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

OBJECTIVES: Previous studies have indicated that obsessive-compulsive disorder (OCD) is associated with high levels of impulsiveness. The aim of this study was to assess whether there are differences in clinical correlates with impulsiveness between OCD patients and healthy controls, and whether there is a significant relation between certain obsessive-compulsive symptomatic dimensions and impulsiveness. METHODS: A group of 45 OCD outpatients and 45 matched healthy controls were interviewed and diagnosed according to DSM-IV criteria. All subjects were assessed by means of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Barratt Impulsiveness Scale (BIS-11), the Hamilton Anxiety Scale (HAM-A), and the Montgomery-Asberg Depression Rating Scale (MADRS). RESULTS: Compared with healthy controls, OCD patients exhibited significantly higher BIS-11 scores except for with respect to non-planning impulsiveness. The MADRS scores and age at onset in patients with OCD were significantly correlated with BIS-11 total scores. Multiple regression analyses revealed that only age at onset showed an independent positive correlation with impulsiveness. Hoarding was the only dimension significantly associated with impulsiveness. CONCLUSION: These findings suggest that groups of patients with early onset OCD may show some association with impulsiveness, and that impulsiveness may be another distinct clinical feature of hoarding in OCD.
Anxiety ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Obsessive Hoarding ; Obsessive-Compulsive Disorder ; Outpatients

BACKGROUND: It is not uncommon to misdiagnose frontotemporal dementia (FTD) because it presents with alterations in personality and behavior rather than cognitive decline. Since compulsive behavior is one of the common early manifestations of FTD, analysis of compulsive behaviors, together with presenting symptoms, would help diagnose FTD in its early stage. METHODS: Subjects consisted of 25 patients (5 men and 20 women with mean age of 56 +/-9 years) who met the FTD criteria proposed by the Lund and Manchester group. We analyzed their presenting symptoms and compulsive behaviors retrospectively. RESULTS: The presenting symptoms were variable, including inappropriate judgement, loss of spontaneity, memory disturbance, personality change, apathy, repetitive movements, hypersexuality, and parsimony. Twenty-two out of the 25 patients (88%) showed compulsive behaviors. They included reading signboards, stereotypy of speech, ordering, hoarding, washing, checking, counting, singing, and wandering a fixed route. CONCLUSIONS: Compulsive behaviors are commonly associated with FTD and thereby understanding of these symptoms together with presenting symptoms may help diagnose FTD early and minimize the misdiagnosis of FTD for Alzheimer's disease or other psychiatric illnesses.
Alzheimer Disease ; Apathy ; Compulsive Behavior* ; Diagnostic Errors ; Female ; Frontotemporal Dementia* ; Humans ; Male ; Memory ; Obsessive Hoarding ; Retrospective Studies ; Singing

OBJECTIVE: There is increasing evidence that obsessive-compulsive disorder (OCD) is a multidimensional and heterogeneous disorder mediated by a range of different factors, including genetic variation. Our aim was to investigate the possible association of OCD with monoamine oxidase-A (MAO-A) gene polymorphisms in a Korean population. METHODS: Patients with OCD (N=121) and normal individuals (N=276) participated. Genomic DNA was extracted from the peripheral blood of all subjects, and genotypes were determined. Males and females were treated as separate groups because the MAO-A gene is located on the X chromosome. MAO-A genotypes and allele frequencies were compared with the Yale-Brown Obsessive-Compulsive Scale (YBOCS) factor scores of both groups. RESULTS: Male OCD patients exhibited a higher frequency of allele 3.00 and a lower frequency of allele 4.00 than did normal male patients. Additionally, male patients with allele 4.00 scored higher for YBOCS factor 1 (obsession: hoarding; compulsion: counting, repeating, hoarding, ordering) than did those with allele 3.00. CONCLUSIONS: The MAO-A gene may be associated with the development of OCD in males. Further study is necessary to evaluate the relationship between OCD and MAO-A genetic polymorphisms.
Alleles ; DNA ; Female ; Gene Frequency ; Genetic Variation ; Genotype ; Humans ; Male ; Monoamine Oxidase ; Obsessive Hoarding ; Obsessive-Compulsive Disorder ; Polymorphism, Genetic ; X Chromosome

INTRODUCTIONHoarding is defined as the acquisition of, and inability to discard items even though they appear to others to have no value. The objectives of the study were to establish the prevalence of hoarding behaviour among the general population and among individuals with obsessive-compulsive disorder (OCD) in a cross-sectional study conducted in Singapore.

MATERIALS AND METHODSThe Singapore Mental Health Study was a cross-sectional epidemiological survey of a nationally representative sample of residents aged 18 years or older, living in households. The diagnoses of mental disorders were established using Version 3.0 of Composite International Diagnostic Interview (CIDI 3.0). Differences between 3 groups i.e. those diagnosed with lifetime/12-month Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) OCD with hoarding, those diagnosed with lifetime/12-month DSM-IV OCD without hoarding and those with lifetime hoarding behaviour without diagnosis of DSM-IV OCD were determined.

RESULTSThe weighted prevalence of lifetime hoarding behaviour was 2% and that of hoarding among those with OCD was 22.6%. Those who met the criteria for hoarding behaviour alone were associated with lower odds of having obsessions of contamination, harming, ordering as well as compulsions of ordering and other compulsions than those who met criteria for both OCD and hoarding.

CONCLUSIONHoarders without OCD were less impaired, in terms of comorbid psychopathology, than those with OCD with and without hoarding, and had a higher quality of life versus those with both OCD and hoarding, though still lower than that of the general population.

Adolescent ; Adult ; Aged ; Cross-Sectional Studies ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Hoarding Disorder ; complications ; diagnosis ; epidemiology ; etiology ; Humans ; Male ; Middle Aged ; Obsessive-Compulsive Disorder ; complications ; diagnosis ; Prevalence ; Quality of Life ; Singapore ; epidemiology ; Young Adult