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Obsessive-Compulsive Disorder: Update on Research and Clinical Management
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Obsessive-Compulsive Disorder: Update on Research and Clinical Management

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (30 April 2023) | Viewed by 35284

Special Issue Editor

Dr. Valentina Ciullo

E-Mail Website
Guest Editor
Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, Santa Lucia Foundation of Rome, Rome, Italy
Interests: obsessive-compulsive disorder; adolescent and adult psychopathology; neurobiological, neuropsychological and neuroradiological markers; cognitive neuroscience; cognitive-behavioral therapy

Special Issue Information

Dear Colleagues,

The area of neuroscientific and clinical research on Obsessive-Compulsive Disorder (OCD) is on the move. OCD is a clinical heterogenous disorder characterized by multiple and temporally stable symptom dimensions. In the majority of cases, OCD has an early onset leading to severe impairments in functioning, individual suffering and high economical costs, and is often associated with a chronic course. Growing evidence suggests that the symptom dimensions of OCD have unique patterns of heritability and neurobiological correlates with possibly a differential course of illness and treatment response. With the intent to provide insights on the pathogenetic process leading to the full manifestation of OCD symptoms, different theoretical models have been proposed. In parallel, systematic research advocate that dysfunctions of the cortico–striato–thalamo–cortical circuitry (CSTC) are linked to deficits in cognitive inhibition and core clinical symptoms of the disorder. However, the large heterogeneity in methodology and clinical characteristics challenge conclusive remarks and evidence-based neurobiological markers for OCD remain to be defined. Despite the valuable advances in emerging neuropharmacology, more than 40% of patients do not respond to conventional treatment approaches. Moreover, cognitive impairments remain substantially unaffected by drug-based therapy, making the search for alternative therapy strategies a compelling priority in clinical practice. The present Special Issue aims to deep multidimensional predictors and correlates of OCD with the ultimate goal of developing effective treatments tailored to specific symptom dimensions. As a step towards this ambicious aim, compelling state-of-the-art techniques to investigate factors that causally contribute to the occurrence of OCD, as well as to the disorder clinical course, and best treatment strategies will be presented.  

Dr. Valentina Ciullo
Guest Editor

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Keywords

  • Obsessive-Compulsive Disorder
  • Predictors
  • MRI
  • Obsessive dimensions
  • Treatment strategies
  • Neuropsychological correlates
  • Neurobiological markers
  • Clinical practice

Published Papers (12 papers)

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Research

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17 pages, 2314 KiB  
Article
Olfactory Obsessions: A Study of Prevalence and Phenomenology in the Course of Obsessive-Compulsive Disorder
by Maciej Żerdziński, Marcin Burdzik, Roksana Żmuda, Paweł Dębski, Agnieszka Witkowska-Berek, Anita Pląder, Patrycja Mozdrzanowska, Marta Stawowy, Joanna Sztuk, Karolina Poremba, Magdalena Piegza and Piotr Gorczyca
J. Clin. Med. 2023, 12(9), 3081; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12093081 - 24 Apr 2023
Cited by 1 | Viewed by 1561
Abstract
Olfactory obsessions (OOs) are rarely described in the medical literature. The features of OOs appear consistent with characteristics of a typical obsession, but since they do not involve the realm of thought, it is questionable to term them obsessions per se. Olfactory Reference [...] Read more.
Olfactory obsessions (OOs) are rarely described in the medical literature. The features of OOs appear consistent with characteristics of a typical obsession, but since they do not involve the realm of thought, it is questionable to term them obsessions per se. Olfactory Reference Syndrome (ORS) presents OOs inconsistently and is a distinctive diagnostic category related to OCD. Therefore, the primary objectives of our study were not only to assess the prevalence of OOs in OCD patients, but also to demonstrate their phenomenological consistency with other OCD symptoms. The study group consisted of 75 patients already diagnosed and treated for OCD. Hence, a comparison was made between OCD patients with and without OOs in terms of: symptom severity, level of insight and comorbidities. Olfactory obsessions (OOs) were found in 21.33% (n = 16). OOs induced compulsive behavior in more than 93% of subjects. The presence of OOs did not significantly differentiate the studied groups in terms of OCD severity (p = 0.876), level of insight (p = 0.680), depression (p = 0.746), mania (p = 0.525) and OCDP traits (p = 0.624). However, a comparison of the two groups showed that OOs patients presented higher levels of hostility (p = 0.036), cognitive impulsivity (p = 0.039), magic-type obsession (75% vs. 35.59%), and contamination obsession (87.50% vs. 67.80%). Conclusions: OOs frequently occur in the course of OCD, and their phenomenology is typical of this disorder. OOs are not a symptom of thought content disorders and are sensory in nature, which is not included in the definition of obsession. The presence of OOs in OCD provokes hostility and cognitive impulsivity. It can be assumed that the Olfactory Obsessions Questionnaire accurately identifies olfactory obsessions. Full article
(This article belongs to the Special Issue Obsessive-Compulsive Disorder: Update on Research and Clinical Management)
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19 pages, 2936 KiB  
Article
App-Based Mindfulness Meditation Training and an Audiobook Intervention Reduce Symptom Severity but Do Not Modify Backward Inhibition in Adolescent Obsessive-Compulsive Disorder: Evidence from an EEG Study
by Sarah Rempel, Lea L. Backhausen, Maria McDonald, Veit Roessner, Nora C. Vetter, Christian Beste and Nicole Wolff
J. Clin. Med. 2023, 12(7), 2486; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12072486 - 24 Mar 2023
Cited by 1 | Viewed by 1682
Abstract
(1) Background: 1–2% of children and adolescents are affected by Obsessive-Compulsive Disorder (OCD). The rigid, repetitive features of OCD and an assumed disability to inhibit recent mental representations are assumed to have led to a paradoxical advantage in that the Backward Inhibition (BI) [...] Read more.
(1) Background: 1–2% of children and adolescents are affected by Obsessive-Compulsive Disorder (OCD). The rigid, repetitive features of OCD and an assumed disability to inhibit recent mental representations are assumed to have led to a paradoxical advantage in that the Backward Inhibition (BI) effect was recently found to be lower in adolescents with OCD as compared to healthy controls. It was hypothesized that app-based mindfulness meditation training could reduce the disability to inhibit recent mental representations and thus increase the BI-effect by adapting cognitive flexibility and inhibition abilities according to healthy controls. (2) Methods: 58 adolescents (10–19 years) with OCD were included in the final sample of this interviewer-blind, randomized controlled study. Participants were allocated to an intervention group (app-based mindfulness meditation training) or an (active) control group (app-based audiobook) for eight weeks. Symptom (CY-BOCS), behavioral (reaction times and mean accuracy), and neurophysiological changes (in EEG) of the BI-effect were analyzed in a pre-post design. (3) Results: The intervention and the control group showed an intervention effect (Reliable Change Index: 67%) with a significant symptom reduction. Contrary to the hypothesis, the BI-effect did not differ between pre vs. post app-based mindfulness meditation training. In addition, as expected the audiobook application showed no effects. Thus, we observed no intervention-specific differences with respect to behavioral (reaction times and mean accuracy) or with respect to neurophysiological (perceptual [P1], attentional [N1], conflict monitoring [N2] or updating and response selection [P3]) processes. However, in an exploratory approach, we revealed that the BI-effect decreased in participants who did not benefit from using an app, regardless of group. (4) Conclusions: Both listening to an app-based mindfulness meditation training and to an audiobook reduce symptom severity in adolescent OCD as measured by the CY-BOCS; however, they have no specific effect on BI. The extent of the baseline BI-effect might be considered as an intra-individual component to predict the benefit of both mindfulness meditation training and listening to an audiobook. Full article
(This article belongs to the Special Issue Obsessive-Compulsive Disorder: Update on Research and Clinical Management)
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15 pages, 438 KiB  
Article
Impulsivity and Attention in Obsessive Compulsive and Tic Disorders: Mismatch in Self-Report and Behavioural Data
by Leonard Guenter Koenn, Sina Kohl, Sophia Schleyken and Jens Kuhn
J. Clin. Med. 2023, 12(6), 2277; https://doi.org/10.3390/jcm12062277 - 15 Mar 2023
Viewed by 1503
Abstract
Impulsivity is a multidimensional, cross-diagnostic behavioural construct that has been described in various psychiatric disorders including obsessive-compulsive disorder (OCD) and Tourette syndrome (TS). Different interpretations of results in the past have raised the question of heightened impulsivity as an explanatory model for self-described [...] Read more.
Impulsivity is a multidimensional, cross-diagnostic behavioural construct that has been described in various psychiatric disorders including obsessive-compulsive disorder (OCD) and Tourette syndrome (TS). Different interpretations of results in the past have raised the question of heightened impulsivity as an explanatory model for self-described impulsive behaviour, especially in OCD. Our study included 16 patients with OCD, 14 patients with TS, and 28 healthy control subjects (HC). Self-assessed impulsivity was examined by the Barratt Impulsiveness Scale-11 (BIS-11), and the behavioural test used was the immediate and delayed memory task (IMT/DMT). Significantly heightened self-assessed impulsivity of the patient collective compared to HC could be observed in in only one dimension: lack of attention (χ2 (2) = 24.910, p < 0.001). Post-hoc tests were performed using Bonferroni adjusted alpha levels of 0.0167 per test (0.05/3) and revealed significantly higher scores in patients with OCD (M = 19.57, SD = 2.82), z = 4.292, p < 0.001 as with TS (M = 19.38, SD = 3.62), z = 3.832, p < 0.001 compared to HC (M = 13.78, SD = 3.18). In patients with OCD, correlations between the dimension of obsessive thoughts with a lack of attention in the form of first-order factor cognitive instability could be shown (n = 14, p = 0.024, rs = 0.599) while in patients with TS, tic symptomatology correlated significantly with second-order factor attentional impulsivity (n = 12, p = 0.027, rs = 0.635). In behavioural testing, no significant group differences could be observed either in impulsive behaviour (IMT: χ2 (2) = 4.709, p = 0.824; DMT: χ2 (2) = 0.126, p = 0.939) or in sustained attention (IMT: χ2 (2) = 0.388, p = 0.095; DMT: χ2 (2) = 0.663, p = 0.718). Heightened impulsivity as an explanatory model for the observed lack of attention, especially in patients with OCD, should be questioned and interpretation biases considered in the future. The necessity of a multidimensional approach to the research of impulsivity is underscored by our results. Full article
(This article belongs to the Special Issue Obsessive-Compulsive Disorder: Update on Research and Clinical Management)
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15 pages, 887 KiB  
Article
Dysfunctional Beliefs and Cognitive Performance across Symptom Dimensions in Childhood and Adolescent OCD
by Federica Piras, Nerisa Banaj, Valentina Ciullo, Fabrizio Piras, Giuseppe Ducci, Francesco Demaria, Stefano Vicari and Gianfranco Spalletta
J. Clin. Med. 2023, 12(1), 219; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12010219 - 28 Dec 2022
Viewed by 2468
Abstract
Although etiological and maintenance cognitive factors have proved effective in predicting the disease course in youths with OCD, their contribution to symptom severity and specific OCD dimensions has been scarcely examined. In a cohort of children and adolescents with OCD (N = 41; [...] Read more.
Although etiological and maintenance cognitive factors have proved effective in predicting the disease course in youths with OCD, their contribution to symptom severity and specific OCD dimensions has been scarcely examined. In a cohort of children and adolescents with OCD (N = 41; mean age = 14; age range = 10–18 yrs.), we investigated whether certain dysfunctional beliefs and cognitive traits could predict symptom severity, and whether they were differentially associated with specific symptom dimensions. We found that self-oriented and socially prescribed perfectionism and intolerance to uncertainty were associated with higher obsession severity, which was not uniquely related to any neuropsychological variable. Greater severity of obsessions and compulsions about harm due to aggression/injury/violence/natural disasters was predicted by excessive concerns with the expectations of other people. Severity in this dimension was additionally predicted by decreasing accuracy in performing a problem-solving, non-verbal reasoning task, which was also a significant predictor of severity of obsessions about symmetry and compulsions to count or order/arrange. Apart from corroborating both the belief-based and neuropsychological models of OCD, our findings substantiate for the first time the specificity of certain dysfunctional beliefs and cognitive traits in two definite symptom dimensions in youth. This bears important clinical implications for developing treatment strategies to deal with unique dysfunctional core beliefs, and possibly for preventing illness chronicity. Full article
(This article belongs to the Special Issue Obsessive-Compulsive Disorder: Update on Research and Clinical Management)
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6 pages, 230 KiB  
Communication
Obsessive Compulsive “Paper Handling”: A Potential Distinctive Behavior in Children and Adolescents with KBG Syndrome
by Francesco Demaria, Paolo Alfieri, Maria Cristina Digilio, Maria Pontillo, Cristina Di Vincenzo, Federica Alice Maria Montanaro, Valentina Ciullo, Giuseppe Zampino and Stefano Vicari
J. Clin. Med. 2022, 11(16), 4687; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11164687 - 11 Aug 2022
Viewed by 1385
Abstract
KBG syndrome (KBGS; OMIM #148050) is a rare disease characterized by short stature, facial dysmorphism, macrodontia of the upper central incisors, skeletal anomalies, and neurodevelopmental disorder/intellectual disability. It is caused by a heterozygous variant or 16q24.3 microdeletions of the ANKRD11 gene (OMIM #611192), [...] Read more.
KBG syndrome (KBGS; OMIM #148050) is a rare disease characterized by short stature, facial dysmorphism, macrodontia of the upper central incisors, skeletal anomalies, and neurodevelopmental disorder/intellectual disability. It is caused by a heterozygous variant or 16q24.3 microdeletions of the ANKRD11 gene (OMIM #611192), which plays a primary role in neuronal development. KBGS traits are variable, and mild expressions of the phenotype may complicate diagnosis. The present work aims at improving the characterization of KBGS in order to facilitate its recognition. A psychopathological evaluation of 17 subjects affected by KBGS found that 10 patients exhibited peculiar behavior related to “paper handling”. These children and adolescents performed repetitive activities with paper, reminiscent of the hoarding and ordering behaviors characteristic of obsessive compulsive disorder. Their activities were time consuming and carried out in solitary, and forced interruption could generate intense emotional reactions. Paper handling may thus be understood as a potential distinct KBGS symptom akin to an obsessive compulsive symptom. Further research is needed to verify this claim. Full article
(This article belongs to the Special Issue Obsessive-Compulsive Disorder: Update on Research and Clinical Management)
12 pages, 669 KiB  
Article
Guilt Feelings in Obsessive Compulsive Disorder: An Investigation between Diagnostic Groups
by Alessandra Mancini, Umberto Granziol, Andrea Gragnani, Giuseppe Femia, Daniele Migliorati, Teresa Cosentino, Olga Ines Luppino, Claudia Perdighe, Angelo Maria Saliani, Katia Tenore and Francesco Mancini
J. Clin. Med. 2022, 11(16), 4673; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11164673 - 10 Aug 2022
Viewed by 2338
Abstract
Guilt plays a role in various forms of psychopathology. However, different types of guilt might be involved in different mental disorders. Obsessive-compulsive (OC) patients are prone to a type of guilt in which the violation of an internalized moral norm is necessary and [...] Read more.
Guilt plays a role in various forms of psychopathology. However, different types of guilt might be involved in different mental disorders. Obsessive-compulsive (OC) patients are prone to a type of guilt in which the violation of an internalized moral norm is necessary and sufficient, whereas data suggest that depression might be linked to more interpersonal types of guilt. However, the extent to which a specific guilt phenomenology is involved in each condition is yet to be determined. Here we assessed the association between different types of guilt and different diagnostic groups. Two clinical samples (33 OCD and 35 non-OCD) filled in the Moral Orientation Guilt Scale (MOGS) along with other OCD and depression measures. Regression was employed to test group differences in the MOGS subscales and to test the influence of MOGS subscales on OCD and depression levels. Results confirm that different types of guilt might be implicated in different psychopathological conditions. Specifically, moral norm violation guilt is more present in OC patients than in other disorders. Depression seems to be associated with different guilt feelings depending on the psychopathological condition, specifically in non-OC patients, with types of guilt involving a “victim”, supporting the accounts viewing interpersonal guilt as involved in the emergence of depressive symptomatology and hyper-altruistic behavior as a vulnerability factor for depression. Full article
(This article belongs to the Special Issue Obsessive-Compulsive Disorder: Update on Research and Clinical Management)
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16 pages, 947 KiB  
Article
Anti-Disgust Cognitive Behavioral Therapy for Contamination-Based Obsessive Compulsive Disorder: A Randomized Controlled Clinical Trial
by Behzad Salmani, Francesco Mancini, Jafar Hasani and Zahra Zanjani
J. Clin. Med. 2022, 11(10), 2875; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11102875 - 19 May 2022
Cited by 5 | Viewed by 4265
Abstract
Background: Disgust is a strong and persistent emotion that frequently occurs during exposure-based treatments for contamination-based obsessive compulsive disorder (C-OCD). This study aimed to examine the efficacy of augmenting cognitive behavioral therapy (CBT) with a novel type of anti-disgust cognitive intervention in reducing [...] Read more.
Background: Disgust is a strong and persistent emotion that frequently occurs during exposure-based treatments for contamination-based obsessive compulsive disorder (C-OCD). This study aimed to examine the efficacy of augmenting cognitive behavioral therapy (CBT) with a novel type of anti-disgust cognitive intervention in reducing the severity of OCD, disgust propensity/sensitivity, and refusal rate of exposure and response prevention, while simultaneously increasing acceptance of disgust. Materials and Methods: Fifty-five individuals with C-OCD (mean age 28.1 years, SD = 3.52; 77% female) were randomly assigned to 15 weekly sessions of anti-disgust plus CBT (AD-CBT) or CBT alone. They were evaluated for outcomes four times (pretreatment, prior to exposure and response prevention (ERP) sessions, posttreatment, and three-month follow-up), and mixed-design ANOVAs were used to analyze the data. Results: The findings indicated that when compared to CBT alone, AD-CBT significantly reduced OCD severity, disgust propensity/sensitivity, and concurrently increased disgust acceptance (p < 0.001). Additionally, engaging in an anti-disgust cognitive intervention was associated with lower ERP refusal rate (4% vs. 16%). The superiority of AD-CBT over CBT persisted through the three-month follow-up period. Conclusions: The current study suggests that supplementing CBT for C-OCD with an anti-disgust cognitive intervention significantly increased acceptance of disgust and decreased the refusal rate of ERP, OCD severity, and disgust-related factors. Full article
(This article belongs to the Special Issue Obsessive-Compulsive Disorder: Update on Research and Clinical Management)
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19 pages, 617 KiB  
Article
Cognitive–Behavioral Treatment of Obsessive–Compulsive Disorder: The Results of a Naturalistic Outcomes Study
by Andrea Gragnani, Vittoria Zaccari, Giuseppe Femia, Valerio Pellegrini, Katia Tenore, Stefania Fadda, Olga Ines Luppino, Barbara Basile, Teresa Cosentino, Claudia Perdighe, Giuseppe Romano, Angelo Maria Saliani and Francesco Mancini
J. Clin. Med. 2022, 11(10), 2762; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11102762 - 13 May 2022
Cited by 1 | Viewed by 4928
Abstract
Cognitive–behavioral therapy is a well-established treatment for obsessive–compulsive disorder (OCD). There are a variety of cognitive and behavioral strategies, and it is necessary to analyze the outcomes of the treatments. The aim of the present study is to verify the effectiveness of a [...] Read more.
Cognitive–behavioral therapy is a well-established treatment for obsessive–compulsive disorder (OCD). There are a variety of cognitive and behavioral strategies, and it is necessary to analyze the outcomes of the treatments. The aim of the present study is to verify the effectiveness of a treatment that combines evidence-based procedures and specific cognitive interventions highlighting the issue of acceptance. Forty patients with OCD were recruited and underwent a specific treatment procedure. All patients had a psychodiagnostic assessment for OCD using the Y–BOCS (Yale–Brown obsessive–compulsive scale) performed twice: before treatment (t0) and after nine months (t1). Data analysis showed a decrease in the scores between t0 and t1 according to the Y–BOCS in terms of the interference, severity, and impairment of obsessive–compulsive symptoms. A repeated-measures ANOVA showed a significant reduction in symptoms after treatment, with values of F (1, 39) = 137.56, p < 0.001, and η2 = 0.78. The ANOVA results were corroborated by a Wilcoxon signed-rank test. A reliable change index analysis indicated that 33 participants reported improvements in symptoms, of which 23 were clinically significant. The results showed clinical relevance for OCD treatment and highlighted how this cognitive procedure favored positive outcomes. Full article
(This article belongs to the Special Issue Obsessive-Compulsive Disorder: Update on Research and Clinical Management)
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Review

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13 pages, 455 KiB  
Review
Orthorexia Nervosa, Eating Disorders, and Obsessive-Compulsive Disorder: A Selective Review of the Last Seven Years
by Maria Pontillo, Valeria Zanna, Francesco Demaria, Roberto Averna, Cristina Di Vincenzo, Margherita De Biase, Michelangelo Di Luzio, Benedetta Foti, Maria Cristina Tata and Stefano Vicari
J. Clin. Med. 2022, 11(20), 6134; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11206134 - 18 Oct 2022
Cited by 12 | Viewed by 3747
Abstract
Orthorexia nervosa (ON) is defined as an exaggerated, obsessive, pathological fixation on healthy food, healthy eating, or health-conscious eating behaviors. In the literature, there is an ongoing debate over whether ON should be considered simply a lifestyle phenomenon or a psychiatric disorder. In [...] Read more.
Orthorexia nervosa (ON) is defined as an exaggerated, obsessive, pathological fixation on healthy food, healthy eating, or health-conscious eating behaviors. In the literature, there is an ongoing debate over whether ON should be considered simply a lifestyle phenomenon or a psychiatric disorder. In this vein, ON seems to share psychopathological characteristics with both eating disorders (EDs) and obsessive-compulsive disorder (OCD). However, there are insufficient data to reconcile the debate. The present study aimed at consolidating evidence on the clinical significance of ON and its relationship with EDs and OCD. A selective review of the literature published between January 2015 and March 2022 was conducted, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Ten studies were included. Some of these studies suggested that ON might follow a full-syndrome DSM-5 ED. Other studies proposed that ON and DSM-5 EDs may co-occur. Finally, only two studies suggested a relationship between ON and OCD. To date, the clinical significance of ON and its relationship with EDs and other DSM-5 psychiatric disorders (e.g., OCD) appears complicated and unclear. Future longitudinal research on the possible clinical course of ON is needed. Full article
(This article belongs to the Special Issue Obsessive-Compulsive Disorder: Update on Research and Clinical Management)
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12 pages, 607 KiB  
Review
Hand Washing: When Ritual Behavior Protects! Obsessive–Compulsive Symptoms in Young People during the COVID-19 Pandemic: A Narrative Review
by Francesco Demaria, Maria Pontillo, Cristina Di Vincenzo, Michelangelo Di Luzio and Stefano Vicari
J. Clin. Med. 2022, 11(11), 3191; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11113191 - 02 Jun 2022
Cited by 7 | Viewed by 2710
Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic had a profound impact on the lifestyles and mental health of young people. It has been hypothesized that the focus on hygiene and the fear of contamination/infection during the pandemic may have exacerbated obsessive–compulsive (OC) symptoms in [...] Read more.
The Coronavirus Disease 2019 (COVID-19) pandemic had a profound impact on the lifestyles and mental health of young people. It has been hypothesized that the focus on hygiene and the fear of contamination/infection during the pandemic may have exacerbated obsessive–compulsive (OC) symptoms in this population. OC symptoms are widespread in the general population, with varying degrees of intensity. At their most extreme, they manifest in obsessive–compulsive disorder (OCD), which is characterized by obsessive thoughts and compulsive behaviors. The present narrative review aimed at evaluating the relationship between the COVID-19 pandemic and OCD and OC symptoms in young people, especially children and adolescents with and without OCD, focusing on vulnerability and risk factors and the impact of lockdown measures. Of the six studies identified, four examined clinical samples diagnosed with OCD and two looked at community-based adolescent samples. Five of the six studies found that OC symptoms increased during the pandemic. Additionally, vulnerability to anxiety may constitute a risk condition and the lockdown measures and personal stressful life events can constitute potential triggers of OC symptoms, while ongoing treatment for OCD had a protective effect. The results suggest that, during the COVID-19 pandemic, obsessive and compulsive behavior (e.g., hand washing) in young people at the greatest risk should be monitored, and the intervention of mental health services should be maintained. More research is needed in this area. Full article
(This article belongs to the Special Issue Obsessive-Compulsive Disorder: Update on Research and Clinical Management)
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Other

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10 pages, 259 KiB  
Brief Report
Phenomenological Considerations of the World of the Obsessive Patient
by Francesco Demaria, Maria Pontillo, Domenica Bellantoni, Cristina Di Vincenzo and Stefano Vicari
J. Clin. Med. 2023, 12(13), 4193; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12134193 - 21 Jun 2023
Viewed by 1084
Abstract
Despite significant scientific advances in research on obsessive-compulsive disorder (OCD), the psychological and behavioral symptoms of this pathological condition remain hard to understand, until they seem paradoxical. The present work seeks to consider the significance and potential contribution of a phenomenological reading of [...] Read more.
Despite significant scientific advances in research on obsessive-compulsive disorder (OCD), the psychological and behavioral symptoms of this pathological condition remain hard to understand, until they seem paradoxical. The present work seeks to consider the significance and potential contribution of a phenomenological reading of OCD and how phenomenalism has influenced some cognitive models of this disorder. Transcendental phenomenology is a philosophical approach that attaches primary importance to intuitive experience and considers all phenomena intrinsically associated with the subject’s inner world. Thus, the subject’s intuition is considered the starting point for understanding their essential experience. This approach has had a profound influence on modern cognitive sciences. Among current cognitive models, post-rationalist cognitivism and cognitive neuropsychological psychotherapy seem most effective in capturing the world experiences of OCD patients. Both apply a phenomenological approach to identify these experiences, which are typically characterized by hyper-reflexivity, at the expense of ‘natural evidence.’ The models have found that OCD patients experience the world emotionally as a sterile set of rules, and this experience determines their suffering. Full article
(This article belongs to the Special Issue Obsessive-Compulsive Disorder: Update on Research and Clinical Management)
16 pages, 1364 KiB  
Concept Paper
An Integrative Model for Understanding Obsessive-Compulsive Disorder: Merging Cognitive Behavioral Theory with Insights from Clinical Neuroscience
by Eyal Kalanthroff and Michael G. Wheaton
J. Clin. Med. 2022, 11(24), 7379; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11247379 - 12 Dec 2022
Cited by 6 | Viewed by 5283
Abstract
Several models have been proposed for the emergence and maintenance of obsessive-compulsive disorder (OCD). Although these models have provided important insights and inspired treatment development, no single model has yet sufficiently accounted for the complexed phenotype of the disorder. In the current paper, [...] Read more.
Several models have been proposed for the emergence and maintenance of obsessive-compulsive disorder (OCD). Although these models have provided important insights and inspired treatment development, no single model has yet sufficiently accounted for the complexed phenotype of the disorder. In the current paper, we propose a novel model that integrates elements from cognitive behavioral models of OCD with neurocognitive approaches to the disorder. This Reciprocal Interaction Model (RIM) for OCD is based on two assumptions: (a) similar observed symptoms can stem from different etiological processes; and (b) neuropsychological deficits (such as reduced response inhibition and overreliance on the habit formation system) and cognitive behavioral processes (such as temporary reduction in anxiety after engaging in compulsive behaviors) mutually affect each other such that abnormalities in one system influence the second system and vice-versa—creating a vicious cycle of pathological processes. Indeed, the bidirectional inhibitory connection between anxiety/obsessions and executive control is at the heart of the model. We begin by briefly reviewing the current models for OCD. We then move on to describe the RIM, the supporting evidence for the model, the model’s predictions, and potential clinical implications. Full article
(This article belongs to the Special Issue Obsessive-Compulsive Disorder: Update on Research and Clinical Management)
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