Symptoms of obsessive-compulsive disorder

Leckman, James F.; Grice, Dorothy E.; Boardman, James P.; Zhang, Heping; Vitale, Amy; Bondi, Colin; Alsobrook, John P.; Peterson, Bradley S.; Cohen, Donald J.; Rasmussen, Steven A.; Goodman, Wayne K.; McDougle, Christopher J.; Pauls, David L.

doi:10.1176/ajp.154.7.911

Cited by 639 publications

(87 citation statements)

References 35 publications

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“…A factor analysis of the Y-BOCS symptom checklist in the current sample yielded a five-factor structure that was highly comparable, but not identical, to previous studies [1, 3, 4, 5, 6]. Specifically, religious obsessions loaded on the first factor together with aggressive obsessions and checking compulsions, as in Leckman et al [4].…”

Section: Discussionsupporting

confidence: 83%

“…Specifically, religious obsessions loaded on the first factor together with aggressive obsessions and checking compulsions, as in Leckman et al [4]. As in Mataix-Cols et al [5], a fifth factor emerged, which included sexual and somatic obsessions.…”

Section: Discussionmentioning

confidence: 90%

“…contamination/washing, symmetry/ordering, hoarding), the aggressive/checking and sexual/religious dimensions need further study, as it is unclear whether they form a unique factor [4, 6], or can be broken down into 2 separate dimensions [present study, 5]. Similarly, it is unclear how to regard somatic obsessions, as they loaded on the contamination/washing factor in Baer [1], on the obsessions/checking factor in Leckman et al [4], and with sexual obsessions in the present study.…”

Section: Discussionmentioning

confidence: 99%

“…Obsessive-compulsive disorder (OCD) is a heterogeneous disorder whose symptoms can be reliably summarised in a few symptom dimensions, namely symmetry/ordering, hoarding, contamination/washing, aggressive/checking, and sexual/religious obsessions [1, 2, 3, 4, 5, 6, 7]. In adult patients, these dimensions remain fairly stable across time [8].…”

Section: Introductionmentioning

confidence: 99%

“…In adult patients, these dimensions remain fairly stable across time [8]. The dimensional approach in OCD has proven useful in various areas of research, such as comorbidity [1, 4, 5, 9, 10], genetics [11], neuroimaging [12, 13]and treatment response to serotonin reuptake inhibitors (SRIs) [5, 14]. …”

Section: Introductionmentioning

confidence: 99%

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Obsessive-Compulsive Symptom Dimensions as Predictors of Compliance with and Response to Behaviour Therapy: Results from a Controlled Trial

Mataix‐Cols

Marks

Greist

et al. 2002

Psychother Psychosom

450

257

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Background: Recent factor-analytic studies in obsessive-compulsive disorder (OCD) identified consistent symptom dimensions. Support for the validity of these dimensions comes from studies of psychiatric comorbidity, functional brain imaging, genetic transmission, and treatment response to medications. This study examined whether previously identified OCD symptom dimensions are associated with treatment compliance and response to behaviour therapy (BT) for OCD. Methods: One hundred and fifty-three OCD outpatients who participated in a multi-centre randomised controlled trial of computer- versus clinician-guided BT for OCD were included in the study. Logistic and multiple regression models tested for significant predictors of compliance with and response to BT and relaxation. Results: The patients studied were phenomenologically comparable (including the presence of ‘pure’ obsessions and mental rituals) to those in previous serotonin reuptake inhibitor (SRI) trials and those in clinical epidemiology studies. High scorers on the ‘hoarding’ dimension were more likely to drop out prematurely from the study and tended to improve less. For those completing treatment, the strongest predictor of outcome was pre-treatment severity. Initial depression scores were unrelated to outcome. After controlling for symptom severity, higher scores on the ‘sexual/religious obsessions’ factor predicted poorer outcome with BT, especially when computer-guided. Conclusions: BT is especially indicated for OCD patients with aggressive/checking, contamination/cleaning and symmetry/ordering symptoms. Previous accounts of unsuccessful BT in patients with hoarding symptoms may be due in part to their propensity to drop out earlier from treatment. Patients with sexual/religious obsessions, but not those with mental rituals, might respond less well to traditional BT techniques. Existing treatments need to be refined and/or new treatments developed to improve these patients’ adherence and response to treatment.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Obsessive-Compulsive Symptom Dimensions as Predictors of Compliance with and Response to Behaviour Therapy: Results from a Controlled Trial

Mataix‐Cols

Marks

Greist

et al. 2002

Psychother Psychosom

450

257

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A Haplotype Containing Quantitative Trait Loci for SLC1A1 Gene Expression and Its Association With Obsessive-Compulsive Disorder

Wendland

Moya

Timpano³

et al. 2009

Arch Gen Psychiatry

138

119

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Context Recent evidence from linkage analyses and follow-up candidate gene studies supports the involvement of SLC1A1, which encodes the neuronal glutamate transporter, in the development of obsessive-compulsive disorder (OCD). Objectives To determine the role of genetic variation of SLC1A1 in OCD in a large case-control study and to better understand how SLC1A1 variation affects functionality. Design A case-control study. Setting Publicly accessible SLC1A1 expression and genotype data. Patients Three hundred twenty-five OCD probands and 662 ethnically and sex-matched controls. Interventions Probands were assessed with the Structured Clinical Interview for DSM-IV, the Yale-Brown Obsessive Compulsive Scale, and the Saving Inventory–Revised. Six single-nucleotide polymorphisms (SNPs) were genotyped. Multiple testing corrections for single-marker and haplotype analyses were performed by permutation. Results Gene expression of SLC1A1 is heritable in lymphoblastoid cell lines. We identified 3 SNPs in or near SLC1A1 that correlated with gene expression levels, 1 of which had previously been associated with OCD. Two of these SNPs also predicted expression levels in human brain tissue, and 1 SNP was further functional in reporter gene studies. Two haplotypes at 3 SNPs, rs3087879, rs301430, and rs7858819, were significantly associated with OCD after multiple-testing correction and contained 2 SNPs associated with expression levels. In addition, another SNP correlating with SLC1A1 gene expression, rs3933331, was associated with an OCD-hoarding subphenotype as assessed by 2 independent, validated scales. Conclusions Our case-control data corroborate previous smaller family-based studies that indicated that SLC1A1 is a susceptibility locus for OCD. The expression and genotype database–mining approach we used provides a potentially useful complementary approach to strengthen future candidate gene studies in neuropsychiatric and other disorders.

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Distinct Neural Correlates of Washing, Checking, and Hoarding SymptomDimensions in Obsessive-compulsive Disorder

Mataix‐Cols¹,

Wooderson

Lawrence³

et al. 2004

Arch Gen Psychiatry

841

487

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Context: Obsessive-compulsive disorder (OCD) is clinically heterogeneous, yet most previous functional neuroimaging studies grouped together patients with mixed symptoms, thus potentially reducing the power and obscuring the findings of such studies.Objective: To investigate the neural correlates of washing, checking, and hoarding symptom dimensions in OCD.Design: Symptom provocation paradigm, functional magnetic resonance imaging, block design, and nonparametric brain mapping analyses.Setting: University hospital.Participants: Sixteen patients with OCD (11 inpatients, 5 outpatients) with mixed symptoms and 17 healthy volunteers of both sexes.Intervention: All subjects participated in 4 functional magnetic resonance imaging experiments. They were scanned while viewing alternating blocks of emotional (washing-related, checking-related, hoarding-related, or aversive, symptom-unrelated) and neutral pictures, and imagining scenarios related to the content of each picture type.Main Outcome Measure: Blood oxygenation leveldependent response.Results: Both patients and control subjects experienced increased subjective anxiety during symptom provocation (patients significantly more so) and activated neural regions previously linked to OCD. Analyses of covariance, controlling for depression, showed a distinct pattern of activation associated with each symptom dimension. Patients demonstrated significantly greater activation than controls in bilateral ventromedial prefrontal regions and right caudate nucleus (washing); putamen/globus pallidus, thalamus, and dorsal cortical areas (checking); left precentral gyrus and right orbitofrontal cortex (hoarding); and left occipitotemporal regions (aversive, symptom-unrelated). These results were further supported by correlation analyses within patients, which showed highly specific positive associations between subjective anxiety, questionnaire scores, and neural response in each experiment. There were no consistently significant differences between patients with (n =9) and without (n=7) comorbid diagnoses. Conclusions:The findings suggest that different obsessive-compulsive symptom dimensions are mediated by relatively distinct components of frontostriatothalamic circuits implicated in cognitive and emotion processing. Obsessive-compulsive disorder may be best conceptualized as a spectrum of multiple, potentially overlapping syndromes rather than a unitary nosologic entity.

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Symptoms of obsessive-compulsive disorder

Cited by 639 publications

References 35 publications

Obsessive-Compulsive Symptom Dimensions as Predictors of Compliance with and Response to Behaviour Therapy: Results from a Controlled Trial

Obsessive-Compulsive Symptom Dimensions as Predictors of Compliance with and Response to Behaviour Therapy: Results from a Controlled Trial

A Haplotype Containing Quantitative Trait Loci for SLC1A1 Gene Expression and Its Association With Obsessive-Compulsive Disorder

Distinct Neural Correlates of Washing, Checking, and Hoarding SymptomDimensions in Obsessive-compulsive Disorder

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