Impulsive compulsivity in obsessive-compulsive disorder: A phenotypic marker of patients with poor clinical outcome

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dc.contributor.authorKashyap, Himani
dc.contributor.authorFontenelle, Leonardo F.
dc.contributor.authorMiguel, Euripedes C.
dc.contributor.authorFerrão, Ygor A.
dc.contributor.authorTorres, Albina Rodrigues [UNESP]
dc.contributor.authorShavitt, Roseli G.
dc.contributor.authorFerreira-Garcia, Rafael
dc.contributor.authorDo Rosário, Maria C.
dc.contributor.authorYücel, Murat
dc.contributor.institutionUniversity of Melbourne and Melbourne Health
dc.contributor.institutionFederal University of Rio de Janeiro
dc.contributor.institutionD'Or Institute for Research and Education
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionHealth Sciences Federal University of Porto Alegre
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.date.accessioned2014-05-27T11:26:57Z
dc.date.available2014-05-27T11:26:57Z
dc.date.issued2012-09-01
dc.description.abstractAlthough traditionally obsessive-compulsive disorder (OCD) and impulse control disorders (ICD) have represented opposing ends of a continuum, recent research has demonstrated a frequent co-occurrence of impulsive and compulsive behaviours, which may contribute to a worse clinical picture of some psychiatric disorders. We hypothesize that individuals with 'impulsive' OCD as characterized by poor insight, low resistance, and reduced control towards their compulsions will have a deteriorative course, greater severity of hoarding and/or symmetry/ordering symptoms, and comorbid ICD and/or substance use disorders (SUD). The sample consisted of 869 individuals with a minimum score of 16 on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Of these, 65 had poor insight, low resistance, and reduced control towards compulsions ('poor IRC') and 444 had preserved insight, greater resistance and better control over compulsions ('good IRC'). These two groups were compared on a number of clinical and demographic variables. Individuals with poor IRC were significantly more likely to have a deteriorative course (p < 0.001), longer duration of obsessions (p = 0.017), greater severity of symmetry/ordering (p < 0.001), contamination/cleaning (p < 0.001) and hoarding (p = 0.002) symptoms, and comorbid intermittent explosive disorder (p = 0.026), trichotillomania (p = 0.014) and compulsive buying (p = 0.040). Regression analysis revealed that duration of obsessions (p = 0.037) and hoarding severity (p = 0.005) were significant predictors of poor IRC. In the absence of specific measures for impulsivity in OCD, the study highlights the utility of simple measures such as insight, resistance and control over compulsions as a phenotypic marker of a subgroup of OCD with impulsive features demonstrating poor clinical outcome. © 2012 Elsevier Ltd.en
dc.description.affiliationMelbourne Neuropsychiatry Centre Department of Psychiatry University of Melbourne and Melbourne Health
dc.description.affiliationAnxiety and Depression Research Program Institute of Psychiatry Federal University of Rio de Janeiro
dc.description.affiliationD'Or Institute for Research and Education, Rio de Janeiro
dc.description.affiliationDepartment of Psychiatry University of São Paulo Medical School
dc.description.affiliationDepartment of Psychiatry Health Sciences Federal University of Porto Alegre
dc.description.affiliationDepartment of Neurology, Psychology and Psychiatry Botucatu Medical School Universidade Estadual Paulista
dc.description.affiliationDepartment of Psychiatry Federal University of São Paulo
dc.description.affiliationUnespDepartment of Neurology, Psychology and Psychiatry Botucatu Medical School Universidade Estadual Paulista
dc.format.extent1146-1152
dc.identifierhttp://dx.doi.org/10.1016/j.jpsychires.2012.04.022
dc.identifier.citationJournal of Psychiatric Research, v. 46, n. 9, p. 1146-1152, 2012.
dc.identifier.doi10.1016/j.jpsychires.2012.04.022
dc.identifier.issn0022-3956
dc.identifier.issn1879-1379
dc.identifier.lattes3837157956819433
dc.identifier.scopus2-s2.0-84864378172
dc.identifier.urihttp://hdl.handle.net/11449/73526
dc.language.isoeng
dc.relation.ispartofJournal of Psychiatric Research
dc.relation.ispartofjcr4.000
dc.relation.ispartofsjr2,126
dc.rights.accessRightsAcesso restrito
dc.sourceScopus
dc.subjectImpulse control disorders
dc.subjectImpulsive-compulsive spectrum
dc.subjectImpulsivity
dc.subjectInsight and resistance
dc.subjectObsessive-compulsive disorder
dc.subjectadult
dc.subjectcompulsion
dc.subjectdemography
dc.subjectdisease duration
dc.subjecthuman
dc.subjectimpulse control disorder
dc.subjectimpulsiveness
dc.subjectmajor clinical study
dc.subjectobsession
dc.subjectobsessive compulsive disorder
dc.subjectphenotype
dc.subjectpriority journal
dc.subjectsymptom
dc.subjecttrichotillomania
dc.subjectYale Brown Obsessive Compulsive Scale
dc.subjectAdult
dc.subjectFemale
dc.subjectHumans
dc.subjectImpulse Control Disorders
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectObsessive-Compulsive Disorder
dc.subjectPsychiatric Status Rating Scales
dc.subjectQuestionnaires
dc.subjectRetrospective Studies
dc.subjectSeverity of Illness Index
dc.subjectStatistics, Nonparametric
dc.subjectYoung Adult
dc.titleImpulsive compulsivity in obsessive-compulsive disorder: A phenotypic marker of patients with poor clinical outcomeen
dc.typeArtigo
dcterms.licensehttp://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy
unesp.author.lattes3837157956819433[5]
unesp.author.orcid0000-0003-1072-5008[5]
unesp.campusUniversidade Estadual Paulista (Unesp), Faculdade de Medicina, Botucatupt

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