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

  • Giacomo Grassi (a1) (a2), Nikos Makris (a3) and Stefano Pallanti (a4) (a2)



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.


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.


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.


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.


Corresponding author

* Address correspondence to: Giacomo Grassi, M.D., University of Florence, Department of Neurofarba, via delle Gore 2H, 50141Florence, Italy. (Email:


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

  • Giacomo Grassi (a1) (a2), Nikos Makris (a3) and Stefano Pallanti (a4) (a2)


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