Neurological Soft Signs in Obsessive Compulsive Disorder: Standardised Assessment and Comparison with Schizophrenia

While several studies have detected raised levels of neurological soft signs in patients with obsessive compulsive disorder (OCD), the specificity of these abnormalities remains uncertain. This study used a new standardised measure, the Cambridge Neurological Inventory (CNI), to assess soft signs in 51 subjects with OCD. Comparison was made with data on patients with schizophrenia and a non-clinical control group from a previously reported study. Individuals with OCD showed raised levels of soft signs compared with non-clinical controls in many categories of the CNI: Motor Coordination, Sensory Integration, Primitive Reflexes, Extrapyramidal Signs, and Failure of Suppression. Compared with patients with schizophrenia, the OCD group had lower levels of neurological signs in some CNI categories: Hard Signs, Motor Co-ordination, Tardive Dyskinesia, Catatonic Signs, and Extrapyramidal Signs. However, levels of soft signs in the OCD group did not significantly differ from those in the schizophrenia group in other CNI categories: Sensory Integration, Primitive Reflexes and Failure of Suppression. The significance of these patterns of findings is discussed.

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Neurological soft signs in obsessive-compulsive disorder: two empirical studies and meta-analysis

Psychological Medicine ◽

10.1017/s0033291712002012 ◽

2012 ◽

Vol 43 (5) ◽

pp. 1069-1079 ◽

Cited By ~ 14

Author(s):

N. Jaafari ◽

L. Fernández de la Cruz ◽

M. Grau ◽

E. Knowles ◽

J. Radua ◽

...

Keyword(s):

Obsessive Compulsive Disorder ◽

Motor Coordination ◽

Meta Analysis ◽

Empirical Studies ◽

The Body ◽

Healthy Controls ◽

Obsessive Compulsive ◽

Neurological Soft Signs ◽

Definitive Answer ◽

Compulsive Disorder

BackgroundNeurological soft signs (NSS) have been inconsistently reported in obsessive-compulsive disorder (OCD) but may make an impact on treatment response.MethodThe current study examined the presence of NSS in two independent European samples of OCD patients (combined 85 patients and 88 matched healthy controls) using a standardized instrument and conducted a meta-analysis of all published studies identified in the literature with the aim to provide a more definitive answer to the question of whether OCD patients are characterized by increased NSS.ResultsBoth empirical studies found elevated NSS scores in patients compared with matched controls. The results of the meta-analysis, which included 15 studies (combined 498 patients and 520 controls) showed large effect sizes (Hedges' g=1.27, 95% confidence interval 0.80–1.75), indicating that OCD patients have significantly higher rates of NSS than matched controls on both sides of the body and in multiple domains (motor coordination, sensory integration and primitive reflexes). The results were robust and remained largely unchanged in our reliability analyses, which controlled for possible outliers. Meta-regression was employed to examine the role of potential variables of interest including sociodemographic variables, symptom severity, medication effects and the use of different instruments, but none of these variables was clearly associated with NSS.ConclusionsAs a group, OCD patients are characterized by increased rates of NSS, compared with healthy controls. However, their origins and potential clinical importance remain to be clarified. Future directions for research are discussed.

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Neurological soft signs in schizophrenia and obsessive compulsive disorder spectrum

European Psychiatry ◽

10.1016/j.eurpsy.2010.03.005 ◽

2012 ◽

Vol 27 (3) ◽

pp. 192-199 ◽

Cited By ~ 12

Author(s):

S. Tumkaya ◽

F. Karadag ◽

N.K. Oguzhanoglu

Keyword(s):

Obsessive Compulsive Disorder ◽

Neurodevelopmental Disorders ◽

Sensory Integration ◽

Normal Population ◽

Audiovisual Integration ◽

Obsessive Compulsive ◽

Neurological Soft Signs ◽

Obsessive Compulsive Symptoms ◽

Compulsive Disorder ◽

Schizophrenia Group

AbstractObsessive compulsive symptoms are more frequent in patients with schizophrenia compared to normal population. Patients with obsessive compulsive disorder may also exhibit psychosis-like symptoms. Based on these findings, it has been suggested that there is a spectrum of disorders between OCD and schizophrenia. We compared two OCD groups (with good and poor insight) and two schizophrenia groups (with and without OCD) in this recommended spectrum especially in terms of neurological soft signs (NSSs) associated with sensory integration. The schizophrenia with OCD (schizo-obsessive) group exhibited worse performance than the schizophrenia group (p = 0.002) in only graphesthesia tasks. Moreover, schizo-obsessive patients exhibited worse performance compared to OCD patients in terms of graphesthesia (p = 0.001) and audiovisual integration (p = 0.001). Interestingly, OCD patients with poor insight tended to exhibit graphesthesia deficit in a similar manner to schizo-obsessive patients rather than OCD patients. According to our results, graphesthesia disorder is strongly associated both with OCD and schizophrenia. This suggests that neurodevelopmental disorders that lead to graphesthesia disorder overlap in comorbid OCD and schizophrenia patients.

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Reducing the Social Stigma Associated with Obsessive Compulsive Disorder: A Controlled Trial of an Intervention Program in a Turkish Community Sample

Journal of Evidence-Based Psychotherapies ◽

10.24193/jebp.2020.2.14 ◽

2020 ◽

Vol 20 (2) ◽

pp. 101-120

Author(s):

Ayça Aktaç Gürbüz ◽

Orçun YORULMAZ ◽

Gülşah DURNA

Keyword(s):

Obsessive Compulsive Disorder ◽

Intervention Program ◽

Controlled Trial ◽

Community Sample ◽

Case Vignette ◽

Control Group ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Significant Difference ◽

The Impact

Scientific research into the reduction of stigmatization, particularly related to specific problems such as Obsessive-Compulsive Disorder (OCD), is scarce. In the present study, we examine the impact of a video-based antistigma intervention program for OCD in a pretest-posttest control group research. After being randomly assigned to either an intervention (n= 101) or control group (n= 96), the participants reported their attitudes on a hypothetical case vignette before and after OCD vs. Multiple Sclerosis (MS) videos, and again six months later as a follow up assessment. The mixed design analyses for the group comparisons indicated that although there was no significant difference in the measures of the control group, the participants watching the anti-stigma OCD video, in which the focus was psychoeducation and interaction strategies, reported significantly lower scores on social distances and negative beliefs for the case vignettes they read, and this difference was maintained six months later. Then, the present results indicate the effectiveness of our anti-stigma intervention program for OCD. Interventions to reduce stigmatization can also be viewed as effective tools for changing the attitudes of people toward OCD, although further research and applications are needed related to specific disorders if a longlasting impact is to be achieved.

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Childhood neuropsychological deficits associated with adult obsessive–compulsive disorder

The British Journal of Psychiatry ◽

10.1192/bjp.bp.108.056812 ◽

2009 ◽

Vol 195 (2) ◽

pp. 138-141 ◽

Cited By ~ 27

Author(s):

Jessica R. Grisham ◽

Tracy M. Anderson ◽

Richie Poulton ◽

Terrie E. Moffitt ◽

Gavin Andrews

Keyword(s):

Executive Functioning ◽

Obsessive Compulsive Disorder ◽

Verbal Ability ◽

Neuropsychological Deficits ◽

Control Group ◽

Developmental Study ◽

Obsessive Compulsive ◽

Cross Sectional ◽

Compulsive Disorder ◽

Visuomotor Skills

BackgroundExisting neuropsychological studies of obsessive–compulsive disorder (OCD) are cross-sectional and do not provide evidence of whether deficits are trait-related (antecedent and independent of symptomatology) or state-related (a consequence, dependent on symptomatology).AimsTo investigate whether there are premorbid neuropsychological deficits associated with adult OCD.MethodLongitudinal data were collected from participants of the Dunedin Multidisciplinary Health and Developmental study. Neuropsychological data collected at age 13 were linked with age 32 diagnosis of OCD.ResultsThe group who had OCD at age 32 differed significantly from the control group with no OCD on their performance at age 13 on neuropsychological tests of visuospatial, visuoconstructive and visuomotor skills, controlling for gender and socioeconomic status, but did not differ on tests of general IQ or verbal ability. Performance of the group with OCD on tests of executive functioning was mixed.ConclusionsIndividuals with OCD have premorbid impairment in visuospatial abilities and some forms of executive functioning, consistent with biological models of OCD.

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Disturbed Monitoring and Response Inhibition in patients with Gilles De La Tourette Syndrome and Co-Morbid Obsessive Compulsive Disorder

Behavioural Neurology ◽

10.1155/2003/832906 ◽

2003 ◽

Vol 14 (1-2) ◽

pp. 29-37 ◽

Cited By ~ 45

Author(s):

Sandra Verena Müller ◽

Sönke Johannes ◽

Berdieke Wieringa ◽

Axel Weber ◽

Kirsten Müller-Vahl ◽

...

Keyword(s):

Executive Functions ◽

Obsessive Compulsive Disorder ◽

Tourette Syndrome ◽

Response Inhibition ◽

Error Detection ◽

Neuropsychological Tests ◽

Cognitive Domain ◽

Control Group ◽

Obsessive Compulsive ◽

Compulsive Disorder

Objective:Fronto-striatal dysfunction has been discussed as underlying symptoms of Tourette syndrome (TS) with co-morbid Obsessive Compulsive Disorder (OCD). This suggests possible impairments of executive functions in this disorder, which were therefore targeted in the present study.Results:A comprehensive series of neuropsychological tests examining attention, memory and executive functions was performed in a group of 14 TS/OCD in co-occurrence with OCD patients and a matched control group.Results:While attentional and memory mechanisms were not altered, TS/OCS patients showed deficits in executive functions predominately in the areas of response inhibition and action monitoring.Conclusions:These findings provide further evidence for a substantial impairment of the frontal-striatal-thalamic-frontal circuit. We propose that the deficits in monitoring, error detection and response inhibition constitute the major impairment of TS/OCD patients in the cognitive domain.

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Voxel-wise meta-analysis of grey matter changes in obsessive–compulsive disorder

The British Journal of Psychiatry ◽

10.1192/bjp.bp.108.055046 ◽

2009 ◽

Vol 195 (5) ◽

pp. 393-402 ◽

Cited By ~ 441

Author(s):

Joaquim Radua ◽

David Mataix-Cols

Keyword(s):

Obsessive Compulsive Disorder ◽

Grey Matter ◽

Antidepressant Treatment ◽

Meta Analysis ◽

Anterior Cingulate ◽

Control Group ◽

Grey Matter Volume ◽

Obsessive Compulsive ◽

Caudate Nuclei ◽

Compulsive Disorder

BackgroundSpecific cortico-striato-thalamic circuits are hypothesised to mediate the symptoms of obsessive–compulsive disorder (OCD), but structural neuroimaging studies have been inconsistent.AimsTo conduct a meta-analysis of published and unpublished voxel-based morphometry studies in OCD.MethodTwelve data-sets comprising 401 people with OCD and 376 healthy controls met inclusion criteria. A new improved voxel-based meta-analytic method, signed differential mapping (SDM), was developed to examine regions of increased and decreased grey matter volume in the OCD group v. control group.ResultsNo between-group differences were found in global grey matter volumes. People with OCD had increased regional grey matter volumes in bilateral lenticular nuclei, extending to the caudate nuclei, as well as decreased volumes in bilateral dorsal medial frontal/anterior cingulate gyri. A descriptive analysis of quartiles, a sensitivity analysis as well as analyses of subgroups further confirmed these findings. Meta-regression analyses showed that studies that included individuals with more severe OCD were significantly more likely to report increased grey matter volumes in the basal ganglia. No effect of current antidepressant treatment was observed.ConclusionsThe results support a dorsal prefrontal–striatal model of the disorder and raise the question of whether functional alterations in other brain regions commonly associated with OCD, such as the orbitofrontal cortex, may reflect secondary compensatory strategies. Whether the reported differences between participants with OCD and controls precede the onset of the symptoms and whether they are specific to OCD remains to be established.

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Assessment of in Obsessive Compulsive Disorder

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i1030915 ◽

2021 ◽

pp. 105-114

Author(s):

Sarah Alaa Mohsen ◽

Fatma Ahmed El Deeb ◽

Ehab Sayed Ramadan ◽

Mai Abd El-Raouf Eissa

Keyword(s):

Obsessive Compulsive Disorder ◽

Test Performance ◽

Age Of Onset ◽

Neuropsychological Test ◽

Control Group ◽

Obsessive Compulsive ◽

Cross Sectional ◽

Compulsive Disorder ◽

Group I ◽

Significant Difference

Background: Obsessive compulsive disorder (OCD) is a common and potentially debilitating disorder. Neuropsychological assessment provides unique complementary information that is critical for evaluating higher cortical abilities. This study aimed to assess the neuropsychological functions in OCD patients which can then point to the brain structures or pathways and to study the correlation between these assessments and different clinical variables. Methods: This cross-sectional case control study had included sixty patients who were divided into two groups, Group I: thirty OCD patients diagnosed by DSM-IV and Group II: thirty healthy controls who were recruited from the community, matched with patients’ age, gender, and education. Results: The age of onset in our study was 19.13 ± 0.35 years, the mean duration was 7.44 ± 3.88 years, 40% of the studied cases had severe OCD symptoms and 33.3% of them were compulsive cleaners. There was a high significant difference between the two groups regarding WCST in favor of the control group. There was a high significant difference between the two groups regarding ROCF where the control group showed better results than the OCD patients. Conclusions: Neuropsychological test performance remains an informative and objective means of investigation, especially when applied to psychiatric disorders. The executive functions in OCD patients were impaired in comparison to the normal study subjects.

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The prevalence of autism spectrum traits and autism spectrum disorders in children and adolescents with obsessive compulsive disorder: a systematic review

BJPsych Open ◽

10.1192/bjo.2021.194 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S56-S56

Author(s):

Claire Tiley ◽

Marinos Kyriakopoulos

Keyword(s):

Systematic Review ◽

Children And Adolescents ◽

Obsessive Compulsive Disorder ◽

Functional Impairment ◽

Body Dysmorphic Disorder ◽

Autism Spectrum ◽

Control Group ◽

Obsessive Compulsive ◽

Global Functioning ◽

Compulsive Disorder

AimsAutism Spectrum Disorder (ASD) and Obsessive Compulsive Disorder (OCD) commonly co-occur in children and adolescents (C&A); evidence suggests functional impairment is increased in those diagnosed with both disorders. The aims of this systematic review were: 1) To review studies that report on the prevalence of ASD traits and/or diagnosis in C&A with OCD. 2) To review whether the severity of OCD symptoms is related to the severity of ASD traits in C&A with OCD. 3)To review whether the severity of comorbid ASD traits or diagnosis in C&A with OCD impact on their global functioning.MethodThis systematic review was registered in PROSPERO. Prisma guidelines were followed . Electronic searches were carried out on Pubmed, EMBASE and Psychinfo with the use of selected keywords. Inclusion criteria : 1) Participants up to the age of 18 who had an ICD or DSM diagnosis of OCD. 2) Journal articles published in the English, with no date specifications. 3) Papers evaluating ASD diagnosis or traits, or where data on this could be extracted. Exclusion criteria: 1) Papers looking at OCD related disorders such as body dysmorphic disorder, compulsive skin picking, trichotillomania and hoarding disorder. 2) Samples including adults where C&A data could not be extracted. 3) Posters, abstracts and dissertations.ResultA total of 15 studies were included in the systematic review. Seven of these studies directly compared the prevalence of ASD traits (measured by questionnaires) or diagnosis in OCD to a control group or normative data, with all studies reporting a significant elevation in ASD trait scores and diagnosis in OCD. Ten of the studies reported on the correlation between ASD trait severity and OCD severity. Four studies identified a significant correlation between ASD and OCD total scores or specified subscales. In contrast, one study found significantly elevated OCD scores in an OCD only group when compared to a comorbid OCD and ASD group. Three studies reported on the correlation between ASD scores and functional impairment or compared an OCD only group to a comorbid group. All three studies demonstrated that the presence ASD or ASD traits are associated with elevated scores in global functional impairment.ConclusionIn conclusion, this review suggests that there is an increased prevalence of ASD traits and diagnosis amongst C&A with OCD. Elevated ASD traits within this population are associated with a greater impact on global functioning.

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A-65 Quality Analysis of Deep Brain Stimulation for Obsessive–Compulsive Disorder Using a Neuropsychological Assessment Battery

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acab062.83 ◽

2021 ◽

Vol 36 (6) ◽

pp. 1107-1107

Author(s):

Rachel Kallus ◽

Lauren Bangert ◽

Elana Farace

Keyword(s):

Deep Brain Stimulation ◽

Obsessive Compulsive Disorder ◽

Brain Stimulation ◽

Verbal Learning ◽

Quality Analysis ◽

Control Group ◽

Word Condition ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Deep Brain

Abstract Objective We completed a case study to investigate whether there are cognitive changes after Deep Brain Stimulation (DBS) surgery in the treatment of refractory Obsessive–Compulsive Disorder (OCD) as an initiation of a quality analysis due to increased referrals for this procedure at our institution. Method We evaluated a 21-year-old male before and after bilateral nucleus accumbens DBS placement for OCD. His pre-operative neurosurgery evaluation and brain imaging were unremarkable. Post-operative imaging revealed stable changes of bilateral DBS lead placement. Pre and post-operative neuropsychological testing included measures of mental status, language, memory, attention, and executive functioning. Results A reliable change estimate was obtained for each test. There was no significant change in performance on the Mini-Mental State Exam, Boston Naming Test, Logical Memory I/II, Faces I, Rey Complex Figure Test (RCFT) immediate and delayed recall, Wisconsin Card Sorting Test-64, Trail Making Tests A & B, Letter Fluency, Animal Fluency, and Stroop Color and Word Test (Stroop) color and color-word condition. There was significant decline for all California Verbal Learning Test-Second Edition trials (trials 1–5, short delay recall, and long delay recall) and RCFT recognition. There was significant improvement for the Stroop word condition. Conclusions. Given mixed findings, it is unclear the extent to which DBS impacted this patient’s overall cognitive functioning. Meanwhile, he showed improvement in OCD symptoms, to the degree that he could live alone, maintain employment, and independently manage daily activities. There is need for future studies to examine the cognitive effects of DBS for OCD, with larger samples and a control group.

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