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Bednarek L, Glover S, Ma X, Pittenger C, Pushkarskaya H. Externally orienting cues improve cognitive control in OCD. J Behav Ther Exp Psychiatry 2024; 84:101959. [PMID: 38531125 DOI: 10.1016/j.jbtep.2024.101959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/31/2023] [Accepted: 03/01/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND AND OBJECTIVES An executive overload model of obsessive-compulsive disorder (OCD) posits that broad difficulties with executive functioning in OCD result from an overload on the executive system by obsessive thoughts. It implies that, if individuals with OCD "snap out" of their obsessive thoughts, their performance on neurocognitive tasks will improve. METHODS We test this prediction using the revised Attention Network Test, ANT-R, and distinct subsamples of data from unmedicated OCD and healthy controls (HC). ANT-R includes Simon and Flanker tasks; in both, incongruent trials take longer to resolve ('conflict costs'). On some trials, a warning cue helps participants to respond faster ('alerting benefits'). In OCD (N = 34) and HC (N = 46), matched on age, IQ, and sex, we tested (1) the effect of OCD on alerting benefits, and (2) the effect of OCD on warning cue related reductions in conflict costs. In a distinct subsample of OCD (N = 32) and HC (N = 51), we assessed whether alerting benefits and cue-related reductions in conflict costs are associated differently with different OCD symptoms. RESULTS A warning cue can help individuals with OCD more than HC to improve performance on Simon and Flanker tasks. This effect is positively associated with severity of contamination symptoms. LIMITATIONS This study did not directly assess how distracted participants are by obsessive thoughts. It relied on the ANT-R subtraction measures. Symptom severity was assessed using self-report measures. CONCLUSIONS Difficulties in resolving conflict during decision-making in OCD can be modulated by a warning cue presented immediately before an attentional task.
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Affiliation(s)
- Lora Bednarek
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Stephanie Glover
- PGSP-Stanford PsyD Consortium, Palo Alto University, Palo Alto, CA, United States
| | - Xiao Ma
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| | - Christopher Pittenger
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States; Department of Psychology, Yale University, New Haven, CT, United States; Yale Child Study Center, Yale School of Medicine, New Haven, CT, United States; Wu Tsai Institute, Yale University, New Haven, CT, United States; Yale Center for Brain and Mind Health, Yale School of Medicine, New Haven, CT, United States
| | - Helen Pushkarskaya
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.
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Strom NI, Burton CL, Iyegbe C, Silzer T, Antonyan L, Pool R, Lemire M, Crowley JJ, Hottenga JJ, Ivanov VZ, Larsson H, Lichtenstein P, Magnusson P, Rück C, Schachar R, Wu HM, Cath D, Crosbie J, Mataix-Cols D, Boomsma DI, Mattheisen M, Meier SM, Smit DJA, Arnold PD. Genome-Wide Association Study of Obsessive-Compulsive Symptoms including 33,943 individuals from the general population. Mol Psychiatry 2024:10.1038/s41380-024-02489-6. [PMID: 38548983 DOI: 10.1038/s41380-024-02489-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/18/2024] [Accepted: 02/15/2024] [Indexed: 04/24/2024]
Abstract
While 1-2% of individuals meet the criteria for a clinical diagnosis of obsessive-compulsive disorder (OCD), many more (~13-38%) experience subclinical obsessive-compulsive symptoms (OCS) during their life. To characterize the genetic underpinnings of OCS and its genetic relationship to OCD, we conducted the largest genome-wide association study (GWAS) meta-analysis of parent- or self-reported OCS to date (N = 33,943 with complete phenotypic and genome-wide data), combining the results from seven large-scale population-based cohorts from Sweden, the Netherlands, England, and Canada (including six twin cohorts and one cohort of unrelated individuals). We found no genome-wide significant associations at the single-nucleotide polymorphism (SNP) or gene-level, but a polygenic risk score (PRS) based on the OCD GWAS previously published by the Psychiatric Genetics Consortium (PGC-OCD) was significantly associated with OCS (Pfixed = 3.06 × 10-5). Also, one curated gene set (Mootha Gluconeogenesis) reached Bonferroni-corrected significance (Ngenes = 28, Beta = 0.79, SE = 0.16, Pbon = 0.008). Expression of genes in this set is high at sites of insulin mediated glucose disposal. Dysregulated insulin signaling in the etiology of OCS has been suggested by a previous study describing a genetic overlap of OCS with insulin signaling-related traits in children and adolescents. We report a SNP heritability of 4.1% (P = 0.0044) in the meta-analyzed GWAS, and heritability estimates based on the twin cohorts of 33-43%. Genetic correlation analysis showed that OCS were most strongly associated with OCD (rG = 0.72, p = 0.0007) among all tested psychiatric disorders (N = 11). Of all 97 tested phenotypes, 24 showed a significant genetic correlation with OCS, and 66 traits showed concordant directions of effect with OCS and OCD. OCS have a significant polygenic contribution and share genetic risk with diagnosed OCD, supporting the hypothesis that OCD represents the extreme end of widely distributed OCS in the population.
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Affiliation(s)
- Nora I Strom
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany.
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany.
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden.
- Department of Biomedicine, Aarhus University, Aarhus, Denmark.
| | - Christie L Burton
- Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Conrad Iyegbe
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
- Department of Genetics and Genomic Sciences, Icahn School of Medicine, Mount Sinai, New York, USA
| | - Talisa Silzer
- Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Lilit Antonyan
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - René Pool
- Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Mathieu Lemire
- Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - James J Crowley
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden
- Departments of Genetics and Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jouke-Jan Hottenga
- Netherlands Twin Register, Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Volen Z Ivanov
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- School of Medical sciences, Örebro University, Örebro, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Patrik Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Christian Rück
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden
| | - Russell Schachar
- Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Hei Man Wu
- Department of Genetics and Genomic Sciences, Icahn School of Medicine, Mount Sinai, New York, USA
| | - Danielle Cath
- Rijksuniversiteit Groningen and Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
- Department of Specialized Training, Drenthe Mental Health Care Institute, Assen, The Netherlands
| | - Jennifer Crosbie
- Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - David Mataix-Cols
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden
| | - Dorret I Boomsma
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Netherlands Twin Register, Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Manuel Mattheisen
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Community Health & Epidemiology, Dalhousie University, NS, Halifax, Canada
| | - Sandra M Meier
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Community Health & Epidemiology, Dalhousie University, NS, Halifax, Canada
| | - Dirk J A Smit
- Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Compulsivity Impulsivity and Attention, Amsterdam, The Netherlands
| | - Paul D Arnold
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Departments of Psychiatry and Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Geller DA, Grossman M. A Family Genetic Study of Obsessive Compulsive Disorder in Youth. J Atten Disord 2024; 28:639-647. [PMID: 38153006 DOI: 10.1177/10870547231217091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
OBJECTIVE To use a family genetic study to evaluate familial risk of obsessive compulsive disorder (OCD) and common comorbid illnesses in first-degree relatives of pediatric-onset probands with primary OCD. METHOD One hundred and thirty youth with OCD and their 133 siblings and 241 parents and 49 pediatric controls were directly evaluated along multiple domains including psychopathology using structured diagnostic interviews and clinical corroboration. RESULTS Rates of anxiety, mood, disruptive behavior, and tic disorders were markedly elevated in the probands while rates in siblings were elevated at rates between the probands and controls. Twenty six percent of first-degree relatives had clinical OCD, 9% had chronic tics or Tourette's disorder, and 21% met criteria for ADHD. CONCLUSION Rates of familial transmission of OCD and common comorbid illnesses were significantly higher in our pediatric-onset probands than rates reported in the literature in relatives of those with adult-onset OCD.
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Affiliation(s)
- Daniel A Geller
- Massachusetts General Hospital, Boston, USA
- Harvard Medical School, Boston, MA, USA
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Vismara M, Benatti B, Fineberg NA, Hollander E, Van Ameringen M, Menchon JM, Zohar J, Dell'Osso B. Lessons from a multicenter, international, large sample size analysis of patients with obsessive-compulsive disorders: an overview of the ICOCS Snapshot studies. CNS Spectr 2024; 29:40-48. [PMID: 37694338 DOI: 10.1017/s1092852923002432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Obsessive-compulsive disorder (OCD) is a prevalent and highly disabling condition, characterized by a range of phenotypic expressions, potentially associated with geo-cultural differences. This article aims to provide an overview of the published studies by the International College of Obsessive-Compulsive Spectrum Disorders, in relation to the Snapshot database which has, over the past 10 years, gathered clinical naturalistic data from over 500 patients with OCD attending various research centers/clinics worldwide. This collaborative effort has provided a multi-cultural worldwide perspective of different socio-demographic and clinical features of patients with OCD. Data on age, gender, smoking habits, age at onset, duration of illness, comorbidity, suicidal behaviors, and pharmacological treatment strategies are presented here, showing peculiar differences across countries.
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Affiliation(s)
- Matteo Vismara
- University of Milan, Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Milan, Italy
| | - Beatrice Benatti
- University of Milan, Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Milan, Italy
- "Aldo Ravelli" Center for Neurotechnology and Brain Therapeutic, University of Milan, Milan, Italy
| | - Naomi A Fineberg
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
- Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, UK
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Eric Hollander
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Montefiore Medical Center, New York, USA
| | - Michael Van Ameringen
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Jose M Menchon
- Psychiatry Unit at the Hospital Universitari de Bellvitge-IDIBELL, University of Barcelona, Cibersam, Barcelona, Spain
| | - Joseph Zohar
- Post-Trauma Center, Research Foundation by the Sheba Medical Center, Tel Aviv University, Sackler School of Medicine, Israel
| | - Bernardo Dell'Osso
- University of Milan, Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Milan, Italy
- "Aldo Ravelli" Center for Neurotechnology and Brain Therapeutic, University of Milan, Milan, Italy
- Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford University, CA, USA
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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.
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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
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Riddle DB, Guzick A, Minhajuddin A, Smárason O, Armstrong GM, Slater H, Mayes TL, Goodman LC, Baughn DL, Martin SL, Wakefield SM, Blader J, Brown R, Goodman WK, Trivedi MH, Storch EA. Obsessive-compulsive disorder in youth and young adults with depression: Clinical characteristics of comorbid presentations. J Obsessive Compuls Relat Disord 2023; 38:100820. [PMID: 37521713 PMCID: PMC10373162 DOI: 10.1016/j.jocrd.2023.100820] [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: 08/01/2023]
Abstract
Obsessive-compulsive disorder (OCD), anxiety disorders, and depressive disorders are highly comorbid, and each contribute to significant functional impairment for affected youth. Comorbid anxiety disorders in depressed youth have been associated with greater depressive symptom severity and impairment, but the impact of comorbid OCD in this population remains unclear. Accordingly, the present study examined the differential clinical characteristics of youth with depression and comorbid OCD relative to age/gender matched depressed youth with no such comorbidity and to those with depression and a comorbid (non-OCD) anxiety disorder. A sample of 797 youth and young adults ages 8-20 years who met diagnostic criteria for depression alone, depression with co-occurring OCD or any anxiety disorder were included in the present study. Rates of comorbid anxiety and OCD were very high (60.5% and 15.5%, respectively). Relative to youth with only depression, depressed youth with comorbid OCD or anxiety had greater severity of depression, suicidality, and overall impairment in social, physical, and emotional functioning. These results highlight the contribution of OCD or anxiety comorbidity in more complex clinical presentations for depressed youth.
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Affiliation(s)
- David B Riddle
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Andrew Guzick
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Abu Minhajuddin
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Orri Smárason
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Gabrielle M Armstrong
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Holli Slater
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Taryn L Mayes
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Lynnel C Goodman
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Denise L Baughn
- Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch, Galveston, TX, USA
| | - Sarah L Martin
- Department of Psychiatry, Texas Tech University Health Science Center, Lubbock, TX, USA
| | - Sarah M Wakefield
- Department of Psychiatry, Texas Tech University Health Science Center, Lubbock, TX, USA
| | - Joseph Blader
- University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Ryan Brown
- Department of Psychiatry and Behavioral Sciences, University of Texas, Austin, TX, USA
| | - Wayne K Goodman
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Madhukar H Trivedi
- Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Eric A Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
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ÖZDEMİR E, HACIÖMEROĞLU AB. Transdiagnostic Approach and Obsessive Compulsive Disorder. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2023. [DOI: 10.18863/pgy.1110989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
The categorical approach of traditional psychiatric nosology has been a forceful approach for a very long time for explaining psychological disorders which are defined by symptom based diagnostic categories. However, in recent years, the importance of the "transdiagnostic" approach which is a new classification system is increasing. The transdiagnostic approach aims to examine dimensionally the common cognitive, behavioral, interpersonal and biological processes underlying many psychopathologies away from the categorical approach that classifies psychopathologies according to observable symptoms. This approach intends to treat the disorders through the common underlying processes and risk factors, thus heterogeneous and comorbid symptoms are better addressed and diagnostic categories that may change during treatment are avoided. In this review study, the current problems in diagnosing based on classification and gaps in the field were examined, and the approach itself was proposed as a solution. RDoC (Research Domain Criteria) which is a new classification system for psychiatric disorders within the scope of the approach, has created a new structure using modern research approaches in genetics, neuroscience and behavioral sciences. In the present study, the definition and emergence of the transdiagnostic approach, obsessive compulsive disorder and RDoC in the context of transdiagnostic approach and transdiagnostic treatment are explained. This review is intended to be a resource for both basic psychopathology research and the development of treatment methods within the framework of a transdiagnostic approach.
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Thatikonda NS, Vinod P, Balachander S, Bhaskarpillai B, Arumugham SS, Reddy YJ. Efficacy of Repetitive Transcranial Magnetic Stimulation on Comorbid Anxiety and Depression Symptoms in Obsessive-Compulsive Disorder: A Meta-Analysis of Randomized Sham-Controlled Trials. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2023; 68:407-417. [PMID: 35989677 PMCID: PMC10331254 DOI: 10.1177/07067437221121112] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To systematically evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) in reducing comorbid anxiety and depressive symptoms in patients with obsessive-compulsive disorder (OCD). METHODS Three electronic databases were searched for randomized, sham-controlled clinical trials evaluating rTMS for the treatment of OCD. Hedge's g was calculated as the effect size for anxiety/depression symptom severity (primary outcome) and OCD severity (secondary outcome). Subgroup analyses and meta-regression analyses were carried out to evaluate the most promising target and whether a reduction in OCD severity moderates the change in anxiety or depression scores. RESULTS Twenty studies (n = 688) were included in the meta-analysis. rTMS had small-medium effect size on OCD (Hedge's g = 0.43; 95% confidence interval [CI]: [0.20, 0.65]; P < 0.001), anxiety (Hedge's g = 0.3; 95% CI: [0.11, 0.48]; P = 0.001) and depression (Hedge's g = 0.24; 95% CI: [0.07, 0.40]; P = 0.003) symptoms. Subgroup analysis showed that protocols targeting dorsolateral prefrontal cortex (DLPFC) were effective for 3 outcome measures. The change in anxiety, but not depression severity, was moderated by a change in OCD symptom scores. However, the findings are uncertain as a majority of the studies had some concerns or a high risk of bias. CONCLUSIONS Active rTMS protocol targeting DLPFC is effective in reducing the comorbid anxiety/depression symptoms along with OCD severity. The antidepressant effect is not moderated by the anti-obsessive effect of rTMS.
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Affiliation(s)
- Navya Spurthi Thatikonda
- Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Pratibha Vinod
- Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Srinivas Balachander
- Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | | | - Shyam Sundar Arumugham
- Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Y.C. Janardhan Reddy
- Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
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Spencer SD, Stiede JT, Wiese AD, Goodman WK, Guzick AG, Storch EA. Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder. Psychiatr Clin North Am 2023; 46:167-180. [PMID: 36740350 PMCID: PMC11170287 DOI: 10.1016/j.psc.2022.10.004] [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] [Indexed: 12/27/2022]
Abstract
Obsessive-compulsive disorder (OCD) is characterized by the presence of debilitating obsessions and compulsions. Cognitive and behavioral models of OCD provide a strong theoretic and empirical foundation for informing effective psychotherapeutic treatment. Cognitive-behavioral therapy (CBT) for OCD, which includes a deliberate emphasis on exposure and response/ritual prevention, has consistently demonstrated robust efficacy for the treatment of pediatric and adult OCD and is the front-line psychotherapeutic treatment for OCD. Two case vignettes describing CBT for OCD in practice as well as recommendations for clinicians are provided.
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Affiliation(s)
- Samuel D Spencer
- Baylor College of Medicine, One Baylor Plaza, MS:350, Houston, TX 77030, USA.
| | - Jordan T Stiede
- Baylor College of Medicine, One Baylor Plaza, MS:350, Houston, TX 77030, USA
| | - Andrew D Wiese
- Baylor College of Medicine, One Baylor Plaza, MS:350, Houston, TX 77030, USA
| | - Wayne K Goodman
- Baylor College of Medicine, One Baylor Plaza, MS:350, Houston, TX 77030, USA
| | - Andrew G Guzick
- Baylor College of Medicine, One Baylor Plaza, MS:350, Houston, TX 77030, USA
| | - Eric A Storch
- One Baylor Plaza, MS:350, 1977 Butler Boulevard, Houston, TX 77030, USA
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Conradi-Hünerman-Happle Syndrome and Obsessive-Compulsive Disorder: a clinical case report. BMC Psychiatry 2023; 23:87. [PMID: 36747187 PMCID: PMC9900547 DOI: 10.1186/s12888-023-04579-1] [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: 11/05/2022] [Accepted: 01/31/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Obsessive-Compulsive Disorder (OCD) is a common and chronic psychiatric disorder with significant morbidity characterized by intrusive, uncontrollable and reoccurring thoughts (i.e., obsessions) and/or ritualistic behaviours (i.e., compulsions). Conradi-Hünerman-Happle Syndrome (CHHS) is a rare inherited X-linked dominant variant of chondrodysplasia punctata, a heterogeneous group of rare bone dysplasias characterized by punctate epiphyseal calcifications of complex etiology and pathophysiology that remain to be defined. Available literature reveals a lacuna in regards to the coexistence of the entities with no clinical reports described. CASE PRESENTATION A 12 year old female patient with diagnosis of CHHS, presents to psychiatric consultation due to aggravation of her OCD clinical picture, with aggravation of hand-washing frequency during the Covid-19 pandemic with significant functional impact. Psychopharmacological treatment aimed at OCD with Selective Serotonin Reuptake Inhibitor (SSRI) and antipsychotic was instituted with favourable, albeit partial response. CONCLUSIONS The authors aim to describe a clinical case in which the patient presents with Conradi-Hünerman-Happle Syndrome and Obsessive-Compulsive Disorder. Clinical descriptions of CHHS and OCD are not available in the literature. Through this case description the authors aim to present a rare case as well as discuss an eventual association between etiology and/or pathophysiology of the two disorders.
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See CCH, Tan JM, Tan VSY, Sündermann O. A systematic review on the links between emotion regulation difficulties and obsessive-compulsive disorder. J Psychiatr Res 2022; 154:341-353. [PMID: 36049435 DOI: 10.1016/j.jpsychires.2022.07.023] [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: 11/15/2021] [Revised: 06/23/2022] [Accepted: 07/04/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Growing evidence suggests a link between emotion regulation (ER) deficits and obsessive-compulsive symptoms (OCS). AIMS A systematic review was conducted to integrate empirical research on the nature of ER difficulties associated with obsessive-compulsive disorder (OCD), validated measures of ER for OCD and evidence base for psychological interventions targeting ER difficulties in OCD. METHODS Database searches were conducted on CINAHL, Cochrane Library, EMBASE, MEDLINE, PUBMED, PsycINFO and Scopus with keywords related to ER and OCD. 2609 articles were found, six were identified from other sources and 21 studies were included in this review. The review was registered on PROSPERO (CDR42020184076). RESULTS The non-acceptance of emotions was the most consistently related to OCS - albeit not uniformly with all OCS dimensions. There was also some evidence suggesting that difficulties in impulse-control, accessing effective ER strategies and engaging in goal-directed behaviours to be related to OCS. No OCD-specific ER measure was identified. Interventions with ER components appeared to be promising for the treatment of OCD. FUTURE DIRECTIONS Recommendations on how to build on the existing literature and improve the quality of evidence were provided.
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Affiliation(s)
- Cassandra C H See
- Department of Psychology, National University of Singapore, Block AS4, 9 Arts Link, Singapore, 117570, Singapore.
| | - Jia Min Tan
- Department of Psychology, National University of Singapore, Block AS4, 9 Arts Link, Singapore, 117570, Singapore
| | - Vanessa S Y Tan
- Department of Psychology, National University of Singapore, Block AS4, 9 Arts Link, Singapore, 117570, Singapore
| | - Oliver Sündermann
- Department of Psychology, National University of Singapore, Block AS4, 9 Arts Link, Singapore, 117570, Singapore
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Efe A, Kaba D, Canlı M, Temeltürk RD. Impact of Attention-Deficit/Hyperactivity Disorder Comorbidity on Phenomenology and Treatment Outcomes of Pediatric Obsessive-Compulsive Disorder. J Child Adolesc Psychopharmacol 2022; 32:337-348. [PMID: 35905054 DOI: 10.1089/cap.2022.0007] [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: 11/12/2022]
Abstract
Objective: This study, with a case-control design, investigates the impact of attention-deficit/hyperactivity disorder (ADHD) comorbidity on the phenomenology and treatment outcomes in a clinical sample of pediatric obsessive-compulsive disorder (OCD). Methods: The data were derived from an evaluation of the sociodemographic and clinical characteristics of 364 children with OCD who were regularly followed up over a 4-year period. Between-group analyses of psychiatric scales were used to compare patients with ADHD comorbidity (n = 144, 39.5%) with their ADHD-free opponents. The clinical course and treatment outcomes of each patient were evaluated based on 4-year clinical follow-up data. Results: Substantial clinical variations in pediatric OCD caused by ADHD comorbidity were identified, including a male preponderance, higher rates of concurrent conduct problems, tic disorders, and learning disabilities, as well as prolonged symptom and treatment durations accompanied by poor response to first-line treatments and higher rates of treatment resistance. Contrary to previous findings, ADHD comorbidity had no impact on the age of OCD onset, and the severity of OCD symptoms was lower in ADHD. With ADHD comorbidity, the OCD symptom course tended to be chronically stable, which may have resulted in complaints persisting into adulthood. In ADHD-free patients, contamination, doubt, religious, somatic obsessions, and cleaning were all more common than in those with ADHD. There was a positive correlation between compulsion scores and the severity of ADHD symptoms, which may be related to increased compulsive coping in ADHD. Impulsivity or compulsivity dominance in the symptom presentation of OCD-ADHD comorbidity may determine phenomenological distinctions such as whether concurrent traits are more prone to tics, conduct problems, or internalizing problems. The primordial associations for clinical characteristics, which were independently associated with ADHD comorbidity, were adjusted using multivariate logistic regression analysis. Clinical variables such as being male, absence of cleaning compulsion, the existence of concurrent conduct problems, tic disorders, and dyslexia, as well as longer treatment duration and poorer treatment response, were all independent predictors of ADHD comorbidity. With an 80.8% accurate classification and relatively fine goodness-of-fit model, the regression model consisting of those predictors had good predictiveness for ADHD comorbidity (R2 = 0.543). Conclusions: The close association between pediatric OCD, ADHD, and tic disorders can be defined as a specific subtype of pediatric OCD, characterized by more conduct problems, a chronically stable course of OCD symptoms, and poorer treatment outcomes. Correlational analyses in a longitudinal design and the inclusion of an impulsivity scale would be beneficial for further research to interpret the impulsivity-related correlates in the findings on tic and conduct problems.
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Affiliation(s)
- Ayşegül Efe
- Department of Child and Adolescent Psychiatry, Dr. Sami Ulus Maternity, Children's Health and Diseases Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Duygu Kaba
- Department of Child and Adolescent Psychiatry, Başkent University, Medical Faculty, Ankara, Turkey
| | - Merve Canlı
- Department of Child and Adolescent Psychiatry, Dr. Sami Ulus Maternity, Children's Health and Diseases Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Rahime Duygu Temeltürk
- Department of Child and Adolescent Psychiatry, Ankara University, Medical Faculty, Ankara, Turkey
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Olgiati P, Fanelli G, Serretti A. Obsessive-compulsive symptoms in major depressive disorder correlate with clinical severity and mixed features. Int Clin Psychopharmacol 2022; 37:166-172. [PMID: 35191860 DOI: 10.1097/yic.0000000000000396] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Obsessive-compulsive symptoms (OCS) are often reported in patients with bipolar disorder. The aim of this study was to investigate OCS and their related clinical features in major depressive disorder (MDD). The analysis involved 482 outpatients with MDD collected within the Combining Medications to Enhance Depression outcomes trial, who were assessed with scales for depression, suicidality, irritability, hypomanic symptomatology, and other comorbid psychiatric manifestations. OCS were reported in 27% of the sample. Patients with MDD experiencing OCS were found to differ from those not experiencing OCS by a greater severity of depression (d = 0.41, P = 0.0001), more hypomanic symptoms (d = 0.48, P < 0.0001) and mixed features (22% vs. 10%, P = 0.001), increased levels of suicidal thoughts (d = 0.40, P = 0.0001), a lower likelihood of achieving remission after antidepressant treatment (19% vs. 33%, P = 0.0109), as well as more comorbid anxiety disorders (i.e. panic disorder: d = 0.98, P < 0.0001; generalized anxiety disorder: d = 0.74, P < 0.0001; social phobia: d = 0.71, P < 0.0001), and post-traumatic stress disorder (d = 0.81, P < 0.0001). In light of these findings, clinicians should pay more attention to the occurrence of OCS in MDD, as these symptoms may reflect greater clinical severity, poorer treatment outcome, and increased risk for bipolarity.
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Affiliation(s)
- Paolo Olgiati
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giuseppe Fanelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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Hoshina N, Johnson-Venkatesh EM, Rally VR, Sant J, Hoshina M, Seiglie MP, Umemori H. ASD/OCD-Linked Protocadherin-10 Regulates Synapse, But Not Axon, Development in the Amygdala and Contributes to Fear- and Anxiety-Related Behaviors. J Neurosci 2022; 42:4250-4266. [PMID: 35504727 PMCID: PMC9145243 DOI: 10.1523/jneurosci.1843-21.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 03/14/2022] [Accepted: 03/17/2022] [Indexed: 11/21/2022] Open
Abstract
The Protocadherin-10 (PCDH10) gene is associated with autism spectrum disorder (ASD), obsessive-compulsive disorder (OCD), and major depression (MD). The PCDH10 protein is a homophilic cell adhesion molecule that belongs to the δ2-protocadherin family. PCDH10 is highly expressed in the developing brain, especially in the basolateral nucleus of the amygdala (BLA). However, the role of PCDH10 in vivo has been debatable: one paper reported that a Pcdh10 mutant mouse line showed changes in axonal projections; however, another Pcdh10 mutant mouse line was reported to have failed to detect axonal phenotypes. Therefore, the actual roles of PCDH10 in the brain remain to be elucidated. We established a new Pcdh10 KO mouse line using the CRISPR/Cas9 system, without inserting gene cassettes to avoid nonspecific effects, examined the roles of PCDH10 in the brain, and studied the behavioral consequences of Pcdh10 inactivation. Here, we show that Pcdh10 KO mice do not show defects in axonal development. Instead, we find that Pcdh10 KO mice exhibit impaired development of excitatory synapses in the dorsal BLA. We further demonstrate that male Pcdh10 KO mice exhibit reduced anxiety-related behaviors, impaired fear conditioning, decreased stress-coping responses, and mildly impaired social recognition and communication. These results indicate that PCDH10 plays a critical role in excitatory synapse development, but not axon development, in the dorsal BLA and that PCDH10 regulates anxiety-related, fear-related, and stress-related behaviors. Our results reveal the roles of PCDH10 in the brain and its relationship to relevant psychiatric disorders such as ASD, OCD, and MD.SIGNIFICANCE STATEMENTProtocadherin-10 (PCDH10) encodes a cell adhesion molecule and is implicated in autism spectrum disorder (ASD), obsessive-compulsive disorder (OCD), and major depression (MD). PCDH10 is highly expressed in the basolateral nucleus of the amygdala (BLA). However, the phenotypes of previously published Pcdh10 mutant mice are debatable, and some are possibly because of the nonspecific effects of the LacZ/Neo cassette inserted in the mice. We have generated a new Pcdh10 mutant mouse line without the LacZ/Neo cassette. Using our new mouse line, we reveal the roles of PCDH10 for excitatory synapse development in the BLA. The mutant mice exhibit anxiety-related, fear-related, and stress-related behaviors, which are relevant to ASD, OCD, and MD, suggesting a possible treatment strategy for such psychiatric disorders.
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Affiliation(s)
- Naosuke Hoshina
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115
| | - Erin M Johnson-Venkatesh
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115
| | - Veronica R Rally
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115
| | - Jaanvi Sant
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115
| | - Miyuki Hoshina
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115
| | - Mariel P Seiglie
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115
| | - Hisashi Umemori
- Department of Neurology, F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115
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Kassel MT, Lositsky O, Vaidya AR, Badre D, Malloy PF, Greenberg BD, Marsland R, Noren G, Sherman A, Rasmussen SA, McLaughlin NC. Differential assessment of frontally-mediated behaviors between self- and informant-report in patients with obsessive-compulsive disorder following gamma ventral capsulotomy. Neuropsychologia 2022; 170:108211. [DOI: 10.1016/j.neuropsychologia.2022.108211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 02/02/2022] [Accepted: 03/08/2022] [Indexed: 10/18/2022]
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16
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Żerdziński M, Burdzik M, Żmuda R, Witkowska-Berek A, Dȩbski P, Flajszok-Macierzyńska N, Piegza M, John-Ziaja H, Gorczyca P. Sense of happiness and other aspects of quality of life in patients with obsessive-compulsive disorder. Front Psychiatry 2022; 13:1077337. [PMID: 36620674 PMCID: PMC9810625 DOI: 10.3389/fpsyt.2022.1077337] [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: 10/22/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Quality of life (QoL) is the intellectual and emotional wellbeing of an individual, which is determined by many factors. The most measurable are the sense of happiness, occupational satisfaction, quality of interpersonal relationships and sex life. Obsessive-compulsive disorder (OCD) is a chronic mental disorder diagnosed by the presence of obsessions and compulsions that disrupt normal psychosocial functioning. Despite early onset, treatment is delayed (OCD-DTI) and unsatisfactory. OBJECTIVES The primary objective of this study is to assess selected correlates of the sense of happiness among patients with OCD. The secondary objective is to compare the sense of happiness with healthy people. METHODS Seventyfive OCD patients and equal number of healthy subjects were compared using a Polish adaptation of the Oxford Happiness Questionnaire (OHQ-23). RESULTS We found a significant negative correlation between sense of happiness and the severity of OCD (r = -0.479), the number of obsessive-compulsive personality traits (r = -0.323), the number of other comorbid mental disorders (r = -0.272), the level of aggression (r = -0.448), impulsivity (r = -0.301), depressiveness (r = -0.357), and the sexual dysfunctions (r = -0.279). The latter were much more common in individuals with OCD compared to healthy subjects (66.67 vs. 12%). The level of loneliness was over two times higher in the study group compared to controls (27 vs. 12%). The mean delay in treatment onset was 13 years. Conclusions. Assessment of aspects of QoL should be an integral part of the diagnostic and therapeutic process in OCD.
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Affiliation(s)
- Maciej Żerdziński
- Dr. Krzysztof Czuma's Psychiatric Center, Psychiatric Department No 2, Katowice, Poland.,Faculty of Medicine, Academy of Silesia, Katowice, Poland
| | - Marcin Burdzik
- Dr. Krzysztof Czuma's Psychiatric Center, Psychiatric Department No 2, Katowice, Poland.,Institute of Law at Faculty of Law and Administration, University of Silesia in Katowice, Katowice, Poland
| | - Roksana Żmuda
- Dr. Krzysztof Czuma's Psychiatric Center, Psychiatric Department No 2, Katowice, Poland
| | | | - Paweł Dȩbski
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Tarnowskie Góry, Poland
| | | | - Magdalena Piegza
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Tarnowskie Góry, Poland
| | - Hanna John-Ziaja
- Dr. Krzysztof Czuma's Psychiatric Center, Psychiatric Department No 2, Katowice, Poland
| | - Piotr Gorczyca
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Tarnowskie Góry, Poland
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Mitra S, Bult-Ito A. Bidirectional Behavioral Selection in Mice: A Novel Pre-clinical Approach to Examining Compulsivity. Front Psychiatry 2021; 12:716619. [PMID: 34566718 PMCID: PMC8458042 DOI: 10.3389/fpsyt.2021.716619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/16/2021] [Indexed: 11/17/2022] Open
Abstract
Obsessive-compulsive disorder (OCD) and related disorders (OCRD) is one of the most prevalent neuropsychiatric disorders with no definitive etiology. The pathophysiological attributes of OCD are driven by a multitude of factors that involve polygenic mechanisms, gender, neurochemistry, physiological status, environmental exposures and complex interactions among these factors. Such complex intertwining of contributing factors imparts clinical heterogeneity to the disorder making it challenging for therapeutic intervention. Mouse strains selected for excessive levels of nest- building behavior exhibit a spontaneous, stable and predictable compulsive-like behavioral phenotype. These compulsive-like mice exhibit heterogeneity in expression of compulsive-like and other adjunct behaviors that might serve as a valuable animal equivalent for examining the interactions of genetics, sex and environmental factors in influencing the pathophysiology of OCD. The current review summarizes the existing findings on the compulsive-like mice that bolster their face, construct and predictive validity for studying various dimensions of compulsive and associated behaviors often reported in clinical OCD and OCRD.
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Affiliation(s)
- Swarup Mitra
- Department of Pharmacology and Toxicology, State University of New York at Buffalo, Buffalo, NY, United States
| | - Abel Bult-Ito
- Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks, AK, United States
- OCRD Biomed LLC, Fairbanks, AK, United States
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Strom NI, Grove J, Meier SM, Bækvad-Hansen M, Becker Nissen J, Damm Als T, Halvorsen M, Nordentoft M, Mortensen PB, Hougaard DM, Werge T, Mors O, Børglum AD, Crowley JJ, Bybjerg-Grauholm J, Mattheisen M. Polygenic Heterogeneity Across Obsessive-Compulsive Disorder Subgroups Defined by a Comorbid Diagnosis. Front Genet 2021; 12:711624. [PMID: 34531895 PMCID: PMC8438210 DOI: 10.3389/fgene.2021.711624] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/27/2021] [Indexed: 01/20/2023] Open
Abstract
Among patients with obsessive-compulsive disorder (OCD), 65-85% manifest another psychiatric disorder concomitantly or at some other time point during their life. OCD is highly heritable, as are many of its comorbidities. A possible genetic heterogeneity of OCD in relation to its comorbid conditions, however, has not yet been exhaustively explored. We used a framework of different approaches to study the genetic relationship of OCD with three commonly observed comorbidities, namely major depressive disorder (MDD), attention-deficit hyperactivity disorder (ADHD), and autism spectrum disorder (ASD). First, using publicly available summary statistics from large-scale genome-wide association studies, we compared genetic correlation patterns for OCD, MDD, ADHD, and ASD with 861 somatic and mental health phenotypes. Secondly, we examined how polygenic risk scores (PRS) of eight traits that showed heterogeneous correlation patterns with OCD, MDD, ADHD, and ASD partitioned across comorbid subgroups in OCD using independent unpublished data from the Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH). The comorbid subgroups comprised of patients with only OCD (N = 366), OCD and MDD (N = 1,052), OCD and ADHD (N = 443), OCD and ASD (N = 388), and OCD with more than 1 comorbidity (N = 429). We found that PRS of all traits but BMI were significantly associated with OCD across all subgroups (neuroticism: p = 1.19 × 10-32, bipolar disorder: p = 7.51 × 10-8, anorexia nervosa: p = 3.52 × 10-20, age at first birth: p = 9.38 × 10-5, educational attainment: p = 1.56 × 10-4, OCD: p = 1.87 × 10-6, insomnia: p = 2.61 × 10-5, BMI: p = 0.15). For age at first birth, educational attainment, and insomnia PRS estimates significantly differed across comorbid subgroups (p = 2.29 × 10-4, p = 1.63 × 10-4, and p = 0.045, respectively). Especially for anorexia nervosa, age at first birth, educational attainment, insomnia, and neuroticism the correlation patterns that emerged from genetic correlation analysis of OCD, MDD, ADHD, and ASD were mirrored in the PRS associations with the respective comorbid OCD groups. Dissecting the polygenic architecture, we found both quantitative and qualitative polygenic heterogeneity across OCD comorbid subgroups.
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Affiliation(s)
- Nora I. Strom
- Department of Psychology, Humboldt Universität zu Berlin, Berlin, Germany
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Biomedicine and the iSEQ Center, Aarhus University, Aarhus, Denmark
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Jakob Grove
- Department of Biomedicine and the iSEQ Center, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Copenhagen, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Sandra M. Meier
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Marie Bækvad-Hansen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Copenhagen, Denmark
- Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Judith Becker Nissen
- Center for Child and Adolescent Psychiatry, Aarhus University Hospital Risskov, Risskov, Denmark
| | - Thomas Damm Als
- Department of Biomedicine and the iSEQ Center, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Copenhagen, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Matthew Halvorsen
- Department of Genetics, University of North Carolina, Chapel Hill, NC, United States
| | - Merete Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Research Centre for Mental Health (CORE), Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Preben B. Mortensen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Copenhagen, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - David M. Hougaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Copenhagen, Denmark
- Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Thomas Werge
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Copenhagen, Denmark
- Lundbeck Foundation Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Copenhagen, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Anders D. Børglum
- Department of Biomedicine and the iSEQ Center, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Copenhagen, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - James J. Crowley
- Department of Genetics, University of North Carolina, Chapel Hill, NC, United States
| | - Jonas Bybjerg-Grauholm
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Copenhagen, Denmark
- Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Manuel Mattheisen
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Biomedicine and the iSEQ Center, Aarhus University, Aarhus, Denmark
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
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Strom NI, Soda T, Mathews CA, Davis LK. A dimensional perspective on the genetics of obsessive-compulsive disorder. Transl Psychiatry 2021; 11:401. [PMID: 34290223 PMCID: PMC8295308 DOI: 10.1038/s41398-021-01519-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 06/04/2021] [Accepted: 06/16/2021] [Indexed: 12/21/2022] Open
Abstract
This review covers recent findings in the genomics of obsessive-compulsive disorder (OCD), obsessive-compulsive symptoms, and related traits from a dimensional perspective. We focus on discoveries stemming from technical and methodological advances of the past five years and present a synthesis of human genomics research on OCD. On balance, reviewed studies demonstrate that OCD is a dimensional trait with a highly polygenic architecture and genetic correlations to multiple, often comorbid psychiatric phenotypes. We discuss the phenotypic and genetic findings of these studies in the context of the dimensional framework, relying on a continuous phenotype definition, and contrast these observations with discoveries based on a categorical diagnostic framework, relying on a dichotomous case/control definition. Finally, we highlight gaps in knowledge and new directions for OCD genetics research.
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Affiliation(s)
- Nora I Strom
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Department of Psychology, Humboldt Universität zu Berlin, Berlin, Germany
| | - Takahiro Soda
- Department of Psychiatry, Duke University, Durham, NC, USA
| | - Carol A Mathews
- Department of Psychiatry, University of Florida, Gainesville, FL, USA
| | - Lea K Davis
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA.
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Carga cognitiva y control atencional en puertorriqueños con trastorno obsesivocompulsivo. REVISTA IBEROAMERICANA DE PSICOLOGÍA 2021. [DOI: 10.33881/2027-1786.rip.15103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Trasfondo:El control ejecutivo de la atención media la resolución de problemas y la acción voluntaria y está implicado en la regulación de las emociones. Se ha reportado que el control atencional está afectado en personas con trastorno obsesivo-compulsivo (TOC). Sin embargo, no se ha considerado la influencia de la carga cognitiva y la distracción en la ejecución de tareas, lo que pudiera tener un impacto en el control atencional. En este estudio evaluamos si la carga cognitiva alta y baja influyen en el control atencional de personas con TOC, en comparación con un grupo control. Método:Quince adultos puertorriqueños con TOC (M=31.60, DE=10.70) y 26 saludables (M=28.42, DE=10.73) participaron en el estudio. Se administró el Attention Network Test y una tarea de carga cognitiva para evaluar el control atencional. Resultados:No se observaron diferencias significativas en las puntuaciones de alerta, orientación y control atencional entre los grupos en ambas condiciones de carga cognitiva (p>0.05). Solo se observó una diferencia significativa en el control atencional de los participantes con TOC (z=1.99, p=0.047) y del grupo control (z=-2.83, p=0.005) durante tareas con carga cognitiva baja y alta. Conclusiones:Ambos grupos experimentaron menor interferencia de distractores bajo alta carga cognitiva, lo que sugiere un mayor control de la atención durante esta condición. Es posible que el aumento de carga cognitiva pueda reducir la distracción en puertorriqueños saludables y aquellos con TOC. Tomar en cuenta la carga cognitiva puede facilitar el entrenamiento cognitivo para el control atencional y aumentar la flexibilidad cognitiva, mejorando la respuesta al tratamiento.
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Weber SR, Holbrook ER, Palettas M, Duchemin AM. Prevalence of Comorbid Anxiety-Anxiety Disorders and the Effect of Comorbidity on Anxiolytic Treatment. Psychiatr Ann 2021. [DOI: 10.3928/00485713-20210606-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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22
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Shephard E, Batistuzzo MC, Hoexter MQ, Stern ER, Zuccolo PF, Ogawa CY, Silva RM, Brunoni AR, Costa DL, Doretto V, Saraiva L, Cappi C, Shavitt RG, Simpson HB, van den Heuvel OA, Miguel EC. Neurocircuit models of obsessive-compulsive disorder: limitations and future directions for research. REVISTA BRASILEIRA DE PSIQUIATRIA 2021; 44:187-200. [PMID: 35617698 PMCID: PMC9041967 DOI: 10.1590/1516-4446-2020-1709] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 03/05/2021] [Indexed: 11/22/2022]
Affiliation(s)
- Elizabeth Shephard
- Universidade de São Paulo (USP), Brazil; Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London, UK
| | - Marcelo C. Batistuzzo
- Universidade de São Paulo (USP), Brazil; Pontifícia Universidade Católica de São Paulo, Brazil
| | | | - Emily R. Stern
- The New York University School of Medicine, USA; Orangeburg, USA
| | | | | | | | | | | | | | | | - Carolina Cappi
- Universidade de São Paulo (USP), Brazil; Icahn School of Medicine at Mount Sinai, USA
| | | | - H. Blair Simpson
- New York State Psychiatric Institute, Columbia University Irving Medical Center (CUIMC), USA; CUIMC, USA
| | - Odile A. van den Heuvel
- Vrije Universiteit Amsterdam, The Netherlands; Vrije Universiteit Amsterdam, The Netherlands
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23
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Chen MH, Tsai SJ, Su TP, Li CT, Lin WC, Chen TJ, Pan TL, Bai YM. Increased Risk of Stroke in Patients With Obsessive-Compulsive Disorder: A Nationwide Longitudinal Study. Stroke 2021; 52:2601-2608. [PMID: 34039028 DOI: 10.1161/strokeaha.120.032995] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Mu-Hong Chen
- Department of Psychiatry (M.-H.C., S.-J.T., T.-P.S., C.-T.L., W.-C.L., Y.-M.B.), Taipei Veterans General Hospital, Taiwan.,Department of Psychiatry, College of Medicine (M.-H.C., S.-J.T., T.-P.S., C.-T.L., W.-C.L., Y.-M.B.), National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry (M.-H.C., S.-J.T., T.-P.S., C.-T.L., W.-C.L., Y.-M.B.), Taipei Veterans General Hospital, Taiwan.,Department of Psychiatry, College of Medicine (M.-H.C., S.-J.T., T.-P.S., C.-T.L., W.-C.L., Y.-M.B.), National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry (M.-H.C., S.-J.T., T.-P.S., C.-T.L., W.-C.L., Y.-M.B.), Taipei Veterans General Hospital, Taiwan.,Department of Psychiatry, College of Medicine (M.-H.C., S.-J.T., T.-P.S., C.-T.L., W.-C.L., Y.-M.B.), National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan (T.-P.S.)
| | - Cheng-Ta Li
- Department of Psychiatry (M.-H.C., S.-J.T., T.-P.S., C.-T.L., W.-C.L., Y.-M.B.), Taipei Veterans General Hospital, Taiwan.,Department of Psychiatry, College of Medicine (M.-H.C., S.-J.T., T.-P.S., C.-T.L., W.-C.L., Y.-M.B.), National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wei-Chen Lin
- Department of Psychiatry (M.-H.C., S.-J.T., T.-P.S., C.-T.L., W.-C.L., Y.-M.B.), Taipei Veterans General Hospital, Taiwan.,Department of Psychiatry, College of Medicine (M.-H.C., S.-J.T., T.-P.S., C.-T.L., W.-C.L., Y.-M.B.), National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine (T.-J.C.), Taipei Veterans General Hospital, Taiwan.,Institute of Hospital and Health Care Administration (T.-J.C.), National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tai-Long Pan
- School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan (T.-L.P.).,Research Center for Chinese Herbal Medicine and Research Center for Food and Cosmetic Safety, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, Taiwan (T.-L.P.).,Liver Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan (T.-L.P.)
| | - Ya-Mei Bai
- Department of Psychiatry (M.-H.C., S.-J.T., T.-P.S., C.-T.L., W.-C.L., Y.-M.B.), Taipei Veterans General Hospital, Taiwan.,Department of Psychiatry, College of Medicine (M.-H.C., S.-J.T., T.-P.S., C.-T.L., W.-C.L., Y.-M.B.), National Yang Ming Chiao Tung University, Taipei, Taiwan
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Tendler A, Roth Y, Harmelech T. Deep repetitive TMS with the H7 coil is sufficient to treat comorbid MDD and OCD. Brain Stimul 2021; 14:658-661. [PMID: 33831605 DOI: 10.1016/j.brs.2021.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 03/26/2021] [Accepted: 04/01/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Aron Tendler
- BrainsWay Ltd, USA; Advanced Mental Health Care Inc, USA; Department of Biology, Ben Gurion University of the Negev, Beer Sheva, Israel.
| | - Yiftach Roth
- BrainsWay Ltd, Israel; Department of Life Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
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25
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Hwang H, Bae S, Hong JS, Han DH. Comparing Effectiveness Between a Mobile App Program and Traditional Cognitive Behavior Therapy in Obsessive-Compulsive Disorder: Evaluation Study. JMIR Ment Health 2021; 8:e23778. [PMID: 33464208 PMCID: PMC7854038 DOI: 10.2196/23778] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 11/19/2020] [Accepted: 11/20/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study proposes a digital program for the treatment of mental illness that could increase motivation and improve learning outcomes for patients. Several studies have already applied this method by using an exposure and response prevention-inspired serious game to treat patients with obsessive-compulsive disorder (OCD). OBJECTIVE We hypothesized that a mobile cognitive behavior therapy (CBT) program would be as effective in treating OCD as traditional offline CBT. In addition, the treatment efficacy in response to mobile CBT for OCD might be associated with increased brain activity within the cortico-striato-thalamo-cortical (CSTC) tract. METHODS The digital CBT treatment program for OCD, OCfree, consists of 6 education sessions, 10 quests, and 7 casual games. Information was gathered from 27 patients with OCD (15 offline CBT and 12 OCfree CBT). During the 6-week intervention period, changes in clinical symptoms and brain function activity were analyzed. RESULTS There was no significant difference in the change in OCD symptoms and depressive symptoms between the two groups. However, the OCfree group showed greater improvement in anxiety symptoms compared to the offline CBT group. Both offline CBT and OCfree CBT increased the functional connectivity within the CSTC tract in all patients with OCD. However, CBT using OCfree showed greater changes in brain connectivity within the thalamus and insula, compared to offline CBT. CONCLUSIONS OCfree, an OCD treatment app program, was effective in the treatment of drug-naïve patients with OCD. The treatment effects of OCfree are associated with increased brain connectivity within the CSTC tract. Multisensory stimulation by education, quests, and games in OCfree increases the activity within the thalamus and insula in patients with OCD.
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Affiliation(s)
- Hyunchan Hwang
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Sujin Bae
- Office of Research, Chung-Ang University, Seoul, Republic of Korea
| | - Ji Sun Hong
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Doug Hyun Han
- Department of Psychiatry, Chung-Ang University Hospital, Seoul, Republic of Korea
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Nicolini H, Martínez-Magaña JJ, Genis-Mendoza AD, Villatoro Velázquez JA, Camarena B, Fleiz Bautista C, Bustos-Gamiño M, Aguilar García A, Lanzagorta N, Medina-Mora ME. Cannabis Use in People With Obsessive-Compulsive Symptomatology: Results From a Mexican Epidemiological Sample. Front Psychiatry 2021; 12:664228. [PMID: 34040556 PMCID: PMC8141625 DOI: 10.3389/fpsyt.2021.664228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 04/12/2021] [Indexed: 01/01/2023] Open
Abstract
Recent studies suggest that the endocannabinoid system could play an important role in the physiopathology of obsessive-compulsive disorder (OCD). There are reports of effective treatment with derivatives of tetrahydrocannabinol (THC). The study of the genetic factor associated with psychiatric disorders has made possible an exploration of its contribution to the pharmacological response. However, very little is known about the genetic factor or the prevalence of cannabis use in the Mexican population with OCD. The objective of this study is to compare the prevalence of use and dependence on cannabis in individuals with obsessive-compulsive symptomatology (OCS) with that of individuals with other psychiatric symptoms (psychosis, depression, and anxiety), and to explore the association between genetic risk and use. The study includes a total of 13,130 individuals evaluated in the second stage of the 2016 National Survey of Drug, Alcohol, and Tobacco Use (Encodat 2016), with genetic analysis (polygenic risk scoring) of a subsample of 3,521 individuals. Obsessive symptomatology had a prevalence of 7.2% and compulsive symptomatology a prevalence of 8.6%. The proportion of individuals with OCS who had ever used cannabis was 23.4%, and of those with cannabis dependency was 2.7%, the latter figure higher than that in individuals with other psychiatric symptoms (hypomania, 2.6%; anxiety, 2.8%; depression, 2.3%), except psychosis (5.9%). Individuals with OCS who reported using cannabis had an increased genetic risk for cannabis dependence but not for OCD. We thus cannot know how the increased genetic risk of cannabis dependence in people with OCD is influenced by their pharmacological response to derivatives of THC. The results, however, suggest paths for future studies.
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Affiliation(s)
- Humberto Nicolini
- Genomics Laboratory of Psychiatric and Neurodegenerative Diseases, National Institute of Genomic Medicine, Mexico City, Mexico
| | - José Jaime Martínez-Magaña
- Genomics Laboratory of Psychiatric and Neurodegenerative Diseases, National Institute of Genomic Medicine, Mexico City, Mexico
| | - Alma Delia Genis-Mendoza
- Genomics Laboratory of Psychiatric and Neurodegenerative Diseases, National Institute of Genomic Medicine, Mexico City, Mexico.,Juan N. Navarro Children's Psychiatric Hospital, Psychiatric Care Services, Mexico City, Mexico
| | - Jorge Ameth Villatoro Velázquez
- Data Analysis and Survey Unit, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico.,Global Studies Seminar, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Beatriz Camarena
- Department of Pharmacogenetics, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Clara Fleiz Bautista
- Data Analysis and Survey Unit, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico.,Global Studies Seminar, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Marycarmen Bustos-Gamiño
- Data Analysis and Survey Unit, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | - Alejandro Aguilar García
- Department of Pharmacogenetics, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
| | | | - María Elena Medina-Mora
- Data Analysis and Survey Unit, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico.,Global Studies Seminar, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
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27
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Responding to uncertain threat: A potential mediator for the effect of mindfulness on anxiety. J Anxiety Disord 2021; 77:102332. [PMID: 33160276 DOI: 10.1016/j.janxdis.2020.102332] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 09/23/2020] [Accepted: 10/16/2020] [Indexed: 02/01/2023]
Abstract
Mindfulness-based interventions have gained extensive support for their application in the treatment of anxiety. However, their mechanisms remain largely unexplored. Excessive reactivity to uncertainty plays a central role in anxiety, and may represent a mechanism for the effect of mindfulness on anxiety, as mindfulness training fosters an open and accepting stance towards all aspects of experience. The present study sought to investigate both (i) self-reported intolerance of uncertainty (IU) as well as (ii) physiological and subjective responding to uncertain threat in a threat-of-shock paradigm, the NPU-threat test, as mediators for the relationship between mindfulness and anxiety in a cross-sectional study of healthy participants (N = 53). The results indicated that IU mediated the effect of mindfulness on some anxiety symptoms. In contrast, scores of physiological as well as subjective responses to uncertain threat from the NPU-threat test were largely unrelated to mindfulness, anxiety, or the IU self-report measure. The results provide initial evidence that reactions to uncertainty may play a role in the mindfulness-anxiety relationship and suggest that studies are needed to address how methodological variations of the NPU-threat test affect perceived levels of uncertainty and uncertainty-related anxiety.
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28
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Williams MT, Taylor RJ, George JR, Schlaudt VA, Ifatunji MA, Chatters LM. Correlates of Obsessive-Compulsive Symptoms Among Black Caribbean Americans. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2020; 50:53-77. [PMID: 33840831 PMCID: PMC8034584 DOI: 10.1080/00207411.2020.1826261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Despite the rapid growth of the Black Caribbean population in the United States, we know little about the presentation and prevalence of obsessive-compulsive disorder (OCD) among these groups. This study examines the demographic correlates and the effect of racial discrimination on OCD symptoms among a nationally-representative sample of Black Caribbean and African American adults (n = 5,191). Drawing on the Composite International Diagnostic Interview Short Form (CIDI-SF) for OCD, we examine two types of obsessions (harm and contamination) and four types of compulsions (repeating, washing, ordering, and counting). There we no significant differences between Black Caribbeans and African Americans in obsessions and compulsions. Analysis among Black Caribbeans found that compared with Jamaican and Trinidadian Americans, Haitian American individuals reported the fewest number of obsessions and compulsions. We show that Black Caribbean Americans with lower income, lower self-rated physical and mental health, and more experiences with racial discrimination report higher levels of OCD. More specifically, racial discrimination was associated with contamination and harm obsessions, as well as washing and repeating compulsions. Our findings highlight the need to consider specific domains of OCD relative to Black Caribbeans, and the relationship between social and demographic variables on symptomology.
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Affiliation(s)
| | | | - Jamilah R. George
- University of Connecticut, Department of Psychological Sciences, Storrs, CT
| | | | - Mosi Adesina Ifatunji
- University of Wisconsin at Madison, Department of Afro American Studies, Madison, WI
| | - Linda M. Chatters
- University of Michigan, School of Social Work, Ann Arbor, MI
- University of Michigan, School of Public Health, Ann Arbor, MI
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29
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Turna J, Grosman Kaplan K, Anglin R, Patterson B, Soreni N, Bercik P, Surette MG, Van Ameringen M. The gut microbiome and inflammation in obsessive-compulsive disorder patients compared to age- and sex-matched controls: a pilot study. Acta Psychiatr Scand 2020; 142:337-347. [PMID: 32307692 DOI: 10.1111/acps.13175] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 04/13/2020] [Accepted: 04/15/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To compare the gut microbiome profile (by way of taxon analysis and indices of β- and α-diversity) and inflammatory markers (C-reactive protein [CRP], interleukin-6[IL-6] and tumour necrosis factor-α [TNF-α]) of obsessive-compulsive disorder (OCD) outpatients and non-psychiatric community controls. METHODS We collected morning stool and blood samples from 21 non-depressed, medication-free OCD patients and 22 age- and sex-matched non-psychiatric community controls. Microbiota analysis was performed using Illumina sequencing of the V3 region of 16S rRNA; serum CRP samples were analysed using immunoturbidimetry and plasma IL-6/TNF-α were examined by high-sensitivity ELISA. Multiple comparisons were corrected for using the false discovery rate (α = 0.05). RESULTS Compared to controls, the OCD group presented lower species richness/evenness (α-diversity, Inverse Simpson) and lower relative abundance of three butyrate producing genera (Oscillospira, Odoribacter and Anaerostipes). Compared to controls, mean CRP, but not IL-6 and TNF-α, was elevated OCD patients. CRP revealed moderate to strong associations with psychiatric symptomatology. CONCLUSION To our knowledge, this is the first investigation of the gut microbiome in OCD. In addition, our findings lend further support for the potential association of inflammation and OCD. These results suggest the gut microbiome may be a potential pathway of interest for future OCD research.
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Affiliation(s)
- J Turna
- Neuroscience Graduate Program, McMaster University, Hamilton, Ontario, Canada.,MacAnxiety Research Centre, Hamilton, ON, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - K Grosman Kaplan
- MacAnxiety Research Centre, Hamilton, ON, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - R Anglin
- School of Medicine, University of Notre Dame, Fiona Stanley Hospital, University of Western Australia, Crawley, WA, Australia
| | - B Patterson
- MacAnxiety Research Centre, Hamilton, ON, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - N Soreni
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - P Bercik
- Farncombe Digestive Health Research Institute, Department of Medicine, McMaster University, Hamilton, ON, Canada.,Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - M G Surette
- Farncombe Digestive Health Research Institute, Department of Medicine, McMaster University, Hamilton, ON, Canada.,Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - M Van Ameringen
- MacAnxiety Research Centre, Hamilton, ON, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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Eskander N, Limbana T, Khan F. Psychiatric Comorbidities and the Risk of Suicide in Obsessive-Compulsive and Body Dysmorphic Disorder. Cureus 2020; 12:e9805. [PMID: 32953317 PMCID: PMC7494407 DOI: 10.7759/cureus.9805] [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] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Obsessive-compulsive disorder (OCD) is a chronic psychiatric disorder that is characterized by obsessions and compulsions. Obsessions are uncontrollable distressful thoughts. Compulsions are recurrent behaviors or thoughts performed in an attempt to decrease the anxiety of the obsessions. Body dysmorphic disorder (BDD) is a mental disorder characterized by a distressful preoccupation with a perceived defect in appearance. The perceived flaw in appearance is minimal or unnoticed by others. BDD was considered an anxiety disorder in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). In the DSM-V, it was added to the obsessive-compulsive and related disorders category. The objective of this literature review was to explore the psychiatric comorbidities and the risk of suicide associated with OCD and BDD. Our study results showed OCD and BDD share common genetic and environmental risk factors, clinical features, and sociodemographic profiles. Both OCD and BDD are related disorders that commonly coexist. The suicide risk in OCD is increased as the intensity of the obsessions, trait perfectionism, and alexithymia increases. The suicide risk in BDD is increased by the presence of other disorders such as substance use disorder, major depressive disorder, eating and personality disorders. People with comorbid OCD-BDD have high morbidity, a decrease in insight and poor psychosocial functions. They have higher rates of anxiety, schizotypal features, and suicidal ideation compared to those with BDD or OCD alone.
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Affiliation(s)
- Noha Eskander
- Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Therese Limbana
- Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Farah Khan
- Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Trait specific modulatory effects of caffeine exposure on compulsive-like behaviors in a spontaneous mouse model of obsessive-compulsive disorder. Behav Pharmacol 2020; 31:622-632. [PMID: 32427622 PMCID: PMC7495980 DOI: 10.1097/fbp.0000000000000570] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Obsessive-compulsive disorder (OCD) is a psychiatric disorder characterized by recurring intrusive thoughts and repetitive compulsive behaviors, ultimately interfering with their quality of life. The complex heterogeneity of symptom dimensions across OCD patient subgroups impedes diagnosis and treatment. The core and comorbid symptomologies of OCD are thought to be modulated by common environmental exposures such as consumption of the psychostimulant caffeine. The effect of caffeine on the expression of obsessions and compulsions are unexplored. The current study utilized mouse strains (HA) with a spontaneous, predictable, and stable compulsive-like phenotype that have face, predictive, and construct validity for OCD. We demonstrate that an acute high dose (25 mg/kg) of caffeine decreased compulsive-like nest-building behavior in the HA strains in the first hour after injection. However, nest-building scores increased in hours 3, 4, and 5 after administration finally decreasing over a 24 h period. In contrast, a high dose of chronic caffeine (25 mg/kg/d) increased nest-building behavior. Interestingly for compulsive-like digging behavior, acute exposure to a high dose of caffeine decreased the number of marbles buried, while chronic exposure had little effect. An acute high dose of caffeine decreased anxiety-like and motor activity in open field behaviors whereas chronic caffeine administration did not have any overall effect on open field activity. The results, therefore, suggest a complex role of caffeine on compulsive-like, anxiety-like, and locomotor behaviors that is dependent on the duration of exposure.
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Çelebi F, Koyuncu A, Ertekin E, Alyanak B, Tükel R. The Features of Comorbidity of Childhood ADHD in Patients With Obsessive Compulsive Disorder. J Atten Disord 2020; 24:973-980. [PMID: 27650395 DOI: 10.1177/1087054716669228] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Objective: Our aim is to investigate the impact of childhood ADHD comorbidity on the clinical features of obsessive compulsive disorder (OCD). Method: Ninety-five adult outpatients with a diagnosis of OCD were assessed by using the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version, ADHD module, and the Yale-Brown Obsessive Compulsive Scale. Patients with or without childhood ADHD were compared in terms of the sociodemographic and clinical features, psychiatric comorbidities, and rating scales. Results: The rate of episodic course of OCD (p < .001), religious and sexual obsessions (p = .009, p = .020, respectively), lifetime comorbidity of bipolar disorder (BD), social anxiety disorder (SAD; p = .001, p = .009, respectively), and tic disorder (TD) comorbidity (p < .001) were higher in the OCD + ADHD group than in the OCD without ADHD group. Conclusion: Childhood ADHD may be associated with higher rates of BD, SAD, and TD comorbidity and episodic course of OCD as well as higher frequency of certain types of obsessions.
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Affiliation(s)
- Fahri Çelebi
- Zonguldak Kadın Dogum ve Cocuk Hastalıkları Hastanesi, Zonguldak, Turkey
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Subramaniam M, Abdin E, Vaingankar J, Shafie S, Chang S, Seow E, Chua BY, Jeyagurunathan A, Heng D, Kwok KW, Chong SA. Obsessive-Compulsive Disorder in Singapore: Prevalence, Comorbidity, Quality of Life and Social Support. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2020. [DOI: 10.47102/annals-acadmedsg.2019185] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Introduction: Using data from Singapore Mental Health Study 2016 (SMHS 2016), we
examined the prevalence of lifetime and 12-month obsessive-compulsive disorder (OCD),its sociodemographics correlates and association with comorbid psychiatric disorders and physical conditions, perceived social support and quality of life. Materials and Methods: The World Mental Health Composite International Diagnostic Interview (version 3.0) was administered by trained interviewers to 6126 residents aged ≥18 years old to assess OCD prevalence and that of other select psychiatric disorders. Details on sociodemographics, perceived social support and health-related quality of life were obtained. Results: Lifetimeand 12-month prevalence of OCD was 3.6% and 2.9%, respectively. Adjusted regression analysis showed that those with OCD had significantly higher odds of major depressive disorder (odds ratio [OR], 5.4), bipolar disorder (OR, 8.9), generalised anxiety disorder (OR, 7.3) and alcohol abuse (OR, 2.7). OCD was significantly associated with suicidal ideation and suicidality (OR, 5.1). OCD subjects also had higher odds of chronic pain (OR, 2.4) and diabetes (OR, 3.1). Finally, OCD subjects had lower mean mental composite summary scores than controls (respondents without any of the psychiatric disorders and physical conditions included in SMHS 2016) and those with other lifetime psychiatric disorders and physical conditions. Conclusion: OCD prevalence in Singapore is high. Most people with OCD do not seek treatment despite experiencing significant comorbidity and loss of quality of life.
Key words: Composite International Diagnostic Interview, Epidemiology, Multi-ethnic,
Psychiatric disorder, Survey
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Affiliation(s)
- Mythily Subramaniam
- Institute of Mental Health, Singapore, Nanyang Technological University, Singapore
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Holland MT, Trapp NT, McCormick LM, Jareczek FJ, Zanaty M, Close LN, Beeghly J, Greenlee JDW. Deep Brain Stimulation for Obsessive-Compulsive Disorder: A Long Term Naturalistic Follow Up Study in a Single Institution. Front Psychiatry 2020; 11:55. [PMID: 32184741 PMCID: PMC7058594 DOI: 10.3389/fpsyt.2020.00055] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 01/22/2020] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Deep brain stimulation (DBS) is a proven, effective tool in the treatment of movement disorders. Expansion of indications for DBS into the realm of neuropsychiatric disorders, especially obsessive-compulsive disorder (OCD), has gained fervent interest, although data on appropriate clinical utilization remains limited. METHODS A retrospective, naturalistic study followed nine severely affected OCD patients (average YBOCs score before implantation 34.2 ± 2.5) treated with DBS of ventral capsule/ventral striatum, with average follow up of 54.8 months. RESULTS With chronic stimulation (years), a majority of the patients achieved significant benefits in obsessive-compulsive and depressive symptoms. Six patients experienced periods of OCD remission following implantation. Four of the six responders required more than 12 months to achieve response. Relief of major depressive symptoms occurred in four out of six patients with documented co-morbid depression. Settings required to achieve efficacy were higher than those typically utilized for movement disorders, necessitating increased impulse generator (IPG) battery demand. We found patients benefited from conversion to a rechargeable IPG to prevent serial operations for IPG replacement. For patients with rechargeable IPGs, the repetitive habit of recharging did not appear to aggravate or trigger new obsessive-compulsive behaviors or anxiety symptoms. CONCLUSIONS Our study supports and builds upon other research suggesting that DBS for OCD in a real-world setting can be implemented successfully and provide long-term benefit for severely affected OCD patients. Optimal patient selection and DBS programming criteria are discussed. The use of rechargeable IPGs appears to be both cost effective and well-tolerated in this population.
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Affiliation(s)
- Marshall T Holland
- Department of Neurosurgery, University of Iowa, Iowa City, IA, United States
| | - Nicholas T Trapp
- Department of Psychiatry, University of Iowa, Iowa City, IA, United States
| | - Laurie M McCormick
- Department of Psychiatry, University of Iowa, Iowa City, IA, United States.,Rein Center: Emotional Health and Well-Being, Iowa City, IA, United States
| | | | - Mario Zanaty
- Department of Neurosurgery, University of Iowa, Iowa City, IA, United States
| | - Liesl N Close
- Department of Neurosurgery, University of Iowa, Iowa City, IA, United States
| | - James Beeghly
- Department of Psychiatry, University of Iowa, Iowa City, IA, United States
| | - Jeremy D W Greenlee
- Department of Neurosurgery, University of Iowa, Iowa City, IA, United States
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Carta MG, Fineberg N, Moro MF, Preti A, Romano F, Balestrieri M, Caraci F, Dell'Osso L, Disciascio G, Drago F, Hardoy MC, Roncone R, Minerba L, Faravelli C, Angst J. The Burden of Comorbidity Between Bipolar Spectrum and Obsessive-Compulsive Disorder in an Italian Community Survey. Front Psychiatry 2020; 11:188. [PMID: 32296351 PMCID: PMC7136520 DOI: 10.3389/fpsyt.2020.00188] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 02/26/2020] [Indexed: 12/24/2022] Open
Abstract
Background: The impact of the comorbidity between Obsessive-Compulsive Disorder (OCD) and Bipolar Disorder Spectrum (BDS) remains to be clarified. The objective of this study was to examine the lifetime prevalence of OCD, the strength of the association of OCD with comorbid BDS and the role of comorbidity of OCD with BDS in the impairment of health-related quality of life (HRQoL) in an Italian community survey. Methods: The study is a community survey. The sample (N = 2,267; women: 55.3%) was randomly selected after stratification by sex and four age groups from the municipal records of the adult population of one urban, one suburban, and at least one rural area in six Italian regions. Physicians using a semi-structured interview (Advanced Tools and Neuropsychiatric Assessment Schedule, ANTAS-SCID) made Diagnostic and Statistical Manual of Mental Disorders - 4th revision (DSM-IV) diagnoses of OCD, Major Depressive Disorder (MDD) and Bipolar Disorder (BD). HR-QoL was measured by the Health Survey Short Form (SF-12). Lifetime Hypomania and subthreshold hypomania were screened by the Mood Disorder Questionnaire (MDQ). BDS was defined as the sum of people shown to be positive for hypomania by the MDQ-with or without a mood disorder diagnosis-plus people with a BD-DSMIV diagnosis even if negative for hypomania at the MDQ. Results: Overall, 44 subjects were diagnosed with OCD, 6 with MDD and 1 with BD. The lifetime prevalence of OCD was 1.8% in men (n = 18) and 2.0% in women (n = 26). MDD with lifetime subthreshold hypomania (i.e., people screened positive at the MDQ, even without diagnosed mania or hypomania at the interview) was associated with OCD (OR = 18.15, CI 95% 2.45-103.67); MDD without subthreshold hypomania (and screened negative at the MDQ) was not (OR = 2.33, CI 95% 0.69-7.01). People with BDS were strongly associated with OCD (OR = 10.5, CI 95% 4.90-12.16,). People with OCD and BDS showed significantly poorer HR-QoL than people with OCD without BDS (F = 9.492; P < 0.003). Discussion: The study found a strong association between BDS and OCD. BDS comorbid with OCD was associated with more severe impairment of HR-QoL than OCD without comorbid BDS. Identification of symptoms of hypomania, including subthreshold symptoms, may therefore be important in people with OCD as they might predict a course with poorer HR-QoL.
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Affiliation(s)
- Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Naomi Fineberg
- Hertfordshire Partnership NHS Foundation Trust, Queen Elizabeth II Hospital, Welwyn Garden City, United Kingdom.,Department of Clinical and Pharmaceutical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Maria Francesca Moro
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Antonio Preti
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Ferdinando Romano
- Dipartimento di Sanità Pubblica e Malattie Infettive, University of Roma La Sapienza, Rome, Italy
| | | | - Filippo Caraci
- Department of Drug Sciences, University of Catania, Catania, Italy.,Oasi Research Institute-IRCCS, Troina, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Guido Disciascio
- Scuola di Specializzazione in Psichiatria, University of Bari, Bari, Italy
| | - Filippo Drago
- Department of Drug Sciences, University of Catania, Catania, Italy
| | | | - Rita Roncone
- Dipartimento di Medicina Clinica, Sanità Pubblica, Scienze della Vita e dell'Ambiente, University of L'Aquila, L'Aquila, Italy
| | - Luigi Minerba
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Carlo Faravelli
- Dipartimento di Scienze Formazione e Psicologia, University of Florence, Florence, Italy
| | - Jules Angst
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
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Wagner G, Köhler S, Peikert G, de la Cruz F, Reess TJ, Rus OG, Schultz CC, Koch K, Bär KJ. Checking and washing rituals are reflected in altered cortical thickness in obsessive-compulsive disorder. Cortex 2019; 117:147-156. [DOI: 10.1016/j.cortex.2019.03.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 12/13/2018] [Accepted: 03/18/2019] [Indexed: 10/27/2022]
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Goto R, Fujio M, Matsuda N, Fujiwara M, Nobuyoshi M, Nonaka M, Kono T, Kojima M, Skokauskas N, Kano Y. The effects of comorbid Tourette symptoms on distress caused by compulsive-like behavior in very young children: a cross-sectional study. Child Adolesc Psychiatry Ment Health 2019; 13:28. [PMID: 31297146 PMCID: PMC6599284 DOI: 10.1186/s13034-019-0290-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 06/22/2019] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Many children 4 to 6 years old exhibit compulsive-like behavior, often with comorbid Tourette symptoms, making this age group critical for investigating the effects of having comorbid Tourette symptoms with compulsive-like behavior. However, these effects have not yet been elucidated: it is unclear whether having comorbid tics with compulsive-like behavior leads to lower quality of life. This cross-sectional study aims to investigate the effect of comorbid Tourette symptoms on distress caused by compulsive-like behavior in very young children. METHODS Self-administered questionnaires were distributed to guardians of children aged 4 to 6 attending any of the 59 public preschools in a certain ward in Tokyo, Japan. The questionnaire contained questions on the presence of Tourette symptoms, the presence of specific motor and vocal tics, frequency/intensity of compulsive-like behavior, and the distress caused by compulsive-like behavior, which was rated on a scale of 1 to 5. Additionally, questions on autism spectrum disorder (ASD) traits, attention-deficit/hyperactivity disorder (ADHD) traits, internalizing behavior traits, and externalizing behavior traits were included in the questionnaire as possible confounders of distress caused by compulsive-like behavior. Wilcoxon rank-sum tests were conducted to compare the distress caused by compulsive-like behavior and frequency/intensity of compulsive-like behavior between children in the Tourette symptoms group and the non-Tourette symptoms group. Furthermore, a stepwise regression analysis was performed to assess the effects of the independent variables on distress caused by compulsive-like behavior. Another stepwise regression analysis was performed to assess the relationship between distress caused by compulsive-like behavior and the presence of five specific motor and vocal tics. RESULTS Of the 675 eligible participants, distress due to compulsive-like behavior was significantly higher in children in the Tourette symptoms group compared to the non-Tourette symptoms group (2.00 vs 1.00, P < 0.001). Stepwise regression analysis showed that frequency/intensity of compulsive-like behavior, being in the Tourette symptoms group, ASD traits, and internalizing behavior traits were predictors of distress due to compulsive-like behavior. Two specific tics, repetitive noises and sounds and repetitive neck, shoulder, or trunk movements, were significant predictors of distress due to compulsive-like behavior. CONCLUSIONS Comorbid Tourette symptoms may worsen distress caused by compulsive-like behavior in children 4 to 6 years old, and specific motor and vocal tics may lead to greater distress.
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Affiliation(s)
- Ryunosuke Goto
- The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Miyuki Fujio
- Graduate School of Education, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Natsumi Matsuda
- Department of Child Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Mayu Fujiwara
- Department of Child Psychiatry, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Marina Nobuyoshi
- Graduate School of Education, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Maiko Nonaka
- Graduate School of Education, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Toshiaki Kono
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, Kodaira, Tokyo, 187-8553 Japan
| | - Masaki Kojima
- Department of Child Psychiatry, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan
| | - Norbert Skokauskas
- Regional Centre for Children and Youth Mental Health and Child Welfare-Central Norway, Norwegian University of Science and Technology, RKBU Midt-Norge, NTNU, Postboks 8905 MTFS, 7491 Trondheim, Norway
| | - Yukiko Kano
- Department of Child Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan
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Spoorthy MS, Chakrabarti S, Grover S. Comorbidity of bipolar and anxiety disorders: An overview of trends in research. World J Psychiatry 2019; 9:7-29. [PMID: 30631749 PMCID: PMC6323556 DOI: 10.5498/wjp.v9.i1.7] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 11/04/2018] [Accepted: 12/05/2018] [Indexed: 02/05/2023] Open
Abstract
Over the last three decades burgeoning research has shown that anxiety disorder comorbidity is not only highly prevalent in bipolar disorder (BD), but it also adversely impacts the course, outcome, and treatment of BD. The present review provides an overview of the current trends in research on comorbid anxiety and BDs based on prior reviews and meta-analyses (n = 103), epidemiological surveys, and large-scale clinical studies. The results reiterated the fact that at least half of those with BD are likely to develop an anxiety disorder in their lifetimes and a third of them will manifest an anxiety disorder at any point of time. All types of anxiety disorders were equally common in BD. However, there was a wide variation in rates across different sources, with most of this discrepancy being accounted for by methodological differences between reports. Comorbid anxiety disorders negatively impacted the presentation and course of BD. This unfavourable clinical profile led to poorer outcome and functioning and impeded treatment of BD. Despite the extensive body of research there was paucity of data on aetiology and treatment of anxiety disorder comorbidity in BD. Nevertheless, the substantial burden and unique characteristics of this comorbidity has important clinical and research implications.
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Affiliation(s)
- Mamidipalli Sai Spoorthy
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Subho Chakrabarti
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
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Grassi G, Pallanti S. Current and up-and-coming pharmacotherapy for obsessive-compulsive disorder in adults. Expert Opin Pharmacother 2018; 19:1541-1550. [PMID: 30321070 DOI: 10.1080/14656566.2018.1528230] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Only 40-60% of obsessive-compulsive patients respond to first line treatments, such as selective serotonin reuptake inhibitors (SSRIs) and cognitive-behavioral therapy. Several second-line treatments have been investigated in the last two decades, and most of them seem to work, at least in a subset of patients. However, since there is still a lack of treatment predictors, the treatment of obsessive-compulsive disorder (OCD) is still empirical and non-evidence based. AREAS COVERED In this paper, we review current and up-and-coming pharmacotherapy for OCD in adults, focusing on two emerging fields of research, inflammation and glutamate systems, since they have attracted the greatest attention in recent years in OCD pharmacological research. EXPERT OPINION Most of the investigated second-line agents seem to work at least in a subset of patients with OCD. These results raise an open question: what works for who? In our opinion, this question should be answered in a precision medicine perspective or, in other words, individualizing diagnostic processes and treatment approaches. In a precision medicine approach, OCD treatment should be sub-type specific, phase specific, multimodal and sequential, and, more importantly, dimensional.
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Affiliation(s)
- Giacomo Grassi
- a Department of Neuroscience, Psychology, Drug Research and Child Health, Neurofarba , University of Florence , Florence , Italy.,b Institute of Neuroscience , Florence , Italy
| | - Stefano Pallanti
- b Institute of Neuroscience , Florence , Italy.,c Department of Psychiatry and Behavioral Science , Stanford University Medical Center , Stanford , CA , USA
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Osland S, Arnold PD, Pringsheim T. The prevalence of diagnosed obsessive compulsive disorder and associated comorbidities: A population-based Canadian study. Psychiatry Res 2018; 268:137-142. [PMID: 30025284 DOI: 10.1016/j.psychres.2018.07.018] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 07/08/2018] [Accepted: 07/08/2018] [Indexed: 02/05/2023]
Abstract
The objective of this study was to provide epidemiological data regarding obsessive compulsive disorder (OCD) in Canada, and examine related conditions, childhood experiences and healthcare utilization. A Statistics Canada population-based health survey was utilized (N = 25,097). The prevalence of diagnosed OCD in Canada was 0.93% (95% CI 0.75-1.11). People with OCD were younger and more likely to have lower incomes. They were more likely to have mood disorders including depression and bipolar disorder (both diagnosed conditions and by screening), and generalized anxiety disorder. The diagnosis of OCD was also associated with alcohol dependence and substance abuse and dependence. Negative childhood experiences were more common in people with OCD, with 72.33%(95% CI 62.25%-82.41%) of people with OCD having experienced some form of childhood maltreatment. Healthcare utilization was more frequent in people with OCD, but they were also more likely to desire help but feel as if they did not receive it. The higher proportion of people with OCD reporting not receiving the care they needed may reveal a crucial gap in treatment and available resources.
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Affiliation(s)
- Sydney Osland
- Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences, University of Calgary, Canada
| | - Paul D Arnold
- Departments of Psychiatry & Medical Genetics, Cumming School of Medicine, University of Calgary, Canada; Division of Child Psychiatry, Faculty of Medicine, University of Toronto, Canada
| | - Tamara Pringsheim
- Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences, University of Calgary, Canada.
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Ong ML, Reuman L, Youngstrom EA, Abramowitz JS. Discriminative Validity of the Dimensional Obsessive-Compulsive Scale for Separating Obsessive-Compulsive Disorder From Anxiety Disorders. Assessment 2018; 27:810-821. [PMID: 30043619 DOI: 10.1177/1073191118791039] [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: 11/16/2022]
Abstract
Objective: We investigated the diagnostic efficiency and clinical utility of the Dimensional Obsessive-Compulsive Scale (DOCS) and subscales for distinguishing obsessive-compulsive disorder (OCD) from anxiety disorders (ADs). Method: A total of 369 participants (167 male, Mage = 29.61 years) diagnosed with DSM-IV OCD or AD, recruited from specialty clinics across the United States, completed clinical interviews and self-report questionnaires, including the DOCS. Receiver operating characteristic analyses and diagnostic likelihood ratios (DiLRs) determined discriminative validity and provided clinical utility. Logistic regressions tested for incremental validity in the DOCS-total scale and subscales in predicting OCD status. Results: The DOCS-total scale and Contamination subscale performed best in differentiating between OCD and AD diagnosis (DOCS-total: Area under curve [AUC] = .75, p < .001; Contamination: AUC = .70, p < .001) as compared with the other subscales. At high scores (DOCS-total: 28+, Contamination: 6+), Contamination was more effective than the DOCS-total in differentiating OCD from ADs, with high scores in Contamination quadrupling OCD odds and DOCS-total by about threefold (Contamination DiLR+ = 4.04, DOCS-total DiLR+ = 2.82). At low scores (DOCS-total: 0-9, Contamination: 0-2), the converse was true, with low scores in Contamination cutting OCD odds by half and DOCS-total by one fifths (Contamination DiLR- = 0.52, DOCS-total DiLR- = 0.23). Conclusion: At high scores, the Contamination subscale is the most helpful subscale to differentiate OCD and ADs. For low scores, the DOCS-total scale performs the best among the scales.
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Affiliation(s)
- Mian-Li Ong
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lillian Reuman
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Skapinakis P, Caldwell D, Hollingworth W, Bryden P, Fineberg N, Salkovskis P, Welton N, Baxter H, Kessler D, Churchill R, Lewis G. A systematic review of the clinical effectiveness and cost-effectiveness of pharmacological and psychological interventions for the management of obsessive-compulsive disorder in children/adolescents and adults. Health Technol Assess 2018; 20:1-392. [PMID: 27306503 DOI: 10.3310/hta20430] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a relatively common and disabling condition. OBJECTIVES To determine the clinical effectiveness, acceptability and cost-effectiveness of pharmacological and psychological interventions for the treatment of OCD in children, adolescents and adults. DATA SOURCES We searched the Cochrane Collaboration Depression, Anxiety and Neurosis Trials Registers, which includes trials from routine searches of all the major databases. Searches were conducted from inception to 31 December 2014. REVIEW METHODS We undertook a systematic review and network meta-analysis (NMA) of the clinical effectiveness and acceptability of available treatments. Outcomes for effectiveness included mean differences in the total scores of the Yale-Brown Obsessive-Compulsive Scale or its children's version and total dropouts for acceptability. For the cost-effectiveness analysis, we developed a probabilistic model informed by the results of the NMA. All analyses were performed using OpenBUGS version 3.2.3 (members of OpenBUGS Project Management Group; see www.openbugs.net ). RESULTS We included 86 randomised controlled trials (RCTs) in our systematic review. In the NMA we included 71 RCTs (54 in adults and 17 in children and adolescents) for effectiveness and 71 for acceptability (53 in adults and 18 in children and adolescents), comprising 7643 and 7942 randomised patients available for analysis, respectively. In general, the studies were of medium quality. The results of the NMA showed that in adults all selective serotonin reuptake inhibitors (SSRIs) and clomipramine had greater effects than drug placebo. There were no differences between SSRIs, and a trend for clomipramine to be more effective did not reach statistical significance. All active psychological therapies had greater effects than drug placebo. Behavioural therapy (BT) and cognitive therapy (CT) had greater effects than psychological placebo, but cognitive-behavioural therapy (CBT) did not. BT and CT, but not CBT, had greater effects than medications, but there are considerable uncertainty and methodological limitations that should be taken into account. In children and adolescents, CBT and BT had greater effects than drug placebo, but differences compared with psychological placebo did not reach statistical significance. SSRIs as a class showed a trend for superiority over drug placebo, but the difference did not reach statistical significance. However, the superiority of some individual drugs (fluoxetine, sertraline) was marginally statistically significant. Regarding acceptability, all interventions except clomipramine had good tolerability. In adults, CT and BT had the highest probability of being most cost-effective at conventional National Institute for Health and Care Excellence thresholds. In children and adolescents, CBT or CBT combined with a SSRI were more likely to be cost-effective. The results are uncertain and sensitive to assumptions about treatment effect and the exclusion of trials at high risk of bias. LIMITATIONS The majority of psychological trials included patients who were taking medications. There were few studies in children and adolescents. CONCLUSIONS In adults, psychological interventions, clomipramine, SSRIs or combinations of these are all effective, whereas in children and adolescents, psychological interventions, either as monotherapy or combined with specific SSRIs, were more likely to be effective. Future RCTs should improve their design, in particular for psychotherapy or combined interventions. STUDY REGISTRATION The study is registered as PROSPERO CRD42012002441. FUNDING DETAILS The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
| | - Deborah Caldwell
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | | | - Peter Bryden
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Naomi Fineberg
- University of Hertfordshire and Hertfordshire Partnerships Mental Health Trust, Hatfield, UK
| | | | - Nicky Welton
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Helen Baxter
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - David Kessler
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Rachel Churchill
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Glyn Lewis
- Division of Psychiatry, University College London, London, UK
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Berlin GS, Lee HJ. Response inhibition and error-monitoring processes in individuals with obsessive-compulsive disorder. J Obsessive Compuls Relat Disord 2018; 16:21-27. [PMID: 29607292 PMCID: PMC5875186 DOI: 10.1016/j.jocrd.2017.11.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Response inhibition (RI) has been putatively linked to the symptoms of OCD. Despite the enticing link between RI and OCD, there are points in the relationship that require clarification. We examined the RI-OCD relationship taking into account a) the potentially differential pattern of RI-OCD relationship between obsessions and compulsions, and b) the potentially confounding effect of negative affect, particularly in regards to depression. Additionally, we investigated how error-monitoring processes in the inhibitory context account for OCD symptoms. Results showed that the RI-OCD relationship is robust in regards to compulsion symptoms, but not for obsessions, even when controlling for negative affect. Additionally, while individuals with OCD display behavioral slow-down following commission errors on the stop-signal task, slow-down following successful inhibition is significantly related to compulsion symptoms. Findings suggest that future studies investigating RI in OCD should take into account heterogeneous clinical presentations in OCD, as well as incorporate error-monitoring variables to better understand RI processes in OCD.
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Affiliation(s)
- Gregory S. Berlin
- University of Wisconsin-Milwaukee, 2441 E Hartford Avenue, Milwaukee, WI 53211
| | - Han-Joo Lee
- University of Wisconsin-Milwaukee, 2441 E Hartford Avenue, Milwaukee, WI 53211
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Mitra S, Mucha M, Owen S, Bult-Ito A. Postpartum Lactation-Mediated Behavioral Outcomes and Drug Responses in a Spontaneous Mouse Model of Obsessive-Compulsive Disorder. ACS Chem Neurosci 2017; 8:2683-2697. [PMID: 28945961 DOI: 10.1021/acschemneuro.7b00231] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Using a spontaneous mouse model of obsessive-compulsive disorder (OCD), the current study evaluated the influence of postpartum lactation on the expression of compulsive-like behaviors, SSRI effectiveness, and the putative role of oxytocin and dopamine in mediating these lactation specific behavioral outcomes. Compulsive-like lactating mice were less compulsive-like in nest building and marble burying and showed enhanced responsiveness to fluoxetine (50 mg/kg) in comparison to compulsive-like nonlactating and nulliparous females. Lactating mice exhibited more anxiety-like behavior in the open field test compared to the nulliparous females, while chronic fluoxetine reduced anxiety-like behaviors. Blocking the oxytocin receptor with L368-899 (5 mg/kg) in the lactating mice exacerbated the compulsive-like and depression-like behaviors. The dopamine D2 receptor (D2R) agonist bromocriptine (10 mg/kg) suppressed marble burying, nest building, and central entries in the open field, but because it also suppressed overall locomotion in the open field, activation of the D2R receptor may have inhibited overall activity nonspecifically. Lactation- and fluoxetine-mediated behavioral outcomes in compulsive-like mice, therefore, appear to be partly regulated by oxytocinergic mechanisms. Serotonin immunoreactivity and serum levels were higher in lactating compulsive-like mice compared to nonlactating and nulliparous compulsive-like females. Together, these results suggest behavioral modulation, serotonergic alterations, and changes in SSRI effectiveness during lactation in compulsive-like mice. This warrants further investigation of postpartum events in OCD patients.
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Affiliation(s)
- Swarup Mitra
- Department
of Chemistry and Biochemistry, University of Alaska Fairbanks, Fairbanks, Alaska 99775, United States
- IDeA
Network of Biomedical Research Excellence (INBRE), University of Alaska Fairbanks, Fairbanks, Alaska 99775, United States
| | - McKenzie Mucha
- Department
of Chemistry and Biochemistry, University of Alaska Fairbanks, Fairbanks, Alaska 99775, United States
| | - Savanah Owen
- Department of Biology & Wildlife, University of Alaska Fairbanks, Fairbanks, Alaska 99775, United States
| | - Abel Bult-Ito
- Department of Biology & Wildlife, University of Alaska Fairbanks, Fairbanks, Alaska 99775, United States
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45
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Sakalli Kani A, Aksoy Poyraz C, Poyraz BC, Bayar MR, Akin E, Kose S. The role of affective temperaments and chronotype in pharmacotherapy response in patients with obsessive-compulsive disorder. PSYCHIAT CLIN PSYCH 2017. [DOI: 10.1080/24750573.2017.1391157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Ayse Sakalli Kani
- Department of Psychiatry, Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Cana Aksoy Poyraz
- Department of Psychiatry, Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey
| | - B. Cağrı Poyraz
- Department of Psychiatry, Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey
| | - M. Reha Bayar
- Department of Psychiatry, Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Ercan Akin
- Department of Psychology, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Samet Kose
- Department of Psychology, Hasan Kalyoncu University, Gaziantep, Turkey
- Department of Psychiatry, University of Texas Medical School of Houston, Houston, TX, USA
- Center for Neurobehavioral Research on Addictions, Houston, TX, USA
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46
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Brooks SJ, Lochner C, Shoptaw S, Stein DJ. Using the research domain criteria (RDoC) to conceptualize impulsivity and compulsivity in relation to addiction. PROGRESS IN BRAIN RESEARCH 2017; 235:177-218. [PMID: 29054288 DOI: 10.1016/bs.pbr.2017.08.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Nomenclature for mental disorder was updated in 2013 with the publication of the fifth edition of the Diagnostic and Statistical Manual (DSM-5). In DSM-5, substance use disorders are framed as more dimensional. First, the distinction between abuse and dependence is replaced by substance use. Second, the addictions section now covers both substances and behavioral addictions. This contemporary move toward dimensionality and transdiagnosis in the addictions and other disorders embrace accumulating cognitive-affective neurobiological evidence that is reflected in the United States' National Institutes of Health Research Domain Criteria (NIH RDoC). The RDoC calls for the further development of transdiagnostic approaches to psychopathy and includes five domains to improve research. Additionally, the RDoC suggests that these domains can be measured in terms of specific units of analysis. In line with these suggestions, recent publications have stimulated updated neurobiological conceptualizations of two transdiagnostic concepts, namely impulsivity and compulsivity and their interactions that are applicable to addictive disorders. However, there has not yet been a review to examine the constructs of impulsivity and compulsivity in relation to addiction in light of the research-oriented RDoC. By doing so it may become clearer as to whether impulsivity and compulsivity function antagonistically, complementarily or in some other way at the behavioral, cognitive, and neural level and how this relationship underpins addiction. Thus, here we consider research into impulsivity and compulsivity in light of the transdiagnostic RDoC to help better understand these concepts and their application to evidence-based clinical intervention for addiction.
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Affiliation(s)
- Samantha J Brooks
- University of Cape Town, Cape Town, South Africa; Uppsala University, Uppsala, Sweden.
| | - Christine Lochner
- US/UCT MRC Unit on Anxiety & Stress Disorders, University of Stellenbosch, Stellenbosch, South Africa
| | - Steve Shoptaw
- David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Dan J Stein
- US/UCT MRC Unit on Anxiety & Stress Disorders, University of Cape Town, Cape Town, South Africa
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47
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Gillan CM, Fineberg NA, Robbins TW. A trans-diagnostic perspective on obsessive-compulsive disorder. Psychol Med 2017; 47:1528-1548. [PMID: 28343453 PMCID: PMC5964477 DOI: 10.1017/s0033291716002786] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 10/04/2016] [Accepted: 10/04/2016] [Indexed: 12/01/2022]
Abstract
Progress in understanding the underlying neurobiology of obsessive-compulsive disorder (OCD) has stalled in part because of the considerable problem of heterogeneity within this diagnostic category, and homogeneity across other putatively discrete, diagnostic categories. As psychiatry begins to recognize the shortcomings of a purely symptom-based psychiatric nosology, new data-driven approaches have begun to be utilized with the goal of solving these problems: specifically, identifying trans-diagnostic aspects of clinical phenomenology based on their association with neurobiological processes. In this review, we describe key methodological approaches to understanding OCD from this perspective and highlight the candidate traits that have already been identified as a result of these early endeavours. We discuss how important inferences can be made from pre-existing case-control studies as well as showcasing newer methods that rely on large general population datasets to refine and validate psychiatric phenotypes. As exemplars, we take 'compulsivity' and 'anxiety', putatively trans-diagnostic symptom dimensions that are linked to well-defined neurobiological mechanisms, goal-directed learning and error-related negativity, respectively. We argue that the identification of biologically valid, more homogeneous, dimensions such as these provides renewed optimism for identifying reliable genetic contributions to OCD and other disorders, improving animal models and critically, provides a path towards a future of more targeted psychiatric treatments.
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Affiliation(s)
- C. M. Gillan
- Department of Psychology,
New York University, New York, NY,
USA
- Department of Psychology,
University of Cambridge, Cambridge,
UK
- Behavioural and Clinical Neuroscience Institute,
University of Cambridge, Cambridge,
UK
| | - N. A. Fineberg
- National Obsessive Compulsive Disorders Specialist
Service, Hertfordshire Partnership NHS University Foundation
Trust, UK
- Department of Postgraduate Medicine,
University of Hertfordshire, Hatfield,
UK
| | - T. W. Robbins
- Department of Psychology,
University of Cambridge, Cambridge,
UK
- Behavioural and Clinical Neuroscience Institute,
University of Cambridge, Cambridge,
UK
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48
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Moore KA, Howell J. Yes: The Symptoms of OCD and Depression Are Discrete and Not Exclusively Negative Affectivity. Front Psychol 2017; 8:753. [PMID: 28553250 PMCID: PMC5427083 DOI: 10.3389/fpsyg.2017.00753] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 04/25/2017] [Indexed: 11/23/2022] Open
Abstract
Although Obsessive-Compulsive Disorder (OCD) and Depression are classified as separate disorders, the high incidence of co-morbidity and the strong correlations between measures of each has led to debate about the nature of their relationship. Some authors have proposed that OCD is in fact a mood disorder while others have suggested that the two disorders are grounded in negative affectivity. A third proposition is that depression is an essential part of OCD but that OCD is a separate disorder from depression. The aim in this study was to investigate these diverse propositions in a non-clinical sample and also to determine whether factors implicated in each, that is anxious and depressive cognitions, hopelessness, and self-criticism, would demonstrate commonality as predictors of the symptoms of OCD and of depression. Two hundred participants (59% female) (M age = 34 years, SD = 16) completed the Padua Inventory, Carroll Rating Scale, Cognitions Checklist, Self-Criticism Scale, Beck Hopelessness Scale, Buss-Durkee Hostility Inventory-Revised and a Negative Affectivity Schedule. Results indicated a strong correlation between OCD and depression, depression, and negative affectivity but a weaker relationship between OCD and negative affectivity. Path analyses revealed that both anxious and depressive cognitions, as well as hostility predicted both disorders but the Beta-weights were stronger on OCD. Self-criticism predicted only depression while hopelessness failed to predict either disorder but was itself predicted by depressive cognitions. Depression was a stronger indicator of negative affect than OCD and while OCD positively predicted depression, depression was a negative indicator of OCD. These results support the hypothesis that OCD and depression are discrete disorders and indicate that while depression is implicated in OCD, the reverse does not hold. While both disorders are related to negative affectivity, this relationship is much stronger for depression thus failing to confirm that both are subsumed by a common factor, in this case, negative affectivity. The proposition that depression is part of OCD but that OCD is not necessarily implicated in depression and is, in fact, a separate disorder, is supported by the current model. Further research is required to support the utility of the model in clinical samples.
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Affiliation(s)
- Kathleen A Moore
- School of Health Sciences and Psychology, Federation University AustraliaChurchill, VIC, Australia
| | - Jacqui Howell
- School of Health Sciences and Psychology, Federation University AustraliaChurchill, VIC, Australia
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Rintala H, Chudal R, Leppämäki S, Leivonen S, Hinkka-Yli-Salomäki S, Sourander A. Register-based study of the incidence, comorbidities and demographics of obsessive-compulsive disorder in specialist healthcare. BMC Psychiatry 2017; 17:64. [PMID: 28183286 PMCID: PMC5301466 DOI: 10.1186/s12888-017-1224-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 02/02/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Incidence of obsessive-compulsive disorder (OCD) has been suspected to increase but nationwide epidemiological studies are limited. This study aims to examine sex-specific incidence time trends and characterize psychiatric and neurodevelopmental comorbidities and sociodemographic risk factors of OCD in specialist healthcare in Finland. METHODS A nationwide register-based study using data from four Finnish registers identified 3372 OCD cases and 13,372 matched controls (1:4). Cumulative incidence in subjects born between 1987 and 2001 was estimated at ages of 10, 15, 20 and 23 years. Conditional logistic regression was used to examine the sociodemographic factors. RESULTS The cumulative incidence of OCD was 0.4% by age 23. Incidence by age 15 among three cohorts increased from 12.4 to 23.7 /10000 live born males and 8.5 to 28.0 /10000 live born females. 73% of the sample had a comorbid condition. Males were significantly more comorbid with psychotic and developmental disorders; females were more comorbid with depressive and anxiety disorders (p <0.001). Higher maternal SES was associated with an increased risk of OCD (OR 1.4; 95% CI 1.1-1.6). CONCLUSIONS These findings suggest that incidence of treated OCD in specialist healthcare has increased. The reason may be increased awareness and rate of referrals but a true increase cannot be ruled out. Further research on risk factors of OCD is warranted.
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Affiliation(s)
- Hanna Rintala
- Department of Child Psychiatry, University of Turku, Turku, Finland
- Research Centre for Child Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, University of Turku, Lemminkäisenkatu 3 / Teutori (3rd floor), 20014 Turku, Finland
| | - Roshan Chudal
- Department of Child Psychiatry, University of Turku, Turku, Finland
- Research Centre for Child Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, University of Turku, Lemminkäisenkatu 3 / Teutori (3rd floor), 20014 Turku, Finland
| | - Sami Leppämäki
- Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
| | - Susanna Leivonen
- Department of Child Psychiatry, University of Turku, Turku, Finland
- Department of Child Neurology, Helsinki University Central Hospital, Helsinki, Finland
- Research Centre for Child Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, University of Turku, Lemminkäisenkatu 3 / Teutori (3rd floor), 20014 Turku, Finland
| | - Susanna Hinkka-Yli-Salomäki
- Department of Child Psychiatry, University of Turku, Turku, Finland
- Department of Child Psychiatry, University of Turku and Turku University Central Hospital, Turku, Finland
- Research Centre for Child Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, University of Turku, Lemminkäisenkatu 3 / Teutori (3rd floor), 20014 Turku, Finland
| | - Andre Sourander
- Department of Child Psychiatry, University of Turku, Turku, Finland
- Department of Child Psychiatry, University of Turku and Turku University Central Hospital, Turku, Finland
- Research Centre for Child Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, University of Turku, Lemminkäisenkatu 3 / Teutori (3rd floor), 20014 Turku, Finland
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50
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Mitra S, Bastos CP, Chesworth S, Frye C, Bult-Ito A. Strain and sex based characterization of behavioral expressions in non-induced compulsive-like mice. Physiol Behav 2016; 168:103-111. [PMID: 27838311 DOI: 10.1016/j.physbeh.2016.11.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 11/01/2016] [Accepted: 11/08/2016] [Indexed: 01/21/2023]
Abstract
There is currently a lack of understanding how genetic background and sex differences attribute to the heterogeneity of obsessive-compulsive disorder (OCD). An animal model of compulsive-like behaviors has been developed through bidirectional selection of house mice (Mus musculus) for high (big cotton nests; BIG mice) and low levels (small nests; SMALL mice) of nest-building behavior. The BIG male strains have predictive and face validity as a spontaneous animal model of OCD. Here, we evaluated compulsive-, anxiety-, cognitive-, and depression-like behaviors among male and proestrus female replicate strains each of BIG (BIG1, BIG2) and SMALL (SML1, SML2) nest-builders, and randomly-bred Controls (C1, C2). BIG1 and BIG2 males and females had higher nesting scores when compared to SMALL and Control strains. Male BIG1 and BIG2 strains showed more compulsive-like nesting than BIG1 and BIG2 proestrus females, which was not observed among the other strains. Nesting scores were also different between BIG replicate male strains. A similar pattern was observed in the compulsive-like marble burying behavior with BIG strains burying more marbles than SMALL and Control strains. Significant replicate and sex differences were also observed in marble burying among the BIG strains. The open field test revealed replicate effects while the BIG strains showed less anxiety-like behavior in the elevated plus maze test compared to the SMALL strains. For novel object recognition only the Control strains showed replicate and sex differences. In the depression-like forced swim test proestrus females demonstrated less depression-like behavior than males. BIG and SMALL nest-building strains had a higher corticosterone stress response than the Control strains. Together these results indicate a strong interplay of genetic background and sex in influencing expression of behaviors in our compulsive-like mouse model. These results are in congruence with the clinical heterogeneity of OCD.
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Affiliation(s)
- Swarup Mitra
- Department of Chemistry & Biochemistry, University of Alaska Fairbanks, USA; IDeA Network of Biomedical Excellence (INBRE), University of Alaska Fairbanks, USA
| | - Cristiane P Bastos
- IDeA Network of Biomedical Excellence (INBRE), University of Alaska Fairbanks, USA; Núcleo de Neurociências, Departamento de Fisiologia e Biofísica, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Brazil
| | - Savanna Chesworth
- Department of Chemistry & Biochemistry, University of Alaska Fairbanks, USA
| | - Cheryl Frye
- Department of Chemistry & Biochemistry, University of Alaska Fairbanks, USA; IDeA Network of Biomedical Excellence (INBRE), University of Alaska Fairbanks, USA; Department of Psychology, University at Albany, State University of New York, USA
| | - Abel Bult-Ito
- Department of Biology & Wildlife, University of Alaska Fairbanks, USA.
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