Treatment of obsessive-compulsive spectrum disorders with SSRIs

1998 ◽  
Vol 173 (S35) ◽  
pp. 7-12 ◽  
Author(s):  
E. Hollander
Keyword(s):  
Serotonin Receptor ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Body Dysmorphic Disorder ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Serotonergic Activity ◽  
Pharmacological Challenge ◽  
Spectrum Disorders ◽  
Serotonin Receptor Agonists ◽  
The Relationship

Background Obsessive-compulsive spectrum disorders (OCSDs) are now recognised as distinct diagnostic entities related to obsessive-compulsive disorder (OCD). The features of OCSDs and OCD overlap in many respects including demographics, repetitive intrusive thoughts or behaviours, comorbidity, aetiology and preferential response to anti-obsessional drugs such as the selective serotonin reuptake inhibitors (SSRIs).Method Literature was reviewed and preliminary data from various studies were re-examined to assess the relationship between compulsivity and impulsivity, and between OCD and OCSDs.Results OCSDs include both compulsive and impulsive disorders and these can be viewed as lying at opposite ends of the dimension of risk avoidance. Compulsiveness is associated with increased frontal lobe activity and increased serotonergic activity, while impulsiveness is associated with reduced activity of these variables. Neural circuits affected by serotonergic pathways have been identified and pharmacological challenge of OCSD patients with serotonin receptor agonists have supported the involvement of serotonergic processes.Conclusions SSRIs such as fluvoxamine have established efficacy in OCD and preliminary studies indicate that they are also effective in OCSDs. The features of three specimen OCSDs –body dysmorphic disorder, pathological gambling and autism – and their treatment with SSRIs are reviewed.

Variable Insight in OCD

2017 ◽  
Author(s):  
Rebecca J. Hamblin ◽  
Jennifer Moonjung Park ◽  
Monica S. Wu ◽  
Eric A. Storch
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Assessment Tools ◽  
Schizophrenia Spectrum Disorders ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
Definition Of ◽  
The Relationship ◽  
Insight Into

Individuals with obsessive-compulsive disorder (OCD) often have good insight into the irrational nature of their obsessions and the excessive character of their compulsions, but insight exists along a continuum and is markedly poor in some patients. This chapter reviews the assessment and phenomenological correlates of variable insight in OCD in both pediatric and adult populations. It reviews the definition of insight and its relationship to the evolution of diagnostic criteria for obsessive-compulsive disorder, as well as the major assessment tools used to measure and quantify insight for clinical and research purposes. The relationships between insight and clinical characteristics of OCD, including symptom severity, comorbidity, and treatment response are reviewed, followed by a review of neurobiological correlates of insight and the relationship between poor insight and schizophrenia spectrum disorders.

scholarly journals Body Dysmorphic Disorder in Adolescents

2019 ◽  
Vol 9 (1) ◽  
pp. 44-57
Author(s):  
Himanshu Sharma ◽  
Bharti Sharma ◽  
Nisheet Patel
Keyword(s):  
Cosmetic Surgery ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Body Dysmorphic Disorder ◽  
Age Of Onset ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Schizophrenia Spectrum Disorders ◽  
Obsessive Compulsive ◽  
Exact Relation ◽  
Treatment Approaches ◽  
Compulsive Disorder

Background and Objectives:Body Dysmorphic Disorder (BDD) is characterized by an abnormal preoccupation with alleged misshapen body parts. There is often poor insight and effort is made to hide the imagined defects, and consultation may be sought seeking unnecessary cosmetic surgery or procedures. It is underdiagnosed and established treatment protocols are lacking. The disease has a chronic and undulating course and is seriously compromises quality of life. Despite the fact that the prime age of onset of BDD is during adolescence relatively little has been written about it during this phase of life. This review aims to comprehensively cover the present understanding of BDD, including clinical features, epidemiology, psychopathology, nomenclature, comorbidity and management.Methods:A literature search was undertaken using suitable key words on Google Scholar, MEDLINE & PsychoINFO up to June 2018 limited to articles in English.Results:he prevalence of BDD is variable in the general and psychiatric population with equal gender distribution. Both sexes are equally affected. It is associated with poor functioning and a chronic course. There is considerable comorbidity and diagnostic overlap between BDD and obsessive-compulsive disorder, major depressive disorder, social anxiety disorder, anorexia nervosa, schizophrenia spectrum disorders and personality disorders. Psychiatric consultation is often late. Selective Serotonin Reuptake Inhibitors (SSRIs) and Cognitive Behavior Therapy (CBT) are currently the first line modalities for treatment. Internet based CBT, Acceptance and commitment therapy, and repetitive Transcranial Magnetic Stimulation (rTMS) are emerging treatment options.Conclusions:BDD is a complex disorder with still lot of uncertainty about its diagnostic placement, treatment approaches, especially for refractory patients, and prognosis. Further study is needed to clarify its prevalence, especially in adolescents; to fully understand its neurobiological aspects, to determine its exact relation to obsessive compulsive related disorders, and to develop better treatment approaches.

scholarly journals Obsessive-compulsive spectrum disorders

2003 ◽  
Vol 5 (3) ◽  
pp. 259-271
Keyword(s):  
Impulse Control ◽  
Body Dysmorphic Disorder ◽  
Patient Characteristics ◽  
Autism Spectrum ◽  
Sexual Compulsivity ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Diagnostic Categories ◽  
Spectrum Disorders ◽  
Fruitful Research

The obsessive-compulsive spectrum is an important concept referring to a number of disorders drawn from several diagnostic categories that share core obsessive-compulsive features. These disorders can be grouped by the focus of their symptoms: bodily preoccupation, impulse control, or neurological disorders. Although the disorders are clearly distinct from one another, they have intriguing similarities in phenomenology, etiology, pathophysiology, patient characteristics, and treatment response. In combination with the knowledge gained through many years of research on obsessive-compulsive disorder (OCD), the concept of a spectrum has generated much fruitful research on the spectrum disorders. It has become apparent that these disorders can also be viewed as being on a continuum of compulsivity to impulsivity, characterized by harm avoidance at the compulsive end and risk seeking at the impulsive end. The compulsive and impulsive disorders differ in systematic ways that are just beginning to be understood. Here, we review these concepts and several representative obsessive-compulsive spectrum disorders including both compulsive and impulsive disorders, as well as the three different symptom clusters: OCD, body dysmorphic disorder, pathological gambling, sexual compulsivity, and autism spectrum disorders.

Obsessive Compulsive Spectrum Disorders in Children and Adolescents

2012 ◽  
Author(s):  
Eric A. Storch ◽  
Omar Rahman ◽  
Mirela A. Aldea ◽  
Jeannette M. Reid ◽  
Danielle Bodzin ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Clinical Characteristics ◽  
Body Dysmorphic Disorder ◽  
Repetitive Behaviors ◽  
Future Research ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Augmentation Strategies ◽  
Spectrum Disorders

This chapter reviews the literature on obsessive compulsive spectrum disorders (i.e., obsessive compulsive disorder, body dysmorphic disorder, trichotillomania, Tourette syndrome, and varied body-focused repetitive behaviors) in children and adolescents. For each disorder, data on phenomenology, associated clinical characteristics, etiology, and treatment are reviewed. The chapter concludes with a discussion of future research and clinical directions, such as novel augmentation strategies, diagnostic classification of obsessive compulsive spectrum disorders, and methods of maximizing treatment outcome.

Revisiting the Obsessive-compulsive Spectrum

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
F. Ramalho e Silva ◽  
C. Branco ◽  
A.E. Ribeiro
Keyword(s):  
Clinical Practice ◽  
Anxiety Disorder ◽  
Genetic Factors ◽  
Body Dysmorphic Disorder ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Medical Disorders ◽  
Wide Range ◽  
Dsm Iv ◽  
Spectrum Disorders

In the DSM IV-TR, Obsessive-Compulsive Disorder (OCD) is categorized as an anxiety disorder. A wide range of psychiatric and medical disorders, not included in this category, has been hypothesized to be related to OCD and to form a family of disorders known as obsessive compulsive spectrum disorders (OCSD). OCSD would include several clinically heterogeneous disorders such as Body Dysmorphic Disorder, Tourette's Syndrome or Pathological Gambling. This construct is based on disorders’ similarities with OCD in a variety of domains such as phenomenology, comorbidity, neurotransmitter or peptide systems, neurocircuitry, family history, genetic factors and treatment response. This presentation provides an overview of the existing literature regarding the concept of the OCD spectrum and the relationships between the disorders included in OCSD. Although there are data supporting the inclusion of some disorders in the OC spectrum, more research is needed to clarify the relationships and the boundaries between these disorders. Ultimately, a better understanding of OC spectrum may have significant implications for clinical practice.

Obsessive-Compulsive Disorder and Its Potential Subtypes

CNS Spectrums ◽  
2000 ◽  
Vol 5 (S4) ◽  
pp. 40-46 ◽  
Author(s):  
Donald W. Black
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Serotonin Receptor ◽  
Late Onset ◽  
Age At Onset ◽  
The United States ◽  
Obsessive Compulsive ◽  
Molecular Genetic Study ◽  
Compulsive Disorder ◽  
Eeg Abnormalities ◽  
Spectrum Disorders

AbstractThis manuscript summarizes presentations by an international panel of experts, representing Brazil, Israel, Italy, Mexico, Portugal, Spain, and the United States, at a symposium on obsessive-compulsive disorder (OCD) and its possible subtypes. Presentations concerned both OCD proper, as well as putative obsessive-compulsive-spectrum disorders (autistic disorders, eating disorders, pathological gambling, and schizo-obsessive disorder). Projects discussed included a study assessing impulsive temperament in eating disorder patients, a study on serotonin receptor sensitivity in autism, a study of sleep EEG abnormalities in OCD, a study of dissociation in pathological gamblers, papers on aspects of schizo-obsessive patients, a study addressing biological alterations in OCD, data from a new family study on OCD, data from a molecular genetic study of OCD, a factor analytic study of Tourette disorder, a study hypothesizing the existence of an OCD continuum, and, finally, a paper on early- vs late-onset OCD. General discussion followed leading to a consensus that 1) OCD is likely heterogeneous with multiple subtypes; 2) division of patients by age-at-onset probably represents a robust and valid subtyping scheme; 3) the presence of schizophrenic features probably identifies a valid subtype; 4) the validation of subtypes in the future will be informed by both family-genetic studies, as well as studies of biological alterations in OCD; and 5) the study of obsessive-compulsive spectrum disorders adds to our understanding of the OCD phenomenon, and helps in our search to identify valid subtypes.

scholarly journals Obsessive–Compulsive Spectrum of Disorders: A Defensible Construct?

2006 ◽  
Vol 40 (2) ◽  
pp. 114-120 ◽  
Author(s):  
David J. Castle ◽  
Katharine A. Phillips
Keyword(s):  
Literature Review ◽  
Obsessive Compulsive Disorder ◽  
Body Dysmorphic Disorder ◽  
Obsessive Compulsive ◽  
Heterogeneous Condition ◽  
Compulsive Disorder ◽  
Spectrum Disorders ◽  
Spectrum Model

Objective: To explore critically whether there is a robust basis for the concept of an obsessive–compulsive (OC) spectrum of disorders, and if so, which disorders should be included. Method: Selective literature review concentrating on three proposed members of the OC spectrum, namely body dysmorphic disorder, hypochondriasis and trichotillomania. Results: Obsessive–compulsive disorder (OCD) itself is a heterogeneous condition or group of conditions, and this needs to be appreciated in any articulation of a ‘spectrum’ of OC disorders. The basis for ‘membership’ of the spectrum is inconsistent and varied, with varying level of support for inclusion in the putative spectrum. Conclusion: A more fruitful approach may be to consider behaviours and dimensions in OCD and OC spectrum disorders, and that this should be encompassed in further developments of the OC spectrum model.

scholarly journals CASE STUDY OF PERSON WITH BODY DYSMORPHIC DISORDER

2016 ◽  
Vol 4 (7) ◽  
pp. 102-108
Author(s):  
M. Senthil
Keyword(s):  
Selective Serotonin Reuptake Inhibitors ◽  
Body Dysmorphic Disorder ◽  
Supportive Therapy ◽  
Family Intervention ◽  
Somatoform Disorder ◽  
Pharmacologic Treatment ◽  
Body Parts ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

This article presents a case study of client with Body dysmorphic disorder. Body dysmorphic disorder is an increasingly recognized somatoform disorder, clinically distinct from obsessive-compulsive disorder, eating disorders, and depression. Patients with body dysmorphic disorder are preoccupied with an imagined deficit in the appearance of one or more body parts, causing clinically significant stress, impairment, and dysfunction. The preoccupation is not explained by any other psychiatric disorder. Patients present to family physicians for primary care reasons and aesthetic or cosmetic procedures. Cosmetic correction of perceived physical deficits is rarely an effective treatment. Pharmacologic treatment with selective serotonin reuptake inhibitors and non-pharmacologic treatment with cognitive behavior therapy are effective. Body dysmorphic disorder is not uncommon, but is often misdiagnosed. Recognition and treatment are important because this disorder can lead to disability, depression, and suicide. Psychiatric social work assessment and intervention was provided to the person with Body dysmorphic disorder, focusing on to building for change in misbelieve and strengthening commitment to change. The psycho social intervention was provided to the patients and his family members. Sessions on Admission counseling, Family intervention, Supportive therapy, Psycho education, role play, reminiscence, Pre discharge counseling, Discharge Counseling and Social Group Work was conducted. At the end of the therapy, the client knowledge about the illness and coping skills has improved.

The Relationship of Body Dysmorphic Disorder to Obsessive-Compulsive Disorder and the Concept of the Obsessive-Compulsive Spectrum

2017 ◽  
Author(s):  
Jessica Simberlund ◽  
Eric Hollander
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Body Dysmorphic Disorder ◽  
Suicide Attempts ◽  
Obsessive Compulsive ◽  
Major Depressive ◽  
Compulsive Disorder ◽  
Compulsive Behaviors ◽  
Genetic And Environmental Factors ◽  
Relationship Of ◽  
The Relationship

This chapter describes the relationship of body dysmorphic disorder (BDD) to obsessive-compulsive disorder (OCD) and the concept of the obsessive-compulsive spectrum. BDD is proposed to be part of an obsessive-compulsive spectrum of disorders, given its many similarities to OCD. OCD and BDD are both characterized by obsessions and compulsions, although in BDD individuals focus specifically on body image concerns, whereas in OCD they typically focus on concerns such as contamination, harm, and aggression. Distress that results from obsessions usually generates compulsive behaviors intended to reduce emotional discomfort. Individuals with BDD are more likely to have delusional beliefs and significantly poorer insight. Individuals with BDD report higher rates of major depressive disorder, substance use disorders, suicidal thoughts, and suicide attempts. OCD and BDD demonstrate familiality, indicating that they are likely related conditions. OCD and BDD are thought to be heterogeneous disorders that result from both genetic and environmental factors, some of which appear to be shared; for example, they appear to share some abnormalities involving the basal ganglia and limbic system (specifically the caudate nucleus).

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