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McGuire JF, Ricketts EJ, Scahill L, Wilhelm S, Woods DW, Piacentini J, Walkup JT, Peterson AL. Effect of behavior therapy for Tourette's disorder on psychiatric symptoms and functioning in adults. Psychol Med 2020; 50:2046-2056. [PMID: 31451122 PMCID: PMC7190082 DOI: 10.1017/s0033291719002150] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Although behavior therapy reduces tic severity, it is unknown whether it improves co-occurring psychiatric symptoms and functional outcomes for adults with Tourette's disorder (TD). This information is essential for effective treatment planning. This study examined the effects of behavior therapy on psychiatric symptoms and functional outcomes in older adolescents and adults with TD. METHOD A total of 122 individuals with TD or a chronic tic disorder participated in a clinical trial comparing behavior therapy to psychoeducation and supportive therapy. At baseline, posttreatment, and follow-up visits, participants completed assessments of tic severity, co-occurring symptoms (inattention, impulsiveness, hyperactivity, anger, anxiety, depression, obsessions, and compulsions), and psychosocial functioning. We compared changes in tic severity, psychiatric symptoms, and functional outcomes using repeated measure and one-way analysis of variance. RESULTS At posttreatment, participants receiving behavior therapy reported greater reductions in obsessions compared to participants in supportive therapy ($\eta _p^2 $ = 0.04, p = 0.04). Across treatments, a positive treatment response on the Clinical Global Impression of Improvement scale was associated with a reduced disruption in family life ($\eta _p^2 $ = 0.05, p = 0.02) and improved functioning in a parental role ($\eta _p^2 $ = 0.37, p = 0.02). Participants who responded positively to eight sessions of behavior therapy had an improvement in tic severity ($\eta _p^2 $ = 0.75, p < 0.001), inattention ($\eta _p^2 $ = 0.48, p < 0.02), and functioning ($\eta _p^2 $ = 0.39-0.42, p < 0.03-0.04) at the 6-month follow-up. CONCLUSION Behavior therapy has a therapeutic benefit for co-occurring obsessive symptoms in the short-term, and reduces tic severity and disability in adults with TD over time. Additional treatments may be necessary to address co-occurring symptoms and improve functional outcomes.
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Affiliation(s)
- Joseph F. McGuire
- Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Emily J. Ricketts
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry, University of California Los Angeles, Los Angeles, California
| | - Lawrence Scahill
- Marcus Autism Center, Emory University School of Medicine, Atlanta, Georgia
| | - Sabine Wilhelm
- Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Douglas W. Woods
- Department of Psychology, Marquette University, Milwaukee, Wisconsin
| | - John Piacentini
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry, University of California Los Angeles, Los Angeles, California
| | | | - Alan L. Peterson
- Department of Psychiatry, University of Texas Health Science at Center, San Antonio, Texas
- Department of Psychology, University of Texas at San Antonio, San Antonio, Texas
- South Texas Veterans Health Care System, San Antonio, Texas
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Mabunda D, Sidat M, Cumbe V, Gouveia ML, Oquendo M, Mari JJ. Primary familial basal ganglia calcification presented with depression and obsessive-compulsive symptoms: A case report. Psychiatry Clin Neurosci 2020; 74:444-446. [PMID: 32367606 PMCID: PMC11016286 DOI: 10.1111/pcn.13021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 04/09/2020] [Accepted: 04/20/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Dirceu Mabunda
- Faculty of Medicine, University Eduardo Mondlane, Maputo, Mozambique
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Mohsin Sidat
- Faculty of Medicine, University Eduardo Mondlane, Maputo, Mozambique
| | - Vasco Cumbe
- Faculty of Medicine, University Eduardo Mondlane, Maputo, Mozambique
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Maria Lídia Gouveia
- Faculty of Medicine, University Eduardo Mondlane, Maputo, Mozambique
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Maria Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Pennsylvania, USA
| | - Jair J Mari
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
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Taylor S, Asmundson GJG, Jang KL. Etiology of obsessions and compulsions: General and specific genetic and environmental factors. Psychiatry Res 2016; 237:17-21. [PMID: 26921046 DOI: 10.1016/j.psychres.2016.01.071] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 01/26/2016] [Accepted: 01/28/2016] [Indexed: 01/07/2023]
Abstract
Evidence suggests that a general etiologic factor plays a role in many forms of psychopathology, possibly including obsessive-compulsive (OC) symptoms. A twin study (N=307 twin pairs) of OC symptoms and their endophenotypes was conducted to investigate the role of general and symptom-specific etiologic factors. OC symptoms and endophenotypes were found to have complex etiologies, being shaped by OC-specific genetic and environmental factors, and by genetic and environmental factors that shape psychopathology in general. Understanding the general and specific etiologies underlying OC symptoms has implications for improving treatments outcomes through the development of therapies that target general and/or specific factors.
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Affiliation(s)
- Steven Taylor
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
| | | | - Kerry L Jang
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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Cicoria T. The electrifying story of the accdental pianist & composer. Mo Med 2014; 111:308. [PMID: 25211857 PMCID: PMC6179476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Abstract
The current study examined the 3-week prospective associations between cyber-victimization and both depressive symptoms and rumination. In addition, a mediation model was tested, wherein rumination mediated the association between cyber-victimization and depressive symptoms. Participants (N = 565 college-age young adults) completed online surveys at two time points 3 weeks apart. Results indicated that cyber-victimization was associated with increases in both depressive symptoms and rumination over time. Furthermore, results of the path analysis indicated that cyber-victimization was associated with increases in rumination over time, which were then associated with greater depressive symptoms, providing support for the proposed mediation effect for women, but not men. Findings extend previous correlational findings by demonstrating that cyber-victimization is associated with increases in symptomatology over time. Findings also suggest that the negative consequences of cyber-victimization extend beyond mental health problems to maladaptive emotion regulation. In fact, rumination may be a mechanism through which cyber-victimization influences mental health problems, at least for women. Mental health professionals are encouraged to assess cyber-victimization as part of standard victimization assessments and to consider targeting maladaptive emotion regulation in addition to mental health problems in clients who have experienced cyber-victimization.
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Tauber JM, Vanlandingham PA, Zhang B. Elevated levels of the vesicular monoamine transporter and a novel repetitive behavior in the Drosophila model of fragile X syndrome. PLoS One 2011; 6:e27100. [PMID: 22087250 PMCID: PMC3206932 DOI: 10.1371/journal.pone.0027100] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Accepted: 10/10/2011] [Indexed: 01/05/2023] Open
Abstract
Fragile X Syndrome (FXS) is characterized by mental impairment and autism in humans, and it often features hyperactivity and repetitive behaviors. The mechanisms for the disease, however, remain poorly understood. Here we report that the dfmr1 mutant in the Drosophila model of FXS grooms excessively, which may be regulated differentially by two signaling pathways. Blocking metabotropic glutamate receptor signaling enhances grooming in dfmr1 mutant flies, whereas blocking the vesicular monoamine transporter (VMAT) suppresses excessive grooming. dfmr1 mutant flies also exhibit elevated levels of VMAT mRNA and protein. These results suggest that enhanced monoamine signaling correlates with repetitive behaviors and hyperactivity associated with FXS.
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Affiliation(s)
- John M. Tauber
- Department of Zoology, University of Oklahoma, Norman, Oklahoma, United States of America
| | | | - Bing Zhang
- Department of Zoology, University of Oklahoma, Norman, Oklahoma, United States of America
- * E-mail:
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7
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Taylor S. Etiology of obsessions and compulsions: a meta-analysis and narrative review of twin studies. Clin Psychol Rev 2011; 31:1361-72. [PMID: 22024245 DOI: 10.1016/j.cpr.2011.09.008] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2011] [Revised: 09/12/2011] [Accepted: 09/28/2011] [Indexed: 12/20/2022]
Abstract
The relative importance of genetic and environmental factors in the etiology of obsessive-compulsive (OC) symptoms is unclear. Cognitive-behavioral models propose that shared environment (e.g., parenting style) is important. Family segregation studies suggest that nonadditive genetic factors may be involved. To investigate the etiology of OC symptoms, a meta-analysis was conducted of 37 twin samples from 14 studies, supplemented by a narrative review. Results indicated that in terms of mean effect sizes, (a) additive genetic effects and nonshared environment accounted for most of the variance in OC symptoms, (b) shared environment and nonadditive genetic effects made little or no contribution; (c) these findings did not vary with sex or symptom severity; (d) variance due to nonshared environment increased with age; (e) gene-environment interactions play an etiologic role; (f) OC symptoms are shaped by etiologic factors common to all types of OC symptoms but also have symptom-specific etiologies; and (g) OC symptoms are also shaped by very general etiologic factors (e.g., those influencing negative emotionality). Overall, the findings indicate that OC symptoms have a complex etiologic architecture that is not adequately explained by contemporary etiological models.
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Affiliation(s)
- Steven Taylor
- Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC V6T 2A1, Canada.
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Kenchadze R, Iverieli M, Okribelashvili N, Geladze N, Khachapuridze N. The psychological aspects of burning mouth syndrome. Georgian Med News 2011:24-28. [PMID: 21685517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
It should be emphasized that at the present stage there is no consensus achieved regarding the etiopathogenesis of BMS. Almost all researchers point to lots of factors, simultaneously participating in genesis and development of BMS and at the same time most of them agreed on one - psychological factors play a crucial role in formation and maintenance of painful sensations. The aim of the study was the identification of psychological or psychiatric deviations (changes) among the patients with BMS to perform an adequate differentiated therapy. Clinico-psychological examination (dentist, neurologist, psychiatrist) was carried out in 39 patients from 46 to 70 years of age. Among them women - 36 and men - 3. To identify clinical types of BMS a classification of P.J. Lamey (1996) was used and as a result, depression, insomnia, cancerophobia, severe neurologic disorders, phobic syndrome were revealed. Three main categories - a chronic somatoform dysfunction (23 cases), chronic vegetative disorders (8), and chronic pain phenomenon (12) were identified. Only in one case was revealed a paranoid syndrome. Alongside with the well-known scheme of treatment (antidepressants, anticonvulsants, or neuroleptics) Psychotherapy was conducted, while EEG-feed back (Biofeed back, Neurofeed back) method was used for the first time. A number of important decisions were made the most important of which are the following: BMS - must be regarded as a psychosomatic problem rather than a psychiatric disorder. In addition to psychotherapy, using of EEG - feedback method greatly improved patients' condition and in 4 cases BMS clinical manifestations were evened-out completely.
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Affiliation(s)
- R Kenchadze
- Tbilisi State Medical University, Department of Therapeutic Stomatology, Georgia
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Perroud N, Guipponi M, Pertusa A, Fullana MA, Iervolino AC, Cherkas L, Spector T, Collier D, Mataix-Cols D. Genome-wide association study of hoarding traits. Am J Med Genet B Neuropsychiatr Genet 2011; 156:240-2. [PMID: 21302353 DOI: 10.1002/ajmg.b.31152] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2010] [Accepted: 11/09/2010] [Indexed: 11/09/2022]
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Gonda X, Lazáry J, Telek T, Pap D, Kátai Z, Bagdy G. Mood parameters and severe physical symptoms of the female reproductive cycle. Neuropsychopharmacol Hung 2008; 10:91-96. [PMID: 18959140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE The cyclic variation of physical and psychological phenomena has been accepted as a natural consequence of the cyclicity of the human female reproductive function. The exact nature of these changes, however, has not been fully understood. The aim of our study was to investigate the fluctuation of psychological and physical symptoms throughout the female reproductive cycle in healthy, non-PMDD women. METHOD 63 psychiatrically healthy, non-PMDD women with normal regular menstrual cycles and not using hormonal contraceptive methods participated in the study. Participants completed the PRISM calendar every night for three consecutive cycles and on three predefined days of the first cycle they completed several other psychometric measures (SCL-51, STAI, ZSDS, EAT and Mind and Body Cathexis Scale). Based on an at least 66% increase in physical symptoms from the late follicular to the late luteal phase on the PRISM, subjects were assigned to LPPS (luteal phase physical symptoms) and nonLPPS (no luteal phase physical symptoms) groups. Average of psychometric scores obtained at the three predefined days were compared between the two groups. RESULTS There was a significant difference between the two groups only in case of the interpersonal sensitivity subscale of the SCL-51. CONCLUSION Our results indicate that the appearance of severe physical symptoms in the late luteal phase of the female reproductive cycle is not accompanied by a worsening of psychological symptoms. The appearance of enhanced psychological symptomatology attributed to the luteal phase of the female reproductive cycle thus seems to be independent of the appearance of severe physical symptoms.
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Affiliation(s)
- Xenia Gonda
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, Faculty of Medicine, Budapest, Hungary.
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Abstract
Gastroenterologists are often faced with the diagnostic problem of differentiating acute symptoms of ulcerative colitis from functional intestinal disorders. Bowel obsession syndrome (BOS) is an OCD-like, functional syndrome characterized by fear of fecal incontinence and compulsive behaviors of evacuation-checking. Only sparse case studies on treatment of BOS with antidepressants have been published. This is the first study on successful psychotherapy of a male patient with ulcerative colitis overlapping functional bowel symptoms and marked symptoms of BOS. Clinical recognition of BOS may help clinicians in differential diagnosis, prevent unnecessary investigations, and give patients the most appropriate treatment.
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Affiliation(s)
- Piero Porcelli
- Psychosomatic Unit and Department of Gastroenterology, IRCCS Ospedale De Bellis Via della Resistenza, 70013 Castellana Grotte, Bari, Italy.
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Abstract
Psychiatric symptoms are rarely reported as presenting symptoms in brainstem gliomas in children, with anxiety being the most common one. An 8-year-old girl patient had loss of appetite, weight loss, and difficulty in swallowing severe enough to warrant parenteral nutrition and hospitalization. Psychiatric examination revealed ego-dystonic obsessions related with choking and compulsory religious rituals. Symptoms partially responded to psychotropic treatment. However, because of unremitting hiccups and left-sided weakness, brain imaging was conducted, and magnetic resonance imaging revealed a diffuse pontine mass. The possible explanations for the relationship between the pontine mass and the psychiatric symptoms are discussed.
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Affiliation(s)
- Ozgur Oner
- SB Diskapi Children's Training Hospital, Child Psychiatry, Ankara, Turkey.
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Asmundson GJG, Wright KD, Hadjistavropoulos HD. Hypervigilance and attentional fixedness in chronic musculoskeletal pain: consistency of findings across modified stroop and dot-probe tasks. J Pain 2005; 6:497-506. [PMID: 16084464 DOI: 10.1016/j.jpain.2005.02.012] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2004] [Revised: 02/23/2005] [Accepted: 02/28/2005] [Indexed: 11/16/2022]
Abstract
UNLABELLED Results from modified Stroop and dot-probe tasks have provided mixed evidence regarding attentional biases for sensory and affect pain stimuli in chronic pain patients. No studies have compared the same groups of chronic pain and healthy control participants on both tasks. We tested 36 patients with chronic musculoskeletal pain and 29 healthy control subjects on the modified Stroop and dot-probe tasks. Stimuli comprised affect pain, sensory pain, physical catastrophe, and neutral words. There was no evidence to suggest differential processing of threat cues by patients and control subjects on the modified Stroop task. All participants did, however, show differential processing of affect pain words. This was evident on both masked and unmasked presentation formats. There were no significant interactions between clinical status and threat word type observed for any of the indices of selective attention derived from the dot-probe task, but all participants had difficulty disengaging attention from affective pain and health catastrophe words. Findings were not influenced by individual differences in mood, anxiety, or fear of pain. Correlational analyses of the standard (unmasked) Stroop interference index and dot-probe indices of selective attention revealed a consistent lack of significant association, suggesting that the 2 tasks might be measuring different phenomena. Taken together, these findings provide evidence that chronic pain patients and healthy control participants do not differ in the way they attend to threatening linguistic stimuli. PERSPECTIVE Some patients with chronic pain might have trouble paying attention to anything other than the affective components of pain and associated catastrophic health consequences. Interventions that specifically target this attentional fixedness might facilitate shifting attention to other targets and thereby reduce pain-specific anxiety and fear.
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Affiliation(s)
- Gordon J G Asmundson
- Faculty of Kinesiology and Health Studies, Department of Psychology, University of Regina, Regina, Saskatchewan, Canada.
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Mainio A, Hakko H, Niemelä A, Salo J, Koivukangas J, Räsänen P. Level of obsessionality among neurosurgical patients with a primary brain tumor. J Neuropsychiatry Clin Neurosci 2005; 17:399-404. [PMID: 16179664 DOI: 10.1176/jnp.17.3.399] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Obsessive-compulsive symptoms have been associated with different types of damages or dysfunctions in the brain. However, the accumulated evidence on obsessive-compulsive symptoms among patients with a primary brain tumor is so far based on case reports only. The study population consisted of 59 neurosurgical patients with a primary brain tumor. One preoperative and two postoperative assessments for the level of obsessionality were done with the Crown-Crisp Experiential Index (CCEI)-instrument. Mean obsessionality scores increased significantly among the patients with a tumor in the left anterior region of the brain measured at 3 months after operation, especially in women, compared to the patients with a tumor in other regions of the brain. The level of obsessionality seemed to increase immediately after operation among patients with a primary tumor left anteriorly in the brain. This increase may be linked with the lesion caused by the tumor itself or the neurosurgical operation.
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Affiliation(s)
- Arja Mainio
- Department of Psychiatry, BOX 26, 90029 OYS, Finland.
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Affiliation(s)
- M F X Lythgoe
- RCS Unit of Biophysics, Institute of Child Health, University College London, London, WC1N 1EH UK.
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Abstract
Two cases of clinically diagnosed sporadic Alzheimer's disease with early and prominent behavioural features (social disinhibition, emotional blunting, stereotyped verbal utterances) sufficient to prompt an initial diagnosis of frontotemporal dementia are presented. It is suggested that the term "frontal variant AD" be used for this clinically defined phenotype, which has also been described in cases of inherited AD associated with certain presenilin-1 gene mutations. This differs from previous usage of the term "frontal variant AD" to describe AD with predominant frontal lobe neuropathological change (although the clinical phenotype may reflect regional distribution of pathology), but parallels the clinical definition of visual agnosic, aphasic and apraxic presentations of AD. The proposed usage would also emphasise differential diagnosis.
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Affiliation(s)
- Andrew J Larner
- Cognitive Function Clinic, Walton Centre for Neurology and Neurosurgery, Lower Lane, Fazakerley, Liverpool L9 7LJ, UK.
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Avery JK. Loss prevention case of the month--Obsessed with family history. Tenn Med 2005; 98:334-5. [PMID: 16092212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Affiliation(s)
- J Kelley Avery
- State Volunteer Mutual Insurance Company, Brentwood, USA
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Marilov VV, Danilin IE, Minakova LR. [Borderline mental disorders in patients with prostate cancer]. Zh Nevrol Psikhiatr Im S S Korsakova 2003; 103:40-2. [PMID: 12789823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Sixty five patients, aged 48-87, with prostate cancer at different stages were studied. Borderline mental disorders were found in all the patients. In the majority of them, affective disorders in the form of anxiety-depressive (52.3%) and astheno-depressive (24.6%) syndromes were observed. Astheno-hypochondriacal and dysphoric syndromes were detected less frequently (in 15.4% and 7.7% of the cases, respectively).
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Halmi KA, Sunday SR, Klump KL, Strober M, Leckman JF, Fichter M, Kaplan A, Woodside B, Treasure J, Berrettini WH, Al Shabboat M, Bulik CM, Kaye WH. Obsessions and compulsions in anorexia nervosa subtypes. Int J Eat Disord 2003; 33:308-19. [PMID: 12655628 DOI: 10.1002/eat.10138] [Citation(s) in RCA: 153] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Obsession and compulsions in anorexia nervosa (AN) patients are often confused with the preoccupations and rituals that are characteristic of obsessive-compulsive disorder (OCD). We examined the type and frequency of characteristic OCD obsessions and compulsions in a large sample of AN patients. METHOD In personal interviews with 324 AN patients, we assessed lifetime histories of eating disorder symptomatology and obsessive-compulsive behaviors with valid semistructured interviews. Checklist category sums on the Yale-Brown Obsessive Compulsive Scale were compared between AN and OCD subjects using generalized estimating equations. RESULTS Lifetime obsessions and compulsions occurred in 68% of the AN restricting type and in 79.1% of the AN binge/purge type. The AN subgroups did not differ from OCD controls in frequency of obsessions in the symmetry and somatic categories or in the compulsion categories of ordering and hoarding. In all other categories, the AN subgroups had a significantly lower frequency compared with the OCD controls. DISCUSSION Some common phenotype characteristics shared by most AN and OCD patients suggest these disorders may share common brain behavioral pathways. However, the lack of complete overlap indicates they most likely have different loci of pathology within those pathways.
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Affiliation(s)
- Katherine A Halmi
- New York Presbyterian Hospital-Westchester Division, Weill Medical College of Cornell University, 21 Bloomingdale Road, White Plains, NY 10605, USA.
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Hampton P, Graham KA, Millar M, McCluskey S, Goodship THJ. Anodipsia nervosa a variant of anorexia in patients with end-stage renal disease. Nephrol Dial Transplant 2002; 17:942-3. [PMID: 11981095 DOI: 10.1093/ndt/17.5.942] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Prueter C, Schultz-Venrath U, Rimpau W. Dissociative and associated psychopathological symptoms in patients with epilepsy, pseudoseizures, and both seizure forms. Epilepsia 2002; 43:188-92. [PMID: 11903467 DOI: 10.1046/j.1528-1157.2002.45900.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE A controversy currently exists regarding the significance of dissociation and conversion in the pathogenesis of pseudoepileptic seizures. After the abolition of the term "hysterical neurosis" from the current diagnostic systems, these seizures were diagnosed as either Dissociative Disorders (ICD-10) or in the DSM IV as Somatoform disorder, most often of conversion type. Recent studies of patients with Dissociative Disorders found that most patients also had conversion symptoms. METHODS In the present study, 60 patients of an outpatient clinic for epilepsy were assessed for the presence of dissociative symptoms and general psychopathologic symptoms by using the German version of the Dissociative Experience Scale (DES) and the Symptom Check List (SCL-90-R). RESULTS The patients with pseudoepileptic seizures showed a significantly higher incidence of dissociation (p < 0.0098) and general psychopathologic symptoms (p < 0.0083). Depression, anxiety, and obsession were dominating psychopathologic symptoms in all patients. CONCLUSIONS The significantly higher incidence of dissociation in the patients with pseudoepileptic seizures suggests dissociation in the pathogenesis of these seizures.
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Affiliation(s)
- Christian Prueter
- Department of Psychiatry and Psychotherapy, University Hospital of the Technical University, Aachen, Germany.
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Cath DC, Spinhoven P, Hoogduin CA, Landman AD, van Woerkom TC, van de Wetering BJ, Roos RA, Rooijmans HG. Repetitive behaviors in Tourette's syndrome and OCD with and without tics: what are the differences? Psychiatry Res 2001; 101:171-85. [PMID: 11286820 DOI: 10.1016/s0165-1781(01)00219-0] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Gilles de la Tourette Syndrome (GTS) and obsessive-compulsive disorder (OCD) share obsessive-compulsive phenomena. The aims of this study were to compare the OC symptom distribution between GTS and OCD and to investigate whether a subdivision of these phenomena into obsessions, compulsions and 'impulsions' is useful in distinguishing GTS and OCD patients. Thirty-two GTS, 31 OCD (10 with tics, 21 without tics) and 29 control subjects were studied using the Leiden repetitive behaviors semi-structured interview to assess GTS as well as OCD-related behaviors. Each reported repetitive thought or action was evaluated on the presence of anxiety and on goal-directedness. This information was used to define whether the behavior was an obsession, compulsion, or 'impulsion'. Both the GTS and OCD study groups showed higher scores than control subjects on rating scales measuring depression, OC behavior and anxiety. In GTS, Y-BOCS severity scores and trait anxiety were lower than in the OCD groups. Furthermore, GTS patients differed from OCD patients in the distribution of symptoms. Aggressive repetitive thoughts, contamination worries and washing behaviors were reported more frequently by tic-free OCD, while mental play, echophenomena, touching and (self)-injurious behaviors were reported more frequently by GTS. OCD individuals with tics were intermediate, but closer to tic-free OCD. GTS individuals reported significantly more 'impulsions' and fewer obsessions and compulsions than OCD individuals with and without tics. Factor analysis revealed three factors accounting for 44% of the variance, resulting in an 'impulsive' factor related to GTS, a 'compulsive' factor related to OCD and an 'obsessive' factor related to tic-free OCD. In conclusion, OCD individuals reported more anxiety and goal-directedness associated with their behaviors than did GTS subjects. The distinction between obsessions, compulsions and impulsions is of importance in identifying Tourette-related vs. non-Tourette-related repetitions.
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Affiliation(s)
- D C Cath
- Department of Psychiatry, GGZ Buitenamstel Outpatient Services, Lassusstraat 2, 1075 GV, Amsterdam, The Netherlands.
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Abstract
Stalking behaviour has long been recognized as causing great distress and prolonged psychological problems in many victims. Individuals subjected to stalking often feel powerless and helpless in the face of such unwelcome intrusions into their daily lives. There now seems to be a greater awareness and understanding of the phenomenon which, in turn, may encourage individuals affected to seek help.
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Biondi M, Fedele L, Arcangeli T, Pancheri P. Development of obsessive-compulsive symptoms during clozapine treatment in schizophrenia and its positive response to clomipramine. Psychother Psychosom 1999; 68:111-2. [PMID: 10026463 DOI: 10.1159/000012321] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- M Biondi
- Third Psychiatric Clinic, University of Rome 'La Sapienza', Rome, Italy
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26
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Abstract
It is proposed that obsessions are caused by catastrophic misinterpretations of the significance of one's thoughts (images, impulses). The obsessions persist as long as these misinterpretations continue and diminish when the misinterpretations are weakened. Evidence and arguments in support of the theory are presented, and the questions of vulnerability and the origins of the thoughts are addressed. A firmly focused treatment strategy is deduced from the theory.
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Affiliation(s)
- S Rachman
- Psychology Department, University of British Columbia, Vancouver, Canada
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Abstract
Cases of slowness among patients who spent large amounts of time to perform daily activities were first reported in 1974, and described as primary obsessional slowness (POS). It was observed that it was neither obsessive thoughts nor compulsions that directly hindered their daily activities. However, in more than 20 years following the original report, the diagnostic independence of POS remains controversial, some insisting that obsessional slowness can be explained as secondary. The authors experienced four cases in Japan which share the same characteristics as the original cases. Long-term observation and treatment has led us to support the diagnostic independence of POS. Slowness remained after other accompanying symptoms of obsessive-compulsive disorder had been successfully treated, showing that the slowness of our patients was not secondary.
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Affiliation(s)
- T Takeuchi
- Hizen National Hospital, Saga-ken, Japan
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Freeston MH, Ladouceur R, Thibodeau N, Gagnon F. Cognitive intrusions in a non-clinical population. II. Associations with depressive, anxious, and compulsive symptoms. Behav Res Ther 1992; 30:263-71. [PMID: 1586363 DOI: 10.1016/0005-7967(92)90072-o] [Citation(s) in RCA: 87] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The relationships between experimental dimensions of cognitive intrusions and depressive, anxious, and compulsive symptoms were studied among 125 university students. The students completed a questionnaire describing and evaluating seven cognitive intrusions and inventories of depressive, anxious, and compulsive symptoms. Principal component factor analysis on the 14 cognitive intrusion questionnaire dimensions identified five factors that were interpreted as general distress, evaluation, control, diversity and attention. Hierarchical regression analysis showed that effortful strategies in response to cognitive intrusions, general distress and diversity were predictors of both Beck Depression and Beck Anxiety Inventory scores. The evaluation factor consisting of perceived responsibility, disapproval and guilt ratings was also associated with depression and was the only significant predictor of Compulsive Activity Checklist scores. The control factor, consisting of items describing successful application of response strategies, was negatively related to BAI scores. The results are discussed as providing support for Salkovskis' formulation of obsessive-compulsive disorder.
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Affiliation(s)
- M H Freeston
- Ecole de psychologie, C.H.U.L., Université Laval, Québec, Canada
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Okano M. [Approach to a schizophrenic patient with obsessive behavior]. Kurinikaru Sutadi 1989; 10:780-2. [PMID: 2634187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Abstract
The results of health questionnaire interviews with 390 electrical power transmission and distribution workers, together with long term estimates of their exposure to 50 Hz electric fields, and short term measurements of the actual exposure for 287 of them are reported. Twenty eight workers received measurable exposures, averaging about 30 kVm-1h over the two week measurement period. Estimated exposure rates were considerably greater, but showed fair correlation with the measurements. Although the general level of health was higher than we have found in manual workers in other industries, there were significant differences in the health measures between different categories of job, different parts of the country, and in association with factors such as overtime, working alone, or frequently changing shift. After allowing for the effects of job and location, however, we found no significant correlations of health with either measured or estimated exposure to electric fields.
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Paunović VR. [Obsessional syndrome after organic cerebral involvement]. Ann Med Psychol (Paris) 1984; 142:379-82. [PMID: 6476677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The obsessive syndrome after an organic brain damage. The evolution of an obsessive syndrome which appeared after a vascular insult in the anterior parts of dominant hemisphere has been followed-up. The conclusion was that the disturbed cingular-dominant frontal connections might play an important role in the genesis of obsession.
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Kopel HM. The autistic child in dental practice. ASDC J Dent Child 1977; 44:302-9. [PMID: 330580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Niederland WG. Scarred: a contribution to the study of facial disfigurement. Psychoanal Q 1975; 44:450-9. [PMID: 1161948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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