Impulsive compulsivity in obsessive-compulsive disorder: A phenotypic marker of patients with poor clinical outcome

dc.contributorUniversidade Estadual Paulista (UNESP)
dc.creatorKashyap, Himani
dc.creatorFontenelle, Leonardo F.
dc.creatorMiguel, Euripedes C.
dc.creatorFerrão, Ygor A.
dc.creatorTorres, Albina Rodrigues
dc.creatorShavitt, Roseli G.
dc.creatorFerreira-Garcia, Rafael
dc.creatorDo Rosário, Maria C.
dc.creatorYücel, Murat
dc.date2014-05-27T11:26:57Z
dc.date2016-10-25T18:38:16Z
dc.date2014-05-27T11:26:57Z
dc.date2016-10-25T18:38:16Z
dc.date2012-09-01
dc.date.accessioned2017-04-06T02:00:31Z
dc.date.available2017-04-06T02:00:31Z
dc.identifierJournal of Psychiatric Research, v. 46, n. 9, p. 1146-1152, 2012.
dc.identifier0022-3956
dc.identifier1879-1379
dc.identifierhttp://hdl.handle.net/11449/73526
dc.identifierhttp://acervodigital.unesp.br/handle/11449/73526
dc.identifier10.1016/j.jpsychires.2012.04.022
dc.identifier2-s2.0-84864378172
dc.identifierhttp://dx.doi.org/10.1016/j.jpsychires.2012.04.022
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/894329
dc.descriptionAlthough traditionally obsessive-compulsive disorder (OCD) and impulse control disorders (ICD) have represented opposing ends of a continuum, recent research has demonstrated a frequent co-occurrence of impulsive and compulsive behaviours, which may contribute to a worse clinical picture of some psychiatric disorders. We hypothesize that individuals with 'impulsive' OCD as characterized by poor insight, low resistance, and reduced control towards their compulsions will have a deteriorative course, greater severity of hoarding and/or symmetry/ordering symptoms, and comorbid ICD and/or substance use disorders (SUD). The sample consisted of 869 individuals with a minimum score of 16 on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Of these, 65 had poor insight, low resistance, and reduced control towards compulsions ('poor IRC') and 444 had preserved insight, greater resistance and better control over compulsions ('good IRC'). These two groups were compared on a number of clinical and demographic variables. Individuals with poor IRC were significantly more likely to have a deteriorative course (p < 0.001), longer duration of obsessions (p = 0.017), greater severity of symmetry/ordering (p < 0.001), contamination/cleaning (p < 0.001) and hoarding (p = 0.002) symptoms, and comorbid intermittent explosive disorder (p = 0.026), trichotillomania (p = 0.014) and compulsive buying (p = 0.040). Regression analysis revealed that duration of obsessions (p = 0.037) and hoarding severity (p = 0.005) were significant predictors of poor IRC. In the absence of specific measures for impulsivity in OCD, the study highlights the utility of simple measures such as insight, resistance and control over compulsions as a phenotypic marker of a subgroup of OCD with impulsive features demonstrating poor clinical outcome. © 2012 Elsevier Ltd.
dc.languageeng
dc.relationJournal of Psychiatric Research
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectImpulse control disorders
dc.subjectImpulsive-compulsive spectrum
dc.subjectImpulsivity
dc.subjectInsight and resistance
dc.subjectObsessive-compulsive disorder
dc.subjectadult
dc.subjectcompulsion
dc.subjectdemography
dc.subjectdisease duration
dc.subjecthuman
dc.subjectimpulse control disorder
dc.subjectimpulsiveness
dc.subjectmajor clinical study
dc.subjectobsession
dc.subjectobsessive compulsive disorder
dc.subjectphenotype
dc.subjectpriority journal
dc.subjectsymptom
dc.subjecttrichotillomania
dc.subjectYale Brown Obsessive Compulsive Scale
dc.subjectAdult
dc.subjectFemale
dc.subjectHumans
dc.subjectImpulse Control Disorders
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectObsessive-Compulsive Disorder
dc.subjectPsychiatric Status Rating Scales
dc.subjectQuestionnaires
dc.subjectRetrospective Studies
dc.subjectSeverity of Illness Index
dc.subjectStatistics, Nonparametric
dc.subjectYoung Adult
dc.titleImpulsive compulsivity in obsessive-compulsive disorder: A phenotypic marker of patients with poor clinical outcome
dc.typeOtro


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