RxPG News : OCD

High Risk of Disordered Eating in OCD

Mon, 08 Jun 2009 10:55:51 PST

( from http://www.rxpgnews.com ) Doctors and other health workers should be more aware of the high risk of eating disorders among people with obsessive compulsive disorder (OCD) and other anxiety disorders.

According to new research presented at the recently concluded Royal College of Psychiatrists’ 2009 Annual Meeting, as many as one in five people with OCD could also have some form of disordered eating. In addition, disordered eating may occur in as many as one in three patients with other anxiety disorders.

OCD is a serious anxiety-related condition that affects 2-3% of the adult population. People with severe OCD may find it difficult to work regularly, or even take part in their family or social life.

Dr Lynne Drummond, a consultant psychiatrist at South West London and St George's NHS Mental Health Trust, collected data from a sample of patients with severe OCD who were referred to a specialist unit for treatment. A control group of patients with other anxiety disorders referred for treatment to the same unit was also studied.

The study found that a fifth of the patients with OCD also had signs of disordered eating. The prevalence for those with other anxiety disorders was a one in three.

Dr Drummond said: “Although these have been several studies examining the prevalence of OCD and obsessive symptoms in patients with eating disorders, there is a dearth of studies where patients with OCD and other anxiety disorders are examined for eating disorders.

“This study suggests that clinicians should be made aware of the high prevalence of disordered eating in patients with all anxiety disorders as well as OCD.”

Men, women have similar rates of compulsive buying

Mon, 02 Oct 2006 01:31:37 PST

( from http://www.rxpgnews.com ) Contrary to popular opinion, nearly as many men as women experience compulsive buying disorder, a condition marked by binge buying and subsequent financial hardship, according to new research from the Stanford University School of Medicine.

"The widespread opinion that most compulsive buyers are women may be wrong," the researchers wrote in their paper, which will be published in the October issue of the American Journal of Psychiatry.

Senior author Lorrin Koran, MD, emeritus professor of psychiatry and behavioral sciences, said the study is the first large, nationwide effort to assess the prevalence of the disorder. The study found that more than one in 20 adults in the United States suffers from the condition.

People who have compulsive buying disorder - sometimes called compulsive shopping disorder - are often struck with an irresistible, intrusive and often senseless impulse to buy. It is common for sufferers to go on frequent shopping binges and to accumulate large quantities of unnecessary, unwanted items. Sufferers often rack up thousands of dollars in debt and lie to their loved ones about their purchases. The consequences can be bankruptcy, divorce, embezzlement and even suicide attempts.

Koran emphasized that this type of shopping and buying is not the same as occasional impulse buying, which many people engage in.

"Compulsive buying leads to serious psychological, financial and family problems including depression, overwhelming debt and the breakup of relationships," Koran explained. "People don't realize the extent of damage it does to the sufferer."

Prior to this study, researchers estimated that compulsive buying disorder affected between 2 and 16 percent of the U.S. population and that 90 percent of sufferers were women. Koran launched this study to get a more definitive estimate of how many people were affected by the disorder.

For the study, the researchers conducted a national, random-sample household telephone survey and interviewed 2,513 adults. The researchers asked respondents about buying attitudes and behaviors, and their financial and demographic data. The team used a screening instrument, the Compulsive Buying Scale, to determine whether respondents were compulsive buyers.

The researchers found that 6 percent of women and 5.5 percent of men had symptoms consistent with compulsive buying disorder. The gender-adjusted prevalence rate was 5.8 percent.

Koran said the fact that men and women have similar rates of compulsive shopping tendencies was surprising. "The difference that we observed between the prevalence in women and men is quite small and contrasts with the marked difference reported in clinical trials, in which women constituted 80 to 95 percent of the participants," the authors noted.

The researchers also discovered interesting tidbits about compulsive buyers. Compared with other respondents, compulsive buyers were younger and more likely to have reported incomes under $50,000. In addition, more of their credit cards were within a few hundred dollars of the credit limit, and compulsive buyers were more than four times as likely as other respondents to make only the minimum payment on credit card balances.

Koran said the latter finding is one that merits more investigation. "Many U.S. adults are laboring under their debt burden," he and his colleagues wrote. "The extent to which compulsive buying plays a role in [this] deserves investigation."

Koran said studies are also needed to explore the apparent link between compulsive buying and younger age and to clarify potential gender differences. As for Koran, he plans to seek federal funding for a study looking at the prevalence of so-called "behavioral addictions" - including pathological gambling, compulsive buying and skin picking - and whether these conditions are associated with other mental disorders.

Kids with OCD bullied more than others

Tue, 15 Aug 2006 02:42:37 PST

( from http://www.rxpgnews.com ) Children with obsessive-compulsive disorder are three times more likely to be bullied than other children, and the name-slinging could cause symptoms of OCD to worsen, University of Florida researchers have found.

"One of the things we have noticed working with many kids with OCD is that peer relations are extremely impaired," said Eric Storch, Ph.D, a UF assistant professor of psychiatry and pediatrics and lead author of the study. "Kids target kids who are different. Kids with OCD sometimes exhibit behaviors that peers simply don't understand."

More than one-quarter of the children with OCD who researchers studied reported chronic bullying as a problem, according to findings described in the September issue of the Journal of Clinical Child and Adolescent Psychology.

By comparison, only 9 percent of kids in the two other groups researchers studied - healthy kids without medical or mental conditions and children with type 1 diabetes - reported serious problems with bullies.

Nearly all children are bullied at least once in their lives. But chronic bullying equates to about one taunt per day, ranging from kicking or hitting to name-calling or excluding children from activities in school.

"The kids with OCD are really experiencing higher rates of peer problems than other kids," Storch said. "We're not saying one causes the other, but there is a positive relationship between (OCD and bullying)."

About one in 100 children struggle with OCD, an anxiety disorder that leads people to engage in rituals such as hand washing to drive away obsessive thoughts about germs or other worries. Rituals often become so involved that they interfere with a person's ability to function, according to the National Institute of Mental Health.

"Their day becomes filled with repeating behaviors," Storch said. "For a lot of kids, peers don't understand what is going on. They are isolated. They are ostracized because it doesn't make sense why they are washing their hands. Why they keep repeating questions."

The researchers also found links between bullying and other problems, namely loneliness and depression, in children with OCD, Storch said. Kids were also apt to internalize bullies' negative comments, telling themselves, "No one will ever love me," or "Maybe I am a loser," Storch said.

Having OCD and conditions such as depression is linked to worsening obsessive-compulsive symptoms, potentially explaining why researchers also found a link between bullying and more serious symptoms.

"It could be that the peers are attacking because they are doing things that are so different," he said. "Or it might be that bullying is in some way contributing to OCD."

Compulsive behaviors such as repeating questions, recounting and rechecking information can draw attention to kids with OCD in school, as can vocal or physical tics, common among children with OCD, said Phoebe Moore, Ph.D., an assistant clinical professor of child psychiatry at Duke University.

"That kind of behavior can draw fire," Moore said. "I definitely see that clinically."

Treating OCD either with approved drugs or behavior modification techniques will help patients control their obsessions and compulsions, Storch said. But he emphasizes that doctors need to examine the whole child and not just treat OCD symptoms.

"When one focuses solely on the obsessions and compulsions you experience a resolution of those problems, but problems like depression or anxiety and loneliness may still exist," he said. "If you address the OCD without addressing the peer problems, that depression and loneliness may not go away."

Storch suggests parents help children learn how to handle aggressive peers, either at home or by finding a counselor who can help them develop social skills. Parents should also take their concerns to their child's school if teachers or administrators are not stopping the bullying before it becomes a problem.

"Bullying is one of the largest challenges kids, with OCD and in general, have to face," he said. "One of the main clinical implications is considering the child as an entire person, one who has OCD but who also has other impairments."

OCD has multiple genetic associations

Thu, 08 Jun 2006 05:29:37 PST

( from http://www.rxpgnews.com ) 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.

OCD is characterized by intrusive and senseless thoughts and impulses that together are defined as obsessions, as well as repetitive and intentional behaviors, referred to as compulsions. OCD is estimated to affect up to 3 percent of the American population.

In what the research team describes as the first whole-genome scan to look for genetic "markers" or similarities in the genomes of people with OCD, results identified six potentially significant regions in the genome, which lie on five different chromosomes that appear "linked" to OCD. It's likely that any genes directly associated OCD are to be found in these regions.

"We've long suspected that, rather than being caused by a single gene, OCD has multiple genetic associations," says Jack Samuels, Ph.D., an epidemiologist and assistant professor of psychiatry at the Johns Hopkins School of Medicine.

To conduct the study, the researchers collected blood samples from 1,008 individuals from a total of 219 families in which at least two siblings were clinically diagnosed with OCD.

DNA from each sample was analyzed by the Hopkins Center for Inherited Disease Research (CIDR) using both molecular biology and statistical analysis computer programs. Specific DNA sequences known as genetic markers on chromosomes 1, 7, 6, and 15 and two markers on chromosome 3 appear more frequently in the patients with OCD than in those without it. The researchers want to further analyze the genetic regions they identified in this report and use more markers to possibly narrow down these regions to identify OCD risk genes.

The researchers suggest that whatever genes are found don't directly cause OCD but increase risk for it in conjunction with other genes or environmental factors.

"OCD is a relative newcomer to these genetic linkage studies," says Shugart, "so it's extremely important to follow up these findings by looking at more families and using more markers to assess the role of gene-environment interactions in OCD. "We are also very interested in finding genes underlying the different subtypes of OCD," she says.

Careful genetic analysis of different clinical categories of OCD has been limited by currently existing computer programs used in analyzing this type of data. The vast amount of data used in whole-genome analysis requires fine-tuned statistical calculations. The research team is eager to develop new methods in this area. "We predict that such findings may have immediate clinical implications for OCD patients," says Shugart.

Riluzole eases obsessive-compulsive symptoms

Sat, 30 Jul 2005 16:54:38 PST

( from http://www.rxpgnews.com ) A medication used to ease symptoms of amyotrophic lateral sclerosis, or Lou Gehrig's disease, also is helpful in treating people with treatment-resistant obsessive-compulsive disorder (OCD), according to a pilot study at Yale School of Medicine.

Although the study included only 13 patients, the preliminary results are promising for persons who have found no relief using other medications and cognitive behavioral therapy, said the first author, Vladimir Coric, M.D., assistant clinical professor in the Department of Psychiatry and director of the Yale OCD clinic.

"Riluzole appears to have significant antiobsessional, antidepressant, and antianxiety properties," said Coric, who will be presenting the data Friday at the Obsessive-Compulsive Foundation annual conference in San Diego.

OCD currently is treated with serotonin reuptake inhibitors, cognitive behavioral therapy and dopamine antagonists, which reduce symptoms in 40-60 percent of patients. "However, a number of patients remain dramatically symptomatic even with the combination of pharmacotherapy and cognitive behavioral therapy," Coric said.

OCD symptoms include obsessive checking, cleaning, washing, counting, hoarding, touching, tapping, ordering, arranging, rubbing, and other repetitive behaviors. Coric said treatment-resistant OCD is one of the few psychiatric indications for neurosurgical intervention. "Novel therapeutic strategies are urgently needed," he said.

Since recent neuroimaging studies suggest that individuals with OCD have abnormalities in corticostriatal glutamate function, Coric and his colleagues tested riluzole, a glutamate modulating agent, on patients with OCD. Glutamate is the most abundant excitatory neurotransmitter in the brain, but when in excess may cause neurotoxicity. Seven of the patients treated with riluzole experienced a 35 percent reduction in symptoms and five were categorized as responsive to the treatment. One patient left the study.

"The use of glutamate modulating agents, such as riluzole, may represent a novel treatment intervention for certain anxiety and mood disorders," Coric said.