The correlates of obsessive–compulsive, schizotypal, and borderline personality disorders in obsessive–compulsive disorder

Melca, Isabela A; Yücel, Murat; Mendlowicz, Mauro V.; Oliveira‐Souza, Ricardo de; Fontenelle, Leonardo F.

doi:10.1016/j.janxdis.2015.04.004

Cited by 21 publications

(19 citation statements)

References 79 publications

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“…A number of studies have examined the co-morbidity of personality disorders in clinical OCD samples [ 6 , 12 , 42 , 47 , 74 ] or epidemiological surveys [ 80 ] (for a review, see [ 65 ]). The prevalence of SPD varied between 0 and 25% with five of six studies reporting a prevalence above 10%.…”

Section: Discussionmentioning

confidence: 99%

Schizophrenia-spectrum psychopathology in obsessive–compulsive disorder: an empirical study

Rasmussen

Nordgaard

Parnas

2019

Eur Arch Psychiatry Clin Neurosci

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The differential diagnosis of obsessive-compulsive disorder (OCD) and schizophrenia-spectrum disorders can be difficult. In the current diagnostic criteria, basic concepts such as obsession and delusion overlap. This study examined lifetime schizophrenia-spectrum psychopathology, including subtle schizotypal symptomatology and subjective anomalies such as self-disorders, in a sample diagnosed with OCD in a specialized setting. The study also examined the differential diagnostic potential of the classic psychopathological notions of true obsession ('with resistance') and pseudo-obsession. The study involved 42 outpatients diagnosed with OCD at two clinics specialized in the treatment of OCD. The patients underwent semi-structured, narrative interviews assessing a comprehensive battery of psychopathological instruments. The final lifetime research-diagnosis was based on a consensus between a senior clinical psychiatrist and an experienced research clinician. The study found that 29% of the patients fulfilled criteria of schizophrenia or another non-affective psychosis as main, lifetime DSM-5 research-diagnosis. Another 33% received a research-diagnosis of schizotypal personality disorder, 10% a research-diagnosis of major depression and 29% a main research-diagnosis of OCD. Self-disorders aggregated in the schizophrenia-spectrum groups. True obsessions had a specificity of 93% and a sensitivity of 58% for a main diagnosis of OCD. In conclusion, a high proportion of clinically diagnosed OCD patients fulfilled diagnostic criteria of a schizophrenia-spectrum disorder. The conspicuous obsessive-compulsive symptomatology may have resulted in a disregard of psychotic symptoms and other psychopathology. Furthermore, the differentiation of obsessions from related psychopathological phenomena is insufficient and a conceptual and empirical effort in this domain is required in the future.

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Section: Discussionmentioning

confidence: 99%

Schizophrenia-spectrum psychopathology in obsessive–compulsive disorder: an empirical study

Rasmussen

Nordgaard

Parnas

2019

Eur Arch Psychiatry Clin Neurosci

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“…Other studies have also found that the majority of depressed patients met criteria for the anxious distress specifier, though the rate was higher in the present study. However, other studies “diagnosed” the anxious distress specifier with scales designed for other purposes and thus did not fully assess all of the anxious distress criteria (McIntyre et al., ; Melca et al., ; Shim et al., ). The lack of full coverage of the anxious distress criteria could account for the lower frequency.…”

Section: Discussionmentioning

confidence: 99%

“…A few recent studies have supported the validity of the specifier, however, they did not use measures that were designed to assess the criteria of the specifier, but instead these studies approximated the DSM‐5 criteria from scales that were part of an already existing data base (Gaspersz, Lamers, Kent, & Beekman, , ; McIntyre, Weiller, Zhang, & Weiss, ; McIntyre, Woldeyohannes, Soczynska, & Vinberg, ; Melca, Yucel, Mendlowicz, & de Oliveira‐Souza, ; Shim, Woo, & Bahk, ). In some of these studies, not all the criteria were assessed (McIntyre et al., ; McIntyre, Woldeyohannes, et al., ; Melca et al., ; Shim et al., ), and in other studies, the authors noted that some of the proxy items may not have been accurate representations of the DSM‐5 criterion (Gaspersz et al., , ). Moreover, in each of these studies, the proxy assessment of the DSM‐5 criteria was cross‐sectional based on symptom presence during the past week.…”

Section: Introductionmentioning

confidence: 99%

Validity of the DSM-5 anxious distress specifier for major depressive disorder

et al. 2018

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Background: DSM-5 introduced the anxious distress specifier in recognition of the clinical significance of anxiety in depressed patients. Recent studies that supported the validity of the specifier did not use measures that were designed to assess the criteria of the specifier but instead approximated the DSM-5 criteria from scales that were part of an existing data base. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we examined the validity of the specifier diagnosed with a semistructured interview. Methods:Two hundred sixty patients with a principal diagnosis of major depressive disorder were evaluated with semistructured diagnostic interviews. The patients were rated on clinician rating scales of depression, anxiety and irritability, and completed self-report measures.Results: Approximately three-quarters of the depressed patients met the criteria for the anxious distress specifier. Patients with anxious distress had a higher frequency of anxiety disorders, particularly panic disorder and generalized anxiety disorder, as well as higher scores on measures of anxiety, depression, and anger. The patients meeting the anxious distress subtype reported higher rates of drug use disorders, poorer functioning during the week before the evaluation, and poorer coping ability compared to the patients who did not meet the anxious distress specifier. Moreover, anxious distress was associated with poorer functioning and coping after controlling for the presence of an anxiety disorder. Conclusions:The results of the present study indicate that anxious distress is common in depressed patients and support the validity of the DSM-5 anxious distress specifier.

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“…In fact, in a previous study, washing (and symmetry) symptoms were over-represented among OCD patients who, besides having low insight, fail to resist and to control performing their compulsions. 2 Other studies have also reported that washing is particularly common in OCD that develops after posttraumatic stress disorder 27 or comorbid with borderline personality disorder, 28 two conditions known to predispose sufferers to substance addiction. 29 There are also neurobiological findings to suggest that association between OCD washing and reward anticipation may be linked to brain deficits in reward processing 9 and altered dopaminergic neurotransmission.…”

Section: Discussionmentioning

confidence: 99%

Investigating the role of anticipatory reward and habit strength in obsessive-compulsive disorder

et al. 2017

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The correlates of obsessive–compulsive, schizotypal, and borderline personality disorders in obsessive–compulsive disorder

Cited by 21 publications

References 79 publications

Schizophrenia-spectrum psychopathology in obsessive–compulsive disorder: an empirical study

Schizophrenia-spectrum psychopathology in obsessive–compulsive disorder: an empirical study

Validity of the DSM-5 anxious distress specifier for major depressive disorder

Investigating the role of anticipatory reward and habit strength in obsessive-compulsive disorder

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