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

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

OBJECTIVES: The purpose of the study was to examine the relationships between temperament and character dimensions and family environments, and to investigate the influences of those factors on the antisocial personality traits in delinquent adolescents. METHODS: The subjects consisted of 160 male adolescents detained at the public prosecutor's office on the suspicion of crimes. To assess personality dimensions and family environmental factors, the Temperament and Character Inventory(TCI) and the Family Environment Scale(FES) were completed. Antisocial personality traits were assessed by the number of antisocial personality disorder symptoms of the Personality Disorder Questionnaire-Revised. RESULTS: Most of the TCI dimensions except Reward Dependence(RD) were highly correlated with the subscales of FES. Among temperament dimensions, Novelty Seeking(NS) and Persistence(P) were significantly affected by Organization, and Harm Avoidance(HA) was influenced by Expressiveness of FES. Self-Directednss(SD) was best predicted by Organization and Achievement-Orientation. While the Independence had significant effect on Cooperativeness, Expressiveness and Achievement-Orientation best predicted the level of Self-Transcendence(ST). On factor analysis, NS, HA, SD and ST were allocated to the same factors with subscales of FES. The level of antisocial personality trait was best predicted by NS, P and SD scores of TCI, and conflict subscale scores of FES. CONCLUSION: The findings of this study suggest that not only the character dimensions but also the temperament dimensions have close relationships with family environmental factors, and that the antisocial personality traits of delinquent adolescents may developed by the interaction between temperament/character dimensions and family environments.
Adolescent* ; Antisocial Personality Disorder* ; Crime ; Humans ; Personality Disorders ; Reward ; Temperament*

One hundred and seven patients with alopecia areata were studied in regard to the character of personality, emotional stress during their military life, socioeconomic status and their possible role in the pathogenesis of alopecia areata by ready-made chart and Minnesota Multiphasic Personality Inventory (M.M.P.I,) While only 55. 4% of out patients were enlisted men, 73. 0% of alopecia areata patients were soldiers suggesting that soldiers are more prone to develop alopecia areata. This trend was more apparent among soldiers who were less than 6 months in the service. In clinical scale, abnormal MMPI profiles were noted in 65 patients (60. 7%). Among abnormal MMPI profiles, hysteria scale is most common (23. 1%) and followed by hypochondriasis scale 18. 5%, psychiasthenia scale 16. 9%, and paranoia scale 12. 3%. The alopecia areata group showed significant difference in psychopathic deviate, schizophrenia, and paranoia which is high in person having psychotic symptoms and psychopathic personality. The neurotic triad or anxiety index is not significantly elevated.
Alopecia Areata ; Alopecia* ; Antisocial Personality Disorder ; Anxiety ; Humans ; Hypochondriasis ; Hysteria ; Male ; Military Personnel ; MMPI ; Outpatients ; Paranoid Disorders ; Schizophrenia ; Social Class ; Stress, Psychological

The concept of bipolar spectrum disorder (BSD) has developed to include affective temperaments such as cyclothymia and hyperthymia. This has greatly helped clinicians to differentiate depressed patients, who would potentially benefit from mood stabilizing treatment, from those with unipolar depression. Cyclothymia, however, has significant similarities with personality disorders, especially with borderline personality disorder (BPD). All the diagnostic items for BPD are frequently found in patients with BSD as well, which presents diagnostic challenges. There are no clear guidelines on how to differentiate BSD from BPD. Featuring borderline pathology for clinical purposes, it may be useful to rely on psychodynamic approaches to identify primitive defense mechanisms of splitting and projective identification suggesting borderline personality organization. Based on new findings on common features between BSD and BPD, some authors have proposed a renewal of the classification system of mental disorders. The dichotomy of bipolar and unipolar depression has gestated a new concept of BSD. Currently, the BSD concept forced us to formulate the border of BSD and personality disorders.
Bipolar Disorder* ; Borderline Personality Disorder ; Classification ; Defense Mechanisms ; Depressive Disorder ; Humans ; Mental Disorders ; Pathology ; Personality Disorders* ; Temperament

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

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

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

OBJECTIVE: The association of offender mental illness (including those on probation) with crime has long been the subject of social interest; however, systematic management has been insufficient. The study purpose was to analyze mental illness prevalence, proportion of first offenses and recidivism with the mental illness of those on probation. METHODS: A total of 206 adults on probation were divided into groups (first offenders and repeat offenders) and they completed self-report instruments and clinical interviews designed to diagnose mental illness. RESULTS: The mental illness prevalence among those on probation was considerably higher than that of the general population, and having mental illness was related to re-sentencing probation or recidivism. In particular, alcohol use disorder, major depressive episode, manic/hypomanic episode, and antisocial personality disorder were shown to affect recidivism. CONCLUSION: To achieve the ultimate purpose of probation, social and systematic intervention on a mental health and medical basis may be required.
Adult* ; Antisocial Personality Disorder ; Crime ; Criminals ; Depressive Disorder, Major ; Humans ; Mental Disorders ; Mental Health* ; Prevalence

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