TY - JOUR
T1 - An investigation of doubt in obsessive–compulsive disorder
AU - Samuels, Jack
AU - Bienvenu, O. Joseph
AU - Krasnow, Janice
AU - Wang, Ying
AU - Grados, Marco A.
AU - Cullen, Bernadette
AU - Goes, Fernando S.
AU - Maher, Brion
AU - Greenberg, Benjamin D.
AU - McLaughlin, Nicole C.
AU - Rasmussen, Steven A.
AU - Fyer, Abby J.
AU - Knowles, James A.
AU - Nestadt, Paul
AU - McCracken, James T.
AU - Piacentini, John
AU - Geller, Dan
AU - Pauls, David L.
AU - Stewart, S. Evelyn
AU - Murphy, Dennis L.
AU - Shugart, Yin Yao
AU - Kamath, Vidya
AU - Bakker, Arnold
AU - Riddle, Mark A.
AU - Nestadt, Gerald
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2017/5/1
Y1 - 2017/5/1
N2 - Background Clinicians have long considered doubt to be a fundamental characteristic of obsessive–compulsive disorder (OCD). However, the clinical relevance of doubt in OCD has not been addressed. Methods Participants included 1182 adults with OCD who had participated in family and genetic studies of OCD. We used a clinical measure of the severity of doubt, categorized as none, mild, moderate, severe, or extreme. We evaluated the relationship between doubt and OCD clinical features, Axis I disorders, personality and personality disorder dimensions, impairment, and treatment response. Results The severity of doubt was inversely related to the age at onset of OCD symptoms. Doubt was strongly related to the number of checking symptoms and, to a lesser extent, to the numbers of contamination/cleaning and hoarding symptoms. Doubt also was related to the lifetime prevalence of recurrent major depression and generalized anxiety disorder; to the numbers of avoidant, dependent, and obsessive–compulsive personality disorder traits; and to neuroticism and introversion. Moreover, doubt was strongly associated with global impairment and poor response to cognitive behavioral treatment (CBT), even adjusting for OCD severity and other correlates of doubt. Conclusions Doubt is associated with important clinical features of OCD, including impairment and cognitive–behavioral treatment response.
AB - Background Clinicians have long considered doubt to be a fundamental characteristic of obsessive–compulsive disorder (OCD). However, the clinical relevance of doubt in OCD has not been addressed. Methods Participants included 1182 adults with OCD who had participated in family and genetic studies of OCD. We used a clinical measure of the severity of doubt, categorized as none, mild, moderate, severe, or extreme. We evaluated the relationship between doubt and OCD clinical features, Axis I disorders, personality and personality disorder dimensions, impairment, and treatment response. Results The severity of doubt was inversely related to the age at onset of OCD symptoms. Doubt was strongly related to the number of checking symptoms and, to a lesser extent, to the numbers of contamination/cleaning and hoarding symptoms. Doubt also was related to the lifetime prevalence of recurrent major depression and generalized anxiety disorder; to the numbers of avoidant, dependent, and obsessive–compulsive personality disorder traits; and to neuroticism and introversion. Moreover, doubt was strongly associated with global impairment and poor response to cognitive behavioral treatment (CBT), even adjusting for OCD severity and other correlates of doubt. Conclusions Doubt is associated with important clinical features of OCD, including impairment and cognitive–behavioral treatment response.
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U2 - 10.1016/j.comppsych.2017.03.004
DO - 10.1016/j.comppsych.2017.03.004
M3 - Article
C2 - 28359017
AN - SCOPUS:85016148729
SN - 0010-440X
VL - 75
SP - 117
EP - 124
JO - Comprehensive Psychiatry
JF - Comprehensive Psychiatry
ER -