Clinical Factors as Predictors of Neuropsychological Dysfunctions in Obsessive Compulsive Disorder
Keywords:
Obsessive compulsive disorder, Clinical Factors, Neuropsychological Dysfunctions, PredictorsAbstract
The aim of the study was to determine the clinical factors such as medication, duration, compliance, severity of illness, co-morbidity, onset, insight, family history, subtypes of OCD predictors of neuropsychological dysfunctions in persons with obsessive compulsive disorder. Material and Methods: An exploratory, single group and cross-sectional design was employed. Participants were selected consecutively from the outpatient department of psychiatry of a tertiary care government hospital from north region of India. Total 32 participants diagnosed as OCD as per WHO ICD-10 DCR criteria, educated minimum 10th class, of any gender, between age of onset 15 years to 55 years with minimum illness duration of 3 months were recruited. Participants those who have co-morbidity of any other psychiatric, neurological and physical/ medical illness, history of long term cognitive retraining were excluded except mental and behavioural disorder due to use of tobacco, and secondary depression due to OCD.
A brief face to face interview was conducted to record the clinical profile of OCD like name of medication, doses of medicine, time, response to treatment, duration of illness,, onset, subtype of OCD, co-morbidity, course, severity of illness (OCD), level of depression, insight and family history of psychiatry illness or other. Further, Yale – Brown Obsessive Compulsive Scale ( Y – BOCS) and Symptom Checklist; Hamilton Rating Scale for Depression ( HAM – D); Medication Compliance Scale; Medication Adherence Rating Scale (MARS); Clinician Rating Scale (CRS). Subtests of Mental speed, Attention, Memory, Executive functions from NIMHANS Neuropsychological Battery for Adults-2004 were administered.
Results: Severity of depression and onset of illness were significant predictors of mental speed. Insight was significant predictor of sustained, focused attention and set shifting. Co-morbidity was also significant predictor for set shifting. Medicine type was significant predictor for verbal fluency. Severity of illness, family history and response of treatment were significant predictor of working memory.
Conclusions: Clinical Factors plays an important role in the development or maintenance of the neuropsychological dysfunctions in OCD, therefore management of OCD requires understanding for the clinical factors contributing to Neuropsychological dysfunctions, so that these can be prevented or managed simultaneously with cognitive retraining.
References
Abbruzzese, M., Ferri, S., & Scarone, S. (1995). Wisconsin Card Sorting Test performance in obsessive-compulsive disorder: no evidence for involvement of dorsolateral prefrontal cortex. Psychiatry Research, 58(1), 37-43.
American Psychiatric Association, 2013. Diagnostic and statistical manual of mental disorders, American Psychiatric Publishing: Washington, DC. 991 pp., ISBN. Medicine, Health Care and Philosophy, 17, 241-244.
Catapano, F., Sperandeo, R., Perris, F., Lanzaro, M., & Maj, M. (2001). Insight and resistance in patients with obsessive-compulsive disorder. Psychopathology, 34(2), 62-68.
Christensen, K. J., Kim, S. W., Dysken, M. W., & Hoover, K. M. (1992). Neuropyschological performance in obsessive-compulsive disorder. Biological psychiatry, 31(1), 4-18.
Eilam, D., & Szechtman, H. (2005). Psychostimulant-induced behavior as an animal model of obsessive-compulsive disorder: an ethological approach to the form of compulsive rituals. CNS Spectr, 10(3), 191-202.
Foa, E. B., Amir, N., Gershuny, B., Molnar, C., & Kozak, M. J. (1997). Implicit and explicit memory in obsessive-compulsive disorder. Journal of Anxiety Disorders, 11(2), 119-129.
Gambini, O., Abbruzzese, M., & Scarone, S. (1993). Smooth pursuit and saccadic eye movements and Wisconsin Card Sorting Test performance in obsessive-compulsive disorder. Psychiatry Research, 48(3), 191-200.
Hashimoto, N., Nakaaki, S., Omori, I. M., Fujioi, J., Noguchi, Y., Murata, Y., ... & Furukawa, T. A. (2011). Distinct neuropsychological profiles of three major symptom dimensions in obsessive–compulsive disorder. Psychiatry Research, 187(1-2), 166-173.
Irle, E., Exner, C., Thielen, K., Weniger, G., & Rüther, E. (1998). Obsessive-compulsive disorder and ventromedial frontal lesions: clinical and neuropsychological findings. American Journal of Psychiatry, 155(2), 255-263.
Jenike, M. A., Baer, L., & Minichiello, W. E. (1990). Obsessive-compulsive disorders:Theory and management. Chicago, IL: Year Book Medical Publishers.
Lawrence, N. S., Wooderson, S., Mataix-Cols, D., David, R., Speckens, A., & Phillips, M. L. (2006). Decision making and set shifting impairments are associated with distinct symptom dimensions in obsessive-compulsive disorder. Neuropsychology, 20(4), 409.
Lezak, M. D., Howieson, D. B., Loring, D. W., & Fischer, J. S. (2004). Neuropsychological assessment. Oxford University Press, USA.
Nakao, T., Okada, K., & Kanba, S. (2014). Neurobiological model of obsessive–compulsive disorder: Evidence from recent neuropsychological and neuroimaging findings. Psychiatry and clinical neurosciences, 68(8), 587-605.
Nelson, E., Early, T. S., & Haller, J. W. (1993). Visual attention in obsessive-compulsive disorder. Psychiatry Research, 49(2), 183-196.
Overbeek, T., Schruers, K., Vermetten, E., & Griez, E. (2002). Comorbidity of obsessive-compulsive disorder and depression: prevalence, symptom severity, and treatment effect. Journal of Clinical Psychiatry, 63(12), 1106-1112.
Purcell, R., Maruff, P., Kyrios, M., & Pantelis, C. (1998). Neuropsychological deficits in obsessive-compulsive disorder: a comparison with unipolar depression, panic disorder, and normal controls. Archives of General Psychiatry, 55(5), 415-423.
Radua, J., van den Heuvel, O. A., Surguladze, S., & Mataix-Cols, D. (2010). Meta-analytical comparison of voxel-based morphometry studies in obsessive-compulsive disorder vs other anxiety disorders. Archives of general psychiatry, 67(7), 701-711.
Rasmussen, S. (1998). Clinical and epidemiologic findings of significance to neuropharmacologic trials in OCD. Psychopharmacol. Bull., 24, 466-470
Sadock, B. J. (2015). Kaplan & Sadock's synopsis of psychiatry: behavioral sciences/clinical psychiatry (Vol. 2015, pp. 648-655). Philadelphia, PA: Wolters Kluwer.
Schmidtke, K., Schorb, A., Winkelmann, G., & Hohagen, F. (1998). Cognitive frontal lobe dysfunction in obsessive-compulsive disorder. Biological psychiatry, 43(9), 666-673.
Shin, N. Y., Lee, T. Y., Kim, E., & Kwon, J. S. (2014). Cognitive functioning in obsessive-compulsive disorder: a meta-analysis. Psychological medicine, 44(6), 1121-1130.
Veale, D. M., Sahakian, B. J., Owen, A. M., & Marks, I. M. (1996). Specific cognitive deficits in tests sensitive to frontal lobe dysfunction in obsessive–compulsive disorder. Psychological medicine, 26(6), 1261-1269.
Woods, C. M., Vevea, J. L., Chambless, D. L., & Bayen, U. J. (2002). Are compulsive checkers impaired in memory? A meta-analytic review. Clinical Psychology: Science and Practice, 9(4), 353.
World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. World Health Organization.
Zhang, C. C., Gong, H., Zhang, Y., Jin, H., Yang, Y., Li, B., ... & Storch, E. A. (2019). Development and psychometric evaluation of the Mandarin Chinese version of the yale-brown obsessive-compulsive scale–second edition. Brazilian Journal of Psychiatry, 41, 494-498.
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Indian Journal of Clinical Psychology
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
