Early Onset Obsessive Compulsive Disorder with Obsessive Slowness: A Case Report and Demonstration of Management

Mittal, Ashish; Majumder, Pradipta; Agrawal, Alok; Sood, Mamta; Khandelwal, Shubham

doi:10.4103/0253-7176.122243

Cited by 8 publications

(11 citation statements)

References 4 publications

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“…The patients described did clearly have OCD, but their slowness was a peculiar and very disabling symptom seemingly unrelated to overt obsessive‐compulsive rituals. Characterizing OS as an unusual symptom that can occur in OCD, rather than as a primary disease entity in its own right, may help make sense of later reports of OS in patients with OCD and neurological disorders known to be associated with OCD, for example, GTS, autistic spectrum disorder, and Down's syndrome . Furthermore, the recognition that catatonia is, in fact, a phenomenon that occurs outside the setting of schizophrenia, for example, in OCD, provides an explanation for the overlap between symptoms observed in patients with OS and the diagnostic criteria for catatonia.…”

Section: Discussionmentioning

confidence: 99%

“…in approximately half of the identified cases in the literature review. 2,7,10,12,14 Another differential that merits attention is apathy. Although apathy can be linked to depression, it represents a distinct syndrome.…”

Section: Discussionmentioning

confidence: 99%

“…Of a total of 58 articles using the terms obsessive/obsessional slowness, 15 with sufficient clinical information for 77 patients were identified . Fifty‐nine (76.6%) of the reviewed cases were male.…”

Section: Methodsmentioning

confidence: 99%

“…Of a total of 58 articles using the terms obsessive/obsessional slowness, 15 with sufficient clinical information for 77 patients were identified. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Fifty-nine (76.6%) of the reviewed cases were male. Onset was during the second decade for most cases.…”

Section: Review Of Literaturementioning

confidence: 99%

“…Approximately half of the reported cases had additional diagnoses, including Gilles de la Tourette syndrome (GTS), depression, parkinsonism and Down's syndrome. 2,7,8,[10][11][12]14 In some cases, prominent speech reduction or mutism, incontinence, perserverations, and mannerisms were also noted. 2,[7][8][9][10]13 Follow-up information upon diagnosis was provided in 14 cases for a period ranging between 4 weeks and 14 years.…”

Section: Review Of Literaturementioning

confidence: 99%

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Revisiting the Syndrome of “Obsessional Slowness”

Ganos

Kassavetis

Cerdan

et al. 2015

Movement Disord Clin Pract

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Background Obsessional slowness (OS) denotes a rare condition of disablingly slow motor performance. It was originally described in patients with obsessive‐compulsive disorder as a “primary” condition; however, subsequent reports have included heterogeneous clinical populations. We wished to reassess patients with this diagnosis at our own institution and also revisit the literature to provide an overview of this condition. Methods Clinical documentation and videos of 3 patients diagnosed with OS in the National Hospital for Neurology and Neurosurgery (London, UK) were reviewed. One of the patients was clinically reappraised. A systematic review of published articles with sufficient clinical patient information was also conducted. Results Our 3 cases were male with symptom onset in adolescence or early adulthood. Motor slowness with poverty of movement and a history of obsessive‐compulsive symptoms were characteristic. Poor speech production, bizarre postures, mannerisms, echophenomena, and oculogyric tics were also noted. Dopaminergic imaging was normal in 2 cases. One case had autistic features. Systematic literature review identified 77 further cases. Male preponderance with symptom onset mainly during the second decade and presence of obsessive‐compulsive symptoms were noted. Additional motor and neuropsychiatric features were often present. Conclusion The existence of OS as a “primary” condition is doubtful. This diagnosis has been given to characterize different clinical presentations ranging from obsessive‐compulsive disorder with motor slowness resulting from covert obsessive‐compulsive symptoms to catatonia. Clinicians should be aware of this syndrome to separate it from juvenile parkinsonism and other causes of motor slowness given that diagnostic approaches and treatment strategies differ.

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Section: Discussionmentioning

confidence: 99%