Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-05T01:03:00.649Z Has data issue: false hasContentIssue false
  • English
  • Français

Neuropsychological function in obsessive-compulsive disorder: effects of comorbid conditions on task performance

Published online by Cambridge University Press:  16 April 2020

Ayse Aycicegi ,
Wayne M. Dinn ,
Catherine L. Harris  and
Husnu Erkmen
Ayse Aycicegi
Affiliation:
Department of Psychology, Istanbul University, Turkey
Wayne M. Dinn*
Affiliation:
Department of Psychology, Boston University, 64 Cummington Street, Boston, MA02215, USA
Catherine L. Harris
Affiliation:
Department of Psychology, Boston University, 64 Cummington Street, Boston, MA02215, USA
Husnu Erkmen
Affiliation:
Bakirkoy Psychiatric Hospital, Istanbul, Turkey
*
2Corresponding author. [email protected]
Get access

Abstract

Background

Neuropsychological testing reveals a pattern of impairment among patients with obsessive-compulsive disorder (OCD) which implicates the orbitofrontal region. Studies of neuropsychological function in OCD differ regarding performance deficits on classical tests of frontal executive function. In some studies, OCD patients did not demonstrate impaired performance on tests of executive function. However, other researchers have documented performance deficits among OCD patients on measures of executive function. Patients with OCD also exhibit performance deficits on tests of visual/spatial memory and verbal memory. Again, in some studies, OCD patients did not demonstrate impaired performance on tests of memory function. How can we account for the conflicting findings? One possibility is that performance deficits on tests of cognitive function are associated with comorbid conditions. In prior work, we observed that OCD patients who did poorly on executive function tasks obtained high scores on a measure of schizotypal personality. A second possibility is that executive function deficits among patients with OCD are associated with comorbid depressive symptoms.

Method

In the present study, a comprehensive neuropsychological test battery was administered to patients with OCD and matched healthy control subjects. We also administered dimensional measures of schizotypal personality and depression to patients with OCD and controls. We conducted analyses of covariance (ANCOVA), with scores on measures of schizotypal personality and depression used as covariates.

Results

OCD patients demonstrated performance deficits on measures of delayed memory, response inhibition, alternation learning, and obtained significantly higher scores on measures of disinhibition, impulsivity, and temporolimbic symptoms; however, OCD patients did not exhibit impaired performance on tests of executive function and verbal fluency, and did not report a significantly greater number of dysexecutive symptoms, when coexistent depressive and schizotypal symptoms were taken into account.

Conclusion

Findings are consistent with the contention that dysfunction of an orbitofrontal-limbic network underlies OCD.

Keywords

Obsessive-compulsive disorderNeuropsychologicalOrbitofrontalExecutive functionSchizotypal personalityDepressive symptoms
Type
Original article
Information
European Psychiatry , Volume 18 , Issue 5 , August 2003 , pp. 241 - 248
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abbruzzese, M, Bellodi, L, Ferri, S, Scarone, S.Frontal lobe dysfunction in schizophrenia and obsessive–compulsive disorder: a neurobehavioral study. Brain Cognition 1995;27:202–12.CrossRefGoogle Scholar
Abbruzzese, M, Ferri, S, Scarone, S.The selective breakdown of frontal functions in patients with obsessive–compulsive disorder and in patients with schizophrenia: a double dissociation experimental finding. Neuropsychologia 1997;35:907–12.CrossRefGoogle ScholarPubMed
Abbruzzese, M, Ferri, S, Scarone, S.Wisconsin card sorting test performance in obsessive–compulsive disorder: no evidence for involvement of dorsolateral prefrontal cortex. Psychiatry Res 1995;58:37–43.CrossRefGoogle ScholarPubMed
Aronowitz, B, Hollander, E, DeCaria, C, Cohen, L, Saoud, J, Stein, D, et al. Neuropsychology of obsessive–compulsive disorder: preliminary findings. Neuropsychiatr Neuropsychol Behav Neurol 1994;7:81–6.Google Scholar
Bannon, S, Gonsalvez, C, Croft, R, Boyce, P.Response inhibition deficits in obsessive–compulsive disorder. Psychiatry Res 2002;110: 165–74.CrossRefGoogle ScholarPubMed
Baer, L, Jenike, M.Personality disorders in obsessive–compulsive disorder. Psychiatr Clin N Am 1992;15:803–12.CrossRefGoogle ScholarPubMed
Baer, L, Minichiello, W.Behavior therapy for obsessive–compulsive disorder. In: Jenike, M, Baer, L, Minichiello, W, editors. obsessive– compulsive disorders: theory and management. Chicago: Year Book Medical Publishers; 1986. p. 45–75.Google Scholar
Barkley, R, Murphy, K.Attention-deficit hyperactivity disorder: a clinical workbook. 2nd ed. New York: Guilford Press; 1998.CrossRefGoogle Scholar
Barnett, R, Maruff, P, Purcell, R, Wainwright, K, Kyrios, M, Brewer, W, et al. Impairment of olfactory identification in obsessive– compulsive disorder. Psychol Med 1999;29:1227–33.CrossRefGoogle ScholarPubMed
Basso, M, Bornstein, R, Carona, F, Morton, R.Depression accounts for executive function deficits in obsessive–compulsive disorder. Neurop-sychiatr Neuropsychol Behav Neurol 2001;14:241–5.Google ScholarPubMed
Boone, K, Ananth, J, Philpott, L, Kaur, A, Djenderedjian, A.Neuropsy-chological characteristics of nondepressed adults with obsessive compulsive disorder. Neuropsychiatr Neuropsychol Behav Neurol 1991; 4:96–109.Google Scholar
Cavedini, P, Ferri, S, Scarone, S, Bellodi, L.Frontal lobe dysfunction in obsessive–compulsive disorder and major depression. Psychiatry Res 1998;78:21–8.CrossRefGoogle ScholarPubMed
Cohen, L, Hollander, E, DeCaria, C, Stein, D, Simeon, D, Liebowitz, M, et al. Specificity of neuropsychological impairment in obsessive–compulsive disorder: a comparison with social phobic and normal control subjects. J Neuropsychiatr Clin Neurosci 1996;8:82–5.Google ScholarPubMed
Cohen, J, MacWhinney, B, Flatt, M, Provost, J.PsyScope: an interactive graphic system for designing and controlling experiments in the psychology laboratory using Macintosh computers. Behav Res Methods Instrum Comput 1993;25:257–71.CrossRefGoogle Scholar
Deckersbach, T, Otto, M, Savage, C, Baer, L, Jenike, M.The relationship between semantic organization and memory in obsessive–compulsive disorder. Psychother Psychosom 2000;69:101–7.CrossRefGoogle ScholarPubMed
Erol, N, Savasyr, I.Maudsley Obsessif-kompulsif Soru Listesi. XXIV Ulusal Psikiyatri ve Norolojik Bilimler Kongresi GATA, Ankara. 1988.Google Scholar
Foa, E, Kozak, M, Salkovskis, P, Coles, M, Amir, N.The validation of a new obsessive–compulsive disorder scale: the obsessive–compulsive inventory. Psychol Assess 1998;10:206–14.CrossRefGoogle Scholar
Foa, E, Molnar, C, Amir, N, Gershuny, B.Implicit and explicit memory in obsessive–compulsive disorder. Paper presented at the Annual Meeting of the Association for theAdvancement of Behavior Therapy, San Diego (CA). 1994.Google Scholar
Freedman, M. Object alternation and orbitofrontal system dysfunction in Alzheimer’s and Parkinson’s disease. Brain Cognition 1990;14: 134–43.CrossRefGoogle ScholarPubMed
Frey, S, Petrides, M.Orbitofrontal cortex and memory formation. Neuron 2002;36:171–6.Google ScholarPubMed
Goodglass, H, Kaplan, E.The assessment of aphasia and related disorders. Philadelphia: Lea & Febiger; 1972.Google Scholar
Grace, J, Malloy, P.Frontal lobe personality scale. Brown University, Providence, RI; 1992.Google Scholar
Gross-Isseroff R, Sasson, Y, Voet, H, Hendler, T, Luca–Haimovici K, Kandel-Sussman, H, et al. Alternation learning in obsessive–compulsive disorder. Biol Psychiatry 1996;39:733–8.Google Scholar
Guilford, J, Hoepfner, R.The analysis of intelligence. New York: McGraw-Hill; 1971.Google Scholar
Harris, C, Dinn, W.Subtyping obsessive–compulsive disorder: Neuropsychol Correlates 2003 in press.Google Scholar
Harvey, N. Impaired cognitive set-shifting in obsessive–compulsive neurosis. IRCS Med Sci 1986;14:936–7.Google Scholar
Head, D, Bolton, D, Hymas, N.Deficit in cognitive shifting ability in patients with obsessive–compulsive disorders. Biol Psychiatry 1989; 25:929–37.CrossRefGoogle Scholar
Hisli, N. Depresyon Envanteri’nin gecerliligi uzerine bir calysma. Psikoloji Dergisi 1988;6:118–22.Google Scholar
Hodgson, R, Rachman, S.Obsessional-compulsive complaints. Behav Res Ther 1977;15:389–95.CrossRefGoogle ScholarPubMed
Iversen, S, Mishkin, M.Perseverative interference in monkey following selective lesions of the inferior prefrontal convexity. Exp Brain Res 1970;11:376–86.CrossRefGoogle ScholarPubMed
Jenike, M, Baer, L, Carey, R.Coexistent obsessive–compulsive disorder and schizotypal personality disorder: a poor prognostic indicator. Arch Gen Psychiatry 1986;43:296.Google ScholarPubMed
Jones-Gotman, M, Milner, B.Design fluency: the invention of nonsense drawings after focal cortical lesions. Neuropsychologia 1977; 15:653–74.Google ScholarPubMed
Jurado, M, Junque, C, Vallejo, J, Salgado, P, Grafman, J.Obsessive– compulsive disorder (OCD) patients are impaired in remembering temporal order and in judging their own performance. J Clin Exp Neuropsychol 2002;24:261–9.CrossRefGoogle ScholarPubMed
Lapierre, D, Braun, C, Hodgins, S.Ventral frontal deficits in psychopathy: neuropsychological test findings. Neuropsychologia 1995;33:139–51.Google ScholarPubMed
Lucey, J, Burness, C, Costa, D, Gacinovic, S, Pilowsky, L, Ell, P, et al. Wisconsin card sorting test (WCST) errors and cerebral blood flow in obsessive–compulsive disorder (OCD). Br J Med Psychol 1997;70: 403–11.CrossRefGoogle Scholar
Malloy, P, Bihrle, A, Duffy, J, Cimino, C.The orbitomedial frontal syndrome. Arch Clin Neuropsychol 1993;8:185–201.CrossRefGoogle ScholarPubMed
Mataix–Cols D, Alonso, P, Pifarre, J, Menchon, J, Vallejo, J.Neuropsy-chological performance in medicated vs. unmedicated patients with obsessive–compulsive disorder. Psychiatry Res 2002;109:255–64.Google Scholar
Mavissakalian, M, Hamann, M, Jones, B.Correlates of DSM–III personality disorder in obsessive–compulsive disorder. Compreh Psychiatry 1990;31:481–9.CrossRefGoogle ScholarPubMed
Milliery, M, Bouvard, M, Aupetit, J, Cottraux, J.Sustained attention in patients with obsessive–compulsive disorder: a controlled study. Psychiatry Res 2000;96:199–209.CrossRefGoogle ScholarPubMed
Minichiello, W, Baer, L, Jenike, M.Schizotypal personality disorder: a poor prognostic indicator for behavior therapy in the treatment of obsessive–compulsive disorder. J Anxiety Disorders 1987;1:273–6.Google Scholar
Mishkin, M. Perseveration of central sets after frontal lesions in monkeys. In: Warren, JM, Akert, K, editors. The frontal granular cortex and behavior. New York: McGraw-Hill; 1964. p. 219–41.Google Scholar
Mishkin, M, Vest, B, Waxler, M, Rosvold, H.A re-examination of the effects of frontal lesions on object alternation. Neuropsychologia 1969;7:357–63.Google Scholar
Moritz, S, Birkner, C, Kloss, M, Jacobsen, D, Fricke, S, Bothern, A, et al. Impact of comorbid depressive symptoms on neuropsychological performance in obsessive–compulsive disorder. J Abnormal Psychol 2001;110:653–7.CrossRefGoogle ScholarPubMed
Ornek, T, Keskiner, A.Mini International Neuropsychiatric Interview. In: Sheehan, D, Janavs, J, Baker, R, Harnett–Sheehan, K, Knapp, E, Sheehan, M, Lecrubier, Y, Weiller, E, Hergueta, T, Amorim, P, Bonora, L, Lepine, JP, editors. J Clin Psychiatry, 59. 1998. p. 34–57 (Suppl 20).Google Scholar
Porteus, SD. Porteus Maze Tests: fifty years application. Palo Alto (CA): Pacific Books; 1955.Google Scholar
Pribram, K, Mishkin, M.Analysis of the effects of frontal lesions in monkeys. III. Object alternation. J Comp Physiol Psychol 1956;49: 41–5.Google ScholarPubMed
Purcell, R, Maruff, P, Kyrios, M, Pantelis, C.Cognitive deficits in obsessive–compulsive disorder on tests of frontal–striatal function. Biol Psychiatry 1998;43:348–57.Google ScholarPubMed
Raine, A, Benishay, D.The SPQ-B: a brief screening instrument for schizotypal personality disorder. J Personal Disord 1995;9:346–55.CrossRefGoogle Scholar
Randolph, C. Repeatable battery for the assessment of neuropsychological status (RBANS). The Psychological Corporation; 1998.Google Scholar
Ravizza, L, Barzega, G, Bellino, S, Bogetto, F, Maina, G.Predictors of drug treatment response in obsessive–compulsive disorder. J Clin Psychiatry 1995;56:368–73.Google ScholarPubMed
Reitan, RM, Wolfson, D.The Halstead-Reitan neuropsychological test battery. Tucson: Neuropsychology Press; 1985.Google Scholar
Rosche, J, Muller, B.Cognitive functions in the course of obsessive– compulsive disorders. Nervenheilkunde 2000;19:395–400.Google Scholar
Rosenberg, D, Dick, E, OHearn, K, Sweeney, J.Response-inhibition deficits in obsessive–compulsive disorder: an indicator of dysfunction in frontostriatal circuits. J Psychiatry Neurosci 1997;22:29–38.Google ScholarPubMed
Savage, C, Baer, L, Keuthen, N, Brown, H, Rauch, S, Jenike, M.Organizational strategies mediate nonverbal memory impairment in obsessive–compulsive disorder. Biol Psychiatry 1999;45:905–16.CrossRefGoogle ScholarPubMed
Schmidtke, K, Schorb, A, Winkelmann, G, Hohagen, F.Cognitive frontal lobe dysfunction in obsessive–compulsive disorder. Biol Psychiatry 1998;43:666–73.CrossRefGoogle ScholarPubMed
Sheehan, D, Janavs, J, Baker, R, Harnett–Sheehan K, Knapp, E, Sheehan, M, et al. Mini International Neuropsychiatric Interview. J Clin Psychiatry 1998;59(Suppl 20):34–57.Google ScholarPubMed
Stanley, M, Turner, S, Borden, J.Schizotypal features in obsessive– compulsive disorder. Compreh Psychiatry 1990;31:511–8.CrossRefGoogle ScholarPubMed
Tallis, F, Pratt, P, Jamani, N.Obsessive compulsive disorder, checking, and non-verbal memory: a neuropsychological investigation. Behav Res Ther 1999;37:161–6.CrossRefGoogle ScholarPubMed
Teicher, MH, Glod, CA, Surrey, J, Swett, C.Early childhood abuse and limbic system ratings in adult psychiatric outpatients. J Neuropsychiatr Clin Neurosci 1993;5(3):301–6.Google ScholarPubMed
Veale, D, Sahakian, B, Owen, A, Marks, I.Specific cognitive deficits in tests sensitive to frontal lobe dysfunction in obsessive–compulsive disorder. Psychol Med 1996;26:1261–9.CrossRefGoogle ScholarPubMed
Zielinski, C, Taylor, M, Juzwin, K.Neuropsychological deficits in obsessive–compulsive disorder. Neuropsychiatr Neuropsychol Behav Neurol 1991;4:110–26.Google Scholar
ZitterlW, Urban, C, Linzmayer, L, Aigner, M, Demal, U, Semler, B, et al. Memory deficits in patients with DSM-IV obsessive–compulsive disorder. Psychopathology 2001;34:113–37.Google Scholar
Submit a response

Comments

No Comments have been published for this article.