11 research outputs found
Obsessive-compulsive disorder, insulin signaling and diabetes – A novel form of physical health comorbidity: The sweet compulsive brain
No full textBackground: While a growing body of research highlights a bi-directional link between diabetes and mood disorders, little is known about the relationship between diabetes and obsessive-compulsive disorder (OCD). The aim of the present review is to investigate current evidence linking OCD, insulin-signaling and diabetes. Methods: A PubMed search was conducted to review all the available studies assessing diabetes, glucose metabolism and insulin-signaling in OCD patients and vice versa. Results: Some clinical and epidemiological studies show a higher prevalence of diabetes in OCD and vice versa compared to the general population. Animal and genetic studies suggest a possible role of insulin-signaling in the pathophysiology of OCD. Deep brain stimulation (DBS) studies suggest that abnormal dopaminergic transmission in the striatum may contribute to impaired insulin sensitivity in OCD. While DBS seems to increase insulin sensitivity, a possible protective role of serotonin reuptake-inhibitors on diabetic risk needs further studies. Conclusion: Despite their preliminary nature, these data highlight the importance of further investigations aimed at assessing metabolic features in OCD patients and OCD symptoms in diabetes patients to understand the impact of each condition on the pathophysiology and course of the other. Understanding the role of insulin in the obsessive-compulsive brain could open new treatment pathways for OCD
Zink- en kraagstukken in ontwikkelingslanden
No full textGrondstoffen en veerwerking, diverse constructies, uitvoering - gebruik van bamboe en van kunststoffen, ballasen en afzinken.Hydraulic EngineeringCivil Engineering and Geoscience
Prevalence of suicide attempt and clinical characteristics of suicide attempters with Obsessive-Compulsive Disorder: a report from the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS)
No full textObjective: Obsessive-Compulsive Disorder (OCD) is associated with a variable risk of suicide but its prevalence and risk factors have not been extensively investigated. The present study was aimed to assess prevalence of suicide attempt (SA) and associated socio-demographic and clinical features in a large international sample of OCD patients.
Methods: 425 OCD outpatients, recruited by the “international college of obsessive-compulsive spectrum disorders” (ICOCS) network, were assessed and categorized in groups with or without lifetime SA and their sociodemographic and clinical variables compared through Pearson Chi-squared and t tests. Logistic regression was performed to assess the impact of collected data on the SA variable.
Results: 14.6% of the sample reported at least one lifetime SA. Patients with SA had significantly higher rates of comorbid psychiatric (60%vs17%, p<.001) and medical disorders (51%vs15%, p<.001) as well as previous hospitalizations (62%vs11%, p<.001), compared with patients with no SA. With respect to geographical differences, European and South African patients showed significantly higher rates of SA (40% and 39%, respectively) compared to North American and Middle-Eastern individuals (13% and 8%, respectively) (χ2=11.4, p<.001). Logistic regression did not show any statistically significant predictor of SA among selected independent variables.
Conclusions: The present international multicenter study found a lifetime SA prevalence of approximately 15% in OCD patients, with higher rates of psychiatric and medical comorbidities and previous hospitalizations in patients with previous SA. Along with potential geographical influences, the presence of the above-mentioned features should recommend additional caution in the assessment of suicide risk in OCD patients
Adaptive reinforcement learning and flexibility in impulsivity and compulsivity
No full textThe project aims at investigating the common and distinct underlying neural mechanisms of impulsivity and compulsivity regarding response- and feedback processing and associated learning of reward and punishment. Our objective is to determine common and distinct mechanisms of volitional control potentially underlying impulsivity and compulsivity, with a focus on adaptive reinforcement learning, response processing and adaptive flexibility. These cognitive control functions and their neural correlates are suggested as constructs for the domain cognitive control in the Research Domain Criteria (RDoC) initiative (Cuthbert & Kozak, 2013; Kozak & Cuthbert, 2016).
Impulsivity and compulsivity have been associated with various mental disorders, e.g. substance use disorder (SUD), obsessive-compulsive disorder (OCD), or attention deficit hyperactivity disorder (ADHD; Berlin & Hollander, 2014; Figee et al., 2016). Both constructs are multidimensional and appear to share a tendency for response disinhibition (Dalley, Everitt, & Robbins, 2011; Fineberg et al., 2014; Robbins, Gillan, Smith, de Wit, & Ersche, 2012). Impulsive and compulsive behaviors appear to result from alterations in the cortical control of fronto-striatal networks or heightened activity in striatal components of these networks, which are distinct but overlap and communicate with each other (Fineberg et al., 2014; Fineberg et al., 2010; Robbins, 2007). Alterations in the activity of the striatal or prefrontal components might lead to increased impulsive or compulsive behavior. Different studies on mental disorders marked by compulsivity and impulsivity, like OCD and SUD, suggest a connection to dysfunctional reinforcement learning, by way of overlap between fronto-striatal networks (see Figee et al., 2016; O’Toole, Weinborn, & Fox, 2012; Robbins et al., 2012). Reinforcement learning is influenced by both appetitive as well as aversive processes; these processes are altered in various mental disorders (Pessiglione & Delgado, 2015). The selection of adaptive behavior in complex environments, typically the pursuit of reward and the avoidance of punishment, has become dysfunctional, leading to biases in decision-making (Darcq & Kieffer, 2018). These biases may be influenced by sensitivity to reward and punishment, but also by tendencies towards approach or avoidance in active decision-making (Pessiglione & Delgado, 2015). The biases in learning and decision-making reduce the flexibility in adapting behavior in reaction to changing environments (Endrass, Kloft, Kaufmann, & Kathmann, 2011; Guitart-Masip, Duzel, Dolan, & Dayan, 2014; Potts, George, Martin, & Barratt, 2006). This cognitive flexibility can be measured using a reversal learning task, which requires the adaptation of learned reinforcement-contingencies, or the active inhibition of learned reward-based behavior (Izquierdo, Brigman, Radke, Rudebeck, & Holmes, 2017; Izquierdo & Jentsch, 2012). In probabilistic reversal learning tasks, reward and punishment learning can also be analyzed depending on approach and avoidance: fictive feedback is used to ensure learning of stimulus-response outcomes and necessary behavioral adaptations, even when actual consequences are avoided (Fischer & Ullsperger, 2013).
An important basis for adaptive behavior control, and therefore learning, is response monitoring (Holroyd & Coles, 2002). Studies on response monitoring have consistently found alterations of neural correlates in compulsive as well as impulsive individuals (Bellato et al., 2021; Endrass, Klawohn, Schuster, & Kathmann, 2008; Pasion & Barbosa, 2019; Potts et al., 2006; Ruchsow, Spitzer, Grön, Grothe, & Kiefer, 2005). How impulsivity and compulsivity interact regarding response processing, is still unclear. Independent of specific tasks, functional connectivity in resting state can help to shed light on altered activity outside of specific task demands (e.g. Allen & Cohen, 2010; Craddock, Holtzheimer III, Hu, & Mayberg, 2009), and heart rate variability during rest as well as during task execution can indicate physiologic adaptability and flexibility (e.g. Colzato, Jongkees, de Wit, van der Molen, & Steenbergen, 2018; Zahn et al., 2016).
The current project will assess cognitive control and adaptive behavior with a flanker task and a probabilistic approach avoidance reversal learning task in addition to resting state EEG and HRV in individuals characterized by low or high expressions of impulsivity and compulsivity (for more details see below). The project addresses how impulsivity and compulsivity relate to and interact regarding: performance monitoring and reversal learning and their neural correlates; resting state EEG and HRV
Prevalence of suicide attempt and clinical characteristics of suicide attempters with obsessive-compulsive disorder: a report from the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS)
No full textOBJECTIVE: Obsessive-compulsive disorder (OCD) is associated with variable risk of suicide and prevalence of suicide attempt (SA). The present study aimed to assess the prevalence of SA and associated sociodemographic and clinical features in a large international sample of OCD patients. METHODS: A total of 425 OCD outpatients, recruited through the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) network, were assessed and categorized in groups with or without a history of SA, and their sociodemographic and clinical features compared through Pearson's chi-squared and t tests. Logistic regression was performed to assess the impact of the collected data on the SA variable. RESULTS: 14.6% of our sample reported at least one SA during their lifetime. Patients with an SA had significantly higher rates of comorbid psychiatric disorders (60 vs. 17%, p<0.001; particularly tic disorder), medical disorders (51 vs. 15%, p<0.001), and previous hospitalizations (62 vs. 11%, p<0.001) than patients with no history of SA. With respect to geographical differences, European and South African patients showed significantly higher rates of SA history (40 and 39%, respectively) compared to North American and Middle-Eastern individuals (13 and 8%, respectively) (χ2=11.4, p<0.001). The logistic regression did not show any statistically significant predictor of SA among selected independent variables. CONCLUSIONS: Our international study found a history of SA prevalence of ~15% in OCD patients, with higher rates of psychiatric and medical comorbidities and previous hospitalizations in patients with a previous SA. Along with potential geographical influences, the presence of the abovementioned features should recommend additional caution in the assessment of suicide risk in OCD patients
The role of gender in a large international OCD sample: A Report from the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) Network
No full textIntroduction: 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.& nbsp;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 throughstructured clinical interviews, the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Montgomery-Asberg Depression Rating Scale (MADRS) and the Self-rating Depression Scale (SDS).& nbsp;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 dif-ferences 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.& nbsp;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
EXPLORING SOCIODEMOGRAPHIC AND CLINICAL CORRELATES OF OLDER ADULTS WITH OBSESSIVE-COMPULSIVE DISORDER: A REPORT FROM THE INTERNATIONAL COLLEGE OF OBSESSIVE-COMPULSIVE DISORDERS (ICOCS)
No full textPrevalence and correlates of current suicide risk in an international sample of OCD adults: A report from the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) network and Obsessive Compulsive and Related Disorders Network (OCRN) of the European College of Neuropsychopharmacology
No full textIntroduction: 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 < .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
A transdiagnostic perspective of constructs underlying obsessive-compulsive and related disorders:An international Delphi consensus study
No full textBackground: The Research Domain Criteria seeks to bridge knowledge from neuroscience with clinical practice by promoting research into valid neurocognitive phenotypes and dimensions, irrespective of symptoms and diagnoses as currently conceptualized. While the Research Domain Criteria offers a vision of future research and practice, its 39 functional constructs need refinement to better target new phenotyping efforts. This study aimed to determine which Research Domain Criteria constructs are most relevant to understanding obsessive-compulsive and related disorders, based on a consensus between experts in the field of obsessive-compulsive and related disorders. Methods: Based on a modified Delphi method, 46 experts were recruited from Australia, Africa, Asia, Europe and the Americas. Over three rounds, experts had the opportunity to review their opinion in light of feedback from the previous round, which included how their response compared to other experts and a summary of comments given. Results: Thirty-four experts completed round one, of whom 28 (82%) completed round two and 24 (71%) completed round three. At the final round, four constructs were endorsed by ⩾75% of experts as ‘primary constructs’ and therefore central to understanding obsessive-compulsive and related disorders. Of these constructs, one came from the Positive Valence System (Habit), two from the Cognitive Control System (Response Selection/Inhibition and Performance Monitoring) and the final construct was an additional item suggested by experts (Compulsivity). Conclusion: This study identified four Research Domain Criteria constructs that, according to experts, cut across different obsessive-compulsive and related disorders. These constructs represent key areas for future investigation, and may have potential implications for clinical practice in terms of diagnostic processes and therapeutic management of obsessive-compulsive and related disorders.</p
Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder: a revision of the 2005 guidelines from the British Association for Psychopharmacology
No full textThis revision of the 2005 British Association for Psychopharmacology guidelines for the evidence-based pharmacological treatment of anxiety disorders provides an update on key steps in diagnosis and clinical management, including recognition, acute treatment, longer-term treatment, combination treatment, and further approaches for patients who have not responded to first-line interventions. A consensus meeting involving international experts in anxiety disorders reviewed the main subject areas and considered the strength of supporting evidence and its clinical implications. The guidelines are based on available evidence, were constructed after extensive feedback from participants, and are presented as recommendations to aid clinical decision-making in primary, secondary and tertiary medical care. They may also serve as a source of information for patients, their carers, and medicines management and formulary committees
