Treatment-Resistant Obsessive-Compulsive Disorder: Clinical and Personality Correlates

The objective of the present study was to establish a clinical/personality profile of Turkish patients with treatment-resistant obsessive-compulsive disorder (TR-OCD). Methods. A neurocognitive/clinical test battery was administered to 17 patients with TR-OCD. Results. TR-OCD patients presented with major psychiatric syndromes (especially mood and generalized anxiety disorders) and personality disorders (particularly paranoid, avoidant, obsessive-compulsive, histrionic), and obtained higher scores on measures of core OCD symptoms (i.e., obsessional ideation, compulsive cleaning/washing, mental neutralizing), depressive symptoms, schizotypal personality features, and impulsiveness relative to normative controls. TR-OCD patients did not differ significantly from normative controls on checking, doubting, ordering, and hoarding subscales, and on measures of venturesomeness and empathy. Conclusions. Lack of insight, suspiciousness, and rigidity associated with schizotypal, paranoid, and obsessive-compulsive personality features may have contributed to treatment failure. (c) 2014 Published by Elsevier Ltd

Effects of two different eight-week walking programs on insulin resistance and ER stress-related markers in pre-menopausal women

WOS: 000387205800003Objective: The relationship between exercise and endoplasmic reticulum (ER) stress, insulin resistance, and obesity is a new field of research. To our knowledge, there are no studies examining the effects of walking exercises on ER stress related markers and insulin resistance in pre-menopausal women. To examine the effect of two different eight-week walking programs on the tumor necrosis factor-alpha (TNF-alpha), Fetuin-A (alpha 2 - Heremans Schmid glycoprotein), c-Jun N-terminal kinase-1 (JNK-1) and retinol-binding protein-4 (RBP-4), the related markers of ER stress and insulin resistance in pre-menopausal women. Methods: Exercise groups (moderate tempo walking group; MTWG; n=11; brisk walking group BWG; n= 12) walked five days a week, starting from 30 minutes, gradually increasing up to 51 minutes. BWG walked at similar to 70-75% and MTWG at similar to 50-55 of HRRmax. Body mass index (BMI), body fat percentage (%), VO2max, serum TNF-alpha, Fetuin-A, JNK-1, RPB-4, blood lipids, and insulin resistance levels were determined before and after the intervention. Results: VO2max increased in both exercise groups favoring BWG; RBP-4 decreased in both exercise groups (p<0.05). Serum TNF-alpha and, TG (p<0.05), BMI and percent body fat (p<0.01), and insulin levels reduced significantly in BWG (p<0.05). The reductions observed in both exercise groups in insulin resistance, and the increases determined in the negative levels of JNK-1 in BWG may be clinically important. Conclusion: Both type of walking resulted in similar positive effects on RBP-4. The reduction observed in TNF-alpha, RBP-4, and the increases in the negative levels of JNK-1 in BWG show the positive effects of brisk walking on ER stress. The reduction in insulin resistance in relation to the possible reductions in ER stress and apoptosis in BWG may be more effective to prevent metabolic diseases.Celal Bayar University Academic Research FoundationThis study was funded by Celal Bayar University Academic Research Foundation

Treatment-Resistant Obsessive-Compulsive Disorder: Neurocognitive and Clinical Correlates

There are a number of studies examining clinical and comorbidity profiles among patients with treatment-resistant obsessivecompulsive disorder (TR-OCD); however, there have been far fewer investigations of neurocognitive function among such patients. Five patients with treatment-refractory obsessive-compulsive symptoms underwent neurocognitive and clinical/ personality testing. A number of TR-OCD patients met diagnostic criteria for major axis I disorders (particularly mood and anxiety disorders) as well as clusters A, B, and C personality disorders. TR-OCD patients demonstrated significant performance deficits on neurocognitive tests of visuospatial working memory, visuoconstructive ability, and executive control as well as one test of processing speed, but not a second, relative to healthy normative controls. TR-OCD patients and normative controls did not differ significantly on measures of verbal working memory, sequencing, figure copy organization, inhibitory control, and odor identification. In addition, TR-OCD patients were directly compared to five healthy controls evaluated in our laboratory for a separate unpublished study. TR-OCD patients demonstrated significant performance deficits on tests of visuospatial working memory, information processing speed, and executive control, and obtained substantially higher scores on dimensional measures of social anxiety and depressive symptom severity, but not schizotypal personality features. Group differences of tests of verbal working memory, inhibitory control, and additional tests of executive function were not significant. In summary, patients with TR-OCD presented with comorbid axis I conditions (primarily mood and anxiety disorders) and personality disorders. TR-OCD patients demonstrated deficits on some, but not all, tests of working memory and executive control. Neurocognitive test findings lend partial support to the hypothesis that right hemisphere (particularly dorsolateralprefrontal, but not orbitofrontal) dysfunction is associated with TR-OCD, and a number of TR-OCD patients met diagnostic criteria for major axis I disorders (particularly mood and anxiety disorders) as well as cluster A, B, and C personality disorders further complicating treatment. (C) 2016 Published by Elsevier Ltd