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PubMed1985

[Clinico-genealogic study of schizophrenia with a predominantly obsessive course].

A clinico-genealogic study of 66 patients with neurosis-like schizophrenia showed a certain genetic heterogeneity of schizophrenia with obsessions. In cases of an unfavourable course of the schizophrenic process in a proband (a malignant disease of obsessions), the familial background was largely determined by disturbances of the schizophrenic spectrum. In cases of a slow progression of the disease (slowly progressive pseudoneurotic schizophrenia), the hereditary background was characterized by a great variability of psychopathological manifestations. Along with schizophrenia-related abnormalities, the families of such patients featured the accumulation of constitutional anomalies, neurotic disturbances and subclinical affective disorders.

Adolescent↗
PubMedDate not supplied

Act of compulsion.

Explore the source record for details and available documents.

Commitment of Persons with Psychiatric Disorders↗
PubMed1996

Diagnosis, neurobiology, and treatment of pathological gambling.

Pathological gambling is a disabling disorder that affects at least 2 1/2 million Americans and their families. Although pathological gambling has been characterized as an impulse control disorder, it has also been associated with compulsivity. Essential features of pathological gambling include constantly recurring gambling behavior that is maladaptive, in that personal, familial, and/or vocational endeavors are disrupted. Affective disorders and substance abuse often co-occur. Incidence of suicidality is extremely high. Despite the fact that this disorder is a widespread public health problem, few controlled studies of causes or treatment have been conducted. Preliminary neurobiological studies implicate serotonergic dysfunction in pathological gamblers. Treatment with serotonin reuptake inhibitors, such as clomipramine and fluvoxamine, may be effective in treating this disorder. Well-defined and controlled clinical trials in large samples of pathological gamblers are needed.

Adolescent↗
PubMed2006

Pervasive developmental disorders in Prader-Willi syndrome: the Leuven experience in 59 subjects and controls.

In the present study we investigated the co-morbidity of pervasive developmental disorder (PDD) in 59 Prader-Willi syndrome (PWS) individuals and in 59 non-specific mentally retarded controls, matched for IQ, gender, and age. The 'Pervasive Developmental Disorder Mentally Retardation Scale' (PDD-MRScale), a screening questionnaire based on the DSM-III-R criteria for PDD, has been applied in the PWS group and in the control group. Results of the present study revealed a striking autistic-like behavioral phenotype in the majority of the PWS individuals, particularly deficits in the quality of language and communication and of imagination and interests. This intersection with autistic symptomatology is an important addition to the behavioral phenotype in PWS persons. A first approach to delineate subtypes of autistic symptomalogy among PWS persons was performed. Nineteen percent of the PWS group did meet the full diagnostic DSM-III-R criteria for PDD in comparison with 15% in the control group. Results revealed that a higher IQ in PWS does not protect to develop genuine PDD and that uniparental disomy/imprinting mutation as genetic origin seems to be an additional risk factor for developing genuine PDD. The results of the present study suggest the importance of reconsidering the commonly recognized obsessive-compulsive like behavior in PWS persons within the broader spectrum of autism disorders.

Adolescent↗
PubMed2003

Representations of therapists by patients with personality disorders.

The purpose of this study was to investigate attributes of mental representations of therapists by patients with specific personality disorders (PDs), schizotypal (STPD), borderline (BPD), avoidant (AVPD), and obsessive-compulsive (OCPD), and a comparison group with Major Depressive Disorder and no PD (MDD). The Therapist Representation Inventory-II (TRI) measured characteristics of participants' extra-session thoughts about their therapists. Results showed that patients with STPD had the highest level of mental involvement with therapy outside the session, missing their therapists and wishing for friendship, while also feeling aggressive or negative. Patients with BPD exhibited the most difficulty in creating a benign image of the therapist. Variables such as gender, co-occurring Axis I disorders, and amount of individual psychotherapy received were significant covariates for a number of analyses. The importance of understanding the internal dynamics of patients' thoughts about their treatment relationship was underscored.

Adolescent↗
PubMed2003

Psychiatric disorders in Prader-Willi syndrome: epidemiology and management.

Although people with intellectual disabilities are at increased risk for psychiatric disorders, the type and rate of these problems differ between those with different causes for their retardation. In this paper, we review behavioural and psychiatric problems in persons with Prader-Willi syndrome, a disorder caused by a paternally derived deletion at chromosome 15(q11-q13) in about 70% of affected patients, and by maternal uniparental disomy in the majority of the remaining patients. In addition to the syndrome's characteristic hyperphagia and food seeking, individuals with Prader-Willi syndrome also have increased risks of nonfood, compulsive behaviours. These include skin picking, which is highly prevalent, as well as more variable rates of hoarding, redoing and concerns with symmetry, exactness, cleanliness, ordering and arranging. Relative to others with mental retardation, persons with Prader-Willi syndrome are at a marked increased risk for developing full-blown, obsessive-compulsive disorder. In addition, many people with Prader-Willi syndrome show increased rates of tantrums, oppositionality and aggression. Recent findings suggest that they also have an increased risk of psychotic disorder or affective illness with a psychotic component, especially young adult patients and those with the maternal uniparental disomy as opposed to paternal deletion. Dietary approaches include a reduced-calorie diet and increased physical activity, as well as close supervision around food and keeping food locked away. To date, neither CNS stimulants nor anorectic agents have been effective in treating hyperphagia, in part because hyperphagia in Prader-Willi syndrome is attributed to decreased satiation as opposed to increased hunger. Treatment for compulsivity and maladaptive behaviours include: behavioural programming; a structured, predictable routine; extra help with transitions; family support; and pharmacotherapy. Although formal drug studies have yet to be conducted, SSRIs have been effective in reducing skin picking, compulsivity and aggressive episodes in some individuals with Prader-Willi syndrome. Atypical antipsychotics have also proven helpful in persons with psychotic features or extreme aggression and impulsivity. Largely on the basis of case studies, the risks and benefits of these and other drugs in Prader-Willi syndrome are reviewed. Drug trials that move beyond case studies and that assess the relative efficacy of behavioural treatments alone or in combination with pharmacotherapy are sorely needed.

Antipsychotic Agents↗
PubMed2005

Obsessive-compulsive dimension localized using low-resolution brain electromagnetic tomography (LORETA).

Electroencephalographic mapping techniques have been used to show differences between normal subjects and those diagnosed with various mental disorders. To date, there is no other research using the techniques of low-resolution brain electromagnetic tomography (LORETA) with the obsessive-compulsive disorder (OCD) population. The current investigation compares current source density measures of persons with OCD symptoms to an age-matched control group. The main finding is excess current source density in the Beta frequencies in the cingulate gyrus. This Beta activity is primarily located in the middle cingulate gyrus as well as adjacent frontal parieto-occipital regions. Lower frequency Beta is prominent more anteriorly in the cingulate gyrus whereas higher frequency Beta is seen more posteriorly. These preliminary findings indicate the utility of LORETA as a clinical and diagnostic tool.

Adolescent↗
PubMed1998

Hospital utilization and personality characteristics of veterans with psychiatric problems.

OBJECTIVE: The relationship between hospital utilization and psychometric, demographic, and diagnostic data was examined among veterans with psychiatric problems. METHODS: Data were obtained from the records of 500 psychiatric inpatients admitted to a Veterans Affairs medical center between 1984 and 1987 and followed for four years. All patients completed the Minnesota Multiphasic Personality Inventory, the California Personality Inventory, the Millon Clinical Multiaxial Inventory, and the Psychological Inventory of Personality and Symptoms. Stepwise linear regression analysis was used to predict the number and length of inpatient stays, and Cox and logistic regression analyses predicted rehospitalization. RESULTS: Higher rates of psychiatric hospital utilization were found among patients who were unmarried, who had disabilities connected with their military service, who had lower levels of adaptive functioning, and who were diagnosed as having posttraumatic stress disorder, drug or alcohol use disorder, or passive-aggressive or antisocial personality disorder. Higher utilization was also found among those whom psychometric data characterized as less responsible and more compulsive. The data also predicted the length of subsequent medical hospitalization and identified patients who stayed out of the hospital longer and who were not rehospitalized. CONCLUSIONS: Hospital utilization was found to be a function of psychiatric diagnosis, marital status, and various personality factors. Factors relating to social disadvantage also played a role. Axis I diagnoses, particularly substance use disorders, were as important as, if not more important than, axis II diagnoses in predicting utilization.

Adult↗
PubMed2007

[Compulsive shopping--current considerations on classification and therapy].

Compulsive shopping is classified by ICD-10 (F63.8) as an "impulse control disorder, not otherwise classified". Several authors consider compulsive shopping rather as a variety of dependence disorder. It is characterized by the impulsive or compulsive buying of unneeded things, personal distress, impaired social and vocational functioning, and/or financial problems. In this case, we discuss a two-way therapy consisting of addiction-specific psychological education and high dose selective serotonin reuptake inhibitors (SSRIs). We further point to compliance problems caused by SSRI side effects.

Behavior, Addictive↗
PubMed2004

Neurological soft signs in obsessive-compulsive disorder.

BACKGROUND: Neurological soft signs (NSSs) are defined as abnormal motor or sensory findings, including involuntary movements, a variety of dispraxia, difficulties in performing rapid alternating movements, difficulties in two-point discrimination, and graphesthesia in a person without a neurological disorder which can be determined as its focus. AIMS: to investigate the relationship of NSSs with obsessive-compulsive disorder (OCD). SETTINGS AND DESIGN: This study was designed in the Psychiatry Polyclinic of Ondokuz Mayis University Hospital. After signing an informed consent form, all the subjects were divided into 2 groups: (1) the patient group and (2) the control group. MATERIAL AND METHODS: Thirty consecutive patients presenting with DSM-IV OCD were included in this study. The control group consisted of 30 healthy subjects without a psychiatric/neurological disorder. All subjects underwent a physical and neurological examination for soft signs (PANESS). STATISTICAL ANALYSIS USED: The Mann-Whitney U test was used for statistical analysis of data. RESULTS: It was seen that graphesthesia, two-point discrimination, and total PANESS scores were significantly higher in the group with OCD than the control group. In other NSSs, there was no significant difference between the patient and control groups. CONCLUSIONS: Unlike some studies, in the present study, the difference between the groups in graphesthesia compared to other NSSs was significant. The results of this preliminary study suggest that there is a relationship between NSSs and OCD. We think that NSSs may point to a structural brain abnormality in patients with OCD.

Adult↗
PubMed2004

Patterns of obsessive-compulsive symptoms and social function in schizophrenia.

Research has alternately found that obsessive and compulsive (OC) symptoms in schizophrenia are associated with graver and lesser levels of negative symptoms. One possible explanation is that there are two distinct groups of persons with OC symptoms: those with cognitive deficits and high levels of negative symptoms and those who generally function well and have low levels of negative symptoms. To examine this question, we performed a cluster analysis on 66 persons with schizophrenia spectrum disorders on the basis of their level of obsessive-compulsive phenomena and global psychosocial function. Four groups were found: high OC/good function (n=9), non-OC/poor function (n=25), non-OC/moderate function (n=20), and high OC/poor function (n=12). A MANCOVA controlling for age found significant group differences on assessments of negative symptoms, executive function and attention among groups. As predicted, the high OC/poor function group had significantly poorer attention than any other group and poorer executive function than either non-OC group. The high OC/good function had lower levels of negative symptoms than either non-OC group. Implications for research and rehabilitation are discussed.

Cluster Analysis↗