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Impulse control disorders in adults with obsessive compulsive disorder.
Jon E Grant1, Maria C Mancebo, Anthony Pinto
1Butler Hospital and the Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI 02906, USA. grant045@umn.edu <grant045@umn.edu>
Journal of Psychiatric Research
|January 25, 2006
Summary
Impulse control disorders (ICDs) are present in 16.4% of individuals with obsessive compulsive disorder (OCD). Comorbid ICDs in OCD patients are linked to more severe symptoms and poorer quality of life.
Area of Science:
- Psychiatry
- Clinical Psychology
- Neuroscience
Background:
- Impulse control disorders (ICDs) and obsessive compulsive disorder (OCD) are distinct conditions, yet their comorbidity and clinical implications remain underexplored.
- Previous research has not extensively investigated the clinical correlates of ICD comorbidity in a large cohort of individuals primarily diagnosed with OCD.
Purpose of the Study:
- To determine the prevalence and clinical correlates of impulse control disorders (ICDs) in a large sample of individuals with a primary diagnosis of obsessive compulsive disorder (OCD).
- To assess the impact of comorbid ICDs on OCD symptom severity, quality of life, and social/occupational functioning.
Main Methods:
- A cohort of 293 individuals with a lifetime diagnosis of DSM-IV OCD underwent structured clinical interviews to assess for lifetime and current ICDs.
- OCD severity was measured using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS).
- Quality of life and social/occupational functioning were evaluated using the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) and the Social and Occupational Functioning Assessment Scale (SOFAS).
Main Results:
- 16.4% of OCD subjects reported a lifetime ICD, and 11.6% had a current ICD.
- Skin picking (10.4% lifetime, 7.8% current) and nail biting (4.8% lifetime, 2.4% current) were the most prevalent ICDs.
- Individuals with current ICDs exhibited significantly higher OCD symptom severity, poorer quality of life, and diminished social/occupational functioning compared to those without ICDs.
Conclusions:
- Impulse control disorders appear to have a relatively low prevalence among individuals with obsessive compulsive disorder.
- The presence of comorbid ICDs in OCD patients is associated with a more severe clinical presentation and functional impairment.
- Targeted assessment and treatment of ICDs may be beneficial for improving outcomes in individuals with OCD.