Signs of Central Nervous System Dysfunction in Obsessive-Compulsive Disorder

Hollander, Eric; Schiffman, Erica; Cohen, Barry S.; Rivera-Stein, Maria A.; Rosen, Wilma G.; Gorman, Jack M.; Fyer, Abby J.; Papp, Laszlo A.; Liebowitz, Michael R.

doi:10.1001/archpsyc.1990.01810130029005

Cited by 218 publications

(113 citation statements)

References 25 publications

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“…Standard deviations of the total NSS scores were not reported in three papers (Hollander et al 1990 ;Bolton et al 1998 ;Poyurovsky et al 2007) and had to be indirectly obtained. In one study (Hollander et al 1990), these could be calculated from the histograms plotted in the paper.…”

Section: Data Extraction and Synthesismentioning

confidence: 99%

“…In one study (Hollander et al 1990), these could be calculated from the histograms plotted in the paper. In another study (Bolton et al 1998), standard deviations could be estimated from the subscores using a basic property of the variance, namely :…”

Section: Data Extraction and Synthesismentioning

confidence: 99%

“…Only one of the included studies employed raters who were blind to the participants' patient or control status (Hollander et al 1990). …”

Section: Study Characteristicsmentioning

confidence: 99%

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Neurological soft signs in obsessive-compulsive disorder: two empirical studies and meta-analysis

et al. 2012

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Background. Neurological soft signs (NSS) have been inconsistently reported in obsessive-compulsive disorder (OCD) but may make an impact on treatment response.Method. The current study examined the presence of NSS in two independent European samples of OCD patients (combined 85 patients and 88 matched healthy controls) using a standardized instrument and conducted a metaanalysis of all published studies identified in the literature with the aim to provide a more definitive answer to the question of whether OCD patients are characterized by increased NSS.Results. Both empirical studies found elevated NSS scores in patients compared with matched controls. The results of the meta-analysis, which included 15 studies (combined 498 patients and 520 controls) showed large effect sizes (Hedges' g=1.27, 95 % confidence interval 0.80-1.75), indicating that OCD patients have significantly higher rates of NSS than matched controls on both sides of the body and in multiple domains (motor coordination, sensory integration and primitive reflexes). The results were robust and remained largely unchanged in our reliability analyses, which controlled for possible outliers. Meta-regression was employed to examine the role of potential variables of interest including sociodemographic variables, symptom severity, medication effects and the use of different instruments, but none of these variables was clearly associated with NSS.Conclusions. As a group, OCD patients are characterized by increased rates of NSS, compared with healthy controls. However, their origins and potential clinical importance remain to be clarified. Future directions for research are discussed.

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Section: Data Extraction and Synthesismentioning

confidence: 99%

Section: Data Extraction and Synthesismentioning

confidence: 99%

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Neurological soft signs in obsessive-compulsive disorder: two empirical studies and meta-analysis

et al. 2012

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“…While the predictive negative value of neurological soft signs (Hollander et al, 1990) has been questioned (Thienemann and Koran, 1995), another possible subtype has been suggested from the hypothesis of an immune reaction to group A beta hemolytic streptococcal infection, involving antineuronal antibodies, in OCD (Swedo et al, 1998). It is yet to be decided whether this type of OCD should be considered a specific subtype, a special pattern of comorbidity or a new disorder.…”

Section: Subtypesmentioning

confidence: 99%

“…Non-responsive patients are more likely to meet criteria for comorbid axis I or axis II disorders and the presence of a specific comorbid condition could be a distinguishing feature in OCD, with influence on the treatment adequacy and outcome. While coexisting depression is generally irrelevant to treatment response (Katz and DeVeaugh-Geiss, 1990;Mavissakalian et al, 1985), a lower response rate has been observed with comorbid chronic tic disorder McDougle et al, 1993a,b) and OCD patients with neurological soft signs (Hollander et al, 1990). A comorbid axis II diagnosis of schizotypal, borderline and avoidant personality also seems to predict poorer treatment outcome , as does obsessive-compulsive personality disorder .…”

Section: Comorbiditymentioning

confidence: 99%

Treatment-refractory obsessive-compulsive disorder: Methodological issues, operational definitions and therapeutic lines

Pallanti

Quercioli

2006

Progress in Neuro-Psychopharmacology and Biological Psychiatry

328

190

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While controlled trials with SRIs have demonstrated a selective efficacy in obsessive-compulsive disorder (OCD), up to 40 -60% of patients do not have a satisfactory outcome. Non-response to treatment in OCD is associated with serious social disability. There are a large number of nonresponsive patients, and they are difficult to cluster due to ambiguities in diagnostic criteria, possibility of subtypes and a high rate of comorbidity. Moreover, the findings of current studies of ''so-called'' non-responsive cases are currently non-generalizable because of the lack of an operational definition of non-response. The result has been that a cumulative body of data on a reasonably homogeneous sample of non-responders has not been developed. The aims of the research in this area are to clarify some of the obstacles in defining stages of response and levels of non-response and, through a comprehensive analysis, to propose a systematic nosology for this rather common condition. Better characterization of which patients respond and do not respond to various treatments will enable more accurate clustering of patients, and help facilitate multisite data collection for future research trials. The authors reviewed also the more recent therapeutic pharmacological and psychological lines for the treatment of refractoriness in OCD. D

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Neurologic Soft Signs in Obsessive-Compulsive Disorder

Bihari¹

1991

Arch Gen Psychiatry

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Signs of Central Nervous System Dysfunction in Obsessive-Compulsive Disorder

Cited by 218 publications

References 25 publications

Neurological soft signs in obsessive-compulsive disorder: two empirical studies and meta-analysis

Neurological soft signs in obsessive-compulsive disorder: two empirical studies and meta-analysis

Treatment-refractory obsessive-compulsive disorder: Methodological issues, operational definitions and therapeutic lines

Neurologic Soft Signs in Obsessive-Compulsive Disorder

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