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Neuroscience and Biobehavioral Reviews Mar 2018Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) are a subtype of acute-onset obsessive-compulsive disorder (OCD)...
Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) are a subtype of acute-onset obsessive-compulsive disorder (OCD) thought to be caused by an autoimmune response to group A streptococcal infection. Based on this proposed pathophysiology, alternative treatments for acute-onset OCD have been introduced, including antibiotics and immunomodulatory interventions. However, the literature on treatment of PANDAS is diverse, and clinical consensus regarding optimal treatment strategy is lacking. We conducted a systematic review of articles in PubMed, Cochrane Library, and Scopus that addressed treatment for PANDAS and related disorders. Twelve research studies involving the following treatments met inclusion criteria: penicillin, azithromycin, intravenous immunoglobulin, plasma exchange, tonsillectomy, cognitive behavior therapy, NSAID and corticosteroids. In addition, 65 case reports in which patients received immunomodulatory treatments, antibiotics, and/or psychotropics were identified. We determined that rigorously conducted research regarding treatments for PANDAS is scarce, and published studies have a high risk of bias. Further research is needed in which promising treatment strategies for PANDAS and other variants of OCD with proposed autoimmune etiology are rigorously investigated.
Topics: Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Autoimmune Diseases; Cognitive Behavioral Therapy; Humans; Obsessive-Compulsive Disorder; Plasma Exchange; Streptococcal Infections; Tonsillectomy
PubMed: 29309797
DOI: 10.1016/j.neubiorev.2018.01.001 -
Psychiatry Research Jun 2019Pediatric obsessive-compulsive disorder (OCD) co-occurs frequently with other mental health conditions, adding to the burden of disease and complexity of treatment.... (Randomized Controlled Trial)
Randomized Controlled Trial
Pediatric obsessive-compulsive disorder (OCD) co-occurs frequently with other mental health conditions, adding to the burden of disease and complexity of treatment. Cognitive behavioral therapy (CBT) is efficacious for both OCD and two of its most common comorbid conditions, anxiety and depression. Therefore, treating OCD may yield secondary benefits for anxiety and depressive symptomatology. This study examined whether anxiety and/or depression symptoms declined over the course of OCD treatment and, if so, whether improvements were secondary to reductions in OCD severity, impairment, and/or global treatment response. The sample consisted of 137 youths who received 12 sessions of manualized CBT and were assessed by independent evaluators. Mixed models analysis indicated that youth-reported anxiety and depression symptoms decreased in a linear fashion over the course of CBT, however these changes were not linked to specific improvements in OCD severity or impairment but to global ratings of treatment response. Results indicate that for youth with OCD, CBT may offer benefit for secondary anxiety and depression symptoms distinct from changes in primary symptoms. Understanding the mechanisms underlying carryover in CBT techniques is important for furthering transdiagnostic and/or treatment-sequencing strategies to address co-occurring anxiety and depression symptoms in pediatric OCD.
Topics: Adolescent; Anxiety; Child; Cognitive Behavioral Therapy; Depression; Female; Humans; Male; Neurodevelopmental Disorders; Obsessive-Compulsive Disorder; Treatment Outcome
PubMed: 31075706
DOI: 10.1016/j.psychres.2019.04.021 -
The Israel Journal of Psychiatry and... 2008
Topics: Antidepressive Agents, Tricyclic; Clomipramine; Humans; Obsessive-Compulsive Disorder; Psychiatric Status Rating Scales; Risk Factors; Selective Serotonin Reuptake Inhibitors
PubMed: 19398818
DOI: No ID Found -
Attention Deficit and Hyperactivity... Sep 2014Obsessive compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD) are two of the most common neuropsychiatric diseases in paediatric populations.... (Review)
Review
Obsessive compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD) are two of the most common neuropsychiatric diseases in paediatric populations. The high comorbidity of ADHD and OCD with each other, especially of ADHD in paediatric OCD, is well described. OCD and ADHD often follow a chronic course with persistent rates of at least 40-50 %. Family studies showed high heritability in ADHD and OCD, and some genetic findings showed similar variants for both disorders of the same pathogenetic mechanisms, whereas other genetic findings may differentiate between ADHD and OCD. Neuropsychological and neuroimaging studies suggest that partly similar executive functions are affected in both disorders. The deficits in the corresponding brain networks may be responsible for the perseverative, compulsive symptoms in OCD but also for the disinhibited and impulsive symptoms characterizing ADHD. This article reviews the current literature of neuroimaging, neurochemical circuitry, neuropsychological and genetic findings considering similarities as well as differences between OCD and ADHD.
Topics: Attention Deficit Disorder with Hyperactivity; Brain; Functional Neuroimaging; Humans; Magnetic Resonance Imaging; Obsessive-Compulsive Disorder
PubMed: 25017045
DOI: 10.1007/s12402-014-0146-x -
Dialogues in Clinical Neuroscience 2010Obsessive-compulsive disorder (OCD) has long been associated with epilepsy The link with temporal lobe (usually refractory) epilepsy (TLE) is particularly prominent Of... (Review)
Review
Obsessive-compulsive disorder (OCD) has long been associated with epilepsy The link with temporal lobe (usually refractory) epilepsy (TLE) is particularly prominent Of TLE patients, 10% to 22% of patients may have OCD, often underdiagnosed in the outpatient clinic. Data on the links include case reports, case series, and controlled studies. Three larger, controlled studies in TLE patients, using comprehensive epilepsy and OCD classifications, in aggregate, have noted the obsessive qualities of washing, symmetry/exactness, and ordering, with a greater preoccupation with certain aspects of religion, compared with controls or patients with idiopathic generalized epilepsy. TLE foci may be either left- or right-sided. Social and neurobiological factors are involved in OCD in TLE. The neurobiology implicates a pathophysiological or structural impairment of the orbitofrontal-thalamic, and fronto-thalamic-pallidal-striatal-anterior cingulate-frontal circuits. Discrete anatomic lesions in these pathways, or their surgical removal, may induce (or conversely) improve OCD in TLE patients.
Topics: Cognition Disorders; Epilepsy; Functional Laterality; Humans; Neuropsychological Tests; Obsessive-Compulsive Disorder; Psychiatric Status Rating Scales
PubMed: 20623928
DOI: 10.31887/DCNS.2010.12.2/pkaplan -
Journal of Affective Disorders Sep 2023Obsessive-compulsive disorder (OCD) is a condition with poor treatment outcomes. Improved understanding of the aetiology can inform prevention and treatment approaches;... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Obsessive-compulsive disorder (OCD) is a condition with poor treatment outcomes. Improved understanding of the aetiology can inform prevention and treatment approaches; hence several studies have assessed early maladaptive schemas (EMSs) in OCD. This systematic review and meta-analysis aimed to synthesise the evidence on relationships between the 18 EMSs and OCD.
METHODS
The study was conducted according to PRISMA guidelines and registered on PROSPERO (CRD42022329337). A systematic search of PubMed, PsycINFO, and CINAHL Complete was conducted on 4 June 2022. Studies in peer-reviewed journal articles were included if they assessed EMSs and OCD (diagnosis or symptom severity) in adults with a mean age of 18 years or older. Studies were excluded if they were not in English, did not include original quantitative data, or reported on case studies. Study details were tabulated and the meta-analysis findings were presented using forest plots. Methodological quality was assessed using the Appraisal tool for Cross-Sectional Studies (AXIS).
RESULTS
Based on 22 studies (pooled N = 3699), all 18 EMSs were positively correlated with OCD. The largest associations were with the dependence/incompetence (r = 0.40 95 % CI [0.32, 0.47]), vulnerability to harm or illness (r = 0.40 95 % CI [0.32, 0.48]), and negativity/pessimism schemas (r = 0.42 95 % CI [0.22, 0.58]).
LIMITATIONS
Several meta-analyses showed considerable heterogeneity and publication bias.
CONCLUSIONS
The findings suggest all EMSs, particularly those relating to disproportionate negative expectations and a perceived inability to cope, are implicated in OCD. Psychological prevention and treatment for OCD may benefit from targeting these schemas.
Topics: Adult; Humans; Adolescent; Cross-Sectional Studies; Obsessive-Compulsive Disorder; Treatment Outcome
PubMed: 37217101
DOI: 10.1016/j.jad.2023.05.053 -
The Journal of Adolescent Health :... Mar 2023The aim of this study is to determine the prospective associations between baseline screen time and obsessive-compulsive disorder (OCD) at 2-year follow-up in a national...
PURPOSE
The aim of this study is to determine the prospective associations between baseline screen time and obsessive-compulsive disorder (OCD) at 2-year follow-up in a national (United States) cohort of 9- to 10-year-old children.
METHODS
We analyzed prospective cohort data from the Adolescent Brain Cognitive Development study (n = 9,208). Logistic regression analyses were used to determine the associations between baseline self-reported screen time (exposure) and OCD, based on the Kiddie Schedule for Affective Disorders and Schizophrenia (outcome), at 2-year-follow-up, adjusting for race/ethnicity, sex, household income, parent education, family history of psychopathology, and study site, excluding participants with baseline OCD.
RESULTS
The sample was 48.9% female and racially and ethnically diverse (43.5% non-White). Each additional hour of total screen time was prospectively associated with 1.05 higher odds of OCD at 2-year follow-up (95% confidence interval [CI] 1.01-1.09). For specific screen time modalities, each additional hour of playing video games (adjusted odds ratio 1.15, 95% CI 1.03-1.28) and watching videos (adjusted odds ratio 1.11, 95% CI 1.01-1.23) was associated with a subsequent OCD diagnosis.
CONCLUSION
Video games and watching videos are prospectively associated with new-onset OCD in early adolescents. Future research should examine mechanisms linking these specific screen modalities to OCD development to inform future prevention and intervention efforts.
Topics: Adolescent; Humans; Female; Child; Male; Prospective Studies; Screen Time; Obsessive-Compulsive Disorder; Psychopathology; Psychiatric Status Rating Scales
PubMed: 36517380
DOI: 10.1016/j.jadohealth.2022.10.023 -
Philosophical Transactions of the Royal... Nov 2014Obsessive-compulsive disorder (OCD) has become a paradigmatic case of goal-directed dysfunction in psychiatry. In this article, we review the neurobiological evidence,... (Review)
Review
Obsessive-compulsive disorder (OCD) has become a paradigmatic case of goal-directed dysfunction in psychiatry. In this article, we review the neurobiological evidence, historical and recent, that originally led to this supposition and continues to support a habit hypothesis of OCD. We will then discuss a number of recent studies that have directly tested this hypothesis, using behavioural experiments in patient populations. Based on this research evidence, which suggests that rather than goal-directed avoidance behaviours, compulsions in OCD may derive from manifestations of excessive habit formation, we present the details of a novel account of the functional relationship between these habits and the full symptom profile of the disorder. Borrowing from a cognitive dissonance framework, we propose that the irrational threat beliefs (obsessions) characteristic of OCD may be a consequence, rather than an instigator, of compulsive behaviour in these patients. This lays the foundation for a potential shift in both clinical and neuropsychological conceptualization of OCD and related disorders. This model may also prove relevant to other putative disorders of compulsivity, such as substance dependence, where the experience of 'wanting' drugs may be better understood as post hoc rationalizations of otherwise goal-insensitive, stimulus-driven behaviour.
Topics: Decision Making; Goals; Habits; Humans; Learning; Obsessive-Compulsive Disorder; White Matter
PubMed: 25267818
DOI: 10.1098/rstb.2013.0475 -
Psychiatria Polska Feb 2021Sexual obsessions in obsessive-compulsive disorder are featured by unsolicited, intrusive sexual thoughts and images. The occurrence of sexual obsessions is estimated at... (Review)
Review
Sexual obsessions in obsessive-compulsive disorder are featured by unsolicited, intrusive sexual thoughts and images. The occurrence of sexual obsessions is estimated at 16.8% among patients with obsessive-compulsive disorder (OCD). The main aim of the article is to present the basic problems related to the phenomenon of sexual obsessions in obsessive-compulsive disorder and to showcase the cognitive and behavioural models of OCD. Apart from that, the article contains a review of literature on the efficacy of cognitive-behavioural therapy in treatment of obsessive-compulsive disorders, including the sexual-oriented ones.
Topics: Cognitive Behavioral Therapy; Humans; Models, Psychological; Obsessive-Compulsive Disorder; Sexual Behavior
PubMed: 34021545
DOI: 10.12740/PP/112051 -
Comprehensive Psychiatry Feb 2020Although a behavioural addiction model of obsessive-compulsive disorder (OCD) has been proposed, it is still unclear if and how self-report and neurocognitive measures...
BACKGROUND
Although a behavioural addiction model of obsessive-compulsive disorder (OCD) has been proposed, it is still unclear if and how self-report and neurocognitive measures of impulsivity (such as risk-taking-, reflection- and motor-impulsivities) are impaired and/or inter-related in this particular clinical population.
METHODS
Seventeen OCD patients and 17 age-, gender-, education- and IQ-matched controls completed the Barratt Impulsivity Scale, the Obsessive-Compulsive Inventory-Revised, and the Beck Depression Inventory and were evaluated with the Yale-Brown Obsessive-Compulsive Scale and three computerized paradigms including reward (the Cambridge Gambling Task), reflection (the Information Sampling Task) and motor impulsivity (Stop Signal Task).
RESULTS
Despite not differing from healthy controls in any neurocognitive impulsivity domain, OCD patients demonstrated increased impulsivity in a self-report measure (particularly attentional impulsivity). Further, attentional impulsivity was predicted by severity of obsessive-compulsive symptoms.
CONCLUSIONS
Our findings suggest that OCD is characterized by a subjective (rather than objective) impulsivity; in addition, self-reported impulsivity was largely determined by severity of OCD symptoms.
Topics: Adult; Behavior, Addictive; Case-Control Studies; Female; Gambling; Humans; Impulsive Behavior; Male; Middle Aged; Obsessive-Compulsive Disorder; Psychiatric Status Rating Scales; Reward; Self Report; Young Adult
PubMed: 31864219
DOI: 10.1016/j.comppsych.2019.152155