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1.
Int. j. clin. health psychol. (Internet) ; 23(2): 1-6, abr.-jun. 2023. tab, graf
Artigo em Inglês | IBECS | ID: ibc-213886

RESUMO

Background: Although many OCD patients benefit from repetitive transcranial magnetic stimulation (rTMS) as treatment, there is still a large group failing to achieve satisfactory response. Sleep problems have been considered transdiagnostic risk factors for psychiatric disorders, and prior work has shown comorbid sleep problems in OCD to be associated with non-response to rTMS in OCD. We therefore set out to investigate the utility of sleep problems in predicting response to rTMS in treatment resistant OCD. Method: A sample of 61 patients (treated with 1-Hz SMA or sequential 1-Hz SMA+DLPFC rTMS, combined with cognitive behavioral therapy) were included. Sleep disturbances were measured using the PSQI, HSDQ and actigraphy. Treatment response was defined as a decrease of at least 35% in symptom severity as measured with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Results: 32 of 61 patients (52.5%) responded to rTMS, and trajectories of response were similar for both rTMS protocols. Three PSQI items (Subjective Sleep Quality; Sleep Latency and Daytime Dysfunction) and the HSDQ-insomnia scale were found to predict TMS response. A discriminant model yielded a significant model, with an area under the curve of 0.813. Conclusion: Future replication of these predictors could aid in a more personalized treatment for OCD. (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Estimulação Transcraniana por Corrente Contínua , Transtorno Obsessivo-Compulsivo , Sono , Córtex Pré-Frontal , Terapia Cognitivo-Comportamental
2.
Neurosciences (Riyadh) ; 28(1): 27-35, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36617460

RESUMO

OBJECTIVES: To determine the prevalence of Obsessive-Compulsive Disorder (OCD) symptoms in patients who have survived COVID-19. METHODS: The study used an observational cross-sectional design between July and October 2021. The target population was adult patients who had confirmed COVID-19 infection prior to joining the study, OCD symptoms were assessed using the Arabic OCD scale created by Abohendy and colleagues, which included 83 questions covering 12 different domains and was administired online. RESULTS: A total of 356 patients were included in the analysis. Approximately 9.0% and 1.7% of the patients had a history of psychiatric disease and OCD diagnosis (respectively). The total symptom score was 32.8%. The most frequently reported domains were rumination of ideas (55.5%), re-checking compulsions (37.0%), and slowness (34.0%), while the least frequently reported domains included obsessive impulses (26.3%), obsessive images (26.5%), and religious compulsions (26.8%). Unlike other domains, the purity and cleanliness compulsions scores were significantly higher than the scale reference population. A higher total symptom score was observed in psychiatric patients (p=0.004) and, to a lesser extent, in OCD patients (p=0.250). CONCLUSION: Overall, OCD symptoms, including cleanliness and fear of disease obsessions, tend to be higher in psychiatric and OCD patients, these findings are valuable for future studies.


Assuntos
COVID-19 , Transtorno Obsessivo-Compulsivo , Adulto , Humanos , Prevalência , Arábia Saudita/epidemiologia , Estudos Transversais , COVID-19/epidemiologia , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/psicologia , Escalas de Graduação Psiquiátrica
3.
BMC Psychiatry ; 23(1): 40, 2023 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-36641432

RESUMO

Schizophrenia (SCZ) is a severe mental illness mainly characterized by a number of psychiatric symptoms. Obsessive-compulsive disorder (OCD) is a long-lasting and devastating mental disorder. SCZ has high co-occurrence with OCD resulting in the emergence of a concept entitled "schizo-obsessive disorder" as a new specific clinical entity with more severe psychiatric symptoms. Many studies have been done on SCZ and OCD, but the common pathogenesis between them is not clear yet. Therefore, this study aimed to identify shared genetic basis, potential biomarkers and therapeutic targets between these two disorders. Gene sets were extracted from the Geneweaver and Harmonizome databases for each disorder. Interestingly, the combination of both sets revealed 89 common genes between SCZ and OCD, the most important of which were BDNF, SLC6A4, GAD1, HTR2A, GRIN2B, DRD2, SLC6A3, COMT, TH and DLG4. Then, we conducted a comprehensive bioinformatics analysis of the common genes. Receptor activity as the molecular functions, neuron projection and synapse as the cellular components as well as serotonergic synapse, dopaminergic synapse and alcoholism as the pathways were the most significant commonalities in enrichment analyses. In addition, transcription factor (TFs) analysis predicted significant TFs such as HMGA1, MAPK14, HINFP and TEAD2. Hsa-miR-3121-3p and hsa-miR-495-3p were the most important microRNAs (miRNAs) associated with both disorders. Finally, our study predicted 19 existing drugs (importantly, Haloperidol, Fluoxetine and Melatonin) that may have a potential influence on this co-occurrence. To summarize, this study may help us to better understand and handle the co-occurrence of SCZ and OCD by identifying potential biomarkers and therapeutic targets.


Assuntos
Transtorno Obsessivo-Compulsivo , Transtornos Psicóticos , Esquizofrenia , Humanos , Haloperidol/uso terapêutico , MicroRNAs , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtornos Psicóticos/complicações , Esquizofrenia/tratamento farmacológico , Esquizofrenia/genética , Esquizofrenia/complicações , Proteínas da Membrana Plasmática de Transporte de Serotonina
4.
Behav Ther ; 54(1): 43-50, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36608976

RESUMO

In clinical trials of obsessive-compulsive disorder (OCD), clinical outcomes are generally measured using lengthy clinician-administered interviews. However, in routine clinical practice, many clinicians lack the time to administer such instruments. This study evaluated cutoffs for treatment response and remission in OCD using the self-rated Obsessive-Compulsive Inventory-Revised (OCI-R). Data from 349 patients in three clinical trials of cognitive-behavioral therapy for OCD were pooled for analysis. The OCI-R was compared to gold-standard criteria for response and remission based on the clinician-administered Yale-Brown Obsessive Compulsive Scale and the Clinical Global Impression Scale. The results showed that a ≥40% reduction on the OCI-R was the optimal cutoff for treatment response, with a sensitivity of 0.72 and a specificity of 0.79. For remission status, the optimal cutoff was ≤8 points on the OCI-R, with a sensitivity of 0.57 and specificity of 0.83. Results from additional analyses using the 12-item version of the OCI were similar. These cutoffs provide a simple and time-efficient way to help determine treatment response and remission in OCD when the administration of clinician-administered instruments is unfeasible.


Assuntos
Terapia Cognitivo-Comportamental , Transtorno Obsessivo-Compulsivo , Humanos , Psicometria , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/terapia , Terapia Cognitivo-Comportamental/métodos , Reprodutibilidade dos Testes
5.
J Affect Disord ; 324: 539-550, 2023 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-36610593

RESUMO

INTRODUCTION: Cognitive models of obsessive-compulsive disorder (OCD) implicate heightened attention allocation to stimuli related to one's obsessions in the disorder. Recently, to overcome several limitations of reaction time-based measures, eye-tracking methodology has been increasingly used in attentional research. METHODS: A meta-analysis of studies examining attention allocation towards OCD-related vs. neutral stimuli, using eye-tracking methodology and a group-comparison design, was conducted conforming to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Separate meta-analyses were performed for attentional vigilance (both latency and location of first fixations) and maintenance (total dwell time and total fixation count, conjointly). Each meta-analysis was conducted twice - once including all studies (main analysis) and once only including studies using the free-viewing paradigm (secondary analysis). RESULTS: The systematic search yielded a total of nine studies. Of those, eight provided the needed data to be included in the meta-analysis. No evidence emerged for vigilance via latency to first fixation. Vigilance reflected via first fixation location emerged in the main analysis, but not in the secondary one. Evidence for attentional maintenance was found only when analyzing free-viewing studies exclusively (the secondary analysis). LIMITATIONS: To increase the accuracy of the research question, correlational studies were excluded, resulting in a small number of available studies. CONCLUSIONS: OCD may be characterized by vigilance, but mainly in tasks entailing specific demands and/or goals. Conversely, attentional maintenance may be evident only when using tasks that pose no requirements or demands for participants.


Assuntos
Tecnologia de Rastreamento Ocular , Transtorno Obsessivo-Compulsivo , Humanos , Transtorno Obsessivo-Compulsivo/terapia , Transtorno Obsessivo-Compulsivo/psicologia , Atenção , Tempo de Reação , Vigília
6.
Artigo em Inglês | MEDLINE | ID: mdl-36673927

RESUMO

Two prominent features of obsessive-compulsive disorder (OCD) are the inability to inhibit intrusive thoughts and behaviors and pathological doubt or intolerance of uncertainty. Previous study showed that uncertain context modeled by equiprobable presentation of excitatory (Go) and inhibitory (NoGo) stimuli requires non-selective response inhibition in healthy subjects. In other words, it requires transient global inhibition triggered not only by excitatory stimuli but also by inhibitory stimuli. Meanwhile, it is unknown whether OCD patients show abnormal brain activity of the non-selective response inhibition system. In order to test this assumption, we performed an fMRI study with an equiprobable Go/NoGo task involving fourteen patients with OCD and compared them with 34 healthy controls. Patients with OCD showed pathological slowness in the Go/NoGo task. The non-selective response inhibition system in OCD included all brain areas seen in healthy controls and, in addition, involved the right anterior cingulate cortex (ACC) and the anterior insula/frontal operculum (AIFO). Moreover, a between-group comparison revealed hypoactivation of brain regions within cingulo-opercular and cortico-striato-thalamo-cortical (CSTC) circuits in OCD. Among hypoactivated areas, the right ACC and the right dorsolateral prefrontal cortex (DLPFC) were associated with non-selective inhibition. Furthermore, regression analysis showed that OCD slowness was associated with decreased activation in cingulate regions and two brain areas related to non-selective inhibition: the right DLPFC and the right inferior parietal lobule (IPL). These results suggest that non-selective response inhibition is impaired in OCD, which could be a potential explanation for a relationship between inhibitory deficits and the other remarkable characteristic of OCD known as intolerance of uncertainty.


Assuntos
Giro do Cíngulo , Transtorno Obsessivo-Compulsivo , Humanos , Giro do Cíngulo/diagnóstico por imagem , Giro do Cíngulo/patologia , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Transtorno Obsessivo-Compulsivo/diagnóstico por imagem , Lobo Frontal , Emoções , Imageamento por Ressonância Magnética
7.
Int J Mol Sci ; 24(2)2023 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-36674940

RESUMO

Tourette's disorder (TD) is a highly heritable childhood-onset neurodevelopmental disorder and is caused by a complex interplay of multiple genetic and environmental factors. Yet, the molecular mechanisms underlying the disorder remain largely elusive. In this study, we used the available omics data to compile a list of TD candidate genes, and we subsequently conducted tissue/cell type specificity and functional enrichment analyses of this list. Using genomic data, we also investigated genetic sharing between TD and blood and cerebrospinal fluid (CSF) metabolite levels. Lastly, we built a molecular landscape of TD through integrating the results from these analyses with an extensive literature search to identify the interactions between the TD candidate genes/proteins and metabolites. We found evidence for an enriched expression of the TD candidate genes in four brain regions and the pituitary. The functional enrichment analyses implicated two pathways ('cAMP-mediated signaling' and 'Endocannabinoid Neuronal Synapse Pathway') and multiple biological functions related to brain development and synaptic transmission in TD etiology. Furthermore, we found genetic sharing between TD and the blood and CSF levels of 39 metabolites. The landscape of TD not only provides insights into the (altered) molecular processes that underlie the disease but, through the identification of potential drug targets (such as FLT3, NAALAD2, CX3CL1-CX3CR1, OPRM1, and HRH2), it also yields clues for developing novel TD treatments.


Assuntos
Transtorno Obsessivo-Compulsivo , Síndrome de Tourette , Humanos , Criança , Síndrome de Tourette/genética , Transtorno Obsessivo-Compulsivo/genética , Encéfalo , Escala de Avaliação Comportamental
8.
Addict Behav ; 139: 107591, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36587418

RESUMO

BACKGROUND AND AIMS: There is a growing interest in determining the specific role of obsessive-compulsive features in different behavioral addictions. However, more studies comparing sizable clinical populations with different addictions are needed.Therefore, a main aim of the present study was to explore the presence of obsessive-compulsive features among people with different behavioral addictions (gambling disorder, internet gaming disorder, compulsive sexual behavior disorder and compulsive buying-shopping concerns). Through a clustering procedure, the existence of empirical clusters among treatment-seeking patients based on obsessive-compulsive measures was explored. MATERIALS AND METHODS: The Symptom Checklist-Revised, and the Temperament and Character Inventory-Revised were obtained from 4,010 treatment-seeking patients. Obsessive-compulsive features were measured with the obsessive-compulsive subscale of the Symptom Checklist-Revised and the harm avoidance and persistence dimensions of the Temperament and Character Inventory-Revised. Cluster analysis was applied to explore the existence of empirical groups based on obsessive-compulsive features. RESULTS: Patients with compulsive sexual behavior disorder and compulsive buying-shopping disorder reported the highest scores on the obsessive-compulsive subscale, while patients with gambling disorder showed the lowest scores on harm avoidance, and patients with internet gaming disorder the lowest scores on persistence. Two mutually exclusive clusters were identified. Cluster 1 exhibited a more maladaptive psychopathological and personality profile than cluster. DISCUSSION AND CONCLUSIONS: These results provide new evidence regarding obsessive-compulsive features in specific behavioral addictions. Therapeutic approaches should consider that different addictions may present distinct levels of obsessive-compulsive features.


Assuntos
Comportamento Aditivo , Jogo de Azar , Transtorno Obsessivo-Compulsivo , Jogos de Vídeo , Humanos , Jogo de Azar/diagnóstico , Comportamento Compulsivo/diagnóstico , Comportamento Aditivo/diagnóstico , Comportamento Sexual
9.
J Affect Disord ; 322: 289-299, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36395988

RESUMO

INTRODUCTION: Despite remotely-delivered cognitive behavioural therapy (CBT) being an emerging field, the evidence of its efficacy in obsessive-compulsive disorder (OCD) is limited. We aimed to estimate the efficacy of remotely-delivered CBT for OCD, compared to face-to-face CBT and non-CBT control conditions. METHODS: Randomised clinical trials (RCTs) identified through a systematic literature search of PubMed, Ovid/PsychINFO and Web of Science until 21/06/2021. Eligible studies included individuals with OCD evaluating at least one form of remotely-delivered CBT versus a control condition. Random-effects meta-analyses, sub-analyses, meta-regressions, heterogeneity analyses, publication bias assessment and quality assessment. RESULTS: Twenty-two RCTs were included (n = 1796, mean age = 27.7 years, females = 59.1 %). Remotely-delivered CBT was more efficacious than non-CBT control conditions for OCD symptoms (g = 0.936 95 % CI = 0.597-1.275, p < .001), depressive symptoms (g = 0.358, 95 % CI = 0.125-0.590, p = .003) and anxiety symptoms (g = 0.468, 95 % CI = 0.135-0.800, p = .006). There were no significant differences in efficacy between remotely-delivered CBT and face-to-face CBT for OCD symptoms (g = -0.104 95 % CI = -0.391-0.184, p = .479), depressive symptoms (g = 0.138, 95 % CI = -0.044-0.320, p = .138), anxiety symptoms (g = 0.166, 95 % CI = -0.456-0.780, p = .601) or quality of life (g = 0.057, 95 % CI = -0.178-0.292, p = .489). Higher baseline severity of OCD symptoms was associated with a lower efficacy of remotely-delivered CBT compared to face-to-face CBT (ß = -0.092, p = .036). The quality of the included studies was mostly identified as "low risk of bias" (45.5 %) or "some concerns" (45.5 %). LIMITATIONS: Heterogeneity and limited evidence for some outcomes. CONCLUSIONS: Remotely-delivered CBT appears efficacious in reducing OCD symptoms and other relevant outcomes and is therefore a viable option for increasing treatment access. Preliminary evidence suggests some individuals with severe OCD may benefit more from face-to-face than remotely-delivered CBT.


Assuntos
Terapia Cognitivo-Comportamental , Transtorno Obsessivo-Compulsivo , Adulto , Feminino , Humanos , Transtorno Obsessivo-Compulsivo/terapia , Viés de Publicação , Qualidade de Vida
10.
Int Clin Psychopharmacol ; 38(1): 4-8, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35695582

RESUMO

Mirtazapine upsurges serotonergic activity by a mechanism different from reuptake inhibition. Our aim is to assess the efficacy of mirtazapine augmentation for patients with obsessive-compulsive disorder (OCD) who did not respond to sertraline monotherapy. Sixty-one patients suffering from OCD who were resistant to sertraline monotherapy were randomly allocated to receive mirtazapine (mean dosage = 39.56 mg/day) or placebo plus their current anti-OCD treatment (sertraline: average dose = 251.37 mg/day and 255.10 mg/day in the mirtazapine and placebo groups, respectively; P = 0.871). The primary outcome was OCD symptom severity as measured by Yale-Brown Obsessive-Compulsive Scale (YBOCS). Forty-five patients (22 in the mirtazapine group and 23 in the placebo group) completed the trial. Average YBOCS score decreased in the mirtazapine group from 27.14 ± 8.05 at baseline to 11.13 ± 4.27 at week 12. In the placebo group, average YBOCS score declined from 28.15 ± 3.27 at baseline to 18.94 ± 3.88 at week 12. Nine patients (40.90%) in the mirtazapine group and only one patient (4.34%) in the placebo group revealed at least a 35% decrease in YBOCS ( P < 0.000). We found that mirtazapine adds to the effect of sertraline in improving obsessive and compulsive symptoms in OCD patients.


Assuntos
Transtorno Obsessivo-Compulsivo , Sertralina , Humanos , Mirtazapina/uso terapêutico , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Sertralina/uso terapêutico
12.
Psychiatry Res ; 319: 115007, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36525901

RESUMO

Body dysmorphic disorder (BDD), hoarding disorder (HD), skin-picking disorder (SPD), and hair-pulling disorder (HPD) are characterized by compulsive behaviours leading to distress and impairment. Current treatments attain only partial or non-response. Interventional psychiatric approaches may target specific regions of the brain for treatment. This scoping review maps the current literature and synthesizes key findings. Databases were searched up to June 27, 2022 for studies examining interventional psychiatric treatments for BDD, HD, SPD, and HPD, producing 910 results. Twenty were included; 16 were case reports, two were case series, and two were randomized controlled trials. Studies reported on electroconvulsive therapy (ECT) (n=7), deep brain stimulation (DBS) (n=1), and intermittent theta-burst stimulation repetitive transcranial magnetic stimulation (rTMS) (n=1) for BDD; rTMS (n=1) and transcranial direct current stimulation (n=1) for HD; gamma knife capsulotomy (n=1) and rTMS (n=1) for SPD; and rTMS (n=2) and ECT (n=1) for HPD. Four studies reported on DBS for other indications complicated by SPD or HPD. The current literature consists mainly of case reports. Future studies should be randomized, controlled, adequately powered and blinded, examining rTMS localized to the anatomical targets for each disorder. Presently, the mainstay of treatment remains disorder-specific psychotherapy with limited evidence for medications.


Assuntos
Transtorno Obsessivo-Compulsivo , Psiquiatria , Estimulação Transcraniana por Corrente Contínua , Tricotilomania , Humanos , Transtorno da Personalidade Compulsiva , Transtorno Obsessivo-Compulsivo/psicologia , Estimulação Transcraniana por Corrente Contínua/métodos , Estimulação Magnética Transcraniana/métodos , Tricotilomania/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto
13.
Stem Cell Res ; 66: 102993, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36502622

RESUMO

Schizophrenia (SCZ) and obsessive-compulsive disorder (OCD) are complex polygenic disorders with brain morphology abnormalities. The etiologies and relationship of both disorders remain elusive, and should be further investigated. Thus, induced pluripotent stem cells (iPSCs) were generated from peripheral blood mononuclear cells (PBMCs) from an OCD patient, his mother with SCZ and his healthy father with reprograming method. All iPSCs were characterized to have normal karyotype and expression of pluripotency makers. These iPSCs will be a valuable model to elucidate the pathophysiological mechanisms and association of both diseases.


Assuntos
Células-Tronco Pluripotentes Induzidas , Transtorno Obsessivo-Compulsivo , Esquizofrenia , Feminino , Humanos , Masculino , Esquizofrenia/genética , Esquizofrenia/metabolismo , Mães , Células-Tronco Pluripotentes Induzidas/metabolismo , Leucócitos Mononucleares , Transtorno Obsessivo-Compulsivo/genética , Transtorno Obsessivo-Compulsivo/metabolismo , Pai
14.
J Dual Diagn ; 19(1): 16-25, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36576218

RESUMO

Objective: Emerging adulthood is a vulnerable period for problematic alcohol use, defined by a pattern of use associated with physical and functional impairment. Obsessive-compulsive psychopathology, which demonstrates high rates of onset in emerging adults, seems to be related to problematic alcohol use in this age group, consistent with research among the general population suggesting an association between emotional disorders and alcohol use in the context of coping drinking motives. Pain intensity, another risk factor of problematic alcohol use, may link obsessive-compulsive symptoms to problematic alcohol use among emerging adults. Therefore, the current study examined the moderating role of pain intensity on the association between obsessive-compulsive symptoms and problematic alcohol use among emerging adults. Methods: Participants were 198 college students (81.30% female, Mage = 22.33, SD = 4.38) who reported problematic alcohol use. Results: Results from the current study supported a significant moderation role of pain intensity for the association between obsessive-compulsive symptoms and problematic alcohol use, whereby the association between obsessive-compulsive symptoms and problematic alcohol use was stronger for emerging adults with high compared to low pain intensity. Conclusions: These results highlighted a clinically-relevant interaction between obsessive-compulsive symptoms and pain intensity concerning the risk of problematic alcohol use among emerging adults as a vulnerable population.


Assuntos
Transtorno Obsessivo-Compulsivo , Humanos , Adulto , Feminino , Adulto Jovem , Masculino , Transtorno Obsessivo-Compulsivo/complicações , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/psicologia , Medição da Dor , Adaptação Psicológica , Comorbidade
15.
J Affect Disord ; 324: 92-101, 2023 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-36584701

RESUMO

OBJECTIVE: We examined the unique predictive strength of anxiety sensitivity (AS) and the role of expectancy, credibility, and therapeutic alliance (TA) as predictors and mediators of cognitive-behavioral treatment (CBT) outcomes in obsessive-compulsive disorder (OCD). METHOD: The current study is a prospective cohort study. Participants (N = 116) were treatment-seeking individuals with a primary diagnosis of OCD. Independent raters assessed patients on Yale-Brown Obsessive-Compulsive Scale (YBOCS) and Anxiety Sensitivity Index-3 at baseline, post-intervention, and three-month follow-up. Participants responded to the Credibility and Expectancy questionnaire and Working Alliance Inventory-Short revised at baseline, first-session, and mid-session. RESULTS: The individual addition of AS, end-of-first-session credibility and expectancy, mid-session credibility and expectancy, and therapeutic alliance predicted significant CBT outcomes. There was a moderate positive correlation between baseline OCD severity and the global score of AS, but a weak one with AS dimensions. Both expectancy and credibility significantly improved from baseline to end-of-first-session treatment. End-of-first and third-session outcome expectancies, not credibility, have significant, indirect effects on OCD CBT outcomes. CONCLUSIONS: AS, within-session credibility and expectancies and TA independently predict CBT outcomes. Within-sessions outcome expectancies mediate CBT outcomes in OCD, not credibility. Expectancy and credibility both include state-like elements that can be influenced to enhance the outcomes of CBT. Proposals for reducing treatment barriers in CBT for OCD are offered.


Assuntos
Saúde Mental , Transtorno Obsessivo-Compulsivo , Humanos , Estudos Prospectivos , Resultado do Tratamento , Transtorno Obsessivo-Compulsivo/terapia , Transtorno Obsessivo-Compulsivo/psicologia , Ansiedade
16.
Schizophr Res ; 251: 37-45, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36549240

RESUMO

BACKGROUND: Schizophrenia patients often show obsessive-compulsive symptoms (OCS) and obsessive-compulsive disorder (OCD) and their presence has been associated with poorer prognosis. However, the impact of OCS/OCD on psychotic severity remains unclear. The aim of this study is twofold: 1) to investigate the effect of OCS/OCD on the severity of positive, negative, and global psychotic symptoms of schizophrenia patients and 2) to analyze the effect of patient and study-related covariates on moderating this relationship. METHODS: A systematic review and meta-analysis (SRMA) of studies comparing the severity of psychotic symptoms among schizophrenia patients with and without OCS/OCD was performed. Standardized mean difference (SMD) was calculated for positive, negative, and global psychotic symptoms. The difference of SMD (Diff SMD) was calculated to analyze the effect of covariates on study outcomes using meta-regression. RESULTS: Sixty-seven studies involving 7740 patients were included. Patients with schizophrenia and OCS/OCD showed a slightly higher severity of positive (SMD = 0.17, p value = 0.0089) and global psychotic symptoms (SMD = 0.24, p value = 0.0104) than patients without OCS/OCD but no differences in negative symptoms were found between groups (SMD = 0.11, p value = 0.0367). Only one covariate "proportion of patients without antipsychotics (AP)" was found to modify the effect on psychotic severity (Diff SMD = -0.008, p value = 0.002). CONCLUSIONS: Comorbid OCS/OCD in schizophrenia has, at most, a minor impact on psychotic severity. Variability in this effect was considerable and was poorly explained by the covariates analyzed.


Assuntos
Transtorno Obsessivo-Compulsivo , Esquizofrenia , Humanos , Esquizofrenia/complicações , Esquizofrenia/epidemiologia , Esquizofrenia/diagnóstico , Comorbidade , Escalas de Graduação Psiquiátrica , Psicologia do Esquizofrênico , Transtorno Obsessivo-Compulsivo/complicações , Transtorno Obsessivo-Compulsivo/epidemiologia , Análise de Regressão
17.
Ann Palliat Med ; 11(11): 3503-3512, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36464963

RESUMO

BACKGROUND: Obsessive-compulsive disorder (OCD) is a chronic neural psychological condition. Its pathogenesis is not yet completely understood. This current research used fluorine-18 fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) imaging to examine the changes in brain glucose metabolism in patients with OCD during the course of treatment, and analyzed its relationship with clinical efficacy. METHODS: A total of 23 patients with OCD were enrolled and divided into case group 1, consisting of patients who received no drug treatment or those who recently stopped drug treatment for more than five half-life periods (OCD1 group, N=10), and case group 2, consisting of patients who were receiving drug treatment before enrollment (OCD2 group, N=13). Ten healthy volunteers were selected as controls. All patients and healthy controls were subjected to head PET-computed tomography (CT) examination. Seven patients in case group 2 underwent scanning again after 3 months of drug treatment, namely, case group 3 (OCD3 group, N=7). Statistical Parametric Mapping (SPM) 8 software was used to analyze the PET-CT results. RESULTS: OCD patients had abnormally enhanced glucose metabolism in the medium orbito-frontal region of the brain, and abnormally reduced glucose metabolism in brain areas including the insula, caudate nucleus, and middle temporal gyrus. No changes in brain glucose metabolism related to curative effect was found. CONCLUSIONS: In OCD patients, abnormal brain function may not only be limited to the usual cortico-striato-thalamo-cortical (CSTC) loop model, but may involve a wide range of brain regions simultaneously.


Assuntos
Glucose , Transtorno Obsessivo-Compulsivo , Humanos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Encéfalo/diagnóstico por imagem , Fluordesoxiglucose F18 , Transtorno Obsessivo-Compulsivo/diagnóstico por imagem , Transtorno Obsessivo-Compulsivo/tratamento farmacológico
18.
J Child Adolesc Psychopharmacol ; 32(10): 522-532, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36548364

RESUMO

Background: Cortico-striato-thalamo-cortical (CSTC) network alterations are hypothesized to contribute to symptoms of obsessive-compulsive disorder (OCD). To date, very few studies have examined whether CSTC network alterations are present in children with OCD, who are medication naive. Medication-naive pediatric imaging samples may be optimal to study neural correlates of illness and identify brain-based markers, given the proximity to illness onset. Methods: Magnetoencephalography (MEG) data were analyzed at rest, in 18 medication-naive children with OCD (M = 12.1 years ±2.0 standard deviation [SD]; 10 M/8 F) and 13 typically developing children (M = 12.3 years ±2.2 SD; 6 M/7 F). Whole-brain MEG-derived resting-state functional connectivity (rs-fc), for alpha- and gamma-band frequencies were compared between OCD and typically developing (control) groups. Results: Increased MEG-derived rs-fc across alpha- and gamma-band frequencies was found in the OCD group compared to the control group. Increased MEG-derived rs-fc at alpha-band frequencies was evident across a number of regions within the CSTC circuitry and beyond, including the cerebellum and limbic regions. Increased MEG-derived rs-fc at gamma-band frequencies was restricted to the frontal and temporal cortices. Conclusions: This MEG study provides preliminary evidence of altered alpha and gamma networks, at rest, in medication-naive children with OCD. These results support prior findings pointing to the relevance of CSTC circuitry in pediatric OCD and further support accumulating evidence of altered connectivity between regions that extend beyond this network, including the cerebellum and limbic regions. Given the substantial portion of children and youth whose OCD symptoms do not respond to conventional treatments, our findings have implications for future treatment innovation research aiming to target and track whether brain patterns associated with having OCD may change with treatment and/or predict treatment response.


Assuntos
Magnetoencefalografia , Transtorno Obsessivo-Compulsivo , Adolescente , Humanos , Criança , Mapeamento Encefálico , Imageamento por Ressonância Magnética , Vias Neurais/fisiologia , Encéfalo/diagnóstico por imagem
19.
Tijdschr Psychiatr ; 64(10): 663-669, 2022.
Artigo em Holandês | MEDLINE | ID: mdl-36583276

RESUMO

BACKGROUND: OCD has an estimated lifetime prevalence of 2,3%, and is accompanied by several emotional, social and work impairments. Virtual reality is increasingly used in the context of mental health treatment and has recently been proposed as a possible tool for assessment and intervention in OCD. AIM: To review the existing literature to investigate the role of virtual reality in the diagnosis/severity measurement and treatment of OCD. METHOD: Systematic literature review using PubMed, Embase and PsycInfo databases. RESULTS: We found 10 studies, of which 6 on diagnosis/severity measurement and 4 on treatment of OCD. Virtual reality can be a valuable objective tool in the diagnostic process of OCD. In addition, the anxiety level and the obsessive and compulsive symptoms decreased significantly in participants in virtual reality exposure therapy. CONCLUSION: Further clinical studies with adequate power and design are needed to determine whether virtual reality offers an added value over clinical tools in terms of diagnosis and severity measurement, and whether virtual reality ERP is superior or at least equivalent to in vivo ERP.


Assuntos
Transtorno Obsessivo-Compulsivo , Realidade Virtual , Humanos , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/terapia , Psicoterapia/métodos
20.
J Med Case Rep ; 16(1): 431, 2022 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-36403006

RESUMO

BACKGROUND: Obsessive-compulsive disorder is a condition in which patients experience an obsession and/or a compulsion. It has a high impact on the quality of life, and is associated with an increased prevalence of psychiatric comorbidities in patients. Onychotillomania is an underestimated psychodermatosis caused by repeated self-inflicted damage to the nail unit. In patients, it is characterized by an obsessive or irrepressible impulse to repeatedly damage their own nails, resulting in their destruction. It is a chronic condition that is difficult to manage, largely because of its psychocutaneous character, as well as its high tendency to interact with underlying neuropsychiatric diseases or other behavioral disorders. Only a few studies have reported an association between obsessive-compulsive disorder and onychotillomania, which typically presents with therapeutic challenges. Cognitive behavioral therapy, physical-barrier approaches, and pharmaceutical treatments have been reported to be beneficial in the management of onychotillomania; however, no major clinical studies have investigated the effectiveness of these therapies. Onychotillomania remains a clinical and therapeutic issue owing to the lack of evidence-based treatment techniques. CASE PRESENTATION: We report a case of an 18-year-old, middle-eastern female patient who developed onychotillomania when she was being treated with paroxetine for obsessive-compulsive disorder and was showing partial improvement. The patient developed side effects from paroxetine, and was switched to fluoxetine. Thereafter, improvement in her obsessive-compulsive disorder was observed, which relapsed when treatment was discontinued. However, the onychotillomania symptoms did not reemerge. CONCLUSION: Onychotillomania typically presents both diagnostic and therapeutic challenges. Fluoxetine plays an important role in the treatment of onychotillomania and other psychiatric disorders. However, large-scale studies should be conducted before these outcomes can be generalized.


Assuntos
Fluoxetina , Transtorno Obsessivo-Compulsivo , Humanos , Feminino , Adolescente , Fluoxetina/uso terapêutico , Paroxetina/uso terapêutico , Qualidade de Vida , Transtorno Obsessivo-Compulsivo/complicações , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Preparações Farmacêuticas
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