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Guideline
. 2014 Oct:57:141-8.
doi: 10.1016/j.jpsychires.2014.06.010. Epub 2014 Jun 26.

Phenomenology of OCD: lessons from a large multicenter study and implications for ICD-11

Roseli G Shavitt  1 , Maria Alice de Mathis  2 , Fábio Oki  3 , Ygor A Ferrao  4 , Leonardo F Fontenelle  5 , Albina R Torres  6 , Juliana B Diniz  2 , Daniel L C Costa  2 , Maria Conceição do Rosário  7 , Marcelo Q Hoexter  2 , Euripedes C Miguel  2 , H Blair Simpson  8
Affiliations
Guideline

Phenomenology of OCD: lessons from a large multicenter study and implications for ICD-11

Roseli G Shavitt et al. J Psychiatr Res. 2014 Oct.

Abstract

This study aimed to investigate the phenomenology of obsessive-compulsive disorder (OCD), addressing specific questions about the nature of obsessions and compulsions, and to contribute to the World Health Organization's (WHO) revision of OCD diagnostic guidelines. Data from 1001 patients from the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders were used. Patients were evaluated by trained clinicians using validated instruments, including the Dimensional Yale-Brown Obsessive-Compulsive Scale, the University of Sao Paulo Sensory Phenomena Scale, and the Brown Assessment of Beliefs Scale. The aims were to compare the types of sensory phenomena (SP, subjective experiences that precede or accompany compulsions) in OCD patients with and without tic disorders and to determine the frequency of mental compulsions, the co-occurrence of obsessions and compulsions, and the range of insight. SP were common in the whole sample, but patients with tic disorders were more likely to have physical sensations and urges only. Mental compulsions occurred in the majority of OCD patients. It was extremely rare for OCD patients to have obsessions without compulsions. A wide range of insight into OCD beliefs was observed, with a small subset presenting no insight. The data generated from this large sample will help practicing clinicians appreciate the full range of OCD symptoms and confirm prior studies in smaller samples the degree to which insight varies. These findings also support specific revisions to the WHO's diagnostic guidelines for OCD, such as describing sensory phenomena, mental compulsions and level of insight, so that the world-wide recognition of this disabling disorder is increased.

Keywords: Insight; Mental compulsions; Obsessive–compulsive disorder; Phenomenology; Sensory phenomena.

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Conflict of interest statement

Conflicts of interest in the last 36 months

Dr. Shavitt has received travel grants from Lundbeck S.A. to participate in the European College of Neuropsycopharmacology Meeting and International College of Obsessive–Compulsive Disorders Meeting in October/2012 and October/2013 and receives research grants from Fundação de Amparo à Pesquisa do Estado de Sao Paulo (FAPESP, State agency, #2011/51485–9) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPQ, Federal agency, #307742/2012–1). Dr. De Mathis receives a research grant from Fundação de Amparo à Pesquisa do Estado de Sao Paulo (FAPESP, #2013/04203–3). Dr. Ferrão has received honoraria as a speaker for GSK, Pfizer and Abbott. Dr. Fontenelle receives grants from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPQ, # 303846/2008–9), Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ, State Agency, E-26/ 103.252/2011) and Instituto D’Or de Pesquisa e Ensino (private agency). Dr. Diniz receives a research grant from Fundação de Amparo à Pesquisa do Estado de Sao Paulo (FAPESP, state agency, #2011/00968–0). Dr. Costa receives a research grant from Fundação de Amparo à Pesquisa do Estado de Sao Paulo (FAPESP, state agency, de Amparo a #2012/14070–8). Dr. Rosario has received honoraria as speaker and part of the advisory board for Novartis and Shire. Dr. Hoexter receives a research grant from Fundação de Amparo à Pesquisa do Estado de Sao Paulo (FAPESP, state agency, #2013/16864–4). Dr. Miguel receives research grants from Fundação de Amparo à Pesquisa do Estado de Sao Paulo (FAPESP, #2011/21357–9) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPQ, #573974/2008–0). Dr. Simpson has received research funds for clinical trials from Janssen Pharmaceuticals (2006–2012), Transcept Pharmaceuticals (2011–2013), has consulted for Quintiles, Inc. (September, 2012), and receives royalties from Cambridge University Press and UpToDate, Inc. Dr. Simpson’s work on this project was supported by the National Institute of Mental Health grant #K24MH09155 and by the New York State Office of Mental Hygiene. All other authors declare that they have no conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Distribution of total Brown Assessment of Beliefs Scale (BABS) scores.1 1Missing data correspond to 3.3% of the sample (n=33).
Fig. 2.
Fig. 2.
Distribution of total Brown Assessment of Beliefs Scale (BABS) scores in relation to medication status.a aWilcoxon test (non-parametric). The median of the total BABS score of the whole sample was used as the reference for the comparison of each group with the whole sample. The two circles refer to outliers.
See this image and copyright information in PMC

References

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