The relation between depressive and obsessive-compulsive symptoms in obsessive-compulsive disorder: Results from a large, naturalistic follow-up study

Objective Despite the frequent occurrence of depressive symptoms in obsessive-compulsive disorder (OCD), little is known about the reciprocal influence between depressive and obsessive-compulsive symptoms during the course of the disease. The aim of the present study is to investigate the longitudinal relationship between obsessive-compulsive and depressive symptoms in OCD patients. Method We used the baseline and 1-year follow-up data of the Netherlands Obsessive Compulsive Disorder Association (NOCDA) study. In 276 patients with a lifetime diagnosis of obsessive-compulsive disorder, depressive and obsessive-compulsive symptoms were assessed at baseline and at one-year follow-up with the Beck Depression Inventory (BDI) and the Yale-Brown Obsessive Compulsive Symptom (Y-BOCS) scale. Relations were investigated using a cross-lagged panel design. Results The association between the severity of depressive symptoms at baseline and obsessive-compulsive symptoms at follow-up was significant (β=0.244, p<0.001), while the association between the severity of obsessive-compulsive symptoms at baseline and depressive symptoms at follow-up was not (β=0.097, p=0.060). Replication of the analyses in subgroups with and without current comorbid major depressive disorder (MDD) and subgroups with different sequence of onset (primary versus secondary MDD) revealed the same results. Limitations There may be other factors, which affect both depressive and obsessive-compulsive symptoms that were not assessed in the present study. Conclusion The present study demonstrates a relation between depressive symptoms and the course of obsessive-compulsive symptoms in OCD patients, irrespective of a current diagnosis of MDD and the sequence of onset of OCD and MDD

Emotional processing and disgust sensitivity in OCD patients with and without contamination-type obsessive-compulsive symptoms - An fMRI study

Objective: Disgust is described as a relevant emotion in OCD, particularly in contamination-type OCD, and may be involved in emotional processing in this OCD-subtype. The present study aimed to investigate the neural correlates of distress processing in contamination-type compared to non-contamination-type OCD, and the relation to disgust sensitivity. Methods: Forty-three OCD patients (n = 19 contamination-type OCD) were exposed to OCD-related, fear-related and neutral pictures. Subjective distress per stimulus was assessed by a visual analogue scale (VAS) and disgust sensitivity by the DS-R. BOLD brain activation was compared between stimuli that provoked high versus low distress at individual level. Results: In contamination- and non-contamination-type OCD, the dorsomedial prefrontal cortex, operculum, visual association cortex and caudate nucleus were activated during high versus low distress. Only in contamination-type OCD, disgust sensitivity correlated positively with the VAS scores and was associated with neural activation in the dorsomedial and visual association cortex, but not with the operculum. Conclusions: Brain activation during distress processing in OCD is similar across the OCD subtypes and related to effortful emotion regulation, processing of aversive internal states and attention. In contamination-type OCD, the distress response is related to disgust sensitivity, which correlates with brain regions associated with attention and emotion regulation

The relation between depressive and obsessive-compulsive symptoms in obsessive-compulsive disorder: Results from a large, naturalistic follow-up study

OBJECTIVE: Despite the frequent occurrence of depressive symptoms in obsessive-compulsive disorder (OCD), little is known about the reciprocal influence between depressive and obsessive-compulsive symptoms during the course of the disease. The aim of the present study is to investigate the longitudinal relationship between obsessive-compulsive and depressive symptoms in OCD patients. METHOD: We used the baseline and 1-year follow-up data of the Netherlands Obsessive Compulsive Disorder Association (NOCDA) study. In 276 patients with a lifetime diagnosis of obsessive-compulsive disorder, depressive and obsessive-compulsive symptoms were assessed at baseline and at one-year follow-up with the Beck Depression Inventory (BDI) and the Yale-Brown Obsessive Compulsive Symptom (Y-BOCS) scale. Relations were investigated using a cross-lagged panel design. RESULTS: The association between the severity of depressive symptoms at baseline and obsessive-compulsive symptoms at follow-up was significant (β=0.244, p<0.001), while the association between the severity of obsessive-compulsive symptoms at baseline and depressive symptoms at follow-up was not (β=0.097, p=0.060). Replication of the analyses in subgroups with and without current comorbid major depressive disorder (MDD) and subgroups with different sequence of onset (primary versus secondary MDD) revealed the same results. LIMITATIONS: There may be other factors, which affect both depressive and obsessive-compulsive symptoms that were not assessed in the present study. CONCLUSION: The present study demonstrates a relation between depressive symptoms and the course of obsessive-compulsive symptoms in OCD patients, irrespective of a current diagnosis of MDD and the sequence of onset of OCD and MDD.publisher: Elsevier articletitle: The relation between depressive and obsessive-compulsive symptoms in obsessive-compulsive disorder: Results from a large, naturalistic follow-up study journaltitle: Journal of Affective Disorders articlelink: http://dx.doi.org/10.1016/j.jad.2016.06.009 content_type: article copyright: © 2016 Elsevier B.V. All rights reserved.status: publishe