Organicity in obsessive-compulsive disorder.

Though pharmacological and/or behavioral interventions have proven highly effective, 20 to 30% of the obsessive-compulsive disorder (OCD) population is treatment refractory. This study describes the OCD clinical profile that is correlated to organicity. Two groups of OCD patients were presented: an organic group and a control nonorganic group. The 9 organic patients exhibit an indifference to their illness, a lack of motivation, are nonanxious even during exposure exercises, are nondepressed, have rigid and concrete thinking, are treatment refractory, and have some type of organic impairment. The 10 nonorganic patients are also treatment refractory but do not exhibit the clinical profile correlated to the organic OCD patients. Furthermore, MRI results indicate that no organic impairment exists in this control group. All of these patients were tried on medication and behavior therapy to no avail. Reasons for lack of response in organic OCD patients, based on cerebral anatomical changes, are discussed.

Nosological insertion of axis I disorders in the etiology of obsessive-compulsive disorder.

This study explores the prevalence of developing Axis I disorders at various time points within an obsessive-compulsive disorder (OCD) population. A sample of 409 patients diagnosed as OCD according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) participated. Of the 409 patients, 132 (32.2%) developed at least one other Axis I disorder. Odds ratio data indicates that an anxiety disorder, mood disorder, eating disorder, or tic disorder is likely to occur first. Second disorder is likely to be another anxiety disorder, mood disorder, eating disorder, somatoform disorder (tic disorders fall out of the continuum). The third disorder is likely to be a mood disorder, or anxiety disorder (all other disorders fall out of the continuum). Demographic data including gender, religion, occupation, marital status, and family psychiatric history is similar to the data reported in other studies of primary OCD. It is suggested that although OCD may present with additional comorbid conditions, other distinct pathology may emerge (be inserted) independently over time. This supports the conceptualization of OCD as a continuum, where additional diagnoses may be expected to occur in the time course of the condition.

Self-mutilation, anorexia, and dysmenorrhea in obsessive compulsive disorder.

This report described 19 female patients (M = 23.5) diagnosed as obsessive compulsive disorder (OCD; DSM-III-R) who exhibited additional symptoms of self-mutilation, dysmenorrhea, and dysorexia. A biphasic pattern related to menstruation during the course of OCD emerged: Phase 1, amenorrheic--characterized by anorexia nervosa, amenorrhea, and aggressive behavior, and Phase 2, postamenorrheic--characterized by self-mutilation following the return of the menstrual cycle, dysorexia, and aggressive behavior. All mutilative acts were reported by the patients to be painless and consisted of slashes. Seventy percent of the patients were sexually abused during childhood. All patients underwent an open trial of clomipramine (M = 200 mg/day) for 6 months, and intensive behavior therapy for 8 weeks. Based on clinical observations and self-reports, there was a decrease in self-harm and OCD symptoms. The emergence of OCD, self-mutilation, dysorexia, and dysmenorrhea in a sequential manner may suggest a specific clinical syndrome or the presence of an OCD subset. A biological working hypothesis of a hypothalamic dysfunction with serotonergic participation was suggested.

[Demographic study of obsessive compulsive disorder]. / Estudio demográfico del trastorno obsesivo-compulsivo.

This study used a large, obsessive- compulsive disorder (OCD) population (N = 157) without comorbidity, and compared them to the general population of the States of New York on the following demographic variables: sex ratio, age of onset, age first seen, marital status, occupation, birth trauma, substance abuse, religion, past psychiatric treatment, and parents' psychiatric history. A 1: 1 sex ratio with a significant gender difference was found for age of onset (females = 20.8; males = 16.3 years), and for age first seen (females = 26.4; males 20.3 years). Other significant findings were the following: More single male OCD patients, fewer widowed female patients, more white-collar workers, less drug abusers, more alcohol abstainers, and less non-problem drinkers as compared to the general population. Significantly also, more atheist/agnostic OCD patients were found as compared to other patients. For the first time, the findings can be evaluated against a comparative group.

Estudio demográfico del trastorno obsesivo-compulsivo. / [Demographic study of obsessive compulsive disorder]

This study used a large, obsessive- compulsive disorder (OCD) population (N = 157) without comorbidity, and compared them to the general population of the States of New York on the following demographic variables: sex ratio, age of onset, age first seen, marital status, occupation, birth trauma, substance abuse, religion, past psychiatric treatment, and parents psychiatric history. A 1: 1 sex ratio with a significant gender difference was found for age of onset (females = 20.8; males = 16.3 years), and for age first seen (females = 26.4; males 20.3 years). Other significant findings were the following: More single male OCD patients, fewer widowed female patients, more white-collar workers, less drug abusers, more alcohol abstainers, and less non-problem drinkers as compared to the general population. Significantly also, more atheist/agnostic OCD patients were found as compared to other patients. For the first time, the findings can be evaluated against a comparative group.