OBJECTIVE: Cognitive behavioral therapy (CBT) is regarded as one of the most effective intervention for obsessive-compulsive disorder (OCD). However, many patients remain untreated or inadequately treated due to time or geographical constraints. The purpose of this study was to develop an internet-based CBT (ICBT) for OCD, and to examine its efficacy in the Korean clinical setting. METHODS: The ICBT program ('COT') was developed from the same OCD manual in the standard CBT intervention. Twenty-seven participants of the total 42 patients completed all training sessions of the ICBT and the remainder (n=15) were classified as non-completers. Self-report measures of OCD, depression, anxiety, and work/social functioning, in addition to a neurocognitive test battery, were administered by face-to-face before and after treatment. RESULTS: The participants showed significant improvements in OCD and depressive symptoms, and in work/social functioning after ICBT completion. The presence of combined medication had no significant impact on treatment effect. The non-completers displayed more severe depressive and anxiety symptoms, and ICBT responders were younger and performed better in the Wisconsin Card Sorting Test. CONCLUSION: ICBT was found to be as effective for patients with moderate OC symptoms and little treatment experience. Considering the high accessibility and convenience of ICBT, it could be a helpful first treatment step for OCD patients when face-to-face treatment is unavailable. In the future a randomized controlled study will be necessary for verification and generalization of these results.
Anxiety ; Cognitive Therapy* ; Depression ; Generalization (Psychology) ; Humans ; Internet ; Korea* ; Obsessive-Compulsive Disorder* ; Treatment Outcome ; Wisconsin

Disease identity of dysmorphophobia and olfactory reference syndrome which used to be manifested by a kind of monosymptomatic somatic delusion is not yet established definitely. So many issues such as whether it be regarded as separate disease, or a spectrum of preexisting diseases such as schizophrenia or obsessive compulsive disorder and whether the monosymptom should be considered as a delusion or not are still on debate and the results are controversial. Consequently few is known about the etiology of the disorder.Obvioulsy, somatic delusion in dysmorphophobia and olfactory reference syndrome is the result of cognitive distortion of body image of the self. It reflects symbolic meaning of unresolved psychological conflict by defense mechanisms such as repression, dissociation, symbolization, projection, and so on. Though psychopharmacological and psychotherapeutic treatment modality has been reported, the treatment efficacy is unclear. Prognosis has been reported unfavorable and one of the leading causes has been thought to be treatment noncompliance. The authors experienced 2 cases of olfactory reference syndrome, so reported with literature review.
Body Image ; Defense Mechanisms ; Delusions ; Obsessive-Compulsive Disorder ; Preexisting Condition Coverage ; Prognosis ; Repression, Psychology ; Schizophrenia ; Treatment Outcome

PURPOSE: The purpose of the study was to investigate psychological factors such as eating psychopathology, depression, and obsessive-compulsion that might influence self-harm behavior in patients with eating disorders. METHODS: Patients with eating disorders (n=135) who visited "M" clinic for eating disorders participated in the study. Data were collected from March to August 2007 using the Eating Disorder Inventory-2, Beck Depression Inventory, Maudsley Obsessional-Compulsive Inventory, and Self-Harm Inventory (SHI). RESULTS: The participants scored high on self-harm as well as on depression and obsessive-compulsion. On the SHI, a high frequency of self harm behavior such as 'torturing self with self-defeating thoughts', 'abused alcohol', 'hit self', and 'suicide attempt' were found for the participants. There were significant correlations between most eating psychopathology variables, depression, obsessive-compulsion, and self-harm behavior. 'Interoceptive awareness' (eating psychopathology), depression, and 'checking' (obsessive-compulsion) were significant predictors of self-harm behavior. CONCLUSION: Future interventions for patients with eating disorders should focus on assessing the possibility of self-harm and suicidal attempts, especially in those patients with high levels of eating psychopathology, depression, or obsessive-compulsion. Early intervention for depression and obsessive-compulsion could contribute to preventing self-harm and suicide in patients with eating disorders.
Adolescent ; Adult ; Child ; Demography ; Depression/complications/diagnosis/*psychology ; Eating Disorders/complications/diagnosis/*psychology ; Female ; Humans ; Obsessive-Compulsive Disorder/complications/diagnosis/*psychology ; Questionnaires ; Suicide, Attempted/psychology

PURPOSE: Alexithymia, defined as a deficit in the ability to recognize and describe one's own feelings, may be related to the development and maintenance of obsessive-compulsive symptoms. The aim of this study was to evaluate the association between the catechol-O-methyltransferase (COMT) Val158Met polymorphism and alexithymia in patients with obsessive-compulsive disorder (OCD). MATERIALS AND METHODS: We recruited 244 patients with OCD (169 males, 75 females). Alexithymia was assessed using the 20-item Toronto Alexithymia Scale (TAS-20), and genotyping of the COMT Val(158)Met polymorphism was evaluated. RESULTS: Patients with the COMT Val/Val genotype had significantly higher total and "difficulty identifying feelings" (DIF) subdimension scores than those with the Val/Met or Met/Met genotypes. Patients with the COMT Val/Val genotype had significantly higher "difficulty describing feelings" (DDF) subdimension scores than those with the COMT Val/Met genotype. However, there were no differences in the scores for the "externally oriented thinking" (EOT) subdimension among the three genotypes. CONCLUSION: These results indicate that the high-activity Val allele of the COMT Val(158)Met polymorphism is associated with increased alexithymic traits in patients with OCD. The present finding suggests that alexithymia is an endophenotype of OCD that is mediated by the COMT Val(158)Met polymorphism.
Adult ; Affective Symptoms/*diagnosis/genetics/psychology ; Alleles ; Catechol O-Methyltransferase/*genetics ; Female ; Genotype ; Humans ; Male ; Middle Aged ; Obsessive-Compulsive Disorder/*diagnosis/genetics/psychology ; Phenotype ; *Polymorphism, Genetic ; Republic of Korea

BACKGROUND/AIMS: To estimate the prevalence and evaluate the associated psychological factors of functional gastrointestinal disorders (FGIDs) in males in their twenties who are currently enrolled in military service. METHODS: A total of 1,073 men in the Korean army were asked to complete questionnaires based on the Rome III criteria and Symptom Checklist-90-revised (SCL-90R). The prevalence of FGIDs was estimated, and the associated psychological factors were evaluated. RESULTS: A total of 967 men participated. The total prevalence of FGIDs was 18.5% (age-adjusted prevalence, 18.1%; 95% confidence interval [CI], 15.3% to 20.8%). The total SCL-90R scores were higher in men with FGIDs than men without FGIDs (24 [interquartile range, 13 to 44] vs 13 [5 to 28], p<0.001) and higher in men with overlapping syndromes than in those with single FGIDs (31 [18 to 57] vs 14 [5.75 to 29], p<0.001). Somatization (odds ratio [OR], 1.141; 95% CI, 1.09 to 1.20; p<0.001), obsessive-compulsive behaviors (OR, 1.084; 95% CI, 1.03 to 1.14; p=0.002) and depression (OR, 0.943; 95% CI, 0.90 to 0.99; p=0.020) were identified as independent predictive factors for FGIDs. CONCLUSIONS: FGIDs are common among men in their twenties who are fulfilling their military duty. Somatization and obsessive-compulsive features from the tense atmosphere are associated with the development or progression of FGIDs. Patients who exhibit overlapping syndromes require greater attention given their more severe psychopathology.
Depression/complications ; Gastrointestinal Diseases/*epidemiology/psychology ; Humans ; Male ; Military Personnel/psychology/*statistics & numerical data ; Obsessive-Compulsive Disorder/complications ; Prevalence ; Psychopathology ; Republic of Korea/epidemiology ; Somatoform Disorders/complications ; Surveys and Questionnaires ; Young Adult

OBJECTIVE: Anger attacks have been observed in patients with obsessive-compulsive disorder (OCD), often triggered by obsessional triggers. However, few studies have reported the clinical characteristics and correlates of anger attacks among Chinese patients with OCD. METHODS: A total of 90 adults with a primary diagnosis of OCD, ranging from 15 to 78 years old, participated in the study. Participants were administered the Rage Outbursts and Anger Rating Scale (ROARS), Yale-Brown Obsessive-Compulsive Scale-Second Edition, and Brown Assessment of Beliefs Scale by a trained clinician. Patients completed the Obsessive-Compulsive Inventory-Revised and Depression Anxiety Stress Scale-21. RESULTS: A total of 31.3% of participants reported anger outbursts in the past week, and ROARS scores had no significant correlation with age, duration of illness, OCD severity, depression, or stress. However, ROARS scores were negatively related to education level, and positively related to obsessing symptoms and anxiety. CONCLUSIONS These data suggest that anger attacks are relatively common in Chinese patients with OCD. The severity of anger attacks is related to educational level, obsessing symptoms, and anxiety, which may be a latent variable reflecting executive functioning and emotion regulation skills.
Adolescent ; Adult ; Age Factors ; Anger ; China ; Depression/complications* ; Emotions ; Executive Function ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Obsessive-Compulsive Disorder/psychology* ; Regression Analysis ; Severity of Illness Index ; Stress, Psychological ; Young Adult

This study investigated the mental health status of medical students in China, and analyzed the influencing factors in order to provide evidence for mental health education for medical students. A stratified cluster sampling method was used to recruit medical students from Huazhong University of Science and Technology, China. The questionnaire survey on general information and Symptom Checklist 90 (SCL-90) were used for investigation and analysis. The results showed among the 1137 valid questionnaires, 278 (24.45%) participants had SCL-90 score ≥ 160. The top three mental problems of medical students were obsessive-compulsive disorder, interpersonal sensitivity and depression in terms of the factor score ≥ 2.5 and the number of participants who reflected on the diseases. The third-year medical students had the worst mental health status, and fifth-year medical students had the best mental health status. Students from rural area had more psychological problems than those from urban area; furthermore, students with high professional satisfaction, those who were the single child of the family, non-poor students, and those whose parents had high education level had better mental health status. It was concluded that the mental health of medical students is not optimistic in China. Medical students have some mental health problems of different degrees. Factors that influence the mental health of medical students include academic pressure, professional satisfaction level and family environment.
Adolescent ; Asian Continental Ancestry Group ; statistics & numerical data ; China ; Depression ; ethnology ; psychology ; Educational Status ; Female ; Health Status ; Humans ; Interpersonal Relations ; Male ; Mental Health ; ethnology ; standards ; statistics & numerical data ; Obsessive-Compulsive Disorder ; ethnology ; psychology ; Parents ; psychology ; Risk Factors ; Rural Health ; statistics & numerical data ; Sex Factors ; Socioeconomic Factors ; Students, Medical ; psychology ; Surveys and Questionnaires ; Urban Health ; statistics & numerical data ; Young Adult