Clinical features of children and adolescents with obsessive-compulsive disorder and hoarding symptoms

Leading international experts in obsessive compulsive disorder (OCD) have published a new consensus report aimed at providing analysis and guidance to drive improved diagnosis and management of OCD worldwide. Presented at The European Congress of Psychiatry, Madrid, 17-21 March 2007 and recently published in CNS Spectrums, the report has made a number of important recommendations including the removal of OCD from anxiety disorders to create its own category. ...

Sunday, March 18, 2007
Together, disorder can be controlled

By Christina Vertullo

"I think it's unfortunate that we have evolved into a language in which we talk about perfectionism as 'adaptive.' That might not be a productive way of thinking about it."
Randy Frost
Smith College

The many faces of perfectionism
APA Online, Volume 34, No. 10 November 2003

The need for perfection comes in different flavors, each associated with its own set of problems, researchers say. ...

Obsessive-compulsive personality disorder

From Wikipedia, the free encyclopedia

http://en.wikipedia.org/wiki/Obsessive-compulsive_personality_disorder

Obsessive-compulsive personality disorder (OCPD), or anankastic personality disorder, is a personality disorder that is characterized by a general psychological inflexibility, rigid conformity to rules and procedures, perfectionism, and excessive orderliness.

Obsessive-compulsive personality disorder (OCPD) is often confused with obsessive-compulsive disorder (OCD). OCD is ego-dystonic where OCPD is ego-syntonic. This is to say, those with OCD know their behavior is problematic where the symtpoms of OCPD are part of a person's personality and are generally unaware of problematic behaviors.

Those who are suffering from OCPD do not generally feel the need to repeatedly perform ritualistic actions (such as excessive hand-washing), while this is a common symptom of OCD. Instead, people with OCPD tend to stress perfectionism above all else, and feel anxious when they perceive that things are not "right."

People with OCPD may hoard money, keep their home perfectly organized, or be anxious about delegating tasks for fear that they won't be completed correctly. There are three primary areas that cause anxiety for OCPD personalities: time, dirt and money. There are few moral gray areas for a person with OCPD; actions and beliefs are either completely right, or absolutely wrong. As might be expected, interpersonal relationships are difficult because of the excessive demands placed on friends, romantic partners, and children.

"My biggest problem is piles all over the house. I just can't throw anything away, not even junk mail. After all, I might need the paper to start a fire one day when there is no heat or electricity in the dead of winter. I finally went to the doctor because I was suffering from severe depression, due to the clutter in my house, and my inability to keep up with any of the housework. I was sleeping most of the day, and crying most of the time I was awake"...

Read the rest here

Anxiety Disorders Linked To Physical Conditions

Compulsive Hoarding and the OCD Population
A Thesis by Janice Galizia
Hofstra University

Abstract:
Hoarding behaviors and compulsive hoarding are found in many individuals with obsessive-compulsive disorder (OCD).  Despite the prevelance, the DSM-IV does not list hoarding as a classification but rather a symptom of both OCD as well as obsessive-compulsive personality disorder (OCPD).  Previous research has shown that OCD hoarders display more severe symptoms than their non-hoarding OCD counterparts. 

Additionally, the presence of hoarding behaviors in OCD individuals correlate with poor response rates with typical treatments including several forms of medications and cognitive behavioral therapy (CBT).  This thesis presents a discussion of the distinguishing factors between hoarding tendencies and compulsive hoarding, differences in OCD individuals with and without hoarding tendencies, a review of past treatment procedures as well as the results of one successful case study.  Since research in this area has not been extensively explored, future studies should focus on both compulsive hoarding and the relationship with hoarding and OCD.

Read the thesis here.

Cognitive Behavioral Therapy Helps Children With Obsessive-compulsive Disorder

Obsessive-Compulsive Spectrum Disorders

There are many other disorders that have qualities involving repetitive thoughts and behaviors, akin to Obsessive-Compulsive Disorder (OCD). These disorders are sometimes called as Obsessive-Compulsive Spectrum Disorders (OC Spectrum Disorders) because of the similarities. Not only that, but some experts believe that these disorders may all have similar underlying neurobiological causes as OCD. Neuroimaging studies taken of the brain show similar activity between OCD and certain OC spectrum disorders. As well as having similarities to OCD, OC Spectrum Disorders are also very comorbid with OCD and vice versa. Many spectrum disorders are classified as impulse control disorders -- where impulsivity can be thought of as seeking a small, short term gain at the expense of a large, long term loss.

Read more about OCD Spectrum Disorders here.

Is BDD a symptom of OCD or is it an entirely different problem?

There is an ongoing debate among researchers regarding the exact categorization of BDD (Body Dysmorphic Disorder) as a disorder, but many professionals consider it to be a form or subtype of Obsessive- Compulsive Disorder. BDD often subsists amidst a cluster of related anxiety disorders including OCD, General Anxiety Disorder, Panic Disorder, as well as Bulimia and Anorexia Nervosa. The BDD fear structure is similar to that of OCD, but the obsessions and compulsions are specifically related to ones body.  Read more, here.

What is OCD?

Obsessive-Compulsive Disorder (OCD) is a mental disorder characterized by obsessive thoughts and/or compulsive behaviors that significantly interfere with normal life. Obsessions are unwanted, recurrent, and disturbing thoughts which the person cannot suppress and which can cause overwhelming anxiety. Compulsions are repetitive, ritualized behaviors that the person feels driven to perform to alleviate the anxiety of the obsessions. The obsessive and compulsive rituals can occupy many hours of each day.

There are many disorders that have been mistakenly labeled as OCD. Some of them are the eating disorders, compulsive shopping, kleptomania, alcoholism, trichotillomania, and body dysmorphic disorder. Whilst there are similarities between OCD and these other disorders, there are also significant differences. Similar disorders that are not in fact OCD may be identified as OC Spectrum Disorders. Some of them require similar treatment, but for others the treatment is different. In addition, people with OCD frequently suffer from mood disorders, such as depression or bipolar disorder, as well as OCD.

Read more here from this source...

FIRST WHOLE-GENOME SCAN FOR LINKS TO OBSESSIVE COMPULSIVE DISORDER REVEALS EVIDENCE FOR GENETIC SUSCEPTIBILITY

A federally funded team of researchers including several from Johns Hopkins have identified six regions of the human genome that might play a role in susceptibility to obsessive compulsive disorder, or OCD. The study was published online June 6 in Molecular Psychiatry.

“OCD once was thought to be primarily psychological in origin,” says Yin Yao Shugart, Ph.D., statistical geneticist and associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health. “But now there is growing evidence that there is a genetic basis behind OCD, which will help us better understand the condition,” she says...

COH Recommended Reading to learn about OCD

Excellent current overview of OCD and treatment options if you are looking to understand what Obsessive Compulsive Disorder is all about.  Quotes from one of the author of the book  Overcoming Compulsive Hoarding as well as from Dr. Penzel who wrote "Saving The World" about compulsive hoarding (and is a consultant for the COH support group).

To read 9/28/06 article from Long Island Press, go here.

PubMed.:  2006 Sep;44(9):1361-74. Epub 2005 Dec 13
Obsessive-Compulsive Disorder Clinical and Research Unit, Department of Psychiatry, Hospital Principes de Espana, Ciudad Sanitaria y Universitaria de Bellvitge, c/ Feixa Llarga s/n 08907, Hospitalet de Llobregat, Barcelona, Spain.

Obsessive-compulsive disorder (OCD) runs in families, but the specific contribution of genetic and environmental factors to its development is not well understood. The aim of this study was to assess whether there are differences in perceived parental child-rearing practices between OCD patients and healthy controls, and whether any relationship exists between parental characteristics, depressive symptoms and the expression of particular OCD symptom dimensions. ...

SCIENCE NEWS
September 20, 2006

Psychiatric ills common in adults with fibromyalgia

By Amy Norton
NEW YORK (Reuters Health) - Many people with the chronic pain disorder fibromyalgia have also suffered from depression, anxiety or
other psychiatric conditions at some point in their lives -- suggesting, researchers say, that the disorders have some common
causes...

Parental rearing style contributes to OCD

25 August 2004 Source: Psychiatry Res 2004; 127: 267–278

Social and cultural variables may interact with biological and genetic factors to contribute to the development of obsessive-compulsive disorder (OCD), say researchers after finding parental child-rearing patterns play a role in the disease.

To investigate whether a relationship exists between parental characteristics, depressive symptoms, and the expression of particular OCD symptom dimensions, Pino Alonso (Hospital Principes de España, Barcelona, Spain) and colleagues studied 40 OCD outpatients and 40 mentally healthy control individuals.

...Hoarding was the only OCD symptom dimension that could be partially predicted by parental traits, specifically low parental emotional warmth....

(Read whole article by clicking "Read more")

Senate moves to require greater mental health coverage

Senate acts on Timothy's Law

The state Senate has passed legislation that would require health insurers to cover far more mental health treatment for adults and children  (note from COH Admin: this includes OCD)Click on Watch video about it here:

By MICHAEL GORMLEY
Associated Press Writer

September 15, 2006, 5:40 PM EDT
ALBANY, N.Y. -- The state Senate on Friday advanced a legislative agreement that would require health insurers to cover far more mental health treatment for adults and children.

Clinical and Research Reports

Obsessive-Compulsive Symptoms in Heart Disease Patients With and Without History of Rheumatic Fever

Pedro G. Alvarenga, M.D., Ana G. Hounie, Ph.D., Marcos T. Mercadante, Ph.D., Juliana B. Diniz, M.D., Marcos Salem, M.D., Guilherme Spina, M.D. and Eurípedes C. Miguel, Ph.D.

By comparing 51 heart disease patients with history of rheumatic fever and 46 heart disease patients with no rheumatic fever history, the authors found a higher prevalence of obsessive-compulsive symptoms in rheumatic fever subjects. This suggests that rheumatic fever activity is not a necessary condition for the expression of neuropsychiatric symptoms.

http://neuro.psychiatryonline.org/cgi/content/abstract/18/3/405

OCD should be out in the open for treatment

DOCTOR'S ORDERS
IAN MCKEE

IF you have seen Shakespeare's play Macbeth or, like me, had to study it for exams, you may remember Lady Macbeth was seen furiously rubbing her hands over and over again in an effort to remove non-existent blood from her hands. "Out damn'd spot" and all that.

Having previously committed a particularly nasty murder she had something to worry about but Shakespeare is giving quite a good description of a mental condition which affects up to one in a hundred people in Scotland today.

Obsessive Compulsive Disorder (OCD) is a serious mental illness but one which is seldom talked about because those affected often feel ashamed and try to keep it hidden. An obsession is when unwanted thoughts keep entering the mind. They may simply be ideas but sometimes urge a person to do something that they know to be a waste of time or generally undesirable.

Compulsions are actions or thoughts that are usually an attempt to settle worry caused by an obsession. Even as the action or thought is being carried out the person knows that it is a waste of time but that does not stop the behaviour. So someone who has an obsession about becoming dirty may wash hands frequently, even though they are already clean...

OCD symptoms characteristic of familial subtype revealed

psychiatrymatters.md.com:Researchers have discovered that individuals with early-onset familial obsessive-compulsive disorder (OCD) have certain symptoms that may help distinguish them from people with the sporadic disease subtype.

"Because of ongoing efforts to map and identify susceptibility genes for early-onset OCD according to family history, it is necessary to further characterize the clinical correlates of familial and sporadic (nonfamilial) forms of OCD," note Gregory Hanna (University of Michigan, Ann Arbor, USA) and colleagues.

The researchers carried out analyses using descriptive data for 50 individuals with early-onset OCD, of whom 33 had the familial and 17 the sporadic disease subtype. They looked for potential differences in 13 lifetime OC symptom categories and five lifetime comorbid psychiatric diagnoses...

Medical News Today
Main Category: Neurology / Neuroscience News

Article Date: 05 Aug 2006 - 16:00pm (PDT)"The data collected in this study begin to solve the problem of not having a way of measuring these neurological mechanisms in mice," Garner said. "Previously we were not able to measure this fundamental disease process in autism, trichotillomania (hair pulling), obsessive-compulsive disorder, Parkinson's disease, schizophrenia, Tourette's syndrome, traumatic frontal brain lobe injury and a host of other human mental disorders for which set shifting is an important monitoring tool." Read More here.

Thursday, August 3, 2006
By Joan Hennessy/ The Baltimore Sun

Karen Mann was diagnosed with bipolar disorder. She remembered that her grandmother also had the disorder. Within two years, a Kentucky genetics company plans to market a home test designed to help consumers determine whether they are genetically susceptible to schizophrenia.

One percent of all Americans -- some 2.4 million people -- have schizophrenia. An estimated 5.7 million have bipolar disorder. And 2.2 million adults have obsessive-compulsive disorder. What if you found out tomorrow that you could become one of them? Within two years, a Kentucky medical genetics company plans to market a home test designed to help consumers determine whether they are genetically susceptible to schizophrenia.

The test, performed at home and analyzed in a lab, is the culmination of 10 years of research -- and for better or worse, an example of what the brave new genomic world has wrought. The AssureGene test for schizophrenia was developed by SureGene, the Louisville, Ky., company that plans to market the assessment. Genes, the minuscule, biological ``instruction manuals'' that tell our bodies how to develop, have been tied to cocaine addiction, bipolar disorder, schizophrenia, anorexia nervosa and more...

Reported by Susan Aldridge, PhD, medical journalist

A gene responsible for glutamate transport plays a role in obessive compulsive disorder, according to two new studies. Obsessive compulsive disorder (OCD) is marked by severe anxiety, disturbing thoughts and a compulsion to repeat certain behaviors, such as handwashing and checking if the gas is switched off. OCD is known to run in families and two new papers from researchers at the University of Michigan and elsewhere shed light on the genetics involved. While more than one gene influences OCD, the researchers have found that a glutamate transporter gene called SLC1A1 is important. Glutamate is a brain chemical already known to play a role in OCD from brain imaging studies. We know from these that there are differences in the glutamate system between those with and without OCD. Variants in the SLC1A1 gene might influence the flow of glutamate into and out of brain cells and may render some people more prone to OCD. The findings may point the way towards better understanding and new treatments for OCD.

Source Archives of General Psychiatry July 2006
http://tinyurl.com/zvuff

Article Date: 28 Jul 2006 - 16:00pm (PDT)

Obsessive-compulsive disorder tends to run in families, causing members of several generations to experience severe anxiety and disturbing thoughts that they ease by repeating certain behaviors. In fact, close relatives of people with OCD are up to nine times more likely to develop OCD themselves.

Now, new research is shedding new light on one of the genetic factors that may contribute to that pattern. And while no one gene "causes" OCD, the research is helping scientists confirm the importance of a particular gene that has been suspected to play a major role in OCD's development...(click "read more" below or "comments" to add yours)