Includes bibliographical references (leaves 109-115).This research aimed to increase current understanding of functional impairment in children and adolescents with Obsessive-Compulsive Disorder (OCD). Twenty-six South African children and adolescents with OCD participated in the study. The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (KSADS-PL), the Mini International Neuropsychiatric Interview For Children and Adolescents Version 5 (MINIKID5.0), the Children's Global Assessment Scale (CGAS), the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) and the Child Obsessive-Compulsive Impact Scale-Revised (COIS-R) were used to assess the children's and adolescent's past and current psychopathology, OCD symptom severity and OCD-related functional impairment. Findings suggest that most of the children (88.46%) in this study had one or more comorbid disorders. Parents and children agreed on very few of the rating items common the COIS-R-P and COIS-R-C. Parents, however, consistently reported higher rates of significant problems than did their children. Correlations between the various instruments revealed that parents are more accurate than their children in rating their child's global impairment and OCD-specific impairment. Therefore, collateral information from parents is vital for the clinician to accurately assess and fully understand the child's OCD-related functional impairment. Moreover, the number of comorbid disorders, and whether the child had ADHD or not, did not impact on the COIS-R total scores, suggesting that the COIS-R is a useful measure to assess OCD-specific impairment. Parents and children both reported that the most significant domain of impairment is the school domain. Moreover, parents reported that the most significant functional problem is "concentrating on his/her work" and children reported that the most significant functional problem is "getting good grades." Findings from studies such as this help clinicians to have a better understanding of childhood OCD-related functional impairment, which helps them to accurately diagnose and treat children with OCD

This article reports on the validation of the Obsessive Beliefs Questionnaire (OBQ) and Interpretations of Intrusions Inventory (III) developed by the Obsessive Compulsive Cognitions Working Group (OCCWG) to assess the primary beliefs and appraisals considered critical to the pathogenesis of obsessions. A battery of questionnaires that assessed symptoms of anxiety, depression, obsessive–compulsive symptoms and worry was administered to 248 outpatients with a DSM-IV diagnosis of Obsessive–Compulsive Disorder (OCD), 105 non-obsessional anxious patients, 87 non-clinical adults from the community, and 291 undergraduate students. Tests of internal consistency and test–retest reliability indicated that the OBQ and III assessed stable aspects of OC-related thinking. Between-group differences and correlations with existing measures of OC symptoms indicated that the OBQ and III assess core cognitive features of obsessionality. However, the various subscales of the OBQ and III are highly correlated, and both measures evidenced low discriminant validity. The findings are discussed in terms of the relevance and specificity of cognitive constructs like responsibility, control and importance of thoughts, overestimated threat, tolerance of uncertainty and perfectionism for OCD

BACKGROUND There are several established structured diagnostic interviews that cover common mental disorders seen in general psychiatry clinics. The administration of more focused diagnostic interviews may be useful in specialty clinics, such as OCD clinics. A semi-structured clinician-administered interview for obsessive-compulsive spectrum disorders (SCID-OCSD) was developed and adapted for DSM-5/ICD-11 obsessive-compulsive and related disorders as well as other putative obsessive-compulsive spectrum conditions. OBJECTIVE To introduce a semi-structured diagnostic interview for in-depth assessment of obsessive-compulsive spectrum disorders (OCSDs), and to report on its implementation in adults with primary OCD attending an OCD-specialized unit. METHODS Patients with primary OCD were interviewed using the SCID-OCSD. The SCID-OCSD assesses disorders drawn from several diagnostic categories that share some core features of obsessive-compulsive phenomenology and that are often comorbid in OCD (e.g., obsessive-compulsive related disorders, impulse-control disorders, and a spectrum of compulsive-impulsive conditions such as tics, eating disorders, non-suicidal self-injury, and behavioral addictions. Participants had to be at least moderately symptomatic on the Yale-Brown Obsessive-Compulsive Severity scale (YBOCS, i.e., a total score ≥ 14) to be included in the current study. RESULTS One hundred and one adult patients with current OCD (n = 101, 37 men and 64 women), took part in the study. Forty-two participants (n = 42) had OCD and one or more current or past comorbid OCSDs, with excoriation (skin-picking) disorder (n = 16) and body dysmorphic disorder (n = 14) being the most common. Nine (n = 9) participants reported a history of non-suicidal self-injury, and 6 participants reported a history of comorbid tics. CONCLUSIONS In OCD clinics, the SCID-OCSD may help diagnose the full range of putative OCSDs, and so facilitate treatment planning and research on these conditions.

In this position statement, developed by The International College of Obsessive-Compulsive Spectrum Disorders, a group of international experts responds to recent developments in the evidence-based management of obsessive-compulsive disorder (OCD). The article presents those selected therapeutic advances judged to be of utmost relevance to the treatment of OCD, based on new and emerging evidence from clinical and translational science. Areas covered include refinement in the methods of clinical assessment, the importance of early intervention based on new staging models and the need to provide sustained well-being involving effective relapse prevention. The relative benefits of psychological, pharmacological and somatic treatments are reviewed and novel treatment strategies for difficult to treat OCD, including neurostimulation, as well as new areas for research such as problematic internet use, novel digital interventions, immunological therapies, pharmacogenetics and novel forms of psychotherapy are discussed.

Background & Aims : the current study was conducted in the order to compare marital satisfaction and quality of life between patients with obsessive compulsive disorder, patients with other anxiety disorders and normal group. Materials & Methods : the two 100 member groups comprised of patients with obsessive compulsive disorder and patients with other anxiety disorders, selected of clients that they referred to psychiatry clinic of Fatemi hospital in Ardabil city by accessible sampling method, and one 100 member group of normal people as comparative group, selected randomly, participated in this cross- sectional study. After psychiatric diagnosis, all the groups were tested by questionnaires of obsessive compulsive disorder; Enrich marital satisfaction and quality of life. Collected data were analyzed by MANOVA, LSD post hog and independent t tests. Results : The results showed that there are no significant differences between OCD and normal groups in marital satisfaction but marital satisfaction in people with other neurotic disorders was significantly lower than other two groups. The results also showed that quality of life in both patients with OCD and other neurotic disorders was significantly lower than normal group. Also compared with people with other neurotic disorders, people with OCD had better quality of life. Conclusion : the result of this research showed that obsessive compulsive patients have high marital satisfaction and quality of life in comparison with patients with other anxiety disorders. These results notifies importance of attention to marital satisfaction and quality of life in diagnose and designing of treatment patterns for mentioned disorders

INTRODUCTION Obsessive-compulsive disorder (OCD) is characterized by a range of phenotypic expressions. Gender may be a relevant factor in mediating the disorder's heterogeneity. The aim of the present report was to explore a large multisite clinical sample of OCD patients, hypothesizing existing demographic, geographical and clinical differences between male and female patients with OCD. METHODS Socio-demographic and clinical variables of 491 adult OCD outpatients recruited in the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) network were investigated with a retrospective analysis on a previously gathered set of data from eleven countries worldwide. Patients were assessed through structured clinical interviews, the Yale- Brown Obsessive-Compulsive Scale (Y-BOCS), the Montgomery-Asberg Depression Rating Scale (MADRS) and the Self-rating Depression Scale (SDS). RESULTS Among females, adult onset (>18 years old) was significantly over-represented (67% vs. 33%, p < 0.005), and females showed a significantly older age at illness onset compared with males (20.85 ± 10.76 vs. 17.71 ± 8.96 years, p < 0.005). Females also had a significantly lower education level than males (13.09 ± 4.02 vs. 13.98 ± 3.85 years; p < 0.05), a significantly higher rate of being married (50.8% vs. 33.5%; p < 0.001) and a higher rate of living with a partner (47.5% vs. 37.6%; p < 0.001) than males. Nonetheless, no significant gender differences emerged in terms of the severity of OCD symptoms nor in the severity of comorbid depressive symptoms. No predictive effect of gender was found for Y-BOCS, MADRS and SDS severity. DISCUSSION/CONCLUSIONS Our findings showed significant differences between genders in OCD. A sexually dimorphic pattern of genetic susceptibility may have a crucial role to OCD clinical heterogeneity, potentially requiring different specific therapeutic strategies. Further research is warranted to validate gender as an important determinant of the heterogeneity in OCD.

© 2020 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

It has been proposed that certain Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I disorders share overlapping clinical features, genetic contributions, and treatment response and fall within an "obsessive-compulsive" spectrum. Obsessive-compulsive personality disorder (OCPD) resembles obsessive-compulsive disorder (OCD) and other spectrum disorders in terms of phenomenology, comorbidity, neurocognition, and treatment response. This article critically examines the nosological profile of OCPD with special reference to OCD and related disorders. By viewing OCPD as a candidate member of the obsessive-compulsive spectrum, we gain a fresh approach to understanding its neurobiology, etiology, and potential treatments.</p

Introduction: Obsessive-compulsive disorder (OCD), characterized by repetitive anxiety-inducing intrusive thoughts and compulsive behaviors, is associated with higher suicide ideation and suicide attempts than the general population. This study investigates the prevalence and the correlates of current suicide risk in adult outpatients in an international multisite cross-sectional sample of OCD outpatients. Methods: Data were derived from the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) network’s cross-sectional data set (N=409). Current suicide risk (assessed by Item C of the MINI) and diagnoses of psychiatric disorders were based on DSM-IV. Chi-squared test for categorical variables and t-test for continuous variables were used to make statistical inferences about main features associated with current suicide risk. P<0.05 was considered as statistically significant. Results: The prevalence of current suicidal risk was 15.9%, with equal likelihood in sociodemographic variables, including age and gender. Increased rates of major depression and generalized anxiety disorder were associated to higher current suicide risk. Current suicide risk was also associated with higher severity of OCD, depressive comorbidity and higher levels of disability. There were no significant differences in treatment correlates—including type of treatment and psychiatric hospitalizations—between the groups of individuals with and without current suicide risk. Conclusion: Our findings suggest that current suicide risk is common in patients with OCD and associated with various forms of pathology. Our work also provides further empirical data to support what is already known clinically: a worse clinical picture characterized by a high severity of OCD, high distress related to obsessions and compulsions, and the presence of comorbidities such as major depression and generalized anxiety disorder should be considered as relevant risk factors for suicide risk.

<i>Background:</i> There has been debate about whether obsessive-compulsive disorder (OCD) should be classified as one of the anxiety disorders, or should rather be categorized with obsessive-compulsive spectrum conditions. <i>Sampling and Methods:</i> The question of where OCD should be located in the diagnostic system was addressed by investigating the relationship of OCD, obsessive-compulsive spectrum disorders (OCSDs), and anxiety disorders. We administered a structured diagnostic interview (the SCID-OCSD) for assessing putative OCSDs in patients who presented with a primary diagnosis of OCD, panic disorder with/out agoraphobia (PD) or social anxiety disorder (SAD) in an attempt to address the proposed differentiation of OCD from the other DSM-IV anxiety disorders. <i>Results:</i> Patients with OCD were significantly more likely to have multiple comorbid putative OCSDs than patients with PD or SAD. Some OCSDs, i.e. any tic disorder/Tourette’s disorder as well as body-focused repetitive behaviors (self-injury, trichotillomania), and certain impulsive/reward-focused disorders (kleptomania, hypersexual disorder) were more common in OCD. Some of the putative OCSDs (e.g. hypochondriasis and body dysmorphic disorder) were more common in PD and SAD, respectively. Depression had equally high comorbidity with OCD, PD, and SAD, while generalized anxiety disorder and alcohol dependence were particularly associated with SAD. <i>Conclusions:</i> These findings suggest that some putative OCSDs may be related to OCD, while some may have a closer relationship to other anxiety disorders. From a nosological perspective, it may be useful to include OCD and certain OCSDs under the rubric of an enlarged category of anxiety and OCSDs.

Objectives: To compare the effectiveness of cognitive behaviour therapy delivered by telephone with the same therapy given face to face in the treatment of obsessive compulsive disorder. Design: Randomised controlled non-inferiority trial. Setting: Two psychology outpatient departments in the United Kingdom. Participants: 72 patients with obsessive compulsive disorder. Intervention: 10 weekly sessions of exposure therapy and response prevention delivered by telephone or face to face. Main outcome measures: Yale Brown obsessive compulsive disorder scale, Beck depression inventory, and client satisfaction questionnaire. Results: Difference in the Yale Brown obsessive compulsive disorder checklist score between the two treatments at six months was -0.55 (95% confidence interval -4.26 to 3.15). Patient satisfaction was high for both forms of treatment. Conclusion: The clinical outcome of cognitive behaviour therapy delivered by telephone was equivalent to treatment delivered face to face and similar levels of satisfaction were reported

Uncomfortable sensations preceding repetitive behaviours, known as sensory phenomena, have been documented across the obsessive–compulsive spectrum. Indirect evidence suggests altered interoception may play a role in these shared experiences of sensory phenomena; however, research explicitly measuring this relationship is limited. The current systematic review aimed to establish the nature of sensory phenomena and interoception in obsessive–compulsive and related disorders (OCRDs) and tic disorders as potential maintaining factors of these disorders. PsycINFO, PubMed, and Scopus databases were searched from 2007 to April 2024, yielding 65 studies. While the majority of studies presented low risk of bias, significant overlap and ambiguity characterised the measurement and conceptualisation of sensory phenomena and interoception. Overall, higher sensory phenomena was associated with greater symptom severity in several obsessive–compulsive spectrum disorders. Obsessive–compulsive disorder and tic disorder samples were characterised by lower interoceptive accuracy, with mixed findings on interoceptive sensibility. Some limited research emerged suggesting altered interoceptive abilities may be associated with greater sensory phenomena in obsessive–compulsive disorder and tic disorders. Sensory phenomena are experienced across the obsessive–compulsive spectrum. Future research should explore interoceptive abilities across the OCRDs, and build upon evidence supporting a relationship between sensory phenomena and interoception in OCD and tic disorders. CRD42023422817.

Alongside harm avoidance, incompleteness and disgust have been proposed as important emotion-related motivators underlying the symptoms of obsessive-compulsive disorder (OCD). The aim of the present study was to investigate the validity of self-report and interview-based measures of these constructs in youth with OCD (N=100) and anxiety disorders (N=96). All participants completed self-report measures of trait-level harm avoidance and incompleteness (Obsessive-Compulsive Trait Core Dimensions Questionnaire; OCTCDQ) and a measure of trait-level disgust propensity (Disgust Emotion Scale for Children; DES-C). Participants with OCD were also interviewed about the role that harm avoidance, incompleteness, and disgust played in their moment-to-moment experience of symptoms using a modified version of the Obsessive-Compulsive Core Dimensions Interview (OC-CDI). All measures exhibited theoretically sound factor structures and good internal consistency. Self-report scores for harm avoidance and incompleteness were significantly correlated with scores on the interview-based measure of these emotions in current OCD symptoms. A weaker relationship was observed for disgust. The OCTCDQ, DES-C, and OC-CDI appear to be valid for use with clinically-referred youth, and may be useful when studying the etiology, phenomenology, and course of pediatric OCD. More work is needed to better understand how trait-level aspects of disgust relate to moment-to-moment experiences of disgust in OCD

There is growing research evidence and public concern over the burgeoning of disorders which share common features with substance addictions. In order to investigate the presence and role of addiction features in disorders outside of substance addictions, symptoms of addiction were explored within three addiction groups: alcohol dependence (AD), an established addiction (n = 24); pathological gambling (PG) a disorder with growing empirical support as an addiction (n = 20); and compulsive shopping (CS), a proposed 'novel' addiction(n = 20). Participants were recruited from either the general population, or from the Auckland Salvation Army Bridge residential alcohol and drug treatment programme; Salvation Army Oasis Gambling Service; Pacific Peoples Addiction Service Incorporated; or Te Kahui Hauora O Ngati Koata Trust. Participants completed a battery of self-report measures comprising a demographics questionnaire; Addictive Disorder Questionnaire (ADQ); anxiety and depression subscales of the Symptom Checklist 90 Revised (SCL-90R); Barratt Impulsivity Scale II-r; and substance specific adaptations of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Three general categories of addiction symptoms: physiological, salience and dyscontrol, were identified as broad aspects of addiction, common across all three groups. Measurable aspects of addiction, including impulsivity, obsessions, anxiety and depression were found to be endorsed similarly across the three addictions, irrespective of the severity of their addiction. Compulsions were found to be higher in the AD group. Higher anxiety was found to be correlated with higher addiction in the behavioural addictions (CS and PG), whereas depression and anxiety were associated with higher addiction severity in the AD group. The results provide support for broadening addiction diagnostic definitions, to be more encompassing of the psychological and physiological experiences of each symptom; and developing different diagnostic categories for non-substance addictions that reflect the severity of the addiction. Results also provide evidence for developmental phases of addiction, from an early 'hedonistic' impulsive phase, to a compulsive phase, in which increased dyscontrol, mood and anxiety, marks the severity of the addiction

Body dysmorphic disorder (BDD) is characterized by a preoccupation with a perceived appearance flaw or flaws that are not observable to others. BDD is associated with distress and impairment of functioning. Psychiatric comorbidities, including depression, social anxiety, and obsessive-compulsive disorder are common and impact treatment. Treatment should encompass psychoeducation, particularly addressing the dangers associated with cosmetic procedures, and may require high doses of selective serotonin reuptake inhibitors* (SSRI*) and protracted periods to establish full benefit. If there is an inadequate response to SSRIs, various adjunctive medications can be employed including atypical antipsychotics*, anxiolytics*, and the anticonvulsant levetiracetam*. However, large-scale randomized controlled trials are lacking and BDD is not an approved indication for these medications. Oxytocin* may have a potential role in treating BDD, but this requires further exploration. Cognitive-behavioural therapy has good evidence for efficacy for BDD, and on-line and telephone-assisted forms of therapy are showing promise. CBT for BDD should be customized to address such issues as mirror use, perturbations of gaze, and misinterpretation of others’ emotions, as well as overvalued ideas about how others view the individual.

Introduction. Bipolar disorder (BD) and obsessive compulsive disorder (OCD) are prevalent, comorbid, and disabling conditions, often characterized by early onset and chronic course. When comorbid, OCD and BD can determine a more pernicious course of illness, posing therapeutic challenges for clinicians. Available reports on prevalence and clinical characteristics of comorbidity between BD and OCD showed mixed results, likely depending on the primary diagnosis of analyzed samples. Methods. We assessed prevalence and clinical characteristics of BD comorbidity in a large international sample of patients with primary OCD (n = 401), through the International College of Obsessive–Compulsive Spectrum Disorders (ICOCS) snapshot database, by comparing OCD subjects with vs without BD comorbidity. Results. Among primary OCD patients, 6.2% showed comorbidity with BD. OCD patients with vs without BD comorbidity more frequently had a previous hospitalization (p < 0.001) and current augmentation therapies (p < 0.001). They also showed greater severity of OCD (p < 0.001), as measured by the Yale–Brown Obsessive Compulsive Scale (Y-BOCS). Conclusion. These findings from a large international sample indicate that approximately 1 out of 16 patients with primary OCD may additionally have BD comorbidity along with other specific clinical characteristics, including more frequent previous hospitalizations, more complex therapeutic regimens, and a greater severity of OCD. Prospective international studies are needed to confirm our findings.

Aims: Harm avoidance (HA) and ‘not just right experience’ (NJRE) have been proposed to be two core motivational processes underlying obsessive-compulsive disorder (OCD). This study was interested in exploring the less well understood construct NJRE in OCD. The study hypothesized that NJRE demarcates a neurodevelopmental OCD subgroup distinct from HA related to autistic traits and/or to a broader phenotype of cognitive rigidity and sensory processing difficulties. In addition, it was hypothesized that NJRE would be associated with an earlier age of OCD onset. It was also predicted that HA, unlike NJRE, would be related to responsibility attitudes, which are characteristic of the traditional cognitive behavioural understanding of OCD. Method: The constructs of NJRE and HA were assessed in an outpatient OCD sample (N=25). A correlational design investigated whether NJRE and HA are distinct entities in OCD and explored their relationships to a range of variables including ASD traits, sensory processing, set-shifting, age of OCD onset, and responsibility attitudes. Results: NJRE was found to be only moderately (r=.34) correlated to HA. Significance was not established in this study. Consistent with predictions, NJRE was associated with sensory processing difficulties and an earlier age of OCD onset, but was not related to responsibility beliefs. No significant relationships were found between NRJE and ASD traits or set-shifting difficulties. Conclusions: There was a lack of evidence demonstrating NJRE as a manifestation of autistic traits. However, NJRE was associated with sensory abnormalities and early onset of OCD, suggesting it may be a marker for difficulties of developmental origin. The role of NJRE as a developmental, and possibly neurodevelopmental, risk factor for OCD warrants further investigation