Neuropsychological performance of OCD patients before and after treatment with fluoxetine: evidence for persistent cognitive deficits

Nielen, M.; Boer, Johan A. den

doi:10.1017/s0033291703007682

Cited by 101 publications

(97 citation statements)

References 35 publications

(52 reference statements)

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“…On the subscale attention to detail, comorbid ASD and pure OCD subjects revealed equally elevated scores, reflecting similar deficits in an underlying ability to distinguish between relevant and irrelevant information. This inability is in line with similar deficits in executive functions at neuropsychological testing of both groups [33,34] .…”

Section: Discussionsupporting

confidence: 80%

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Symptom Overlap between Autism Spectrum Disorder, Generalized Social Anxiety Disorder and Obsessive-Compulsive Disorder in Adults: A Preliminary Case-Controlled Study

Cath¹,

Ran²,

Smit³

et al. 2007

Psychopathology

174

110

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Background: Obsessive-compulsive disorder (OCD) and social anxiety disorder (SAD) frequently co-occur in persons with autism spectrum disorder (ASD). We studied which features distinguish ‘pure’ anxiety disordered patients from those with co-morbid ASD. Method: In a case-controlled design in which groups were matched for age, sex and educational level, patients with OCD or SAD and co-morbid ASD were compared with patients with ‘pure’ (i.e. without ASD) OCD, with ‘pure’ SAD and a control group, using the Autism Questionnaire (AQ), Yale-Brown Obsessive-Compulsive Scales, Liebowitz Social Anxiety Scale, Beck Anxiety Inventory and questions on egodystonia of OC behaviors. Results: No between patient group differences were found on social or general anxiety measures. The AQ subscales communication problems and lack of imagination discriminated best between patients with comorbid ASD and the other groups, ASD patients showing elevated scores, whereas the other patient groups scored equal to controls. On the AQ social skill subscale all patient groups showed elevated scores. On OC symptom severity, pure OCD patients showed highest scores, whereas comorbid ASD subjects scored intermediate between controls and the pure OCD group, the differences being explained by lower obsession severity in the ASD group. There were no differences between the pure OCD and comorbid ASD groups on egodystonia. Conclusion: Patients with comorbid ASD differ from patients with pure OCD and SAD on autism-related problem behaviors, but there is also overlap between groups, possibly reflecting overlapping etiologies. Despite the relatively small sample size, these data strongly suggest that specific autism symptom domains should be assessed to pick up autism-related problems in OCD and SAD patients, and subsequently fine-tune treatment programs for these patients.

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Section: Discussionsupporting

confidence: 80%

“…Support for this suggestion can be found in neuropsychological studies in which all three patient groups reveal similar impairments in planning ability and flexibility [34][35][36] . Furthermore, the symptom overlap between groups might reflect etiological overlap.…”

Section: Discussionmentioning

confidence: 88%

Symptom Overlap between Autism Spectrum Disorder, Generalized Social Anxiety Disorder and Obsessive-Compulsive Disorder in Adults: A Preliminary Case-Controlled Study

Cath¹,

Ran²,

Smit³

et al. 2007

Psychopathology

174

110

View full text Add to dashboard Cite

show abstract

“…The order of the neuropsychological tasks was counterbalanced in each group. Braw et al 2008 Longer initial thinking times, longer subsequent thinking times, solved fewer problems in minimum moves Chamberlain et al 2006b Lower strategy scores, generated fewer novel sequences after training Pantelis et al 1997 Fewer perfect solutions, required more moves for completion, slower movement times and slower subsequent thinking latencies Nielen and Den Boer, 2003 Fewer minimum move solutions, longer subsequent thinking time and longer time spent initiating and completing one sequence divergent thinking is required in order to shift attention away from a previously correct stimulus dimension to a novel (previously irrelevant) one. The total number of errors on the ID-ED and the number of errors at the EDS stage were used as the principal measures of attentional set-shifting.…”

Section: Neuropsychological Measuresmentioning

confidence: 99%

The neuropsychology of the schizo-obsessive subtype of schizophrenia: a new analysis

et al. 2009

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Background. Interest in the neuro-cognitive profile of patients with schizophrenia and co-morbid obsessive compulsive disorder (schizo-OCD) is rising in response to reports of high co-morbidity rates. Whereas schizophrenia has been associated with global impairment in a wide range of neuro-cognitive domains, OCD is associated with specific deficits featuring impaired performance on tasks of motor and cognitive inhibition involving frontostriatal neurocircuitry.Method. We compared cognitive function using the CANTAB battery in patients with schizo-OCD (n=12) and a schizophrenia group without OCD symptoms (n=16). The groups were matched for IQ, gender, age, medication, and duration of illness.Results. The schizo-OCD patients made significantly more errors on a task of attentional set-shifting (ID-ED set-shift task). By contrast, no significant differences emerged on the Stockings of Cambridge task, the Cambridge Gamble Task or the Affective Go/NoGo tasks. No correlation emerged between ID-ED performance and severity of schizophrenia, OCD or depressive symptoms, consistent with neurocognitive impairment holding trait rather than statemarker status. Schizo-obsessives also exhibited a trend toward more motor tics emphasizing a neurological contribution to the disorder. Conclusion.Our findings reveal a more severe attentional set-shifting deficit and neurological abnormality that may be fundamental to the neuro-cognitive profile of schizo-OCD. The clinical implications of these impairments merit further exploration in larger studies.

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“…In particular, participants classified as ''major responders'' (n 5 15) performed comparably to healthy controls on all cognitive measures at post-treatment (12-week) follow-up. Conversely, Nielen and den Boer [16] found no changes in NP functioning from pre-to post-treatment with fluoxetine. One potential explanation for these discrepant findings may be that cognitive functions corresponding to the orbitofrontal feedback-loop are more sensitive to CBT.…”

mentioning

confidence: 90%

“…Several studies, however, have examined this topic among adults with OCD. [13][14][15][16] These findings are mixed. Katrin Keulz et al [14] found that, at baseline, adults with OCD exhibited significantly greater impairment in several areas of NP functioning than healthy controls, most notably relating to set-shifting (e.g., Trail Making Test B), organization and nonverbal memory (e.g., ROCF), and set shifting and flexibility (e.g., Trail Making Test B).…”

mentioning

confidence: 99%

The impact of neuropsychological functioning on treatment outcome in pediatric obsessive-compulsive disorder

et al. 2010

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Although alternative explanations exist, these findings suggest that poorer performance on the ROCF and, in turn, poorer response to treatment, particularly among those youths receiving CBT alone, may be due to executive functioning difficulties. Clinicians and researchers should be sensitive to this fact and may warrant modification(s) to existing treatment protocols. Limitations to this study, however, suggest the need for replication and extension of these findings in the future.

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Neuropsychological performance of OCD patients before and after treatment with fluoxetine: evidence for persistent cognitive deficits

Cited by 101 publications

References 35 publications

Symptom Overlap between Autism Spectrum Disorder, Generalized Social Anxiety Disorder and Obsessive-Compulsive Disorder in Adults: A Preliminary Case-Controlled Study

Symptom Overlap between Autism Spectrum Disorder, Generalized Social Anxiety Disorder and Obsessive-Compulsive Disorder in Adults: A Preliminary Case-Controlled Study

The neuropsychology of the schizo-obsessive subtype of schizophrenia: a new analysis

The impact of neuropsychological functioning on treatment outcome in pediatric obsessive-compulsive disorder

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