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

AbstractThe 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

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

AbstractThere are a number of studies examining clinical and comorbidity profiles among patients with treatment-resistant obsessive-compulsive 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In addition, TR-OCD patients were directly compared to five healthy controls evaluated in our laboratory for a separate unpublished study.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 dorsolateral-prefrontal, 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

Clomipramine trial for treatment-resistant persistent genital arousal disorder: a case series

Introduction: Treatment of persistent genital arousal disorder (PGAD), as a chronic and disabling condition, implicates substantial compelling complexities. Methods: In this case series, seven women diagnosed with PGAD who were referred to the Sexual Dysfunction Unit of Psychotherapy Outpatient Clinic of Bakirkoy Research and Training Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey between 2006 and 2009 were included. All patients were previously resistant to other antidepressants, antipsychotics and antiepileptics. The additional details of PGAD onset, frequency, type and duration of arousal, previous pharmacological interventions, and maximum and maintenance doses of clomipramine were recorded. Results: All patients achieved a substantial symptomatic improvement with clomipramine within the follow-up period of 2–9 years. Discussion: Based on our study results, we recommend clomipramine in combination with psychotherapy as the treatment of choice in PGAD and to be used before any invasive procedure such as electroconvulsive therapy (ECT) or surgery

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

Correlation of selective serotonin re-uptake inhibitor use with weight gain and metabolic parameters

WOS: 000325901500009Objective: Psychotropic drugs during the treatment period of psychiatric disorders can cause changes in metabolic parameters such as weight, lipid profile, fasting glucose level, and resting metabolic rate. The aim of this study is to investigate the correlation of selective serotonin re-uptake inhibitor (SSRI) use with weight gain and metabolic parameters. Methods: In this study, the resting metabolic rates (RMR) of 14 male patients intended to use selective serotonin re uptake inhibitor at least three months, were measured baseline, first and third month after SSRI use. Body weight, percentage body fat, body mass index and waist/hip ratio were measured before treatment, at the end of the first and second weeks and the first, second and third months. Laboratory tests including total cholesterol, LDL, HDL, VLDL, triglycerides and fasting blood glucose were performed before treatment and at the end of the third month. The correlation of body weight changes with RMR changes was also analyzed. Results: RMR did not differ in the beginning, first month and third month. No statistically significant difference was found in RMR between the beginning and the third month. RMR significantly decreased in the increased-dose group while it wasn't changed in the constant-dose group. No correlation was found between RMR changes and body weight changes. The mean body weight decreased significantly between the beginning and the first week and the first month. Even though the mean body weight of all patients was higher in the third month than the beginning, no statistically significant difference was found. The total cholesterol levels, body lipid ratio, and waist/hip ratio increased significantly between initiation of treatment and the third month. Conclusion: As a result, we suggest that SSRI's use did not cause body weight increase due to reduction in RMR. The waist/hip ratio, total cholesterol levels were increased in the third month. Further studies which look more closely to fat metabolism in patients under SSRI's treatment are necessary

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

The relationship between adulthood traumatic experiences and psychotic symptoms in female patients with schizophrenia

Background: Previously, research aiming to investigate the effects of interpersonal traumatic experiences on psychotic symptoms mainly focused on adverse experiences in childhood. As mentioned above, patients with schizophrenia, particularly women, are at high risk for physical and sexual abuse in adulthood. In this study we aimed to investigate the effects of adulthood trauma in a sample of patients with schizophrenia who did not report childhood trauma

Case Reports of a Mother and Daughter Diagnosed With Persistent Genital Arousal Disorder

WOS: 000401768400001PubMed: 2759902