Vitamin B12, folate, and homocysteine levels in patients with obsessive-compulsive disorder.

It is known that elevated serum homocysteine, decreased folate, and low vitamin B12 serum levels are associated with poor cognitive function, cognitive decline, and dementia. Current literature shows that some psychiatric disorders, mainly affective and psychotic ones, can be related to the levels of vitamin B12, folate, and homocysteine. These results can be explained by the importance of vitamin B12, folate, and homocysteine in carbon transfer metabolism (methylation), which is required for the production of serotonin as well as for other monoamine neurotransmitters and catecholamines. Earlier studies focused on the relationship between folate deficiency, hyperhomocysteinemia, and depressive disorders. Although depressive and anxiety disorders show a common comorbidity pattern, there are few studies addressing the effect of impaired one-carbon metabolism in anxiety disorders - especially in obsessive-compulsive disorder (OCD). This study aimed to measure the levels of vitamin B12, folate, and homocysteine specifically in order to see if eventual alterations have an etiopathogenetic significance on patients with OCD. Serum vitamin B12, folate, and homocysteine concentrations were measured in 35 patients with OCD and 22 controls. In addition, the Structured Clinical Interview for the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, Text Revision, Yale-Brown Obsessive Compulsive Scale, Hamilton Rating Scale for Depression, and Hamilton Rating Scale for Anxiety were conducted for each patient. It was found that vitamin B12 levels were decreased and homocysteine levels were increased in some OCD patients. Homocysteine levels were positively correlated with Yale-Brown compulsion and Yale-Brown total scores. In conclusion, findings of this study suggest that some OCD patients might have vitamin B12 deficiency and higher homocysteine levels.

Clinical characteristics in obsessive-compulsive disorder with schizophrenia.

The objective of this study was to compare two groups of patients with obsessive-compulsive disorder (OCD) with and without comorbid schizophrenia in terms of demographic and clinical features. A total of 65 patients diagnosed with OCD were divided into two groups: one comprising 20 patients with schizophrenia and the other comprising 45 patients without schizophrenia. The groups were then compared with respect to demographic variables and scores obtained on various scales. The two groups were similar for the frequency and severity of obsessive-compulsive symptoms. Insight into obsessive-compulsive symptoms was significantly better in the group with schizophrenia. Our findings suggest that the characteristics of obsessive-compulsive symptoms in schizophrenic OCD patients are similar to those in nonschizophrenic OCD patients.

Comparison of clinical characteristics in good and poor insight obsessive-compulsive disorder.

Beginning with DSM-III-R, the condition of an intact insight towards obsessive-compulsive symptoms, which was essential for the classical definition of obsessivecompulsive neurosis, has been removed, permitting inclusion of cases with poor insight. A total of 94 cases who met DSM-III-R criteria for obsessive-compulsive disorder were included in this study. The Structured Clinical Interview for DSM-III-R (SCID-P), YaleBrown Obsessive Compulsive Scale (Y-BOCS), Hamilton Rating Scale for Depression (HRSD), Hamilton Rating Scale for Anxiety (HRSA), and State-Trait Anxiety Inventory (STAI) were administered to each patient. Two subgroups determined by DSM-IV item "poor insight" were compared for demographic variables and the scores obtained on the scales. Scores on the Y-BOCS, HRSA, HRSD and STAI-state were significantly higher in the poor insight group. Current and past major depression were also more frequent. Among personality disorders (PDs), avoidant PD was more common in the good insight group and borderline and narcissistic PDs were more common in the poor insight group. HRSA, HRSD, and STAI-state scores had weak to moderate but significant correlations with insight as defined by the item 11 of Y-BOCS. Findings are discussed in view of previous reports.

Comorbid conditions in obsessive-compulsive disorder.

The objective of this study was to investigate axis I comorbidity in obsessive-compulsive disorder (OCD). A total of 147 patients diagnosed as OCD for DSM-III-R criteria were included in the study. At least one comorbid axis I disorder was present in 68.7% of the patients. Major depression was the most common comorbid disorder (39.5%). Uncomplicated (n = 46) and comorbid (n = 101) OCD groups were compared with respect to the demographic variables and the scores obtained from the Hamilton Rating Scale for Anxiety (HRSA), the Hamilton Rating Scale for Depression (HRSD) and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). No significant difference in terms of age, sex, marital status, age at onset, or duration of illness was found between the groups. The scores on the HRSA, HRSD, and Y-BOCS were significantly higher in the comorbidity group. Our results demonstrate that at least one psychiatric disorder is present in approximately two thirds of OCD patients, the majority being depressive disorders and anxiety disorders. The fact that comorbid conditions raise not only anxiety and depression levels, but also the severity of obsessions and compulsions, is noteworthy.