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OC Spectrum Disorders: The Impulsive and Schizo-Obsessive Clusters

Published online by Cambridge University Press:  07 November 2014

Eric Hollander ,
Jennifer Rosen  and
IOCDC OC Spectrum Work Group
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Abstract

Two symptom clusters within the obsessive-compulsive (OC) spectrum—the impulsive cluster and the schizo-obsessive cluster—are discussed in this paper. Disorders characterized by impulsivity include disorders of impulse control (eg, intermittent explosive disorder, pyromania, kleptomania, pathologic gambling, trichotillomania); paraphilias, sexual impulsions, and sexual addictions; and impulsive aggression personality disorders (eg, borderline, antisocial, histrionic, and narcissistic personality disorders). The schizo-obsessive cluster includes comorbid symptoms of obsessive-compulsive disorder (OCD) and schizophrenia. Both clusters of disorders have a substantial impact on individuals and society. This article examines the overlap of symptoms between OCD and OC spectrum disorders, along with possible treatment options. Studies on the effectiveness of serotonin reuptake inhibitors in treating pathologic gambling, compulsive buying, and comorbid OCD and schizophrenia are presented. The need for additional large scale, adequately-controlled studies is discussed.

Type
Academic Supplement Monograph
Information
CNS Spectrums , Volume 4 , supplement S3: The Third International Obsessive-Compulsive Disorder Conference , May 1999 , pp. 16 - 21
Copyright
Copyright © Cambridge University Press 1999

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References

REFERENCES

1.Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
2.Hollander, E, Wong, CM. Spectrum boundary and subtyping issues: implications for treatment refractory obsessive-compulsive disorder. In: Goodman, WK, Rudorfer, MV, Maser, J, eds. Obsessive-Compulsive Disorder: Contemporary Issues in Treatment. Mahwah, NJ: Lawrence Erlbaum Associates Inc; 1999. In press.Google Scholar
3.Hollander, E, Wong, CM. Body dysmorphic disorder, pathological gambling, and sexual compulsions. J Clin Psychiatry. 1995;56(suppl 4):7–12.Google ScholarPubMed
4.Hollander, E, ed. Obsessive-Compulsive Related Disorders. Washington, DC: American Psychiatric Association; 1993.Google Scholar
5.Hollander, E. Obsessive-compulsive spectrum disorders: an overview. Psychiatr Ann. 1993;23:355–358.CrossRefGoogle Scholar
6.Theil, A, Broocks, A, Ohlmeier, M. Obsessive-compulsive disorder among patients with anorexia nervosa and bulimia nervosa. Am J Psychiatry. 1995;152:72–5.Google Scholar
7.Hollander, E. Treatment of obsessive-compulsive spectrum disorders with SSRIs. Br J Psychiatry. 1998;173(suppl 35):7–12.CrossRefGoogle Scholar
8.Carrasco, J. OCD spectrum: low platelet MAO as a marker of the impulsive pole. Paper presented at: Third International Obsessive-Compulsive Disorder Conference; September 11-12, 1998; Madeira, Portugal.Google Scholar
9.Buschbaum, MS, Coursey, RD, Murphy, DL. The biochemical high-risk paradigm: behavioral and familial correlates of low platelet monoamine oxidase activity. Science. 1976;194:339–341.Google Scholar
10.Ladouceur, R, Mireault, C. Gambling behaviour among high school students in the Quebec area. J Gambling Behav. 1988;4:3–12.CrossRefGoogle Scholar
11.Westphal, JR, Rush, J. Pathological gambling in Louisiana: an epidemiological perspective. J La State Med Soc. 1996;148:353–358.Google ScholarPubMed
12.DeCaria, C, Hollander, E, Nora, R, Stein, D, Simeon, D, Cohen, L. Gambling: biological/genetic, treatment, government, and gambling concerns: neurobiology of pathological gambling. Paper presented at: Annual Meeting of the American Psychiatric Association; May 17-22, 1997; San Diego, Calif.Google Scholar
13.Moss, HB, Yao, JK, Panzak, GL. Serotonergic responsivity and behavioral dimensions in antisocial personality disorder with substance abuse. Biol Psychiatry. 1990;28:325–338.CrossRefGoogle ScholarPubMed
14.Hollander, E, Stein, D, DeCaria, CM, et al.Serotonergic sensitivity in borderline personality disorder: preliminary findings. Am J Psychiatry. 1994;15:277–280.Google Scholar
15.Stein, DJ, Hollander, E, DeCaria, C, Cohen, L, Simeon, D. Behavioral response to m-chlorophenyl-piperazine and clonidine in trichotillomania. J Serotonin Res. 1997;4:11–15.Google Scholar
16.Benkelfat, C, Murphy, DL, Hill, JL, George, T, Nutt, D, Linnoila, M. Ethanol like properties of the serotonergic partial agonist m-chlorophenylpiperazine in chronic alcoholic patients [letter]. Arch Gen Psychiatry. 1991;48:383.CrossRefGoogle Scholar
17.Stewart, RM, Brown, RIF. An outcome study of Gamblers Anonymous. Br J Psychiatry. 1988;152:284–288.CrossRefGoogle ScholarPubMed
18.Brown, RF. The effectiveness of Gamblers Anonymous. In: Eadington, WR, ed. The Gambling Studies: Proceedings of the Sixth National Conference on Gambling and Risk Taking, Reno, Nevada. Las Vegas, Nev: Univ of Nevada Bureau of Business and Economic Research; 1985.Google Scholar
19.Russo, AM, Taber, JI, McCormick, RA, Ramirez, LF. An outcome study of an inpatient treatment program for pathological gamblers. Hosp Community Psychiatry. 1984;35:823–827.Google ScholarPubMed
20.Goodman, W, Price, I, Rasmussen, S, et al.The Yale-Brown Obsessive-Compulsive Scale, I: development, use and reliability. Arch Gen Psychiatry. 1989;49:1006–1011.CrossRefGoogle Scholar
21.Goodman, W, Price, L, Rasmussen, S, et al.The Yale-Brown Obsessive Compulsive Scale, II: validity. Arch Gen Psychiatry. 1989;49:1012–1016.CrossRefGoogle Scholar
22.DeCaria, CM, Hollander, E, Begaz, T, et al. Reliability and validity of a pathological gambling modification of the Yale-Brown Obsessive-Compulsive Scale (PG-YBOCS): preliminary findings. Paper presented at: Third International Obsessive-Compulsive Disorder Conference; September 11-12, 1998; Madeira, Portugal.Google Scholar
23.Hollander, E, DeCaria, C, Mari, E, et al.Short-term single-blind fluvoxamine treatment of pathological gambling. Am J Psychiatry. 1998;155:1781–1783.CrossRefGoogle ScholarPubMed
24.McElroy, SL, Keck, PE, Pope, HG, Smith, JM, Strakowski, SM. Compulsive buying: a report of 20 cases. J Clin Psychiatry. 1994;55:242–248.Google Scholar
25.Black, DW, Repertinger, S, Gaffney, GR, Gabel, J. Family history and psychiatric comoridity in persons with compulsive buying: preliminary findings. Am J Psychiatry. 1998;155:960–963.CrossRefGoogle ScholarPubMed
26.Black, DW. Is compulsive buying related to obsessive-compulsive disorder (OCD)? Paper presented at: Third International Obsessive-Compulsive Disorder Conference; September 11-12, 1998; Madeira, Portugal.Google Scholar
27.McElroy, SL, Keck, PE, Phillips, KA. Kleptomania, compulsive buying, and binge-eating disorder. J Clin Psychiatry. 1995;56(suppl 4):14–25.Google ScholarPubMed
28.Schlosser, S, Black, D, Repertinger, S, Freet, D. Compulsive buying: demography, phenomenology, and comorbidity in 46 subjects. Gen Hosp Psychiatry. 1994;16:205–212.CrossRefGoogle ScholarPubMed
29.Christenson, GA, Faber, RJ, de Awann, M, et al.Compulsive buying: descriptive characteristics and psychiatric comorbidity. J Clin Psychiatry. 1994;55:5–11.Google ScholarPubMed
30.Pauls, DL, Alsobrook, JP II, Goodman, W, Rasmussen, S, Leckman, JF. A family study of obsessive-compulsive disorder. Am J Psychiatry. 1995;152:76–84.Google ScholarPubMed
31.Zohar, J, Sasson, Y, Chopra, M, Inacu, Y, Gross, R. Schizo-obsessive subtype: obsessions and delusions. CNS Spectrum. 1998;3(5)(suppl 1):38–39.CrossRefGoogle Scholar
32.Weiss, AA, Robinson, S, Winnik, HZ. Obsessive psychosis, psychodiagnostic findings. Isr Ann Psychiatry. 1969;7:175–178.Google ScholarPubMed
33.Rasmussen, SA, Tsuang, MT. Epidemiology and clinical features of obsessive compulsive disorder. In: Jenicke, MA, Baer, L, Minichiello, WE, eds. Obsessive-Compulsive Disorder: A Theory of Management. Littleton, Mass: PSG Publishing; 1986:23–44.Google Scholar
34.Karno, M, Golding, J, Sorenson, S, Burnam, A. The epidemiology of obsessive-compulsive disorder in five US communities. Arch Gen Psychiatry. 1988;45:1094–1099.CrossRefGoogle ScholarPubMed
35.Zohar, J, Insel, TR, Zohar-Kadouch, RC, Hill, JL, Murphy, DL. Serotonergic responsivity in obsessive-compulsive disorder: effects of chronic clomipramine treatment. Arch Gen Psychiatry. 1988;45:167–197.CrossRefGoogle ScholarPubMed
36.Fenton, WS, McGlasham, TH. The prognostic significance of obsessive-compulsive symptoms in schizophrenia. Am J Psychiatry. 1986;143:437–441.Google ScholarPubMed
37.Yaryura-Tobias, JA, Neziroglu, MA, Bergman, L. Clomipramine for obsessive-compulsive neurosis: an organic approach. Curr Ther Res. 1976;20:541–548.Google Scholar
38.Cottraux, J. Obsessive-compulsive disorder with magical thinking and schizotypal personality traits: a cognitive approach. Paper presented at: Third International Obsessive-Compulsive Disorder Conference; September 11-12, 1998; Madeira, Portugal.Google Scholar
39.Sasson, Y, Bermanzohn, PC, Zohar, J. Treatment of obsessive-compulsive (OC) symptoms in schizophrenia. CNS Spectrums. 1997;3:321–325.Google Scholar
40.Yaryura-Tobias, J. Obsessional thought process pathology. Paper presented at: Third International Obsessive-Compulsive Disorder Conference; September 11-12, 1998; Madeira, Portugal.Google Scholar
41.Pulman, J, Yassa, R, Anath, J. Clomipramine treatment of repetitive behavior. Can J Psychiatry. 1984;29:254–255.CrossRefGoogle ScholarPubMed
42.Stoebel, CF, Szarek, BL, Glueck, BC. Use of clomipramine in treatment of obsessive compulsive symptomatology. J Clin Psychopharmacol. 1984;4:98–100.CrossRefGoogle Scholar
43.Zohar, J, Kaplan, Z, Benjamin, J. Clomipramine treatment of obsessive compulsive symptomatology. J Clin Psychiatry. 1993;4:385–388.Google Scholar
44.Berman, I, Kalinowski, A, Berman, SM, Lengua, J, Green, AL. Obsessive and compulsive symptoms in chronic schizophrenia. Compr Psychiatry. 1995;36:6–10.CrossRefGoogle ScholarPubMed
45.Baker, RW, Chengappa, KNR, Baird, JW, Steingard, S, Christ, MA, Schooler, NR. Emergence of obsessive-compulsive symptoms during treatment with clozapine. J Clin Psychiatry. 1992;53:439–442.Google ScholarPubMed
46.McDougle, CJ, Fleischmann, RL, Epeerson, CN, Wasylink, S, Leckman, JF, Price, LH. Risperidone addition in fluvoxamine-refractory obsessive-compulsive disorder: three cases. J Clin Psychiatry. 1995;56:526–528.Google ScholarPubMed
47.Baker, RW, Ames, D, Umbricht, DSG, Chengappa, KNR, Schooler, NR. Obsessive compulsive symptoms in schizophrenia: a comparison of olanzapine and placebo. Psychopharmacol Bull. 1996;32:89–93.Google ScholarPubMed
48.Baker, RW, Chengappa, KNR, Baird, JW, Steingard, S, Christ, MA, Schooler, NR. Emergence of obsessive compulsive symptoms during treatment with clozapine. J Clin Psychiatry. 1992;53:439–442.Google ScholarPubMed
49.Patel, B, Tandon, R. Development of obsessive compulsive symptoms during clozapine treatment. Am J Psychiatry. 1993;150:836.Google ScholarPubMed
50.Levkovitch, Y, Kronnenberg, Y, Gaoni, B. Can clozapine trigger OCD? J Am Acad Child Adolesc Psychiatry. 1995;34:263.CrossRefGoogle ScholarPubMed
51.Wong, DT, Calligaro, DO, Bymaster, FP, Moore, NA, Seeman, P. Preclinical pharmacology of olanzapine: a novel antipsychotic agent. Paper presented at: Ninth World Congress of Psychiatry; June 25, 1993; Rio de Janeiro, Brazil.Google Scholar
52.Pato, M. Delusional OCD treated with olanzapine augmentation. Paper presented at: Third International Obsessive Compulsive Disorder Conference; September 11-12, 1998; Madeira, Portugal.Google Scholar
53.Eisen, JL, Phillips, KA, Baer, L, et al.The Brown Assessment of Beliefs Scale: reliability and validity. Am J Psychiatry. 1998;155:102–108.CrossRefGoogle ScholarPubMed
54.Eisen, JL, Rasmussen, SA. Obsessive-compulsive disorders with psychotic features. J Clin Psychiatry. 1993;54:373–379.Google ScholarPubMed
55.Eisen, JL, Rasmussen, SA, Phillips, KA, Lydiard, RB, Pigott, TA. Does degree of insight in OCD predict improvement? Abstract. Presented at: American Psychiatric Association 148th Annual Meeting; 1995; Miami, Fla.Google Scholar
56.Rasmussen, SA, Eisen, JL. Treatment strategies for chronic and refractory obsessive-compulsive disorder. J Clin Psychiatry. 1997;58(suppl 13):9–13.Google ScholarPubMed
57.Goodman, WK, McDougle, CJ, Barr, LC, et al.Biological approaches to treatment-resistant obsessive compulsive disorder. J Clin Psychiatry. 1993;54(suppl 6): 16–22.Google ScholarPubMed