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Although Repetitive Transcranial Magnetic Stimulation (rTMS) is a promising new noninvasive brain stimulation therapy, its underlying mechanisms of action remain unknown. OCD patients exhibit impaired response control and attention shifting, which is linked to some brain areas such as anterior cingulate cortex and basal ganglia. OCD patients also display altered neurometabolic concentrations in cortical cortical-striatal-thalamic-cortical (CSTC). In this study, we aimed to elucidate efficacy of rTMS treatment in alleviating related symptoms and pregenual anterior cingulate cortex (pACC) neurometabolites. OCD patients were randomly divided into either drug (n = 23) or drug + rTMS (n = 29) groups, and those in the latter group subjected to 4-week rTMS treatment. All participants were visited twice, at baseline and follow-up after four weeks. During both visits, all patients were subjected to 1H-MRS, then Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Global Assessment Function (GAF) used to assess severity of obsessive-compulsive symptoms. We also evaluated synchronous anxiety and depression by Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Hamilton Anxiety Scale (HAM-A) and Hamilton Depression Scale (HAM-D). After 4 weeks of treatment, patients in the Drug + rTMS group displayed significantly lower Y-BOCS (p = 0.038), BDI (p = 0.009), HAM-D (p = 0.013), HAM-A (p = 0.012) scores than their counterparts in the Drug group. Conversely, patients in the Drug + rTMS group had significantly higher tNAA concentrations (p = 0.030) than those in the Drug group. Notably, the Drug + rTMS group exhibited higher, but insignificant Glu (p = 0.055) and Glx (p = 0.068) concentrations compared to the Drug group. Partial correlation analysis revealed a significant negative correlation between post HAM-A scores and 4-week change of pACC glutamate levels in the Drug + rTMS group (r = −0.434, p = 0.02). rTMS treatment is an efficacious treatment therapy for OCD, mainly by inducing changes in neurometabolites. • The study explored the direct changes of neurometabolic concentrations in pACC after 4-week rTMS treatment in OCD patients. • The combination of rTMS treatment can enhance the therapeutic effect beneficial to the OCD patients. • The rTMS treatment could increase the concentrations of glutamate, glutamate + glutamine(Glx) and tNAA. • The greater the change in glutamate concentrations was the less anxiety after rTMS treatment. [ABSTRACT FROM AUTHOR]

Background/aim: Family accommodation (FA) is associated with disease severity and response to treatment rates in patients with obsessive-compulsive disorder (OCD) and is therefore particularly important in this patient group. This study investigated the structure of FA and associated factors in a Turkish society sample. Materials and methods: The study was carried out with 92 patients diagnosed with OCD for at least 1 year, who applied to Alanya ALKU Training and Research Hospital psychiatry outpatient clinic between February 2021 and March 2022. Sociodemographic data form, Family Accommodation Scale-Patient Form (FAS-PF), Dimensional Obsessive-Compulsive Scale (DOCS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Acceptance and Action Questionnaire (AAQ-II) were applied to all of the cases. Relatives filled out the Sociodemographic Data. Results: The mean age of the patients was 32.11 ± 11.56 years. Sixty-nine (75%) of the patients were women. Fifty (54.3%) patients were married. All participants reported FA behavior at least once in the previous week. FA exhibited no significant variation by sex (p = 0.679) or marital status (p = 0.256). Significant positive correlation was determined between DOCS-T (r = 0.370, p < 0.001), AAQ-II (r = 0.261, p = 0.013), BDI (r = 0.235, p = 0.024) and BAI (r = 0.342, p = 0.001) scores and the FAS-PF. In the regression analysis, only OCD disease severity predicted FA [(ß = 0.295, p = 0.036, 95% confidence interval (95% CI) = 0.02 to 0.55)]. Higher FA scores were obtained in this study (23.93 ± 15.28) compared to previous research in Western societies (14.3 ± 15.2). Conclusion: Clinicians should consider FA in the examination of OCD patients. High FA values for both frequency and severity suggest that interventions directed toward FA may be associated with more positive outcomes in outpatient Turkish patients with OCD. [ABSTRACT FROM AUTHOR]

Objective: Perfectionism is one of the leading clinical symptoms of the obsessive-compulsive personality disorder (OCPD). This research aimed to compare perfectionism and serum thyroid hormone levels between individuals with OCPD and healthy individuals of a control group. Methods: The serum levels of free T4, free T3, and thyroid-stimulating hormone of 37 patients diagnosed with OCPD and 36 healthy controls with similar sociodemographic traits were measured. Furthermore, the Sociodemographic and Clinical Data Form, the Beck Anxiety Inventory (BAI), the Beck Depression Inventory (BDI), and the Frost Multidimensional Perfectionism Scale (FMPS) were applied to all participants in the study. Results: There was a statistically remarkable correlation between the FMPS total score and the T3 level (r = -0.47, P = .004), and between the BAI and the T3 level (r = -0.41, P = .011). Conclusion: The research findings demonstrated that there could be a correlation between perfectionism and thyroid hormone levels. [ABSTRACT FROM AUTHOR]

Aim: Anterior capsulotomy (AC) is one of the last therapeutic options for obsessive–compulsive disorder (OCD) refractory to conservative treatments. Several forms of cognitive dysfunction have been identified after assessment of neuropsychological outcomes in OCD patients; however, few studies focused on cognitive changes in OCD patients after surgery. In the present study, we evaluated the effects of AC on cognitive performance and mood status in patients with refractory OCD. Methods: A total of 12 patients underwent bilateral AC between 2012 and 2019 at our institution. The patients (n = 12, female : male 5:7; mean age 39.7 years; duration ≥5 years) were assessed before and 6 months after intervention. The diagnosis of treatment‐refractory OCD was based on recommended criteria for surgical treatment. Patients were assessed using a neuropsychological battery and questionnaires focused on anxiety–depressive symptomatology. The Yale–Brown Obsessive Compulsive Scale was administered as a measure of severity of OCD symptoms. Results: We detected a significant decrease of OCD, and anxiety and depressive symptomatology assessed by Yale–Brown Obsessive Compulsive Scale, Beck Depression Inventory, and Beck Anxiety Inventory (P < 0.05) 6 months after AC in eight patients, and a partial decrease in four patients. Four patients underwent repeated AC with more pronounced improvement achieved after the first procedure. We did not detect decline in cognitive performance in any patients, but did find better visual memory performance (P < 0.05). Conclusion: AC reduced OCD and anxiety–depressive symptoms, and did not appear to influence cognitive performance, even after repeated surgery. [ABSTRACT FROM AUTHOR]

Trichotillomania is a psychiatric disorder characterised by compulsive pulling out of one's hair resulting in hair loss, which is included in the Diagnostic and Statistical Manual of Mental Disorders 5th edition category 'obsessive-compulsive disorder and related disorders'. Behavioural therapy and some medications are suggested for the treatment of trichotillomania, though these are not effective for all patients. Therefore, new treatment options are needed. Five female patients diagnosed with trichotillomania applied low-frequency repetitive transcranial magnetic stimulation (rTMS) over bilateral supplementary motor area for 3 weeks. Baseline and after rTMS, patients were given Beck Depression Inventory, Beck Anxiety Inventory and Massachusetts General Hospital Hair Pulling Scale to evaluate the severity of disorder at baseline and post-rTMS. In this case series, three of five patients with trichotillomania obtained a substantial benefit from treatment, while one patient obtained a partial symptom reduction. The last patient experienced a mild increase in severity of disease after rTMS treatment. rTMS treatment can be effective in some patients with trichotillomania and can be a promising option in treatment of trichotillomania. [ABSTRACT FROM AUTHOR]

While stressful life events increase the risk of developing a range of psychiatric disorders, including obsessive-compulsive disorder (OCD), their ability to precipitate specific obsessive-compulsive symptoms' dimensions is unknown. Here we aimed to evaluate the potential role of three different types of stressful life events, herein termed losses (death of a loved one, termination of a romantic relationship and severe illness) in predicting the speed of progression from subclinical to clinical OCD and the severity of specific OCD dimensions in a large multicentre OCD sample. Nine hundred and fifty-four OCD outpatients from the Brazilian OCD Research Consortium were included in this study. Several semi-structured and structured instruments were used, including the Structured Clinical Interview for DSM-IV Axis I Disorders, the Yale-Brown Obsessive-Compulsive Scale, the Dimensional Yale-Brown Obsessive-Compulsive Scale, the Brown Assessment of Beliefs Scale, the Beck Depression Inventory, the Beck Anxiety Inventory and the Yale OCD Natural History Questionnaire. Regression models investigated the interaction between types of loss and gender to predict speed of progression from subclinical obsessive-compulsive symptoms to OCD, and the severity of five symptom dimensions. While termination of a relationship was associated with a faster speed of progression from subthreshold to clinical OCD, the death of a loved one was associated with increased severity of hoarding symptoms. There was also an interaction between gender and experiences of death, which predicted a faster speed of progression to OCD in males. Stressful life events have the ability to accelerate the progression from subclinical to clinical OCD, as well as impact the severity of specific OCD dimensions. Gender also plays a role in both the progression and severity of symptoms. These findings suggest that stressful life events may represent a marker to identify individuals at risk of progressing to clinical OCD. [ABSTRACT FROM AUTHOR]

The study examined psychometric properties of the Turkish version of the Inventory of Depression and Anxiety Symptoms-II (IDAS-II) in a Turkish sample. The sample consisted of nonclinical (N = 931) and clinical (N = 208) individuals. Confirmatory factor analysis showed that Turkish IDAS-II was similar to the original IDAS-II and supported the construct validity of the test. The Turkish IDAS-II showed good internal consistency, significant acceptable retest correlations, and was sensitive to changes over time. The Turkish IDAS-II also showed good convergent and discriminant validity in relation to the Beck Depression Inventory, the Beck Anxiety Inventory, the Mood Disorder Questionnaire, the Maudsley Obsessive Compulsive Inventory, the Panic Agoraphobia Scale, and the Post-Traumatic Stress Disorder Checklist-Civilian Version. Discriminant analyses revealed that the subscales of the Turkish IDAS-II significantly differentiated healthy controls from outpatients. The Turkish IDAS-II is a reliable and valid measure for assessing symptoms of depression and anxiety in Turkish-speaking participants. [ABSTRACT FROM AUTHOR]

Objective: Obsessions have been categorized as autogenous obsessions and reactive obsessions on the original of the cognitive theory and this study aimed to evaluate whether differences are found between obsessive compulsive disorder (OCD) subgroups in terms of biochemical markers. Methods: Thirty patients with obsessions defined as autogenous, 30 patients with obsessions defined as reactive group and 30 healthy volunteers were consisted the sample of the study. Sociodemographic Data Form, Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) were filled to the participants. The activity of paraoxanase, prolidase and Hs-CRP and brain-derived neurotrophic factor (BDNF) levels were detected. Results: There was no any statistically significant difference between autogenous and reactive obsession groups in terms of total mean score of Y-BOCS, BDI and BAI. Paraoxanase activity did not statistically significant difference between all groups. Prolidase activity showed significantly higher in reactive group than autogenous obsession and control groups. Serum Hs-CRP levels were not statistically different among participants of autogenous group, reactive group and control groups. Serum BDNF levels were significantly lower in autogenous obsession group rather than reactive obsession and control groups. Conclusion: This finding indicates that neurobiological processes have important role in the pathophysiology of autogenous obsessions. [ABSTRACT FROM AUTHOR]

Background: It is known that obsessive-compulsive disorder (OCD) patients with poor insight display more severe neuropsychological impairments than other patients with OCD. There are limited studies of OCD and theory of mind (ToM). Aim: To investigate ToM skills in patients with OCD and the relationship between insight and ToM skills by comparing OCD patients with good and poor insight. Methods: Eighty patients with OCD and 80 healthy controls completed the structured clinical interview for DSM-IV axis I disorders, the Yale Brown Obsessive-Compulsive Scale, the Beck Anxiety and Beck Depression Inventories, and the Brown Assessment of Beliefs Scale. To assess ToM skills, first- and second-order false-belief tests, a hinting test, a faux pas test, a reading the mind in the eyes test, and a double-bluff test were administered. Results: Patients with OCD had poorer ToM abilities than healthy controls. All ToM scores were significantly lower in the poor insight group than in the good insight group (p < .001). A significant negative correlation was found between the BABS-total scores and all the ToM test mean scores (p < .05). Conclusions: The finding of significantly lower ToM skills in OCD with poor insight than in OCD with good insight may contribute to the idea of OCD with poor insight being a subtype with different clinical and neuropsychological characteristics. [ABSTRACT FROM AUTHOR]

Abstract: In this cross-sectional study, we assessed the levels of neurotrophins (NF) of patients with obsessive-compulsive disorder (OCD) in different stages of treatment and their relationship with OCD clinical features. Forty patients with OCD and 40 healthy controls had Brain-Derived Neurotrophic Factor (BDNF), Nerve Growth Factor (NGF), and Glial Cell-Derived Neurotrophic Factor (GNDF) plasma levels measured by enzyme-linked immunosorbent assay (ELISA). Patients with OCD were further examined with the Obsessive-Compulsive Inventory-Revised, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Sheehan Disability Scale (SDS). Patients with OCD exhibited significantly lower levels of BDNF and significantly increased levels of NGF as compared to healthy controls. In OCD, statistically significant negative correlations between BDNF levels and number of working days lost per week were found. Additional analyses revealed a statistically significant positive correlation between both NGF and GDNF and severity of washing symptoms. Plasma levels of NF were not affected by age, age at OCD onset, gender, major depressive disorder, the relative dose of serotonin-reuptake inhibitors being prescribed, or the use of antipsychotics. Our findings suggest that patients with OCD may exhibit a particular NF profile, with functional impairment correlating with BDNF levels and severity of washing symptoms correlating with NGF and GDNF levels. [Copyright &y& Elsevier]

Abstract: The cognitive behavioural models of Obsessive Compulsive Disorder (OCD) have stressed the role of cognitions, not only in aetiology but also in maintenance of the disorder. Little is known about the temporal relations between obsessive-compulsive cognitions and OCD symptoms. The aim of this study was to carry out a prospective assessment of OCD related beliefs and symptoms in a non-clinical sample. A total of 99 university students completed the Obsessive Beliefs Questionnaire (OBQ), Padua Inventory (PI), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) and Worry Domain Questionnaire (WDQ) one, three and five years after baseline administration. Structural modelling predicting scores at later time periods and growth curve modelling were used to analyze the data. The results showed that obsessive-compulsive cognitions varied significantly over time. It was also found that the OBQ predicted symptom scales (Impaired Mental Control, Contamination and Checking) only at baseline. However symptom scores remained stable at each time point, as shown by the subscales of Impaired Mental Control, Contamination and Checking of the PI and the BAI, BDI and WDQ. Implications for future research and the cognitive model of OCD are discussed. [Copyright &y& Elsevier]

This case report illustrates the management of a patient with obsessive compulsive disorder who presented with hypochondriacal and persecutory ideas. Cognitive behavioural hypnotherapy approaches were applied in the management as the patient not keen for pharmacological treatment. Obsessive thoughts were managed via distraction technique, thought stopping and modified it to a more helpful compulsive behavior via direct suggestion during hypnotic state. The compulsive behavior was managed via hypno-behavioural approaches, reinforced by direct suggestion and pseudo-orientation in time. The Subjective Unit of Distress Scale (SUDS), Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) scales were used to measure the progress of anxiety and depressive symptoms. [ABSTRACT FROM AUTHOR]

Introduction In the last decade, accumulating evidence has been produced on the role of dissociation in Obsessive Compulsive Disorder (OCD). Understanding which dissociation dimensions are specific to OCD could suggest the integration of therapeutic strategies for dissociation in the treatment of patients with OCD. Objectives The current study explored the role of dissociation in a sample of patients with OCD, patients with anxiety disorders and healthy controls with the aim to understand which dissociation dimensions could be specific to OCD. Method One hundred seventy-one participants were included in the study (56% females, mean age = 35.96, SD = 12.61), of which 52 were patients with primary OCD, 59 were patients with Anxiety Disorders (AD), and 60 were healthy controls. The Dissociative Experiences Scale (DES), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), Yale-Brown Obsessive Compulsive Scale (Y-BOCS) were administered. Results Patients with OCD had significantly higher dissociative amnesia symptoms than patients with AD and health controls ( F = 6.08, P < 0.01) and higher depersonalization/derealization symptoms than healthy controls but not than patients with AD. Patients with OCD did not report significantly higher dissociative absorption than healthy controls and patients with AD. Conclusions Strategies targeting dissociative amnesia and depersonalization/derealization symptoms in OCD are discussed. Future studies should examine which OCD subtypes are more strongly associated to dissociation dimensions. [ABSTRACT FROM AUTHOR]