Symptom Dimensions in Obsessive-Compulsive Disorder: Factor Analysis on a Clinician-Rated Scale and a Self-Report Measure

2004 ◽  
Vol 37 (4) ◽  
pp. 181-189 ◽  
Author(s):  
Damiaan Denys ◽  
Femke de Geus ◽  
Harold J.G.M. van Megen ◽  
Herman G.M. Westenberg
2007 ◽  
Vol 29 (4) ◽  
pp. 303-307 ◽  
Author(s):  
Dan J Stein ◽  
Elisabeth W Andersen ◽  
Kerstin Fredricson Overo

OBJECTIVE: There is increasing evidence that the symptoms of obsessive-compulsive disorder lie on discrete dimensions. Relatively little work has, however, explored the relationship between such factors and response to pharmacotherapy. METHOD: Data from a multi-site randomized placebo-controlled study of citalopram in obsessive-compulsive disorder were analyzed. Factor analysis of individual items and symptom categories of the Yale-Brown Obsessive-Compulsive Scale Checklist were undertaken, and the impact of symptom dimensions on treatment outcomes was analysed. RESULTS: Factor analysis of Yale-Brown Obsessive-Compulsive Scale Checklist individual items yielded 5 factors (contamination/cleaning, harm/checking, aggressive/sexual/religious, hoarding/symmetry, and somatic/hypochondriacal). Hoarding/symmetry was associated with male gender, longer duration of obsessive-compulsive disorder and early onset, whereas contamination/cleaning was associated with female gender. Citalopram was more effective than placebo, but high scores on the symmetry/hoarding and contamination/cleaning subscales predicted worse outcome at the end of study while high scores on the aggressive/religious/sexual subscale predicted better outcome. Factor analysis of Yale-Brown Obsessive-Compulsive Scale Checklist symptom clusters yielded a 4 factor solution, but confirmed that symmetry/ordering was associated with male gender, early onset, and long duration of obsessive-compulsive disorder while high scores on the hoarding subscale predicted worse response to pharmacotherapy. CONCLUSION: Citalopram shows good efficacy across the range of obsessive-compulsive disorder symptom dimensions. The relatively worse response of symmetry/hoarding to a selective serotonin reuptake inhibitor is consistent with other evidence that this symptom dimension is mediated by the dopamine system. There may be associations between symmetry/hoarding, male gender, early onset, tics, and particular genetic variants; further work is, however, needed to delineate fully obsessive-compulsive disorder subtypes and their underlying neurobiology.


CNS Spectrums ◽  
2008 ◽  
Vol 13 (6) ◽  
pp. 492-498 ◽  
Author(s):  
Dan J. Stein ◽  
Paul D. Carey ◽  
Christine Lochner ◽  
Soraya Seedat ◽  
Naomi Fineberg ◽  
...  

ABSTRACTIntroduction:There is a substantial body of evidence that obsessive-compulsive disorder (OCD) symptoms can be grouped into a series of discrete dimensions, and some evidence that not all OCD symptom dimensions respond equally well to pharmacologic or psychotherapeutic intervention. The response of OCD symptom dimensions to 12 weeks of treatment with escitalopram or placebo was investigated.Methods:Data from a randomized, double-blind, placebo-controlled study of escitalopram in 466 adults with OCD were analyzed. Exploratory factor analysis of individual items of the Yale-Brown Obsessive-Compulsive Scale checklist was performed and subscale scores based on the extracted factors were determined. Analyses of covariance were undertaken to determine whether inclusion of each subscale score in these models impacted on the efficacy of escitalopram versus placebo.Results:Exploratory factor analysis of individual Yale-Brown Obsessive-Compulsive Scale items yielded 5 factors (contamination/cleaning, harm/checking, hoarding/symmetry, religious/sexual, and somatic/hypochondriacal). Analyses of covariance including all the subscales demonstrated that escitalopram was more effective than placebo. There was a significant interaction for the hoarding/symmetry factor, which was associated with a poor treatment response.Conclusion:Escitalopram shows good efficacy across the range of OCD symptom dimensions. Nevertheless, hoarding/symmetry was associated with a poorer treatment response. Hoarding/symmetry may be particularly characteristic of an early-onset group of OCD patients, with the involvement of neurotransmitters other than serotonin. Further work is needed to delineate fully the subtypes of OCD, and their correlates with underlying psychobiology and treatment responsivity.


2021 ◽  
Author(s):  
Behrang Mahjani ◽  
Christina Gustavsson Mahjani ◽  
Abraham Reichenberg ◽  
Sven Sandin ◽  
Christina M. Hultman ◽  
...  

Background: We have established an epidemiological obsessive-compulsive disorder (OCD) cohort in Sweden. Individuals contributed DNA for genotyping and sequencing and also completed a Swedish translation of the Obsessive-Compulsive Inventory-Revised (OCI-R), a self-report questionnaire for assessing the severity and type of symptoms of OCD. This study made use of the OCI-R data to examine the severity and symptom dimensions of OCD as well as comorbidity with other psychiatric disorders. Methods: OCI-R data for 1,134 individuals were available for this study, 1,010 diagnosed with OCD, and 124 diagnosed with chronic tic disorders without OCD used as a comparison group. We first evaluated the psychometric properties of the Swedish translation of the OCI-R. Then, we linked data from the Swedish national registries to access and analyze psychiatric comorbidities of OCD. Results: The Swedish translation of OCI-R demonstrated internal consistency (Cronbach's α = 0.9) and clear agreement with the OCI-R six-factor model. The mean total OCI-R score for females was significantly higher than for males. The most comorbid psychiatric condition to OCD were anxiety disorders (13.6%) and major depression (12%). We observed that individuals with OCD frequently had additional comorbid psychiatric disorders and that the severity of OCD was significantly higher in individuals with at least one additional psychiatric comorbidity compared to individuals with no psychiatric comorbidity. Conclusion: We showed that the Swedish translation of the OCI-R has appropriate psychometric properties. Using an epidemiological framework, we were able to assess the severity and symptom dimensions of OCD and comorbidity with other psychiatric disorders.


2017 ◽  
Vol 33 (2) ◽  
pp. 97-103 ◽  
Author(s):  
Tíscar Rodríguez-Jiménez ◽  
Antonio Godoy ◽  
José A. Piqueras ◽  
Aurora Gavino ◽  
Agustín E. Martínez-González ◽  
...  

Abstract. Evidence-based assessment is necessary as a first step for developing psychopathological studies and assessing the effectiveness of empirically validated treatments. There are several measures of obsessive-compulsive disorder (OCD) and/or symptomatology in children and adolescents, but all of them present some limitations. The Obsessive-Compulsive Inventory-Revised (OCI-R) by Foa and her colleagues has showed to be a good self-report measure to capture the dimensionality of OCD in adults and adolescents. The child version of the OCI (OCI-CV) was validated for clinical children and adolescents in 2010, showing excellent psychometric properties. The objective of this study was to examine the factor structure and invariance of the OCI-CV in the general population. Results showed a six-factor structure with one second-order factor, good consistency values, and invariance across region, age, and sex. The OCI-CV is an excellent inventory for assessing the dimensions of OCD symptomatology in general populations of children and adolescents. The invariance across sex and age warrants its utilization for research purposes.


2014 ◽  
Vol 121 (1) ◽  
pp. 123-130 ◽  
Author(s):  
Andre F. Gentil ◽  
Antonio C. Lopes ◽  
Darin D. Dougherty ◽  
Christian Rück ◽  
David Mataix-Cols ◽  
...  

Object Recent findings have suggested a correlation between obsessive-compulsive disorder (OCD) symptom dimensions and clinical outcome after limbic system surgery for treatment-refractory patients. Based on previous evidence that the hoarding dimension is associated with worse outcome in conventional treatments, and may have a neural substrate distinct from OCD, the authors examined a large sample of patients undergoing limbic surgery (40 with capsulotomy, 37 with cingulotomy) and investigated if symptom dimensions, in particular hoarding, could influence treatment outcome. Methods Data from 77 patients from 3 different research centers at São Paulo (n = 17), Boston (n = 37), and Stockholm (n = 23) were analyzed. Dimensional Yale-Brown Obsessive Compulsive Scale (Y-BOCS; São Paulo) or Y-BOCS Symptom Checklist scores (Boston and Stockholm) were used to code the presence of 4 well-established symptom dimensions: forbidden thoughts, contamination/cleaning, symmetry/order, and hoarding. Reductions in YBOCS scores determined clinical outcome. Results Mean Y-BOCS scores decreased 34.2% after surgery (95% CI 27.2%–41.3%), with a mean follow-up of 68.1 months. Patients with hoarding symptoms had a worse response to treatment (mean Y-BOCS decrease of 22.7% ± 25.9% vs 41.6% ± 32.2%, respectively; p = 0.006), with no significant effect of surgical modality (capsulotomy vs cingulotomy). Patients with forbidden thoughts apparently also had a worse response to treatment, but this effect was dependent upon the co-occurrence of the hoarding dimension. Only the negative influence of the hoarding dimension remained when an ANOVA model was performed, which also controlled for preoperative symptom severity. Conclusions The presence of hoarding symptoms prior to surgery was associated with worse clinical outcome after the interventions. Patients with OCD under consideration for ablative surgery should be carefully screened for hoarding symptoms or comorbid hoarding disorder. For these patients, the potentially reduced benefits of surgery need to be carefully considered against potential risks.


2014 ◽  
Vol 43 (4) ◽  
pp. 385-395 ◽  
Author(s):  
Meredith E. Coles ◽  
Casey A. Schofield ◽  
Jacob A. Nota

Background: Despite literature establishing a relationship between maladaptive beliefs and symptoms of obsessive-compulsive disorder (OCD), there are few studies addressing how these beliefs develop. Salkovskis and colleagues (1999) proposed specific domains of childhood experiences leading to heightened beliefs regarding responsibility. Prior studies in students and individuals who just completed treatment for OCD have found support for this theory. However, we are not aware of published data from individuals with current OCD. Aims: This paper presents initial data from adults currently meeting criteria for OCD as well as both anxious and non-anxious controls. Method: Recollections of childhood experiences, current OCD-related beliefs, and OCD symptoms were assessed using self-report measures in 39 individuals seeking treatment for OCD, 36 anxious controls and 39 healthy controls. Results: Initial data suggested that in individuals with OCD, increased reports of childhood exposure to overprotection and experiences where one's actions caused or influenced misfortune were associated with stronger OCD-related beliefs. Further, compared to community controls, individuals with OCD reported more childhood experiences where one's actions caused or influenced misfortune, though they did not differ from anxious controls in childhood responsibility experiences. Conclusions: These initial findings provide minimal support for the proposed model of the development of inflated responsibility beliefs, and highlight the need for research examining the etiology of OCD related beliefs with updated models, larger samples, and ultimately using prospective methods.


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