Cognitive functioning in obsessive-compulsive disorder: a meta-analysis

2013 ◽  
Vol 44 (6) ◽  
pp. 1121-1130 ◽  
Author(s):  
N. Y. Shin ◽  
T. Y. Lee ◽  
E. Kim ◽  
J. S. Kwon

BackgroundSubstantial empirical evidence has indicated impairment in the cognitive functioning of patients with obsessive-compulsive disorder (OCD) despite inconsistencies. Although several confounding factors have been investigated to explain the conflicting results, the findings remain mixed. This study aimed to investigate cognitive dysfunction in patients with OCD using a meta-analytic approach.MethodThe PubMed database was searched between 1980 and October 2012, and reference lists of review papers were examined. A total of 221 studies were identified, of which 88 studies met inclusion criteria. Neuropsychological performance and demographic and clinical variables were extracted from each study.ResultsPatients with OCD were significantly impaired in tasks that measured visuospatial memory, executive function, verbal memory and verbal fluency, whereas auditory attention was preserved in these individuals. The largest effect size was found in the ability to recall complex visual stimuli. Overall effect estimates were in the small to medium ranges for executive function, verbal memory and verbal fluency. The effects of potentially confounding factors including educational level, symptom severity, medication status and co-morbid disorders were not significant.ConclusionsPatients with OCD appear to have wide-ranging cognitive deficits, although their impairment is not so large in general. The different test forms and methods of testing may have influenced the performance of patients with OCD, indicating the need to select carefully the test forms and methods of testing used in future research. The effects of various confounding variables on cognitive functioning need to be investigated further and to be controlled before a definite conclusion can be made.

2006 ◽  
Vol 40 (11-12) ◽  
pp. 1031-1038 ◽  
Author(s):  
Shelley Bannon ◽  
Craig J. Gonsalvez ◽  
Rodney J. Croft ◽  
Philip M. Boyce

Objective: Despite the neuropsychology literature providing reliable evidence of impaired executive functions in obsessive–compulsive disorder (OCD), to date it has not been determined whether these deficits are trait-related (independent of symptomatology) or state-dependent (dependent on symptomatology). The current research examines the executive functions in OCD in a comprehensive manner and, for the first time, assesses the stability of these deficits over the developmental course of the disorder. Method: Using a cross-sectional design, Study 1 examined the executive functions (set shifting, inhibition, planning, verbal fluency and working memory) in 60 subjects (20 actively Symptomatic OCD, 20 Remitted OCD and 20 Panic Disorder). Using a longitudinal design, Study 2 reassessed a subsample of OCD subjects (participants in Study 1) once they reached remitted status. Results: Study 1 found that the OCD groups exhibited deficits in set shifting and inhibition relative to Panic Disorder controls; however, no deficits were observed in planning, verbal fluency or working memory. There were no differences found between the Symptomatic and Remitted OCD groups on any of the executive function measures. Study 2 found that the identified executive function deficits in individuals were stable over time and remained unchanged despite symptom remittance. Conclusion: Current results confirm the presence of specific executive function deficits in OCD, and indicate that these deficits are trait-like in nature.


2020 ◽  
Author(s):  
Sofia Persson ◽  
Alan Yates ◽  
Klaus Kessler ◽  
Ben Harkin

Even though memory performance is a commonly researched aspect of Obsessive-Compulsive Disorder (OCD), a coherent and unified explanation of the role of specific cognitive factors has remained elusive. To address this, the present meta-analysis examined the predictive validity of Harkin and Kessler’s (2011) Executive Function (E), Binding Complexity (B) and Memory Load (L) Classification System with regards to affected vs. unaffected memory performance in OCD. We employed a multi-level meta-analytic approach (Viechtbauer, 2010) to accommodate the interdependent nature of the EBL model and interdependency of effect sizes (305 effect sizes from 144 studies, including 4424 OCD patients). Results revealed that the EBL model predicted memory performance, i.e., as EBL demand increases, those with OCD performed progressively worse on memory tasks. Executive function was the driving mechanism behind the EBL’s impact on OCD memory performance and negated effect size differences between visual and verbal tasks in those with OCD. Comparisons of sub-task effect sizes were also generally in accord with the cognitive parameters of the EBL taxonomy. We conclude that standardised coding of tasks along individual cognitive dimensions and multi-level meta-analyses provides a new approach to examine multi-dimensional models of memory and cognitive performance in OCD and other disorders.


Author(s):  
Jordana Muroff ◽  
Abigail Ross ◽  
Joseph Rothfarb

While cognitive-behavioral therapy (CBT) and pharmacotherapy are “gold standard” treatments for obsessive-compulsive disorder (OCD), complementary and alternative treatments are frequently sought for anxiety disorders. The purpose of this chapter is to review and discuss the available research on the application, efficacy and effectiveness of complementary and alternative methods for treating OCD. The first section identifies and reviews studies focusing on specific alternative and complementary treatments that are independent from, or work in conjunction with CBT, such as yoga, herbal remedies, motivational strategies, and bibliotherapy. The second section discusses alternative and complementary methods of more mainstream CBT and related techniques, with a particular focus on technology-supported approaches. The chapter concludes with a discussion of the methodological issues in the existing research on complementary and alternative methods in the treatment of OCD, questions for future research, and implications for providers.


2014 ◽  
Vol 16 (2) ◽  
pp. 239-254 ◽  

The purpose of the article was to provide an overview of patient-reported outcomes (PROs) and related measures that have been examined in the context of obsessive-compulsive disorder (OCD). The current review focused on patient-reported outcome measures (PROMs) that evaluated three broad outcome domains: functioning, health-related quality of life (HRQoL), and OCD-related symptoms. The present review ultimately included a total of 155 unique articles and 22 PROMs. An examination of the PROs revealed that OCD patients tend to suffer from significant functional disability, and report lower HRQoL than controls. OCD patients report greater symptom severity than patients with other mental disorders and evidence indicates that PROMs are sensitive to change and may be even better than clinician-rated measures at predicting treatment outcomes. Nonetheless, it should be noted that the measures reviewed lacked patient input in their development. Future research on PROMs must involve patient perspectives and include rigorous psychometric evaluation of these measures.


Author(s):  
Damian Mellifont

The inclusivity of neurodiversity conferences is a new field of research. Utilising Obsessive Compulsive Disorder (OCD) as an example, this study aims to critically investigate issues of inclusivity in the flyers advertising these conferences. This exploratory research is informed by 22 conference flyers and 14 scholarly articles retrieved from respective internet and Google Scholar enquiries. These articles offered evidence-based justifications for a greater inclusion of OCD-focused content in neurodiversity conferences. The study cautions that the lack of explicit inclusion of OCD as a topic among conferences can be harmful to persons who identify with this particular type of neurodivergence. This study offers a sound base from which future research focusing upon other forms of neurodivergence and issues of neurodiversity conference inclusivity and intersectionality can develop.


10.2196/11643 ◽  
2019 ◽  
Vol 6 (12) ◽  
pp. e11643 ◽  
Author(s):  
Florian Ferreri ◽  
Alexis Bourla ◽  
Charles-Siegfried Peretti ◽  
Tomoyuki Segawa ◽  
Nemat Jaafari ◽  
...  

Background New technologies are set to profoundly change the way we understand and manage psychiatric disorders, including obsessive-compulsive disorder (OCD). Developments in imaging and biomarkers, along with medical informatics, may well allow for better assessments and interventions in the future. Recent advances in the concept of digital phenotype, which involves using computerized measurement tools to capture the characteristics of a given psychiatric disorder, is one paradigmatic example. Objective The impact of new technologies on health professionals’ practice in OCD care remains to be determined. Recent developments could disrupt not just their clinical practices, but also their beliefs, ethics, and representations, even going so far as to question their professional culture. This study aimed to conduct an extensive review of new technologies in OCD. Methods We conducted the review by looking for titles in the PubMed database up to December 2017 that contained the following terms: [Obsessive] AND [Smartphone] OR [phone] OR [Internet] OR [Device] OR [Wearable] OR [Mobile] OR [Machine learning] OR [Artificial] OR [Biofeedback] OR [Neurofeedback] OR [Momentary] OR [Computerized] OR [Heart rate variability] OR [actigraphy] OR [actimetry] OR [digital] OR [virtual reality] OR [Tele] OR [video]. Results We analyzed 364 articles, of which 62 were included. Our review was divided into 3 parts: prediction, assessment (including diagnosis, screening, and monitoring), and intervention. Conclusions The review showed that the place of connected objects, machine learning, and remote monitoring has yet to be defined in OCD. Smartphone assessment apps and the Web Screening Questionnaire demonstrated good sensitivity and adequate specificity for detecting OCD symptoms when compared with a full-length structured clinical interview. The ecological momentary assessment procedure may also represent a worthy addition to the current suite of assessment tools. In the field of intervention, CBT supported by smartphone, internet, or computer may not be more effective than that delivered by a qualified practitioner, but it is easy to use, well accepted by patients, reproducible, and cost-effective. Finally, new technologies are enabling the development of new therapies, including biofeedback and virtual reality, which focus on the learning of coping skills. For them to be used, these tools must be properly explained and tailored to individual physician and patient profiles.


2019 ◽  
Vol 5 ◽  
pp. 205520761988217
Author(s):  
Susan Thorpe ◽  
Alexander Bolster ◽  
Nick Neave

While the hoarding of physical objects has been extensively explored, there is little research relating to the hoarding of digital materials. The research that has been conducted suggests that digital hoarding (DH) behaviours appear to have some similarities with physical hoarding (PH) behaviours, and can be just as psychologically distressing. This study uses the framework of the cognitive behavioural model of PH to explore DH behaviours, including possible similarities regarding emotional attachment to digital possessions, and possible links with Obsessive Compulsive Disorder (OCD) and indecisiveness. For the study, 282 participants completed an online survey which measured levels of digital and physical hoarding, compulsive acquisition, OCD, indecisiveness and mood. Strong emotional attachments to particular types of digital possessions were evident: this was especially true for photographs and videos. Significant positive relationships were found between all the variables measured. However, a regression analysis revealed that only OCD and PH scores were significant predictors of DH. DH thus appears to share some of the features of PH. Implications, limitations and future research possibilities are discussed.


2019 ◽  
Vol 52 (04) ◽  
pp. 203-204
Author(s):  
Anton J.M. Loonen ◽  
Svetlana A. Ivanova

AbstractRecently, in a review article in this journal, Vlček and colleagues described the putative role played by the glutamatergic system in obsessive-compulsive disorder (OCD) and how this might explain the effects of certain treatments. They describe a neuroanatomical model, which includes a specific role of the amygdala-hippocampus complex (AHC) and would complete the classic cortico-striatal-thalamo-cortical (CSTC) mechanism of OCD. The role of the AHC can perhaps be better understood when considering its ancient relationship to the rest of the forebrain of mammals. This leads to distinguishing between primary (lamprey-like), secondary (amphibian-like) and tertiary (mammal-like) parts of the forebrain including amygdaloid, ventral extrapyramidal and dorsal extrapyramidal systems, respectively. A specific role in OCD may be played by the habenula-projecting part of the pallidum, which evaluated the result of behaviour in human’s earliest vertebrate ancestors. The addition of these primary relationship to the authors’ description could be fruitful when planning the future research, as suggested by them.


Author(s):  
Steven Taylor ◽  
Jonathan S. Abramowitz ◽  
Dean McKay ◽  
Carrie Cuttler

This chapter focuses on cognitive models of obsessive compulsive disorder (OCD) and related disorders. It begins with a historical perspective, in which the antecedents of cognitive models are described. Contemporary cognitive models are then reviewed, predictions derived from the models are identified, and empirical evidence for these predictions is summarized. This is followed by a review of cognitive models of four OC-related disorders: hoarding, hypochondriasis, body dysmorphic disorder, and trichotillomania. Finally, the conceptual problems with cognitive models of OCD and related disorders are identified, suggestions for improvements to the models are made, and potentially fruitful directions for future research are proposed.


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