Vulnerability Factors of Obsessive-Compulsive Disorder on the Temperamental and Affective Aspects and the Effect of Pharmacotherapy / 대한정신약물학회지

ABSTRACT

OBJECTIVE: Recently some behavioral features and affective traits are considered important for the phenotype of obsessive-compulsive disorder (OCD). The purpose of this study was to assess some specific behavioral, temperamental, emotional features of OCD patients and to investigate if there is any change in patterns of temperament-character after 4-month pharmacotherapy. METHODS: Fifty-six patients with OCD and 70 normal controls were enrolled in this study. Four self-report questionnaires were employed to assess temperamental characteristics and affective traits: The behavioral inhibition system and behavioral activation system scale, the Baratt impulsiveness scale, state-trait anger expression inventory, emotional intelligence inventory. Among 56 OCD patients, 21 subjects started pharmacotherapy and 4 months later, they repeated 4 self-report tests as the same above and Yale-Brown obsessive compulsive scale (Y-BOCS). And then we investigated the changes from initial results. RESULTS: Patients with OCD showed significantly greater expression of behavioral inhibition system (p<0.0001), more cognitive impulsiveness (p<0.0001), motor impulsiveness (p=0.0067) and increased level of state anger (p<0.0001), trait anger (p<0.0001) than healthy controls. Compared to the controls, the OCD patients also expressed significantly lower level of emotional intelligence for using to facilitate thinking (p<0.0001) and managing emotions (p<0.0001). After 4-month pharmacotherapy for 21 OCD patients, Y-BOCS scores significantly decreased while self-report tests showed no meaningful differences from baseline assessments. CONCLUSION: Our results suggest that patients with OCD may have some differences in behavioral and affective tendencies including behavioral inhibition, impulsiveness, anger experiences, and emotional patterns. And short term pharmacotherapy during 4 months improved the severity of obsessive-compulsive symptoms but didn't influence these traits. These results provide some perspectives about possible vulnerability or trait markers of OCD. Further research is needed to examine the effects of long term treatment and other investigation might be helpful to assess the relationships between these behavioral and affective aspects and clinical phenotypes of OCD.