Obsessive-compulsive disorder(OCD) is characterized by recurrent obsessions or compulsions causing marked distress. The lifetime prevalence of OCD in general population is estimated about 2~3%. OCD can usually be distinguished from psychosis by the facts that the patients recognize the irrational nature of the symptoms. OCD is also different from obsessive-compulsive personality in that the patients suffer from obsessions and compulsions which accompany marked distress. The etiology of OCD is not know yet. However, numerous studies suggest that OCD may be associated with several psychological and neurobiological factors such as functional abnormalities of cortico-striatal circuit and serotonin. Selective serotonin reuptake inhibitors(SSRI) are the first-line drugs for the treatmemt of OCD. Approximately 50~80% of OCD patients improved with these anti-obsessional drugs with average reduction in symptoms between 30~70%. Benefits may not appear for 2 or more weeks. Continuing a medication for more than 10 weeks is required to determine the anti-obsessional efficacy. Maintenance treatment is usually required for more than several months. Cognitive-behavioral therapy also proved to be effective, particularly for patients with prominent compulsions. Therefore, it is a logical choice to combine pharmacotherapy and cognitive-behavioral therapy. For extreme cases electroconvulsive therapy(ECT) or stereotaxic neurosurgery may be considered. However, at present, neurosurgery is recommended only for a few patients who remained severely disabled even after years of sufficient treatments.
Compulsive Personality Disorder ; Drug Therapy ; Humans ; Logic ; Neurosurgery ; Obsessive Behavior ; Obsessive-Compulsive Disorder* ; Prevalence ; Psychotic Disorders ; Serotonin

This study examined the clinical features of patients with obsessive-compulsive disorders who had been admitted to the Department of psychiatry, Seoul National Univ. Hospital from 1980 to 1995, using retrospective investigation of medical records. The subjects were 26 patients(male 22, female 4) who were compatible with the criteria of OCD by DSM-III-R. The results were as follows: 1) The most common obsessive thinking was pathologic doubt, followed by contamination, need for symmetry, somatic and sexual obsession, religious and aggressive obsession in descending order. Twenty three percent of patients had multiple obsessions. 2) The most common compulsive ritual was checking, followed by washing, need to ask and confess, symmetry and precision, counting in descending order. Thrity nine percents of patients had multiple rituals. 3) Depression, schizophrenia, Tourette's syndrome and tic disorder were the co-existing disorder with obsessive compulsive disorder. Cormorbid personality disorders in OCD were obsessive personality disorder, borderline personality disorder, schizotypal personality disorder and passive-aggressive personality disorder. 4) The course in OCD with co-existing disorder was worse than that in pure OCD. 5) The verbal IQ was significantly higher than the performance IQ checked by KWIS in obsessive compulsive disorder.
Borderline Personality Disorder ; Ceremonial Behavior ; Compulsive Behavior ; Depression ; Female ; Humans ; Inpatients* ; Medical Records ; Obsessive Behavior ; Obsessive-Compulsive Disorder* ; Passive-Aggressive Personality Disorder ; Personality Disorders ; Retrospective Studies ; Schizophrenia ; Schizotypal Personality Disorder ; Seoul ; Thinking ; Tic Disorders ; Tourette Syndrome

Although serotonin reuptake inhibitors (SRIs) are the primary therapeutic drugs for obsessive compulsive disorder (OCD), as many as 40% (up to 60%) of OCD patients do not show an adequate response to these drugs. SRI-refractory patients with OCD may have abnormalities in their central dopaminergic system as well as serotonergic system. The combination therapy with SRIs and antipsychotic drugs is considered to be effective especially for treatment-refractory OCD patients who have comorbid tic disorders or schizotypal personality disorder. Recently, the augmentation of atypical antipsychotics has been suggested to be effective in treating SRI-refractory OCD patients, and risperidone and olanzapine could be promising drugs for SRI-refractory OCD patients. We reviewed recent literatures regarding the clinical efficacy of atypical antipsychotics for treatment-refractory OCD patients.
Antipsychotic Agents* ; Humans ; Obsessive-Compulsive Disorder* ; Risperidone ; Schizotypal Personality Disorder ; Serotonin Uptake Inhibitors ; Tic Disorders

OBJECTIVE: The identifying schizotypal trait in obsessive-compulsive disorder (OCD) patients is important to predict clinical course, since those patients are hardly overcome through conventional intervention methods. This paper presents the trial of classification method of obsessive-compulsive disorder with schizotypal trait using Frontal Lobe Function Test (FLFT). METHODS: 110 OCD patients are divided into two groups:27 pure OCD patients, and 83 non-pure OCD patients. After training artificial neural network (ANN) using frontal-lobe function test data of train data (schizophrenia, pure OCD, and normal group), we classify test data (non-pure OCD patients) into one of the three groups. RESULTS: Among the total 83 test data (non-pure OCD patients), 44 patients were classified as schizophrenia, 32 patients as normal, and 7 patients as pure OCD. With respect to the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) data of those classified patients, ordering score in compulsion was significantly different between three groups. Moreover, cluster A socre (Schizoid, Schizotypal) of Personality Diagnostic Questionnaire (PDQ) data showed significant difference between them. CONCLUSION: The results presented that those OCD patients who are classified as schizophrenia using generated model with machine learning technique is tend to have compulsive symptom of arrangement and schizotypal personality disorder.
Machine Learning ; Classification* ; Frontal Lobe* ; Humans ; Obsessive-Compulsive Disorder* ; Surveys and Questionnaires ; Schizophrenia ; Schizotypal Personality Disorder

The purpose of this study was to assess the comorbid axis-II disorders of obsessive compulsive disorder(OCD) patients and to investigate the relationship between symptoms of OCD and the comorbid personality traits. The subjects were 59 patients who met DSM-IV criteria for obsessive-compulsive disorder and 32 normal controls. All subjects completed Personality Disorder Questionnaire-IV(PDQ-IV). The patients completed Beck Depression Inventory(BDI) and Beck Anxiety Inventory(BAI), and were rated with Yale-Brown Obsessive Compulsive Scale(YBOCS). The results were as follows. 1) The OCD patients showed significantly higher prevalence of avoidant, depresssive and borderline personality disorder(p<0.01) compared to controls. 2) The BAI score had significant effect on the avoidant personality score(t=3.23, p<0.003). The BDI score had significant effect on the depressive personality score(t=3.08, p=0.004). The YBOCS(t=2.10, p=0.043) and BAI(t=2.60, p=0.014)scores had significant effects on the borderline personality score. We found that OCD patients had higher prevalence of avoidant, depressive, and borderline personality disorders. We also found that obsessive-compulsive symptoms have significant effect on the severity of borderline personalty traits. We suggest that it would be very helpful to consider Axis-II disorders for managing patients with obsessive-compulsive disorder.
Anxiety ; Borderline Personality Disorder ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Obsessive-Compulsive Disorder* ; Personality Disorders ; Prevalence

BACKGROUND: The goal of the present study was to determine the relationships between attachment styles and resiliency in obsessive-compulsive personality disorder. METHODS: A random sample of 260 subjects was obtained from the population of undergraduate students of the Nour Branch of Islamic Azad University, which is located in Mazandaran, and these subjects were enrolled in this descriptive and correlational study. The collected data included the subjects' responses to an adult attachment style questionnaire, resilience scale, and obsessive-compulsive personality disorder questionnaire. The data were analyzed with Pearson correlation coefficient indices and multiple regressions. RESULTS: The results of the data analysis showed a positive correlation (relationship) between ambivalent/avoidant attachment styles and obsessive-compulsive personality disorder and a negative correlation between resilience and obsessive-compulsive personality disorder. Furthermore, these results demonstrated that attachment style and resiliency can predict obsessive-compulsive personality disorder. In addition, no significant relationships were found between the demographic variables (convertibles) and obsessive-compulsive personality disorder. CONCLUSION: These results suggested that attachment style and resiliency contribute to the development of obsessive-compulsive personality disorder.
Adult ; Compulsive Personality Disorder* ; Humans ; Islam ; Object Attachment ; Resilience, Psychological ; Statistics as Topic

OBJECTIVES: A great deal of attention has been paid to comorbid personality disorders in obsessive-compulsive disorder not only from the theoretical perspectives but also from the clinical aspects related to the prediction of the treatment response. The purpose of the current study was to investigate the relations of the symptoms dimensions in OCD to the comorbid personality pathology. METHODS: One-hundred thirty subjects with OCD completed Yale-Brown Obsessive Compulsive Scale (YBOCS) and Personality Disorder Questionnaire-4+ (PDQ-4+). Factor scores of symptom dimensions yielded from a factor analysis of 13 categories in YBOCS symptom checklist were inspected how to be related with the presence of any personality disorder and the PDQ scores for cluster A, B, and C personality pathology. RESULTS: The PDQ total score was significantly correlated with aggressive/sexual/religious obsessions, hoarding, and symmetry/ordering dimensions. The hoarding and repeating/counting dimensions were correlated with cluter A pathology, the symmetry/ordering dimension was with cluster B pathology, while the obsessions dimension was globally related to personality disorders of all the clusters. CONCLUSION: These findings add the evidence of the heterogeneity of OCD. The presence of pure obsessions, hoarding, and symmetry/ordering dimensions may need a close screening for comorbid personality disorders and individualized therapeutic strategies.
Checklist ; Mass Screening ; Obsessive Behavior ; Obsessive Hoarding ; Obsessive-Compulsive Disorder* ; Pathology* ; Personality Disorders ; Population Characteristics

OBJECTIVE: The aim of this study was to describe and evaluate the clinical data and short-term treatment response in patients with obsessive-compulsive disorder (OCD) based on an outpatient setting. METHODS: A group of patients with OCD underwent mean 12-weeks treatment with selective serotonin reuptake inhibitors. The patients were divided into two groups according to treatment response, defined as a reduction of the Yale-Brown Obsessive Compulsive Scale total score >35% and CGI of 1 or 2. RESULTS: 1) Among the 249 patients, 24.1% had checking type and 23.7% washing type. Among these two types, 31.9% had mood disorder, 15.0% had anxiety disorder and 24.5% personality disorder as co-morbidity. One hundred fourteen patients (45.8%) responded to the treatment and 135 (54.2%) did not. The responders decreased Y-BOCS scores from 27.9+/-7.2 at baseline to 21.3+/-6.4 and 19.3+/-3.8 at post-treatment 8 and 12 weeks, respectively (repeated measure ANOVA, p=0.039). There were no differences among the treatment responses to serotonin reuptake inhibitors. CONCLUSION: About half of the OCD patients showed a response to pharmacological treatment using SSRI in the outpatient clinic setting for 12 weeks. Long-term and contrast studies of OCD may elucidate further clinical aspects of this disorder in the future.
Ambulatory Care Facilities ; Anxiety Disorders ; Comorbidity ; Humans ; Mood Disorders ; Obsessive-Compulsive Disorder* ; Outpatients ; Personality Disorders ; Serotonin Uptake Inhibitors

Although obsessive-compulsive disorder (OCD) is recognized as a major psychiatric illness, few studies have investigated obsessive-compulsive symptoms in patients with schizophrenia. Recent increases in dual diagnosis due to changes to the DSMIV diagnostic criteria, findings of obsessive-compulsive symptoms (OCS) after administration of atypical antipsychotics, increased reports of co-occurrence of schizophrenia and OCD have increased the interest in OCS in schizophrenia. The incidence of OCS in patients with schizophrenia is reported to be 3-59%; however, the rate of progression to schizophrenia from OCD is not higher than in the general population. Level of insight, which differentiates obsessions from delusions, can be confounded by the specifier 'with poor insight' in OCD. OCD with schizotypal personality disorder or poor insight differs from pure OCD in that it responds poorly to treatment, has a poor prognosis, leads to deficits in cognitive functioning similar to those observed in schizophrenia, and responds well to low-dose antipsychotics. In the past, it was believed that OCS could prevent or delay the deteriorative course of schizophrenia. However, recent studies have shown that co-occurrence of OCD and schizophrenia increases the severity of symptoms, delays the treatment response, and reduces socio-occupational functions. Schizophrenia and OCD share the same pathophysiology in that both diseases have defects in the fronto-basal functional circuitry of the brain. The use of serotonin and dopamine has been addressed in schizophrenia due to the use of atypical antipsychotics in patients with schizophrenia. The finding of drug-induced OCS suggested that the two diseases share a similar pathogenesis involving neurotransmitters. Further studies are needed to make an exact diagnosis between the two diseases and to determine the common pathophysiology between OCD and schizophrenia.
Antipsychotic Agents ; Anxiety ; Brain ; Delusions ; Diagnosis, Dual (Psychiatry) ; Dopamine ; Humans ; Incidence ; Neurotransmitter Agents ; Obsessive Behavior ; Obsessive-Compulsive Disorder ; Prognosis ; Schizophrenia ; Schizotypal Personality Disorder ; Serotonin

The average age of frontotemporal dementia onset is much younger than that of the Alzheimer's disease. Behavioral disturbances occur at the early stage of frontotemporal dementia, and social dysfunction and personality deterioration may ensue. For this reason, it may be misdiagnosed as other psychiatric disorders. Therefore, more careful observation and concern is required for proper diagnosis. This report is about the case of a patient who had been misdiagnosed of disorders like schizotypal personality disorder, schizophrenia, obsessive compulsive disorder etc., and therefore have been treated for those. We reviewed this case based on the data of neuropsychiatric history, family history, neuropsychological test, brain MRI, and SPECT, and considered this case as frontotemporal dementia with family history. This is the first frontotemporal dementia case with family history in Korea, so hereafter we may discover the gene locus associated with this case. This study can be very useful for the following frontotemporal dementia studies in Korea.
Alzheimer Disease ; Brain ; Dementia ; Diagnosis ; Frontotemporal Dementia* ; Humans ; Korea ; Magnetic Resonance Imaging ; Neuropsychological Tests ; Obsessive-Compulsive Disorder ; Schizophrenia ; Schizotypal Personality Disorder ; Tomography, Emission-Computed, Single-Photon