scholarly journals The Evidence before One’s Eyes: A Case Report on Schizo-Obsessive Disorder

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Elliott B. Martin

Obsessive compulsive disorder is still considered primarily an anxiety disorder, though historically there has always been a question of whether obsessive-compulsive symptoms may be more properly considered psychotic in nature, the so-called schizo-obsessive disorder or subtype. A case is presented here of a middle-aged man with debilitating obsessive-compulsive symptoms of sudden onset in his late teens. Given the nature of onset and symptomatology, and the failure of prior therapies, the case was approached as a primary psychotic disorder. The neuroleptic-naive patient had remarkable response to low-dose antipsychotic medication, as well as to psychodynamic psychotherapy modeled along the lines of neuroplasticity. The case illustrates the blurred distinctions among anxiety, mood, and psychotic disorders and the improved outcomes when the proper underlying disorder is addressed.

1998 ◽  
Vol 32 (4) ◽  
pp. 579-581
Author(s):  
Erik Monasterio ◽  
Roger T. Mulder ◽  
Thomas D. Marshall

Objective: We describe the sudden onset of obsessive—compulsive symptoms fol lowing a peritoneal infection with α-haemolytic streptococci. Clinical picture: A 35–year-old woman with no past history or family history of obsessions or compulsions developed these symptoms 2 weeks after a peritoneal infection. Treatment: The patient received 80 mg fluoxetine daily. Outcome: She responded to treatment with a progressive reduction in symptoms. Conclusions: It is suggested that these obsessions and compulsions may be related to an autoimmune response to the streptococcal infection.


2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Jonathan G. Leung ◽  
Brian A. Palmer

One underrecognized adverse event of clozapine is the emergence or worsening of obsessive-compulsive symptoms (OCS). OCS, particularly violent thoughts, can be inaccurately described as psychosis and result in a misdiagnosis. We report a case of a 42-year-old man, initially diagnosed with schizoaffective, who was placed on clozapine for the management of “violent delusions.” However, clozapine led to a worsening of these violent thoughts resulting in suicidal ideation and hospitalization. After exploration of the intrusive thoughts and noting these to be egodystonic, clearly disturbing, and time consuming, an alternative diagnosis of obsessive-compulsive disorder (OCD) was made. Clozapine was inevitably discontinued resulting in a significant reduction of the intrusive thoughts without emergence of psychosis or adverse events. While an overlapping phenomenology between OCD and psychotic disorders has been described, clozapine and other antiserotonergic antipsychotics have been implicated with the emergence or worsening of OCS. Unique to our case is that the patient’s obsessions had been treated as psychosis leading to the inadequate treatment of his primary illness, OCD. This case highlights the potential for OCD to masquerade as a psychotic disorder and reminds clinicians that clozapine may worsen OCS.


2021 ◽  
pp. 216770262199386
Author(s):  
Asher Y. Strauss ◽  
Isaac Fradkin ◽  
Jonathan D. Huppert

Experiencing doubt in an uncertain situation has been theorized to be an antecedent of compulsive checking. However, whether and when obsessive compulsive (OC) symptoms are associated with experiencing doubt and increased checking is unclear. In this study, we investigated the relationship between OC symptoms, the experience of doubt, and checking in a tone-discrimination task. Doubt was measured using mouse tracking, an indirect, unobtrusive measure. The results of two studies ( N = 119) showed that OC symptoms were associated with elevated experiences of doubt when uncertainty was low. However, OC symptoms were not associated with increased checking, but doubt was. Results highlight the utility of mouse-tracking measures to capture the tendency of individuals with OC symptoms to experience doubt even under neutral conditions. The unexpected null results concerning checking suggest some specific directions for research to determine the conditions under which doubt evolves into checking in obsessive compulsive disorder.


2010 ◽  
Vol 4 (1) ◽  
pp. 16-29 ◽  
Author(s):  
Danielle A. Einstein ◽  
Ross G. Menzies ◽  
Tamsen St Clare ◽  
Juliette Drobny ◽  
Fjola Dogg Helgadottir

AbstractData collected from clinical populations indicate that magical ideation (MI) may play a causal or a mediating role in the expression of obsessive compulsive symptoms. If this is the case then when targeted in treatment, symptoms of obsessive compulsive disorder (OCD) should be altered. Two individuals diagnosed with OCD received a trial treatment targeting magical thinking. The intervention consisted of a series of procedures designed to undermine superstitious/MI without targeting obsessions or compulsions. The procedures involved critical analysis of the following material: (1) a free astrology offer; (2) a horoscope prediction exercise; (3) a description of four different cultural explanations of the origin of fire; (4) an instructive guide for Tarot card readers; (5) a report of a UFO sighting; (6) a video-clip describing a cult festival; (7) a description of a ‘hoax’ channeler and (8) a superstition exercise. Measures of obsessive compulsive symptoms, superstition, MI and thought–action fusion were administered pre-treatment, post-treatment and at 3 months’ follow-up. According to the twofold criterion of Jacobson et al. (Behaviour Therapy 1984, 15, 336–352), following treatment the patients were identified as being recovered on measures of magical and superstitious thinking and on the Padua Inventory.


PLoS ONE ◽  
2015 ◽  
Vol 10 (6) ◽  
pp. e0125103 ◽  
Author(s):  
Marije Swets ◽  
Frank Van Dael ◽  
Sabine Roza ◽  
Robert Schoevers ◽  
Inez Myin-Germeys ◽  
...  

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
D. Kontis ◽  
V. Boulougouris ◽  
S. Papadopoulos ◽  
V.-M. Papakosta ◽  
S. Kalogerakou ◽  
...  

Rationale:In the rewarded alternation model of obsessive compulsive disorder (OCD), the serotonin agonist m-chlorophenylpiperazine (mCPP) increases persistent behaviour, while chronic pretreatment with selective serotonin reuptake inhibitor (SSRI-fluoxetine) but not benzodiazepine or desipramine abolishes mCPP effects. However, we noted that acute SSRI administration also causes transient persistence increases, counteracted by mCPP pretreatment.Objectives:This studya.further explores the apparent cross-tolerance between fluoxetine and mCPP andb.extends the model by investigating its sensitivity to dopaminergic manipulations (D2,3 agonism - quinpirole).Methods:In both experiments, baseline and drug testing was carried out under daily T-maze alternation training.Exp.1:Matched group (n=8) pairs of rats received one of the following 20-day pretreatments (daily intraperitoneal administration):1.saline,2.low-dose fluoxetine (2.5mg/kg),3.low-dose mCPP (0.5mg/kg) or4.combined fluoxetine+mCPP.One group per pretreatment then received a 4-day challenge with high-dose fluoxetine (10mg/kg), the other with high-dose mCPP (2.5mg/kg).Exp.2:One group (n=12) of rats received 20-day treatment with saline, another with quinpirole (0.5 mg/kg).Results:Exp.1:Saline and low-dose mCPP- or fluoxetine-pretreated animals showed significant persistence increases under both challenges, while combined low-dose fluoxetine+mCPP pretreatment afforded full protection from either challenge.Exp.2:Quinpirole significantly increased directional persistence after 13 administration days.Conclusions:These results establish the sensitivity of the rewarded alternation OCD model to D2,3receptor activation, thereby extending its profile of pharmacological isomorphism with OCD. Furthermore, they suggest a common mechanism of action of an SSRI and a serotonin agonist in the control of directional persistence.


CNS Spectrums ◽  
2004 ◽  
Vol 9 (8) ◽  
pp. 607-612 ◽  
Author(s):  
Carlos Cruz-Fuentes ◽  
Claudia Blas ◽  
Laura Gonzalez ◽  
Beatriz Camarena ◽  
Humberto Nicolini

ABSTRACT:Objective:The present study examined the psychobiological Temperament and Character model of personality on obsessive-compulsive disorder (OCD) patients, as well as the relation of temperament and/or character dimensions on the severity of obsessive-compubive symptoms.Methods:Fifty-four subjects diagnosed with OCD, were assessed with the Temperament and Character Inventory, the Yale-Brown Obsessive-Compulsive scale and the Hamilton Rating Scales for depression and anxiety.Results:Compared with controls, OCD subjects displayed increased harm avoidance and lower self-directedness and cooperativeness. Low self-directedness and high Hamilton depression scores were associated with increased severity of obsessive-compulsive symptoms.Conclusions:The Temperament and Character profile of OCD patients characterized in the present stud personality model and can be linked to some of their behavioral features. Furthermore, our data provides support of the influence that some personality traits may have on the severity of OCD symptoms.


2003 ◽  
Vol 34 (2) ◽  
pp. 70-74 ◽  
Author(s):  
Elsebet S. Hansen ◽  
Leslie S. Prichep ◽  
Tom G. Bolwig ◽  
E. Roy John

The effectiveness of drugs that have a specific effect on the activity of the serotonergic neurotransmitter system has changed the outlook for patients suffering from obsessive-compulsive disorder (OCD). With a response rate of about 70% to such compounds and the great amount of brain imaging studies conducted over the past decades, an understanding of the biochemical nature and origins of OCD is beginning to unfold. Convergent data including ethological and experimental observations, clinico-pathological findings and different imaging methods have implicated the basal ganglia along with the cortical and related thalamic structures to be involved in the pathophysiology of OCD. In a previous study using the quantitative electroencephalographic (QEEG) method known as neurometrics, in which QEEG data from OCD patients were compared statistically with those from an age-appropriate normative population, two subtypes within a clinically homogeneous patient group were classified. Patients with relative excess theta activity, especially in the frontal regions, were nonresponders to treatment with serotonin reuptake inhibitors (SSRI), while those with increased relative power in alpha activity were responders to pharmacological treatment. These findings suggested at least two subgroups in a patient population with similar symptoms but differential responses to treatment. In the present study we used neurometric QEEG to subtype a group of 20 non-depressed OCD patients, fulfilling DSM-R-III criteria, treated with paroxetine, of whom 18 were responders to treatment. Of the treatment responders, 94.4% were predicted by subtype membership to be SSRI responsers. In these subjects there was a strong relative alpha baseline activity; after successful treatment through at least 3 months this activity decreased, looking more normal. The group average topographic maps showed none of the characteristics seen in the nonresponder cluster (no excess relative power in theta). As in the previous investigation, baseline QEEG profile membership points to a predictive value with regard to therapeutic response.


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