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This essay argues that one of the distinguishing characteristics of Chuck Palahniuk's self-described "Horror Trilogy" of novels, Lullaby, Diary, and Haunted, is their representation of obsessions, compulsions, and obsessive–compulsive disorders. This essay analyses these representations from a variety of different perspectives, including medical and psychiatric approaches, clinical and self-help narratives, and biocultural readings emanating from cultural history and critical disability studies. It is demonstrated that the novels reflect a range of the debates that arise from these competing approaches, and the points of similarity and difference in the readings produced are identified. Palahniuk's representations, it is suggested, must be seen in the contexts of a number of his recurrent thematic preoccupations, and of his engagement with existential comedy. Ultimately, this essay suggests that Palahniuk's representations of obsessions, compulsions, and OCD must be seen as multi-faceted and protean, as befitting the awareness of the complicated current debates about their conceptualisation that the novels display. [ABSTRACT FROM AUTHOR]

Background: In recent years, the evaluation of disability in people with severe mental health disorders has grown in importance. Caregivers of individuals with chronic psychiatric diseases face a multitude of psychological challenges. The burden of care is the aggregate term for these challenges. The assessment of burden has become particularly important with the emergence of deinstitutionalization and the treating individuals in the community. Objective: The objective was to study the level of disability and family burden among family caregivers of individuals with schizophrenia and obsessive–compulsive disorder (OCD). Materials and Methods: A total of 120 patients (60 with schizophrenia and 60 with OCD) diagnosed as per the International Classification of Diseases-10 were selected purposively from a mental health institute in North India. The Indian Disability Evaluation and Assessment Scale was used for measuring disability, and the Family Burden Scale was administered to know the level of family burden. Results: Twenty-six percent of individuals with schizophrenia had a profound level of disability, and about 45% of individuals had a severe level of disability from both the groups; more than half (53%) of the OCD individuals reported moderate-level disability. The family burden was found high (53%) to moderate (46%) in both the groups. Conclusion: Although individuals with schizophrenia had more severe disability and family burden, individuals with OCD were not too far behind. A holistic management plan should address these parameters in addition to symptomatic recovery. Thus, the management planning should consider yielding better outcomes in both conditions.

Introduction: Obsessive-compulsive disorder (OCD) is a tremendous psychiatric illness with a variety of severe symptoms. Feelings of shame and guilt are universal social emotions that fundamentally shape the way people interact with each other. Mental illness is therefore often related to pronounced feelings of shame and guilt in a maladaptive form. Methods: A total of 62 participants (38 women and 24 men) were clinically and psychometrically investigated. Results: The OCD patients (n = 31) showed a maladaptive guilt and shame profile, characterized by increased interpersonal feelings of guilt accompanied by a stronger tendency to self-criticism and increased punitive sense of guilt with a simultaneous prevailing tendency to perfectionism, as well as an increased concern for the suffering of others. The proneness to profuse shame in OCD patients seems to be in the context of the violation of inner values and a negative self-image with persistent self-criticism. Conclusion: Although there are limitations with a small sample size in this monocentric approach, our study underlines the importance of an individual consideration of the leading obsessive-compulsive symptomatology, especially in the context of very personal feelings of guilt and shame. Further multidimensional studies on guilt and shame could contribute to their implementation more strongly in individualized psychotherapy. [ABSTRACT FROM AUTHOR]

Introduction: Trichotillomania (TTM) is an obsessive-compulsive disorder characterized by the uncontrollable pulling of hair from various parts of the body, most commonly from the scalp, eyebrows, and eyelashes. Clinical manifestations of TTM include patchy alopecia, uneven hair shaft growth, and characteristic changes visible in trichoscopy, such as the presence of black dots, twisted hairs, split ends, and hairs shaped like exclamation marks. The etiology of TTM is complex and involves genetic, neurological, and psychological factors. In some patients, TTM co-occurs with trichophagia, leading to the formation of trichobezoars in the gastrointestinal tract. In extreme cases, such as Rapunzel Syndrome, bezoars can lead to intestinal obstruction. Treatment for TTM is multifaceted and includes both psychotherapeutic and pharmacological interventions. Objective: The objective of this study is to provide a comprehensive review of trichotillomania (TTM), with a particular focus on its clinical symptoms, etiology, diagnostics, and treatment methods. The aim is to understand this obsessive-compulsive disorder, its impact on patients' lives, and its connections to serious complications such as trichobezoars and Rapunzel Syndrome. Materials and Methods: The study utilized analyses of scientific research, review articles, and reports concerning trichotillomania (TTM), trichobezoars, trichophagia, and Rapunzel Syndrome. It is primarily based on data from PubMed, Google Scholar, Cochrane Library, and studies published between 2000 and 2024, focusing on the diagnostics, etiology, and treatment of TTM and related disorders. Conclusions: The purpose of this study is to provide a comprehensive review of the current knowledge on trichotillomania, including its clinical symptoms, etiology, diagnostics, and treatment methods, while considering serious complications such as trichobezoars and Rapunzel Syndrome.

Abstract In children and adolescents, autism spectrum disorders (ASD) and obsessive–compulsive disorders (OCD) may share similar features, such as deficits in social communication, repetitive behaviours and presence of obsession and compulsion. Studies have shown that children with OCD may exhibit the presence of ASD traits. Up to date research shows that selective serotonin reuptake inhibitors are commonly used to treat OCD, while treatment options for ASD are limited. A literature search was performed using the PubMed database and retrieving relevant papers up to December 2022. This review includes 9 case reports and 8 randomized controlled trials. The main psychopharmacological drugs used include antidepressants and antipsychotics. This review shows that the management of OCD behaviours in individuals with ASD and related conditions is of complex nature and pharmacological interventions may not be an effective method in managing this group of patients. Hence, more comprehensive research and deeper knowledge is important in optimizing pharmacological management for patients with OCD behaviours with underlying ASD.

In children and adolescents, autism spectrum disorders (ASD) and obsessive–compulsive disorders (OCD) may share similar features, such as deficits in social communication, repetitive behaviours and presence of obsession and compulsion. Studies have shown that children with OCD may exhibit the presence of ASD traits. Up to date research shows that selective serotonin reuptake inhibitors are commonly used to treat OCD, while treatment options for ASD are limited. A literature search was performed using the PubMed database and retrieving relevant papers up to December 2022. This review includes 9 case reports and 8 randomized controlled trials. The main psychopharmacological drugs used include antidepressants and antipsychotics. This review shows that the management of OCD behaviours in individuals with ASD and related conditions is of complex nature and pharmacological interventions may not be an effective method in managing this group of patients. Hence, more comprehensive research and deeper knowledge is important in optimizing pharmacological management for patients with OCD behaviours with underlying ASD. [ABSTRACT FROM AUTHOR]

(1) Background: The literature regarding orthorexia nervosa (ON) has well documented the association with other mental disorders, such as obsessive–compulsive and eating disorders. However, the research has not taken into account stress-related behavior and the conduction of physical activity (PA), both structured and unstructured. (2) Methods: In this cross-sectional study, 165 students of the University of Parma (92 females and 74 males) aged between 18 and 49 years old (mean = 24.62 ± 4.81) were consecutively recruited. The ORTO-15 questionnaire was used to divide the total sample into a group without orthorexia (score > 40) and a group with orthorexia (score < 40). All subjects completed the P Stress Questionnaire, and specific items were extrapolated from the Eating Habits Structured Interview (EHSI) to investigate lifestyle, including structured and unstructured PA. (3) Results: Subjects with orthorexia represented 83% of the total sample and reported higher levels of stress-related risk behaviors (i.e., sense of responsibility (t = −1.99, p = 0.02), precision (t = −1.99, p = 0.03), stress disorders (t = −1.38, p = 0.05), reduced spare time (t = −1.97, p = 0.03), and hyperactivity (t = −1.68, p = 0.04)) and a higher frequency of PA (i.e., hours spent training in structured PA, daily (t = −1.68, p = 0.05), weekly (t = −1.91, p = 0.03), and monthly (t = −1.91, p = 0.03), the tendency to carry out physical exercise even if tired (t = −1.97, p = 0.02), and to adhere to unstructured PA (i.e., moving on foot or by bike rather than using transport (t = 1.27, p = 0.04)). (4) Conclusions: The results confirmed the presence of hyperactivity at a motor and behavioral level in people with orthorexia. Further studies are necessary to highlight the causality between ON, stress, and physical activity but it may be possible to hypothesize that "obsessive" physical exercise may not generate the benefits generally known by the literature. [ABSTRACT FROM AUTHOR]

ABSTRACT Musical hallucinations and musical obsessions are distinct phenomena. The first can be understood as a manifestation of the musical ear syndrome, which produces deafferentation auditory hallucinations, while the latter is an obsessive symptom of obsessive-compulsive disorders. Both symptoms are often poorly understood and mistaken for one another or for signs of psychotic disorders. We report two cases, one characterized by musical hallucinations and the other by musical obsessions, both with comorbid hearing impairment, which is the main confounding factor in their differential diagnosis. We critically compare the two cases and their key features, allowing diagnostic differentiation and a targeted therapeutic approach.

Background: A small number of studies are available to assess the role of stressful life events (SLEs) in obsessive-compulsive disorder (OCD). The previous studies have reported contradictory results and they have methodological limitations. Aims and Objectives: The objectives of our study are (i) to find out the frequency of life events in patients with OCD in comparison to their matched healthy controls and (ii) to find out the impact of life events on the severity of the disorder. Materials and Methods: Sixty patients fulfilling Diagnostic and Statistical Manual of Mental Disorder, 5th edition (DSM-V) criteria of OCD were rated with Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Hamilton Rating Scale for Anxiety (HAM-A), Hamilton Rating Scale for Depression (HAM-D), and Presumptive Stressful Life Events Scale (PSLES). A group of 60 normal controls were also rated on PSLES. Finally, both groups were compared in terms of life events. Results: The frequency of life events, past 1 year (t=5.307, P=0.006) and lifetime (t=11.527, P

This essay argues that one of the distinguishing characteristics of Chuck Palahniuk’s self-described “Horror Trilogy” of novels, Lullaby, Diary, and Haunted, is their representation of obsessions, compulsions, and obsessive–compulsive disorders. This essay analyses these representations from a variety of different perspectives, including medical and psychiatric approaches, clinical and self-help narratives, and biocultural readings emanating from cultural history and critical disability studies. It is demonstrated that the novels reflect a range of the debates that arise from these competing approaches, and the points of similarity and difference in the readings produced are identified. Palahniuk’s representations, it is suggested, must be seen in the contexts of a number of his recurrent thematic preoccupations, and of his engagement with existential comedy. Ultimately, this essay suggests that Palahniuk’s representations of obsessions, compulsions, and OCD must be seen as multi-faceted and protean, as befitting the awareness of the complicated current debates about their conceptualisation that the novels display.

Background: A small number of studies are available to assess the role of stressful life events (SLEs) in obsessive-compulsive disorder (OCD). The previous studies have reported contradictory results and they have methodological limitations. Aims and Objectives: The objectives of our study are (i) to find out the frequency of life events in patients with OCD in comparison to their matched healthy controls and (ii) to find out the impact of life events on the severity of the disorder. Materials and Methods: Sixty patients fulfilling Diagnostic and Statistical Manual of Mental Disorder, 5th edition (DSM-V) criteria of OCD were rated with Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Hamilton Rating Scale for Anxiety (HAM-A), Hamilton Rating Scale for Depression (HAM-D), and Presumptive Stressful Life Events Scale (PSLES). A group of 60 normal controls were also rated on PSLES. Finally, both groups were compared in terms of life events. Results: The frequency of life events, past 1 year (t=5.307, P=0.006) and lifetime (t=11.527, P<0.001), were significantly higher in the patient group in comparison to controls. PSLES scores showed a significant correlation with Y-BOCS total scores, Y-BOCS obsession scores, and HAM-A scores. There was a positive correlation between past 1 year PSLES score and HAM-D scores. Step-wise linear regression analysis showed PSLES scores significantly positively predicted Y-BOCS total score, Y-BOCS obsession score, and Y-BOCS compulsion score. Conclusion: Life events were significantly more frequent in OCD patients both past 1 year and lifetime, as compared to healthy controls. The severity of obsessive compulsive symptoms was found to be directly proportional to the number of SLEs experienced in the past 1 year and lifetime. [ABSTRACT FROM AUTHOR]

Background: Smart phone use has become a part of people’s everyday life. However, when the lack of using the smart phone to establish and maintain electronic communication is related to psychological distress, such a behavior may be considered a modern-age phobia, or nomophobia (no mobile phone phobia). The aims of the present study were to investigate among a sample of young adults the associations between scores for nomophobia and symptoms of depression, anxiety, stress, insomnia, and obsessive–compulsive disorders. Methods: A total of 537 students (mean age: 25.52 years; 42.3% females) participated in the study. They completed a booklet of self-rating questionnaires covering sociodemographic information and symptoms of nomophobia, depression, anxiety, stress, insomnia, and obsessive–compulsive disorders. Results: Higher scores for nomophobia were associated with higher scores for depression, anxiety, and stress, but not with scores for insomnia and obsessive–compulsive disorders. The regression model confirmed that symptoms of anxiety predicted nomophobia. Conclusions: The present results support the assumption that nomophobia appears to be a mood disturbance related to stronger associations with symptoms of anxiety and, to a lesser extent, with symptoms of depression and stress. By contrast, nomophobia appeared to be unrelated to insomnia and symptoms of obsessive–compulsive disorders.

Objective: Orthorexia nervosa (ON) is characterized as obsessional healthy eating that results in malnutrition and/or psychosocial impairment. Yet, ON shares theoretical overlap with eating disorders (EDs), especially anorexia nervosa (AN), as well as obsessive‐compulsive disorder (OCD). This study aimed to further understand ON and its overlap with related disorders by assessing the ability of ON for detecting the presence/absence of threshold ED, AN, and OCD symptoms. Method: An observational survey was completed by 197 participants recruited through eating disorder, dieting, and mental health support groups. Receiver operating characteristic (ROC) curve analyses determined the predictive ability of ON symptoms (assessed by Eating Habits Questionnaire [EHQ] orthorexia nervosa [OrNe] and healthy orthorexia [HeOr] subscales, and the Orthorexia Nervosa Inventory [ONI]) for detecting disordered eating symptoms (determined by Eating Disorder Examination Questionnaire [EDE‐Q] global cut‐scores), probable AN (determined by EDE‐Q cut‐scores and body mass index [BMI] <18.5), and OCD symptoms and obsessional thinking (assessed by the Revised Obsessive‐Compulsive Inventory [OCI‐R]). Results: Results showed both the ONI and EHQ OrNe measures are able to adequately predict ED symptoms and AN; however, both were poor to moderate at detecting OCD symptoms and obsessional thinking. Healthy orthorexia was poor to moderate at detecting outcomes. Discussion: These results suggest that ON, as it is currently operationalized, may be more closely related to EDs than OCD, and that ON may represent a subtype of AN. Results also support healthy orthorexia as a distinct construct to ON. While results are limited by the lack of definitive ON diagnostic criteria, findings suggest that treatments developed for EDs might be most suited to ON. Public Significance: ON has been proposed as a psychiatric disorder, and it shares theoretical overlap with several existing disorders. This study adopts a novel approach to assessing and exploring the overlap of ON with EDs, AN and OCD. Results suggest that ON shares more overlap with EDs and might best be understood as a subtype of EDs or AN. [ABSTRACT FROM AUTHOR]

Background: Smart phone use has become a part of people's everyday life. However, when the lack of using the smart phone to establish and maintain electronic communication is related to psychological distress, such a behavior may be considered a modern-age phobia, or nomophobia (no mobile phone phobia). The aims of the present study were to investigate among a sample of young adults the associations between scores for nomophobia and symptoms of depression, anxiety, stress, insomnia, and obsessive–compulsive disorders. Methods: A total of 537 students (mean age: 25.52 years; 42.3% females) participated in the study. They completed a booklet of self-rating questionnaires covering sociodemographic information and symptoms of nomophobia, depression, anxiety, stress, insomnia, and obsessive–compulsive disorders. Results: Higher scores for nomophobia were associated with higher scores for depression, anxiety, and stress, but not with scores for insomnia and obsessive–compulsive disorders. The regression model confirmed that symptoms of anxiety predicted nomophobia. Conclusions: The present results support the assumption that nomophobia appears to be a mood disturbance related to stronger associations with symptoms of anxiety and, to a lesser extent, with symptoms of depression and stress. By contrast, nomophobia appeared to be unrelated to insomnia and symptoms of obsessive–compulsive disorders. [ABSTRACT FROM AUTHOR]

(1) Background: The literature regarding orthorexia nervosa (ON) has well documented the association with other mental disorders, such as obsessive–compulsive and eating disorders. However, the research has not taken into account stress-related behavior and the conduction of physical activity (PA), both structured and unstructured. (2) Methods: In this cross-sectional study, 165 students of the University of Parma (92 females and 74 males) aged between 18 and 49 years old (mean = 24.62 ± 4.81) were consecutively recruited. The ORTO-15 questionnaire was used to divide the total sample into a group without orthorexia (score > 40) and a group with orthorexia (score < 40). All subjects completed the P Stress Questionnaire, and specific items were extrapolated from the Eating Habits Structured Interview (EHSI) to investigate lifestyle, including structured and unstructured PA. (3) Results: Subjects with orthorexia represented 83% of the total sample and reported higher levels of stress-related risk behaviors (i.e., sense of responsibility (t = −1.99, p = 0.02), precision (t = −1.99, p = 0.03), stress disorders (t = −1.38, p = 0.05), reduced spare time (t = −1.97, p = 0.03), and hyperactivity (t = −1.68, p = 0.04)) and a higher frequency of PA (i.e., hours spent training in structured PA, daily (t = −1.68, p = 0.05), weekly (t = −1.91, p = 0.03), and monthly (t = −1.91, p = 0.03), the tendency to carry out physical exercise even if tired (t = −1.97, p = 0.02), and to adhere to unstructured PA (i.e., moving on foot or by bike rather than using transport (t = 1.27, p = 0.04)). (4) Conclusions: The results confirmed the presence of hyperactivity at a motor and behavioral level in people with orthorexia. Further studies are necessary to highlight the causality between ON, stress, and physical activity but it may be possible to hypothesize that “obsessive” physical exercise may not generate the benefits generally known by the literature.

Background: A complex and challenging mental health condition due to which millions of people are affected worldwide is depression. It extends well beyond mere sadness or occasional spells of low mood. Instead, depression is a persistent and pervasive sense of despair, hopelessness, and emotional pain that can significantly disrupt a person's life. Objective: Anxiety disorders can significantly diminish a person's quality of life (QOL), as this appears to be especially pertinent in the case of individuals dealing with obsessive-compulsive disorder (OCD). This research delves into how obsessions, compulsions, and the presence of depression uniquely influence the life quality of individuals living with OCD. Method: A group of eighty-six individuals who had been diagnosed with OCD based on “DSM-IV criteria” and were dealing with significant compulsions and obsessions participated in this study. The completed assessments related to their quality of life, the intensity of their obsessive-compulsive symptoms, and the severity of their depression. Results: The severity of obsessive-compulsive disorders was found to significantly predict patients with depression, a significant relationship between obsession severity and sickness intrusiveness was also found (t = 2.09, P

Anxiety disorders are among the most common mental disorders worldwide and often respond incompletely to existing treatments. Selenium, a micronutrient that is a component of several biologically active selenoproteins, is also involved in several aspects of brain functioning and may exert antidepressant and anxiolytic effects through multiple pathways. The current paper is a scoping review of translational, observational, and interventional evidence on the potential role of selenium and its compounds in the management of anxiety and related disorders. Evidence from animal models suggests that this approach may be promising. Though evidence from observational studies in humans is inconsistent and affected by several confounding factors, the available evidence from randomized controlled trials suggests that selenium supplementation may be beneficial in the management of certain anxiety-related conditions, such as anxiety in medically ill patients, prevention of anxiety following exposure to traumatic stress, and obsessive-compulsive disorder. This paper provides a critical evaluation of the existing evidence base, including unanswered questions that could serve as the focus of further research, and outlines the potential benefits and risks associated with the use of selenium in anxiety disorders.

Introduction: An increase in obsessive-compulsive disorder (OCD) was predicted as a consequence of the COVID-19 pandemic and the measures established for controlling it. Aims: This review seeks to analyze the relationship between the COVID-19 pandemic and obsessive-compulsive disorder (OCD), and in particular the pandemic’s effect on the prevalence of obsessive-compulsive (OC) symptoms, predisposing factors, interventions carried out, their effectiveness and the proposal of interventions in future situations similar to the one studied. Methods: For this purpose, a systematic review of empirical articles, published from November 2019 to June 2022, is carried out, following the PRISMA methodology. The review was registered in Open Science Forum [10.17605/OSF.IO/DV8GZ]. Results: The studies indicated an increase in the prevalence of OC symptoms in the general population, as well as new obsessions, relapses, and/ or worsening of the pre-existing symptoms in patients with OCD mainly related to contamination obsessions and cleaning and hand washing compulsions. Predisposing factors are being younger, low resilience, low social support, the presence of previous contamination symptoms, overexposure to news about COVID-19, the previous severity and aggressiveness of OC symptomatology, and the absence or lack of treatment adherence. The combined use of pharmacological treatment, cognitive-behavioral therapies, teaching skills to reinforce resilience, and training in coping strategies will be recommended. Conclusions: The data obtained can be used as a basis for future OCD prevention plans in crises similar to the one studied.

Abstract Neurodegenerative dementias such as the behavioral variant of frontotemporal dementia, Alzheimer’s disease, and Parkinson’s disease dementia are linked to various behavioral and psychological abnormalities. Whether these abnormalities precede, coincide or follow the onset of cognitive symptoms is still controversial in existing literature, with trajectories available so far dependent on types of dementia. The authors aim to review the different kinds of premorbid behavioral symptoms/personality traits associated with an increased risk of developing specific types of neurodegenerative dementia. Neuroticism has been associated with an increased risk of Alzheimer’s disease and late-onset behavioral abnormalities with the behavioral variant of frontotemporal dementia. The presence of obsessive–compulsive spectrum disorders in Parkinson’s disease dementia is also not rare. Analyzing this evidence, we propose “behavioral biomarkers” as neuroticism in Alzheimer’s disease, late-onset behavioral abnormalities in behavioral variant of frontotemporal dementia, and obsessive–compulsive traits in Parkinson’s disease dementia. These noninvasive behavioral biomarkers will be of immense help, particularly in developing countries, and will prevent the need for costlier investigations and aid in therapeutic strategies.

As no French validated measurement tool distinguishing healthy orthorexia (HeOr) from orthorexia nervosa (OrNe) currently exists, this study aimed at examining psychometric properties of the French version of the Teruel Orthorexia Scale (TOS). A sample of 799 participants (Mean [SD] age: 28.5 [12.1] years-old) completed the French versions of the TOS, the Düsseldorfer Orthorexia Skala, the Eating Disorder Examination-Questionnaire, and the Obsessive–Compulsive Inventory-Revised. Confirmatory factor analysis and exploratory structural equation modeling (ESEM) were used. Although the bidimensional model, with OrNe and HeOr, of the original 17-item version showed an adequate fit, we suggest excluding items 9 and 15. The bidimensional model for the shortened version provided a satisfactory fit (ESEM model: CFI =.963, TLI =.949, RMSEA =.068). The mean loading was.65 for HeOr and.70 for OrNe. The internal consistency of both dimensions was adequate (αHeOr =.83 and αOrNe =.81). Partial correlations showed that eating disorders and obsessive–compulsive symptomatology measures were positively related to OrNe and unrelated or negatively related to HeOr. The scores from the 15-item French version of the TOS in the current sample appears to present an adequate internal consistency, pattern of associations in line with what was theoretically expected, and promising for differentiating both types of orthorexia in a French population. We discuss why both dimensions of orthorexia should be considered in this area of research. Plain English summary: Orthorexia ('right appetite', from the Greek) covers two dimensions: (1) orthorexia nervosa (OrNe), a strong preoccupation with healthy diet with negative emotional, cognitive, and/or social consequences while trying to approach this goal and when the eating behavior deviates from it, and (2) healthy orthorexia (HeOr), which can be defined as a healthy interest in diet, (self-assessed) healthy behavior with regard to diet and eating healthily as part of one's identity. OrNe is not yet indexed into mental disorder classifications. Some prominent measurement tools in the area of orthorexia present important limitations: it is unclear if they validly assess OrNe and they do not tap HeOr by design. To overcome these limitations, a promising self-reported instrument was developed: the Teruel Orthorexia Scale (TOS), a bidimensional questionnaire whose structure has been replicated in different samples. Our research based on 799 participants aimed to adapt this instrument in a French speaking population. The results revealed that the French version of the TOS is an empirically supported tool allowing to differentiate both forms of orthorexia (healthy and nervosa). It also suggests that OrNe is associated with psychopathological symptoms while opposite patterns were found with HeOr. We discuss the importance of measuring both orthorexia dimensions. [ABSTRACT FROM AUTHOR]

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Introduction: Obsessive-compulsive disorder can decrease the quality of life and is often experienced by patients throughout their lives. They involve the presence of obsessions (persistent, unwanted thoughts) and compulsions (actions/rituals performed by the patient to alleviate the discomfort associated with the obsessions). Currently, they are diagnosed based on the criteria of DSM-5. Aim of the study: The aim of this study is to review and analyze the available literature on obsessive-compulsive disorders. Materials and methods: A review of the literature available in the PubMed and Google Scholar databases on obsessive-compulsive disorders was conducted. Results: The exact cause of OCD remains unknown. The involvement of genetic and environmental factors is suspected. It has been shown that damage to certain brain structures due to injury or neurodegenerative diseases can lead to the development of obsessions and/or compulsions. The severity of symptoms is influenced by cognitive inflexibility, a high sense of responsibility, and magical thinking. Currently, pharmacotherapy and/or psychotherapy form the basis of treatment. The portrayal of individuals with OCD has been present in history and art for centuries. Summary: Aspects, causes, and treatment methods of OCD are still being investigated and discovered. Presenting this disorder through art can positively impact awareness and social acceptance.

Cervical dystonia (CD) has a wide range of non-motor (neuropsychiatric, sensory, dyssomnic) disorders. Relationships between dystonia, nonmotor manifestations of the disease and patients quality of life (QoL) require clarification.Objective: to clarify the impact of dystonia, sensory, affective, behavioral disorders, quality of sleep and wakefulness on the quality of life of patients with CD.Patients and methods. We examined 61 patients with CD (mean age – 48.03±11.49 years, mean duration of CD – 4.89±4.05 years). We used Toronto Western Hospital Spasmodic Torticollis Rating Scale (TWSTRS), Cervical Dystonia Quality of Life Questionnaire (CDQ-24, with five subscales: «stigma», «emotional wellbeing», «pain», «activities of daily living», «social/family life»), Spielberger–Khanin Inventory (STAI),Beck Depression Inventory (BDI), Barratt Behavioral Impulsivity (BIS-11), Yale–Brown Obsessive Compulsive Scale (Y-BOCS), Montreal Cognitive Assessment Scale (MoCA), Stroop Test (VST), 12 Word Memory Test, Pittsburgh Sleep Quality Assessment Scale (PSQI), Epworth Sleepiness Scale (ESS).Results and discussion. There was a deterioration in all characteristics of QoL in patients with CD, largely in emotional well-being, stigmatization, pain syndrome (50% change from the maximum CDQ-24 score). A statistically significant moderate correlation was established between the total assessment of QoL and the severity of dystonia (r=0.35; p

Anxiety disorders are among the most common mental disorders worldwide and often respond incompletely to existing treatments. Selenium, a micronutrient that is a component of several biologically active selenoproteins, is also involved in several aspects of brain functioning and may exert antidepressant and anxiolytic effects through multiple pathways. The current paper is a scoping review of translational, observational, and interventional evidence on the potential role of selenium and its compounds in the management of anxiety and related disorders. Evidence from animal models suggests that this approach may be promising. Though evidence from observational studies in humans is inconsistent and affected by several confounding factors, the available evidence from randomized controlled trials suggests that selenium supplementation may be beneficial in the management of certain anxiety-related conditions, such as anxiety in medically ill patients, prevention of anxiety following exposure to traumatic stress, and obsessive-compulsive disorder. This paper provides a critical evaluation of the existing evidence base, including unanswered questions that could serve as the focus of further research, and outlines the potential benefits and risks associated with the use of selenium in anxiety disorders. [ABSTRACT FROM AUTHOR]

Orthorexia nervosa (ON) is defined as an exaggerated, obsessive, pathological fixation on healthy food, healthy eating, or health-conscious eating behaviors. In the literature, there is an ongoing debate over whether ON should be considered simply a lifestyle phenomenon or a psychiatric disorder. In this vein, ON seems to share psychopathological characteristics with both eating disorders (EDs) and obsessive-compulsive disorder (OCD). However, there are insufficient data to reconcile the debate. The present study aimed at consolidating evidence on the clinical significance of ON and its relationship with EDs and OCD. A selective review of the literature published between January 2015 and March 2022 was conducted, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Ten studies were included. Some of these studies suggested that ON might follow a full-syndrome DSM-5 ED. Other studies proposed that ON and DSM-5 EDs may co-occur. Finally, only two studies suggested a relationship between ON and OCD. To date, the clinical significance of ON and its relationship with EDs and other DSM-5 psychiatric disorders (e.g., OCD) appears complicated and unclear. Future longitudinal research on the possible clinical course of ON is needed. [ABSTRACT FROM AUTHOR]

Introduction: An increase in obsessive-compulsive disorder (OCD) was predicted as a consequence of the COVID-19 pandemic and the measures established for controlling it. Aims: This review seeks to analyze the relationship between the COVID-19 pandemic and obsessive-compulsive disorder (OCD), and in particular the pandemic’s effect on the prevalence of obsessive-compulsive (OC) symptoms, predisposing factors, interventions carried out, their effectiveness and the proposal of interventions in future situations similar to the one studied. Methods: For this purpose, a systematic review of empirical articles, published from November 2019 to June 2022, is carried out, following the PRISMA methodology. The review was registered in Open Science Forum [10.17605/OSF.IO/DV8GZ]. Results: The studies indicated an increase in the prevalence of OC symptoms in the general population, as well as new obsessions, relapses, and/ or worsening of the pre-existing symptoms in patients with OCD mainly related to contamination obsessions and cleaning and hand washing compulsions. Predisposing factors are being younger, low resilience, low social support, the presence of previous contamination symptoms, overexposure to news about COVID-19, the previous severity and aggressiveness of OC symptomatology, and the absence or lack of treatment adherence. The combined use of pharmacological treatment, cognitive-behavioral therapies, teaching skills to reinforce resilience, and training in coping strategies will be recommended. Conclusions: The data obtained can be used as a basis for future OCD prevention plans in crises similar to the one studied. [ABSTRACT FROM AUTHOR]

Body focused repetitive behaviors (BFRBs) are psychiatric disorders belonging under obsessive-compulsive disorders characterised by performing unwanted, difficult to stop or limit grooming behaviors that result in hair loss or epidermal damage. For many patients, it is an embarrassing problem, hidden from relatives, which leads progressively to a significant deterioration of their quality of life. Knowledge of BFRBs is still not widespread, and this has a direct effect on a lack of effective and widely available treatments. This article briefly characterizes the types (mainly tricho- and dermatillomania), epidemiology, etiology, pathogenesis of BFRBs and current treatment approaches, paying special attention to the diversity of these disorders as well as diagnostic and therapeutic difficulties. [ABSTRACT FROM AUTHOR]

Neurodegenerative dementias such as the behavioral variant of frontotemporal dementia, Alzheimer's disease, and Parkinson's disease dementia are linked to various behavioral and psychological abnormalities. Whether these abnormalities precede, coincide or follow the onset of cognitive symptoms is still controversial in existing literature, with trajectories available so far dependent on types of dementia. The authors aim to review the different kinds of premorbid behavioral symptoms/personality traits associated with an increased risk of developing specific types of neurodegenerative dementia. Neuroticism has been associated with an increased risk of Alzheimer's disease and late-onset behavioral abnormalities with the behavioral variant of frontotemporal dementia. The presence of obsessive–compulsive spectrum disorders in Parkinson's disease dementia is also not rare. Analyzing this evidence, we propose "behavioral biomarkers" as neuroticism in Alzheimer's disease, late-onset behavioral abnormalities in behavioral variant of frontotemporal dementia, and obsessive–compulsive traits in Parkinson's disease dementia. These noninvasive behavioral biomarkers will be of immense help, particularly in developing countries, and will prevent the need for costlier investigations and aid in therapeutic strategies. [ABSTRACT FROM AUTHOR]

Up to 30% of subjects with obsessive compulsive disorder (OCD) also have a lifetime tic disorder. Several meta-analyses of pharmaceutical or psychotherapeutic interventions for the management of OCD have been published, but none specifically on patients with OCD comorbid with tics. The literature regarding pharmacological treatments of patients with this condition is mainly focused on studies of OCD. After a search of the Cochrane, EMBASE, PubMed, PsychINFO and Science Direct databases, we performed a proportion meta-analysis of the percentage of patients whose condition improved and a paired meta-analysis of the change in the OCD score (Y-BOCS). Twelve case reports were retained for qualitative analysis and 14 articles for meta-analysis. Case reports showed better efficacy of combined antidepressant-antipsychotic treatment for OCD comorbid with tic disorder. The meta-analysis showed an improvement in 29% [18-42] of patients with antidepressants. Although there was no significant difference with placebo add-on, in antidepressant-resistant OCD patients, adding an antipsychotic to the antidepressant regimen led to an increase in the number of patients who improved (67% [45-86] vs 7% [0-35]) and seemed to show a decrease in the Y-BOCS score (-10.06 [-20.38; 0.26] vs (-3.61 [-9.08; 13.85]). Our study provides new evidence on the pharmacological treatment of OCD comorbid with tics. In some patients, the condition is improved by a first-line antidepressant. In case of non-response or insufficient efficacy of antidepressants, add-on treatment with certain antipsychotics can be implemented., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: To assess the clinical efficacy of Morita therapy in combination with pharmacotherapy in adults who were diagnosed with current OCDs. Methods: We searched 10 databases to identify articles written in English or Chinese that were published until 15 April 2021. Randomized controlled trials were included. Two authors of this review independently selected the studies, assessed the risk of bias, and extracted the data. Results: Twenty-one studies with a total of 1604 participants met the inclusion criteria. Morita therapy plus pharmacotherapy was significantly superior to pharmacotherapy alone in the efficiency of OCD (RR = 1.34, 95% CI: 1.26 to 1.44, I 2 = 0%), and better in reducing OCD severity symptoms (MD = −3.55, 95% CI: −4.34 to −2.75, I 2 = 80%). Conclusion: Our meta-analysis and systematic review suggest that Morita therapy may be an effective approach to improve OCDs. [ABSTRACT FROM AUTHOR]

Abstract Introduction Although many variables have been examined as potentially contributing to the manifestation of trichotillomania (TTM), little research has focused on problems in social interactions. Hair pulling has many similarities to the stereotypies seen in autism spectrum disorders (ASD), and thus the present study examined autistic traits in adults with trichotillomania. Methods Fifty nontreatment‐seeking adults with DSM‐5 TTM were recruited. Participants completed standard diagnostic interviews, basic demographic information, and symptom inventories about TTM. Autistic traits were quantified using the Brief Autism‐ Spectrum Quotient (AQ‐10) which screens for autistic traits. Results The sample comprised 50 participants, mean (standard deviation) age of 30.2 (5.6) years, 10% being male, 86% female, and 4% nonbinary. Eight of the participants had a history of major depressive disorder and six had a history of an anxiety disorder. No one had current or lifetime obsessive‐compulsive disorder. The mean AQ10 score was 3.5 (2.0), with 14.6% scoring 6 or greater. Autism scores correlated significantly only with family dysfunction and not with symptom severity or impulsivity. Conclusions This study examined autistic traits in a community‐based sample of adults with TTM and found elevated rates of probable ASD (based on a self‐report screening tool) among those with TTM. These results highlight the need to carefully screen for autistic traits in those with TTM. To what extent these traits may influence response to treatment, however, remains unclear.

Objective: The aim of this study is comparing gray matter alterations in SCZ pediatric patients with those suffering from obsessive-compulsive disorder (OCD) based on a systematic review and an activation likelihood estimation (ALE) meta-analysis. Methods: A systematic literature search was performed in PubMed, Elsevier, and China National Knowledge Infrastructure (CNKI). A systematic review and an ALE meta-analysis were performed to quantitatively examine brain gray matter alterations. Results: Children and adolescents with schizophrenia had decreased gray matter volume (GMV) mainly in the prefrontal cortex (PFC), temporal cortex (such as the middle temporal gyrus and transverse temporal gyrus), and insula, while children and adolescents with OCD mainly had increased GMV in the PFC and the striatum (including the lentiform nucleus and caudate nucleus), and decreased GMV in the parietal cortex. Conclusions: Our results suggest that gray matter abnormalities in the PFC may indicate homogeneity between the two diseases. In children and adolescents, structural alterations in schizophrenia mainly involve the fronto-temporal and cortico-insula circuits, whereas those in OCD mainly involve the prefrontal-parietal and the prefrontal-striatal circuits. [ABSTRACT FROM AUTHOR]

ObjectiveThe aim of this study is comparing gray matter alterations in SCZ pediatric patients with those suffering from obsessive-compulsive disorder (OCD) based on a systematic review and an activation likelihood estimation (ALE) meta-analysis.MethodsA systematic literature search was performed in PubMed, Elsevier, and China National Knowledge Infrastructure (CNKI). A systematic review and an ALE meta-analysis were performed to quantitatively examine brain gray matter alterations.ResultsChildren and adolescents with schizophrenia had decreased gray matter volume (GMV) mainly in the prefrontal cortex (PFC), temporal cortex (such as the middle temporal gyrus and transverse temporal gyrus), and insula, while children and adolescents with OCD mainly had increased GMV in the PFC and the striatum (including the lentiform nucleus and caudate nucleus), and decreased GMV in the parietal cortex.ConclusionsOur results suggest that gray matter abnormalities in the PFC may indicate homogeneity between the two diseases. In children and adolescents, structural alterations in schizophrenia mainly involve the fronto-temporal and cortico-insula circuits, whereas those in OCD mainly involve the prefrontal-parietal and the prefrontal-striatal circuits.

Interdisciplinary mobile health (mHealth) technologies and intervention approaches are changing the nature of health research, providing the opportunity to shift from more reactive approaches for patient care to a more proactive stance. As with the larger field of medicine, mHealth and technology‐enhanced approaches in psychiatry and clinical psychology are opening an unparalleled number of avenues to help reduce the risk for psychiatric disease, treat psychological disorders, and increase well‐being of our patients. While promising, this research is characterized by complex challenges across the domains of concept development, initial design and testing, and downstream implementation and scaled‐up dissemination. This Special Issue in the British Journal of Clinical Psychology was designed to highlight the development and implementation of mHealth research in the anxiety and obsessive‐compulsive spectrum disorders. In addition to informing readers about important advances that have been made, the present special issue also draws attention to the myriad challenges that will need to be considered in future research. Three domains relevant for mHealth research are addressed, including a careful consideration of where the research currently stands and what challenges we should prepare for, the adaptation of traditional and adjunctive treatments to mobile or online platforms, and the ability for technology and associated methodological approaches to provide further insight into aetiological investigations. [ABSTRACT FROM AUTHOR]

Objective: A moderate sport activity is considered beneficial for both physical and mental health. On the contrary, different studies have shown that professional players may be more vulnerable to suffer from psychological and/or psychiatric disorders. Given the limited information available, the present study aimed to investigate the possible presence of depressive and obsessive-compulsive symptoms or disorders in a group of professional tennis players. Method: Twenty-five current or former professional tennis players (18 men and 7 women; mean age ± SD: 42.32 ± 13.45 years), were recruited within the Italian Tennis Federation during an international competition and during a master meeting of coaches. They were compared with a control group, recruited from university students, doctors and nurses. All of them underwent a psychiatric interview with a structured scale and a psychopathological assessment carried out with the Mini-International Neuropsychiatric Interview (MINI), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Self Assessment Scale for Depression (SAD). Results: The Y-BOCS total and subscale scores were significantly higher in both current and past athletes than controls. Current athletes showed higher scores at Y-BOCS total, subscales and some items. The majority of the current athletes also showed superstitions and magical thinking. Conclusions: The present study demonstrated that professional tennis players show a relevant increase of obsessive-compulsive symptoms and supertistions than controls. Interestingly, current athletes resulted more severe than past ones. Taken together, our findings support the notion that agonistic sport activities of high level require intensive training and compliance to strict daily routines that might represent a sort of vulnerability toward the onset of full-blown obsessive-compulsive disorder (as well as other disorders) in more fragile individuals. Not suprisingly, sport psychological support experts are increasingly needed. [ABSTRACT FROM AUTHOR]

Neuropsychiatric disorders represent a set of severe and complex mental illnesses, and the exact etiologies of which are unknown. It has been well documented that impairments in the early development of the brain contribute to the pathogenesis of many neuropsychiatric disorders. Currently, the diagnosis of neuropsychiatric disorders largely relies on subjective cognitive assessment, because there are no widely accepted biochemical or genetic biomarkers for diagnosing mental illness. Circular RNAs (circRNAs) are a novel class of endogenous non-coding RNA (ncRNA) with a closed-loop structure. In recent years, there have been tremendous advances in our understanding of the expression profiles and biological roles of circRNAs. In the brain, circRNAs are particularly enriched and are expressed more abundantly in contrast to linear counterpart transcripts. They are highly active at neuronal synapses. These features make circRNAs uniquely crucial for understanding brain health, disease, and neuropsychiatric disorders. This review focuses on the role of circRNAs in early brain development and other brain-related processes that have been associated with the development of neuropsychiatric disorders. In addition, we discuss the potential for blood or cerebrospinal fluid circRNAs to be used as novel biomarkers in the early diagnosis of neuropsychiatric disorders. The findings reviewed here may provide new insight into the pathological mechanisms underlying the onset and progression of neuropsychiatric disorders.

Musical hallucinations and musical obsessions are distinct phenomena. The first can be understood as a manifestation of the musical ear syndrome, which produces deafferentation auditory hallucinations, while the latter is an obsessive symptom of obsessive-compulsive disorders. Both symptoms are often poorly understood and mistaken for one another or for signs of psychotic disorders. We report two cases, one characterized by musical hallucinations and the other by musical obsessions, both with comorbid hearing impairment, which is the main confounding factor in their differential diagnosis. We critically compare the two cases and their key features, allowing diagnostic differentiation and a targeted therapeutic approach., Competing Interests: Disclosure: The authors report no conflicts of interest.

Background: Psychiatric illnesses are often associated with severe forms of headache as chronic migraine (CM) with medication overuse headaches (MOH). Few data are available about obsessive-compulsive disorders (OCD) in migraineurs. This study aimed to investigate OCD traits in CM with MOH patients of both sexes and the impact on migraine treatment.Methods: We enrolled all consecutive patients with CM and MOH treated with onabotulinumtoxin-A (OBT-A) in our Headache Center. Each subject was submitted to the Obsessive-Compulsive Inventory-Revised (OCI-R) test at the start (T0) and after four OBT-A sessions (T1). Statistical analysis compared OCI-R results at T0 and T1 according to sex with the chi-square test.Results: We analyzed a sample of 60 subjects (40 females, 66.7%). At T0, 25% of males and 37.5% of females had a normal profile while 60% of males and 22.5% of females presented pathologic OCD traits. At T1, 30% of males and 60% of females were normal, while 40% of males and 15% of females resulted frankly pathologic. The difference in the OCI-R distribution was significant at T0 (p = 0.024) and at T1 (p = 0.047). Both males and females underwent a significant increase in normalization rates at T1 (p < 0.05).Conclusion: We observed a significant OCD traits rate at baseline, moreover among men. Females showed a more significant improvement in OCD traits at T1. OBT-A confirmed its high efficacy on CM, with a migraine severity improvement in both genders and all the OCI-R classes. Psychological attitude in the management of migraine should be better investigated in future studies. [ABSTRACT FROM AUTHOR]

The experience of domestic and foreign clinicians shows that the real possibilities of overcoming school and social maladjustment are associated with a correct assessment of the diagnostic significance of clinical manifestations of behavioral and mental disorders. Among the various variants of mental pathology, borderline neuropsychic disorders are often encountered, accompanied by various forms of impaired behavior and social and labor maladjustment. The choice of a rational method of treatment and highly effective medical and social rehabilitation are possible only if there is accurate information about the mechanism of occurrence and dynamics of mental and behavioral disorders. The purpose of this research: to study clinical and pathogenetic patterns and age-related dynamics of behavioral and mental disorders in patients with a neurosis-like state of residual organic genesis. Methods of research: psychodiagnostic, clinical-anamnestic, radiological, principles of age dynamics (the main stages of ontogenesis), clinical-psychopathological, catamnestic, clinical Yale-Brown Obsessive and Symptom Checklist, statistical ("SPSS 16.0" and Excel from Microsoft Office 2003). Results: clinical scale of obsessions and compulsions Yale-Brown (Yale-Brown Obsessive and Symptom Checklist), statistical ("SPSS 16.0" and Excel from the package "Microsoft Office 2003). The carried-out research has allowed allocating clinical variants of clinical and pathogenetic laws and age dynamics of behavioral and mental disorders at patients with neurosis-like condition of the residual-organic genesis. The research presents the identification and study of features of formation and dynamics of various forms of deviant behavior in the clinic of neurosis-like states of residual-organic genesis. Study of typology of obsessive-compulsive symptom complex gives possibility to develop the program of complex treatment that essentially improves quality of life of the given research contingent. [ABSTRACT FROM AUTHOR]

Chronic constipation is one of the most common problems in children. It can cause anxiety and psychological problems in patients and parents. The purpose of this study was to investigate the relationship between obsessive-compulsive disorders (OCD) in children with chronic functional constipation. This is a case-control study performed at the gastroenterology clinic of Besat Hospital Sanandaj for one year. The children aged 7-14-year-old with chronic functional constipation were selected as a case group, and the healthy children were recruited as a control group, who referred for growth control. Then, the Maudsley questionnaire for obsessive-compulsive disorders was completed by a trained assistant. With this questionnaire, the presence or absence of OCD and its type can be determined. Forty-three children were selected as the case group and sixty-seven children as the control group. The mean age of the case and control group was 9.3±1.5 and 8.8±1.6 years, respectively. Based on the results, there was a significant difference between the groups in terms of checking, cleaning, slowness, doubting, and total obsessive score (P˂0.05). Therefore, all five types of obsessive-compulsive disorder in the case group were greater than the control group. Obsessive-compulsive disorders were more common in children with functional constipation, and the total obsessive score in these children than the healthy children was a significant difference.

Chronic constipation is one of the most common problems in children. It can cause anxiety and psychological problems in patients and parents. The purpose of this study was to investigate the relationship between obsessive-compulsive disorders (OCD) in children with chronic functional constipation. This is a case-control study performed at the gastroenterology clinic of Besat Hospital Sanandaj for one year. The children aged 7-14-year-old with chronic functional constipation were selected as a case group, and the healthy children were recruited as a control group, who referred for growth control. Then, the Maudsley questionnaire for obsessive-compulsive disorders was completed by a trained assistant. With this questionnaire, the presence or absence of OCD and its type can be determined. Forty-three children were selected as the case group and sixty- seven children as the control group. The mean age of the case and control group was 9.3±1.5 and 8.8±1.6 years, respectively. Based on the results, there was a significant difference between the groups in terms of checking, cleaning, slowness, doubting, and total obsessive score (P<0.05). Therefore, all five types of obsessive- compulsive disorder in the case group were greater than the control group. Obsessive-compulsive disorders were more common in children with functional constipation, and the total obsessive score in these children than the healthy children was a significant difference. [ABSTRACT FROM AUTHOR]

Introduction: Although many variables have been examined as potentially contributing to the manifestation of trichotillomania (TTM), little research has focused on problems in social interactions. Hair pulling has many similarities to the stereotypies seen in autism spectrum disorders (ASD), and thus the present study examined autistic traits in adults with trichotillomania. Methods: Fifty nontreatment‐seeking adults with DSM‐5 TTM were recruited. Participants completed standard diagnostic interviews, basic demographic information, and symptom inventories about TTM. Autistic traits were quantified using the Brief Autism‐ Spectrum Quotient (AQ‐10) which screens for autistic traits. Results: The sample comprised 50 participants, mean (standard deviation) age of 30.2 (5.6) years, 10% being male, 86% female, and 4% nonbinary. Eight of the participants had a history of major depressive disorder and six had a history of an anxiety disorder. No one had current or lifetime obsessive‐compulsive disorder. The mean AQ10 score was 3.5 (2.0), with 14.6% scoring 6 or greater. Autism scores correlated significantly only with family dysfunction and not with symptom severity or impulsivity. Conclusions: This study examined autistic traits in a community‐based sample of adults with TTM and found elevated rates of probable ASD (based on a self‐report screening tool) among those with TTM. These results highlight the need to carefully screen for autistic traits in those with TTM. To what extent these traits may influence response to treatment, however, remains unclear. This study found that autistic traits were common in adults with trichotillomania and associated with family dysfunction. These results highlight the need to carefully screen for autistic traits in those with TTM. To what extent these traits may influence response to treatment, however, remains unclear. [ABSTRACT FROM AUTHOR]

Introduction Skin-Picking Disorder (SPD) is psychiatric condition characterized by recurrent and excessive picking of the skin. There are several attempts to stop the behavior and it causes negative consequences such as dermatological complications and functional impairment. Objectives The aim of this study is to describe a case report of SPD. Methods Data was collected retrospectively from case notes. Results A 30 year-old male, married with 2 children, currently on sick leave, was admitted to the Day Hospital at Centro Hospitalar Psiquiátrico de Lisboa (CHPL) with worsen skin-picking behaviour and functional impairment. During childhood the patient would “cut my toe nails the wrong way so that I could fix them”. By adolescence the patient suffered from acne and felt the need to “solve” them and take out the pus. Over the years the skin-picking behaviour spread to other areas of the body, mainly dorsal and chest areas. Before being admitted to the Day Hospital the episodes were daily and had 2-3 hours duration, using scissors and tweezers and evolving his family, asking his wife’s help with picking. He is being treated with fluoxetine 80 mg, risperidone 2 mg and N-acetylcysteine 1200 mg and Cognitive Behavioural Therapy. He is also participating in the Day Hospital activities that include occupational therapy, movement therapy, psychoeducation. After 2 months he has a few 20 minutes episodes per week, spends more time with his children and thinks about coming back to work. Conclusions SPD is a severe and debilitating illness that benefits from a multidisciplinary approach. Disclosure No significant relationships.

Rationale, aims, and objectives: People worldwide are affected by psychiatric disorders that lack a "best" treatment option. The role of shared decision‐making (SDM) in psychiatric care seems evident, yet remains limited. Research on SDM in specialized mental health is scarce, concentrating on patients with depressive disorder or psychiatric disorders in general and less on patients with anxiety and obsessive‐compulsive disorder (OCD). Furthermore, recent research concentrates on the evaluation of interventions to promote and measure SDM rather than on the feasibility of SDM in routine practice. This study investigated patients' and clinicians' perspectives on SDM to treat depression, anxiety disorders, and OCD as to better understand SDM in specialized psychiatric care and its challenges in clinical practice. Methods: Transcripts of eight focus groups with 17 outpatients and 33 clinicians were coded, and SDM‐related codes were analysed using thematic analyses. Results: Motivators, responsibilities, and preconditions regarding SDM were defined. Patients thought SDM should be common practice given the autonomy they have over their own bodies and felt responsible for their treatments. Clinicians value SDM for obtaining patients' consent, promoting treatment adherence, and establishing a good patient‐clinician relationship. Patients and clinicians thought clinicians assumed the most responsibility regarding the initiation and achievement of SDM in clinical practice. According to clinicians, preconditions were often not met, were influenced by illness severity, and formed important barriers (eg, patient's decision‐making capacity, treatment availability, and clinicians' preferences), leading to paternalistic decision‐making. Patients recognized these difficulties, but felt none of these preclude the implementation of SDM. Personalized information and more consultation time could facilitate SDM. Conclusions: Patients and clinicians in specialized psychiatric care value SDM, but adapting it to daily practice remains challenging. Clinicians are vital to the implementation of SDM and should become versed in how to involve patients in the decision‐making process, even when this is difficult. [ABSTRACT FROM AUTHOR]

Objective: Eating disorders (EDs) are complex, heterogeneous, and severe psychiatric syndromes. They are highly comorbid with obsessive–compulsive disorder (OCD) which exacerbates the course of illness and impedes treatment. However, the direct functional relations between EDs and OCD symptoms remain largely unexplored. Hence, using network analysis, we investigated the relationship between ED and OCD at the level of symptoms in a heterogeneous clinical sample. Method: We used cross sectional data of 303 treatment‐seeking patients with clinically relevant ED and OCD pathology. We constructed a regularized partial correlation network that featured both ED and OCD symptoms as nodes. To determine each symptom's influence, we calculated expected influence (EI) as an index of symptom centrality (i.e., "importance"). Bridge symptoms (i.e., symptoms from one syndromic cluster that have strong connections to symptoms of another syndromic cluster) were identified by computing bridge expected influence metrics. Results: Fear of weight gain and dietary restraint were especially important among the ED symptoms. Interference due to obsessions was the key feature of OCD. ED and OCD clustered distinctly with few potential bridges between clusters. Discussion: This study underscores the importance of cognitive symptoms for both ED and OCD although direct functional links between the two clusters are missing. Potentially, a network incorporating nodes capturing features of personality may account for diagnostic comorbidity better than specific symptoms of EDs or features of OCD do. [ABSTRACT FROM AUTHOR]

Anxiety and insomnia disorders are two of the most common and costly mental health conditions. They are frequently comorbid, but current treatments do not target both. To streamline treatment, we developed a computerized intervention targeting a transdiagnostic factor, safety aids (cognitive or behavioral strategies used to cope with distress that paradoxically exacerbate symptoms). We conducted a randomized controlled trial to determine the acceptability and efficacy of this brief one-session intervention. Young adult undergraduates (N = 61) with elevated subclinical anxiety and insomnia were randomized to receive the anxiety-insomnia intervention or a physical health control condition. Participants were followed for 1 month and completed self-report measures. Analyses indicated that participants found the intervention acceptable, credible, and engaging. Analyses revealed the active intervention reduced sleep- and anxiety-related safety aids, with medium to large effect sizes. Findings suggest that targeting safety aids for anxiety and insomnia is acceptable and effective in reducing the target mechanism, safety aids, as well as worry. Future research should replicate these findings within a clinical sample and with a longer-term follow-up. [ABSTRACT FROM AUTHOR]

Introduction: Orthorexia nervosa is a pathological behaviour characterised by an obsession with proper nutrition and avoiding foods considered by the affected individual to be unhealthy, which leads to severe dietary restrictions. So far, the disease has not been included in any official diagnostic classification, and nosological considerations in this regard are inconclusive. Aim: The aim of this study was to characterise patients with orthorexic behaviours as well as to analyse the relationship between orthorexia and selected sociodemographic factors and psychopathologies, such as eating disorders, obsessive-compulsive disorders and hypochondria. Materials and methods: Questionnaires measuring the symptoms of orthorexia, eating disorders, obsessive-compulsive disorders and hypochondria as well as an author's original were used. The study included 236 Polish respondents aged 18--35 years. Results: Appearance and health were the main motivational factors in the group of respondents presenting with higher severity of orthorexic behaviours (27%). There were no differences between high- and low-orthorexic behaviour groups in terms of variables such as sex, age or body mass index. Increased severity of orthorexic behaviours was associated with lower education levels and reporting high frequency of physical activity. Increased severity of orthorexic behaviours was also accompanied by dietary restrictions (a symptom seen in eating disorders) and signs of obsessive-compulsive disorders. Conclusions: Orthorexia is characterised by the use of special diets and dietary restrictions, making nutritional decisions based on appearance and health as well as reporting more frequent physical activity. Based on the clinical picture, orthorexia nervosa should be classified into the spectrum of eating disorders, with the possible involvement of obsessive-compulsive disorders in its development. [ABSTRACT FROM AUTHOR]