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Impulse control disorders in patients with obsessive-compulsive disorder.
Leonardo F Fontenelle1, Mauro V Mendlowicz, Marcio Versiani
1Anxiety and Depression Research Program, Institute of Psychiatry of the Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. leofontenelle@hotmail.com
Psychiatry and Clinical Neurosciences
|February 1, 2005
Summary
Obsessive-compulsive disorder (OCD) patients with impulse control disorders (ICD) show earlier onset and more severe symptoms. Comorbid ICD in OCD patients requires more treatment attempts and indicates a more complex clinical picture.
Area of Science:
- Psychiatry
- Clinical Psychology
- Neuroscience
Background:
- Obsessive-compulsive disorder (OCD) is a debilitating mental health condition characterized by intrusive thoughts and repetitive behaviors.
- Impulse control disorders (ICD) involve difficulties in resisting urges, leading to harmful behaviors.
- The comorbidity between OCD and ICD is not fully understood, necessitating further investigation into their shared characteristics and clinical implications.
Purpose of the Study:
- To determine the prevalence rate of impulse control disorders (ICD) in patients diagnosed with obsessive-compulsive disorder (OCD).
- To compare sociodemographic, clinical, and prognostic features of OCD patients with and without comorbid ICD.
- To elucidate the clinical profile and treatment challenges associated with comorbid ICD in OCD.
Main Methods:
- A cohort of 45 OCD patients was assessed using the Structured Clinical Interview for DSM-IV, supplemented with ICD modules.
- Standardized scales including Yale-Brown Obsessive-Compulsive Scale and Beck Depression Inventory were employed for symptom assessment.
- Statistical analyses, including Mann-Whitney U-test and Pearson's chi-squared test, were used to compare patient groups.
Main Results:
- 35.5% of OCD patients (16 out of 45) presented with comorbid ICD.
- Patients with comorbid ICD exhibited significantly earlier OCD onset, more insidious symptom presentation, and higher rates of anxiety disorders.
- ICD comorbidity was associated with increased number and severity of compulsive symptoms, specifically counting compulsions, and a greater number of required serotonin re-uptake inhibitor (SRI) trials.
Conclusions:
- Comorbid impulse control disorders are prevalent in obsessive-compulsive disorder patients, affecting approximately one-third of the studied cohort.
- The presence of ICD in OCD patients signifies a more severe clinical presentation, including earlier onset, heightened symptom severity, and increased treatment resistance.
- These findings underscore the importance of screening for ICD in OCD patients to tailor more effective and comprehensive treatment strategies.