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Addicted to compulsion: assessing three core dimensions of addiction across obsessive-compulsive disorder and gambling disorder

Published online by Cambridge University Press:  20 May 2019

Giacomo Grassi Open the ORCID record for Giacomo Grassi [Opens in a new window] ,
Nikos Makris  and
Stefano Pallanti
Giacomo Grassi*
Affiliation:
University of Florence, Department of Neuroscience, Psychology, Drug Research and Child Health – Neurofarba, Florence, Italy Institute of Neuroscience, CNS onlus, Florence, Italy
Nikos Makris
Affiliation:
Center for Morphometric Analysis, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, USA
Stefano Pallanti
Affiliation:
Department of Psychiatry and Behavioral Science, Stanford University Medical Center, Stanford, CA, USA Institute of Neuroscience, CNS onlus, Florence, Italy
*
* Address correspondence to: Giacomo Grassi, M.D., University of Florence, Department of Neurofarba, via delle Gore 2H, 50141Florence, Italy. (Email: [email protected])
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Abstract

Objective

Several studies suggested that obsessive-compulsive disorder (OCD) patients display increased impulsivity, impaired decision-making, and reward system dysfunction. In a Research Domain Criteria (RDoC) perspective, these findings are prototypical for addiction and have led some authors to view OCD as a behavioral addiction. Thus, the aim of this study was to investigate similarities and differences on impulsivity, decision-making, and reward system, as core dimensions of addiction, across OCD and gambling disorder (GD) patients.

Methods

Forty-four OCD patients, 26 GD patients, and 40 healthy controls (HCs) were included in the study. Impulsivity was assessed through the Barratt Impulsiveness Scale, decision-making through the Iowa Gambling Task, and reward system through a self-report clinical instrument (the Shaps-Hamilton Anhedonia Scale) assessing hedonic tone and through an olfactory test assessing hedonic appraisal to odors.

Results

Both OCD and GD patients showed increased impulsivity when compared to HCs. More specifically, the OCD patients showed cognitive impulsivity, and the GD patients showed both increased cognitive and motor impulsivity. Furthermore, both OCD and GD patients showed impaired decision-making performances when compared to HCs. Finally, GD patients showed increased anhedonia and blunted hedonic response to pleasant odors unrelated to gambling or depression/anxiety symptoms, while OCD patients showed only increased anhedonia levels related to OC and depression/anxiety symptoms.

Conclusion

OCD patients showed several similarities and some differences with GD patients when compared to HCs on impulsivity, decision-making, and reward system, three core dimensions of addiction. These results could have relevant implications for the research of new treatment targets for OCD.

Keywords

obsessive-compulsive disordergambling disorderbehavioral addictionimpulsivityreward
Type
Original Research
Information
CNS Spectrums , Volume 25 , Issue 3 , June 2020 , pp. 392 - 401
Copyright
© Cambridge University Press 2019

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Footnotes

Research reported in this publication was supported by the National Institute on Drug Abuse of the National Institutes of Health under Award Number R21DA042271 (NM and SP). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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