scholarly journals Symptom Dimensions and Clinical Presentations in Obsessive Compulsive Disorder

2016 ◽  
Vol 3 (4) ◽  
Author(s):  
Hemant Kumar

In Obsessive compulsive disorder (OCD) a wide range of symptoms are seen, along with different responses to treatment, this has pointed to the direction that OCD is more heterogeneous than thought before and clinically different subtypes of OCD exist. This article presents a wide variety of symptoms dimension seen in OCD with many pioneering and important work done in this area. The different clinical presentations of patients with OCD have also been seen. The heterogeneity and the vastness of the symptoms of this disorder could lead to new breakthroughs and pathways in our current understanding of OCD.

2014 ◽  
Vol 121 (1) ◽  
pp. 123-130 ◽  
Author(s):  
Andre F. Gentil ◽  
Antonio C. Lopes ◽  
Darin D. Dougherty ◽  
Christian Rück ◽  
David Mataix-Cols ◽  
...  

Object Recent findings have suggested a correlation between obsessive-compulsive disorder (OCD) symptom dimensions and clinical outcome after limbic system surgery for treatment-refractory patients. Based on previous evidence that the hoarding dimension is associated with worse outcome in conventional treatments, and may have a neural substrate distinct from OCD, the authors examined a large sample of patients undergoing limbic surgery (40 with capsulotomy, 37 with cingulotomy) and investigated if symptom dimensions, in particular hoarding, could influence treatment outcome. Methods Data from 77 patients from 3 different research centers at São Paulo (n = 17), Boston (n = 37), and Stockholm (n = 23) were analyzed. Dimensional Yale-Brown Obsessive Compulsive Scale (Y-BOCS; São Paulo) or Y-BOCS Symptom Checklist scores (Boston and Stockholm) were used to code the presence of 4 well-established symptom dimensions: forbidden thoughts, contamination/cleaning, symmetry/order, and hoarding. Reductions in YBOCS scores determined clinical outcome. Results Mean Y-BOCS scores decreased 34.2% after surgery (95% CI 27.2%–41.3%), with a mean follow-up of 68.1 months. Patients with hoarding symptoms had a worse response to treatment (mean Y-BOCS decrease of 22.7% ± 25.9% vs 41.6% ± 32.2%, respectively; p = 0.006), with no significant effect of surgical modality (capsulotomy vs cingulotomy). Patients with forbidden thoughts apparently also had a worse response to treatment, but this effect was dependent upon the co-occurrence of the hoarding dimension. Only the negative influence of the hoarding dimension remained when an ANOVA model was performed, which also controlled for preoperative symptom severity. Conclusions The presence of hoarding symptoms prior to surgery was associated with worse clinical outcome after the interventions. Patients with OCD under consideration for ablative surgery should be carefully screened for hoarding symptoms or comorbid hoarding disorder. For these patients, the potentially reduced benefits of surgery need to be carefully considered against potential risks.


2018 ◽  
Vol 31 ◽  
pp. 150-151 ◽  
Author(s):  
Biju Viswanath ◽  
Reshma Jabeen Taj MJ ◽  
Ravi Kumar Nadella ◽  
Tulika Shukla ◽  
Madhuri H. Nanjundaswamy ◽  
...  

CNS Spectrums ◽  
1999 ◽  
Vol 4 (S3) ◽  
pp. 25-34 ◽  
Author(s):  
Scott L. Rauch ◽  
Chawki Benkelfat ◽  
Stephen R. Dager ◽  
Benjamin D. Greenberg ◽  
Talma Hendler ◽  
...  

AbstractA summary of the Third International Obsessive Compulsive Disorder Conference proceedings on neuroimaging research and neurocircuitry models of obsessive-compulsive disorder (OCD) is presented. This survey of recent and ongoing research indicates that a wide range of modern techniques and experimental strategies are being employed in a complementary fashion to enhance our understanding of OCD. Imaging studies in animal models of OCD are helping to elaborate relevant normal anatomy and neuro-chemistry. Functional imaging methods are being employed in conjunction with behavioral, pharmacologic, and cognitive challenge paradigms. Magnetic resonance spectroscopy as well as radiotracer methods are being utilized to measure neurochemical and neuropharmacologic indices in OCD. Transcranial magnetic stimulation has emerged as a tool for probing neurocircuitry that may also have therapeutic potential. Experimental designs and data-analytic methods are evolving to help elucidate the pathophysiology of OCD and related disorders, delineate neurobiologically meaningful subtypes of OCD, and identify potential predictors of treatment response. Collectively, these efforts promise important advances as we approach the new millennium.


2014 ◽  
Vol 204 (1) ◽  
pp. 61-68 ◽  
Author(s):  
Esther Via ◽  
Narcís Cardoner ◽  
Jesús Pujol ◽  
Pino Alonso ◽  
Marina López-Solà ◽  
...  

BackgroundDespite knowledge of amygdala involvement in fear and anxiety, its contribution to the pathophysiology of obsessive–compulsive disorder (OCD) remains controversial. In the context of neuroimaging studies, it seems likely that the heterogeneity of the disorder might have contributed to a lack of consistent findings.AimsTo assess the influence of OCD symptom dimensions on amygdala responses to a well-validated emotional face-matching paradigm.MethodCross-sectional functional magnetic resonance imaging (fMRI) study of 67 patients with OCD and 67 age-, gender- and education-level matched healthy controls.ResultsThe severity of aggression/checking and sexual/religious symptom dimensions were significantly associated with heightened amygdala activation in those with OCD when responding to fearful faces, whereas no such correlations were seen for other symptom dimensions.ConclusionsAmygdala functional alterations in OCD appear to be specifically modulated by symptom dimensions whose origins may be more closely linked to putative amygdala-centric processes, such as abnormal fear processing.


CNS Spectrums ◽  
2004 ◽  
Vol 9 (4) ◽  
pp. 275-283 ◽  
Author(s):  
Mary L. Phillips ◽  
David Mataix-Cols

ABSTRACTDespite its heterogeneous symptomatology, obsessive-compulsive disorder (OCD) is currently conceptualized as a unitary diagnostic entity. Recent factor-analytic studies have identified several OCD symptom dimensions that are associated with different demographic variables, comorbidity, patterns of genetic transmission, and treatment response. Functional abnormalities in neural systems important for emotion perception, including the orbitofrontal cortex, lateral prefrontal cortex, anterior cingulate gyrus, and limbic regions, have been reported in OCD. In this review, we discuss the extent to which neurobiological markers may distinguish these different symptom dimensions and whether specific symptom dimensions, such as contamination/washing, are associated with abnormalities in emotion and, in particular, disgust, perception in OCD. Also discussed are findings that indicate that anxiety can be induced in healthy volunteers in response to OCD symptom-related material, and that associated increases in activity within neural systems important for emotion perception occur to washing- and hoarding-related material in particular in these subjects. Further examination of neural responses during provocation of different symptom dimensions in OCD patients will help determine the extent to which specific abnormalities in neural systems underlying emotion perception are associated with different symptom dimensions and predict treatment response in OCD.


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