Is There a Distinct OCD Spectrum?

Abstract

The obsessive-compulsive disorders spectrum concept has grown in recent years because of the common clinical features, such as obsessive thinking and compulsive rituals, biological markers, presumed etiology, and treatment response, that these disorders may share with obsessive-compulsive disorder (OCD). This concept has important implications in regard to diagnosis, nosology, neurobiology, and treatment of a wide group of diverse disorders affecting up to 10% of the population. New insights in central nervous system (CNS) mechanisms that drive the repetitive behaviors of the obsessive-compulsive spectrum disorders have heightened interest in the spectrum in researchers, clinicians, and those involved in drug development.An important approach in neuropsychiatry centers on employing a dimensional classification of psychopathology. Psychiatric phenomena often fall on a continuum. A dimensional approach allows for the classification of patients who fall at the border of classical entities or who are otherwise atypical. Diagnostic categories are considered along a spectrum if there is considerable overlap in symptoms and in etiology, as demonstrated by familial linkage biological markers, and pharmacological dissection. Categorical and dimensional approaches to the OCD spectrum could have significant implications for diagnosis, nosology, neurobiology, and treatment of a wide group of disorders affecting a sizable percentage of the population.Recent interest has focused on spectrums in movement disorders, affective disorders, schizophrenia, epileptic and impulsive disorders, and obsessive-compulsive disorders (which we will examine here); in addition, there has been interest in the overlap between these spectrums. Viewing disorders in terms of overlapping spectrums provides researchers and clinicians a framework with which to better understand and treat these disorders.

Topiramate Versus Fluvoxamine in the Treatment of Pathological Gambling

“…The OCD spectrum concept refers to a group of diagnoses that are related to OCD in terms of common clinical characteristics, neurobiology, and treatment response. 14 The OCD spectrum disorders can be viewed in terms of 3 overlapping clusters. In the first cluster there is an obsessive preoccupation with bodily appearance together with related compulsions (ie, bulemia nervosa, binge eating, and body dysmorphic disorder); the second cluster includes impulsive-style disorders (ie, PG, compulsive buying, kleptomania, trichotillomania, and pyromania), and the third cluster includes neurobiological disorders with compulsive features (ie, autism, Asperger disorder, and Tourette syndrome).…”

The role of medication in the treatment of pathological gambling: Bridging the gap between research and practice

“…Most often, comparisons are made with substance dependence. Hollander (Hollander & Wong, 1995;Hollander & Benzaquen, 1996), on the other hand, places pathological gambling in an obsessive-compulsive spectrum, a group of disorders believed to share symptomatology, neurobiology, and treatment response with OCD. This assumption has led him to use clomipramine (Hollander et al, 1992) and fluvoxamine (Hollander, 1998;Hollander et al, 1998;Hollander et al, 2000) with pathological gamblers.…”

Obsession in the Strict Sense: A Helpful Psychopathological Phenomenon in the Differential Diagnosis between Obsessive-Compulsive Disorder and Schizophrenia

“…The obsessive reaction is thus immediate, not disrupted by any intercepting psychic processes or by any refl exive consciousness. The step from here to the current concept of a spectrum disorder [13,14] is only a small one. The disorders of impulse control are taken together under the heading of obsession and thus ordered into convenient units as regards aspects of neurobiology and behavioural therapy.…”