Obsessional neurosis: etiology and biopsychological presuppositions. A comparative study involving Freudian and Piagetian theory.
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Adolescent↗
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Results for “Compulsive Behavior”
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A standardized behavioral group treatment program for obsessive-compulsive disorder: preliminary outcomes.
This paper provides outcome data about the efficacy of a behavioral group therapy program for obsessive-compulsive disorder (OCD). Thirty-six patients completed a 7-week outpatient treatment program which provides: (1) education about OCD and its treatment, (2) instruction in a cognitive and behavioral approach to the self-treatment of OCD and (3) guided behavioral treatment. Significant improvement in obsession, compulsion, and depression scores were observed at completion of the group and at 3 month follow-up. Significant improvement in obsessions and compulsions was observed for both patients taking anti-obsessional medications and those who did not.
Adult↗
Genetic dissociation of two behaviors associated with nicotine addiction: beta-2 containing nicotinic receptors are involved in nicotine reinforcement but not in withdrawal syndrome.
RATIONALE: Nicotine addiction is characterized by two distinct behaviors, chronic compulsive self-administration and the induction of a withdrawal syndrome upon cessation of nicotine consumption. OBJECTIVE: To examine if these two processes rely on beta2-containing nicotinic receptors--beta2*nAChRs--we analyzed the behavior of mice lacking these receptors in the two situations. RESULTS: First, we showed that, in contrast to wild-type (WT) mice, beta2-knockout (beta2-/-) mice exhibit no intra-ventral tegmental area (VTA) nicotine self-administration, whereas their ability to self-administer morphine is intact. However, beta2-/- mice showed some sensitivity to locomotor effects of nicotine, implying an effect of the drug on other nicotinic subtypes. Then, we observed that beta2-/- mice exhibited a normal nicotine withdrawal syndrome, i.e., increased levels of rearing and jumping upon precipitated withdrawal. Thus, the beta2*nAChRs are not involved in the behaviors induced by cessation of nicotine consumption. CONCLUSION: Taken together, the present data demonstrated a genetic dissociation of two distinct behavioral patterns associated with nicotine addiction. They further suggested that independent molecular mechanisms underlie these two aspects, offering the possibility of controlling them separately.
Animals↗
Follow-up studies in obsessional neurosis.
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Adolescent↗
[Psychopathology of stealing acts without substantial personal enrichment (author's transl)].
On the basis of a descriptive study of eight cases, four different types of stealing act without substantial personal enrichment are determined: 1. Stealing for substitutional sexual satisfaction 2. Stealing as a reaction to relieve strong emotions 3. Stealing during a state of disturbed consciousness 4. Stealing from psychotic motives. In this context terminologic and diagnostic problems are dicussed. Stealing acts without substantial personal enrichment are classified as a subgroup of pathologic stealing.
Adult↗
Progressive right frontotemporal degeneration: clinical, neuropsychological and SPECT characteristics.
The behavioral, neuropsychological and single photon emission computerized tomography characteristics of 5 patients with progressive degeneration of the right hemisphere are described. In all, the brain regions with greatest involvement were right-frontal and temporal. Psychosis, compulsions and behavioral disinhibition were the dominant, and often first, symptoms. Affect was flattened and the patients seemed distant and remote. Neuropsychological testing did not reveal a consistent pattern that helped localize the abnormality to the right frontotemporal region. These patients contrast dramatically to those with left frontotemporal degeneration in whom behavior and psychiatric status is often normal. This study suggests that the right hemisphere may be primary for the control of social conduct.
Aged↗
[Compulsion neurosis and latent homosexuality. The significance of the compulsion ritual].
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Compulsive Behavior↗
Genetic variants of the human obesity (OB) gene: association with body mass index in young women, psychiatric symptoms, and interaction with the dopamine D2 receptor (DRD2) gene.
To examine the possible role of genetic variants of the OB gene in obesity we examined alleles of a dinucleotide repeat polymorphism, D7S1875, close to the gene, in a group of adult, non-Hispanic Caucasians. There was a significant correlation with body mass index (BMI) at age 26-30 years for males and females combined (P = 0.04) and females only (P = 0.028). Because of the frequent association between obesity and psychiatric symptoms all subjects were screened with the Symptom List 90 (SCL-90). There was a significant increase in scores for anxiety (P = 0.0005), depression (P = 0.003), and other behaviors for subjects homozygous for the OB1875 < 208-bp alleles. Analysis of covariance indicated that this was directly related to the OB alleles and not secondary to the presence of obesity. There was a significant association between the BMI at ages 16 to 40 and homozygosity for the OB1875 < 208-bp alleles and/or the presence of the DRD2 Taq A1 allele for males and females combined (P = 0.002 to 0.005), and for females alone (P = 0.0017 to 0.0005). For females alone these two genes accounted for up to 22.8% of the variance of the BMI. These results are consistent with the polygenic inheritance of obesity, the greater involvement of genetic factors in women and younger individuals, and suggest that variants of the OB gene are causally involved not only in human obesity but its associated behavioral disorders.
Adult↗
Cognitive-behavioral group therapy for obsessive-compulsive disorder: a 1-year follow-up.
OBJECTIVE: The aim of this study was to evaluate the results of cognitive-behavioral group therapy (CBGT) for obsessive-compulsive disorder (OCD) over a 1-year follow-up period. METHOD: Forty-two OCD patients, who completed 12 sessions of CBGT, were followed for 1 year. Measures of the severity of symptoms were obtained at the end of the acute treatment and at 3, 6, and 12 months post-treatment using the Yale-Brown obsessive-compulsive scale (Y-BOCS) and the clinical global impression (CGI). RESULTS: The reduction in the severity of symptoms observed at the end of the treatment was maintained during 1 year (F2,41=1.1; P=0.342). Eleven patients (35.5%) relapsed in the follow-up period. The intensity of improvement (log rank=12.97, GL=1, P=0.0003) and full remission (log rank=6.17; GL=1; P=0.001) were strong predictors for non-relapsing. CONCLUSION: The CBGT is an effective treatment for OCD and its results are maintained for 1 year. However, further long-term randomized controlled trials are needed in order to confirm this finding.
Adult↗
Paroxetine treatment of compulsive hoarding.
OBJECTIVE: Compulsive hoarding, found in many patients with obsessive-compulsive disorder (OCD), has been associated with poor response to serotonin reuptake inhibitor (SRI) medications in some reports. However, no prior study has quantitatively measured response to standardized pharmacotherapy in compulsive hoarders. We sought to determine whether compulsive hoarders would respond as well as non-hoarding OCD patients to the SRI, paroxetine. METHODS: Seventy-nine patients with OCD (32 patients with the compulsive hoarding syndrome and 47 patients without prominent hoarding symptoms) were treated openly with paroxetine (mean dose 41.6+/-12.8 mg/day; mean duration 80.4+/-23.5 days) according to a standardized protocol, from 3/1993 to 7/2005. All subjects were free of psychotropic medication for at least four weeks prior to study entry. No psychotherapy or psychotropic medications except paroxetine were allowed during the study period. Subjects were assessed before and after treatment with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Scale (Ham-A), Global Assessment Scale (GAS), and Clinical Global Impression/Improvement (CGI) scale. RESULTS: Both compulsive hoarders and non-hoarding OCD patients improved significantly with treatment (p<0.001), with nearly identical changes in Y-BOCS, HDRS, Ham-A, and GAS scores. There were no significant differences between groups in the proportions of patients who completed or responded to treatment. Hoarding symptoms improved as much as other OCD symptoms. CONCLUSIONS: Compulsive hoarders responded as well to paroxetine treatment as non-hoarding OCD patients, suggesting that SRI medications are effective for compulsive hoarding. Controlled trials of SRI medications for compulsive hoarding are now warranted.
Adult↗
Cognitive-behavioral family treatment of childhood obsessive-compulsive disorder: preliminary findings.
The effectiveness of a 14-week cognitive-behavioral family treatment protocol for childhood obsessive-compulsive disorder (OCD) was piloted using a volunteer sample of seven children aged 10-14 years. The primary outcome measures were diagnostic status, symptom severity, and global functioning which were assessed at pre- and post-treatment, and at three-month follow-up. A series of self-report measures assessing obsessive-compulsive symptomatology, depression, and family factors were also completed at pre- and post-treatment. The results indicated that six participants no longer met criteria for OCD at post-treatment, with a mean reduction of 60% in symptom severity. Self-reported obsessive-compulsive symptomatology and family involvement in the disorder also significantly decreased across time. The findings support the efficacy of cognitive-behavioral treatment with a structured family component for childhood OCD. Further research investigating the comparative efficacy of treatment with and without family involvement is warranted.
Adolescent↗
[Effects of behavior therapy applied to obsessive-compulsive disorders--comparison with drug therapy].
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Adult↗
The use of dextromethorphan to treat repetitive self-directed scratching, biting, or chewing in dogs with allergic dermatitis.
OBJECTIVE: To evaluate the efficacy of oral dextromethorphan in dogs with a repetitive behavior problem (self-licking, self-chewing, and self-biting associated with chronic allergic dermatitis). ANIMALS: Fourteen dogs with chronic allergic dermatitis were enrolled in the study. Twelve dogs completed the study. PROCEDURE: The dogs were treated for 2 weeks each with dextromethorphan (2 mg/kg BID) and placebo in a randomized, double blind, crossover designed study. A dermatology score, including an assessment of affected areas of the integument and the level of self-directed behavior, was generated before and following each 2-week phase of the study. Owners were required to record daily the amount of time they spent with their dog and the amount of time that the dog was observed to be engaged in any of the specified self-directed behaviors. RESULTS: The percent of the observed time that the dogs were reported to be involved in self-directed behaviors was significantly less during the 2-week active drug treatment phase. The pruritus score component of the dermatology score also was significantly less during the active treatment phase. In addition, a dermatologist-rated global assessment was more favorable in 11 of 12 dogs following the active treatment phase. CONCLUSIONS: Dextromethorphan significantly reduces the percentage of time that allergic dogs spend self-licking, self-chewing, and self-biting. CLINICAL RELEVANCE: Dextromethorphan may be a useful adjunct in the management of self-directed behaviors associated with allergic dermatitis and possibly in other repetitive behaviors as well.
Analgesics, Opioid↗
Use of a portable computer program to assist behavioral treatment in a case of obsessive compulsive disorder.
This case study describes the development and use of a portable computer program to assist in behavioral treatment of obsessive compulsive disorder. A 58-year-old female with a 37-year history of compulsive checking rituals, who had mild improvement following 36 months of standard behavioral techniques and pharmacotherapy, showed improved compliance with behavioral treatments of exposure and response prevention following use of the portable computer program. Computer records indicated marked reductions in frequency of checking rituals and a 91-week follow-up indicated that treatment effects were maintained at home where the patient had resumed using the laptop computer. She had stopped using the pocket computer outside the home, and there her checking rituals had returned to baseline levels.
Behavior Therapy↗
Patients with obsessive-compulsive disorder and hoarding symptoms: a distinctive clinical subtype?
We investigated whether patients with obsessive-compulsive disorder (OCD) and hoarding symptoms can be differentiated from their counterparts with other types of obsessions and compulsions in terms of sociodemographic and clinical features. Ninety-seven patients with OCD were assessed with a sociodemographic and clinical questionnaire, the Structured Clinical Interview for DSM-IV (SCID-I), the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Beck Depression Inventory (BDI), the Hamilton Rating Scale for Depression (HDRS), and the Global Assessment of Functioning (GAF). Fifteen patients who reported hoarding symptoms in the Y-BOCS checklist (15.6% of the total sample) were compared and contrasted with 82 patients without those symptoms using the Mann-Whitney U test for continuous variables and the Pearson's goodness-of-fit chi-square test for categorical ones; Fisher's exact test was employed when indicated. Hoarders were characterized by (1) higher educational levels (chi(2) = 7.49; df = 2; P =.02); (2) earlier age at onset (Z = -2.99; P =.003); (3) higher rates of symmetry obsessions (chi(2) = 7.03; df = 1; P =.01); (4) greater frequency of ordering (chi(2) = 10.08; df = 1; P =.004); (5) rituals repetition (chi(2) = 4.42; df = 1; P =.03); (6) counting compulsions (chi(2) = 5.92; df = 1; P =.02); and (7) significantly higher rates of comorbidity with bipolar II disorder (chi(2) = 10.62; df = 1; P =.02) and (8) with eating disorders (chi(2) = 7.42; df = 1; P =.02). In conclusion, patients with OCD exhibiting hoarding feature a distinctive sociodemographic and clinical profile. It remains to be investigated whether these phenotypical characteristics are underlined by specific neurobiological mechanisms.
Adolescent↗
Hoarding as a psychiatric symptom.
Collecting is a normal behavior in childhood and adulthood, while hoarding--the gathering, ordering, and disposal of articles without clear conscious motivation or control--is characterized as the pathologic counterpart of collecting. The literature describing the characteristics of collecting and the theories concerning its underlying mechanisms is presented along with eight case studies of adults who exhibited hoarding as a prominent symptom. It is apparent that hoarding is the final common pathway for a variety of processes: compulsive hoarding in obsessive compulsive disorder, fears of theft and poisoning in paranoid delusions, and the deterioration of habits in organic mental disorder.
Adult↗
[Gambling behavior and gambling experience of pathologic gamblers using slot machines].
A representative sample of 106 men playing at slotmachines with possibility to win money in 61 casinos in Zürich were interviewed. One questionnaire contained sociodemographic variables and gambling habits, the second questionnaire (GBE) was about gambling behaviour and the emotional experience of gambling. One out of four persons proved to be a compulsive gambler on the ground of gambling frequency and duration. 85% of these excessive gamblers could also be identified as pathological gamblers because of their behaviour and emotional experience (GBE-questionnaire) with analysis of discriminance. Compulsive gamblers showed side effects of an addiction like strong tendencies for denial and rationalization. At the same time they heavily relied on acquaintances and friends for acquiring finances. On the other hand they were characterized by being unable to set limits to the gambling habit and the perception of being dependent.
Adolescent↗
Body checking and avoidance in overweight patients with binge eating disorder.
OBJECTIVE: Repetitive body checking and avoidance are viewed as behavioral manifestations of the core psychopathology of eating disorders (EDs). We examined select body checking and avoidance behaviors in overweight patients with binge eating disorder (BED). METHOD: Three hundred seventy-seven overweight (body mass index [BMI] > or = 25) treatment-seeking BED patients (80 men and 297 women) were administered measures to assess body checking and avoidance, other key behavioral features of EDs (binge eating, dietary restraint, and disinhibition), and the core psychopathology of EDs (overevaluation of weight and shape). RESULTS: The majority of participants reported regularly pinching areas of their body to check for fatness and avoided wearing clothing that made them particularly aware of their body. Significant associations emerged between checking and restraint, and conversely, between avoidance and binge eating. Both checking and avoidance were positively and significantly associated with overevaluation of weight and shape, even after controlling for their unique effects. DISCUSSION: These findings offer support to the potential role of checking and avoidance behaviors in the maintenance of BED.
Adult↗