ucinet software was utilized to calculate K-core values, degree centrality, and mediated centrality to better present the research hotspots, sort out the current status and reveal the research characteristics in the field of depression with valuable information and support for subsequent research. This research indicates that major depressive disorder, anxiety, and mental health had a high occurrence among adolescents and the aged. This present study provides policy recommendations for the government, non-governmental organizations and other philanthropic agencies to help furnish resources for treating and controlling depression orders.

Anger and aggressiveness in obsessive-compulsive disorder (OCD) and the mediating role of responsibility, non-acceptance of emotions, and social desirability

According to psychodynamic and cognitive models of obsessive-compulsive disorder (OCD), anger and aggression play an important role in the development and maintenance of the disorder. (Sub-) clinical samples with OCD have reported higher anger and anger suppression. Patients with checking-related symptoms of OCD showed a less aggressive self-concept as assessed by an Implicit Association Test (IAT). This study assessed anger and aggressiveness self-concepts in OCD as well as possible mediators of the link between OCD and aggressiveness. A total of 48 patients with OCD and 45 healthy controls were included. Measures included the State-Trait Anger Expression Inventory-II and an aggressiveness self-concept IAT (Agg-IAT). An inflated sense of responsibility, non-acceptance of emotions, and social desirability were tested as mediators. As expected, patients with OCD reported higher trait anger and anger suppression compared to healthy controls. Contrary to hypotheses, the aggressiveness self-concept (Agg-IAT) did not differ between groups. The inflated sense of responsibility mediated the relationship between group and anger suppression. Non-acceptance of negative emotions mediated the relationship between group and trait anger, as well as anger suppression. However, comorbidities and medication may account for some effect in anger suppression. Elevated trait anger and anger suppression in OCD patients could be explained by dysfunctional beliefs or maladaptive emotion regulation strategies. Emotion regulation therapy might help to enhance awareness and acceptance of emotions and possibly improve treatment outcomes.

Obsessive-Compulsive Symptoms and Cannabis Misuse: The Explanatory Role of Cannabis Use Motives

The purpose of the present investigation was to examine the unique explanatory role of cannabis use motives above the effects of each other, for the relationship between obsessive-compulsive symptomatology and different aspects of cannabis misuse among young adults. The transitional years of young adulthood are characterized by new opportunities for experimentation as well as novel external stressors. Collectively, this makes this developmental epoch a sensitive time for manifestations of cannabis misuse. Methods: Bivariate correlations were conducted to examine the association between obsessive-compulsive symptomatology and risky cannabis use, cannabis use problems, and the average quantity of cannabis used per occasion among a young ethno-racially diverse sample of college students with the past year history of cannabis use (N = 177, 68.95% female, Mage = 21.51, SD = 4.24). Next, multiple mediation analyses were conducted to examine the unique explanatory role of cannabis use motives (e.g., enhancement, conformity, coping, social, and expansion) for the association between the obsessive-compulsive symptoms and cannabis misuse variables which showed significant correlation with these symptoms at the bivariate level. Results: Obsessive-compulsive symptoms were significantly correlated with risky cannabis use (r = .19; p = .02), but not cannabis use problems or the average quantity of cannabis used per occasion. Conducting the multiple mediation for the relationship with the significant bivariate correlation, coping motives significantly explained the relationship between obsessive-compulsive symptoms and risky cannabis use (b = 0.04, SE = 0.02, 95% Bootstrapped CI [0.003, 0.10], Completely Standardized Indirect Effects = 0.07), after controlling for the variance accounted for by problematic alcohol use and smoking status. This indirect effect was not significant after adding anxiety and depressive symptoms as covariates to the model. Conclusions: These findings are discussed in terms of the development of specialized treatments to specifically target cannabis use coping motives among individuals with comorbid obsessive-compulsive disorder and cannabis misuse.