A critical evaluation of obsessive–compulsive disorder subtypes: Symptoms versus mechanisms

McKay, Dean; Abramowitz, Jonathan S.; Calamari, John E.; Kyrios, Michael; Radomsky, Adam S.; Sookman, Debbie; Taylor, Steven; Wilhelm, Sabine

doi:10.1016/j.cpr.2004.04.003

Cited by 534 publications

(308 citation statements)

References 114 publications

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“…So, in summary, we feel that there are still many issues to be clarified with regard to the correct nosological placement of OCD. Possibly, the heterogeneity of OCD (Ivarsson et al, 2007;Ivarsson & Valderhaug, 2006;McKay et al, 2004) is the problem and that one sub-sample of OCD might be more similar to the classical anxiety disorders while another sub-sample might be more akin to ASD. Studying the temperamental features of children and adolescents with OCD, we found that about half of the sample had low levels of activity, low levels of sociability and high levels of shyness (Ivarsson & WingeWestholm, 2004).…”

Section: Discussionmentioning

confidence: 99%

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Autism spectrum traits in children and adolescents with obsessive-compulsive disorder (OCD)

Ivarsson

Melin

2008

Journal of Anxiety Disorders

118

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Objective: Assess the prevalence of autistic traits (AST) in pediatric OCD and relate them to OCD co-morbidity and compare them with published normative data.Methods: Pediatric patients with Obsessive-Compulsive Disorder (n=109) according to the DSM IV were studied using parent ratings of the Autistic Symptom/Syndrome Questionnaire to assess AST symptoms as a continuous rather than categorical trait. The KSADS, a semistructured psychiatric interview, was used for the psychiatric diagnostic evaluation. Also, the Children's Yale-Brown Obsessive Compulsive Scale was used to assess OCD severity and other clinical features.Results: AST was common among our patients. Symptom scores were highest in cases with co-morbid Autistic Spectrum Disorders, but cases with other co-morbidities as tics/Tourette and attention/behavioral disorders also scored higher. All sub-groups, including OCD without these co-morbidities scored higher than the Swedish normative group. Using ANOVA, comorbid ASD and tics/Tourette (plus a term for gender by tic interaction indicating that girls with tics scored high, otherwise low) and pathological doubt contributed (R 2 = .41) to the AST-traits, while OCD severity and co-morbid anxiety-and depressive disorders did not.Conclusion: AST traits are prevalent in OCD and seem to be intricately associated with the co-morbidities as well as the OCD syndrome itself. The findings might have implication for our nosological understanding of OCD which currently is discussed.4

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Section: Discussionmentioning

confidence: 99%

“…This is the consequence of many aspects of OCD phenomenology. One reason is the remarkably heterogeneous features found in OCD patients (McKay et al, 2004). For one, the OCD phenomenology itself shows many diverse features (Calamari et al, 1999;Ivarsson & Valderhaug, 2006;Leckman et al, 1997).…”

Section: Ocd Nosology Debatementioning

confidence: 99%

Autism spectrum traits in children and adolescents with obsessive-compulsive disorder (OCD)

Ivarsson

Melin

2008

Journal of Anxiety Disorders

118

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“…Similar efforts are currently underway by other groups of investigators. 50,51 The DY-BOCS has excellent content validity. The self-report checklist assesses the presence of the most common OC symptoms, and includes items that are usually underrepresented in other scales, such as mental rituals, checking, repetition and avoidance behaviors.…”

Section: Discussionmentioning

confidence: 99%

The Dimensional Yale–Brown Obsessive–Compulsive Scale (DY-BOCS): an instrument for assessing obsessive–compulsive symptom dimensions

et al. 2006

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Obsessive-compulsive disorder (OCD) encompasses a broad range of symptoms representing multiple domains. This complex phenotype can be summarized using a few consistent and temporally stable symptom dimensions. The objective of this study was to assess the psychometric properties of the Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS). This scale measures the presence and severity of obsessive-compulsive (OC) symptoms within six distinct dimensions that combine thematically related obsessions and compulsions. The DY-BOCS includes portions to be used as a self-report instrument and portions to be used by expert raters, including global ratings of OC symptom severity and overall impairment. We assessed 137 patients with a Diagnostic and Statistical Manual-IV diagnosis of OCD, aged 6-69 years, from sites in the USA, Canada and Brazil. Estimates of the reliability and validity of both the expert and self-report versions of the DY-BOCS were calculated and stratified according to age (pediatric vs. adult subjects). The internal consistency of each of the six symptom dimensions and the global severity score were excellent. The inter-rater agreement was also excellent for all component scores. Self-report and expert ratings were highly intercorrelated. The global DY-BOCS score was highly correlated with the total Yale-Brown Obsessive-Compulsive Scale score (Pearson r = 0.82, P < 0.0001). Severity scores for individual symptom dimensions were largely independent of one another, only modestly correlated with the global ratings, and were also differentially related to ratings of depression, anxiety and tic severity. No major differences were observed when the results were stratified by age. These results indicate that the DY-BOCS is a reliable and valid instrument for assessing multiple aspects of OCD symptom severity in natural history, neuroimaging, treatment response and genetic studies when administered by expert clinicians or their highly trained staff.

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“…Many OCD researchers who study hoarding have assumed that hoarding by packrats lies on a continuum with hoarding by those who qualify for OCD. Although severe hoarding may constitute a discrete subtype different in kind from other forms of OCD (McKay et al, 2004), key features of hoarding do vary on a continuous dimension and thus may shade into normality. Indeed, many of the studies on hoarding have involved college students (e.g., Frost & Shows, 1993) or self-identified ''packrats or chronic savers'' recruited via advertisements (e.g., Frost & Gross, 1993, Study 2).…”

Section: Introductionmentioning

confidence: 99%

Cognitive aspects of nonclinical obsessive–compulsive hoarding

Luchian

McNally

Hooley

2007

Behaviour Research and Therapy

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Research on the cognitive variables associated with obsessive-compulsive hoarding is scarce. In this study, we investigated cognitive variables that may contribute to the maintenance and possibly etiology of hoarding. College students who characterized themselves as either ''packrats'' (nonclinical hoarders; n ¼ 21) or not (control participants; n ¼ 20) completed questionnaires assessing hoarding behavior and beliefs about hoarding, and completed a task requiring them to categorize diverse objects and trinkets of minimal value into groups. The results revealed that nonclinical hoarders, relative to control participants, rated the categorization task as significantly more stressful and difficult. Relative to control participants, hoarders took longer to complete the task and sorted objects into more categories. These findings suggest that underinclusiveness and indecisiveness, characteristic of clinical hoarders, are evident in nonclinical hoarders as well. r

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A critical evaluation of obsessive–compulsive disorder subtypes: Symptoms versus mechanisms

Cited by 534 publications

References 114 publications

Autism spectrum traits in children and adolescents with obsessive-compulsive disorder (OCD)

Autism spectrum traits in children and adolescents with obsessive-compulsive disorder (OCD)

The Dimensional Yale–Brown Obsessive–Compulsive Scale (DY-BOCS): an instrument for assessing obsessive–compulsive symptom dimensions

Cognitive aspects of nonclinical obsessive–compulsive hoarding

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