OBJECTIVES: To explore the psychological status of medical staff in the epidemic period of coronavirus disease 2019 (COVID-19), and to analyze its influential factors. METHODS: A total of 373 medical staff from Xiangya Hospital and the Second Xiangya Hospital of Central South University were enrolled for this study. The General Sociological Data Questionnaire, Symptom Check-List 90 (SCL-90), and self-designed public opinion response questionnaire were used to assess general sociological data, mental health scores, and ability to respond to COVID-19 related public opinion information of medical staff. The mental health scores of medical staff with different general sociological data and public opinion information coping abilities were compared. Influential factors of mental health were analyzed. RESULTS: The average score of 10 factors in SCL-90 of 373 medical staff was less than 2 points. 14.21% medical staff had one or more factor scores more than two points, including 11.26% with terror symptoms, 7.77% with compulsive symptoms, and 5.63% with anxiety. The main sources of COVID-19 information for medical staff included WeChat, microblog, Jinri toutiao, TV and radio. 66.22% medical staff regularly verified information about COVID-19 through official websites or formal channels. A great deal of COVID-19 information in WeChat could make medical staff nervous (34.05%), anxious (30.29%), and insecure (29.22%). 68.63% medical staff sometimes were worried about getting infected because they knew information about COVID-19. Different departments of medical staff, getting cough or having a fever recently, and the degree of fear of infection had an impact on the SCL-90 score of medical staff, the differences were all statistically significant (all <0.05). Stepwise regression analysis showed that the impact of COVID-19 information on their life in WeChat, getting cough or having a fever recently, insomnia-early caused by COVID-19 information in WeChat, different departments, and the degree of fear of infection COVID-19 were the influential factors for the mental health of medical staff (all <0.05). CONCLUSIONS During the epidemic of COVID-19, medical staff suffered from psychological problems to various degrees. It is necessary to establish a psychological assistance platform and guide the direction of public opinion correctly to promote the mental health of medical staff.
Anxiety ; Betacoronavirus ; China ; Compulsive Behavior ; Coronavirus Infections ; epidemiology ; psychology ; Fear ; Health Status ; Humans ; Medical Staff ; psychology ; Mental Health ; Pandemics ; Pneumonia, Viral ; epidemiology ; psychology ; Surveys and Questionnaires

Most patients with Tourette's disorder experience an uncomfortable sensory phenomenon called the premonitory urge immediately before experiencing tics. It has been suggested that premonitory urges are associated with comorbidities such as obsessive compulsive disorder, anxiety disorders, and attention-deficit/hyperactivity disorder, although these associations have been inconsistent. Most patients experience tics as a result of the premonitory urges, and after the tics occur, most patients report that the premonitory urges are temporarily relieved. As a consequence, several studies have assessed the premonitory urge and its potential therapeutic utility. Based on the concept that the premonitory urge induces tics, behavioral treatments such as Exposure and Response Prevention and Habit Reversal Therapy have been developed. However, it is still unclear whether habituation, the main mechanism of these therapies, is directly related to their effectiveness. Moreover, the observed effects of pharmacological treatments on premonitory urges have been inconsistent.
Anxiety Disorders ; Behavior Therapy ; Comorbidity ; Drug Therapy ; Humans ; Obsessive-Compulsive Disorder ; Tics ; Tourette Syndrome

Diagnosing and managing dementia, presenting with compulsions is challenging. Presented are three cases, a possible representative subset of the Donepezil responders. Selective degeneration of dorsolateral prefrontal cortex networking striatum leading to compulsions would be amenable to cholinergic modulation.
Compulsive Behavior* ; Dementia* ; Prefrontal Cortex ; Psychotic Disorders

Parkinson's disease (PD) is the second most common neurodegenerative disorder. Although its major manifestation is motor symptoms, resulting from the loss of dopaminergic neurons in the substantia nigra, psychiatric symptoms, such as depression, anxiety, hallucination, delusion, apathy and anhedonia, impulsive and compulsive behaviors, and cognitive dysfunction, may also manifest in most patients with PD. Given that the quality of life — and the need for institutionalization — is so highly dependent on the psychiatric well-being of patients with PD, psychiatric symptoms are of high clinical significance. We reviewed the prevalence, risk factors, pathophysiology, and treatment of psychiatric symptoms to get a better understanding of PD for improved management.
Anhedonia ; Anxiety ; Apathy ; Compulsive Behavior ; Delusions ; Dementia ; Depression ; Dopaminergic Neurons ; Hallucinations ; Humans ; Institutionalization ; Neurodegenerative Diseases ; Parkinson Disease* ; Prevalence ; Psychotic Disorders ; Quality of Life ; Risk Factors ; Substantia Nigra

The seeds of addiction are typically sown years prior to the onset of addictive substance use or engagement in addictive behaviors, due to the priming of the reward pathway (RewP) by alterations in the mechanism of stress-signaling from the hypothalamic-pituitary-adrenal axis (HPA) and related pathways. Excessive stress from a single-event and/or cumulative life experiences during childhood, such as those documented in the Adverse Childhood Experiences Study, is translated into neurobiological toxicity that alters the set-point of the HPA axis and limbic system homeostasis [suggested new term: regulation pathway (RegP)]. The resultant alteration of the RegP not only increases the risk for psychiatric and physical illness, but also that for early onset and chronic addictions by dysregulating the RewP. This paper reviews the interface of these symbiotic pathways that result in the phenotypic pathology of emotional dysregulation, cognitive impairment, and compulsive behaviors, as well as morbidity and shorter life expectancy when dysregulated by chronic stress.
Behavior, Addictive ; Cognition Disorders ; Compulsive Behavior ; Homeostasis ; Life Change Events ; Life Expectancy ; Limbic System ; Pathology ; Reward

OBJECTIVE: The goal of this study was to evaluate consistencies and discrepancies between clinician-administered and self-report versions of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and to examine relationships between these scales and personality traits. METHODS: A total of 106 patients with obsessive-compulsive disorder (OCD) participated in this study. All participants were assessed with both clinician-administered and self-report versions of the Y-BOCS. The Structured Clinical Interview for DSM-IV Axis II Disorders Personality Questionnaire (SCID-II-PQ) was used to evaluate relationships between personality traits and scores on the Y-BOCS. RESULTS: Scores on the clinician-administered Y-BOCS and its obsession subscale were significantly higher than were those on the self-report version. However, we found no significant differences in compulsion subscale scores. We also found that the discrepancies in the scores on the two versions of the Y-BOCS and its compulsion subscale were significantly positively correlated with scores for narcissistic personality traits on the SCID-II-PQ. Additionally, narcissistic personality traits had a significant effect on the discrepancy in the scores on the two versions of the Y-BOCS and its compulsion subscale in the multiple linear regression analysis. CONCLUSION: This is the first study to elucidate relationships between personality traits and discrepancies between scores on the two versions of the Y-BOCS. Although clinicians tend to rate obsessive symptoms as being more severe than do patients, clinicians may underestimate the degree to which individuals with narcissistic personality traits suffer more from subjective discomfort due to compulsive symptoms. Therefore, the effect of personality traits on symptom severity should be considered in the treatment of OCD.
Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Linear Models ; Obsessive Behavior ; Obsessive-Compulsive Disorder* ; Surveys and Questionnaires ; Weights and Measures

OBJECTIVES: Non-completion rate of cognitive behavioral therapy (CBT) for Obsessive Compulsive Disorder (OCD) was reported to be higher than expected and it could interfere with the effectiveness of treatment. The aim of this study was to investigate predictors of treatment non-completion and to compare the effectiveness of CBT for OCD between completers and non-completers. METHODS: We studied 107 patients with a principal diagnosis of OCD who initiated a 13-week CBT for OCD from June 2004 to June 2011. Demographic and clinical characteristics, psychiatric co-morbidity, and medication of 20 participants who did not complete therapy were compared with those of treatment completers (n=87). Clinical Global Impression scores were also compared between the two groups in order to evaluate the effect of CBT for OCD at the 13th week. RESULTS: The results showed a difference in marital status between treatment completers and non-completers : more non-completers were not married (p=0.04). Patients with aggressive obsessions at baseline showed a trend (p=0.06) toward lower treatment completion than those with only non-aggressive obsession. In addition, the non-completer group showed a trend of not being medicated (p=0.08). No other differences were observed between completers and non-completers. The 13th week Clinical Global Impression-Improvement scores were significantly different ; completers (2.5+/-0.8) and non-completers (3.2+/-0.8) (p<0.001). CONCLUSION: In this study, we confirmed that CBT could affect symptom improvement of OCD and treatment non-completion interfered with effectiveness of CBT. However, in the current state of our knowledge, no factor is clinically applicable as a predictor of treatment non-completion. Therefore, these results suggest that clinicians should monitor compliance during CBT for OCD patients.
Cognitive Therapy* ; Compliance* ; Diagnosis ; Fibrinogen ; Humans ; Marital Status ; Obsessive Behavior ; Obsessive-Compulsive Disorder*

OBJECTIVE: Although several self-report versions of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) have been developed and used widely, few psychometric studies have established the construct validity of this measure. Therefore, we developed Korean self-report version of the Y-BOCS and evaluated its factor structure, reliability, and validity. METHODS: A non-clinical student sample (n=206) and a clinical OCD sample (n=199) completed the Korean self-report version and other measures of obsessive-compulsive disorder (OCD), depression, and anxiety. RESULTS: Consistent with the originally proposed structure, confirmatory factor analyses supported a factor structure comprised of Obsessions and Compulsions factors in the Korean self-report version. Two subscale scores and the total score of the Korean self-report version showed good internal consistency and convergent validity, but relatively poor discriminant validity. Applying a cutoff score of 16, 84% of OCD patients and 93% of the non-clinical sample were classified correctly. CONCLUSION: Korean self-report version of the Y-BOCS is a psychometrically sound and valid measure for assessing OCD symptoms as compared with the clinician-administered version. The originally proposed division of OCD severity into obsessions and compulsions appears accurate in the Korean self-report version. The cutoff score for the Korean self-report version needs adjustment based on further researches.
Depression ; Humans ; Obsessive Behavior ; Obsessive-Compulsive Disorder ; Psychometrics

OBJECTIVE: In this study, we aimed to investigate the predictors of clinical response to escitalopram (ESC) in obsessive-compulsive disorder (OCD) from the baseline clinical characteristics. In addition, we aimed to search the differences of prescription pattern between responders and non-responders to ESC. METHODS: Two hundred and twenty-three patients who met the DSM-IV criteria for OCD and visited at least once after the initiation of ESC prescription were included in this study. A primary outcome measure was the Clinical Global Impression-Improvement scale (CGI-I), which was scored at the time of retrospective chart review. Responders were defined as those with a CGI-I score of 1 or 2 at the final point of evaluation. Baseline clinical characteristics, prescription patterns, and adverse events were compared between responders and non-responders. We also examined the validity of the prediction model regarding treatment response to ESC. RESULTS: The OCD patients having aggressive obsessions and related compulsions showed significantly decreased response rate to ESC (odd ratio=0.285) in comparison with the OCD patients not having aggressive symptom dimension (p=0.002). The maximum dose of ESC prescription and rate of antipsychotics combination were higher in responders in comparison to the nonresponders. Among the adverse effects, sedation and constipation showed significantly different occurrence rate between responders versus non-responders. CONCLUSION: Aggressive obsessions and related compulsions seem to be associated with poor clinical response to ESC in OCD. Obsessive-compulsive symptom dimension should be considered when choosing a serotonin reuptake inhibitor for OCD.
Antipsychotic Agents ; Citalopram ; Constipation ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Obsessive Behavior ; Obsessive-Compulsive Disorder ; Outcome Assessment (Health Care) ; Prescriptions ; Retrospective Studies ; Serotonin

OBJECTIVE: There has been no study in the literature evaluating total blood count in obsessive-compulsive disorder (OCD). Therefore, we performed the present study to spesifically measure serum total blood count particularly white blood cells to see whether or not its eventual alterations might have an etiopathogenetic significance in patients with OCD. METHODS: Total blood count was measured in thirty patients and same number of healthy controls. Additionally, all patients were assessed by Yale-Brown Obsession Compulsion Scale (Y-BOCS). RESULTS: Except for neutrophil count, there were no significant differences between the groups regarding any haematological parameter. The mean neutrophil count of the patient group was lower compared to that of the control subjects. CONCLUSION: In conclusion, the present study suggests that neutrophil count is reduced in pure OCD patients and this finding may contribute to the role of immunological factors in the pathogenesis of OCD.
Humans ; Immunologic Factors ; Leukocytes ; Neutrophils ; Obsessive Behavior ; Obsessive-Compulsive Disorder