Korean Journal of Biological Psychiatry (생물정신의학)

The Korean Society of Biological Psychiatry (대한생물정신의학회)
권호 표지

Neurocognitive Dysfunction in Patients with Obsessive-Compulsive Disorder in Association of Duration of Untreated Illness : A Preliminary Study

강박장애의 치료받지 않은 유병기간에 따른 신경인지기능 이상 : 예비연구

  • Oh, Sang Hoon (Department of Psychiatry, Seoul National University Hospital) ;
  • Kim, Sung Nyun (Department of Psychiatry, Seoul National University College of Medicine) ;
  • Han, Jaewook (Department of Psychiatry, Seoul National University College of Medicine) ;
  • Lee, Junhee (Department of Psychiatry, Seoul National University Hospital) ;
  • Lee, Tae Young (Department of Psychiatry, Seoul National University Hospital) ;
  • Shin, Min-Sup (Department of Psychiatry, Seoul National University Hospital) ;
  • Kwon, Jun Soo (Department of Psychiatry, Seoul National University Hospital)
  • 오상훈 (서울대학교병원 정신건강의학과) ;
  • 김성년 (서울대학교 의과대학 정신과학교실) ;
  • 한재욱 (서울대학교 의과대학 정신과학교실) ;
  • 이준희 (서울대학교병원 정신건강의학과) ;
  • 이태영 (서울대학교병원 정신건강의학과) ;
  • 신민섭 (서울대학교병원 정신건강의학과) ;
  • 권준수 (서울대학교병원 정신건강의학과)
  • Received : 2017.03.02
  • Accepted : 2017.04.04
  • Published : 2017.05.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives Obsessive-compulsive disorder (OCD) is a chronic and disabling psychiatric disorder. The duration of untreated illness (DUI) has been suggested as one of the predictors of clinical course and outcome in various psychiatric disorders. There is increasing evidence that cognitive dysfunction is associated with the prognosis of OCD. The aim of this study was to investigate the influence of DUI on the neurocognitive functions in patients with OCD. Methods Sixty-two patients with a DSM-IV diagnosis of OCD from the outpatient clinic were included in this study. We defined the short DUI if the DUI was 2-year or less and the long DUI if it was longer than 2-year. Neurocognitive functions were assessed by visuospatial memory function test and 4 subsets of K-WAIS such as vocabulary, arithmetic, block design and picture arrangement. Differences in neurocognitive functions as well as clinical variables between OCD patients with short DUI and those with long DUI were investigated. Correlation analyses were also performed to determine the correlation between DUI and neurocognitive functions. Results Compared with the short DUI group, the long DUI group performed worse in the block design test, which measures executive function. The long DUI group also had a higher level of compulsive symptom severity than the short DUI group. However, the DUI was not correlated with neurocognitive functions. Conclusions Findings in this preliminary study suggest that the long DUI in patients with OCD is associated with more severe executive dysfunction. Studies with larger samples and longitudinal design are needed to further confirm the prognostic role of the DUI in OCD.

Keywords

References

  1. Ruscio AM, Stein DJ, Chiu WT, Kessler RC. The epidemiology of obsessive-compulsive disorder in the national comorbidity survey replication. Mol Psychiatry 2010;15:53-63. https://doi.org/10.1038/mp.2008.94
  2. Skoog G, Skoog I. A 40-year follow-up of patients with obsessivecompulsive disorder [see commetns]. Arch Gen Psychiatry 1999;56: 121-127. https://doi.org/10.1001/archpsyc.56.2.121
  3. Subramaniam M, Soh P, Vaingankar JA, Picco L, Chong SA. Quality of life in obsessive-compulsive disorder: impact of the disorder and of treatment. CNS Drugs 2013;27:367-383. https://doi.org/10.1007/s40263-013-0056-z
  4. Fineberg NA, Reghunandanan S, Brown A, Pampaloni I. Pharmacotherapy of obsessive-compulsive disorder: evidence-based treatment and beyond. Aust N Z J Psychiatry 2013;47:121-141. https://doi.org/10.1177/0004867412461958
  5. Jakubovski E, Diniz JB, Valerio C, Fossaluza V, Belotto-Silva C, Gorenstein C, et al. Clinical predictors of long-term outcome in obsessive- compulsive disorder. Depress Anxiety 2013;30:763-772. https://doi.org/10.1002/da.22013
  6. Eisen JL, Pinto A, Mancebo MC, Dyck IR, Orlando ME, Rasmussen SA. A 2-year prospective follow-up study of the course of obsessivecompulsive disorder. J Clin Psychiatry 2010;71:1033-1039. https://doi.org/10.4088/JCP.08m04806blu
  7. Thomsen PH. Obsessive-compulsive disorder in children and adolescents. A 6-22 year follow-up study of social outcome. Eur Child Adolesc Psychiatry 1995;4:112-122. https://doi.org/10.1007/BF01977739
  8. Orloff LM, Battle MA, Baer L, Ivanjack L, Pettit AR, Buttolph ML, et al. Long-term follow-up of 85 patients with obsessive-compulsive disorder. Am J Psychiatry 1994;151:441-442. https://doi.org/10.1176/ajp.151.3.441
  9. Leonard HL, Swedo SE, Lenane MC, Rettew DC, Hamburger SD, Bartko JJ, et al. A 2- to 7-year follow-up study of 54 obsessive-compulsive children and adolescents. Arch Gen Psychiatry 1993;50:429-439. https://doi.org/10.1001/archpsyc.1993.01820180023003
  10. Altamura AC, Buoli M, Albano A, Dell'Osso B. Age at onset and latency to treatment (duration of untreated illness) in patients with mood and anxiety disorders: a naturalistic study. Int Clin Psychopharmacol 2010;25:172-179. https://doi.org/10.1097/YIC.0b013e3283384c74
  11. Dell'Osso B, Camuri G, Benatti B, Buoli M, Altamura AC. Differences in latency to first pharmacological treatment (duration of untreated illness) in anxiety disorders: a study on patients with panic disorder, generalized anxiety disorder and obsessive-compulsive disorder. Early Interv Psychiatry 2013;7:374-380. https://doi.org/10.1111/eip.12016
  12. Poyraz CA, Turan S, Saglam NG, Batun GC, Yassa A, Duran A, et al. Factors associated with the duration of untreated illness among patients with obsessive compulsive disorder. Compr Psychiatry 2015; 58:88-93. https://doi.org/10.1016/j.comppsych.2014.12.019
  13. Dell'Osso B, Buoli M, Hollander E, Altamura AC. Duration of untreated illness as a predictor of treatment response and remission in obsessive-compulsive disorder. World J Biol Psychiatry 2010;11:59-65. https://doi.org/10.3109/15622970903418544
  14. Altamura AC, Dell'osso B, D'Urso N, Russo M, Fumagalli S, Mundo E. Duration of untreated illness as a predictor of treatment response and clinical course in generalized anxiety disorder. CNS Spectr 2008;13:415-422. https://doi.org/10.1017/S1092852900016588
  15. Altamura AC, Dell'osso B, Vismara S, Mundo E. May duration of untreated illness influence the long-term course of major depressive disorder? Eur Psychiatry 2008;23:92-96. https://doi.org/10.1016/j.eurpsy.2007.11.004
  16. Savage CR, Baer L, Keuthen NJ, Brown HD, Rauch SL, Jenike MA. Organizational strategies mediate nonverbal memory impairment in obsessive-compulsive disorder. Biol Psychiatry 1999;45:905-916. https://doi.org/10.1016/S0006-3223(98)00278-9
  17. Muller J, Roberts JE. Memory and attention in obsessive-compulsive disorder: a review. J Anxiety Disord 2005;19:1-28. https://doi.org/10.1016/j.janxdis.2003.12.001
  18. Olley A, Malhi G, Sachdev P. Memory and executive functioning in obsessive-compulsive disorder: a selective review. J Affect Disord 2007;104:15-23. https://doi.org/10.1016/j.jad.2007.02.023
  19. de Geus F, Denys DA, Sitskoorn MM, Westenberg HG. Attention and cognition in patients with obsessive-compulsive disorder. Psychiatry Clin Neurosci 2007;61:45-53. https://doi.org/10.1111/j.1440-1819.2007.01609.x
  20. Bannon S, Gonsalvez CJ, Croft RJ, Boyce PM. Executive functions in obsessive-compulsive disorder: state or trait deficits? Aust N Z J Psychiatry 2006;40:1031-1038.
  21. Shin NY, Lee TY, Kim E, Kwon JS. Cognitive functioning in obsessive-compulsive disorder: a meta-analysis. Psychol Med 2014;44:1121-1130. https://doi.org/10.1017/S0033291713001803
  22. Oh UJ, Moon HS. Memory impairment and organizational strategies in obsessive-compulsive disorder. Korean J Clin Psychol 2002; 21:147-158.
  23. Tukel R, Gurvit H, Ertekin BA, Oflaz S, Ertekin E, Baran B, et al. Neuropsychological function in obsessive-compulsive disorder. Compr Psychiatry 2012;53:167-175. https://doi.org/10.1016/j.comppsych.2011.03.007
  24. Rajender G, Bhatia MS, Kanwal K, Malhotra S, Singh TB, Chaudhary D. Study of neurocognitive endophenotypes in drug-naive obsessive-compulsive disorder patients, their first-degree relatives and healthy controls. Acta Psychiatr Scand 2011;124:152-161. https://doi.org/10.1111/j.1600-0447.2011.01733.x
  25. Chamberlain SR, Blackwell AD, Fineberg NA, Robbins TW, Sahakian BJ. The neuropsychology of obsessive compulsive disorder: the importance of failures in cognitive and behavioural inhibition as candidate endophenotypic markers. Neurosci Biobehav Rev 2005; 29:399-419. https://doi.org/10.1016/j.neubiorev.2004.11.006
  26. Nielen MM, Den Boer JA. Neuropsychological performance of OCD patients before and after treatment with fluoxetine: evidence for persistent cognitive deficits. Psychol Med 2003;33:917-925. https://doi.org/10.1017/S0033291703007682
  27. Roh KS, Shin MS, Kim MS, Ha TH, Shin YW, Lee KJ, et al. Persistent cognitive dysfunction in patients with obsessive-compulsive disorder: a naturalistic study. Psychiatry Clin Neurosci 2005;59:539-545. https://doi.org/10.1111/j.1440-1819.2005.01411.x
  28. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association;1994.
  29. Kim SJ, Choi NK, Hong HJ, Hwang YS, Kim YK, Lee HS, et al. Dimensional analyses of the Yale-Brown Obsessive-Compulsive Scale and Yale-Brown Obsessive-Compulsive Scale Checklist. Korean J Psychopharmacol 2004;15:339-345.
  30. Yi JS, Bae SO, Ahn YM, Park DB, Noh KS, Shin HK, et al. Validity and reliability of the Korean version of the Hamilton Depression Rating Scale (K-HDRS). J Korean Neuropsychiatr Assoc 2005;44:456-465.
  31. Hamilton M. The assessment of anxiety states by rating. Br J Med Psychol 1959;32:50-55. https://doi.org/10.1111/j.2044-8341.1959.tb00467.x
  32. Yeom TH, Park YS, Oh KJ, Kim JK, Lee YH. Korean Wechsler Adult Intelligence Scale (K-WAIS) manual. Seoul: Guidance;1992.
  33. Osterrieth PA. The challenge of copying a complex figure. Arch Psychol (Geneve) 1944;30:205-353.
  34. Kuelz AK, Hohagen F, Voderholzer U. Neuropsychological performance in obsessive-compulsive disorder: a critical review. Biol Psychol 2004;65:185-236. https://doi.org/10.1016/j.biopsycho.2003.07.007
  35. Head D, Bolton D, Hymas N. Deficit in cognitive shifting ability in patients with obsessive-compulsive disorder. Biol Psychiatry 1989; 25:929-937. https://doi.org/10.1016/0006-3223(89)90272-2
  36. D'Alcante CC, Diniz JB, Fossaluza V, Batistuzzo MC, Lopes AC, Shavitt RG, et al. Neuropsychological predictors of response to randomized treatment in obsessive-compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2012;39:310-317. https://doi.org/10.1016/j.pnpbp.2012.07.002
  37. Moritz S, Kloss M, Katenkamp B, Birkner C, Hand I. Neurocognitive functioning in OCD before and after treatment. CNS Spectr 1999;4:21-22.
  38. Kohn R, Saxena S, Levav I, Saraceno B. The treatment gap in mental health care. Bull World Health Organ 2004;82:858-866.
  39. Dell'Osso B, Benatti B, Buoli M, Altamura AC, Marazziti D, Hollander E, et al. The influence of age at onset and duration of illness on long-term outcome in patients with obsessive-compulsive disorder: a report from the international college of obsessive compulsive spectrum disorders (ICOCS). Eur Neuropsychopharmacol 2013;23: 865-871. https://doi.org/10.1016/j.euroneuro.2013.05.004
  40. Simonds LM, Thorpe SJ. Attitudes toward obsessive-compulsive disorders--an experimental investigation. Soc Psychiatry Psychiatr Epidemiol 2003;38:331-336. https://doi.org/10.1007/s00127-003-0637-0
  41. Cotrena C, Branco LD, Cardoso CO, Wong CE, Fonseca RP. The predictive impact of biological and sociocultural factors on executive processing: the role of age, education, and frequency of reading and writing habits. Appl Neuropsychol Adult 2016;23:75-84. https://doi.org/10.1080/23279095.2015.1012760
  42. Masellis M, Rector NA, Richter MA. Quality of life in OCD: differential impact of obsessions, compulsions, and depression comorbidity. Can J Psychiatry 2003;48:72-77. https://doi.org/10.1177/070674370304800202
  43. Lawrence NS, Wooderson S, Mataix-Cols D, David R, Speckens A, Phillips ML. Decision making and set shifting impairments are associated with distinct symptom dimensions in obsessive-compulsive disorder. Neuropsychology 2006;20:409-419. https://doi.org/10.1037/0894-4105.20.4.409