Anxiety and the Spectrum of Obsessive-Compulsive Disorder

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S14) ◽  
pp. 4-5 ◽  
Author(s):  
Donald W. Black
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Obsessive Compulsive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Age Of Onset ◽  
The Other ◽  
Specific Response ◽  
Obsessive Compulsive ◽  
Important Place ◽  
Compulsive Disorder

This supplement to CNS Spectrums focuses on the obsessive-compulsive spectrum of disorders and their relationship to anxiety. Hollander and others pioneered the concept of the obsessive-compulsive spectrum in the early 1990s, and have described its breadth and overlap with other psychiatric disorders. While its place in the psychiatric nomenclature is uncertain, the obsessive-compulsive spectrum is intertwined with the anxiety disorders in both its symptoms and biologic substrates.Obsessive-compulsive disorder (OCD) has an important place at the center of the spectrum. While currently classified in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition as an anxiety disorder, OCD is distinct from these conditions in the International Classification of Diseases. There is a strong rationale for its separation from the anxiety disorders. First, OCD often begins in childhood, whereas other anxiety disorders typically have a later age of onset. OCD has a nearly equal gender distribution, unlike the other anxiety disorders, which are more common in women. Studies of psychiatric comorbidity show that, unlike the other anxiety disorders, persons with OCD generally tend not to have elevated rates of substance misuse. Family studies suggest that first-degree relatives of persons with OCD have an elevated prevalence of OCD-related disorders including body dysmorphic disorder, hypochondriasis, and grooming disorders, but not other anxiety disorders except for generalized anxiety disorder. The brain circuitry that mediates OCD appears to be different from that involved in other anxiety disorders. Lastly, OCD is unique with regard to its specific response to selective serotonin reuptake inhibitors, while noradrenergic medications, effective in the anxiety and mood disorders, are largely ineffective. On the other hand, the benzodiazepines, which have little effect on OCD, are often effective for the other anxiety disorders.

scholarly journals Comparative Prevalence of Eating Disorders in Obsessive-Compulsive Disorder and Other Anxiety Disorders

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Himanshu Tyagi ◽  
Rupal Patel ◽  
Fabienne Rughooputh ◽  
Hannah Abrahams ◽  
Andrew J. Watson ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Obsessive Compulsive Disorder ◽  
Geographical Area ◽  
Primary Diagnosis ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Significant Difference

Objective. The purpose of this study was to compare the prevalence of comorbid eating disorders in Obsessive-Compulsive Disorder (OCD) and other common anxiety disorders.Method. 179 patients from the same geographical area with a diagnosis of OCD or an anxiety disorder were divided into two groups based on their primary diagnosis. The prevalence of a comorbid eating disorder was calculated in both groups.Results. There was no statistically significant difference in the prevalence of comorbid eating disorders between the OCD and other anxiety disorders group.Conclusions. These results suggest that the prevalence of comorbid eating disorders does not differ in anxiety disorders when compared with OCD. However, in both groups, it remains statistically higher than that of the general population.

scholarly journals Schizophrenia with Co-morbid Obsessive-Compulsive Disorder: A Case Series

2021 ◽  
pp. 69-74
Author(s):  
Prakash B. Behere ◽  
Pooja Raikar ◽  
Debolina Chowdhury ◽  
Aniruddh P. Behere ◽  
Richa Yadav
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Negative Symptoms ◽  
Age Of Onset ◽  
Case Series ◽  
Post Traumatic Stress ◽  
Obsessive Compulsive ◽  
Course Of Illness ◽  
Obsessive Compulsive Symptoms ◽  
Compulsive Disorder

The frequency of co-morbidities like Obsessive Compulsive Disorder (OCD) is common in schizophrenia. Some studies have reported earlier age of onset, more positive and negative symptoms, more depressive symptoms, and worse prognosis in such patients. The phenomenology and management of OCD in schizophrenia is understudied. Evidence claims that the course of illness of both schizophrenia and bipolar disorders may be affected by obsessive-compulsive disorder whereas in other cases antipsychotic induced obsessive-compulsive symptoms have been observed. A meta-analysis of of schizophrenia and its co-morbid psychiatric conditions, found a prevalence of 12.1% for obsessive compulsive disorder, 9.8% for panic disorders, 12.4% for post-traumatic stress disorder and 14.9% for social phobia. SGAs like amisulpride and aripiprazole are found to be useful in the treatment of comorbid OCD in schizophrenia due to their negligible serotonergic properties. A combination of selective serotonin reuptake inhibitors (SSRI) with antipsychotics has been recommended by the American Psychiatric Association (APA) for treatment of comorbid OCD in schizophrenia. Escitalopram at a dose of 20 mg/day has been found to be beneficial in such cases while psychosis worsened with the use of fluvoxamine and clomipramine. Below is a series of seven cases of schizophrenia with co-morbid obsessive-compulsive symptoms who are on treatment for their illness from the psychiatric outpatient department of a rural hospital in central India.

Patterns of Reassurance Seeking and Reassurance-Related Behaviours in OCD and Anxiety Disorders

2012 ◽  
Vol 41 (1) ◽  
pp. 1-23 ◽  
Author(s):  
Osamu Kobori ◽  
Paul M. Salkovskis
Keyword(s):  
Panic Disorder ◽  
Anxiety Disorders ◽  
Obsessive Compulsive Disorder ◽  
Reliability And Validity ◽  
The Other ◽  
Self Report ◽  
Healthy Controls ◽  
Obsessive Compulsive ◽  
Reassurance Seeking ◽  
Compulsive Disorder

Background: Reassurance seeking is particularly prominent in obsessive-compulsive disorder (OCD) and may be important in OCD maintenance. Aims: This study used a new self-report questionnaire to measure the range of manifestations of reassurance-seeking behaviours, describing their sources from which they seek, frequency, process (how they seek), and consequences (as opposed to triggers and motivations). This study also attempts to identify the degree to which reassurance is specific to OCD as opposed to panic disorder. Method: Reassurance Seeking Questionnaire (ReSQ) was administered to 153 individuals with OCD, 50 individuals with panic disorder with/without agoraphobia, and 52 healthy controls. The reliability and validity of the measure was evaluated and found to be satisfactory. Results: Reassurance seeking was found to be more frequent in both anxiety disorders relative to healthy controls. Individuals diagnosed with OCD were found to seek reassurance more intensely and carefully, and were more likely to employ “self-reassurance” than the other two groups. Conclusions: Further investigation of reassurance will enable better understanding of its role in the maintenance of anxiety disorders in general and OCD in particular.

Panic Attacks and Anxiety Disorders

2020 ◽  
Author(s):  
Curtis Wittmann
Keyword(s):  
Emergency Department ◽  
Anxiety Disorder ◽  
Panic Disorder ◽  
Anxiety Disorders ◽  
Obsessive Compulsive Disorder ◽  
Stress Disorder ◽  
Acute Stress ◽  
Panic Attacks ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

This review discusses the acute diagnosis and management of panic and anxiety disorders. Anxiety disorders are among the most common psychiatric disorders in the country and are a relatively common cause of presentation to the emergency department. Most anxiety disorders can be conceptualized as fear- or phobia-based disorders, including panic disorder, specific phobia, social phobia, acute stress disorder, posttraumatic stress disorder, and obsessive-compulsive disorder. Each of these disorders is discussed, including prevalence and common clinical presentations. The initial evaluation of patients with a suspected or diagnosed anxiety disorder will be based on their current symptoms. Some patients may be highly agitated and may require deescalation or sedation to perform a reasonable history and physical examination. To achieve this, providers should ensure their own safety first, with attention to the physical layout of the emergency department, ensuring that they are closer to the room exit than the patient (so that they cannot be trapped). The presence of police or security may be necessary to provide optimal care and an appropriate evaluation. Typical treatment of acute exacerbations of anxiety disorders includes medical management, most often benzodiazepines, which can provide immediate relief. Psychiatric consultation may be necessary in certain cases. For most patients, outpatient management rather than inpatient admission will lead to the most effective management of their anxiety.   Key words: anxiety disorder, obsessive-compulsive disorder, panic disorder, phobia, stress disorder This review contains 1 highly rendered figure, 17 tables, and 29 references.

Overview of Diagnosis and Drug Treatments of Anxiety Disorders

CNS Spectrums ◽  
2005 ◽  
Vol 10 (1) ◽  
pp. 49-56 ◽  
Author(s):  
David J. Nutt
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Drug Treatments ◽  
The Common

AbstractAnxiety disorders are common and often disabling. They fall into five main categories: panic disorder, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder and posttraumatic stress disorder, each of which have characteristic symptoms and cognitions. All anxiety disorders respond to drugs and psychological treatments. This review will focus on drug treatments. Recent research has emphasized the value of antidepressants especially the selective serotonin reuptake inhibitors, benzodiazepines, and related sedative-like compounds. The common co-existence of depression with all of the anxiety disorders means that the selective serotonin reuptake inhibitors are now generally considered to be the first-line treatments but the benzodiazepines have some utility especiaRy in promoting sleep and working acutely to reduce extreme distress.

Obsessive-Compulsive Disorder

2009 ◽  
Author(s):  
Vladan Starcevic, MD, PhD
Keyword(s):  
Anxiety Disorders ◽  
Obsessive Compulsive Disorder ◽  
Clinical Features ◽  
Age Of Onset ◽  
Clinical Manifestations ◽  
Severity Of Illness ◽  
Repetitive Behaviors ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Close Relationship

As its name implies, the main characteristics of obsessive-compulsive disorder (OCD) are obsessions and/or compulsions. Different types of obsessions and compulsions make OCD a heterogeneous condition. Also, OCD exists on a continuum from mild cases to those with extremely severe and incapacitating manifestations generally not seen in other anxiety disorders. Clinical manifestations of OCD are striking and leave few people who observe them unimpressed. This is arguably due to the seriousness with which persons with OCD take their own obsessions and compulsions along with concurrent realization that these same obsessions and compulsions are senseless and should be gotten rid of. Indeed, there are few other examples in psychopathology where insight and deficiency of insight stand together, and where espousing and fighting the absurd are so intertwined. For all these reasons, OCD is often portrayed as a puzzling or intriguing disorder; in addition, it often represents a treatment challenge. Obsessive-compulsive disorder is probably the least controversial condition within the anxiety disorders because its clinical features are well described and relatively easily recognized and because hardly anyone doubts its existence as a psychopathological entity. What is controversial about OCD, however, is where it belongs and how it should be classified. This is a consequence of a number of features of OCD that make it look different from other anxiety disorders and of the close relationship that OCD has with some conditions outside of the realm of anxiety disorders. Listed below are a number of key questions about OCD…. 1. In view of its different clinical features and the vastly different severity of these features, should OCD be considered a unitary condition or divided into subtypes? 2. If OCD is to be divided into subtypes, on the basis of what criteria should it be done? Types of obsessions and compulsions, reasons for performing compulsions, severity of illness, degree of insight, age of onset, or something else? 3. Should neutralizing responses other than compulsions be given a more prominent role in the description and conceptualization of OCD? 4. How does insight contribute to the conceptualization of OCD? 5. What are the core features of OCD? Is OCD primarily an affective disorder, is it characterized by a primary disturbance in thinking, or is it essentially a disorder of repetitive behaviors?

Obsessional states: anxiety disorders or schizotypes? An information processing and personality assessment

1990 ◽  
Vol 20 (3) ◽  
pp. 621-627 ◽  
Author(s):  
Simon J. Enright ◽  
Anthony R. Beech
Keyword(s):  
Information Processing ◽  
Anxiety Disorder ◽  
Selective Attention ◽  
Anxiety Disorders ◽  
Obsessive Compulsive Disorder ◽  
Personality Assessment ◽  
Normal Population ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Inhibitory Mechanisms

SynopsisThis paper presents evidence that on an information processing task, designed to investigate putative inhibitory mechanisms in selective attention, obsessive compulsive disordered individuals can be clearly distinguished from other anxiety disorder clients and show significantly higher scores on questionnaire measures designed to detect schizotypy in the normal population. It is suggested that these results provide some support for the idea that obsessive compulsive disorder may be misclassified as an anxiety disorder and may in fact be categorically more closely aligned to the schizophrenic constellation of disorders.

Combination Pharmacotherapy and Psychotherapy for the Treatment of Major Depressive and Anxiety Disorders

2015 ◽  
Author(s):  
Cindy J. Aaronson ◽  
Gary Katzman ◽  
Rachel L. Moster
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Posttraumatic Stress ◽  
Obsessive Compulsive Disorder ◽  
Randomized Clinical Trials ◽  
Stress Disorder ◽  
Obsessive Compulsive ◽  
Major Depressive ◽  
Compulsive Disorder

Clinical wisdom and intuition suggest that when treating major depression and/or anxiety disorders, combining two documented efficacious treatments such as antidepressants and psychotherapy would improve outcome. However, the data do not completely support this conclusion. This chapter reviews randomized clinical trials comparing combined pharmacotherapy and psychotherapy with monotherapy for the treatment of major depressive disorder, panic disorder, obsessive-compulsive disorder, posttraumatic stress disorder, generalized anxiety disorder, and social anxiety disorder in adults. Although DSM-V no longer categorizes posttraumatic stress disorder and obsessive-compulsive disorder as anxiety disorders, the authors continue to include them in this chapter.

Is obsessive–compulsive disorder an anxiety disorder, and what, if any, are spectrum conditions? A family study perspective

2011 ◽  
Vol 42 (1) ◽  
pp. 1-13 ◽  
Author(s):  
O. J. Bienvenu ◽  
J. F. Samuels ◽  
L. A. Wuyek ◽  
K.-Y. Liang ◽  
Y. Wang ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Obsessive Compulsive Disorder ◽  
Family Study ◽  
General Pattern ◽  
Family Data ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
First Degree Relatives ◽  
Co Morbidity

BackgroundExperts have proposed removing obsessive–compulsive disorder (OCD) from the anxiety disorders section and grouping it with putatively related conditions in DSM-5. The current study uses co-morbidity and familiality data to inform these issues.MethodCase family data from the OCD Collaborative Genetics Study (382 OCD-affected probands and 974 of their first-degree relatives) were compared with control family data from the Johns Hopkins OCD Family Study (73 non-OCD-affected probands and 233 of their first-degree relatives).ResultsAnxiety disorders (especially agoraphobia and generalized anxiety disorder), cluster C personality disorders (especially obsessive–compulsive and avoidant), tic disorders, somatoform disorders (hypochondriasis and body dysmorphic disorder), grooming disorders (especially trichotillomania and pathological skin picking) and mood disorders (especially unipolar depressive disorders) were more common in case than control probands; however, the prevalences of eating disorders (anorexia and bulimia nervosa), other impulse-control disorders (pathological gambling, pyromania, kleptomania) and substance dependence (alcohol or drug) did not differ between the groups. The same general pattern was evident in relatives of case versus control probands. Results in relatives did not differ markedly when adjusted for demographic variables and proband diagnosis of the same disorder, though the strength of associations was lower when adjusted for OCD in relatives. Nevertheless, several anxiety, depressive and putative OCD-related conditions remained significantly more common in case than control relatives when adjusting for all of these variables simultaneously.ConclusionsOn the basis of co-morbidity and familiality, OCD appears related both to anxiety disorders and to some conditions currently classified in other sections of DSM-IV.

Obsessive–compulsive disorder and separation anxiety co-morbidity in early onset panic disorder

2001 ◽  
Vol 31 (7) ◽  
pp. 1307-1310 ◽  
Author(s):  
R. GOODWIN ◽  
J. D. LIPSITZ ◽  
T. F. CHAPMAN ◽  
S. MANNUZZA ◽  
A. J. FYER
Keyword(s):  
Anxiety Disorder ◽  
Panic Disorder ◽  
Obsessive Compulsive Disorder ◽  
Separation Anxiety ◽  
Age Of Onset ◽  
Separation Anxiety Disorder ◽  
Obsessive Compulsive ◽  
Obsessive Compulsive Symptoms ◽  
Compulsive Disorder ◽  
Co Morbidity

Background. This study was undertaken to examine the relationship between anxiety co-morbidity and age of onset of panic disorder.Methods. Age of onset of panic disorder and co-morbid anxiety disorders were assessed among 201 panic disorder probands with childhood separation anxiety disorder, obsessive–compulsive disorder, obsessive–compulsive symptoms, social phobia and specific phobia as part of a clinician-administered lifetime diagnostic interview. A generalized linear model was used to test the association between each anxiety co-morbidity and age of panic disorder onset while simultaneously controlling for the potential confounding effects of sociodemographic characteristics and other psychiatric co-morbidity.Results. Earlier onset of panic disorder was found in patients with co-morbid obsessive–compulsive disorder, obsessive–compulsive symptoms and separation anxiety disorder, but not simple phobia or social phobia. Patients with both childhood separation anxiety disorder and obsessive–compulsive disorder had an even earlier panic onset than those with either childhood separation anxiety disorder or obsessive–compulsive disorder.Conclusions. The association between anxiety co-morbidity and earlier onset of panic disorder is specific to obsessive–compulsive disorder and childhood separation anxiety disorder.

Sign in / Sign up

Export Citation Format

Share Document