Search

Objective: Measuring, diagnosing, and determining the severity of the symptoms of Obsessive-Compulsive Disorder (OCD) is essential for studying mental health issues. This study aimed to determine the psychometric properties of the Persian version of the Dimensional Obsessive-Compulsive Scale (DOCS) in a non-clinical population. Methods: In this cross-sectional study, 252 residents of Tehran (Iran) were selected by cluster sampling method from different districts. They were asked to complete DOCS, Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), and Obsessive-Compulsive Inventory-Revised (OCI-R). SPSS v. 21 and LISREL statistical software were used for data analysis. Cronbach's alpha, exploratory and confirmatory factor analysis, Spearman correlation were also used. Results: The Internal consistency of DOCS was 0.916 based on the Cronbach α value. The correlations of DOCS with Y-BOCS and OCI-R were 0.57 and 0.55, respectively. Exploratory factor analysis showed four factors. Confirmatory factor analysis also showed that this four-factor and higher-order factor models had a good fit for the data. Conclusion: The present study indicated acceptable validity and reliability of DOCS in non-clinical populations in Iran. Therefore, this scale be used to screen people with OCD symptoms in non-clinical centers of mental health assessment.

Background Suicidal ideations were reported in many studies among patient with obsessive-compulsive disorder (OCD); this study aimed to evaluate the prevalence and factors associated with current suicidal ideations among Egyptian patients with obsessive-compulsive disorder (OCD). A consecutive sample of 120 Egyptian OCD patients was included in the study. OCD was diagnosed using the structured clinical interview for DSM-V axis Ι disorders, clinical version (SCID-I-CV). Yale-Brown Obsessive Compulsive Scale (Y-BOCS) was also applied to the patients. Presence of current suicidal ideations was assessed using Scale for Suicidal Ideation (SSI). Results Twenty eight (23.3%) of the OCD patients reported presence of current suicidal ideations, religious obsessions OR = 3.53, P = 0.009, and presence of comorbid major depressive disorder OR = 1.77, P = 0.04. Conclusion Religious obsessions and comorbid major depressive disorder were found to be significant predictors for the current suicidal ideations in patients with OCD; however, religious obsessions were the strongest predictor. Religious obsessions should be evaluated and treated to decrease the risk of suicidal thoughts in Egyptian OCD patients.

Background: Extended research has pointed to the efficacy of deep brain stimulation (DBS) in treatment of patients with treatment-refractory Tourette syndrome (TS). The four most commonly used DBS targets for TS include the centromedian nucleus–nucleus ventrooralis internus (CM-Voi) and the centromedian nucleus–parafascicular (CM-Pf) complexes of the thalamus, and the posteroventrolateral (pvIGPi) and the anteromedial portion of the globus pallidus internus (amGPi). Differences and commonalities between those targets need to be compared systematically.Objective: Therefore, we evaluated whether DBS is effective in reducing TS symptoms and target-specific differences.Methods: A PubMed literature search was conducted according to the PRISMA guidelines. Eligible literature was used to conduct a systematic review and meta-analysis.Results: In total, 65 studies with 376 patients were included. Overall, Yale Global Tic Severity Scale (YGTSS) scores were reduced by more than 50 in 69% of the patients. DBS also resulted in significant reductions of secondary outcome measures, including the total YGTSS, modified Rush Video-Based Tic Rating Scale (mRVRS), Yale-Brown Obsessive Compulsive Scale (YBOCS), and Becks Depression Inventory (BDI). All targets resulted in significant reductions of YGTSS scores and, with the exception of the CM-Pf, also in reduced YBOCS scores. Interestingly, DBS of pallidal targets showed increased YGTSS and YBOCS reductions compared to thalamic targets. Also, the meta-analysis including six randomized controlled and double-blinded trials demonstrated clinical efficacy of DBS for TS, that remained significant for GPi but not thalamic stimulation in two separate meta-analyses.Conclusion: We conclude that DBS is a clinically effective treatment option for patients with treatment-refractory TS, with all targets showing comparable improvement rates. Future research might focus on personalized and symptom-specific target selection.

Practice guidelines for adults with obsessive-compulsive disorder (OCD) recommend augmenting serotonin reuptake inhibitors (SRIs) with exposure and ritual prevention (EX/RP). However, fewer than half of patients remit after a standard 17-session EX/RP course. We studied whether extending the course increased overall remission rates and which patient factors predicted remission. Participants were 137 adults with clinically significant OCD (Yale-Brown Obsessive Compulsive Scale [Y-BOCS] score ≥18) despite an adequate SRI trial (≥12 weeks). Continuing their SRI, patients received 17 sessions of twice-weekly EX/RP (standard course). Patients who did not remit (Y-BOCS ≤12) received up to 8 additional sessions (extended course). Of 137 entrants, 123 completed treatment: 49 (35.8%) remitted with the standard course and another 46 (33.6%) with the extended course. Poorer patient homework adherence, more Obsessive-Compulsive Personality Disorder (OCPD) traits, and the Brain-Derived Neurotrophic Factor (BDNF) Val66MET genotype were associated with lower odds of standard course remission. Only homework adherence differentiated non-remitters from extended course remitters. Extending the EX/RP course from 17 to 25 sessions enabled many (69.3%) OCD patients on SRIs to achieve remission. Although behavioral (patient homework adherence), psychological (OCPD traits), and biological (BDNF genotype) factors influenced odds of EX/RP remission, homework adherence was the most potent patient factor overall.

Purpose This study was conducted to examine the obsessive behaviors and coping behaviors of nursing students during the coronavirus disease 2019 (COVID‐19) pandemic. Design and Methods This descriptive study was conducted between October 4 and October 17, 2020. Findings In this study, it was found that nursing students had a mean total COVID‐19 Obsessive Compulsive Scale score of 3.88 ± 3.02 and a mean total Ways of Coping Inventory (WCI) score of 47.05 ± 11.68. When the subscales of the WCI were examined, mean scores were found to be 13.64 ± 4.85 for the self‐confident approach, 8.91 ± 3.35 for the optimistic approach, 7.25 ± 2.24 for the seeking social support approach, 10.97 ± 4.43 for the helpless approach, and 6.24 ± 3.20 for the submissive approach. Practice Implications Nursing students have low levels of obsession with COVID‐19 and moderate levels of coping behaviors. For this reason, it is very important to recognize the psychological symptoms of today's nursing students—the health workforce of the future—and to determine priorities for their solution.

To explore the clinical effect and adverse reactions of modified electroconvulsive therapy for refractory obsessive-compulsive disorder. 76 patients with refractory obsessive-compulsive disorder admitted to our hospital from June 2019 to February 2021 were selected and randomly divide into two groups, with 38 cases in each group. The control group was treated with conventional drug treatment and the study group was treated with modified electroconvulsive therapy on the basis of the control group. Follow-up was given every 6 w for a total of 12 w and corresponding evaluation was given every follow-up. The total effective rate of the study group was 92.11 %, which was significantly higher than that of the control group (78.95 %) and the difference was statistically significant (p 0.05). At the 6th and 12th w after treatment, it increased with time compared with that before treatment, The scores of Yale-brown obsessive compulsive scale, Hamilton depression scale and Hamilton anxiety scale decreased gradually. The difference was statistically significant (p 0.05). Modified electroconvulsive therapy for refractory obsessive-compulsive disorder has good clinical effect, low adverse reactions and can effectively improve patient’s anxiety, depression and obsessive-compulsive symptoms, and improve patient’s quality of life and cognitive function. However, there is a high incidence of near memory impairment.

Background: Children with Tourette syndrome (TS) often have comorbid disorders, particularly attention-deficit/hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD). While subtle premorbid symptoms have been described in various psychiatric disorders, the presence of clinical precursors that may exist before the onset of tics is unknown. This longitudinal study aimed to find clinical precursors of tics by assessing a range of clinical characteristics prior to tic onset in comparison with children without onset of tics.Methods: A sample of 187 3- to 10-year-old first-degree unaffected relatives of children with TS were followed up to 7 years in the European Multicentre Tics in Children Study (EMTICS). We investigated whether clinical characteristics assessed at baseline predicted tic onset, comparing 126 children without tic onset to 61 children who developed tics. We used the least absolute shrinkage and selection operator (LASSO) method, a penalised logistic regression approach. We also explored sex differences and repeated our analyses in an age- and sex-matched subsample.Results: Children with tic onset were more frequently male (beta = -0.36), had higher baseline severity of conduct problems (beta = 0.23), autism spectrum disorder symptoms (ASD; beta = 0.08), compulsions (beta = 0.02) and emotional problems (beta = 0.03) compared to children without tic onset. Conduct and ASD problems were male-specific predictors, whereas severity of compulsions and oppositional (beta = 0.39) and emotional problems were female-specific predictors.Conclusion: This study supports the presence of clinical precursors prior to tic onset and highlights the need of sex-specific monitoring of children at risk of developing tics. This may aid in the earlier detection of tics, particularly in females. We moreover found that tics most often persisted one year after tic onset, in contrast to the common belief that tics are mostly transient.

Background and objectives: Criticism is thought to play an important role in obsessive-compulsive disorder (OCD), and obsessive behaviors have been considered as childhood strategies to avoid criticism. Often, patients with OCD report memories characterized by guilt-inducing reproaches. Starting from these assumptions, the aim of this study is to test whether intervening in memories of guilt-inducing reproaches can reduce current OCD symptoms. The emotional valence of painful memories may be modified through imagery rescripting (ImRs), an experiential technique that has shown promising results. Methods: After monitoring a baseline of symptoms, 18 OCD patients underwent three sessions of ImRs, followed by monitoring for up to three months. Indexes of OCD, depression, anxiety, disgust and fear of guilt were collected. Results: Patients reported a significant decrease in OCD symptoms. The mean value on the Yale−Brown Obsessive Compulsive Scale (Y-BOCS) changed from 25.94 to 14.11. At the three-month follow-up, 14 of the 18 participants (77.7%) achieved an improvement of ≥ 35% on the Y-BOCS. Thirteen patients reported a reliable improvement, with ten reporting a clinically significant change (reliable change index = 9.94). Four reached the asymptomatic criterion. Clinically significant changes were not detected for depression and anxiety. Conclusions: Our findings suggest that after ImRs intervention focusing on patients’ early experiences of guilt-inducing reproaches there were clinically significant changes in OCD symptomatology. The data support the role of ImRs in reducing OCD symptoms and the previous cognitive models of OCD, highlighting the role of guilt-related early life experiences in vulnerability to OCD.

Obsessive-compulsive symptom dimensions are important in studies about the pathogenesis and treatment of obsessive-compulsive disorder. More than 30 factor analytic studies using the Yale-Brown Obsessive Compulsive Scale Symptom Checklist (Y-BOCS-SC) interview version have been published. However, a drawback of the Y-BOCS-SC interview is that it is time-consuming for the clinician. Baer's self-report version of the Y-BOCS-SC could be a less time-consuming alternative. The purpose of this study was to examine the factor structure of Baer's self-report Y-BOCS-SC. In a sample of 286 patients, we performed two factor analyses, one using categories and one using items of the Y-BOCS-SC. Using category-level data, we identified four factors; when using items we identified six factors. Symptom dimensions for contamination/cleaning, symmetry/repeating/counting/ordering and hoarding were found in both analyses. The impulsive aggression, pathological doubt, sexual, religious somatic and checking categories formed one factor in the analysis using category-level data and divided into three factors using item-level data. These factors correspond with studies using the interview version and support our hypothesis that the self-report version of the Y-BOCS-SC could be an alternative for the interview version.

The present study aimed at investigating the affects of attachment and thought control strategies in a clinical sample (OCD patients) in Turkey. For these purposes 101 clinical OCD participants completed questionnaires related to research variables. Experience in Close Relationship Scale (Fraley, Waller & Brennan, 2000) to evaluate attachment, Thought Control Strategies Questionnaire (Wells & Davies, 1994) to evaluate thought control and Yale-Brown Obsessive Compulsive Scale (Goodman, Price & Rassmussen, 1989) to evaluate OCD symptoms were used in this study. A series of hierarchical analyses were done. Findings of the analyses revealed that there was significant relation between attachment, thought control strategies and OCD symptoms. Moreover, It is seen that there is a mediating role of punishment between the anxiety level of attachment and the severity of obsessive symptom, the mediating role of worry control strategy between the anxiety level of attachment and pathological responsibility symptoms, and the mediating role of social control management between the avoidance level of attachment and avoidance symptom severity.To sum up according to results of this study attachment and control strategies are important to understand OCD symptoms. The results were discussed in the light of the related literature and dependent recommendations to the area were given. [JCBPR 2018; 7(2.000): 80-91]

Ä°lkay Keleş Altun,1 Emel Uysal,2 Evrim Özkorumak Karagüzel2 1Department of Psychiatry, Kanuni Research and Training Hospital, Trabzon, 2Department of Psychiatry, Karadeniz Technical University, Trabzon, Turkey Background: Obsessive compulsive disorder (OCD) is characterized by obsessions and compulsions. Obsessions have been classified as autogenous obsessions and reactive obsessions on the basis of the cognitive theory of Lee and Kwon. The aim of this study was to investigate the differences between autogenous groups (AG) and reactive groups (RG) in terms of metacognition and automatic thoughts, for the purpose of investigating the differences of cognitive appraisals.Methods: One hundred and thirty-three patients diagnosed with OCD were included in the study as the patient group. A control group was formed of 133 age, gender and education-matched healthy individuals. The OCD group patients were separated into subgroups according to the primary obsessions. The sociodemographic data, and the Yale–Brown Obsessive Compulsive Scale, Metacognition Questionnaire-30 (MCQ-30), Automatic Thoughts Questionnaire (ATQ), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) scores of the AG, RG, and control groups were compared.Results: The MCQ-30 (total) and the subscales of MCQ-30 and ATQ scale points were seen to be significantly higher in the AG than in the RG and significantly higher in the RG than in the control group. In the reactive obsession group, the predictive variables of the ATQ points were determined to be MCQ-30 (total), BDI and BAI. In the autogenous obsession group, the predictive variables of the ATQ points were determined to be BDI and BAI.Conclusion: In the current study, differences were determined between the AG and the RG in respect of metacognitions and automatic thoughts. In light of these results, the recommended grouping can be considered useful in the identification of OCD sub-types. There is a need for further studies to identify more homogenous sub-types of OCD. Future multi-centered studies of sub-typing with larger samples using more specific instruments to sub-type and dimensional evaluation will be useful for detailed evaluation and better understanding of the subject. Keywords: obsessive compulsive disorder, autogenous, reactive, obsessions, metacognitions, automatic thoughts

Background: This study was carried out to enumerate the level of difference in functional impairment and quality of life (QOL) in obsessive-compulsive disorder (OCD) patients and normal control group to find out the relationship among ICD functional impairment and QOL. Methodology: Thirty patients diagnosed with OCD as per International Classification of Diseases Diagnostic Criteria for Research-10 were taken for study. The control group consists of 30 normal participants from the community. Functional impairment and QOL questionnaires were administered on both groups to measure functional impairment and QOL in OCD. Results: The mean age of onset of OCD was (23.8 ± 7.25), mean duration of illness was (6.3 ± 4.47), and mean duration of treatment was (2.56 ± 2.47). It was also observed that total score as well as all the domains of the World Health Organization QOL-BREF, OCD patients scored significantly less (P < 0.001) compared to normal controls. Dysfunctional Analysis Questionnaire (DAQ)-Social area and DAQ-Personal area had statistically significant positive correlation (P < 0.05) with an obsessive subscale of Yale–Brown Obsessive Compulsive Scale (Y-BOCS) whereas DAQ-social area (P < 0.05), DAQ-Personal Area (P < 0.05) had statistically significant positive correlation with a total score of Y-BOCS. Conclusion: The presence of functional impairment leads to poor QOL in the persons with OCD.

Trichotillomania (TTM) and eating disorders (ED) share many phenomenological similarities, including ritualized compulsive behaviors. Given this, and that comorbid EDs may represent additional functional burden to hair pullers, we sought to identify factors that predict diagnosis of an ED in a TTM population. Subjects included 555 adult females (age range 18–65) with DSM-IV-TR TTM or chronic hair pullers recruited from multiple sites. 7.2% (N = 40) of our TTM subjects met criteria for an ED in their lifetime. In univariable regression analysis, obsessive-compulsive disorder (OCD), Yale-Brown Obsessive Compulsive Scale (Y-BOCS) worst-ever compulsion and total scores, certain obsessive-compulsive spectrum disorders, anxiety disorder, attention-deficit/hyperactivity disorder (ADHD), and substance disorder all met the pre-specified criteria for inclusion in the multivariable analysis. In the final multivariable model, diagnosis of OCD (OR: 5.68, 95% CI: 2.2–15.0) and diagnosis of an additional body-focused repetitive behavior disorder (BFRB) (OR: 2.69, 95% CI: 1.1–6.8) were both associated with increased risk of ED in TTM. Overall, our results provide further support of the relatedness between ED and TTM. This finding highlights the importance of assessing for comorbid OCD and additional BFRBs in those with TTM. Future research is needed to identify additional predictors of comorbid disorders and to better understand the complex relationships between BFRBs, OCD and EDs.

BACKGROUND: Patients with obsessive compulsive disorder (OCD) frequently show traits of autism spectrum disorders (ASD). This is one of the first studies to explore the clinical impact of the overlap between OCD and ASD as a categorical diagnosis. METHODS: A cross-sectional survey in 73 adult outpatients with DSM-IV OCD. Autistic traits were measured using the Autism-Spectrum Quotient (AQ). A clinical estimate ASD diagnosis was made by interview using DSM-IV-TR criteria. OCD patients with and without autistic traits or ASD were compared on demographic and clinical parameters and level of OCD treatment-resistance based on treatment history. RESULTS: Thirty-four (47%) patients scored above the clinical threshold on the AQ (> =26) and 21 (27.8%) met diagnostic criteria for ASD. These diagnoses had not been made before. Patients with autistic traits showed a borderline significant increase in OCD symptom-severity (Yale-Brown Obsessive Compulsive Scale (Y-BOCS); p=.054) and significantly increased impairment of insight (Brown Assessment of Beliefs Scale; p=.01). There was a positive correlation between AQ and Y-BOCS scores (p =.04), but not with OCD treatment resistance. CONCLUSION: There is a high prevalence of previously undiagnosed ASD in patients with OCD. ASD traits are associated with greater OCD symptom-severity and poor insight.

Background: This study aimed to evaluate eye-movement desensitisation and reprocessing (EMDR) as a treatment for obsessive-compulsive disorder (OCD), by comparison to cognitive behavioural therapy (CBT) based on exposure and response prevention.\ud \ud Method: This was a pragmatic, feasibility randomised controlled trial in which 55 participants with OCD were randomised to EMDR (n = 29) or CBT (n = 26). The Yale-Brown obsessive compulsive scale (YBOCS) was completed at baseline, after treatment and at 6 months follow-up. Treatment completion and response rates were compared using chi square tests. Effect size was examined using Cohen’s d and multilevel modelling.\ud \ud Results: Overall, 61.8% completed treatment and 30.2% attained reliable and clinically significant improvement in OCD symptoms, with no significant differences between groups (p > .05). There were no significant differences between groups in YBOCS severity post-treatment (d = -0.24, p = .38) or at 6 months follow-up (d = -0.03, p = .90).\ud \ud Conclusions: EMDR and CBT had comparable completion rates and clinical outcomes.

Obsessive-compulsive disorder (OCD) is characterized by obsessions and compulsions. Treatment usually consists of serotonergic medications along with exposure therapies. Danger ideation reduction therapy (DIRT) is an alternative therapy predominantly for washing compulsions and focuses on reduction of danger ideations. DIRT was tried on Ms. S. with a history of OCD for 15 years and improvement was noticed on Yale–Brown Obsessive Compulsive Scale, Padua Inventory, Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale after 15 sessions of DIRT though she was not fully symptom-free. Thus, DIRT was found to improve OCD symptoms and improved her insight into illness.

Determining response or remission status in body dysmorphic disorder (BDD) usually requires a lengthy interview with a trained clinician. This study sought to establish empirically derived cutoffs to define treatment response and remission in BDD using a brief self-report instrument, the Appearance Anxiety Inventory (AAI). Results from three clinical trials of BDD were pooled to create a sample of 123 individuals who had received cognitive-behavioral therapy for BDD, delivered via the Internet. The AAI was compared to gold-standard criteria for response and remission in BDD, based on the clinician-administered Yale–Brown Obsessive Compulsive Scale, modified for BDD (BDD-YBOCS), and evaluated using signal detection analysis. The results showed that a ≥ 40% reduction on the AAI best corresponded to treatment response, with a sensitivity of 0.71 and a specificity of 0.84. A score ≤ 13 at posttreatment was the optimal cutoff in determining full or partial remission from BDD, with a sensitivity of 0.75 and a specificity of 0.88. These findings provide benchmarks for using the AAI in BDD treatment evaluation when resource-intensive measures administered by clinicians are not feasible.

Contains fulltext : 219241.pdf (Publisher’s version ) (Closed access) INTRODUCTION: Obsessive compulsive disorder (OCD) is a chronic psychiatric disorder where most patients do not reach full symptomatic remission. Identifying predictors of course can improve patients' care by informing clinicians on prognosis and enhancing treatment strategies. Several predictors associated with improved outcome of OCD were identified. However, research focused mainly on clinical, illness-related predictors of the course of OCD. This study examined the contribution of environmental and interpersonal predictors on the long-term outcome of OCD, in addition to the previously identified clinical indicators. METHODS: We used the baseline, two and four-year data of 382 adult OCD patients participating in the naturalistic cohort study of the Netherlands Obsessive Compulsive Disorder Association (NOCDA). Remission was assessed using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Predictors of outcome were assessed at baseline, via clinician-rated and self-report instruments. RESULTS: Remission at two and at four-year follow-up ranged from 11% to 26%. Early age of onset and the presence of childhood trauma predicted a worse four-year course. Secure attachment style emerged as a protective predictor of improved outcome. LIMITATIONS: The naturalistic design of our study did not enable a systematic estimation the effect of treatments received during the follow-up period. Furthermore, age of onset and childhood trauma were assessed retrospectively, which may contribute to recall bias. CONCLUSION: Results coincide with previous prediction research and stress the importance of adaptive interpersonal functioning in the course of OCD. Clinical implications and future research directions are discussed. 9 p.

Background: The aim of this study was to test, through a chronobiologic approach, the existence of a significant circannual rhythm of tics and obsessive-compulsive symptoms in patients with Obsessive-Compulsive Tic Disorder (OCTD). The chronotype effect on tics and OC symptoms during seasons was also studied. Methods: Patients with a diagnosis of OCTD (N = 37; mean age = 18.78 ± 8.61) underwent four clinical evaluations: Winter (WIN), Spring (SPR), Summer (SUM) and Autumn (AUT). Tics were evaluated through Yale Global Tic Severity Scale (YGTSS) and OC symptoms through Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Patients’ chronotype was assessed by the Horne-Ostberg morningness-eveningness questionnaire (MEQ), which categorizes subjects according to the individuals'chronotype, being morning-type, evening-type, and neither-type. Results: A statistically significant circannual rhythm was observed for OC symptoms (p = 0.007), with the acrophase occurring between AUT and WIN. Y-BOCS differed along the year (p = 0.0003 and η2p = 0.40) with lower results in SUM compared to WIN (p < 0.05) and AUT (p < 0.01). Tics displayed no circannual rhythm and YGTSS scores were comparable among seasons. Patients were classified as 15 morning-types (40.5%) 15 neither-types (40.5%) and 7 evening-types (19.0%). YGTSS data were similar for all chronotypes while Y-BOCS results were greater during SUM in evening-types than morning-type patients (p < 0.05; 15.7 ± 5.2 vs 3.4 ± 6.0). Limitations: It is essential to investigate the existence of tics and OC symptoms circannual rhythms over the course of more than one year with a larger sample. Conclusions: OC symptoms displayed a significant circannual rhythm and were influenced by patients’ chronotype. On the contrary, tics resulted similar among seasons and chronotypes.

The current study examined the temporal precedence of change in obsessive-compulsive symptoms and change in depressive symptoms during the course of an Exposure and Response Prevention (ERP) for pediatric OCD. Participants included 142 children and adolescents (7–17 years; mean age = 12.39, SD = 2.92; 51.40% female; 60.40% Non-Hispanic White) with a primary or co-primary diagnosis of OCD who received ERP in a two-site randomized controlled trial on d -cycloserine augmentation of CBT for pediatric OCD. Participants completed clinician-administered assessments of OC symptoms (Children's Yale-Brown Obsessive Compulsive Scale) and depressive symptoms (Children's Depression Rating Scale-Revised) from baseline to post-treatment follow-up. Lagged mediational analyses did not yield evidence in support of a mediating role for the change in OC symptoms in the effect of ERP on the change in depressive symptoms. In contrast, change in depressive symptoms mediated the effect of ERP treatment on the subsequent change in OC symptoms (95% confidence interval for indirect effect = −0.04 to −0.001), though the effect size was small. Controlling for the prior levels of the depressive symptoms this indirect effect became non-significant. Theoretical and clinical implications of the findings for the youth with OCD and comorbid depression are discussed.

Introduction.Bipolar disorder (BD) and obsessive compulsive disorder (OCD) are prevalent, comorbid, and disabling conditions, often characterized by early onset and chronic course. When comorbid, OCD and BD can determine a more pernicious course of illness, posing therapeutic challenges for clinicians. Available reports on prevalence and clinical characteristics of comorbidity between BD and OCD showed mixed results, likely depending on the primary diagnosis of analyzed samples.Methods.We assessed prevalence and clinical characteristics of BD comorbidity in a large international sample of patients with primary OCD (n = 401), through the International College of Obsessive–Compulsive Spectrum Disorders (ICOCS) snapshot database, by comparing OCD subjects with vs without BD comorbidity.Results.Among primary OCD patients, 6.2% showed comorbidity with BD. OCD patients with vs without BD comorbidity more frequently had a previous hospitalization (p < 0.001) and current augmentation therapies (p < 0.001). They also showed greater severity of OCD (p < 0.001), as measured by the Yale–Brown Obsessive Compulsive Scale (Y-BOCS).Conclusion.These findings from a large international sample indicate that approximately 1 out of 16 patients with primary OCD may additionally have BD comorbidity along with other specific clinical characteristics, including more frequent previous hospitalizations, more complex therapeutic regimens, and a greater severity of OCD. Prospective international studies are needed to confirm our findings.

IntroductionWe previously reported that deep brain stimulation (DBS) in the anterior limb of the internal capsule/bed nucleus of the stria terminalis (IC/BST) is effective in reducing symptoms in severe treatment-resistant obsessive-compulsive disorder patients.ObjectiveTo examine the long-term evolution of obsessive compulsive disorder (OCD) symptoms in 24 patients treated with chronic electrical stimulation in IC/BST.AimsWe aimed to examine the evolution of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and to determine if a number of predictors assessed before surgery are significantly related to this evolution.MethodsWe used a linear mixed model to investigate the evolution of the Y-BOCS in 24 patients. Data was collected in a naturalistic manner. Seven hundred measurements, taken during a total of 1836 follow-up months, are included in this analysis.ResultsOur analysis showed a long-term, sustained effect of electrical stimulation in the IC/BST. After a fast initial decline of OCD symptoms, these symptoms stay relatively stable. In addition, results show a strong ON/OFF effect of stimulation (e.g., due to battery depletion). Beside the ON/OFF effect of stimulation, the surgery itself has no additional effect on OCD symptoms. The Beck Depression Inventory (BDI) at baseline was the only predictor significantly related to the evolution of the Y-BOCS. A higher BDI at baseline seemed to be related to a smaller decrease of the Y-BOCS over time.ConclusionElectrical stimulation in the IC/BST has a fast and sustained effect on OCD symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Over the last two decades, deep brain stimulation (DBS) has gained popularity as a treatment of severe and medically refractory obsessive-compulsive disorder (OCD), often using brain targets informed by historical lesional neurosurgical procedures. Paradoxically, the use of DBS in OCD has led some multidisciplinary teams to revisit the use of lesional procedures, especially anterior capsulotomy (AC), although significant aversion still exists toward the use of lesional neurosurgery for psychiatric disorders. This paper aims to review all literature on the use of AC for OCD to examine its effectiveness and safety profile.All publications on AC for OCD were searched. In total 512 patients were identified in 25 publications spanning 1961–2018. In papers where a Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score was available, 73% of patients had a clinical response (i.e., > 35% improvement in Y-BOCS score) and 24% patients went into remission (Y-BOCS score < 8). In the older publications, published when the Y-BOCS was not yet available, 90% of patients were deemed to have had a significant clinical response and 39% of patients were considered symptom free. The rate of serious complications was low.In summary, AC is a safe, well-tolerated, and efficacious therapy. Its underuse is likely a result of historical prejudice rather than lack of clinical effectiveness.

ObjectiveIn this study, it is aimed to determine obsessive compulsive-related disorders (OCRDs) comorbidity among the patients with obsessive compulsive disorder (OCD) and compare patients with OCD with or without comorbid OCRDs in terms of the severity of their OCD symptoms, symptom dimensions, and comorbidity with other axis I disorders.MethodsThe study included 90 patients diagnosed as having OCD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria for OCRDs were used to determine the presence of OCRDs. In order to determine the symptom dimensions and severity of these individuals' OCD symptoms, we administered the Dimensional Obsessive Compulsive Scale (DOCS) and The Yale-Brown Obsessive Compulsive Scale (Y-BOCS).ResultsIn our study, 20% of the patients with OCD simultaneously met the criteria for at least one OCRD, we also found that a significantly greater proportion of this group were men. None of the mentioned disorders was associated with any symptom dimensions we evaluated using DOCS. In addition, no differences were found in the severity of OCD symptoms and comorbid axis I disorders between the group with comorbid OCRDs and the group without comorbid OCRDs.DiscussionThere was no significant relationship between the symptom dimensions of OCD and OCRDs. It is found that OCRD comorbidity does not increase the severity of OCD symptoms and the prevalence of an axis I diagnosis.

Background and objectives: Some individuals with Obsessive Compulsive Disorder (OCD) may experience recurrent intrusive distressing images, which may be emotionally linked to past aversive memories. Our aim was to investigate whether Imagery Rescripting was an effective intervention for such individuals with OCD. Method: Twelve cases who experienced intrusive distressing images are presented in a A1BA2CA3 single case experimental design. After a baseline of Compulsive Scale, with a decrease from a mean of 24.1 to 10.7. Reliable symptom monitoring (A1), participants had a control intervention of talking about the memory related image (B), followed by symptom monitoring (A2), a single session of Imagery Rescripting (C) and further monitoring for up to 3 months (A3). Results: Minimal change was seen following the control intervention. However, at 3 months following ImRs, there was a drop in the Yale-Brown Obsessive improvement was achieved in 9 out of the 12 cases and clinically significant change in 7 out of 12 at 3-month follow up. The limitations are that all cases were selected on the basis that they had an aversive memory linked to their imagery. Conclusions: Imagery Rescripting is a promising therapeutic technique for OCD as an adjunct to CBT where intrusive images are linked to aversive memories.

Broad and narrow specificity are current issues within cognitive models of psychopathology. The aim of this study was to describe the nature of the relationship between inflated responsibility (measured with the Responsibility Attitudes Scale [RAS]) and obsessive-compulsive symptoms (measured with the Yale-Brown Obsessive Compulsive Scale self-report [Y-BOCS]) and between intolerance of uncertainty (measured with the Intolerance of Uncertainty Scale [IUS]) and generalized anxiety symptoms (measured with the Worry and Anxiety Questionnaire [WAQ]). A sample consisting of undergraduates was used in both cases. Hierarchical regression analysis and a methodological approach proposed by Garber and Hollon (1991) were used. The results showed that responsibility was relevant to, and specific to, obsessive-compulsive symptoms even when other associated variables were controlled for. Intolerance of uncertainty was relevant to, but not specific to, generalized anxiety symptoms. These results clarify the roles of bot...

The present research aimed to investigate the difficulties in emotion regulation (DER) among patients with obsessive-compulsive disorder (OCD) and to predict obsessive-compulsive (OC) symptom dimensions based on DER dimensions. Eighty outpatients with OCD and 80 normal controls completed the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Obsessive Compulsive Inventory-Revised (OCI-R), the Difficulties in Emotion Regulation Scale (DERS) and the Depression Anxiety Stress Scales (DASS-21). OCD patients revealed significantly higher scores on DER dimensions including lack of emotional clarity, limited access to emotion regulation strategies and non-acceptance of emotional responses than healthy controls. Partial correlations indicated significant associations between OC dimensions such as checking/doubting, obsessing, mental neutralizing, and ordering with non-acceptance of emotional responses, checking/doubting with lack of emotional awareness, and ordering with limited access to emotion regulation strategies. Results indicated that non-acceptance of emotional responses was a significant predictor of checking/doubting, obsessing, mental neutralizing and ordering. These findings revealed that DER, especially non-acceptance of emotional responses, may constitute evidence to improve our understanding of OCD.

Background and Objectives: Recent studies explored the relationships between metacognitive beliefs and body dysmorphic disorder. The purpose of this study was to develop and validate one self-report scale of metacognitive factor about body dysmorphic. Methods: Development of this scale involved three steps: 1) items generated from a qualitative study with lecture and care professionals, 2) expert panel review, and 3) pilot test. A factor analysis of the responses from 600 participants suggested the creation of a 25-item scale. Results: Study showed that scores on the 25-item measure correlated with five theoretically related constructs, including positive and negative metacognitive beliefs about body dysmorphic, thought-fusion and metacognitive control strategies. Convergent validity of Body Dysmorphic Metacognitive Scale (BDMCS) with Yale-Brown Obsessive Compulsive Scale was modified for Body Dysmorphic Disorder (BDD) and Thought Fusion Instrument (r = 0.44, r = 0.52, P

BACKGROUND AND OBJECTIVE The present study attempted to assess childhood trauma events and dissociative symptoms in patients with obsessive compulsive disorder (OCD). METHOD The study included all patients who were admitted for the first time to the psychiatric outpatient unit over a 24-month period. Seventy-eight patients were diagnosed as having OCD during the two-year study period. Childhood traumatic events were assessed with a Childhood Trauma Questionnaire (CTQ). Obsessive compulsive disorder symptoms were assessed with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). A Dissociation Questionnaire (DIS-Q) was also used to measure dissociative symptoms. RESULTS The mean of Y-BOCS points were 23.37 +/- 7.27. Dissociation questionnaire scores were between 0.40 and 3.87 and the mean was 2.23 +/- 0.76. Childhood trauma points were 1.27-4.77 and the mean was 2.38 +/- 0.56. There was no statistically significant relationship between Y-BOCS points and childhood trauma points (p > 0.05). There was a statistically significant positive relationship between Y-BOCS points and DIS-Q points. There was no statistically significant relationship between DIS-Q points and childhood trauma points (p > 0.05). CONCLUSION Childhood trauma questionnaire points might be significant clinically, although there was not a statistically significant correlation in our study. We also conclude that dissociative symptoms among patients with OCD should alert clinicians to treatment of the disorder.

About one third of patients with obsessive-compulsive disorder (OCD) fail to experience significant clinical benefit from currently available treatments. Hyperactivity of the presupplementary motor area (pre-SMA) has been detected in OCD patients, but it is not clear whether it is the primary cause or a secondary compensatory mechanism in OCD pathophysiology. Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique with polarity-dependent effects on motor cortical excitability. A 33-year-old woman with treatment-resistant OCD received 20 daily consecutive 2 mA/20 min tDCS sessions with the active electrode placed on the pre-SMA, according to the 10-20 EEG system, and the reference electrode on the right deltoid. The first 10 sessions were anodal, while the last 10 were cathodal. Symptoms severity was assessed using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) severity score. In the end of anodal stimulation, OCD symptoms had worsened. Subsequent cathodal stimulation induced a dramatic clinical improvement, which led to an overall 30% reduction in baseline symptoms severity score on the Y-BOCS. Our study supports the hypothesis that pre-SMA hyperfunction might be responsible for OCD symptoms and shows that cathodal inhibitory tDCS over this area might be an option when dealing with treatment-resistant OCD.

Background: Family accommodation (FA) is a phenomenon whereby caregivers assist/facilitate rituals or behaviors related to obsessive–compulsive disorder (OCD). FA, however, has been explored primarily in the Western population, and it is unclear to what extent it might be present in diverse cultural settings. At present, little is known about the extent and predictors of FA among caregivers of adult OCD patients in India. Aims: The study aims to assess the extent, clinical correlates, and predictors of FA in the caregivers of adults with OCD. Settings and Design: Cross-sectional study conducted in an outpatient setting in a tertiary-care hospital. Materials and Methods: Hundred and one adult patients of either gender with Diagnostic and Statistical Manual of Mental Disorders-5 diagnosis of OCD and 101 caregivers were included. The patients were assessed using Yale–Brown Obsessive Compulsive Scale (YBOCS), Hamilton Rating Scale for Depression (HAM-D), World Health Organization Disability Assessment Schedule Version 2.0 12-item version (WHO-DAS 2.0.12), Clinical Global Impressions Scale for Severity (CGI-S), and Clinical Global Impressions Scale for Improvement. The FA Scale-Self Rated Version (FAS-SR) was applied on caregivers after Hindi translation. Statistical Analysis: Descriptive statistics, group comparisons, and Pearson's product moment correlations were carried out. Multiple linear regression modeling was performed with the total FAS-SR score as the dependent variable. Results: About 92% of caregivers displayed at least some form of FA. Higher scores on HAM-D, YBOCS, WHODAS, and CGI-S were associated with higher scores on FAS-SR scale, which reached statistical significance (P < 0.01). Conclusions: FA in OCD appears to be a frequent phenomenon. Higher FA is associated with higher symptom severity and disability, emphasizing its clinical and research relevance for future studies.

OZET Calismamizda OKB hastalari ile saǧlikli bireylerin aleksitimi duzeyleri karsilastirilip aralarinda anlamli bir fark olup olmadiǧi incelenmistir. Bununla birlikte kisilerin bazi sosyodemografik ozelliklerinin de OKB ve aleksitimi duzeyleri uzerinde etkili olup olmadiǧi arastirilmistir. Calismaya, Istanbul ilindeki Uskudar Universitesi NP Feneryolu Tip Merkezi'nde tani almis ve tedavileri halen devam eden, yaslari 18-45 araliǧinda olan 25'i kadin 15'i erkek olmak uzere 40 gonullu OKB hastasi ile Istanbul ilinde yasayan rastgele secilmis, herhangi bir psikiyatrik tanisi bulunmayan, yaslari 18-45 araliǧinda olan 25'i kadin 15'i erkek olmak uzere 40 gonullu saǧlikli birey katilmistir. Katilimcilar oncelikle calisma ve kisisel bilgilerin gizliliǧi konusunda bilgilendirilmistir. Arastirmada elde edilecek verileri toplamak amaciyla, 80 katilimciya, “Sosyodemografik Veri Formu, Toronto Aleksitimi Olceǧi (TAO-20) ve Yale-Brown Obsesyon Kompulsiyon Olceǧi ve Semptom Listesi (Y-BOCS)” uygulanmistir. Bu olceklerden elde edilen veriler ise SSPS v. 21 (Statistical Package for Social Sciences) programi ile istatistiksel analize tabi tutulmustur. Surekli deǧiskenlerin normallik daǧilimi Skewness-Kurtosis deǧerlerinin -1.5 ve +1.5 araliǧinda olusuna gore deǧerlendirilmistir. OKB tanili hastalarla saǧlikli kontrollerin olceklerden aldiklari puanlarin karsilastirilmasinda baǧimsiz orneklem t testi yurutulmustur. Sosyodemografik deǧiskenler bakimindan yurutulen gruplar arasi karsilastirmalarda baǧimsiz orneklem Mann Whintey U testi yurutulmustur. Olceklerden alinan puanlar arasindaki korelasyon deǧerleri ise puanlarin normal daǧiliyor olmasi nedeniyle Pearson korelasyon analizi ile yurutulmustur. Yapilan calismanin sonuclarina gore; OKB hastalarinin aleksitimi duzeyleri saǧlikli bireylerin aleksitimi duzeylerine gore anlamli bir bicimde daha yuksek bulunmustur. OKB hastalarinin TAO-20'nin alt boyutlari olan duygu ifadesinde zorluk puanlari ile duygu tanimlamada zorluk puanlari arasinda pozitif yonde anlamli iliski bulunmustur. Anahtar kelimeler: Aleksitimi, obsesif kompulsif bozukluk, OKB In this study, we compared the levels of alexithymia in healthy individuals with OCD patients and investigated whether there is a significant difference between them. Furthermore, some of the sociodemographic characteristics of the subjects were also examined to determine whether they had an effect on OCD and alexithymia levels. 40 volunteer OCD patients, 25 of whom were women and 15 men, aged 18-45 years, who were diagnosed at the NP Feneryolu Medical Center of Uskudar University, Istanbul, and who were randomly selected and living in Istanbul, 40 volunteer healthy individuals, 25 of whom are women and 15 of whom are men and whose ages are between 18 and 45, are attended to this study. Participants were first informed about the privacy of work and personal information. “Sociodemographic Data Form, Toronto Alexithymia Scale (TAS-20) and Yale-Brown Obsessive Compulsive Scale and Symptom List (Y-BOCS)” were applied to all 80 participants in order to collect the data obtained in the study. The data obtained from these scales were subjected to statistical analysis with the SSPS v. 21 (Statistical Package for Social Sciences) program. The normality distribution of continuous variables was evaluated according to the occurrence of Skewness-Kurtosis values in the range of -1.5 and +1.5. An independent sample t-test was conducted to compare the scores of healthy controls and OCD patients. Independent sample Mann Whintey U test was performed among the groups in terms of demographic variables. Correlation values between the scores obtained from the scales were analyzed by Pearson correlation analysis because the scores were normally distributed. According to the results of this study; a significant difference was found between the levels of alexithymia of healthy individuals and OCD patients. The levels of alexithymia in OCD patients were significantly higher than those of healthy individuals. Apart from this, there was a significant positive correlation between the difficulty describing feelings scores of OCD patients and the their difficulty identifying feelings scores of the TAS-20 subscales. In addition, a number of suggestions have been added in order to make contribution to the literature of this research which is also included in similar studies.

Introduction: Obsessive-compulsive disorder has a broadly diverse clinical expression that reflects heterogeneity. Several studies have identified consistent symptom dimensions of obsessivecompulsive disorder. The purpose of this study was to conduct an exploratory symptoms analysis of obsessive-compulsive symptoms in adolescents and adults with obsessive-compulsive disorder. Methods: This was a cross-sectional study conducted in the Department of Psychiatry, National Medical College. This study examined lifetime occurrence of obsessive-compulsive symptoms included in the 13 symptom categories of the Yale–Brown Obsessive Compulsive Scale. Symptoms analysis was performed on 60 patients with obsessive-compulsive disorder. Eight categories of obsessions and six categories of compulsions from Yale–Brown Obsessive Compulsive Scale were included in the analyses. SPSS software package (version 16) was used to analyze the data and shown in the table. Results: Of 60 adolescents and adults, female and male were in the ratio of 1.2:1. Contamination was the most common occurring obsession followed by aggressive obsession. The most common occurring compulsion was checking followed by washing. Only a minority of patients (13.33%) presented predominantly with obsessions however 18.33% patients presented predominantly with compulsions. Certain obsessions and compulsions co-occur to form a cluster. Conclusions: In adolescents and adults, obsessive-compulsive disorder is a multidimensional disorder. Symptom dimensions are predominantly congruent with those described in similar studies of adults with obsessive-compulsive disorder. Keywords: compulsion; obsession; obsessive-compulsive disorder.

The current study sought to investigate the cognitive dimensions associated with subtypes of obsessive-compulsive disorder (OCD) and determine whether changes in symptoms following inference-based therapy (IBT) coincided with the modification of cognitive domains. Fifty-nine participants were classified into various OCD subtypes using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and completed the Y-BOCS, Obsessional Beliefs Questionnaire (OBQ-44), Inferential Confusion Questionnaire: The Expanded Version (ICQ-EV), Beck Depression Inventory, the Second Edition (BDI-II), and Beck Anxiety Inventory (BAI) before and after therapy. It was found that the OBQ-44 belief domain Importance/Control of Thoughts was associated with the impulse phobia subtype. Inferential confusion levels were found to be similar across subtypes. Change in OCD symptoms was correlated with change in the level of inferential confusion and of the OBQ belief domain Responsibility/Threat Estimation. Percentage of change in levels of i...

Economic analyses of treatments for OCD have been limited. This study analysed the comparative economic benefits and costs of an internet-based CBT (iCBT) relative to internet-based progressive relaxation therapy (iPRT) control. These were benchmarked against current estimates for face-to-face CBT (ffCBT) sourced from literature. The benefits to society of providing increased access to treatment was assessed using a cost-benefit analysis based upon productivity gains arising from treatment. Identification of the most cost-effective treatment amongst the three treatments was assessed using a cost-effectiveness analysis based upon both effectiveness as measured by the Yale-Brown Obsessive Compulsive Scale (YBOCS) and percentage of responders. The cost-effectiveness analysis showed iCBT to be the most cost effective treatment of the three analysed, followed by ffCBT based upon percentage of responders and iPRT based upon overall effectiveness of treatment. The cost-benefit analyses showed all treatment options delivered substantial benefits to society. These benefits ranged from three to thirty-five times the cost of providing treatment, depending on the assumptions used and the treatment provided, with iCBT showing the greatest ratio of benefits to costs but the ffCBT providing the greatest absolute benefits. Overall, the findings provide support for increased access to CBT intervention, for all patients with OCD; with online therapist-assisted modes of delivery as a cost-effective alternative to existing face-to-face treatments. Further work to more accurately quantify the benefits and costs resulting from CBT treatment modalities is required to support these preliminary findings., Highlights • Comparing cost-effectiveness of internet-based CBT (iCBT), progressive relaxation therapy (iPRT) and face-to-face CBT ffCBT) • The cost-effectiveness analysis showed iCBT to be the most cost effective treatment of the three analysed • The cost-benefit analyses showed all treatment options delivered substantial benefits to society.

Objectives Our main goal was to provide the psychometric properties of the Spanish version of the Dimensional Obsessive–Compulsive Scale (DOCS) in a non-clinical sample (n = 237) and in adult patients with Obsessive–Compulsive Disorder (OCD) (n = 110). We also examined the association between OC symptom dimensions and obsessive beliefs. Methods The psychometric properties involved four steps: reliability, structural validity, convergent and discriminant validity and diagnostic sensitivity. Linear regression analyses were used to assess the associations between OC symptoms and obsessive beliefs. Results Exploratory and confirmatory factor analyses replicated the original four-factor structure in both samples. The DOCS showed good performance in terms of internal consistency, test–retest reliability and convergent validity in both samples. The DOCS showed better diagnostic sensitivity than another self-report instrument of OC symptoms, the Obsessive–Compulsive Inventory Revised. Findings of the relationship between obsessive beliefs and OC symptoms revealed that certain obsessive beliefs predicted specific OC symptom dimensions. Conclusions The Spanish version of the DOCS has similar psychometric properties than the original English instrument, although its performance is somewhat better in OCD patients than in students. It will be important to ascertain its ability to discriminate OCD from other associated disorders.

Accurately and reliably measuring the presence and severity of Obsessive-Compulsive Disorder (OCD) symptoms is essential for both routine clinical work and research. The current study investigated psychometric properties of the dimensional obsessive-compulsive scale-short form (DOCS-SF). DOCS-SF was developed and validated in Norwegian. DOCS-SF contains a checklist with four symptom categories and five severity items scored on a zero to eight scale yielding a total score of 0–40. Data were collected from adults with a current diagnosis of OCD (n = 204) and a community comparison group (n = 211). The results provided evidence of internal consistency and convergent validity, although evidence for discriminant validity was mixed. Evidence was also found for diagnostic sensitivity and specificity, and treatment sensitivity. The analyses suggested a cut-off score of 16. In summary, the data obtained proved similar to studies published on the original dimensional obsessive-compulsive scale. There is strong evidence for the reliability and validity of the DOCS-SF for assessing OCD symptoms in individuals with this condition and in non-clinical individuals. Copyright © 2017 Eilertsen, Hansen, Kvale, Abramowitz, Holm and Solem. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).

This study evaluated acceptance and commitment therapy (ACT) for scrupulosity-based obsessive compulsive disorder (OCD). Five adults were treated with eight sessions of ACT, without in-session exposure, in a multiple baseline across participants design. Daily monitoring of compulsions and avoided valued activities were tracked throughout the study. The Obsessive Compulsive Inventory–Revised, Yale–Brown Obsessive Compulsive Scale (Y-BOCS), Penn Inventory of Scrupulosity, Beck Depression Inventory–II, Quality of Life Scale, Santa Clara Strength of Religious Faith Questionnaire, and the Acceptance and Action Questionnaire–II were completed at pretreatment, posttreatment, and 3-month follow-up. The Treatment Evaluation Inventory was completed at posttreatment. Average daily compulsions reduced as follows: pretreatment = 25.0, posttreatment = 5.6, and follow-up = 4.3. Average daily avoided valued activities reduced as follows: pretreatment = 6.0, posttreatment = 0.7, and follow-up = 0.5. Other measures showed similar patterns. Religious faith only slightly declined: 4% at posttreatment and 7% at follow-up. Treatment acceptability was high.

Ranked fourth in the list of mental illnesses, Obsessive-Compulsive Disorder (OCD) accounts for about ten percent of patients visiting medical centers. There have so far been various methods of treatment for OCD. An attempt was made in this study to determine the effectiveness of dialectical behavior therapy (DBT) on clinical signs and emotion regulation among patients with OCD. This was a quasi-experimental study involving intervention and control groups. The statistical population included all female patients referred to psychological counseling centers in Neyshabur during 2015. Each group comprised 15 patients selected through the convenient sampling method. The measurement tool was Yale-Brown’s Obsessive Compulsive Scale (Y-BOCS) and Garnefski’s Cognitive Emotion Regulation Questionnaire (CERQ). Training was provided for the intervention group during eight 90-minute sessions of dialectical behavior therapy, whereas the control group received no intervention. Analysis of covariance of the scores revealed that dialectical behavior therapy effectively reduced the observed symptoms and improved cognitive emotion regulation among patients. Generally, the results suggested that DBT alleviated OCD by modifying emotional responses of patients and that DBT could prove a highly effective treatment in this regard. DOI: 10.5901/mjss.2016.v7n4p412

The Obsessive Compulsive Inventory (OCI) is often used as a screening instrument for symptoms of Obsessive-Compulsive disorder (OCD) and as an outcome measure for treatment. Three versions of the OCI are available: the original 42-item version, the revised 18-item version (OCI-R) and a shorter version that focuses on the highest subscale (OCI-R Main). Our aim was to determine sensitivity to change and evaluate cut-off scores for caseness in each version of the OCI using the same dataset. Method: We compared the effect size and the number of patients who achieved reliable and clinically significant change after cognitive behavior therapy in two samples of out-patients with OCD. One sample (n=63) had OCD of minor to moderate severity and a second sample (n=73) had severe, treatment refractory OCD. Results: The OCI-R is a valid self-report outcome measure for measuring change and is less burdensome for patients to complete than the OCI. Questions remain about whether the OCI or OCI-R is sufficiently sensitive to change for a service evaluation. We would recommend a slightly higher cut-off score of ≥17 on the OCI-R for the definition of caseness. Discussion: In both samples, the OCI and OCI-R had very similar treatment effect sizes and to a lesser extent in the percentage who achieved reliable improvement and clinically significant change. The OCI-R Main was more sensitive to change than the OCI or OCI-R in both samples. All versions of the OCI were less sensitive to change compared with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS).

Pharmacotherapy and cognitive–behavioral therapy (CBT) are currently the most effective interventions for treating obsessive–compulsive disorder (OCD). These treatments, however, are time consuming and in some cases the patients do not show significant improvement. In all, 30%–60% of OCD patients do not respond adequately to pharmacotherapy and 20%–40% of OCD patients who complete CBT do not improve significantly, suggesting a more efficacious approach is needed. The objectives of this study are to demonstrate an efficacious pharmacotherapy plus psychotherapy, named cognitive–coping therapy (CCT), for OCD and to investigate the efficacy of this approach in a larger sample size. Therefore, a total of 108 patients with OCD were randomly allocated into three groups: pharmacotherapy (N = 38), pharmacotherapy plus CBT (PCBT, N = 34), and pharmacotherapy plus CCT (PCCT, N = 36). The severity of symptoms and the patients' functioning were assessed pretreatment and after 7, 14, 21 days, and 1-, 3-, 6-, and 12-month treatment using the Yale-Brown Obsessive Compulsive Scale and Global Assessment of Functioning (GAF). Compared with the pharmacotherapy and PCBT groups, the severity of OCD symptoms was significantly reduced (P < 0.001), the rates of response (100%) and remission (85.0%) were significantly higher (P < 0.001), and relapse rate was lower (P = 0.017) in PCCT group during the 1-year follow-up. In addition, the GAF score was significantly higher in the PCCT group than in the other two groups (P < 0.001). Our preliminary data suggest that PCCT is a more efficacious psychotherapy for OCD patients than pharmacotherapy or PCBT.

Objective: To determine and compare the plasma nesfatin-1 (a satiety peptide) levels of patients with obsessive compulsive disorder (OCD) and healthy control subjects.Method: Plasma nesfatin-1 levels of 31 patients with OCD (18 females, 13 males) and 28 healthy control subjects (16 females and 12 males) similar to the study group in terms of weight, age, and gender were measured in this study. Severity of obsessions and compulsions both in OCD patients and control subjects were determined by using Yale-Brown Obsessive Compulsive Scale (Y-BOCS). ELISA method was used to measure plasma nesfatin-1 levels.Results: Median plasma nesfatin-1 levels in patients with OCD and healthy control subjects were 4.61 ng/ml (min-max: 1.28-8.11) and 2.0 ng/ml (min-max: 0.11-4.98) respectively. The observed difference in plasma nesfatin-1 levels between two groups was statistically significant (p

IntroductionObsessive Compulsive Personality Disorder (OCPD) is a common, highly co-morbid disorder. Subjected to comparatively little research, OCPD shares aspects of phenomenology and neuropsychology with obsessive-compulsive spectrum disorders and neurodevelopmental disorders such as autism spectrum disorder (ASD). A greater understanding of this interrelationship would provide new insights into its diagnostic classification and generate new research and treatment heuristics.AimsTo investigate the distribution of OCPD traits within a cohort of OCD patients. To evaluate the clinical overlap between traits of OCPD, OCD and ASD, as well as level of insight and treatment resistance.MethodWe interviewed 73 consenting patients from a treatment seeking OCD Specialist Service. We evaluated the severity of OCPD traits (Compulsive Personality Assessment Scale; CPAS), OCD symptoms (Yale–Brown Obsessive Compulsive Scale; Y-BOCS), ASD traits (Adult Autism Spectrum Quotient; AQ) and insight (Brown Assessment of Beliefs Scale; BABS).ResultsOut of 67 patients, 24 (36%) met DSM-IV criteria for OCPD, defined using the CPAS. Using Pearson's test, CPAS scores significantly (P < 0.01) correlated with total AQ and selected AQ domains but not with BABS. Borderline significant correlation was observed with Y-BOCS (P = 0.07). OCPD was not over-represented in a highly resistant OCD subgroup.ConclusionDisabling OCPD traits are common in the OCD clinic. They strongly associate with ASD traits, less strongly with OCD severity and do not appear related to poor insight or highly treatment-resistant OCD. The impact of OCPD on OCD treatment outcomes requires further research.Disclosure of interestThis work did not receive funding from external sources. Over the past few years, Dr. Fineberg has received financial support in various forms from the following: Shire, Otsuka, Lundbeck, Glaxo-SmithKline, Servier, Cephalon, Astra Zeneca, Jazz pharmaceuticals, Bristol Myers Squibb, Novartis, Medical Research Council (UK), National Institute for Health Research (UK), Wellcome Foundation, European College of Neuropsychopharmacology, UK College of Mental Health Pharmacists, British Association for Psychopharmacology, International College of Obsessive-Compulsive Spectrum Disorders, International Society for Behavioural Addiction, World Health Organization, Royal College of Psychiatrists.

Aim: The study aimed to examine the family burden and quality of life (QOL) of caregivers of patients with obsessive–compulsive disorder (OCD). Methods: A cross-sectional assessment of 50 patients with OCD and their caregivers was carried out. The severity of OCD was assessed using the Yale–Brown Obsessive Compulsive Scale. The caregivers were assessed using the Family Burden Interview Schedule and the World Health Organization Quality of Life BREF version (WHOQOL-BREF). Results: Fifty-six percent of caregivers reported a high objective burden. Severity of illness correlated with burden and impaired QOL of caregivers. Age of patient, longer duration of illness and longer duration of treatment were predictive of poorer QOL of caregivers in the physical health domain. Greater objective burden, disruption of family leisure and interaction due to OCD led to significantly poorer QOL in all domains in caregivers. Higher financial burden, perception of poorer mental health, and higher subjective burden were predictive of poorer physical, general health and general and psychological QOL, respectively. Conclusions: The study provides important insights into the QOL and perceived burden of caregivers of OCD patients. It highlights the need for improving the quality of care not only for patients but also for primary caregivers.

This study aims at comparing beliefs and defense mechanism in patients with obsessive compulsive disorder and normal individuals. Sample consisted of 50 patients with obsessive compulsive disorder and 100 normal individuals. Defensive Styles Questionnaire DSQ-40, Whimsical-Yale-Brown Obsessive Compulsive Scale and Jones's Irrational Beliefs Test were used as the instruments of the study. To analyze the data descriptive statistics and independent t-tests were used. The results showed that there was a significant difference between two groups in their irrational beliefs and defense mechanisms. The findings of this study generally confirmed the findings of other studies. However, research in the field of defense mechanisms requires more attention.

OCD is a clinically heterogeneous condition. This heterogeneity has the potential to reduce power in genetic, neuroimaging, and clinical trials. Despite a mounting number of studies, there remains debate regarding the exact factor structure of OCD symptoms. The authors conducted a meta-analysis to determine the factor structure of the Yale-Brown Obsessive Compulsive Scale Symptom Checklist.Studies were included if they involved subjects with OCD and included an exploratory factor analysis of the 13 Yale-Brown Obsessive Compulsive Scale Symptom Checklist categories or the items therein. A varimax-rotation was conducted in SAS 9.1 using the PROC FACTOR CORR to extract factors from sample-size weighted co-occurrence matrices. Stratified meta-analysis was conducted to determine the factor structure of OCD in studies involving children and adults separately.Twenty-one studies involving 5,124 participants were included. The four factors generated were 1) symmetry: symmetry obsessions and repeating, ordering, and counting compulsions; 2) forbidden thoughts: aggression, sexual, religious, and somatic obsessions and checking compulsions, 3) cleaning: cleaning and contamination, and 4) hoarding: hoarding obsessions and compulsions. Factor analysis of studies including adults yielded an identical factor structure compared to the overall meta-analysis. Factor analysis of child-only studies differed in that checking loaded highest on the symmetry factor and somatic obsessions, on the cleaning factor.A four-factor structure explained a large proportion of the heterogeneity in the clinical symptoms of OCD. Further item-level factor analyses are needed to determine the appropriate placement of miscellaneous somatic and checking OCD symptoms.

This paper describes the phenomenological features of early childhood onset obsessive compulsive disorder (OCD; defined as children meeting DSM-IV criteria for OCD with age of onset

Obsessive compulsive disorder (OCD) is a common disorder characterised by persistent and unwanted intrusive thoughts, images, and urges and repetitive behaviours or mental acts and can cause pervasive impairments. In Bangladesh, the prevalence of OCD among children is 2% which is higher than in previous reporting. This study was aimed at looking into the type, frequency, and severity of symptoms of OCD and comorbidity among children and adolescents. A consecutive 60 OCD cases from a child mental health service with age range of 5–18 years were recruited and divided into below and above 12 years of age group. The assessment was carried out using standardized Bangla version of Development and Wellbeing Assessment and Children’s Yale-Brown Obsessive Compulsive Scale was administered. Of the obsession, contamination was the highest followed by doubt, and of the compulsion, washing/cleaning was the highest followed by checking, repeating, and ordering rituals. More than half of the subjects had severe OCD and comorbidity was present in 58% subjects. Specific phobia, social phobia, major depressive disorder, and tic disorder were more prevalent. These symptoms and comorbidity profile can serve the baseline data for a country like Bangladesh and further large scale study would better generalize the study results.

Objective: With the intensified public awareness and media coverage of issues concerning gender identity and gender incongruence, distinguishing true gender dysphoria or incongruence from the sexual obsessions of obsessive-compulsive disorder (OCD) is especially important. Although intrusive sexual obsessions are not uncommon in OCD, obsessions concerning sexual content are more difficult for clinicians to identify as OCD than other types of obsessions (e.g., obsessions concerning contamination). Making the correct diagnosis helps ensure that appropriate clinical treatment can be offered.Methods: We present a case report of a homosexual, single, young male with new-onset intrusive repetitive obsessive thoughts that he was transgender. The case report is accompanied by a review of the pertinent endocrine and psychiatric literature.Results: A Yale-Brown Obsessive Compulsive Scale indicated a significant negative impact of the patient's symptoms.Conclusion: To our knowledge, this is the first case report of an OCD patient whose symptoms include the unwanted, intrusive obsessive thought that he was transgender. The described case and associated review highlight the characteristics that distinguish the distress in patients with OCD who present with obsessions concerning being transgender relative to patients who are transgender or gender incongruent who present with gender dysphoria. The case illustrates the importance of considering OCD as a potential diagnosis in patients who present with new-onset obsessions regarding gender identity and the importance of establishing the durability and pattern of gender identification and obsessions before embarking on treatment.Abbreviations: DSM = Diagnostic and Statistical Manual of Mental Disorders OCD = obsessive-compulsive disorder Y-BOCS = Yale-Brown Obsessive Compulsive Scale