Obsessive Compulsive Disorder

Given the widely recognized genetic basis for Gilles de la Tourette syndrome (TS) and the suggestion that the putative TS gene(s) may be expressed as or associated with a variety of psychiatric illnesses, this study was undertaken to assess the prevalence of tics and TS in a psychiatric inpatient population. Cross-sectional study. 200 consecutive adult patients who were admitted to the psychiatric wards of University College London Teaching Hospitals. TS and related behaviours, as assessed by the comprehensive semi-structured National Hospital Interview Schedule. None of the 200 patients had definite TS, but 2 were observed to have motor tics; 10 had a history of tics (present for less than a year), and 7 reported a family history of tics. Thus, 19 (9.5%) inpatients qualified for inclusion in a broadly defined TS diathesis. These rates are significantly lower than those reported in a similar community based epidemiological study of adolescents (p = 0.018). Our findings do not suppor...

BackgroundChildren with Tourette syndrome generally experience improvement of tics by age 18 years, but psychosocial and comorbidity outcomes at this age are unclear.AimsTo compare psychosocial outcomes and lifetime comorbidity rates in older adolescents with Tourette syndrome and controls. We hypothesised a priori that individuals with Tourette syndrome would have lower Children's Global Assessment Scale (CGAS) scores.MethodA total of 65 individuals with Tourette syndrome, identified in childhood, and 65 matched community controls without tic or obsessive–compulsive disorder (OCD) symptoms were assessed around 18 years of age regarding psychosocial functioning and lifetime psychiatric disorders.ResultsCompared with controls, individuals with Tourette syndrome had substantially lower CGAS scores (P=10−8) and higher rates of attention-deficit hyperactivity disorder (ADHD), major depression, learning disorder and conduct disorder (P⩽0.01). In the participants with Tourette syndrom...

BackgroundTourette syndrome is a heterogeneous familial disorder for which the genetic mechanisms are unknown. A better characterisation of the phenotype may help identify susceptibility genesAimsTo extend previous factor-analytic studies of the syndromeMethodSymptom data from 410 people with Tourette syndrome were included in agglomerative hierarchical cluster and principal components analysesResultsFive factors were observed, characterised by: (1) socially inappropriate behaviours and other complex vocal tics; (2) complex motor tics; (3) simple tics; (4) compulsive behaviours; and (5) touching self. Individuals with co-occurring attention-deficit hyperactivity disorder had significantly higher factor scores on Factors 1 and 3, whereas individuals with co-occurring obsessive-compulsive disorder and behaviours had significantly higher factor scores for Factors 1–4ConclusionsThese findings add to the growing body of evidence that Tourette syndrome is not a unitary condition and can b...

Objective: The main characteristic of body dysmorphic disorder (BDD) is a preoccupation with an imagined defect in appearance in a normal-appearing person or an excessive preoccupation with appearance in a person with a small physical defect. In this non-controlled study, our objective was to describe the socio-demographic, phenomenological, and long-term outcome features of a Brazilian sample of patients with BDD. Methods: We performed a chart-review of the 166 patients who attended the Obsessions, Compulsions, and Impulsions Subprogram of the Institute of Psychiatry of the Federal University of Rio de Janeiro, Brazil, during the period between 1998 and 2005. Results: Twenty patients (12%) had clinically significant BDD. This sample was characterized by a predominance of female ( n = 11; 55%), single or divorced ( n = 18; 90%), and economically unproductive patients ( n = 17; 85%). We found an average of 2.5 current imagined defects per patient. The most frequently reported body pa...

Introduction.Bipolar disorder (BD) and obsessive compulsive disorder (OCD) are prevalent, comorbid, and disabling conditions, often characterized by early onset and chronic course. When comorbid, OCD and BD can determine a more pernicious course of illness, posing therapeutic challenges for clinicians. Available reports on prevalence and clinical characteristics of comorbidity between BD and OCD showed mixed results, likely depending on the primary diagnosis of analyzed samples.Methods.We assessed prevalence and clinical characteristics of BD comorbidity in a large international sample of patients with primary OCD (n = 401), through the International College of Obsessive–Compulsive Spectrum Disorders (ICOCS) snapshot database, by comparing OCD subjects with vs without BD comorbidity.Results.Among primary OCD patients, 6.2% showed comorbidity with BD. OCD patients with vs without BD comorbidity more frequently had a previous hospitalization (p < 0.001) and current augmentation the...

Obsessive-compulsive disorder (OCD) is associated with variable risk of suicide and prevalence of suicide attempt (SA). The present study aimed to assess the prevalence of SA and associated sociodemographic and clinical features in a large international sample of OCD patients. A total of 425 OCD outpatients, recruited through the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) network, were assessed and categorized in groups with or without a history of SA, and their sociodemographic and clinical features compared through Pearson's chi-squared and t tests. Logistic regression was performed to assess the impact of the collected data on the SA variable. 14.6% of our sample reported at least one SA during their lifetime. Patients with an SA had significantly higher rates of comorbid psychiatric disorders (60 vs. 17%, p<0.001; particularly tic disorder), medical disorders (51 vs. 15%, p<0.001), and previous hospitalizations (62 vs. 11%, p<0.001) tha...

Este artigo revisa a literatura sobre o transtorno obsessivocompulsivo com o objetivo de informar o estado atual da pesquisa científica nesse tema. Os autores citam a literatura internacional buscando enfatizar a pesquisa nacional, principalmente a pesquisa do seu grupo, o Projeto Transtornos do espectro Obsessivo-compulsivo.

This narrative review covers research from the years 2019-2024 on eating disorders in children. This research suggests that global prevalence rates have been highly variable, ranging from a low of .95% to 22% and the rates are increasing. The variability of rates may relate to different types of eating disorders or to age range differences of the samples, as the rates are higher for older children and those with less severe problems. Several different types are represented here including anorexia nervosa, bulimia nervosa, binge eating and avoidant/restrictive food intake disorder. Other feeding problems reviewed here are neophobia, picky eating, failure to thrive and obesity. A few comorbidities exacerbate feeding disorders including anxiety, depression, conduct disorder, obsessive-compulsive disorder and attention deficit/hyperactivity disorder. Predictors/risk factors have been the primary focus in this literature and have included perfectionism, appearance comparison and body image dissatisfaction. Both psychological and physical interventions have included family-based treatment and unguided internet cognitive behavioral therapy as well as manual therapies and herbal medicine. Surprisingly, only a couple papers were found on potential underlying mechanisms including a review of studies showing EEG waves suggestive of attention to visual food stimuli. Similarly, another group reported altered reward responses to food related stimuli on fMRIs as well as decreased gray matter volume and cortical thickness in areas of the brain associated with reward. The studies in this review highlight the prevalence and severity of eating disorders in children. However, they have been primarily based on parent-report surveys that have yielded mixed results across different types of eating disorders.

This paper is about the use of an unconventional intervention for treatment‐resistant OCD that we describe as ‘Therapist Assumes Responsibility’ (TAR). The use of TAR in this paper as a clinical treatment parallels an experimental analysis by Lopatka and Rachman (1995). Two case studies are used to illustrate TAR and the use of the therapist‐client relationship in the treatment of OCD. These include learning to trust others and accepting reasonable levels of insecurity. It is proposed that the addition of an interpersonal factor to CBT theories of OCD helps to explain the role of inflated responsibility and how the client‐therapist relationship can be used during treatment. It is further proposed that reassurance seeking might also be the result of this same interpersonal factor.

OBJECTIVE: The aim of this study was to determine the childhood clinical predictors of early adult outcomes in pediatric-onset obsessive-compulsive disorder (OCD) and to assess whether dimensional subtypes of OCD and the presence of comorbid tic symptoms influence long-term outcomes.METHODS: We conducted a longitudinal cohort study in which 45 of 62 eligible children with OCD were reassessed an average of 9 years later, in early adulthood. Main outcome measures included expert-rated, obsessive-compulsive (OC) symptom severity and time to remission of OC symptoms. Baseline clinical characteristics were evaluated in terms of their influence on OCD severity in adulthood and time to remission of OC symptoms.RESULTS: Forty-four percent of subjects were determined to have subclinical OC symptoms at the follow-up evaluation. The absence of a comorbid tic disorder and the presence of prominent hoarding symptoms were associated with the persistence of OCD symptoms. Female gender, earlier age...

This study aimed to explore the mediating role of stress and fear of COVID-19 in the association between obsessive beliefs and obsessive-compulsive symptoms. Using a correlation-type descriptive research method, 391 participants were selected from the general population through accessible sampling. The research employed tools such as the revised practical obsessive-compulsive scale, obsessive beliefs scale, the fear of COVID-19 scale and the COVID stress scale. Data analysis involved Pearson correlation and structural equation modeling (SEM). Results indicated that stress and fear of COVID-19 played a mediating role in the connection between obsessive beliefs and obsessive-compulsive symptoms. Overall, the model demonstrated a good fit, suggesting potential use in designing interventions to alleviate fear and stress during infectious disease outbreaks.

Prader Willi syndrome is a genetic disorder with a behavioural expression characterized by the presence of obsessive-compulsive phenomena ranging from elaborate obsessive eating behaviour to repetitive skin picking. Obsessive-compulsive disorder (OCD) has been recently associated with abnormal functional coupling between the frontal cortex and basal ganglia. We have tested the potential association of functional connectivity anomalies in basal ganglia circuits with obsessive-compulsive behaviour in patients with Prader Willi syndrome. We analyzed resting-state functional MRI in adult patients and healthy controls. Whole-brain functional connectivity maps were generated for the dorsal and ventral aspects of the caudate nucleus and putamen. A selected obsessive-compulsive behaviour assessment included typical OCD compulsions, self picking and obsessive eating behaviour. We included 24 adults with Prader Willi syndrome and 29 controls in our study. Patients with Prader Willi syndrome s...