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PubMed1977

A factorial study of personal development of unmarried mothers, college, alcoholic, and schizophrenic populations.

Reported the results of a factor analytic study of the Personal Development Study (PDS). The PDS was administered for research purposes to four diagnostic groups, which included 89 institutionalized alcoholics, 336 unmarried mothers, 159 college students, and 388 chronic schizophrenics. A principal component factor analysis with Varimax rotation performed on the combined populations (N = 972) yielded five main factors labeled as projection, optimism-responsibility, reaction and symptom formation, repressive-compulsive, and intropunitiveness-guilt. Analysis of base rates of responding to the individual items revealed that the four populations ranged along a continuum, with the normals at one extreme and the institutionalized schizophrenics at the other extreme of greater pathological responding.

Adolescent↗
PubMedDate not supplied

The predictors of health care seeking behavior in obsessive-compulsive disorder.

A majority of individuals with obsessive-compulsive disorder (OCD) do not seek health care. To better understand why not, health care-seekers (HCS) with OCD (n = 25) were compared with non-health care-seekers (NHCS) with OCD (n = 23) regarding their sociodemographic variables, symptom severity, types of obsessions and compulsions, insight degree, comorbid diagnosis, and quality-of-life (QOL) level. There was no significant difference for sociodemographic characteristics between the groups. NHCS scored significantly lower on a measure of illness severity than HCS. The NHCS group had significantly poorer insight degree than the HCS group. Aggressive and religious obsessions were significantly less identified in the NHCS group compared to the HCS group. NHCS were significantly less likely to have comorbid diagnosis than HCS. The NHCS group reported significantly higher levels of QOL in psychological health and level of independence domains [corrected]. To identify the predictors of health care seeking behavior, probable variables were entered in a logistic regression model. Insight degree and level of independence emerged as the predictors of health care seeking. Our results suggest that health care seeking behavior in OCD is associated with the individuals' ability to recognize their symptoms as a disorder and subjective interpretation regarding the impact of OCD on their level of independence. Results of the present study extend findings of two recent studies that have investigated factors related to health care seeking in OCD.

Adult↗
PubMed2006

The differential impact of executive attention dysfunction on episodic memory in obsessive-compulsive disorder patients with checking symptoms vs. those with washing symptoms.

Neuropsychological studies of obsessive-compulsive disorder (OCD) have pointed to memory and attention deficits among its sufferers, but these reports have largely ignored the possibility that cognitive disturbances may vary across OCD clinical subtypes, or that their interactions may differ between subtypes. The purpose of the present study was to determine whether "checkers" and "washers" demonstrate differences in their memory and executive attention function. Fifty-three outpatients with primary DSM-IV diagnosis of OCD with typical checking (n=27) or washing (n=26) rituals participated in the study. Patients were administered the Wechsler Memory Scale-Revised and a comprehensive neuropsychological battery to assess executive attention function. Various neuropsychological tests were then subjected to factor analysis. Neuropsychological test results and obtained factor scores were compared between "washers" and "checkers". Effects of these factor scores on memory by OCD subtypes were examined. No significant difference in terms of demographic and clinical variables was found between the two groups. Checkers displayed performance deficits on Stroop test, Trail Making Test, GO/NO GO test (commission errors) and category fluency. Three factors, inhibition, cognitive flexibility, and multi-tasking, were obtained. Statistically significant differences were observed between the two groups on the inhibition and the cognitive flexibility scores, but not on the general memory or the multi-tasking score. There was a statistically significant interaction between groups and the inhibition score. Only among "checkers", a significant correlation was noted between the inhibition factor and the general memory, while no such correlation was observed among "washers". Among "checkers", poor general memory was related to inhibition deficits.

Adolescent↗
PubMed2003

Depression and suicidal behavior in adolescent inpatients with obsessive compulsive disorder.

BACKGROUND: To investigate the prevalence and correlations of suicidal behavior in obsessive compulsive disorder (OCD) among adolescent psychiatric inpatients. METHODS: A total of 348 adolescents, representing consecutive admissions to an adolescent inpatient unit, were assessed. Of these, 40 patients had OCD, 118 had schizophrenia, 59 had an affective disorder, 81 had a conduct disorder and 50 had an eating disorder. In addition, 87 normal community controls were assessed. All subjects were assessed for suicidal behavior by the Childhood Suicide Potential Scale (CSPS), for depression by the Beck Depression Inventory, for impulsiveness by the Impulse Control Scale, for anxiety by the State-Trait Anxiety Scale and for aggression by the Yudowsky Overt Aggression Scale. RESULTS: All the psychiatrically ill subjects, including those with OCD, had high levels of depression, anxiety and impulsiveness, which were far higher than those of the controls. The rate of attempted suicide was, however, much lower in the OCD subjects. In addition, there was a significant inverse correlation between suicidal behavior levels on the CSPS and depression in the OCD subjects, while all other subjects showed the expected significant positive correlation between level of suicidal behavior and depression. LIMITATIONS: This study looked at a referred population and generalization to outpatient and community samples cannot be made. Distinguishing between the primary and the comorbid diagnosis is difficult and some findings are based on small sample size and therefore may be vulnerable to type I error. CONCLUSIONS: Although suicidal ideation and depressive symptoms are common in OCD adolescent inpatients, they seem to be protected against suicide attempts. The inverse relationship between suicidal behavior and depression may mean that suicidal behavior is, in some ways, qualitatively different from that seen in other psychiatrically ill adolescents.

Adolescent↗
PubMed2005

Clinical characteristics and psychiatric comorbidity in males with exhibitionism.

BACKGROUND: This study was constructed to detail the demographic and phenomenological features of males with exhibitionism. METHOD: Male subjects with DSM-IV exhibitionism were administered a semistructured interview to elicit demographic data and information on the phenomenology, age at onset, and associated features of the disorder. Subjects also underwent structured clinical interviews to assess both Axis I and Axis II comorbidities. Data were collected from September 2003 to March 2005. RESULTS: Twenty-five males with exhibitionism (mean +/- SD age = 35.0 +/-13.1 years [range, 14-68 years]) were studied. The majority of subjects were single (60% [N = 15]) and heterosexual (80% [N = 20]). The mean +/- SD age at onset for exhibitionism was 23.4 +/-13.1 years. All subjects reported urges to expose themselves with little control over these urges. Exposing oneself while driving was the most common expression of the disorder. Twenty-three (92%) suffered from a current comorbid Axis I disorder (major depressive disorder, compulsive sexual behavior, and substance use disorders were most common), and 40% (N = 10) suffered from a personality disorder. Suicidal thoughts were common (52% [N = 13]), and many (36% [N = 9]) had been arrested for exhibitionism. CONCLUSION: Exhibitionism appears to be associated with high rates of psychiatric comorbidity and impairment. Research is needed to optimize patient care for men with this disorder.

Adolescent↗
PubMed1995

Impulse control disorders and attention deficit disorder in pathological gamblers.

Little systematic research has been done on psychiatric comorbidity of pathological gambling, an impulse control disorder. This report describes the occurrence of attention deficit disorder and impulse control disorders in 40 pathological gamblers in treatment for gambling problems and 64 controls. Diagnoses were made by structured interviews which utilized operationalized diagnostic criteria. An impulse control disorder other than pathological gambling was noted in 35% of the pathological gamblers, compared to 3% of the controls (p < .001). Compulsive buying (p < .001) and compulsive sexual behavior (p < .05) were significantly higher in pathological gamblers than controls. A strong association was seen among pathological gambling, attention deficit, and other impulse control disorders. Attention deficit disorder was seen in 20% of the pathological gamblers. Rates of impulse control disorders did not differ by gender. Implications of these high rates of comorbidity are discussed.

Adult↗
PubMed2003

Psychopharmacology of compulsive buying.

No standard treatment exists for the DSM-IV Impulse Control Disorders, Not Elsewhere Classified, including Compulsive Buying Disorder. This paper reviews the suggested pharmacotherapies for this disorder and their theoretical basis. McElroy et al. first reported benefit from antidepressant therapy in three cases of Compulsive Buying Disorder with comorbid depression and anxiety. In a retrospective chart review, McElroy's group reported on 20 patients that benefited from antidepressants, often in combination with mood stabilizers. Lejoyeux reported on two patients in whom treatment of a comorbid mood disorder led to remission of compulsive buying behavior. Black reported fluvoxamine to be effective in patients without comorbid major depression, suggesting that improvement was independent of the treatment of mood symptoms. Kim reported improvement with naltrexone, an opioid antagonist, in a case series. Two double-blind placebo-controlled trials found fluvoxamine no better than placebo; however, in both studies patients kept shopping logs, which may have confounded the results. An open-label trial of citalopram and a double-blind crossover trial which excluded shopping logs both reported positive results. Twelve-month follow-up data for the open-label group found that remission rates at quarterly time points were independent of continuing drug therapy. The data reviewed above suggest that pharmacologic interventions may be effective for compulsive buying disorder. Whether pharmacological treatment is superior to placebo and whether it is more, less or equally effective compared to psychotherapeutic interventions remains to be established.

Compulsive Behavior↗
PubMed1995

[A case of focal encephalitis with psychological symptoms similar to chorea minor].

We reported a patient with choreic movements, emotional lability, and compulsive-obsessive behavior that developed 4 weeks after onset of fever and lasted for several years. There was no evidence of streptococcal infection or rheumatic fever. T2-weighted MRI showed hyperintense lesions in the bilateral caudate nuclei and putamina. A diagnosis of focal encephalitis was made according to initial fever, convulsion, and CSF pleocytosis. Treatments with haloperidol and prednisolone were effective in some degree. The neurobehavioral syndrome as well as the involuntary movements in this patient can be attributed to the striatal damage, which may disrupt the basal ganglia-limbic-frontal lobe tracts. A symptomatic similarity between the syndrome in this patient and chorea minor suggests a striatal damage in chorea minor, where the causative lesions remain unknown.

Affective Symptoms↗
PubMed1999

Managing aggressive behavior in patients with obsessive-compulsive disorder and borderline personality disorder.

Obsessive-compulsive disorder (OCD) is one of the most common psychiatric disorders, occurring in 2% to 3% of the U.S. population. Borderline personality disorder is found in 2% of the U.S. population. These disorders denote the endpoints on a spectrum of compulsive and impulsive disorders. One endpoint marks compulsive or risk-aversive behaviors characterized by overestimation of the probability of future harm, highlighted by OCD. The other endpoint designates impulsive action characterized by the lack of complete consideration of the negative results of such behavior, such as borderline and antisocial personality disorders. This article examines studies testing the efficacy of different medications in treating compulsive and impulsive disorders. Mood stabilizers such as divalproex, selective serotonin reuptake inhibitors, monoamine oxidase inhibitors, and neuroleptics have documented efficacy in treating aggression and affective instability in impulsive patients.

Aggression↗
PubMed2003

Dissociable aspects of performance on the 5-choice serial reaction time task following lesions of the dorsal anterior cingulate, infralimbic and orbitofrontal cortex in the rat: differential effects on selectivity, impulsivity and compulsivity.

It is becoming increasingly apparent that multiple functions of the frontal cortex such as inhibitory control and executive attention are likely sustained by its functionally distinct and interacting sub-regions but the precise localization of dissociable executive processes has proved difficult and controversial. In the present series of studies, we investigated the behavioural effects of bilateral excitotoxic lesions of different regions of the rat neocortex in the 5-choice serial reaction time task. Whereas lesions of the dorsal anterior cingulate cortex (ACC) impaired performance of the task as revealed by a reduction in discriminative accuracy, lesions made to distinct ventral regions of the frontal cortex showed selective deficits in inhibitory measures of control. Specifically, the infralimbic lesion produced increases in premature responding that was accompanied by fast response latencies. By comparison, the orbitofrontal lesion showed perseverative tendencies particularly when the inter-trial interval was made long and unpredictable, a challenge that would normally promote premature responding instead. These different behavioural effects following dorsal and ventral lesions of the rodent frontal cortex signifies the integrity of the frontal cortex in multiple executive mechanisms that work independently and complementarily by which performance is optimized. Furthermore, these data provide new insights into the functional organization of the rodent frontal cortex with a particular emphasis on localization of function.

Animals↗
PubMed2005

Compulsive-like behaviour according to the sex and the reproductive stage of female rats.

The aim of the present study was to explore putative differences in the responses assessed in an animal model of obsessive-compulsive disorder (OCD) according to the sex and the reproductive cycle of female rats. The model consists of the induction of perseveration (repetitive choices of the same arm in a T-maze) by 8-OH-DPAT (1.0mg/kg). Males and females (pooled in all stages of their oestrous cycle) persevered after 8-OH-DPAT administration and no differences were observed between groups. During the oestrous cycle, this 5-HT(1A) agonist induced perseveration in metoestrus, dioestrus and prooestrus and reduced levels of this behaviour in oestrus. 8-OH-DPAT provoked perseveration in mid-gestation, an effect that was reduced in late-gestation and blocked during lactation. Reproductive cycle changes in the induced perseveration are discussed from the standpoint of the ovarian steroids' action on the serotoninergic system and on the bases of the variations in stress responsiveness along the reproductive cycle of the female. Present results validate the use of females in this model of OCD and could be relevant for studying the role of reproductive hormones in the pathophysiology of this disorder.

8-Hydroxy-2-(di-n-propylamino)tetralin↗
PubMedDate not supplied

[Eating behaviors, attitudes and obsessive-compulsive traits in adolescents of Buenos Aires City].

OBJECTIVE: Eating disorders are psychiatric illnesses of important prevalence in Argentina. Some typical characteristics of adolescence, such as body image fragility, media influence and social pressure lead partly into the development of eating disorders at that age. The objective of our study was to explore the eating behaviors, attitudes and obsessive-compulsive traits of the adolescents of Buenos Aires City. METHODS: A questionnaire survey was administered to 380 students of 5 Buenos Aires high schools (mean age:16,8 years old) and their answers were analyzed. RESULTS: Almost 50% of the adolescents were not satisfied with their weight, 43% of them has been on a diet at least once (the majority because of aesthetic reasons). A percentage of 23,5 had bulimic behaviors, 34,5% had a high number of obsessive-compulsive traits. Women were significantly more dissatisfied with their weight, had been on more diets and had more bulimic behaviors and obsessive-compulsive traits. CONCLUSIONS: Weight dissatisfaction and bulimic behaviors are frequent in adolescents of Buenos Aires City, specially among women. Preventive measures against eating disorders should be done on this population.

Adolescent↗
PubMed1976

Cognitive conditioning therapy in the treatment of stuttering.

A therapy is described in which clients vividly imagine the cognitions that usually trigger their stuttering, and then contingently experience a painful shock. With the cessation of shock, alternate desirable cognitions are imagined that are designed to facilitate fluent speech. A case study illustrating the treatment is presented. Stuttering is compared with addictive behaviors such as smoking, and it is concluded that cognitive commonalities exist among seemingly disparate behaviors. The cognitive conditioning framework provides an integrative model that can be usefully applied in a variety of situations.

Adolescent↗