Obsessive-Compulsive Disorder and Obsessive-Compulsive Spectrum Disorders: Diagnostic and Dimensional Issues

CNS Spectrums ◽  
2007 ◽  
Vol 12 (S3) ◽  
pp. 5-13 ◽  
Author(s):  
Eric Hollander ◽  
Suah Kim ◽  
Sumant Khanna ◽  
Stefano Pallanti
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Affective Disorders ◽  
Dimensional Approach ◽  
Obsessive Compulsive ◽  
Course Of Illness ◽  
Compulsive Disorder ◽  
Advantages And Disadvantages ◽  
Dsm Iv ◽  
Spectrum Disorders ◽  
The Relationship

AbstractAlthough obsessive-compulsive disorder (OCD) is classified as an anxiety disorder in the DSM-IV, recent considerations for a reclassification into an obsessive-compulsive spectrum disorders (OCSDs) cluster are gaining prominence. Similarities in symptomatology, course of illness, patient population, and neurocircuitry of OCD and OCSD are supported by comorbidity, family, and neurological studies, which also offer a critical re-evaluation of the relationship between OCD and anxiety disorders. This review examines potential classifications of OCD among the wider spectrum of affective disorders and at the interface between affective disorders and addiction. In addition, it has been suggested that the categorical diagnostic approach would be enhanced by an additional dimensional approach, including parameters such as stability of mood and ability to sustain attention. With further studies, it is ultimately the goal to define OCD and related disorders based on endophenotypes.Despite efforts in this field, there are several fundamental unresolved issues, including the question of which disorders should be grouped together in this category and which characteristics to include as their shared common features. A reclassification of OCD among the OCSDs would allow for better scrutiny of distinct obsessive-compulsive symptoms, as currently this disorder often goes undetected in patients who complain of a broad symptom of anxiety. Advantages and disadvantages of establishing OCSDs and its implications for diagnosis, treatment, and research are discussed.

Variable Insight in OCD

2017 ◽  
Author(s):  
Rebecca J. Hamblin ◽  
Jennifer Moonjung Park ◽  
Monica S. Wu ◽  
Eric A. Storch
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Assessment Tools ◽  
Schizophrenia Spectrum Disorders ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
Definition Of ◽  
The Relationship ◽  
Insight Into

Individuals with obsessive-compulsive disorder (OCD) often have good insight into the irrational nature of their obsessions and the excessive character of their compulsions, but insight exists along a continuum and is markedly poor in some patients. This chapter reviews the assessment and phenomenological correlates of variable insight in OCD in both pediatric and adult populations. It reviews the definition of insight and its relationship to the evolution of diagnostic criteria for obsessive-compulsive disorder, as well as the major assessment tools used to measure and quantify insight for clinical and research purposes. The relationships between insight and clinical characteristics of OCD, including symptom severity, comorbidity, and treatment response are reviewed, followed by a review of neurobiological correlates of insight and the relationship between poor insight and schizophrenia spectrum disorders.

The relationship between obsessive–compulsive disorder and anxiety and affective disorders: results from the Johns Hopkins OCD Family Study

2001 ◽  
Vol 31 (3) ◽  
pp. 481-487 ◽  
Author(s):  
G. NESTADT ◽  
J. SAMUELS ◽  
M. A. RIDDLE ◽  
K.-Y. LIANG ◽  
O. J. BIENVENU ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Obsessive Compulsive Disorder ◽  
Affective Disorders ◽  
Substance Dependence ◽  
Separation Anxiety ◽  
Family Study ◽  
Separation Anxiety Disorder ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
The Relationship

Objective. This study investigates the relationship of specific anxiety and affective disorders to obsessive–compulsive disorder (OCD) in a blind, controlled family study.Method. Eighty case and 73 control probands, as well as 343 case and 300 control first-degree relatives of these probands, participated in the study. Subjects were examined by psychologists or psychiatrists using the Schedule for Affective Disorder and Schizophrenia-Lifetime Anxiety version (SADS-LA). Two experienced psychiatrists independently reviewed all clinical materials, and final diagnoses were made according to DSM-IV criteria, by consensus procedure.Results. Except for bipolar disorder, all anxiety and affective disorders investigated were more frequent in case than control probands. Substance dependence disorders were not more frequent. Generalized anxiety disorder (GAD), panic disorder, agoraphobia, separation anxiety disorder (SAD) and recurrent major depression were more common in case than control relatives. These disorders occurred more frequently if the relative was diagnosed with OCD. Only GAD and agoraphobia were more frequent in case relatives independent of OCD.Conclusion. GAD and agoraphobia share a common familial aetiology with OCD. The other anxiety and affective disorders, when comorbid with OCD, may emerge as a consequence of the OCD or as a more complex syndrome.

Gender-related clinical differences in obsessive-compulsive disorder

1999 ◽  
Vol 14 (8) ◽  
pp. 434-441 ◽  
Author(s):  
F. Bogetto ◽  
S. Venturello ◽  
U. Albert ◽  
G. Maina ◽  
L. Ravizza
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Clinical Features ◽  
Age At Onset ◽  
Obsessive Compulsive ◽  
Course Of Illness ◽  
Compulsive Disorder ◽  
History Of ◽  
Axis I ◽  
Dsm Iv ◽  
Chronic Course

SummaryThe purpose of the present study was to investigate the gender-related differences of clinical features in a sample of obsessive-compulsive (OCD) patients. One hundred and sixty outpatients with a principal diagnosis of obsessive-compulsive disorder (DSM-IV, Y-BOCS = 16) were admitted. Patients were evaluated with a semi-structured interview covering the following areas: socio-demographic data, Axis I diagnoses (DSM-IV), OCD clinical features (age at onset of OC symptoms and disorder, type of onset, life events and type of course). For statistical analysis the sample was subdivided in two groups according to gender. We found an earlier age at onset of OC symptoms and disorder in males; an insidious onset and a chronic course of illness were also observed in that group of patients. Females more frequently showed an acute onset of OCD and an episodic course of illness; they also reported more frequently a stressful event in the year preceding OCD onset. A history of anxiety disorders with onset preceding OCD and hypomanic episodes occurring after OCD onset was significantly more common among males, while females showed more frequently a history of eating disorders. We found three gender-related features of OCD: males show an earlier age at onset with a lower impact of precipitant events in triggering the disorder; OCD seems to occur in a relative high proportion of males who already have phobias and/or tic disorders; and a surfeit of chronic course of the illness in males in comparison with females.

scholarly journals Lifetime bipolar disorder comorbidity and related clinical characteristics in patients with primary obsessive compulsive disorder: a report from the International College of Obsessive–Compulsive Spectrum Disorders (ICOCS)

CNS Spectrums ◽  
2019 ◽  
Vol 25 (3) ◽  
pp. 419-425 ◽  
Author(s):  
Bernardo Dell’Osso ◽  
Matteo Vismara ◽  
Beatrice Benatti ◽  
Giovanna Cirnigliaro ◽  
Benedetta Grancini ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Obsessive Compulsive Disorder ◽  
Clinical Characteristics ◽  
Primary Diagnosis ◽  
International Studies ◽  
Obsessive Compulsive ◽  
Course Of Illness ◽  
Compulsive Disorder ◽  
International College ◽  
Spectrum Disorders

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 therapies (p < 0.001). They also showed greater severity of OCD (p < 0.001), as measured by the Yale–Brown Obsessive Compulsive Scale (Y-BOCS).Conclusion.These findings from a large international sample indicate that approximately 1 out of 16 patients with primary OCD may additionally have BD comorbidity along with other specific clinical characteristics, including more frequent previous hospitalizations, more complex therapeutic regimens, and a greater severity of OCD. Prospective international studies are needed to confirm our findings.

Definitions and Defining Responsibility

1992 ◽  
Vol 26 (3) ◽  
pp. 517-518
Author(s):  
Paul Dignam
Keyword(s):  
Social Phobia ◽  
Obsessive Compulsive Disorder ◽  
Affective Disorders ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Real Value ◽  
The Relationship ◽  
Stratified Model

In the older nosologies under which I first studied psychiatry the terms “character neurosis” and “symptom neurosis” served to highlight the possibility of interaction or continuity between personality and illness. DSM-111 sought to clarify the relationship by establishing separate axes. This stratified model has real value in conceptualising diagnosis and organizing treatment, but reifies a distinction that is far from proven, and seems even to be fading as time passes: witness the various studies linking social phobia and avoidant PD, affective disorders and borderline PD, obsessive-compulsive disorder and personalty, and of course schizotypal PD and schizophrenia, to name a few. This is hardly surprising considering the complex and overlapping origins of both personality and disorder.

The relationship of obsessive–compulsive disorder to possible spectrum disorders: results from a family study

2000 ◽  
Vol 48 (4) ◽  
pp. 287-293 ◽  
Author(s):  
O.Joseph Bienvenu ◽  
Jack F Samuels ◽  
Mark A Riddle ◽  
Rudolf Hoehn-Saric ◽  
Kung-Yee Liang ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Family Study ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Spectrum Disorders ◽  
Relationship Of ◽  
The Relationship

scholarly journals The Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders: recruitment, assessment instruments, methods for the development of multicenter collaborative studies and preliminary results

2008 ◽  
Vol 30 (3) ◽  
pp. 185-196 ◽  
Author(s):  
Euripedes Constantino Miguel ◽  
Ygor Arzeno Ferrão ◽  
Maria Conceição do Rosário ◽  
Maria Alice de Mathis ◽  
Albina Rodrigues Torres ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Obsessive Compulsive Disorder ◽  
Assessment Instruments ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Preliminary Results ◽  
Dsm Iv ◽  
Spectrum Disorders ◽  
Research Consortium

OBJECTIVE: To describe the recruitment of patients, assessment instruments, implementation, methods and preliminary results of The Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders, which includes seven university sites. METHOD: This cross-sectional study included a comprehensive clinical assessment including semi-structured interviews (sociodemographic data, medical and psychiatric history, disease course and comorbid psychiatric diagnoses), and instruments to assess obsessive-compulsive (Yale-Brown Obsessive-Compulsive Scale and Dimensional Yale-Brown Obsessive-Compulsive Scale), depressive (Beck Depression Inventory) and anxious (Beck Anxiety Inventory) symptoms, sensory phenomena (Universidade de São Paulo Sensory Phenomena Scale), insight (Brown Assessment Beliefs Scale), tics (Yale Global Tics Severity Scale) and quality of life (Medical Outcome Quality of Life Scale Short-form-36 and Social Assessment Scale). The raters' training consisted of watching at least five videotaped interviews and interviewing five patients with an expert researcher before interviewing patients alone. The reliability between all leaders for the most important instruments (Structured Clinical Interview for DSM-IV, Dimensional Yale-Brown Obsessive-Compulsive Scale, Universidade de São Paulo Sensory Phenomena Scale) was measured after six complete interviews. RESULTS: Inter-rater reliability was 96%. By March 2008, 630 obsessive-compulsive disorder patients had been systematically evaluated. Mean age (±SE) was 34.7 (±0.51), 56.3% were female, and 84.6% Caucasian. The most prevalent obsessive compulsive symptom dimensions were symmetry and contamination. The most common comorbidities were major depression, generalized anxiety and social anxiety disorder. The most common DSM-IV impulsive control disorder was skin picking. CONCLUSION: The sample was composed mainly by Caucasian individuals, unmarried, with some kind of occupational activity, mean age of 35 years, onset of obsessive-compulsive symptoms at 13 years of age, mild to moderate severity, mostly of symmetry, contamination/cleaning and comorbidity with depressive disorders. The Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders has established an important network for standardized collaborative clinical research in obsessive-compulsive disorder and may pave the way to similar projects aimed at integrating other research groups in Brazil and throughout the world.

The Price of Love: An Investigation into the Relationship between Romantic Love and the Expression of Obsessive-Compulsive Disorder

CNS Spectrums ◽  
2021 ◽  
pp. 1-33
Author(s):  
James McLauchlan ◽  
Emma M. Thompson ◽  
Ygor A. Ferrão ◽  
Euripedes C. Miguel ◽  
Lucy Albertella ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Romantic Love ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
The Relationship

Obsessive-Compulsive Disorder With and Without Tic Disorder: A Comparative Study From India

CNS Spectrums ◽  
2008 ◽  
Vol 13 (8) ◽  
pp. 705-711 ◽  
Author(s):  
T.S. Jaisoorya ◽  
Y.C. Janardhan Reddy ◽  
S. Srinath ◽  
K. Thennarasu
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Age Of Onset ◽  
Early Age ◽  
Obsessive Compulsive ◽  
The West ◽  
Tic Disorder ◽  
Compulsive Disorder ◽  
Symptom Profile ◽  
Spectrum Disorders ◽  
Motor Tics

ABSTRACTIntroduction: Evidence from phenomenological, family, genetic, and treatment studies from Western centers have suggested that tic-related obsessive-compulsive disorder (OCD) could be different from non-tic-related OCD. This study from India investigated the differences in OCD with and without tics, with respect to sociode-mographics, symptom profile, and comorbidity, including obsessive-compulsive spectrum disorders, to examine whether the clinical profile of tic-related OCD is similar to that reported previously.Methods: Fifty subjects with OCD and tics (chronic motor tics and Tourette syndrome) were compared with 141 OCD subjects without tics.Results: Subjects having OCD with tics tended to be males, and had an earlier onset of illness. They had more of symmetry/aggressive and religious obsessions, and cleaning, ordering/arranging, hoarding, and repeating compulsions and were associated with trichotillomania and hypochondraisis. Stepwise backward (Wald) regression analysis showed that an early age of onset, male gender, aggressive obsessions, cleaning compulsions, and trichotillomania were significantly associated with tic-related OCD.Conclusion: The findings of this study from India are broadly similar to those reported previously from the West indicating the universality of differences in tic- and non-tic-related OCD. Our findings also support the existing evidence that tics contribute to the heterogeneity of OCD.

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