Obsessive-Compulsive Characteristics: From Symptoms to Syndrome

Apter, Alan; Fallon, Theodore; King, Robert A.; Ratzoni, Gidi; Zohar, Ada H.; Binder, Monica; Weizman, Abraham; Leckman, James F.; Pauls, David L.; Kron, Shmuel; Cohen, Donald J.

doi:10.1097/00004583-199607000-00016

Cited by 98 publications

(44 citation statements)

References 13 publications

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“…For instance, no direct correlation exists between the severity of obsessive and compulsive symptoms and severity of distress, especially in the young, where only 1 out of 10 subjects report symptoms to be disturbing (Apter et al, 1996). Subjective well being is a neglected dimension of assessment, only partially considered in the patients' CGI score.…”

Section: Measures Of Treatment Response: Impact On Definition Of Non-mentioning

confidence: 99%

Treatment-refractory obsessive-compulsive disorder: Methodological issues, operational definitions and therapeutic lines

Pallanti

Quercioli

2006

Progress in Neuro-Psychopharmacology and Biological Psychiatry

337

190

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While controlled trials with SRIs have demonstrated a selective efficacy in obsessive-compulsive disorder (OCD), up to 40 -60% of patients do not have a satisfactory outcome. Non-response to treatment in OCD is associated with serious social disability. There are a large number of nonresponsive patients, and they are difficult to cluster due to ambiguities in diagnostic criteria, possibility of subtypes and a high rate of comorbidity. Moreover, the findings of current studies of ''so-called'' non-responsive cases are currently non-generalizable because of the lack of an operational definition of non-response. The result has been that a cumulative body of data on a reasonably homogeneous sample of non-responders has not been developed. The aims of the research in this area are to clarify some of the obstacles in defining stages of response and levels of non-response and, through a comprehensive analysis, to propose a systematic nosology for this rather common condition. Better characterization of which patients respond and do not respond to various treatments will enable more accurate clustering of patients, and help facilitate multisite data collection for future research trials. The authors reviewed also the more recent therapeutic pharmacological and psychological lines for the treatment of refractoriness in OCD. D

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Section: Measures Of Treatment Response: Impact On Definition Of Non-mentioning

confidence: 99%

Treatment-refractory obsessive-compulsive disorder: Methodological issues, operational definitions and therapeutic lines

Pallanti

Quercioli

2006

Progress in Neuro-Psychopharmacology and Biological Psychiatry

337

190

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“…Despite the increased incidence of subclinical obsessive-compulsive symptoms in OCD families, however, the etiological relationship between OCD, subclinical OCD, and non-clinical obsessionality is still not entirely clear. To date, definite susceptibility genes for OCD and obsessionality have not yet been identified, due in part to phenotypic and likely etiologic heterogeneity [Leonard et al, 1990;Apter et al, 1996;Veenstra-VanderWeele et al, 2001;Brynska and Wolanczyk, 2005;Yao et al, 2005;Arnold et al, 2006;Hemmings and Stein, 2006;Shugart et al, 2006].…”

Section: Introductionmentioning

confidence: 99%

Evidence for a heritable unidimensional symptom factor underlying obsessionality

Mathews

Greenwood

Wessel

et al. 2008

American J of Med Genetics Pt B

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The division of obsessive-compulsive symptoms (OCS) into specific factors is now widely accepted. However, the utility of these categories for genetic studies remains unclear, as studies examining their heritability have been inconsistent. Less attention has been paid to the possibility that clinically significant obsessionality is primarily determined by a "core" group of OCS that crosses the boundaries between symptom subgroups. The aim of this study is to determine whether such a core group exists, and to compare its heritability to that of the more traditionally derived symptom factors. We examined the properties and heritability of obsessive-compulsive symptoms in college students, medical students, and obsessive-compulsive disorder (OCD) families using the Leyton Obsessional Inventory. In each of the three samples, we identified a core group of symptoms that comprised a single unique construct and accounted for over 90% of the variation of the four more traditional symptom factors. This core construct was highly correlated with OCD in our families and had a heritability estimate of 0.19 when OCD was not included as a covariate and 0.49 when OCD was included as a covariate. In contrast, the four symptom factors were not heritable. There appears to be an underlying unidimensional component to obsessionality, both in non-clinical and clinical samples. This component, which is heritable, accounts for the majority of the variation of the more traditionally derived symptom factors in our sample, and is composed of OCS that are not specific to any of the symptom subgroups.

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“…30 No figures exist for the UK military. Most recruits join in late adolescence when obsessional symptoms, although common, 31 may not be precursors of OCD. 32 Those attendees of MAP who enlisted at age 16 or 17 were no more likely to have obsessive-compulsive symptoms than attendees who joined at a later age.…”

Section: Obsessive-compulsive Symptomsmentioning

confidence: 99%

UK extended Medical Assessment Programme for ex-service personnel: the first 150 individuals seen

Palmer

2012

Psychiatrist

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Aims and method To describe an interim service set up to examine the breadth of UK ex-service personnel's concerns in relation to their mental health and military service and provide a record of the first 150 individuals assessed following conformation of military service and examination of all available military and civilian medical records.Results The majority of attendees were White male ex-soldiers. Average age, service and time to assessment were 44.5, 15.8 and 11.7 years respectively. Two-thirds were receiving help from the National Health Service and ex-service nongovernmental organisations. Rates of post-traumatic stress disorder were similar to previous UK studies. Obsessional symptoms were of relevance to the clinical presentation in a third. Fabrication and/or exaggeration occurred in about 10%. Clinical implicationsThe spread of diagnoses and delay in help-seeking are similar to civilians. The link between mental disorders and military service is seldom straightforward and fabrication or exaggeration is difficult for civilians to recognise. Verification and contextualisation of service using contemporaneous service medical records is important given the possible occupational origin of mental health conditions.Declaration of interest I.P. is employed by the Pensions, Compensation and Veterans Department of the UK Ministry of Defence. The Ministry had no input into the completion or presentation of this paper and sought no changes.

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Obsessive-Compulsive Characteristics: From Symptoms to Syndrome

Cited by 98 publications

References 13 publications

Treatment-refractory obsessive-compulsive disorder: Methodological issues, operational definitions and therapeutic lines

Treatment-refractory obsessive-compulsive disorder: Methodological issues, operational definitions and therapeutic lines

Evidence for a heritable unidimensional symptom factor underlying obsessionality

UK extended Medical Assessment Programme for ex-service personnel: the first 150 individuals seen

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