Obsessive-Compulsive Disorder Spectrum as a Scientific “Metaphor”

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S14) ◽  
pp. 6-15 ◽  
Author(s):  
Stefano Pallanti ◽  
Eric Hollander

AbstractAs a result of clinical, epidemiological, neuroimaging, and therapy studies that took place in the late 1980s, obsessive-compulsive disorder (OCD) has been well-characterized in the field of anxiety disorders. Other disorders attracted attention for their similarities to OCD, and were located in the orbit of the disorder. OCD has become known as the “primary domain” of a scientific “metaphor” comprising the putative cluster of OCD-related disorders (OCRDs). It is a “paradigm” with which to explore basal ganglia dysfunction. The OCRDs share common phenomenology, comorbidities, lifetime course, demographics, possible genetics, and frontostriatal dysfunction (particularly caudate hyperactivity.) The adoption of this metaphor analogy has proven useful. However, 15 years since its emergence, the spectrum of obsessive-compulsive disorders remains controversial. Questions under debate include whether OCD is a unitary or split condition, whether it is an anxiety disorder, and whether there exists only one spectrum or several possible spectrums. Further work is needed to clarify obsessive-compulsive symptoms, subtypes, and endophenotypes. There is need to integrate existing databases, better define associated symptom domains, and create a more comprehensive endophenotyping protocol for OCRDs. There is also a need to integrate biological and psychological perspectives, concepts, and data to drive this evolution. By increasing research in this field, the OCD spectrum may evolve from a fragmented level of conceptualization as a “metaphor” to one that is more comprehensive and structured.

Author(s):  
Philip Cowen ◽  
Paul Harrison ◽  
Tom Burns

Chapter 9 discusses how the symptom of anxiety is found in many disorders. In the anxiety disorders, it is the most severe and prominent symptom, and it is also prominent in the obsessional disorders, although these are characterizedby their striking obsessional symptoms. In DSM-IV, obsessive–compulsive disorder is classifi ed as a type of anxiety disorder, but in ICD-10 it is classified separately. We have followed the DSM convention and included obsessional disorders in this chapter, as well as covering generalized anxiety disorder (GAD), phobias, panic, mixed anxiety and depression, transcultural variations, and obsessive-compulsive disorder (OCD).


1999 ◽  
Vol 54 (6) ◽  
pp. 213-221 ◽  
Author(s):  
Alex S. S. Freire Maia ◽  
Egberto Reis Barbosa ◽  
Paulo Rossi Menezes ◽  
Eurípedes C. Miguel Filho

Obsessive-compulsive disorder (OCD) has been reported in association with some neurological diseases that affect the basal ganglia such as Tourette's syndrome, Sydenham's chorea, Parkinson's disease, and Huntington's disease. Furthermore, studies such as neuroimaging, suggest a role of the basal ganglia in the pathophysiology of OCD. The aim of this paper is to describe the association of OCD and several neurologic disorders affecting the basal ganglia, report the existing evidences of the role of the basal ganglia in the pathophysiology of OCD, and analyze the mechanisms probably involved in this pathophysiology.


2020 ◽  
Vol 14 ◽  
Author(s):  
Mei-Xue Dong ◽  
Guang-Hui Chen ◽  
Ling Hu

Objective: The dopaminergic system is involved in many psychiatric disorders as a GABAergic, serotonergic, and glutamatergic system. A systematic review and meta-analysis was performed to elucidate the alteration of the dopaminergic system in anxiety and compulsive disorders.Methods: The databases of Pubmed, Embase, and ScienceDirect were searched and articles reporting the involvement of the dopaminergic system in patients with anxiety disorder and obsessive compulsive disorder (OCD) were recognized. The key research data were extracted from the included articles and standardized mean differences were calculated using meta-analyses if there were more than two studies with obtainable data. Sensitivity analyses were further performed to detect the stability of results, and the qualities of all the included studies were assessed using the Newcastle Ottawa scale.Results: Finally, we identified 8 and 11 studies associated with anxiety disorder and OCD for further analysis, respectively. Most consistently, the striatal dopamine D2 receptor (D2R) of OCD patients had decreased while no significant correlation was found between striatal D2R and disease severity. The striatal dopamine transporter (DAT) had not been significantly altered in both the anxiety disorder and OCD patients. The heterogeneity values from the meta-analyses were extremely high while those results remained stable after sensitivity analyses. Inconsistent data were found in the striatal D2R of patients with anxiety disorder. Limited data had suggested that dopamine synthesis increased in most regions of the cerebral cortex and cerebellum in OCD patients.Conclusions: The most convincing finding was that the D2 receptor decreased in patients with obsessive compulsive disorder. The dopamine transporter may have no relationship with anxiety and compulsive disorder.


2021 ◽  
Vol 9 (06) ◽  
pp. 61-72
Author(s):  
H. Rharbaoui ◽  
◽  
D. Mzamba ◽  
H. Nafiaa ◽  
M. Kadiri ◽  
...  

Introduction: Obsessive-compulsive disorder is characterized by persistent irrational thoughts manifested by repeated actions. These disorders often have an impact on the social life of those who suffer from them, with a tendency towards isolation which can be exacerbated during this period of confinement. Among these disorders, the fear of contamination is very common. This fear is influenced by culture, society, and global health issues. Thus, in 1920, many cases of fear of syphilis emerged following major awareness campaigns pertaining to the disease. In the 1980s, obsessive disorders related to the risk of HIV infection appeared. Likewise, the Covid-19 coronavirus epidemic is likely to cause a significant deal of anxiety for some people with obsessive-compulsive disorder, thus justifying the aggravation of the clinical condition of this category of patients. The hand-washing recommendations that were promoted during the pandemic would prove to be a major trigger for obsessive-compulsive disorder. Quickly, this gesture becomes an obsession and gradually as the virus spreads, experts expect the cases of associated obsessive-compulsive disorders to increase [1]. Closeness between family members and disrupted habits during confinement can lead to conflict, which can increase the frequency of compulsions. Meditation can also increase the flow of uncontrolled thoughts which can promote the emergence of obsessions. During this time of the pandemic, doctors and people with obsessive-compulsive disorders find themselves in a dilemma. On the one hand, to treat obsessive-compulsive disorders, hand washing is prohibited, and on the other hand, to prevent the spread of the virus, hand washing is strongly recommended. Covid-19 can therefore be an unbearable nightmare, and harder to manage for people with obsessive-compulsive disorders. Objective: This study aims to assess the psychological repercussions of confinement on patients suffering from obsessive-compulsive disorders during the Covid-19 pandemic, and to underline the link between the aggravation of the symptoms of obsessive-compulsive disorder and the underlying perceived stress associated with it. Methodology: This is a descriptive and analytical study, which involves a sample of patients tracked for obsessive-compulsive disorders, and which is founded on collecting their individual information through an anonymous survey, which was submitted via social networks, either by using smartphones or during consultations. As an assessment instrument, in addition to the survey for collecting socio-demographic data, we opted for the Yale-Brown Scale to assess the severity of the symptoms of obsessive-compulsive disorder, as well as the Cohen Perceived Stress Scale (PSS-10) to assess the perceived stress on this group of patients during this pandemic. These scales were chosen because of their frequent use in several studies on the same topic. Results:We collected 102 responses, of which 55% were women 39% of our candidates worked remotely and only 38.8% of patients were able to continue their medical follow-up at the hospital during the confinement. Concerningour results,it was observed that our participants experienced significant changes in terms of the severity of the total symptoms of obsessive-compulsive disorder during the period of confinement with an accentuation of 90% of the symptoms of contamination and 53.8% of the hands washing compulsions during the Covid-19 pandemic. Respondents, who had symptoms of obsessive-compulsive disorder, since the onset of Covid-19, were the only ones who were significantly more likely to be vulnerable to moderately high stress. Likewise, respondents who compulsively washed their hands were significantly more likely to experience vulnerability to moderate to high stress. 45.3% of our applicants were extremely anxious, 33% were very anxious, and 21.7% were anguished to a tolerable level, with a rate of 75.5% of patients developing a social handicap or an inability to function. The sample showed that subjects who could not work or study from a remote position during the quarantine, those who lived with a relative in the same house during the quarantine, and those who showed symptoms of contamination, had significantly greater aggravation of the obsessive-compulsive disorder total symptoms during the confinement. Effects were not significant for other variables including gender, use of online social network sites and applications during the quarantine and remission status on obsessive-compulsive disorder symptoms before quarantine. Conclusion: Our results suggest that the stressful period of the pandemic is associated with a significant worsening of symptoms on patients with obsessive-compulsive disorder, particularly on those with contamination obsessions and washing compulsions. Having obsessive-compulsive disorder would increase the likelihood of experiencing significant stress during this pandemic.


2017 ◽  
Vol 41 (S1) ◽  
pp. S321-S322
Author(s):  
K. Najafi ◽  
Y. Fakour ◽  
H. Zarrabi ◽  
S.M.R. Khalkhali ◽  
N. Ramezanghorbani ◽  
...  

IntroductionDirect brain stimulation with electrical currents is an effective treatment for depression and considering is an effective supplementary treatment of resistant obsessive-compulsive disorder.AimAssess the effects of brain stimulation with direct electrical current in the treatment of resistant obsessive-compulsive disorders.MethodsThe present study is a paired clinical trial conducted in a group of 42 patients diagnosed with treatment resistant obsessive-compulsive disorder in the province of Rasht. Direct brain stimulation with electrical current was performed according to the protocol throughout the 15 treatment sessions. The effectiveness of the first, fifth, tenth and fifteenth session(s) of treatment were evaluated based on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and results were analyzed using Repeated Measure ANOVA, Spearman Correlation and Pearson Correlation software SPSS version 22.ResultsAll 42 participants stayed throughout the study. Mean age of patients was 10.14 ± 29.10. Mean test scores of Yale-Brown Obsessive Compulsive Scale in the first, fifth, tenth and fifteenth session of treatment was 6.78 ± 28.4, 4.58 ± 22.8, 6.3 ± 16.4 and 5.37 ± 10.8,respectively which is significantly lower (P-value = 0.00, F = 80.12). No significant correlation was observed between the participant's age, sex, education level, marital status and employment status and in any of the test scores of Yale-Brown Obsessive Compulsive Scale in the first, fifth, tenth and fifteenth session of treatment (P-value > 0.05).ConclusionIn order to attain a sustainable long term effects of the proposed treatment, it is recommended that patients be reminded on their next schedule of treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.


Author(s):  
Wuqianhui Liu ◽  
Haitao Zhang ◽  
Yuan He

The Coronavirus Disease 2019 (COVID-19) exerts variable impact on patients with obsessive compulsive disorders (OCD). There remains a challenge to determine the extent to which OCD is exacerbated due to the pandemic. Therefore, our aim is to explicate the latest researching progress of OCD under COVID-19 based on a review of 15 existing articles. Our review confirms the prevalence of OCD exacerbation in different age groups and particular symptoms. However, it also reveals nonconformity among research, lack of investigation in OCD treatment, and imbalance in OCD symptoms research. Further, we discuss the probable reasons of the exacerbation and current situation of OCD treatments. Finally, based on our discussion, we offer suggestions on how to manage OCD under the new circumstance, including the introduction of new policies, the use of communications technology, the improvement of researching methods, and possible angles for further research.


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